Civic Intelligence

Sutter Health Alliance

990 • Fiscal year 2016 • EIN 46-1183948

Jan 01, 2016 to Dec 31, 2016 • Filed on Oct 23, 2017

C/O Sh Tax 2200 River Plaza DriveSacramento, CA 95833

(916) 286-6665

Siviq Scores

Precomputed percentiles for this filing year versus similar nonprofits in the same peer cohort.

Liabilities / Assets

80th percentile

0.83x

Higher debt load relative to assets than 80% of similar nonprofits.

2016 filings • $100M-$250M nonprofits • Source year 2016

Liabilities / Revenue

36th percentile

0.30x

Higher debt load relative to revenue than 36% of similar nonprofits.

2016 filings • $100M-$250M nonprofits • Source year 2016

Net Margin

11th percentile

-19%

Higher net margin than 11% of similar nonprofits.

2016 filings • $100M-$250M nonprofits • Source year 2016

Top Officer Pay

100th percentile

$13,450,002

Higher top officer pay than 100% of similar nonprofits.

Top officer pay equals 6.4% of source-year revenue.

2016 filings • $100M-$250M nonprofits • Source year 2016

Asset Growth

98th percentile

84%

Faster asset growth than 98% of similar nonprofits.

2016 filings • $100M-$250M nonprofits • Annualized from 2015 to 2016

Revenue Growth

98th percentile

165%

Faster revenue growth than 98% of similar nonprofits.

2016 filings • $100M-$250M nonprofits • Annualized from 2015 to 2016

Assets

Up

$76,233,810

Up $34,790,057 (+84%) from 2015

Net Assets

Up

$13,089,706

Up $2,842,182 (+28%) from 2015

Liabilities

Up

$63,144,104

Up $31,947,875 (+102%) from 2015

Revenue

Up

$208,877,752

Up $130,106,928 (+165%) from 2015

Expenses

Up

$249,466,666

Up $143,233,335 (+135%) from 2015

Net Income

Down

-$40,588,914

Down $13,126,407 (-48%) from 2015

Historical Trend

Balance Sheet Trend

The highlighted filing sits inside the broader history for assets, liabilities, and net assets.

$300M$200M$100M$0Assets 2015: $41,443,753Liabilities 2015: $31,196,229Net Assets 2015: $10,247,5242015Assets 2016: $76,233,810Liabilities 2016: $63,144,104Net Assets 2016: $13,089,7062016Assets 2017: $98,018,484Liabilities 2017: $72,850,927Net Assets 2017: $25,167,5572017Assets 2018: $95,180,080Liabilities 2018: $78,250,742Net Assets 2018: $16,929,3382018Assets 2019: $132,507,976Liabilities 2019: $90,147,274Net Assets 2019: $42,360,7022019Assets 2020: $155,751,979Liabilities 2020: $99,397,580Net Assets 2020: $56,354,3992020Assets 2021: $169,138,076Liabilities 2021: $113,585,868Net Assets 2021: $55,552,2082021Assets 2022: $170,197,585Liabilities 2022: $104,252,172Net Assets 2022: $65,945,4132022Assets 2023: $191,334,683Liabilities 2023: $113,682,807Net Assets 2023: $77,651,8762023Assets 2024: $293,849,584Liabilities 2024: $205,976,526Net Assets 2024: $87,873,0582024

Highlighted filing

2016

Assets$76,233,810
Liabilities$63,144,104
Net Assets$13,089,706

Operations Trend

Revenue, expenses, and net income across loaded years, with this filing highlighted.

