Quartz Health Plan Corporation

“Michael j. Dolan, robert w. Flannery, william j. Farrell, alan s. Kaplan, jennifer b. Atkins, susan i. Erickson, carey m. Gehl, and gerald p. Oetzel have a business relationship outside of the organization.”

“Gundersen health system, inc., unitypoint health (iowa health system), university health care, inc., and aurora health care are the corporate members.”

“University health care, inc. Shall appoint 4 members of the board of directors, gundersen health system, inc. Shall appoint 3 members of the board of directors, and aurora health care, shall appoint 1 member of the board of directors. The remaining four independent individual members of the board are elected by the board by a supermajority.”

“Some governance decisions are reserved to the corporate members and not the board.”

“The form 990 is prepared by baker tilly us, llp and is reviewed for completeness and accuracy by management. For this purpose, management includes the cfo for quartz health solutions, inc. The organization informs the members of the board finance committee that a copy of form 990 is available for review prior to filing with the irs.”

“All health plan employees and committee members must review, complete, and sign a conflict of interest disclosure form on an annual basis as part of the mandatory education process. Board members are also sent a disclosure form to complete on an annual basis along with the employees and committee members. All disclosures are tracked and housed in the compliance department. Further, if at any time an individual becomes aware of an actual, potential, or perceived conflict of interest, the policy indicates that the individual shall immediately notify the compliance officer, who then reviews any disclosed conflicts to assess any risk and/or negative influence on the health plan and drafts proposed recommendations to any disclosed conflicts of interest. The compliance officer then provides the disclosed conflicts of interest(s) and proposed recommendation(s) to a conflict of interest review group for final review and determination regarding the recommendation. Once the conflict of interest review group makes its final determination with respect to the recommendation the compliance officer shall communicate the recommendation to the employee and, when applicable, to the chairperson of any committee which may be referenced in the recommendation.”

“Requests for the organization's governing documents, conflict of interest policy and financial statements are made through the legal department who then reviews the requests and makes the appropriate documents available for inspection in the legal department itself for the same period of disclosure as set forth in irc section 6104(d).”

“All employees are legal employees of quartz health solutions (fein: 46-5710709), which files all required federal employment forms each year.”

“Rx rebate adjustment added for stat -147,652. Gain in subsidiary income 2,238. State deferred income tax benefit 619,676. Additional paid in capital - university health care, inc. 4,271,000. Additional paid in capital - unity point health 1,000,000. Additional paid in capital - aurora health care, inc. 1,170,249. Additional paid in capital - gundersen lutheran health system, inc. 7,000,000.”

“The organization has prepared the form 990 in accordance with generally accepted accounting principles (gaap), but does not follow sfas 117 (asc 958). The irs does not require reporting according to asc 958.”