2024-11-11T12:26:39-06:00 2023-12-31 861065722 DELOITTE TAX LLP 50 SOUTH SIXTH STREET MINNEAPOLIS MN 55402 990 2023-01-01 872944493 SCAN HEALTH PLAN TEXAS INC SCAN 5629895100 3800 KILROY AIRPORT WAY 100 LONG BEACH CA 90806 KAREN SCHULTE PRESIDENT 5629895100 2024-11-11 1 0 ANNA KOLAKALURI P01275237 6123974000 2023 2024-10-15 13:58:12Z X KAREN SCHULTE 3800 KILROY AIRPORT WAY 100 LONG BEACH CA 90806 5622742 0 X WWW.SCANHEALTHPLAN.COM X 2021 TX KEEPING SENIORS HEALTHY AND INDEPENDENT 4 0 0 0 0 0 4500000 3900000 0 1719661 2172 3081 0 0 4502172 5622742 75000 85000 0 0 119489 540605 0 0 0 3503765 4508902 3698254 5134507 803918 488235 3686143 5009427 1286043 2119739 2400100 2889688 KEEPING SENIORS HEALTHY AND INDEPENDENT 0 0 4532549 85000 1719661 HEALTH CARE SERVICESAS A MEDICARE ADVANTAGE AND PRESCRIPTION DRUG PLAN (MAPD) IN TEXAS, SCAN HEALTH PLAN TEXAS COLLABORATES WITH A NETWORK OF DELEGATED AND NON-DELEGATED PROVIDERS TO OFFER MEDICARE COVERED HEALTH CARE AND BEHAVIORAL HEALTHCARE AND ADDITIONAL SUPPLEMENTAL BENEFITS. OUR MEMBER-CENTRIC MODEL OF CARE ENSURES QUALITY, INDIVIDUALIZED CARE FOR ALL MEMBERS, INCLUDING MEMBERS WITH CHRONIC CONDITIONS AND FRAIL MEMBERS WITH FUNCTIONAL DEFICITS. 4532549 0 1 0 0 0 0 0 0 0 0 0 0 0 1 1 1 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 33 0 1 0 0 0 0 0 0 0 0 0 X 4 0 0 0 0 0 1 0 0 1 1 0 0 1 1 1 1 1 1 0 0 0 TX X VIRGINIA HAVAI 5629895100 3800 KILROY AIRPORT WAY SUITE 100 LONG BEACH CA 908065616 JAIN MD SACHIN H CHIEF EXECUTIVE OFFICER 1.00 39.00 X X 0 3268166 1554958 PLUMB MICHAEL CHIEF FINANCIAL OFFICER 1.00 39.00 X X 0 1101248 666170 STANISLAW SHERRY GENERAL MANAGER OFFICER (END 06/2023) 1.00 39.00 X X 0 1246301 32580 SCHULTE KAREN H PRESIDENT, MEDICARE (BEG 12/2022) 1.00 39.00 X X 0 740787 486465 KROEKER KEVIN B SPECIAL COUNSEL (END 07/2023) 1.00 39.00 X X 0 1017186 51046 DELPHIN-RODRIGUEZ RENEE C CHIEF LEGAL OFFICER & GC (BEG 3/23) 1.00 39.00 X X 0 435053 374248 HAMMASH MUHANNAD CVP, CORP MEDICAL DIRECTOR 2.00 38.00 X 0 603415 215012 HAVAI VIRGINIA A VP CONTROLLER 1.00 39.00 X 0 526736 194989 LEUNG KWAN-MOON SVP, CHIEF DATA OFFICER 2.00 38.00 X 0 790378 290566 SELBY JILL V SVP PRODUCT DEV & MKT EXP 0.50 39.50 X 0 591867 57440 BLEA MICHAEL CVP, CHIEF GROWTH OFFICER (BEG 02/2023) 2.00 38.00 X 0 416368 145644 HAWKINS GINETTE SVP, CHIEF RISK OFFICER 1.00 39.00 X 0 420404 95275 0 11157909 4164393 0 0 1 0 INTEGRANET PHYSICIAN RESOURCE INC DBA 2900 NORTH LOOP WEST SUITE 700 HOUSTON TX 77092 HEALTHCARE SERVICES 1004105 EXPRESS SCRIPTS INC ONE EXPRESS WAY ST LOUIS MO 63121 HEALTHCARE SERVICES 500768 PROSPECT HEALTH SERVICES TX INC 600 CITY PKWY WEST SUITE 1000 ORANGE CA 92868 HEALTHCARE SERVICES 238799 MINER BUTCHER MEDIA GROUP LLC 11150 W OLYMPIC BLVD LOS ANGELES CA 90064 MARKETING SERVICES 151558 4 3900000 3900000 MEDICARE PREMIUMS 900099 1719661 1719661 1719661 3081 3081 5622742 