Highmark Health Group

“Allegheny health network (ahn), based in pittsburgh, pennsylvania, is a tax-exempt, patient-centered and physician-led academic healthcare system that provides charitable care and high-quality, comprehensive health care services to patients from western pennsylvania and the adjacent regions of ohio, west virginia, new york and maryland. Ahn comprises eight hospitals and more than 250 healthcare sites, including five health + wellness pavilions, surgical centers and outpatient clinics; a research institute; more than 2,400 employed and affiliated physicians; approximately 21,000 total employees; 2,000 volunteers; a group purchasing organization; and a complete spectrum of home and community based healthcare services. The networks hospitals include one quaternary academic medical center (allegheny general hospital in pittsburgh) and seven tertiary/community hospitals that provide a wide array of general and advanced clinical services (allegheny valley hospital, natrona heights, pa; canonsburg hospital, canonsburg, pa; forbes hospital, monroeville, pa; jefferson hospital, jefferson hills, pa; saint vincent hospital, erie, pa; west penn hospital, pittsburgh, pa; and westfield memorial hospital, westfield, ny.) ahn was established in 2013, but its member hospitals share legacies of charitable care that date back 170 years (west penn hospital was chartered in 1848). Ahn was formed to act as the parent company of the hospitals of the west penn allegheny health system, inc. (wpahs), as well as jefferson hospital, saint vincent hospital and westfield memorial hospital. Highmark health (hh), in turn, serves as the ultimate parent of ahn and its affiliates. In 2018, the hospitals and clinics of ahn together admitted nearly 90,000 patients, logged nearly 300,000 emergency room visits and delivered nearly 8,000 babies; and its physicians performed more than 100,000 surgical procedures. Anchored by nationally and internationally recognized clinical and research programs in the areas of bone and joint care, sports medicine, cardiovascular disease, neurosurgery and neurology, womens health, cancer, emergency medicine, bariatric and metabolic disease, ahn provides a complete spectrum of advanced diagnostic, medical and surgical care across all medical specialties, including primary care, trauma and burn care, general surgery, diabetes, autoimmune diseases, critical care, digestive diseases, mens health/urology, lung and esophageal diseases and rehabilitation services. Ahn also plays a pivotal role in the training of future generations of healthcare professionals by offering four dozen graduate medical programs, and by maintaining affiliations with three medical schools and two nursing schools. The networks hospitals serve as clinical campuses for the medical schools of drexel university, temple university and the lake erie college of osteopathic medicine (lecom). Nearly 250 students are enrolled each year in nursing programs at the west penn hospital school of nursing and the citizens school of nursing in natrona heights, and about 450 medical residents and fellows receive advanced training on staff at ahn hospitals. Ahns plan is to transform the current model of health care delivery in western pennsylvania by encouraging health care providers within ahn, whether hospitals or physicians, to use the most cost-effective venue for care, adhere to the highest, evidence-based standards of care, and deliver superior outcomes by reducing unnecessary readmissions and healthcare associated complications. Providing cost-efficient, conveniently accessed care delivers value and benefit to local communities, partner health carriers, area businesses, and most of all to ahns patients. The goal of ahn is to promote health and wellness in its communities by providing safe, compassionate, affordable health care to all who seek it, regardless of a patients race, creed, gender, national origin, physical or mental disability, or ability to pay. Vision and strategy”

