2023-10-31T11:29:37-05:00 2022-12-31 910189318 MOSS ADAMS LLP 2707 COLBY AVENUE SUITE 801 EVERETT WA 98201 990 2022-01-01 911577184 COMMUNITY HEALTH NETWORK OF WASHINGTON COMM 2065218833 1111 3RD AVENUE 400 SEATTLE WA 98101 STACY KESSEL CHIEF FINANCE AND STRATEGY OFFICER 2065218833 2023-10-19 1 STACY KESSEL XXX-XX-XXXX 0 ROBERT GRANNUM P00355876 4252597227 2023-10-09 2 AAL1 IAL1 2022 2023-04-26 12:10:37Z STACY KESSEL 1111 3RD AVENUE 400 SEATTLE WA 98101 247346465 0 X CHNW.CHPW.ORG X 1992 WA IMPROVE HEALTH STATUS AND SUSTAIN NETWORK OF COMMUNITY HEALTH CENTERS. 25 25 0 1 13290138 220470 0 0 201004826 246091545 463425 1127634 -208905 127286 201259346 247346465 0 791168 196983739 228827794 7717357 7705417 0 0 0 4545271 5765706 209246367 243090085 -7987021 4256380 297369203 329406840 56417403 68652499 240951800 260754341 X TO IMPROVE THE HEALTH STATUS OF OUR COMMUNITIES THROUGH THE PROVISION OF HIGH-QUALITY, AFFORDABLE, COMMUNITY-BASED HEALTH CARE TO UNDERSERVED INDIVIDUALS AND FAMILIES, AND THROUGH SUSTAINING THE NETWORK OF COMMUNITY HEALTH CENTERS AND AFFILIATED BUSINESSES. 0 0 230432425 791168 232928693 PROMOTION OF ACCESSIBLE, AFFORDABLE, AND QUALITY HEALTH CARE FOR 106,645 NETWORK MEMBERS PRIMARILY PARTICIPATING IN MEDICAID. EFFECTIVE JANUARY 1, 2021, THE COMPANY PROVIDES HEALTH INSURANCE COVERAGE TO ENROLLEES OF THE WASHINGTON STATE HEALTH CARE AUTHORITY'S (HCA) MANAGED CARE "PUBLIC OPTION" PROGRAM KNOWN AS CASCADE SELECT. CASCADE SELECT WAS DEVELOPED TO CREATE NEW AFFORDABLE HEALTH COVERAGE OPTIONS AVAILABLE THROUGH THE WASHINGTON HEALTHPLANFINDER. THE NETWORK HAS EXITED THE INDIVIDUAL MARKET EFFECTIVE JANUARY 1, 2023, AND COMMUNITY HEALTH PLAN OF WASHINGTON (THE PLAN) WILL BEGIN OFFERING CASCADE SELECT PRODUCTS EFFECTIVE JANUARY 1, 2023. THE PLAN, A CONTROLLED AFFILIATE OF THE NETWORK (COLLECTIVELY, THE COMPANY), IS ALSO A HEALTH CARE SERVICE CONTRACTOR LICENSED (HCSC) BY THE STATE OF WASHINGTON OFFICE OF THE INSURANCE COMMISSIONER (THE OIC). 230432425 0 0 1 1 0 0 0 0 0 0 0 0 0 1 1 0 1 0 0 0 0 0 0 0 0 0 1 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 1 1 1 0 1 258 0 1 0 1 1 0 0 0 0 0 0 0 X 25 25 0 0 0 0 1 1 1 1 1 0 0 1 1 1 1 1 1 0 0 0 X STACY KESSEL 2065218833 1111 3RD AVENUE 400 SEATTLE WA 98101 X JOSEPH EUGENE VESSEY CHAIR OF THE BOARD 1.00 1.00 X X 0 0 0 CARLA MARIE DEWBERRY VICE CHAIR OF THE BOARD 1.00 1.00 X X 0 0 0 RHONDA DIANE HAUFF BOARD SECRETARY 1.00 1.00 X X 0 0 0 AARON GABRIEL WILSON BOARD TREASURER 1.00 1.00 X X 0 0 0 SHEILA ANN BERSCHAUER BOARD MEMBER 1.00 1.00 X 0 0 0 REGINA BONNEVIE ROGERS BOARD MEMBER 1.00 