1719661 0 3081 X 85000 85000 316803 183746 133057 135459 135459 27378 10881 16497 33817 20133 13684 27148 11292 15856 27517 27517 68742 68742 2559875 2459709 100166 1585475 1585163 312 18323 17129 1194 70156 29743 40413 31600 22270 9330 43914 32923 10991 2161 1182 979 13 13 6148 4488 1660 2386 221 2165 BROKER COMMISSIONS 60393 60393 DUES AND SUBSCRIPTIONS 18862 388 18474 OTHER 11046 7243 3803 FEDERAL, STATE, COUNTY 2291 645 1646 5134507 4532549 601958 0 -25500 -8533 3597637 4698540 572 155802 9493 2461 103941 161157 3686143 5009427 1286043 2079728 269 0 39742 1286043 2119739 X 2400100 2889688 2400100 2889688 3686143 5009427 488235 1353 0 X 0 1 X 1 0 RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED 0 ROU LEASE LIABILITY 39742 39742 X 1719661 0 1719661 3903081 3903081 5622742 4351181 -783326 -783326 5134507 0 5134507 PART X, LINE 2: UNDER FASB ASC 740, INCOME TAXES, THE COMPANY IS REQUIRED TO RECOGNIZE A LIABILITY FOR EACH UNCERTAIN TAX POSITION AT THE AMOUNT ESTIMATED TO BE REQUIRED TO SETTLE THE ISSUES. AS OF DECEMBER 31, 2023, THERE WERE NO LIABILITIES RECORDED FOR UNCERTAIN TAX POSITIONS. PART XI, LINE 4B - OTHER ADJUSTMENTS: CONTRIBUTION FROM SCAN GROUP 3,900,000. INVESTMENT INCOME 3,081. STATUTORY-BASIS AUDITED FINANCIAL STATEMENTS THE 2023 STATUTORY-BASIS AUDITED FINANCIAL STATEMENTS ARE PRESENTED ON THE BASIS OF ACCOUNTING PRACTICES PRESCRIBED OR PERMITTED BY THE NATIONAL ASSOCIATION OF INSURANCE COMMISSIONERS (NAIC) AND THE TEXAS DEPARTMENT OF INSURANCE (DOI). 1 BAKERRIPLEY 4450 HARRISBURG BLVD STE 200 HOUSTON TX 77011 237062976 501(C)(3) 30000 0 GRANT TO SUPPORT PROGRAMMING AT THE ALIEF SENIOR CENTER SERVING DIVERSE COMMUNITIES. BOAT PEOPLE SOS - HOUSTON 11360 BELLAIRE BLVD SUITE 910 HOUSTON TX 77072 454040991 501(C)(3) 10000 0 GRANT TO SUPPORT SENIOR SERVICES PROGRAM TO REDUCE BARRIERS TO SERVICES AND SOCIAL SUPPORTS FOR VIETNAMESE ADULTS (AGE 55+). HOUSE OF NEIGHBORLY SERVICE 407 N CALAVERAS SAN ANTONIO TX 78207 741153442 501(C)(3) 15000 0 GRANT TO SUPPORT CULTURALLY PREFERRED MEALS FOR OLDER ADULTS. THE MONTROSE CENTER 401 BRANARD ST 2ND FLOOR HOUSTON TX 77006 742050245 501(C)(3) 25000 0 GRANT TO SUPPORT SENIOR EMERGENCY FOOD PANTRY FOR LOW-INCOME OLDER ADULTS IN THE LGBTQ+ COMMUNITY. 4 PART I, LINE 2: ALL GRANTEES SUBMIT IMPACT REPORTS DOCUMENTING METRICS AND PERFORMANCE YEAR-TO-DATE THROUGHOUT THE DURATION OF THE FUNDING, COMMUNITY GIVING STAFF, TRACK AND REVIEW THE REPORTS TO ENSURE COMPLIANCE. COMMUNITY GIVING STAFF ADDRESSES ANY IDENTIFIED ISSUES WITH THE GRANTEE TO DETERMINE CAUSES AND ANY REMEDIATION REQUIRED. ISSUES WITH COMPLIANCE ARE RAISED TO DIRECTOR, COMMUNITY GIVING, WHO WILL ASSIST WITH REMEDIATION OR ELEVATE TO THE COMMUNITY GIVING COMMITTEE (CGC) FOR ADVISEMENT AND/OR APPROVAL IF A CHANGE TO THE GRANTEE'S SCOPE OF WORK IS REQUIRED. 