“Ahn and its tax-exempt subsidiary facilities support a broad array of charitable services to the community by providing subsidized health care; sponsoring community events (health fairs, cancer screenings, walks, educational seminars; support groups); and making charitable donations. The services benefit children and teens, adults and seniors, patients and their families, and the community at large. The following is not a total account of all of ahns charitable activities, but a sampling of ahns many contributions to the community, and its commitment to provide a wide range of quality health services to diverse communities, and to all who seek ahns care: ahn positive health clinic: the positive health clinic (phc) is a comprehensive hiv primary care clinic providing state-of-the-art care to hiv-positive persons. Its support staff includes physicians, nurses, medical assistants, social workers, behavioral health therapists, psychiatrists and patient advocates. The team treats more than 750 patients and has extensive experience with all aspects of hiv management, providing a wide range of primary and specialized hiv care, regardless of an individual's medical insurance coverage or ability to pay. Services and programs include: comprehensive hiv care; rapid hiv testing and counseling and partner testing; medication adherence counseling and pharmacy support; gynecologic care; nutritional assessment and counseling by a registered dietitian; treatment for persons co-infected with hiv and hepatitis c; smoking cessation programs; mental health assessment, counseling and psychiatric support; and case-management for non-medical needs. The staff assists with financial or social issues that may interfere with the provision of medical care. Ahn also provides significant financial support to a regional aids-prevention partnership whose goal is to end new hiv infections in allegheny county, pa., by 2020. Alexis joy dachille center for perinatal mental health: in 2018, ahn opened the alexis joy dachille center for perinatal mental health at west penn hospital, an innovative new facility that offers women with pregnancy-related depression access to a spectrum of family-focused care options under one roof. The 7,300-square-foot, $2.5 million center is designed so that mothers can stay with their babies while undergoing treatment. The facility houses rooms for individual therapy as well as space for intensive outpatient care - a three-hours-daily, three-day-a-week program that focuses on group therapy, mother-child bonding and complementary modalities for stress relief, such as yoga and meditation. The center will also offer child care services for older children, addressing a major barrier to care for women. Braddock urgent care: in 2015, ahn and hh opened the ahn urgent care center, subsidizing health care access for the underserved braddock, pa., community, by providing care on a charitable basis and serving a significant share of medicare and medicaid patients. With the help of a grant from highmark inc., ahn has launched a community health improvement plan, intended to educate and improve outcomes for braddock-area residents in four key areas: behavioral health, including substance abuse and mental health disorders; cancer, particularly of the prostate, lung, colon or breast; chronic disease, with a focus on asthma and diabetes, and maternal and child health, with a particular focus on sexually transmitted disease prevention. The ahn urgent care center was built following the closure of braddocks community hospital, which had been the primary jobs source and health care access point for braddock residents. The ahn urgent care center is staffed by board certified physicians, registered nurses, medical assistants and radiology technicians, and equipped with 12 patient exam rooms and diagnostic capabilities such as x-ray imaging and blood work. Build: the build health challenge, a national program that leverages multi-sector community partners”

“$1 million, four-year grant to establish the "front door initiative for emergency medicine," a comprehensive effort to better understand and address the social determinants of health among patients who visit the hospitals emergency department. Patients who frequently utilize emergency department often do so because of challenges faced in their social environment. Jefferson hospital will apply the grant toward: extensive assessment of community needs related to its emergency services; identification of model practices for social emergency medicine; working with community partners on the development of a front door vision and plan; implementation of a strong data system; educational interventions for staff; and development of an integrated support network and ensuring patients are properly connected to it. Healthy food center: a first of its kind in the region, ahns new healthy food cneter acts as a "food pharmacy" where patients who lack access to food can receive nutritious food items, education on disease-specific diets, and additional services for other social challenges they might face. According to the greater pittsburgh community food bank, a partner of the healthy food center, food insecurity affects more than 350,000 people or one in seven adults in the pittsburgh region. Food insecurity refers to a lack of available financial resources for nutritionally-adequate food such as fruits, vegetables, lean proteins and whole grains. The healthy food center is piloting its program among patients with diabetes who are screened by their doctor as being food insecure. Patients receive a referral to the healthy food center where they initially meet with an onsite dietitian to discuss their dietary needs based on their condition. After shopping at the center for the recommended food items, patients go home with two to three days worth of food for all members of their household. The healthy food center opened in 2018. Immigrant health program: the immigrant health program at ahn, part of the ahn center for inclusion health, was awarded a $250,000 grant from the jewish healthcare foundation in support of its efforts to deliver a new community health model aimed at meeting the health care needs of immigrant women in our region. From 2005-2015, the number of foreign-born area residents grew from 48,266 to 72,265, more than half of whom are women. Over the next three years, ahns center for inclusion health and more than a dozen local community health and social service providers will convene to deliver the "immigrant women-community health model" aimed at providing immigrant women access to culturally- competent and quality perinatal services, as well as other womens health and social services. Medical respite program: in 2016, ahn established a new medical respite program that provides itinerant patients recovering from illnesses with a safe place to recuperate and receive ongoing non-acute care and support following a hospital stay. This innovative model represents the first and only medical respite program in the pittsburgh region. The medical respite program first addresses the patients primary needs for safe temporary housing and nutrition (through partnerships with local homeless services facilities located in downtown pittsburgh); then follows up with patients health needs with visits from ahn health care professionals (ahns center for inclusion health and healthcare@home programs). Through this model, the program helps achieve better health outcomes and social stability for at-risk patient populations, while lowering their risk of dangerous and costly re-hospitalizations. Open heart surgery observation: since 2008, high school students from western pennsylvania, west virginia and ohio have been invited to observe ahns cardiovascular surgeons in action through the cardiovascular institutes (cvi) open heart surgery observation program. The program, which has hosted more than 15,000 area students from dozens of schools, is supporte”