1.00 X 0 0 0 JAMES KENNETH COFFEE BOARD MEMBER 1.00 1.00 X 0 0 0 RASHAD ALI COLLINS BOARD MEMBER 1.00 1.00 X 0 0 0 WILLIAM LAINE DOWLING BOARD MEMBER 1.00 1.00 X 6000 0 0 DAVID ELDOR FLENTGE BOARD MEMBER 1.00 1.00 X 0 0 0 JEFFREY SPENCER GIBBS BOARD MEMBER 1.00 1.00 X 0 0 0 ANGELA MARIA GONZALEZ BOARD MEMBER 1.00 1.00 X 0 0 0 JESUS HERNANDEZ BOARD MEMBER 1.00 1.00 X 0 0 0 JODI SUE JOYCE BOARD MEMBER 1.00 1.00 X 0 0 0 JENNIFER LYNN KREIDLER-MOSS BOARD MEMBER 1.00 1.00 X 0 0 0 MICHAEL SCOTT MAXWELL BOARD MEMBER 1.00 1.00 X 0 0 0 MANUEL IGNACIO NAVARRO BOARD MEMBER 1.00 1.00 X 0 0 0 KRISTY NEEDHAM BOARD MEMBER 1.00 1.00 X 0 0 0 KELLI ANN NOMURA BOARD MEMBER 1.00 1.00 X 0 0 0 GAELON BROOK SPRADLEY BOARD MEMBER 1.00 1.00 X 0 0 0 DESIREE LYN SWEENEY BOARD MEMBER 1.00 1.00 X 0 0 0 STEPHEN LESLIE TARNOFF BOARD MEMBER 1.00 1.00 X 6000 0 0 BRANDY DIANE TAYLOR BOARD MEMBER 1.00 1.00 X 0 0 0 CHRISTINE SUE TROTTER BOARD MEMBER 1.00 1.00 X 0 0 0 LISA CORRINE YOHALEM BOARD MEMBER 1.00 1.00 X 0 0 0 TERESITA IGNACIO BATAYOLA BOARD MEMBER (THRU 12/22) 1.00 1.00 X 0 0 0 DAVID RUSSELL OLSON BOARD MEMBER (THRU 2/22) 1.00 1.00 X 0 0 0 MEREDITH ELIZABETH VAUGHAN BOARD MEMBER (THRU 3/22) 1.00 1.00 X 0 0 0 JAMES MICHAEL MERRILL BOARD MEMBER (THRU 10/22) 1.00 1.00 X 0 0 0 LEANNE BERGE CHIEF EXECUTIVE OFFICER 15.00 25.00 X 0 932706 52290 STACY ANN KESSEL CHIEF FINANCE AND STRATEGY OFFICER 15.00 25.00 X 0 810946 58403 ALAN REED LEDERMAN CHIEF OPERATING OFFICER 15.00 25.00 X 0 558844 48540 KELLI MICHELE HOUSTON CHIEF EQUITY OFFICER 15.00 25.00 X 0 40609 761 PAUL EDWARD SHERMAN CHIEF MEDICAL OFFICER 15.00 25.00 X 0 599960 47531 MICHAEL EVANS VP, CUSTOMER EXPERIENCE 15.00 25.00 X 0 316956 36734 STEPHEN SWANSON VP, INFORMATION TECHNOLOGY 1.00 39.00 X 0 307808 41516 COLLIN FOULDS VP, GENERAL COUNSEL 13.00 27.00 X 0 301265 48337 ALEXANDER GARRARD VP, PEOPLE AND CULTURE 4.00 36.00 X 0 304112 54321 TERRY GIT LEE SENIOR BEHAVIORAL HEALTH MEDICAL DIRECTOR 9.00 31.00 X 0 434032 50538 LUANN LAWTON CHEN SR MEDICAL DIRECTOR 9.00 31.00 X 0 361476 55108 FAIZA N ZAFAR MEDICAL DIRECTOR 9.00 31.00 X 0 352716 40462 MA'ATA HARDMAN VP, HEALTH SERVICES 9.00 31.00 X 0 326788 40525 TAWNYA L CHRISTIANSEN MD BH MEDICAL DIRECTOR 9.00 31.00 X 0 318442 50164 12000 5966660 625230 0 0 1 0 ARCADIA SOLUTIONS LLC 20 BLANCHARD RD STE 10 BURLINGTON MA 018035155 IT CONTRACTING 817111 THE CROSSROADS GROUP INC 440 JOHNSON ROAD STE C KELLER TX 76248 SURVEY SERVICES 519962 TWO MEDICINE COMMUNICATIONS 2255 WILDWOOD ROAD CURTIS WA 98538 LOBBYIST 180000 TEAM SOAPBOX 2815 2ND AVENUE SUITE 555 SEATTLE WA 