1 1 0 0 0 0 0 0 0 JAIN MD SACHIN H CHIEF EXECUTIVE OFFICER 0 1021668 0 2245658 0 840 0 1538636 0 16322 0 4823124 0 1761300 PLUMB MICHAEL CHIEF FINANCIAL OFFICER 0 586926 0 489890 0 24432 0 638903 0 27267 0 1767418 0 489890 STANISLAW SHERRY GENERAL MANAGER OFFICER (END 06/2023 0 257416 0 531893 0 456992 0 23100 0 9480 0 1278881 0 327446 SCHULTE KAREN H PRESIDENT, MEDICARE (BEG 12/2022) 0 497800 0 218656 0 24331 0 467408 0 19057 0 1227252 0 218656 LEUNG KWAN-MOON SVP, CHIEF DATA OFFICER 0 453115 0 262304 0 74959 0 287864 0 2702 0 1080944 0 311151 KROEKER KEVIN B SPECIAL COUNSEL (END 07/2023) 0 331937 0 591206 0 94043 0 33230 0 17816 0 1068232 0 493571 HAMMASH MUHANNAD CVP, CORP MEDICAL DIRECTOR 0 416000 0 162983 0 24432 0 206650 0 8362 0 818427 0 162983 DELPHIN-RODRIGUEZ RENEE C CHIEF LEGAL OFFICER & GC (BEG 3/23) 0 411923 0 0 0 23130 0 372844 0 1404 0 809301 0 0 HAVAI VIRGINIA A VP CONTROLLER 0 316596 0 182979 0 27161 0 157650 0 37339 0 721725 0 132979 SELBY JILL V SVP PRODUCT DEV & MKT EXP 0 358023 0 207987 0 25857 0 37220 0 20220 0 649307 0 207987 BLEA MICHAEL CVP, CHIEF GROWTH OFFICER (BEG 02/20 0 301508 0 100000 0 14860 0 115086 0 30558 0 562012 0 0 HAWKINS GINETTE SVP, CHIEF RISK OFFICER 0 290769 0 120632 0 9003 0 84956 0 10319 0 515679 0 120632 PART I, LINE 3 COMPENSATION FOR KAREN SCHULTE (PRESIDENT MEDICARE-SCAN HEALTH PLAN TEXAS) WAS ESTABLISHED BY A RELATED ORGANIZATION, SCAN GROUP, AND PAID BY SCAN HEALTH PLAN. SCAN GROUP USED THE FOLLOWING TO ESTABLISH THE PRESIDENT'S COMPENSATION: 1) COMPENSATION COMMITTEE; 2) INDEPENDENT COMPENSATION CONSULTANT; 3) COMPENSATION SURVEY OR STUDY; 4) APPROVAL BY THE SCAN HEALTH PLAN CEO AND SCAN GROUP BOARD OF DIRECTORS. PART I, LINES 4A-B PART I, LINES 4A DURING 2023, THE EMPLOYMENT RELATIONSHIP OF THE FOLLOWING EMPLOYEES OF SCAN GROUP AND SCAN HEALTH PLAN ENDED. IN CONNECTION WITH THE TERMINATION OF EMPLOYMENT, SCAN GROUP AND SCAN HEALTH PLAN NEGOTIATED AND PAID SEVERANCE TO THE EMPLOYEES. SHERRY STANISLAW - $ 401,782 PART I, LINE 4B: SCAN GROUP AND SCAN HEALTH PLAN PROVIDE A SUPPLEMENTAL NON-QUALIFIED RETIREMENT PLAN TO OFFICERS AND SENIOR VICE PRESIDENTS VIA ITS SECTION 457(F) PLAN. FOR CONTRIBUTIONS MADE PRIOR TO DECEMBER 31, 2017, A PARTICIPANT BECOMES VESTED IN THE 457(F) PLAN UPON COMPLETION OF ONE OF THE CHOSEN VESTING OPTIONS: 1) FIVE YEARS OF SERVICE AND 62 YEARS OF AGE OR 2) CONTRIBUTIONS MADE ON OR AFTER THAT DATE, A PARTICIPANT BECOMES VESTED IN NON-QUALIFIED PLAN PAYMENTS WERE MADE DURING THE YEAR TO THE FOLLOWING 10 YEARS OF SERVICE. ON JANUARY 1, 2018, A NEW PLAN WAS ADOPTED, FOR THE 457(F) PLAN FOLLOWING A 4 YEAR CLASS VESTING CYCLE. SUPPLEMENTAL LISTED PERSONS IN PART VII: SHERRY STANISLAW - $ 27,376 KEVIN KROEKER - $ 68,078 KWAN-MOON LEUNG - $ 48,847 DEFERRED COMPENSATION FOR 2023, REPORTED ON SCHEDULE J, PART 11, COLUMN B AND COLUMN C CONSISTS OF THE FOLLOWING: 1) 457(F) EMPLOYER CONTRIBUTIONS ARE SUBJECT TO VESTING TERMS AND CONDITIONS AS NOTED IN THE PLAN DOCUMENTS. BASED ON THESE VESTING TERMS AND CONDITIONS, THERE IS SUBSTANTIAL RISK OF FORFEITURE. 