$1.0B$500M$0-$500MRevenue 2015: $78,770,824Expenses 2015: $106,233,331Net Income 2015: -$27,462,5072015Revenue 2016: $208,877,752Expenses 2016: $249,466,666Net Income 2016: -$40,588,9142016Revenue 2017: $336,016,644Expenses 2017: $359,877,975Net Income 2017: -$23,861,3312017Revenue 2018: $451,186,584Expenses 2018: $467,305,368Net Income 2018: -$16,118,7842018Revenue 2019: $533,987,669Expenses 2019: $509,633,556Net Income 2019: $24,354,1132019Revenue 2020: $589,661,573Expenses 2020: $576,856,594Net Income 2020: $12,804,9792020Revenue 2021: $619,408,553Expenses 2021: $620,942,211Net Income 2021: -$1,533,6582021Revenue 2022: $652,440,680Expenses 2022: $641,238,120Net Income 2022: $11,202,5602022Revenue 2023: $710,850,630Expenses 2023: $700,184,338Net Income 2023: $10,666,2922023Revenue 2024: $837,848,532Expenses 2024: $827,761,932Net Income 2024: $10,086,6002024

Highlighted filing

2016

Revenue$208,877,752
Expenses$249,466,666
Net Income-$40,588,914
Jump To
Filing Snapshot
Filing Period
Jan 1, 2016 to Dec 31, 2016
Signed
Oct 23, 2017
Return Version
2016v3.1
Gross Receipts
$208,877,752
Mission and Program Overview

Mission

Sutter health plan provides comprehensive health care coverage options that offer high quality accessible care to our socially and economically diverse communities at reasonable prices for members.

The specific and primary purpose of this corporation is to support or benefit sutter health and its charitable subsidiaries.

Balance Sheet Detail
LineBeginningEndChange
Assets
Cash and Non-Interest-Bearing Accounts$12,093,459$41,992,604▲ $29,899,145
Accounts Receivable$12,691,887$18,042,967▲ $5,351,080
Savings and Temporary Cash Investments$13,342,535$9,481,899▼ $3,860,636
Land, Buildings, and Equipment, Net$1,048,123$4,320,766▲ $3,272,643
Prepaid Expenses and Deferred Charges$2,267,749$2,395,574▲ $127,825
Other Notes and Loans Receivable, Net$0$0→ $0
Pledges and Grants Receivable$0$0→ $0
Receivable From Disqualified Prsn$0$0→ $0
Receivables From Officers Etc$0$0→ $0
Investments Other Securities$0$0→ $0
Investments Program Related$0$0→ $0
Investments in Publicly Traded Securities$0$0→ $0
Intangible Assets$0$0→ $0
Inventories for Sale or Use$0$0→ $0
Loans From Officers Directors$0$0→ $0
Total Assets$41,443,753$76,233,810▲ $34,790,057
Other Assets Total$0$0→ $0
Liabilities
Accounts Payable and Accrued Expenses$14,964,896$35,533,526▲ $20,568,630
Deferred Revenue$15,165,600$25,752,006▲ $10,586,406
Other Liabilities$1,065,733$1,858,572▲ $792,839
Grants Payable$0$0→ $0
Mortgage Notes Payable Secured by Investment Property$0$0→ $0
Unsecured Notes Loans Payable$0$0→ $0
Escrow Account Liability$0$0→ $0
Tax Exempt Bond Liabilities$0$0→ $0
Total Liabilities$31,196,229$63,144,104▲ $31,947,875
Net Assets / Fund Balance
Unrestricted Net Assets$10,247,524$13,089,706▲ $2,842,182
Permanently Rstr Net Assets$0$0→ $0
Temporarily Rstr Net Assets$0$0→ $0
Total Net Assets Fund Balance$10,247,524$13,089,706▲ $2,842,182
Total Liabilities and Net Assets / Fund Balance$41,443,753$76,233,810▲ $34,790,057

Asset Categories

AssetBook ValueDepreciationBasis
Leasehold Improvements$3,632,837$427,393$4,060,230
Equipment$687,929$127,109$815,038
Compensation and Service Providers

Employees

NameTitleFull / Part TimeBaseOtherTotal
Paul BrunettaAccount ExecutiveFT$84,807$166,233$251,040
Jackie R NolenDirector, Benefit Admin.FT$196,740$39,564$236,304
Jill a GlennDirector Util. & Case MgmtFT$178,664$52,722$231,386
Jill M KelleyAccount ManagerFT$126,079$101,798$227,877
Jeri LazaroDirector Network Dev. & ContrctingFT$165,225$41,511$206,736
Dennis BalmerCFO, Shp (part Year)FT$157,207$44,035$201,242