“Allegheny general hospital: founded in 1885, allegheny general hospital (agh) is ahns flagship hospital, serving as ahns primary teaching hospital, its premier quaternary care facility, offering highly advanced specialties such as organ transplantation, neurosurgery, surgical oncology and cardiovascular surgery. Located in pittsburghs north side, agh has 552 licensed beds and approximately 800 physicians and 5,000 staff members. Agh is also a level i shock trauma center, and its lifeflight aeromedical service was the first to fly in the northeastern united states. For the 2018 reporting period, total discharges plus observations were approximately 28,000, emergency department visits were 53,000, and outpatient visits were 320,000. Allegheny valley hospital: allegheny valley hospital (avh) has served natrona heights, pa., and the surrounding community for over 100 years. Avh has 188 licensed beds and provides emergency care, surgical care, rehabilitation care and other quality health care services for its patients. For the 2018 reporting period, total discharges plus observations were approximately 7,500, emergency department visits were 33,000, and outpatient visits were 175,000. Canonsburg hospital: since 1904, 104-bed canonsburg hospital (ch), based in canonsburg, pa., has served the communities of northern washington and southern allegheny counties, providing quality medical care and improving the health and well-being of its patients. For the 2018 reporting period, total discharges plus observations were approximately 3,000, emergency department visits were 17,000 and outpatient visits were 64,000. Forbes hospital: since 1978, forbes hospital (fh) has been providing high-quality care for the communities of eastern allegheny and westmoreland counties. Forbes features a level ii trauma center, a top rated cardiovascular surgery program and a comprehensive obstetrics and gynecology service among its many clinical offerings. A 315-bed facility based in monroeville, pa., in 2018, fh recorded approximately 21,000 discharges plus observations, 41,000 emergency department visits, 151,000 outpatient visits and nearly 1,400 births. Jefferson hospital: jefferson hospital (jh) was organized in 1973. Located just south of pittsburgh, the 341-bed hospital provides a wide spectrum of high quality health care services, from emergency care and intensive care, comprehensive surgical programs and rehabilitation. In 2014, jh opened a new labor and delivery unit, the first new hospital-based maternity program to be built and developed in pennsylvania in three decades. For the 2018 reporting period, total discharges plus observations were approximately 21,000, emergency department visits were nearly 50,000, outpatient visits were 275,000 and births totaled more than 1,000. Saint vincent hospital: saint vincent hospital (svh) is a 371-bed facility that provides inpatient, outpatient and emergency care services for residents of northwestern pennsylvania and adjacent areas of new york and ohio. Founded by the sisters of st. Joseph in 1875, svh continues to exemplify the values of the sisters in providing compassionate care to all. Additionally, svhs four-bed satellite facility, westfield memorial hospital, has provided high quality health care to residents of western new york for more than half a century. For the 2018 reporting period, svhs total discharges plus observations were approximately 20,000, emergency department visits were 62,000, outpatient visits were 180,000, and births were nearly 900. West penn hospital: serving the bloomfield area of pittsburgh and its surrounding communities since 1848, west penn hospital (wph) is a 333-bed academic medical center with private acute-care patient rooms and one of pennsylvanias most advanced obstetrical and newborn care programs, including a level 3 neonatal intensive care unit. Wph has a reputation for outstanding clinical care and nursing excellence; and was the first hospital in western pennsylv”

