Kaiser Foundation Health Plan of the Northwest

“The Executive Committee, composed of the Directors that are the chairs of the Board's other standing committees, has authority to act for the Board between meetings except it has no authority to: a. Fill vacancies on the Board or the Committee; b. Fix the compensation of Directors for serving on the Board or any committee; c. Adopt, amend or repeal Bylaws; d. Amend or repeal any resolution of the Board which by its express terms cannot be amended or repealed by the Executive Committee; e. Appoint committees of the Board or appoint the members thereof; or f. Approve any aspect of a transaction involving the company when a Director has a material financial interest in that transaction, except as expressly provided by the law. FORM 990, PART VI, QUESTION 4 The Bylaws of the Corporation were amended in 2017 as follows: On March 17, 2017, Article E, Sections E-7 and E-9 were amended to reflect that the Executive Vice President and Group President instead of the Executive Vice President and Chief Financial Officer shall perform the duties of the President in the absence or disability of the President.”

“Kaiser foundation health plan, inc. is the sole member. Upon dissolution, remaining assets shall be distributed to a 501(c)(3) organization.”

“Kaiser foundation health plan, inc. Appoints the directors (and fills vacancies and has authority to remove directors). The same individuals who comprise the board of directors of kfhp also serve as the directors of kfhp colorado, northwest, mid-atlantic states, and kfhpw holdings.”

“The following actions of the corporation require approval of the sole member: a) removal of the chairman of the board or the president, the group president or regional president; b) amendment of article d, section d-4 of the bylaws - election and term of office.”

“Form 990 Review Process: 1. Key information necessary for the preparation of the tax return is obtained and/or confirmed with internal sources including regional finance, executive compensation, community benefits, treasury, government relations, and legal. 2. Prior to finalization, the return is reviewed by an external tax advisor. 3. Once signed by an external tax advisor, the return and underlying data are reviewed by an officer or a member of management designated by an officer for signature and filing. 4. Copies are then provided to board members prior to filing.”

“Compliance enforcement a. Regularly and consistently monitors compliance with the conflicts of interest policy - kaiser permanente regularly monitors compliance with the conflicts of interest policy in 3 key ways: a1. The kaiser permanente compliance hotline is available to all employees and vendors to report actual or potential conflicts of interest. All calls are answered by a third party and provided to kaiser permanente's national compliance office for review and appropriate action. Employees can report anonymously. Retaliation is prohibited. Reports of actual or potential conflicts of interest are generated and investigations are conducted as required and information is tracked and trended to determine if additional guidance is required to avoid or manage conflicts of interest. Compliance hotline reports are provided for review and action to the kaiser foundation health plan/hospitals boards of directors annually. A2. The national compliance office and internal audit services annually review the directors', officers', key employees', and executives' annual conflicts of interest questionnaire disclosures and provide direction on any investigations required. Investigations are documented, tracked and trended to determine if additional controls or education is required. In addition, conflicts of interest questionnaire reports are provided for review and action to the kaiser foundation health plan/hospitals boards of directors annually; and a3. Annually, as a component of the external audit, an outside certified public accounting firm reviews the annual conflicts of interest questionnaires process completed by directors, officers, key employees, and executives, and actions taken as a result of the disclosures. The results of the annual audit, including any findings in this area are presented to the kaiser foundation health plan/hospitals audit and compliance committee. B. Regularly and consistently enforces compliance with the conflicts of interest policy - to ensure consistency in the enforcement of the policy kaiser permanente uses the following steps as a general guideline: b1. Represented employees are subject to any corrective/disciplinary action provisions described in specific regional/national collective bargaining agreements and/or organizational policies and practices. B2. Kaiser permanente notifies employees of the national human resources policy no. 14. Corrective/disciplinary action policy during new employee orientation and in annual compliance training. B3. In the event that it is necessary to discipline any employee because of, but not limited to, failure to comply with applicable legal/regulatory requirements, kaiser permanente policies and procedures, or the principles of responsibility, or for unsatisfactory performance or misconduct, coaching/counseling and/or corrective/disciplinary action may include, but is not limited to: - oral discussion and/or warning by the employee's immediate supervisor or higher level manager to correct the problem; - written notice, with or without final warning; - paid or unpaid suspension, with or without final warning; - termination of employment.”

