Geisinger Health Plan

“There was a delegation of authority to the geisinger health emergency action committee, which is comprised of the chair of the board, vice-chair of the board, the president and ceo (ex-officio director), chair of the finance committee and chair of the patient experience, academic affairs and quality committee. Under the nonprofit corporation law and under geisinger health's corporate bylaws, the emergency action committee shall exercise the power and authority of the board of directors to act on emergency matters between meetings of the board of directors.”

“Benjamin k. Chu, md, mph, macp, donald t. Rosini, eric galvin, cpa, frank k. Davis, esquire, heather m. Acker, jaewon ryu, md, jd, jeffrey m. Alex, esquire, kevin v. Roberts, mba, cpa, kurt wrobel, fsa, maaa, sherry a. Glied, phd, steven b. Bender, esquire, terry gilliland, md, thomas h. Lee, jr, md, msc, thomas j. Liston, and v. Chris holcombe all have a business relationship with one another because they serve as officers and/or directors on one or more for-profit affiliates of the entity. All of the affiliates are part of geisinger.”

“The members of the corporation have the power and authority to elect and remove the directors; elect and remove the president and fill any vacancy in the office of the president of the corporation; and, may approve amendments to the corporate bylaws in lieu of such approval by the board of directors. The members also have the reserve powers as set forth in the pennsylvania nonprofit corporation law.”

“The board of directors of the corporation shall serve as the governing body of the corporation. The president of the corporation shall be a director by reason of holding such office. The remaining directors shall be elected by the members at the annual meeting of the members. The members of the corporation may serve as directors and directors may succeed themselves from term to term. Vacancies on the board of directors shall be filled by the members at their discretion at the annual meeting of the members or at a special meeting called for such purpose.”

“The members of the corporation have the power and authority to elect and remove the directors; elect and remove the president and fill any vacancy in the office of the president of the corporation; and, may approve amendments to the corporate bylaws in lieu of such approval by the board of directors. The members also have the reserve powers as set forth in pennsylvania nonprofit corporation law.”

“The form 990 is prepared by kaiser foundation health plan, inc.'s tax preparation and oversight department with information provided from geisinger finance, human resources, legal services and other relevant departments within geisinger. Prior to finalization, the return is reviewed by pwc us tax, llp. The chief financial officer of geisinger and the individual organizations senior financial managers review their respective form 990 prior to making the final return available to the board. All officers and directors were electronically provided a final copy of the form 990 prior to filing the return with the irs. An executive summary of the information reported on the return is provided to assist in the review. In accordance with the geisinger health board of director's finance committee charter, geisinger organizations' form 990 filings are reviewed annually.”

“The officers and directors of the organization are subject to the geisinger conflict of interest policy for directors, officers and senior leaders. At least once each year directors, officers, key employees, senior leaders and others designated by the board of directors are required to disclose in writing the existence of any potential financial interests that may give rise to a conflict of interest with any affiliate within geisinger. The disclosures are reviewed by the office of the chief compliance officer and reported to the audit and compliance committee and/or board of directors. After review of the financial interest and all material facts, input from department of legal services and any discussion with the person desired by the board or committee, the committee/board decides if a conflict exists and takes appropriate action. The individual disclosing the financial interest is absent during the committee/board deliberations and decisions on the matter.”

“The process to review and approve the compensation of geisinger employed board directors, officers, and executive management is designed to satisfy the rebuttable presumption procedure available for intermediate sanction purposes. The process requires a review of compensation determinations by disinterested parties, use of appropriate comparability data and contemporaneous documentation of the process. On an annual basis an independent, nationally recognized compensation consultant completes a comparative assessment of compensation for the ceo and senior management within geisinger. The consultant's report is presented to the geisinger family committee prior to any compensation adjustment. The report supports the rigorous review completed by the geisinger family committee to ensure that the program is responsible to the geisinger charitable mission, reflects reasonable compensation within the nonprofit market and is compliant with the irs's intermediate sanction requirements. The survey data in the comparative analysis is captured for functionally comparable positions in multiple similar nonprofit organizations and reflects total remuneration provided in the market. All surveys are conducted by third party organizations and not conducted at the specific direction of geisinger. Any compensation adjustments are approved by the geisinger family committee prior to the effective date of the payment. The geisinger family committee at its sole discretion may positively or negatively adjust any recommended compensation.”

“See schedule o response to form 990, part vi, section b, question 15a.”