Board Members and Trustees

NameTitle
Sarah KrevansChair,pres & CEO Sutter Health
Jim GrayTrustee, Chair Finance & Plan
Patrick FryPresident & CEO, Sutter Health
Steve NolteTrustee, President Shp (pt-yr)
Tracy MessineoTrustee, President Shp (pt-yr)
Dave ComarcheroTrustee
Marjorie GinsbergTrustee
Stephanie Walton MdTrustee
Steve PleauTrustee
Jeff BurdaTrustee (part Year)
Shelly BoehmCFO, Shp (part Year)
Jennifer Nuovo MdCME, Sutter Health Plan
Gretchen LachanceSecretary & Assist Gen Counsel
Suzanne ChammoutSh Office of General Council
Peter AndersonSh VP Strategy & Bus. Develop.
Monica MajorsVP, Mktg & Strtg Sales Sh Plan
Jennifer SchirmerVP, Operations, Shp
Robert CarnaroliVP, Sales Sutter Health Plan

Highest Paid Contractors

ContractorServicesLocationCompensation
Healthedge Software INCConsultingPO BOX 347589, Pittsburgh, PA 15251-4816$3,972,197
High Point Solutions LLCConsulting301 E GERMANTOWN PIKE, East Norriton, PA 19401$2,744,868
Itc Infotech USA INCConsulting12 ROUTE 17 NO STE 303, Paramus, NJ 07652$1,295,768
Dpr ConstructionConstruction Svcs1450 VETERANS BLVD, Redwood City, CA 94063$1,280,020
Highroads INCConsulting120 PRESIDENTIAL WAY STE 330, Woburn, MA 01801$751,498
Revenue and Support

Revenue Composition

Contributions and Grants
$0
Program Service Revenue
$208,842,324
Investment Income
$31,149
Other Revenue
$4,279
Change in Net Assets
$-40,588,914
Expenses and Functional Allocation

Major Expense Lines

Line ItemAmount
Other Expenses$233,818,178
Salaries, Compensation, and Employee Benefits$15,311,489
Grants and Similar Amounts Paid$336,999
Professional Fundraising Fees$0
Total Fundraising Expense$0

Functional Expense Allocation

Line ItemProgramManagementFundraisingTotal
Insurance$20,670,645$76,562-$20,747,207
Other Expenses$12,525,903$729,811-$12,525,903
Fees for Services Management-$8,222,078-$8,222,078
Other Salaries and Wages-$7,437,626-$7,437,626
Other Employee Benefits-$4,534,555-$4,534,555
All Other Expenses$1,190,461$1,221,936-$2,412,397
Current Officers, Directors, Trustees, and Key Employees-$2,292,697-$2,292,697
Payroll Taxes-$672,516-$672,516
Fees for Services Accounting-$589,867-$589,867
Occupancy-$586,787-$586,787
Depreciation Depletion-$573,673-$573,673
Fees for Services Legal-$572,883-$572,883
Information Technology-$472,067-$472,067
Advertising-$429,192-$429,192
Pension Plan Contributions-$374,095-$374,095
Office Expenses-$370,783-$370,783
Grants to Domestic Orgs$336,999--$336,999
Fees for Services Other-$134,314-$134,314
Travel-$126,171-$126,171
Conferences and Meetings-$18,782-$18,782
Fees for Service Investment Mgmnt Fees-$5,785-$5,785
Interest$2,527--$2,527
Total Functional Expenses$213,935,313$35,531,353$0$249,466,666
International Activity

Grant and Assistance Recipients

RecipientLocationCategoryPurposeAmount
Wellspace HealthSacramento, CA501(c)(3)Program Support$114,000
Shady Creek Outdoor Education FoundationYuba City, CA501(c)(3)Program Support$75,000
Heal ProjectHalf Moon Bay, CA501(c)(3)-$43,333
Street Level Health ProjectOakland, CA501(c)(3)Program Support$43,333
County of SonomaSanta Rosa, CAGovtProgram Support$38,333
Center for Healthcare Decisions IncSacramento, CA501(c)(3)Program Support$10,000
Fundraising, Events, and Gaming
Fundraising activities
No
Gaming activities
No
Professional fundraiser used
No