98121 PUBLIC RELATIONS CONSULTING 109263 4 PREMIUM REVENUE 524114 246091545 232801407 13290138 246091545 1112950 1112950 14684 0 14684 14684 14684 OTHER REVENUES 524114 127286 127286 127286 247346465 232928693 13290138 1127634 791168 791168 228827794 228827794 12000 12000 6356903 604 6356299 247703 247703 706988 706988 381823 381823 48035 48035 183109 9215 173894 402127 402127 10503 10503 2571302 193977 2377325 6941 232 6709 73019 4365 68654 914023 914023 326083 326083 29525 29525 78461 78461 POLITICAL ACTIVITY 571114 571114 BOARDS, BUREAUS & ASSOC 167254 167254 384210 33956 350254 243090085 230432425 12657660 0 9712083 57652686 35831439 3733630 251825579 267967727 102 52797 297369203 329406840 1692714 1763023 273731 0 54450958 66889476 56417403 68652499 X 0 0 0 0 240951800 260754341 240951800 260754341 297369203 329406840 X 4256380 15583855 -37694 X X 0 1 X 1 0 187000 187000 187000 1 COMMITTEE FOR JOHN LOVICK 2403 157TH PLACE SE MILL CREEK WA 98012 900040477 1000 COMMITTEE TO ELECT JT WILCOX PO BOX 747 MCKENNA WA 98558 270758934 2000 ELECT MONICA STONIER PO BOX 61762 VANCOUVER WA 98666 271504430 1000 ELECT SATWINDER KAUR PO BOX 6642 KENT WA 98064 845126669 1000 FRIENDS OF APRIL BERG PO BOX 14893 MILL CREEK WA 98082 850659766 1000 FRIENDS OF JESSICA BATEMAN 120 STATE AVE NE 1462 OLYMPIA WA 98501 473224161 1000 FRIENDS OF LAURIE JINKINS PO BOX 2032 TACOMA WA 98401 272214467 1000 FRIENDS OF LISA CALLAN PO BOX 2095 ISSAQUAH WA 98027 824666035 1000 FRIENDS OF MANKA PO BOX 2467 REDMOND WA 98073 815223744 1000 FRIENDS OF MARCUS RICELLI PO BOX 1325 SPOKANE WA 99210 455222828 1000 FRIENDS OF NICOLE MACRI PO BOX 9100 SEATTLE WA 98109 811159785 1000 HACKNEY FOR THE 11TH PO BOX 12066 SEATTLE WA 98102 844680106 1000 HARRY TRUMAN FUND PO BOX 9100 SEATTLE WA 98109 911769570 60000 JOHN BRAUN FOR STATE SENATE 1955 SALZER VALLEY RD CENTRALIA WA 98531 455101339 2000 PEOPLE FOR YASMIN 2522 N PROCTOR ST 520 TACOMA WA 98406 873173541 2000 REAGAN FUND PO BOX 904 OLYMPIA WA 98507 911716818 20000 SENATE LEADERSHIP COUNCIL PO BOX 11025 OLYMPIA WA 98508 911714860 20000 THARINGER FOR STATE REPRESENTATIVE PO BOX 834 SEQUIM WA 98382 272555702 1000 THE KENNEDY FUND 119 1ST AVE S STE 320 SEATTLE WA 98104 911713677 69000 1 0 0 SCHEDULE C, PART I-A DESCRIPTION OF THE ORGANIZATION'S INDIRECT POLITICAL CAMPAIGN ACTIVITIES AS ONE OF THE STATE'S LARGEST SAFETY NET PROVIDER NETWORKS, PROVIDING AND EXPANDING ACCESS TO HEALTH CARE FOR THE UNDERSERVED IS A CORE PART OF OUR MISSION. PARTICIPATION IN EVERY FACET OF THE PUBLIC POLICY PROCESS IS A NATURAL EXTENSION OF OUR EFFORTS. WE BELIEVE IT IS BOTH OUR ROLE AND OUR RESPONSIBILITY TO INVEST IN EXPANDING ACCESS TO HEALTH CARE AND HEALTH INSURANCE FOR POPULATIONS THAT ARE VERY VULNERABLE AND TYPICALLY HAVE NO VOICE. THEREFORE, WE FINANCIALLY SUPPORT THE CAMPAIGNS OF THE POLICY MAKERS THAT HAVE PRIORITIZED HEALTH CARE ACCESS FOR EVERYONE IN WASHINGTON STATE. 