“Clinical offices, ahn operates five large, multi-specialty health + wellness pavilions (two in allegheny county, one in washington county, and two in erie county); five urgent care clinics (three in allegheny county and two in erie county); and eight hospital-based and free-standing surgery centers (six in allegheny county, one in washington county and one in erie county). Allegheny health network research institute: ahns research institute offers access to new drug therapies, hones revolutionary surgical procedures, and has advanced expertise with innovative devices and wearable technologies that help reduce the impact of chronic disease. The institute partners with industry, government, academia, and health systems across the region to work toward a series of common goals: discovering cures, developing the next clinical "best practices" improving the health of patients and advancing the science of medicine. Physicians and scientists at ahn are often on the cutting edge of advanced treatments and new technologies. Innovative medical research across all of the networks programs is a critical component of the organizations mission. The networks research institute coordinates private and federally funded interdisciplinary programs designed to better understand, treat and prevent disease, and the networks hospitals are frequently involved in clinical trials of breast, prostate and bowel cancer, burn and traumatic injuries, gene therapy, cardiovascular disease, leukemia and lymphoma, autoimmune diseases, neurological diseases, and more. The network is currently home to hundreds of active clinical research trials. Allegheny clinic: with more than 1,200 employed physicians and 4,700 total employees, the allegheny clinic is one of western pennsylvanias largest physician groups. Since the formation of ahn, ahn has added hundreds of primary care physicians, specialists and surgeons to the allegheny clinic. Those physicians and administrative staff support dozens of specialty service lines and clinical institutes, including the bariatric and metabolic institute, the cancer institute, the cardiovascular institute, the esophageal and lung institute, the neuroscience institute, the orthopaedic institute and the transplant institute. Foundations: in addition to the aforementioned entities, ahn also includes a number of affiliated philanthropic organizations: the alle-kiski medical center trust, forbes health foundation, suburban health foundation, and the western pennsylvania hospital foundation. Key institutes and services lines allegheny health network cancer institute: ahns cancer institute includes more than 50 cancer institute clinics, two dozen separate clinical locations and a multidisciplinary team of more than 200 physicians. The institute treats 10,000 patients annually in western pennsylvania, erie, west virginia, and ohio. Ahn recently opened an extended hours oncology clinic at west penn hospital to better care for patients experiencing the side effects of chemotherapy treatments, and over the next few years, ahn will invest more than $225 million in new infrastructure and capabilities to support their vision and strategy for serving ahn patients who are diagnosed with cancer; that infrastructure will include a new academic cancer institute on the agh campus as well as several new community-based cancer centers. Additionally, ahn collaborates with johns hopkins kimmel cancer center, to offer more stream-lined access to clinical trials and provide additional treatment options and second opinions for patients with rare and complex cancers, among other benefits.”

“Frontier of advanced specialty heart care, the allegheny health network cardiovascular institute (cvi) is one of the premier cardiac programs in the country, providing superior state-of-the-art care for patients with heart disease and access to western pennsylvania's most comprehensive, multidisciplinary team of specialists and innovative therapies, including many available only through advanced clinical trials. The physicians of the ahn cvis seven hospitals and 20 outpatient pittsburgh- and erie-area locations have helped to pioneer the use of the latest generation of implantable cardioverter-defibrillators; were among the first in the nation to perform trans-catheter aortic valve replacement (tavr), replacing defective aortic heart valves via a minimally invasive catheter procedure; introduced new treatments to repair defective mitral valves via robot-assisted minimally invasive surgery; and played an instrumental role in the development of left ventricular assist devices (lvad), a mechanical pump that is surgically implanted to assist a weakened heart muscle. Currently, the physicians at the cardiovascular institute are conducting research that leads to better ways to prevent, find and treat heart disease; currently, ahn researchers and physicians are working on more than 75 research projects and clinical trials. Additionally, ahns womens heart center, the first heart center of its kind in allegheny county, treats complex cardiovascular conditions for adult women of all ages. Allegheny health network medicine institute: ahns medicine institutes houses the one-of-a-kind autoimmunity institute, which opened a new facility in 2018 that combines multispecialty care with cutting-edge research, patient education and advocacy to advance the treatment of autoimmune diseases and accelerate discovery of a cure for more than 100 different disease types. The ahn autoimmunity institute hosts four "centers of excellence" for the treatment of common autoimmune diseases including lupus, rheumatoid arthritis, inflammatory bowel disease and celiac disease. The institute includes physicians from an array of clinical subspecialties such as rheumatology, allergy and clinical immunology, pulmonary, dermatology, gastroenterology, nephrology, endocrinology, cardiology and infusion therapy. The medicine institute also includes specialty programs dedicated to dermatology, dentistry, infectious disease, nephrology, and inclusion health. Allegheny health network neuroscience institute: ahns neuroscience institute is a national leader in providing innovative, expert care for complex brain, spine, or neurological conditions. Ahns renowned neurosurgeons have developed groundbreaking surgeries and treatment advancements that lead to improved care for patients experiencing the symptoms of parkinsons disease, trigeminal neuralgia, stroke complications, congenital spinal conditions, and more. Additionally, agh has earned a "comprehensive stroke center" designation, the highest distinction of stroke care awarded by the american heart associations joint commission. Ahns neuroscience program includes renowned experts in the subspecialties of neurology, neuro-otology, neuroradiology, neuro-critical care, and neurosurgery, and the institute has been identified as a neurosciences center of excellence and a spine center of excellence, enabling ahn and agh to serve as a national and international referral center for treatment of all types of neurological conditions. Allegheny health network orthopaedic institute: the orthopaedic institutes multidisciplinary team of surgeons, physicians, nurses, physician assistants and rehabilitation specialists work together to develop a coordinated treatment plan specifically designed for each patient, specializing in pediatric orthopaedics, joint replacement, orthopaedic surgery, spinal surgery, and sports medicine. Together, ahn and hh have made significant investments in ahns orthopaedic capabilities and infrastructure, includi”