Fundraising and Gaming Totals

Line ItemAmount
Fundraising Direct Expenses$0
Fundraising Gross Income$0
Gaming Direct Expenses$0
Gaming Gross Income$0
Professional Fundraising Fees$0
Political and Lobbying Activity
Political campaign activity
No
Subject to proxy tax
No
Insider Transactions and Loans

Loans and Receivables

Line ItemBeginningEndChange
Loans from Officers, Directors, Trustees, and Key Employees$0$0→ $0
Receivables from Disqualified Persons$0$0→ $0
Receivables from Officers, Directors, Trustees, and Key Employees$0$0→ $0
Debt and Bond Financing

Other Reported Liabilities

LiabilityAmount
Other Liabilities$1,081,922
Intercompany Payables$774,447
Insurance/self-insurance$2,203
Governance and Compliance

Governance Checklist

Compiled or reviewed by an accountant
No
Annual disclosure for covered persons
Yes
Audit committee
Yes
Backup withholding compliance
Yes
Business relationship with family members
No
Business relationship with organization members
No
Material changes to governing documents
Yes
Compensation from other sources disclosed
No
CEO compensation reviewed
Yes
Other officer compensation reviewed
Yes
Conflict-of-interest policy
Yes
Audited financial statements prepared
Yes
Key decisions subject to board approval
Yes
Management duties delegated
No

Governance Explanations

Form 990, Part VI, Lines 6 & 7A

This corporation is an affiliate of sutter health, a california nonprofit public benefit corporation. Sutter health is the sole member with the right to elect at least a majority of the members of the board of directors.

Form 990, Part VI, Line 7B

Sutter health as the sole member of the organization is entitled to exercise fully all rights and privileges of members of nonprofit corporations under the california nonprofit public benefit corporation law, and all other applicable laws. The member has the rights and powers to appoint (and remove) members of the corporation's board of directors, subject to the provisions of the bylaws. In addition, the member has the right to approve the following actions of the corporation's board of directors: a. Merger, consolidation, reorganization, or dissolution of the corporation or any subsidiary or affiliate entity; b. Amendment or restatement of the articles of incorporation or the bylaws of the corporation or any subsidiary or affiliate entity; c. Adoption of operating budgets of the corporation or any subsidiary or affiliate entity, including consolidated or combined budgets of the corporation and all subsidiary organizations of the corporation; d. Adoption of capital budgets of the corporation or any subsidiary or affiliate entity; e. Aggregate operating or capital expenditures on an annual basis that exceed approved operating or capital budgets by a specified dollar amount to be determined from time to time by the general member; f. Long-term or material agreements of the corporation or any subsidiary or affiliate entity including but not limited to, borrowings, equity financings, capitalized leases and installment contracts; and purchase, sale, lease, disposition, hypothecation, exchange, gift, pledge or encumbrance of any asset, real or personal, with a fair market value in excess of a dollar amount to be determined from time to time by the directors of the general member, which shall not be less than 10% of the total annual routine capital budget of the corporation or any subsidiary or affiliate entity; g. Appointment of an independent auditor and hiring of independent counsel except in conflict situations between the general member and the corporation or any subsidiary or affiliate entity. H. The creation or acquisition of any subsidiary or affiliate entity; i. Contracting with any third party for all or substantially all of the management of the assets or operations of the corporation or any subsidiary or affiliate entity. J. Approval of major new programs and clinical services of the corporation or any subsidiary or affiliate entity. The general member shall from time to time define the term "major" in this context; k. Approval of strategic plans of the corporation or any subsidiary or affiliate entity; l. Adoption of quality improvement policies not in conformity with policies established by the general member; m. Any self dealing transaction between a director of the corporation and the corporation or a subsidiary or the corporation or affilate entity of the corporation; n. Rehiring, contracting with, or otherwise compensating a sutter health executive, or any officer or member of management of the corporation or any subsidiary or affiliate entity after their employment ended. In addition, the general member shall have the authority to require the prior review and approval of those activities of the corporation or any subsidiary or affiliate entity which the general member determines to be major activities. "major activities" shall be those which the general member by a vote of its board of directors has declared "major activities".