“Financial statements, form 990, the conflicts of interest policy, and other governing documents are available to the public upon request.”

“The intercompany revenue represents revenue from intercompany management, administrative, and consulting services provided to related taxable organizations. The organization and related taxable organizations are all controlled by geisinger health. The services, provided at or below cost, are performed without a profit motive to promote the efficient operation of geisinger in carrying out its charitable mission. The services are not offered to unrelated organizations or to the general public. Under irs advisory dated march 7, 2014, these intercompany shared services are not included in the definition of unrelated business income and should not be included on form 990-t due to the absence of the following two conditions: (1) the services must be above cost or at fair market value, and (2) there must be a profit motive.”

“I. General information as health care evolves around the country, geisinger health plan (ghp) influences that evolution from its headquarters in rural danville, pennsylvania. In partnership with the geisinger clinical enterprise, ghp develops new models of care that raise the bar for both quality and cost effectiveness of care. In addition, ghp takes this same approach with other provider groups in our network to ensure that patients and members enjoy the best possible experience with their care and coverage. The plan started in 1972 when the health system and capital blue cross began a pilot program based on a prepaid model offered to geisinger employees and approximately 1,500 residents. The success of the pilot and the beginning of the managed care movement in the mid-80s led geisinger to apply for and receive a certificate of authority to operate an hmo under the authority of the pennsylvania health maintenance organization act of 1973. In march 1985, ghp began operations in five counties surrounding geisinger medical center. By 1990, ghp expanded into 31 counties and enrolled 100,000 members. Ghp introduced new products into the marketplace over time, including new ppo products for individuals and groups, an hmo with cost sharing, and several medicare products. In march 2013, ghp began offering medicaid coverage and in 2022, expanded that coverage statewide in pennsylvania. Medicaid now covers more than 265,000 members. In 2023, ghp kids chip coverage followed, expanding statewide in pennsylvania to ensure every child has access to quality affordable healthcare. Ghp kids now covers more than 20,500 members. In 2014, ghp launched a private marketplace and offered coverage via the federally facilitated marketplace. Recently, ghp launched a tiered-network option that encourages members to visit high-quality providers and expanded self-funded employer group plans to include groups as small as five employees. Geisinger health plan and its affiliate companies, geisinger quality options, inc. And geisinger indemnity insurance company, now serve the needs of more than 550,000 members in all 67 counties of pennsylvania. Following our initial accreditation in 1990, ghp received the highest available rating in each succeeding review through 2018. The development, delivery and demonstration of quality and value drive our organization and help us constantly improve the member experience. In april 2024, geisinger became part of risant health, inc. As its first health system dedicated to increasing access to value-based care and coverage. Risant health brings together kaiser permanente's integrated care and coverage expertise and geisinger's experience in advancing value-based care in a model that includes various payers and a broad network of providers. New facilities and more services ghp, a 501(c)(4) nonprofit organization, invests revenues in excess of costs to provide healthcare to members to improve facilities and services, increase benefits and provide affordable rates. Ghp typically makes annual contributions to geisinger health (gh), it's 501(c)(3) parent, to enhance teaching, education and research projects to benefit all pennsylvanians. These contributions are used to fund new facilities and to add services to our existing hospitals and physician clinics in direct support of gh's charitable mission and of its charitable affiliates by enhancing healthcare programs and services throughout the region while improving the availability of patient care in our service area. Providing affordable, high quality, comprehensive healthcare and benefits increases access of care to those who might not otherwise be able to afford healthcare and contributes to quality of life in the communities we serve. Ghp provides complete healthcare services on a prepaid basis through an integrated healthcare delivery system, providing healthcare to the entire community. Ghp channels experience, knowledge and funds to pursue geisinger's projects. No other”