“Over the years, ahn has been recognized for its advanced technologies, clinical quality, and the depth and breadth of its professional and clinical programming. In 2018, it received the following awards, recognitions and accreditations, among others: als association western pennsylvania chapter: sandeep rana, md, medical director of the als certified center of excellence at ahn, was recognized with the robert f. Balint above and beyond award. American heart association: allegheny general hospital and jefferson hospital earned gold plus honors for the sixth consecutive year, while forbes hospital and allegheny valley hospital (avh) received silver plus recognition in this years american heart association/american stroke association get with the guidelines - heart failure achievement awards. The award recognizes hospitals that implement specific quality improvement measures outlined by the aha/american college of cardiology foundations secondary prevention guidelines for patients with heart failure. American heart association and american stroke association: five ahn hospitals received national recognition for their commitment to delivering excellent, evidence-based care for stroke patients. Allegheny general, forbes, jefferson, and saint vincent hospitals each earned the stroke gold plus quality achievement award in the get with the guidelines achievement awards. West penn hospital earned the stroke bronze quality achievement award. American nurses credentialing center: in 2018, ahns west penn hospital for the third time earned the magnet recognition designation. American society for reproductive medicine: in 2018, ahns center for reproductive medicine was named a nursing center of excellence by the american society for reproductive medicine. Centers for disease control: the cdc granted westfield memorial hospital full recognition for its diabetes prevention program (dpp). This designation is reserved for programs that have effectively delivered a quality, evidence-based program that meets all of the standards for cdc recognition. College of healthcare information management executives: allegheny general hospital, forbes hospital, jefferson hospital, saint vincent hospital, west penn hospital, and westfield memorial hospital were recognized as 2018 most wired hospitals for advanced technological capabilities such as epic. Community liver alliance: ahns robin midian, md, was a recipient of the community liver alliance's 2018 "make a difference" award, which recognizes individuals who go above and beyond to educate the community about liver health and drive awareness about liver disease. Hospital and healthsystem association of pennsylvania: ahn was recognized for its outstanding efforts to raise awareness for organ donation in the 2018 donate life pa hospital challenge. Each participating ahn hospital earned a titanium-level finish, the highest ranking possible for the initiative which recognizes hospitals that engage in unprecedented levels of outreach activities throughout the month of april. Participating ahn hospitals included: allegheny general, allegheny valley, canonsburg, forbes, jefferson, saint vincent and west penn. International board of lactation consultants: the ahn women and infants center at west penn hospital received the international board of lactation consultants care award in 2018. Journal of emergency medical services: benjamin j. Lawner, do, ms, emt-p, facep, medical director of prehospital care services, lifeflight and ems at ahns allegheny general hospital, was awarded the john p. Pryor, md, street medicine society award. Keystone 10: jefferson hospital has received "keystone 10" desgination, indicating the hospitals high level of support for breast-feeding families. National adult and influenza immunization summit: premier medical associates received an immunization excellence award at the may 2018 summit. National kidney foundation: the national kidney foundation of the alleghenies honored ahns barbara”

“Form 990, part i, line 3 the number of voting members of the governing body reflected in irs form 990, page 1, part i, line 3 will not correspond to the actual number of voting members listed in irs form 990, page 7, part vii because certain voting members of the governing body are voting members for more than one of the organizations included in this group filing. In these instances, the individual is counted in part i, line 3 in accordance with the number of organizations for which they are voting members but will only be listed in part vii once.”

“Form 990, part i, line 8 pursuant to treasury regulation section 1 6033-2(d)(5) the sponsoring entity of highmark health group, highmark health, has elected to report information about contributions, grants, and similar amounts received, information about officers, directors, trustees, and key employees, certain other highly paid employees, certain independent contractors on a consolidated basis along with all members of the highmark health group in the highmark health group return.”