Form 990, Part VI, Line 11B

Sutter health has a centralized tax department responsible for the preparation of the form 990. Annually the tax department provides training and education to affiliate personnel who assist the tax department in collecting and reviewing data to be reported on the form 990. The preparation material is reviewed by various departments including tax, finance, legal, and human resources. A national accounting firm prepares and/or reviews the return. A completed return is then reviewed by the tax department, the affiliate, and the cfo before the return is filed.

Form 990, Part VI, Line 12C

Employees are educated on the conflict of interest policy and the need to make disclosure as part of annual compliance education. In addition, annually a disclosure statement is completed by all directors and officers that includes an acknowledgement that they have read the conflict of interest policy. On this statement the individual will list a wide range of information which includes business relationships, employment relationships, property interests, and those of related parties. The ceo and board chair will review the statements and monitor situations that may pose a potential conflict of interest. The ceo and board chair may consult with the office of the general counsel as necessary. If there is a potential conflict of interest related to a particular transaction, the interested individual must disclose the existence and nature of the relationship. The board chair may appoint a disinterested person or committee to investigate the conflict. Until the potential conflict is resolved, the board chair may request the individual to not participate during related presentations and discussions. In all circumstances involving an actual conflict, the interested individual shall refrain from voting on any matter related to the transaction.

Form 990, Part VI, Lines 15A & 15B

The compensation committee of the sutter health board of directors retains ultimate discretionary authority over all elements of compensation to assure that organizational purposes are appropriately being served. The compensation committee uses credible data sources and maintains an objective "arms length" decision-making process, ensuring the integrity of sutters executive programs and consistency with the organizations overall mission. In order to ensure external competitiveness, national compensation data comparisons are reviewed. Competitive analysis includes: (a) base salary, (b) total cash (base salary + annual incentive), (c) total direct cash (base salary + annual incentive + long term incentive) and (d) total remuneration (base salary + annual incentive + benefits and long term incentive). This analysis includes national comparisons for organizations similar in size, scope and complexity as sutter health. This method is most appropriate since it is a national marketplace in which sutter competes for executive talent. Officers and key employees of this organization undergo an annual review by the compensation committee or a delegated sub-committee. Approval is recorded in the minutes. Executive compensation review was last completed in december 2016.

Form 990, Part VI, Line 19

The sutter health system posts its current and past audited financial statements at sutterhealth.org. Other documents are also located at this website including the annual report, mission statement, history, and links to affiliate websites. The governing documents are not available to the public at this time.

Form 990, Part VII, Section A

The following board members of the organization are full-time employees (40 hours per week) of sutter health and their sutter health salaries are reported herein. These individuals receive no compensation for their service as board members of this organization. - sarah krevans - steve nolte - tracy messineo

Filing and Contact Details

Filer

Filer Name
Sutter Health Plan
EIN
46-1183948
In Care Of
% CARLA WHITE-SNYDER
Phone
9162866665
Address
C/O SH TAX 2200 RIVER PLAZA DRIVE, SACRAMENTO, CA 95833
Doing Business As
Sutter Health Plus

Signing Officer

Name
Brian Fellner
Title
CFO
Signed
2017-10-23
Discuss with paid preparer
Yes

Organization Details

Principal Officer
Phil Jackson
Formed
2012
Legal Domicile
CA
Voting Board Members
7
Independent Board Members
5
Employees
107
Volunteers
0

Preparer

Firm
Ernst & Young US Llp
Address
560 MISSION ST STE 1600, SAN FRANCISCO, CA 94105
Preparer
Eva Nitta
Phone
4158948000
Supplemental Narrative