“Compensation determination the executive compensation program as administered by kaiser foundation health plan, inc. Is designed to recruit, retain and motivate qualified senior management personnel. Senior management personnel have a significant impact on the strategic and policy direction and results of the organization. Therefore, the executive compensation program is, to a significant degree, performance-based. The compensation program is reviewed annually by the compensation committee of the board of directors and the management committee on compensation. Prior to payment, all programs and payments to the ceo, executive director, and top management officials (executives) are reviewed by the compensation committee of the board of directors and the management committee on compensation. Base pay for executive positions is established at a level comparable to the relevant market. In addition, other components of the compensation program bear 'at-risk' features designed to focus on strategically important performance goals and to assist in attracting and retaining top performers. The executive compensation program is targeted to be competitive to the comparable external market in which the organization competes for executive leadership. Evaluation of comparable pay data is performed by an independent compensation, benefit & human resources consulting firm. The compensation program focuses on objectives in the areas of quality of member care and service, membership growth, financial soundness, and the community and social mission of the organization.”

“Forms 990 are available on www.guidestar.org.”

“Public Inspection Copy: Governing documents, conflict of interest policy are available upon request as disclosed to other regulatory bodies. Financial Statements are on file with state insurance agency on a statutory basis (stand alone entity). Combined data is published for Kaiser Foundation Health Plan Inc. and subsidiaries and Kaiser Foundation Hospitals and Subsidiaries with Independent Auditors' Report. To request copies contact: Vice President, Communication Kaiser Foundation Health Plan and Hospitals One Kaiser Plaza, 18th Floor Oakland, CA 94612”

“Hours for Related Organization: Individuals who are both officers and members of Boards of Directors work full time as employees as well as fulfill their board assignment. All officers work full time in their employee capacity. Full time work may require in excess of the traditional 40 hour week. Given the integrated nature of our organization, employees may provide support for various Kaiser Permanente companies. The average hours per week reported for the filing organization and related organizations was estimated.”

“CHANGE IN pension and other retirement liabilities $(169,531,224) BOOK-TO-TAX DIFFERENCE ON SALE OF INVESTMENTS 2,302,453 OTHER THAN TEMPORARY IMPAIRMENT LOSS (3,540,764) ---------------- TOTAL (170,769,535)”

“2017 Community Benefit Report Kaiser Foundation Health Plan of the Northwests Commitment to the Community Kaiser Foundation Health Plan of the Northwest (Northwest Health Plan or KFHP-NW) provides and arranges comprehensive health care services for members on a predominantly prepaid basis. Its contractual obligations to group and individual members are fulfilled by contracting with Kaiser Foundation Hospitals (KFH) and Permanente Medical Group physicians to provide health care services for its members. KFHP-NW strives for excellence in serving its members through market-leading performance in quality and service. As a subsidiary of Kaiser Foundation Health Plan, Inc. (KFHP, Inc.), membership is available without regard to age, sex, race, religion, or national origin, or to the individuals ability to pay. Northwest Health Plan members are broadly representative of the communities served. Once enrolled, a member may maintain membership regardless of health or employment status. As related nonprofit organizations, Kaiser Foundation Health Plan, Inc. and Kaiser Foundation Health Plan of the Northwest are committed to improving the health of communities beyond enrolled membership. Annual investments in a range of Community Benefit programs are a fundamental embodiment of the organizations ongoing commitment to improve the general wellbeing within the broader community. These investments result in intentional, planned, measurable, and accountable benefits intended to address many of the health challenges faced at the individual, local, state, and national levels. In 2007, Kaiser Foundation Health Plan, Inc.s board of directors refined the focus of the organizations Community Benefit programs and established the following four priority areas which have come to be known as "Streams of Work": A. Care and Coverage for Low-Income People Creates and supports programs that lower the financial barriers for the under- and uninsured. B. Community Health Initiatives (CHI) Seeks to measurably improve the health of the communities we serve. Designs, delivers, and sustains long-term programs that engage communities in work to improve conditions in their neighborhoods. C. Safety Net Partnerships Builds partnerships with community clinics, local health departments, and public hospitals. Provides funding, technical assistance, dissemination of care management, and quality improvements technology to help improve care and expand treatment capacity for vulnerable populations. D. Developing and Disseminating Knowledge Improves health care by sharing our knowledge educating practitioners, advancing research, empowering consumers, and informing policymakers about evidence-based care and health. In addition to the streams of work above, KFHP-NW also made contributions to benefit the communities served in the following areas: E. Other Community Benefit Investments Support Community Benefit activities and programs beyond the national streams of work, including the administrative expenses of regional Community Benefit departments dedicated to supporting the organizations Community Benefit programs and services and coordinating related initiatives. F. Environmental Stewardship Protecting and improving the natural environment is a key component of KFHP-NWs mission to improve the health of the community it serves. Although costs associated with this initiative are not included in the dollars reported as Community Benefit investments, efforts in this area contribute to advancing a broader vision emphasizing healthy people and healthy environments while also improving health care quality and affordability. The following are details of the Community Benefit activities provided by Kaiser Foundation Health Plan of the Northwest: In 2017, Northwest Health Plan served nearly 580,000 members and expended approximately $82.8 million (at cost, net of $122.8 million of related revenues) to support Community Benefit activities. The following summarizes many of the signature”