“FORM 990, PART VI, SECTION A, LINE 2 THE FOLLOWING BOARD MEMBERS HAVE A BUSINESS RELATIONSHIP THROUGH THEIR CONNECTION OF SERVING TOGETHER ON THE BOARD OF RELATED TAXABLE NON-PROFIT ORGANIZATIONS: JOSEPH GUYAUX, DAVID BLANDINO, M.D., VICTOR ROQUE, DAVID MALONE, DAVID MATTER, AND DAVID HOLMBERG. MEMBERS OR STOCKHOLDERS FORM 990, PART VI, SECTION A, LINE 6 WEST PENN ALLEGHENY HEALTH SYSTEM, INC. IS THE SOLE MEMBER OF THE FOLLOWING ENTITIES: - CANONSBURG GENERAL HOSPITAL - ALLEGHENY MEDICAL PRACTICE NETWORK - ALLEGHENY SINGER RESEARCH INSTITUTE - ALLE-KISKI MEDICAL CENTER - THE WESTERN PENNSYLVANIA HOSPITAL FOUNDATION - FORBES HEALTH FOUNDATION - ALLEGHENY CLINIC - ALLEGHENY CLINIC MEDICAL ONCOLOGY AHN IS THE SOLE MEMBER OF THE FOLLOWING ENTITIES: - JEFFERSON REGIONAL MEDICAL CENTER - WEST PENN ALLEGHENY HEALTH SYSTEM, INC. - SAINT VINCENT HEALTH SYSTEM - SAINT VINCENT HEALTH CENTER ALLE-KISKI MEDICAL CENTER IS THE SOLE MEMBER OF: - ALLE-KISKI MEDICAL CENTER TRUST HIGHMARK HEALTH IS THE SOLE MEMBER OF: - ALLEGHENY HEALTH NETWORK SAINT VINCENT HEALTH SYSTEM IS THE SOLE MEMBER OF THE FOLLOWING ENTITIES: - SAINT VINCENT FOUNDATION FOR HEALTH AND HUMAN SERVICES - SAINT VINCENT AFFILIATED PHYSICIANS - SAINT VINCENT MEDICAL EDUCATION & RESEARCH INSTITUTE - Westfield Memorial Hospital CANONSBURG GENERAL HOSPITAL IS THE SOLE MEMBER OF: - CANONSBURG GENERAL HOSPITAL AMBULANCE SERVICE MEMBERS OR STOCKHOLDERS WHO MAY ELECT FORM 990, PART VI, SECTION A, LINE 7A PURSUANT TO THE BYLAWS OF EACH ENTITY, THE SOLE MEMBER OF SUCH ENTITY HAS THE POWER TO ELECT OR APPOINT ALL OR A SIGNIFICANT PORTION OF SUCH ENTITY'S BOARD OF DIRECTORS AND TO REMOVE OR REPLACE SUCH DIRECTORS.”