“Community health, education and outreach ghp employees provide the public with information on topics such as insurance education, advance directives, dental and hand hygiene, asthma care, the importance of screenings & immunizations and wellness. Ghp provided information to 51,721 individuals at 1,425 events including health fairs, school based presentations, seminars and organizational meetings. This education included: 1. 303 health education events for children were held covering dental, nutrition & physical activity, hand hygiene and sun safety topics, reaching 5,557 children at these events. 2. 265 events supported evidence based chronic disease programming, reaching a total participation of over 150 unique individuals. 3. Over 824 wellness activities were held at employer groups and community events. All of our programs are available to our commercial members, which represent approximately 167,764 individuals. Ghp educates the general public, members, employer groups, brokers, participating providers and office personnel on health and wellness topics ranging from women's health to cold and flu prevention. The information is available in a variety of formats including newspaper articles, newsletters, emails, brochures and posters. Ghp supports many local organizations through community sponsorships. The organizations included local chambers of commerce and the boy scouts of america. The cost of community health, education and outreach activities was $3.7m during 2024. Health equity at geisinger health plan, fostering diversity, equity, and inclusion (dei) is fundamental to our mission to provide optimal care and engage with our communities. In 2021, geisinger hired its first chief diversity, equity and inclusion officer (cdeio). In this role, the cdeio implemented a multipronged strategy that prioritized the importance of implementing strategies that support hiring diverse talent, creating an inclusive culture, supporting community engagement, promoting health equity, and ensuring supplier diversity. The health equity steering committee (hesc) supports the health plan and clinical enterprise to provide governance oversight of the health equity strategy. The hesc has created four subcommittees to assist with data, patient and member services, community health initiatives, and cultural competency. In 2023, ghp implemented health equity steering committee, which guides the health plan in addressing disparities among specific populations. The steering committee guides the strategy, workflows, and processes unique to geisinger health plan and is comprised of a multidisciplinary team of key leaders and stakeholders from across the health plan. The ghp steering committee has 5 pillars of focus: information gathering, data and reporting; health plan operations; member engagement, programs, pilots and interventions; vendors, partnerships and cbos. In our electronic health record, we have defined data elements, clinical workflows and organizational practice to ask patients and members their race, ethnicity, language preference, sex, gender identity, sex assigned at birth, organ inventory, and affirmation history, including utilizing the sogi smartform to collect additional information of pronouns and sexual orientation, as well as veteran status. The same data elements were adopted by the health plan for workflows and data collection. Ghp aligns information technologies for member data management. We invest in data informatics to develop pathways to collect health care data, which we analyze using reporting tools. We identify outcome disparities due to inequities and social determinants that impact our members' health and build interventions and programs to close the gaps. This enables us to incorporate the ways we collect key demographic data, such as race/ethnicity, language preferences, age, sexual orientation, and gender identity. Geisinger continues to develop new and innovative ways to utilize our data to best serve our membe”

“Programs: in response to the growing social needs of our patients and members, programs in partnership with local community-based organizations across pennsylvania have been developed. The network of over 75 trusted partnerships has fostered the connectivity between clinical care and social care and connects members to resources in their local communities. In addition, trusted partnerships, the network of geisinger-led programs is part of the network to address social needs of members. Examples include: geisinger led programs fresh food farmacy: fresh food farmacy is designed to address the adversity and challenges faced by individuals with diabetes and food insecurity. Started in 2016, the "food as medicine" approach empowers participants to manage their medical condition through food-related behavior change and the support of a clinical care team. The program provides enough healthy food for 10 meals per week to feed patient and their entire family. Currently, the clinic locations, provide evidence-based standard-of-care diabetes management and a comprehensive suite of education, outreach services, nutritional consultations, case management, medication management, and healthy recipes. Satellite locations opened in 2021 and 2024 with community partners and a digital application for fff patients has been developed to support tracking health metrics, view upcoming events and classes, track medication, meal plan, monitor health trends, and message fff care team members. Mobile food trailers are offered in partnership with cbos to bring choice style pantries to address food access in rural communities. Ups food boxes: a pilot program launched in late 2023 in partnership with central pa food bank mails food boxes to members who are struggling with food needs. Referrals for members are made in neighborly. Snap assistance: in partnership with the central pennsylvania food bank (cpfb), the snap referral program went live in fall 2022. Referrals for members and patients are made in neighborly and the cpfb will coordinate access to emergency food boxes while the person is receiving other supports such as snap enrollment assistance or connection to a local food pantry. 4ride transportation: this program was launched in april 2018 and provides transportation to medical appointments for ghp members with a transportation barrier. The trips are provided at no-cost to the member through the shared-ride service in the member's county. Members who reside within 50 miles of danville, pa or 25 miles of scranton, pa may be eligible for this service. Ged program: started in january 2020, the ged program offers financial support to ghp members by providing funding to cover the costs for training materials, practice testing, ged test and retest (as applicable). Getting a ged expands options for job opportunities as well as higher education and career advancement. Opioid education and awareness a care delivery program was designed to help opioid dependent women during pregnancy and two years after childbirth. Started in february 2019, free2bmom supports moms and babies affected by substance use disorder in luzerne, montour, northumberland, columbia, snyder, and union counties. Free2bmom provides moms and babies with an lcsw and crs that connect moms to resources, services, and support for ongoing recovery and wellbeing for up to two years post partum. The goals are to prevent relapse, reduce severity of neonatal abstinence syndrome, form support systems, and keep moms and their babies together. Early 2018, geisinger health and wellness partnered with greater susquehanna valley united way and the c.e. Mendez foundation, inc. To host a training to offer the too good for drugs (tgfd) program. This 10 week evidence based program designed to promote healthy and safe life skills, build character values, learn resistance skills related to unsafe behaviors and negative peer pressure. The program also focuses on resistance to the use of illegal drugs, alcohol”