“Northwest Health Plans Medical Financial Assistance program provides financial assistance for emergency and medically necessary services, medications, and supplies to patients with a demonstrated financial need. Patients must receive health care services at a Kaiser Permanente facility and/or from a Kaiser Permanente provider. Eligibility is based upon prescribed levels of income to patients who have exhausted other private and public sources of support. In 2017, KFHP-NW provided approximately $18 million (at cost, net of related revenues of $0) of services under this program. At KFHP-NW, patients who are eligible for medical financial assistance, but do not receive an MFA award, are not charged more than amounts generally billed. Contracted collection agency practices are aligned with the organizations social values and IRC section 501(r). Additionally, any patient experiencing financial hardship due to high medical expenses relative to their income level may qualify for the program under KPs high medical expense criteria. Northwest Health Plans MFA eligibility criteria allows all insured patients falling at or below 300% of the Federal Poverty Guidelines (FPG) to receive full (100%) write off of medical charges. Any patient who does not meet income-based eligibility criteria, but is experiencing financial hardship due to high medical expenses relative to their income may qualify for MFA under high medical expense criteria. Eligibility for high medical expenses exists when the patients incurred out-of-pocket medical and pharmacy expenses over the previous 12-month period is equal to or exceeds 10% of annual income. High medical expenses can apply to any income level. In Oregon and Washington, the MFA program also covers full or partial expenses for dental services if applicants meet qualifying guidelines. Promoting this medical-dental integration within the community is a priority for Kaiser Foundation Health Plan of the Northwest. The Health Plan supports the Oregon Primary Care Association in its efforts to bring dental directors together from Federally Qualified Health Centers to share best practices. Health Plan also employs a Community Benefit dentist for several hours each week to work with safety net partners to increase dental access and medical-dental integration in our community. In 2017, the MFA program assisted more than 15,000 qualified applicants, including nearly 2,200 patients who were not otherwise covered by a health care plan offered by Kaiser Foundation Health Plan of the Northwest. This population received full or partial forgiveness for nearly 133,000 outpatient visits and over 137,000 prescriptions. A.1.1.1. Community Medical Financial Assistance (CMFA) The MFA program also includes support for community based initiatives, known as Community Medical Financial Assistance (CMFA) programs. CMFA programs are designed to broaden access to health care within the community and help KFHP-NW fulfill its objectives to reduce the financial barriers that limit access to care for qualified low income populations. Northwest Health Plan is partnering with Project Access NOW (PAN) in Multnomah, Clackamas and Washington Counties and The Free Clinics of Clark County and Cowlitz County in Washington in a broad based community initiative that builds access to health care for low income and uninsured people through the provision of donated medical services. Patients referred to Kaiser Permanente facilities from the partnering organizations are set up with a Health Record Number, Primary Care Provider and Home Clinic for a period of one year. These patients then have access to the full range of Kaiser Permanente services. Services may include primary care, specialty care and hospitalizations. This prevents medical emergencies, alleviates the burden on clinics and emergency rooms when medical conditions persist untreated, and enables patients to be treated for the root causes of their symptoms. A.1.2. Charitable Health Covera”