0 CLAIMS UNPAID 46340472 ACCRUED MEDICAL INCENTIVE POOL 14832997 UNPAID CLAIMS ADJUSTMENT EXPENSES 77141 AGGREGATE HEALTH POLICY RESERVES 5620603 AMOUNTS DUE TO PARENT, SUBSIDIARIES, AND AFFILIATES 18263 66889476 X 247335962 0 247335962 10503 10503 247346465 243079582 0 243079582 10503 10503 243090085 PART X, LINE 2: AS OF DECEMBER 31, 2022, AND 2021, THE COMPANY HAS NO UNCERTAIN TAX POSITIONS, AND IN ACCORDANCE WITH ACCOUNTING GUIDANCE, HAS NOT RECORDED A CONTINGENT LIABILITY. THERE ARE NO TAX POSITIONS FOR WHICH MANAGEMENT BELIEVES IT IS REASONABLY POSSIBLE THAT THE TOTAL AMOUNT OF TAX CONTINGENCIES WILL SIGNIFICANTLY INCREASE OR DECREASE WITHIN 12 MONTHS OF THE REPORTING DATE. THE COMPANY FILES AN EXEMPT ORGANIZATION RETURN WITH THE U.S. FEDERAL JURISDICTION ANNUALLY. 1 COMMUNITY HEALTH ASSOCIATION OF SPOKANE 611 NORTH IRON BRIDGE WAY SPOKANE WA 99202 911641797 501C(3) 50000 0 P4P PERFORMANCE IMPROVEMENT PROJECT. COMMUNITY HEALTH CARE 1148 BROADWAY SUITE 100 TACOMA WA 98402 911349657 501C(3) 50000 0 P4P PERFORMANCE IMPROVEMENT PROJECT. COMMUNITY HEALTH OF CENTRAL WASHINGTON 501 S 5TH AVE YAKIMA WA 98902 571140982 501C(3) 41168 0 P4P PERFORMANCE IMPROVEMENT PROJECT. COUNTRY DOCTOR COMMUNITY CLINIC 500 19TH AVE E SEATTLE WA 981224007 237100868 501C(3) 50000 0 P4P PERFORMANCE IMPROVEMENT PROJECT. FAMILY HEALTH CENTERS 716 1ST AVE S OKANOGAN WA 98840 911275011 501C(3) 50000 0 P4P PERFORMANCE IMPROVEMENT PROJECT. HEALTHPOINT 955 POWELL AVE SW SUITE A RENTON WA 98057 910884412 501C(3) 50000 0 P4P PERFORMANCE IMPROVEMENT PROJECT. INTERNATIONAL COMMUNITY HEALTH SERVICES MS 313692 PO BOX 3692 SEATTLE WA 981243692 910947084 501C(3) 50000 0 P4P PERFORMANCE IMPROVEMENT PROJECT. MOSES LAKE COMMUNITY HEALTH CENTER 605 COOLIDGE DRIVE STE 101 MOSES LAKE WA 988371893 911537371 501C(3) 50000 0 P4P PERFORMANCE IMPROVEMENT PROJECT. NEIGHBORCARE HEALTH 1200 12TH AVE S SUITE 901 SEATTLE WA 98144 910893287 501C(3) 50000 0 P4P PERFORMANCE IMPROVEMENT PROJECT. NEW HEALTH PROGRAMS ASSOCIATION PO BOX 808 CHEWELAH WA 99109 911053847 501C(3) 50000 0 P4P PERFORMANCE IMPROVEMENT PROJECT. NORTH OLYMPIC HEALTHCARE NETWORK 240 WEST FRONT ST STE A PORT ANGELES WA 98362 471444061 501C(3) 50000 0 P4P PERFORMANCE IMPROVEMENT PROJECT. PENINSULA