“Ghp funding directly supports staff education and the recruitment and hiring of residents, researchers and other health professionals. Often, the benefits of our integrated health system are a key factor in the decision to join geisinger. The unreimbursed cost of geisinger research programs was approximately $16 million in 2024. Ii. Uncompensated care ghp recognizes its mission is to further geisinger's charitable mission by enhancing the value and the quality of health to the community through managed care insurance products and programs that coordinate the delivery and financing of health services. Medicare/medicaid in recognizing its mission to the community, ghp provides insurance to the elderly through the provision of geisinger gold, a medicare advantage insurance program. As part of its medicare advantage program, ghp offers a special needs plan for citizens eligible for both medicaid and medicare. During fiscal year 2013, ghp was awarded a healthchoices (medicaid) contract by the pa department of public welfare. On march 1, 2013 "ghp family" began to provide health benefits to over 102,000 medicaid beneficiaries. Prior to march 1, 2013 ghp incurred operating expenses of $7.7 million to prepare for this launch of managed medicaid in central and northeast pa. Ghp family incurred operating losses of $24.3 million from the launch of the program through june 30, 2015. In 2024, geisinger provided $1.2 billion in health services to the elderly and the poor which represents the difference between the amount reimbursed by medicare and medicaid and the cost to deliver the care. Geisinger also provided $6 million in services to those in other governmental programs. Uncompensated care various practices and policies allow for uncompensated care and financial assistance to geisinger patients with limited financial means, reflecting the primary purpose of the health system to provide medically necessary treatment to anyone regardless of race, creed, religious preference or ability to pay. During 2024, the total cost of uncompensated care provided to patients with limited means was approximately $51 million. Iii. Community health education and outreach community health, education and outreach $3,709,813 community health benefit fund 3,999,347 other health professions education 52,677 provenhealth navigator healthcare services to nonmembers 615,078 total ghp community health education and outreach $8,376,915 in total, geisinger spent approximately $41 million during 2024 in community health, education and outreach programs that benefited thousands of pennsylvanians through health fairs, health screenings, important health and prevention information, health clinics and support groups that brought the expertise of geisinger physicians, physician assistants, nurses and nurse extenders, dieticians and other health professionals to the communities throughout the ghp service area. In all, when combined with $857 thousand of subsidized services, $9 million in services provided by volunteers on behalf of patients, students & members and approximately $1.8 million in payments to various taxing districts to assist in providing municipal services, geisinger provided approximately $1,389 billion in community benefit in 2024, equal to approximately 14% of total operating expenses reported.”

“Geisinger system services (gss), an affiliate of the organization, provides a centralized accounts payable function for all geisinger organizations. As the accounts payable processor, gss prepares and files form 1099 under its ein for certain reportable payments of the filing organization. The number of form 1099's filed by gss for the 2024 reporting period on behalf of itself and its affiliates was 1,166. The response entered on line 1a for the organization includes only those form 1099s filed under the organizations ein, it does not include those filed by gss on its behalf.”

“Federal and state unrelated business income tax expense was $180,982 for the reporting period.”

“Form 990t book to tax adjustment: 481a revenue $ -2,241 total $ -2,241”

“Federal awards are audited as a part of the geisinger's consolidated report on federal awards in accordance with uniform guidance, 2 c.f.r. Part 200, subpart f. Footnote: throughout this document, the terms "geisinger"geisinger health" shall refer to the entire health care system comprised of geisinger health foundation (the "foundation") as parent and all subsidiary corporate entities comprising the health care system. In addition, throughout this document, the term "system" shall refer to the entire health care system as previously defined plus its affiliates.”