“Northwest Health Plan participated in three Medicaid managed care programs in Oregon and Washington as well as a fee-for-service provider for patients who have no formal affiliation with KFHP-NW. In 2017, KFHP-NW expended approximately $52.5million (at cost, net of $122.8 million of related revenues) to subsidize care under Medicaid. In Oregon, Health Plan partners with the Health Share of Oregon as a fully capitated, risk-accepting entity and Trillium Community Health as a fee for service provider. In Washington, Health Plan participates as a fully capitated contractor of Molina Healthcare of Washington. The following describe the programs and target populations. A.2.1.1. Medicaid Managed Care Programs A.2.1.1.1. Health Share of Oregon Northwest Health Plan is a direct contractor with Health Share of Oregon under a Provider Care Organization contract to deliver primary and specialty care paid by the state. All reporting, analysis, auditing, and member administration is performed by KFHP-NW as a Managed Care Organization. As a result, KFHP-NW is engaged in policy development, program structure, and technical capabilities in partnership with the Health Share of Oregon. Currently, Northwest Health Plan, along with other regional health care providers, Tuality Healthcare, Care Oregon, and Providence Health Services, is a risk-accepting entity and a founding partner of Health Share of Oregon for Multnomah, Clackamas, and Washington counties. This is the largest Coordinated Care Organization in the state. A.2.1.1.2. Washington Apple Health Care Washington Apple Health program is a Medicaid program offered by Molina Healthcare for low-income individuals that meet eligibility requirements for Medicaid. It is a fully-capitated state program managed by the Washington State Health Care Authority (HCA). Northwest Health Plan provides services to eligible participants who reside in either Clark or Cowlitz counties through a subcontract with Molina Healthcare. A.2.1.2. Medicaid Fee-for-Service Northwest Health Plan contributed $5.6 million (at cost, net of $4.3 million of related revenues) in subsidized care to Medicaid Fee-for-Service patients during 2017. These patients have no formal membership affiliation with KFHP-NW. When a Medicaid nonmember receives services from Kaiser Permanente providers at hospitals or outpatient services as a result of hospital visit follow-up, these expenses are recorded as non-capitated services and billed to the Medicaid program on a fee-for-service basis. A.2.1.3. Child Health Insurance Program (CHIP) In both Oregon and Washington, KFHP-NW participates as a provider in the states Child Health Insurance Program. The program provides health insurance to children whose family income is between 200 percent and 300 percent of the federal poverty level, and who are not eligible for Medicaid. Subsidies are provided on a sliding scale based on income. In both states, the program is governed by the Medicaid contract, and offers the same benefits. Northwest Health Plan incurred net losses of $7.9 million (at cost, net of $16.8 million of related revenues) under this program in 2017. A.2.2. Other Government Programs The Oregon Transitional Reinsurance Program supplements the federal program by helping to pay for high claims costs associated with individuals in previous high risk programs. The Washington Medical Insurance Pool provides coverage to individuals who were enrolled in the prior insurance pool program. Legislation allows the states to spread a portion of the expenses for enrollees across the pools of individuals who are insured wholly or in-part by all health insurers, re-insurers, and stop-loss carriers licensed in each state. Northwest Health Plan paid $1.2 million to these programs in 2017. A.3. Care and Coverage Programs and Services A.3.1. On-site Wellness Center at Faubion Elementary School Kaiser Permanente openned an on-site Wellness Center at Faubion Elementary School in North Portland in August 20”

“During 2017, Northwest Health Plan spent $2.2 million to support Community Benefit activities and programs beyond the national streams of work. This included the administrative expenses of a Community Benefit department dedicated to supporting regional Community Benefit programs and services and coordinating related initiatives. KAISER FOUNDATION HEALTH PLAN OF THE NORTHWEST RECOGNIZED NO SIGNIFICANT FINANCIAL INVESTMENTS IN THE FOLLOWING STREAMS OF WORK DURING 2017: C. - SAFETY NET PARTNERSHIPS D. - DEVELOPING AND DISSEMINATING KNOWLEDGE E. OTHER COMMUNITY BENEFIT INVESTMENTS F. Environmental Stewardship A stable and non-toxic environment contributes to health and wellness. Safeguarding and healing the natural environment is therefore a key component of Kaiser Permanentes multifaceted efforts to improve the total health of our members and the communities we serve. Kaiser Permanente maintains a governance structure for environmental stewardship that steers actions across our organization to detoxify the ways in which healthcare is delivered while catalyzing environmental improvement throughout society. This structure includes clearly defined roles, responsibilities, plans and routines, and has resulted in five organization-wide focus areas that have been selected based on their ability to have the most impact on the forces that shape environmental- and human-health: - Responding to climate change - Promoting sustainable farming and food choices - Reducing, reusing, and recycling to eliminate waste - Finding safe alternatives to harmful industrial chemicals - Conserving water In each of these focus areas, Kaiser Permanente has established ambitious goals (including a 2025 target to remove more greenhouse gases from the atmosphere than we emit); implemented initiatives; achieved measurable improvements; and regularly reported progress to our Board of Directors, our staff, and the communities we serve. F.1. Performance Metrics During 2017, key performance indicators for Kaiser Foundation Health Plan of the Northwest included: F.1.1. Reduced our greenhouse gas emissions associated with routine use of anesthetic agents by over 1,800 metrics tons of carbon dioxide equivalent, compared to our 2014 baseline. F.1.2. Improved our energy use intensity (kBtu/rentable square foot) by 8% compared to our 2010 baseline. F.1.3. Improved our water use intensity (gallons/rentable square foot) by 3% compared to our 2013 baseline. F.1.4. Responsibly reused, recycled or composted over 1,700 tons of materials.”

“Description:purchased medical services total fees:xxx-xx-xxxx”

“Description:purchased other non-medical sv total fees:78982743”