COMMUNITY HEALTH SERVICES PO BOX 960 BREMERTON WA 98337 943079770 501C(3) 50000 0 P4P PERFORMANCE IMPROVEMENT PROJECT. SEA MAR COMMUNITY HEALTH CENTERS 1040 S HENDERSON STREET SEATTLE WA 98108 911020139 501C(3) 50000 0 P4P PERFORMANCE IMPROVEMENT PROJECT. UNITY CARE NORTHWEST 1616 CORNWALL AVE 205 BELLINGHAM WA 98225 912168190 501C(3) 50000 0 P4P PERFORMANCE IMPROVEMENT PROJECT. LEWIS COUNTY COMMUNITY HEALTH SERVICES 2690 NE KRESKY AVE CHEHALIS WA 985322412 421599749 501C(3) 50000 0 P4P PERFORMANCE IMPROVEMENT PROJECT. YAKIMA NEIGHBORHOOD HEALTH SERVICES PO BOX 2605 YAKIMA WA 98907 910928817 501C(3) 50000 0 P4P PERFORMANCE IMPROVEMENT PROJECT. 16 0 PART I, LINE 2: THE GRANT RECIPIENTS ARE ALL U.S. ORGANIZATIONS AND ALL FUNDS ARE USED WITHIN THE U.S. 0 0 0 0 0 0 0 1 0 LEANNE BERGE CHIEF EXECUTIVE OFFICER 0 672807 0 259899 0 0 0 18300 0 33990 0 984996 0 0 STACY ANN KESSEL CHIEF FINANCE AND STRATEGY OFFICER 0 542801 0 268145 0 0 0 18300 0 40103 0 869349 0 0 PAUL EDWARD SHERMAN CHIEF MEDICAL OFFICER 0 466326 0 133634 0 0 0 9736 0 37795 0 647491 0 0 ALAN REED LEDERMAN CHIEF OPERATING OFFICER 0 446121 0 112723 0 0 0 18300 0 30240 0 607384 0 0 TERRY GIT LEE SENIOR BEHAVIORAL HEALTH MEDICAL DIR 0 357313 0 76719 0 0 0 16215 0 34323 0 484570 0 0 LUANN LAWTON CHEN SR MEDICAL DIRECTOR 0 296982 0 64494 0 0 0 18300 0 36808 0 416584 0 0 FAIZA N ZAFAR MEDICAL DIRECTOR 0 295110 0 57606 0 0 0 9422 0 31040 0 393178 0 0 TAWNYA L CHRISTIANSEN MD BH MEDICAL DIRECTOR 0 276890 0 41552 0 0 0 18300 0 31864 0 368606 0 0 MA'ATA HARDMAN VP, HEALTH SERVICES 0 268856 0 57932 0 0 0 11519 0 29006 0 367313 0 0 ALEXANDER GARRARD VP, PEOPLE AND CULTURE 0 249565 0 54547 0 0 0 16390 0 37931 0 358433 0 0 MICHAEL EVANS VP, CUSTOMER EXPERIENCE 0 261774 0 55182 0 0 0 13769 0 22965 0 353690 0 0 COLLIN FOULDS VP, GENERAL COUNSEL 0 247388 0 53877 0 0 0 17906 0 30431 0 349602 0 0 STEPHEN SWANSON VP, INFORMATION TECHNOLOGY 0 253564 0 54244 0 0 0 18300 0 23216 0 349324 0 0 PART I, LINE 3 THE CHPW CEO COMPENSATION IS SET BY THE EXECUTIVE COMMITTEE OF THE CHPW BOARD OF DIRECTORS BASED UPON INDEPENDENT THIRD PARTY COMPENSATION INFORMATION AND PROFESSIONAL OPINION. PART I, LINE 7 CERTAIN INDIVIDUALS RECEIVE NON-FIXED PAYMENTS DETERMINED IN PART BY THE CHPW BOARD-APPROVED STRATEGIC PLAN. SCHEDULE J, PART I, LINE 3 SUPPLEMENTAL COMPENSATION INFORMATION THE CEO OF THE ORGANIZATION IS NOT PAID BY THE FILING ORGANIZATION. SEE SCHEDULE O DISCLOSURE FOR FORM 990, PART VI, LINE 15 FOR THE PROCESS USED BY COMMUNITY HEALTH PLAN OF WASHINGTON, A RELATED TAX - EXEMPT ORGANIZATION, TO DETERMINE