“FORM 990, PART VI, SECTION A, LINE 7B For the following entities that comprise the group, Highmark Health, as the direct or indirect sole member, holds certain reserve powers pursuant to the bylaws of: - CANONSBURG GENERAL HOSPITAL - ALLEGHENY HEALTH NETWORK - JEFFERSON REGIONAL MEDICAL CENTER - ALLEGHENY SINGER RESEARCH INSTITUTE - ALLE-KISKI MEDICAL CENTER - THE WESTERN PENNSYLVANIA HOSPITAL FOUNDATION - ALLE-KISKI MEDICAL CENTER TRUST - FORBES HEALTH FOUNDATION - WEST PENN ALLEGHENY HEALTH SYSTEM, INC. - SAINT VINCENT FOUNDATION FOR HEALTH AND HUMAN SERVICES - SAINT VINCENT MEDICAL EDUCATION AND RESEARCH INSTITUTE - SAINT VINCENT HEALTH SYSTEM - SAINT VINCENT HEALTH CENTER - SAINT VINCENT AFFILIATED PHYSICIANS - CANONSBURG GENERAL HOSPITAL AMBULANCE SERVICE - ALLEGHENY CLINIC - ALLEGHENY CLINIC MEDICAL ONCOLOGY - ALLEGHENY MEDICAL PRACTICE NETWORK THE FOLLOWING ARE THE RESERVED POWERS OF HIGHMARK HEALTH: 1) TO APPROVE THE ELECTION, RE-ELECTION AND REMOVAL OF ALL OFFICERS, INCLUDING THE PRESIDENT AND CHIEF EXECUTIVE OFFICER, OF THE CORPORATION AND ITS SUBSIDIARIES; 2) TO AMEND, REVISE OR RESTATE THE CORPORATIONS ARTICLES OF INCORPORATION AND BYLAWS AND APPROVE ALL AMENDMENTS OR REVISIONS OF THE CORPORATIONS ARTICLES OF INCORPORATION AND BYLAWS THAT MAY BE PROPOSED OR APPROVED BY AHN, THE MEMBER OR BOARD OF DIRECTORS OF THE CORPORATION, SUBJECT TO CERTAIN EXCEPTIONS. 3) TO ADOPT OR CHANGE THE MISSION, PURPOSE, PHILOSOPHY OR OBJECTIVES OF THE CORPORATION OR ITS SUBSIDIARIES; 4) TO CHANGE THE GENERAL STRUCTURE OF THE CORPORATION OR ANY OF ITS SUBSIDIARIES AS A VOLUNTARY, NONPROFIT CORPORATION; 5) TO (A) DISSOLVE, DIVIDE, CONVERT OR LIQUIDATE THE CORPORATION OR ITS SUBSIDIARIES, (B) CONSOLIDATE OR MERGE THE CORPORATION OR ITS SUBSIDIARIES WITH ANOTHER CORPORATION OR ENTITY, (C) SELL OR ACQUIRE ASSETS, WHETHER IN A SINGLE TRANSACTION OR SERIES OF TRANSACTIONS, WHERE THE CONSOLIDATION EXCEEDS 1% OF THE CORPORATIONS OR THE RELEVANT SUBSIDIARYS TOTAL ASSETS, AND (D) APPROVE ANY OF THE FOREGOING ACTIONS THAT MAY BE PROPOSED BY AHN, THE MEMBER OR THE BOARD OF DIRECTORS OF THE CORPORATION BEFORE SUCH ACTION BECOMES EFFECTIVE; 6) TO APPROVE THE ANNUAL CONSOLIDATED CAPITAL AND OPERATING PLAN AND BUDGET OF THE CORPORATION AND ITS SUBSIDIARIES, AND ANY AMENDMENTS THERETO OR SIGNIFICANT VARIANCES THEREFROM; 7) APPROVE THE INCURRENCE OF DEBT BY THE CORPORATION AND ITS SUBSIDIARIES OR THE MAKING OF CAPITAL EXPENDITURES BY THE CORPORATION AND THE SUBSIDIARIES DURING ANY FISCAL YEAR OF THE CORPORATION, IN EITHER CASE IN EXCESS OF ONE QUARTER OF 1% OF THE CONSOLIDATED ANNUAL OPERATING BUDGET OF THE CORPORATION AND ITS SUBSIDIARIES FOR EACH FISCAL YEAR IF SUCH DEBT OR CAPITAL EXPENDITURES ARE NOT INCLUDED IN THE CORPORATIONS SUBSIDIARIES APPROVED BUDGETS, WHETHER IN A SINGLE TRANSACTION OR A SERIES OF RELATED TRANSACTIONS. 8) TO APPROVE ANY DONATION OR ANY OTHER TRANSFER OF THE CORPORATIONS OR ITS SUBSIDIARIES ASSETS, OTHER THAN TO THE MEMBER OR TO THE CORPORATION BY ITS SUBSIDIARIES, IN EXCESS OF $10,000,000, UNLESS SPECIFICALLY AUTHORIZED IN THE CORPORATIONS OR ITS SUBSIDIARIES APPROVED BUDGETS. 9) TO APPROVE STRATEGIC PLANS AND MISSION STATEMENTS OF THE CORPORATION AND ITS SUBSIDIARIES; 10) TO APPROVE INVESTMENT POLICIES OF THE CORPORATION AND SUBSIDIARIES; 11) TO APPROVE THE CLOSURE OR RELOCATION OF A LICENSED HEALTHCARE FACILITY OF THE CORPORATION AND ITS SUBSIDIARIES; 12) TO APPROVE THE FORMATION OF SUBSIDIARY CORPORATIONS, PARTNERSHIPS AND JOINT VENTURES OR TO MAKE NEW INVESTMENTS IN EXISTING SUBSIDIARY CORPORATIONS, PARTNERSHIPS AND JOINT VENTURES, IF THE NEW INVESTMENTS OF THE CORPORATION AND THE SUBSIDIARIES IN SUCH SUBSIDIARIES CORPORATIONS, PARTNERSHIPS, AND JOINT VENTURES DURING ANY FISCAL YEAR WOULD, IN THE AGGREGATE, EXCEED 1% OF THE CORPORATIONS CONSOLIDATED TOTAL ASSETS AT THE END OF THE PRIOR FISCAL YEAR OF THE CORPORATION; 13) TO ESTABLISH AND MANAGE THE CORPORATIONS PROGRAM FOR COMPLIANCE WITH ALL LEGAL REQUIREMENTS APPLICABLE”

“FORM 990, PART VI, SECTION B, LINE 11B HIGHMARK HEALTH GROUP IRS FORM 990 WAS PREPARED BY ITS EXTERNAL ADVISORS, PRICEWATERHOUSECOOPERS LLP AND REVIEWED BY THE HIGHMARK HEALTH TAX DEPARTMENT, SENIOR MANAGEMENT OF THE ORGANIZATION, AND THE AUDIT AND COMPLIANCE COMMITTEE. Before filing the tax return with the Internal Revenue Service, a final copy was provided to all members of the Boards of Directors.”