Additional Explanations

Form 990, Part III, Line 4A

Program service accomplishments sutter health plan (doing business as sutter health plus) is an affiliate of the sutter health system, a comprehensive network of care spanning more than 20 counties across northern california. The sutter network includes nine physician organizations, two dozen acute care hospitals and a wide array of medical research facilities, training programs, care centers and specialty services. We believe that all people deserve access to excellent medical care - whoever they are and wherever they live. Sutter health doctors, hospitals and other caregivers partner with each other to advance our medical services and increase patients access to them. Sutter-affiliated hospitals are regional leaders in cardiac care, womens and childrens services, cancer care, orthopedics and advanced patient safety technology. The primary purpose of sutter health plus is to improve the health of the community by increasing access to sutter healths network of high-quality doctors, hospitals and other health care services. The health plan promotes affordability through the delivery of cost-effective health care services; this includes partnering with our provider network to improve quality and reduce costs. Sutter health plus is licensed by the department of managed health care as a knox-keene health maintenance organization with plan coverage beginning in january 2014. Sutter health plus members are assigned primary care providers exclusively with physicians through related sutter health tax-exempt medical foundations. Sutter health plus develops its plan products under a not-for-profit mission with a commitment to provide affordably priced hmo health plans in accordance with patient protection and affordable care act and federal guidelines that allow northern californias socially and economically diverse communities to access high quality and accessible care at sutter healths network of doctors and hospitals. Sutter health plus participates in activities designed to promote the general health of communities, promotes and encourage advancement and improvement of high-quality and cost-effective health care services; and facilitates the interchange of ideas among health care service organizations and communities served. Additionally, sutter health plus will: - participate in and support the community benefit efforts of sutter healths affiliated hospitals and doctors in the sacramento and central valley areas, including increasing access to health education and child access to care and activities. - participate in new care models that promote and encourage the advancement and improvement of high quality and cost-effective care services; - facilitate the interchange of ideas among provider organizations and the communities served through education activities and advance the planning for and delivery of high quality health care services in the communities served; - to engage in, conduct or support charitable, educational or scientific activities, and to further such activities as may be deemed advisable for the advancement of health care; - to promote or carry on such other activities as may be deemed advisable for the betterment of the general health of the communities served. Sutter health plus participates in activities designed to promote the general health of communities; promotes and encourage advancement and improvement of high-quality and cost-effective health care services; and facilitates the interchange of ideas among health care service organizations and communities served. Form 990, part vi, line 4 the bylaws were amended to remove vice chair as an officer position and add assistant secretary as an officer position.

Form 990, Part XI, Line 9

Other changes in net assets: equity transfers: $43,419,942

Financial Statement Notes

Schedule D, Part X, Line 2

Asc 740 (fin 48) footnote from audit: this organization was part of a consolidated financial system audit. The asc 740 audit footnote disclosure for the sutter system is as follows: sutter health, the legal entity, and most affiliates have been determined to be exempt organizations by the internal revenue service and the california franchise tax board and, generally, are not subject to taxes on income. Certain activities of sutter are subject to income taxes; however, such activities are not significant to the consolidated financial statements. With respect to its taxable activities, sutter records income taxes using the liability method, under which deferred tax assets and liabilities are determined based on the differences between the financial accounting and tax basis of assets and liabilities. Deferred tax assets or liabilities at the end of each period are determined using the currently enacted tax rate expected to apply to taxable income in the periods that the deferred tax asset or liability is expected to be realized or settled. Sutter recognizes the tax benefit from uncertain tax positions only if it is more likely than not that the tax positions will be sustained on examination by the tax authorities, based on the technical merits of the position. The tax benefit is measured based on the largest benefit that has a greater than 50% likelihood of being realized upon ultimate settlement. The statute of limitations for tax years 2013 through 2015 remain open in u.s. Tax jurisdictions in which sutter and its affiliates are subject to taxation. Sutter recognizes interest and penalties related to income tax matters in operating expenses. At december 31, 2016 and 2015, there were no such uncertain tax positions.

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