EXECUTIVE COMPENSATION. FORM 990, PART VI, SECTION A, LINE 6 THE ORGANIZATION HAS 21 CORPORATE MEMBERS. EACH CORPORATE MEMBER IS A 501(C)(3) FEDERALLY QUALIFIED HEALTHCARE CENTER (FQHC). FORM 990, PART VI, SECTION A, LINE 7A ALL 21 NETWORK MEMBERS ARE ELIGIBLE TO APPOINT THEIR CEO, EXECUTIVE DIRECTOR, OR ANOTHER SENIOR EXECUTIVE TO SERVE ON THE COMMUNITY HEALTH NETWORK OF WASHINGTON (CHNW) BOARD. CURRENTLY 21 CEOS/EXECUTIVE DIRECTORS/SENIOR EXECUTIVES ARE SERVING ON THE CHNW BOARD. THE CHNW BOARD ALSO ELECTS THREE (3) INDEPENDENT BOARD MEMBERS AND A MEDICAL DIRECTOR FROM ONE OF THE NETWORK MEMBERS THAT SERVE ON THE BOARD. FORM 990, PART VI, SECTION A, LINE 7B THE FOLLOWING ACTIONS ARE RESERVED TO THE MEMBERS OF THE COMMUNITY HEALTH NETWORK OF WASHINGTON (CHNW): A) AMENDMENT TO THE ARTICLES OF INCORPORATION OF EITHER CHNW OR COMMUNITY HEALTH PLAN OF WASHINGTON (CHPW); B) AMENDMENT TO THE BYLAWS OF EITHER CHNW OR CHPW; C) REMOVAL OF ONE OR MORE DIRECTORS FROM THE BOARD OF EITHER CHNW OR CHPW; D) REMOVAL OF A MEMBER; E) APPROVAL OF ARTICLES OF MERGER INVOLVING CHNW OR CHPW; F) APPROVAL OF THE SALE OR LEASE OF ALL OR SUBSTANTIALLY ALL OF THE ASSETS OF CHNW OR CHPW OTHER THAN IN THE ORDINARY COURSE OF BUSINESS; G) APPROVAL OF THE VOLUNTARY DISSOLUTION OF CHNW AND/OR CHPW; AND H) CHANGES TO THE CRITERIA FOR ADMISSION OF NEW CHNW MEMBERS. FORM 990, PART VI, SECTION B, LINE 11B THE 990, INCLUDING ALL REQUIRED SCHEDULES, IS REVIEWED BY THE VP OF FINANCE, CHIEF FINANCE AND STRATEGY OFFICER, AND CHIEF EXECUTIVE OFFICER. THE CHIEF FINANCE AND STRATEGY OFFICER THEN PROVIDES THE 990 TO THE CHNW FINANCE COMMITTEE AND THE CHNW BOARD OF DIRECTORS FOR REVIEW BEFORE IT IS FILED WITH THE INTERNAL REVENUE SERVICE. FORM 990, PART VI, SECTION B, LINE 12C ALL BOARD MEMBERS, CORPORATE OFFICERS, AND EMPLOYEES AT THE DIRECTOR LEVEL AND ABOVE ARE REQUIRED TO ANNUALLY DISCLOSE POTENTIAL CONFLICTS OF INTEREST. WITH RESPECT TO BOARD MEMBERS, POTENTIAL CONFLICTS ARE DISCLOSED PRIOR TO DELIBERATION; IF AN ACTUAL CONFLICT EXISTS, THE INDIVIDUAL WITH THE CONFLICT WILL NOT PARTICIPATE AND IS ASKED TO LEAVE THE MEETING DURING FINAL DELIBERATION AND VOTE. WITH RESPECT TO EMPLOYEES, INCLUDING CORPORATE OFFICERS AND EMPLOYEES AT THE DIRECTOR LEVEL AND ABOVE, POTENTIAL CONFLICTS ARE GOVERNED BY THE ORGANIZATION'S CONFLICT OF INTEREST POLICY; ACTUAL OR POTENTIAL CONFLICTS MUST BE DISCLOSED TO THE HUMAN RESOURCES DEPARTMENT OR A CORPORATE OFFICER. THE COMPLIANCE OFFICER, IN COOPERATION WITH HUMAN RESOURCES, WILL REVIEW THE CONFLICT AND ADVISE THE EMPLOYEE WITH A POTENTIAL