“FORM 990, PART VI, SECTION B, LINE 12C Highmark Health (HH) has a corporate compliance department that monitors and oversees compliance with the Conflict of Interest Policy for all entities within the filing group. The following describes the manner in which the corporate compliance department monitors and oversees compliance with the conflict of interest policy: Conflict of interest disclosure statements are completed upon hire/appointment and on an annual basis by all board members, officers, key employees, supervisors and above, persons with purchasing authority including procurement department employees and committee members which may influence purchasing decisions, and any other employees as designated by the compliance department. Upon completion of the above disclosure statement by all applicable individuals, the Corporate Compliance Department reviews all disclosures. Those disclosure statements that require additional information or clarification are contacted by the corporate compliance department requesting such. Once received, the Corporate Compliance Department reviews the information to determine whether a real or potential conflict of interest exists. As applicable, Legal and Senior Management are consulted to determine whether a real or potential conflict of interest exists. When a conflict requires a mitigation plan, the mitigation plan is developed and approved in coordination with the respective responsible senior management. The senior managers are responsible for discussing the mitigation plan with the individual and monitoring compliance with the mitigation plan. A Conflict of Interest/Independence Disclosure Summary Report of all board members, officers, and executive management with reportable disclosures is provided to the Audit and Compliance committee of the Board of Highmark Health as well as the Board of Directors of Highmark Health, AHN and any applicable hospital.”

“FORM 990, PART VI, SECTION B, LINES 15A AND 15B AHN follows a process for determining compensation for executive positions, (including officers, key employees and other management positions), and is covered by the Highmark Health executive compensation policy. The policy was approved by the Highmark Health board of directors. It is the policy of AHN management to compensate its executives in accordance with the market and in relation to the experience, service and accomplishments of the individual both prior to and during their service with AHN. The Highmark Health personnel and compensation committee (P&C) of the Board of Directors approves the compensation for the president and CEO of AHN and all non-hospital senior executives who report directly to the president and CEO of AHN. The personnel and compensation committee uses comparability data provided by an independent compensation consultant. The external consultant provides a letter of reasonability for all offers made to new executives that report to the AHN CEO. Each P&C committee member voting on a senior executive's compensation arrangement ensures that he or she has no conflict of interest, including that he or she (a) does not economically benefit from the proposed employment; (b) does not receive compensation subject to the approval of the proposed employee; and (c) has no material financial interest affected by the transaction. The executive compensation program for the hospital entities within the group is administered by the CEO of AHN with respect to the CEOs, COOs and CFOs of each hospital, pursuant to overall guidelines established by the personnel and compensation committee of the board of directors of Highmark Health. It is the policy of AHN to compensate its executives in accordance with competitive market practices, taking into account organizational performance and the skills, experience, qualifications and performance of each executive. AHN generally targets the median of the relevant market with reasonable variation based on each executives skills, experience, performance and current positioning relative to market. Highmark Health management, in coordination with the independent consultant to the P&C committee obtains appropriate market comparability data for each position, including nationally published compensation surveys and/or specific organization peer groups, to prepare compensation recommendations for all key executives, including officers, key employees, and other disqualified persons. Recommendations are reviewed and approved by a committee that is independent with respect to the compensation provided to the executives. Compensation may include several forms of cash compensation, including base salary, performance-based incentive compensation, and a competitive employee benefits program. Base salary is the fixed element of compensation intended to align with each executives role, responsibilities, overall performance and other contributions. Incentive compensation is used to provide variable, or "at risk" compensation, based on the performance of both the executive and the organization. Typically, AHN and hospital executives can earn incentive compensation only if the organization achieves certain pre-determined goals as approved by the P&C Committee. The plans are intended to hold executives accountable for achieving performance that is consistent with the long-term goals and objectives of the organization. All entities within the filing follow the requirement in the regulations to comply with the rebuttable presumption of the reasonableness of compensation. THE P&C COMMITTEE COMPLETED A REVIEW AND APPROVAL OF THE ANNUAL COMPENSATION STUDY OF CORPORATE EXECUTIVES PREPARED BY THE INDEPENDENT COMPENSATION CONSULTANT IN JULY 2019.”

“Form 990, part vi, section c, line 19 the organization does not make its governing documents or conflict of interest policy available to the public. Financial statements are on a consolidated basis, and are available upon request and approval by the cfo of highmark health. Independent contractors part vii, section b, line 2 listed in this form 990, part vii are the five highest paid independent contractors that provided services the highmark health group. The amount of independent contractors reported on line 2 includes the total amount of vendors paid over $100,000.”

“Form 990, part xi, line 9 equity transfers 321,645,050 pension liability adjustments (71,431,241) other (70,263,014) ------------- total 179,950,795”