CONFLICT CONCERNING ANY LIMITATIONS THEY MUST OBSERVE IN REGARDS TO THE CONFLICT OF INTEREST. FORM 990, PART VI, SECTION B, LINE 15 THE ORGANIZATION'S CEO AND OTHER OFFICERS AND KEY EMPLOYEES ARE NOT PAID BY THE FILING ORGANIZATION. SEE SCHEDULE O DISCLOSURE FOR FORM 990, PART VI, LINE 15 FOR THE PROCESS USED BY COMMUNITY HEALTH PLAN OF WASHINGTON, A RELATED TAX-EXEMPT ORGANZIATION, TO DETERMINE EXECUTIVE COMPENSATION. FORM 990, PART VI, SECTION C, LINE 19 COPIES OF GOVERNANCE DOCUMENTS, THE CONFLICT OF INTEREST POLICY, AND FINANCIAL STATEMENTS ARE AVAILABLE BY REQUEST MADE TO THE CORPORATE OFFICES AT 1111 3RD AVENUE SUITE 400, SEATTLE, WA 98101 OR BY FAXING A REQUEST TO (206) 521-8834. FORM 990, PART VII: ALL EMPLOYEES ARE PAID THROUGH COMMUNITY HEALTH PLAN OF WASHINGTON (CHPW). SALARIES REPORTED AS EXPENSES ON THE NETWORK'S STATEMENT OF FUNCTIONAL EXPENSES ARE REPORTED THROUGH CHPW AS A COMMON PAYMASTER. THE FOLLOWING INDIVIDUALS SERVE ON THE BOARD OF COMMUNITY HEALTH NETWORK OF WASHINGTON (CHNW) IN CONNECTION WITH THEIR ROLES AS THE CEO, EXECUTIVE DIRECTOR, OR OTHER SENIOR EXECUTIVE OF THE TAX-EXEMPT COMMUNITY HEALTH CENTER OR CLINIC (CHC) MEMBERS OF COMMUNITY HEALTH NETWORK OF WASHINGTON. THESE INDIVIDUALS DO NOT RECEIVE COMPENSATION FOR THEIR BOARD SERVICE; HOWEVER, CHNW PAYS THEIR RESPECTIVE CHC A STIPEND FOR SERVICES ON BOARD COMMITTEES AND REIMBURSEMENT FOR TRAVEL EXPENSES. - JOSEPH EUGENE VESSEY - RHONDA DIANE HAUFF - AARON GABRIEL WILSON - SHEILA ANN BERSCHAUER - REGINA BONNEVIE ROGERS - JAMES KENNETH COFFEE - RASHAD ALI COLLINS - DAVID ELDOR FLENTGE - JEFFREY SPENCER GIBBS - ANGELA MARIA GONZALEZ - JESUS HERNANDEZ - JODI SUE JOYCE - JENNIFER LYNN KREIDLER-MOSS - MICHAEL SCOTT MAXWELL - MANUEL IGNACIO NAVARRO - KRISTY NEEDHAM - KELLI ANN NOMURA - GAELON BROOK SPRADLEY - DESIREE LYN SWEENEY - BRANDY DIANE TAYLOR - CHRISTINE SUE TROTTER - LISA CORRINE YOHALEM - TERESITA IGNACIO BATAYOLA - DAVID RUSSELL OLSON - MEREDITH ELIZABETH VAUGHAN - JAMES MICHAEL MERRILL FORM 990, PART XI, LINE 9: CHANGE IN NONADMITTED ASSETS -37,694. COMMUNITY HEALTH PLAN OF WASHINGTON 1111 3RD AVENUE SUITE 400 SEATTLE WA 98101 911729710 HEALTHCARE WA 501(C)(4) CHNW 1 0 0 0 0 0 0 0 0 0 0 0 1 0 1 1 1 1 1 1 COMMUNITY HEALTH PLAN OF WASHINGTON L 10420081 FMV COMMUNITY HEALTH PLAN OF WASHINGTON N 347918 FMV COMMUNITY HEALTH PLAN OF WASHINGTON O 8758838 FMV COMMUNITY HEALTH PLAN OF WASHINGTON P 20542954 FMV COMMUNITY HEALTH PLAN OF WASHINGTON Q 20542954 FMV COMMUNITY HEALTH PLAN OF WASHINGTON R 212137703 FMV COMMUNITY HEALTH PLAN OF WASHINGTON S 293308207 FMV