2) 457(B) IS A DEFERRED COMPENSATION PLAN THAT THE EMPLOYER AND EMPLOYEE CONTRIBUTE TO, UP TO THE SCAN GROUP AND SCAN HEALTH PLAN'S DEFINED AND IRS ANNUAL LIMITS. 3) 401(K) QUALIFIED RETIREMENT PLAN CONTRIBUTIONS (EMPLOYER MATCH AND SAFE HARBOR), UP TO THE IRS ANNUAL LIMITS. 4) SCAN GROUP AND SCAN HEALTH PLAN PROVIDE AN INCENTIVE PLAN TO VICE PRESIDENTS AND ABOVE. THE INCENTIVE PLAN IS BASED ON ORGANIZATION AND INDIVIDUAL PERFORMANCE METRICS. PAYMENTS ARE MADE ON OR AROUND APRIL 1 OF THE SUBSEQUENT CALENDAR YEAR. SCHEDULE J CEO COMPENSATION IT IS IMPORTANT TO NOTE THAT SCHEDULE J REFLECTS ALL COMPENSATION THAT THE CEO "EARNED" IN 2023, WHICH INCLUDES INCENTIVE PAYMENTS RELATED TO 2023 THAT WILL BE PAID IN SUBSEQUENT YEARS AND UNVESTED RETIREMENT BENEFITS. SCHEDULE J ALSO INCLUDES COMPENSATION THAT THE CEO "EARNED" IN 2022 THAT WAS PAID IN 2023. FOR AVOIDANCE OF CONFUSION, THE CEO WAS PAID $3,268,166 IN 2023 [COLUMNS (B)(I), (B)(II), (B)(III)], OF WHICH $1,761,300 WAS "EARNED" IN 2022 [COLUMN (F)] AND PAID IN 2023. THE CEO'S "EARNED" COMPENSATION FOR 2023 IS EQUAL TO ROUGHLY $3,061,824, WHICH REPRESENTS COLUMN (E) MINUS COLUMN (F), SINCE COLUMN (F) IS COMPENSATION EARNED IN A PREVIOUS YEAR AND INCLUDED IN A PREVIOUS 990. FORM 990, PART VI, SECTION A, LINE 6 THE SOLE MEMBER OF THE ORGANIZATION IS SCAN GROUP, A CALIFORNIA NONPROFIT PUBLIC BENEFIT CORPORATION. FORM 990, PART VI, SECTION B, LINE 11B THE FORM 990 IS PREPARED BY THE ACCOUNTING FIRM OF DELOITTE TAX, LLP WORKING IN CONJUNCTION WITH SCAN'S FINANCE DEPARTMENT. SCAN HEALTH PLAN'S DIRECTOR OF ACCOUNTING HAS DIRECT RESPONSIBILITY FOR THIS EFFORT, SUBJECT TO SUPERVISION BY THE VICE PRESIDENT AND CONTROLLER OF SCAN HEALTH PLAN. AFTER AN INITIAL DRAFT OF THE FORM 990 IS PREPARED, IT IS CIRCULATED FOR REVIEW AND COMMENT BY RELEVANT MEMBERS OF THE EXECUTIVE TEAM WHO HAVE RESPONSIBILITY FOR AND/OR KNOWLEDGE REGARDING THE VARIOUS MATTERS DISCLOSED AND/OR DESCRIBED IN THE FORM. THE GENERAL COUNSEL, IN PARTICULAR, REVIEWS THE FORM 990 FOR ACCURACY AND COMPLETENESS. THE FORM 990 IS PROVIDED TO THE SCAN HEALTH PLAN TEXAS BOARD FOR REVIEW AFTER IT IS PREPARED, BUT PRIOR TO FILING. FORM 990, PART VI, SECTION B, LINE 12C DURING 2023, SCAN HEALTH PLAN TEXAS BOARD OF DIRECTORS OFFICIALLY ADOPTED THE SCAN HEALTH PLAN CONFLICT OF INTEREST POLICY AND ARE REQUIRED TO COMPLY WITH ITS TERMS. SCAN HEALTH PLAN TEXAS HAD UNOFFICIALLY BEEN FOLLOWING THE POLICY SINCE ITS INCEPTION. SCAN HEALTH PLAN TEXAS FOLLOWS SCAN HEALTH PLAN'S CONFLICT OF INTEREST PROCESS. A DESCRIPTION OF THE PROCESS IS AS FOLLOWS: SCAN HEALTH PLAN REGULARLY AND CONSISTENTLY MONITORS AND ENFORCES COMPLIANCE WITH ITS CONFLICT OF INTEREST POLICY THROUGH ANNUAL CIRCULATION OF A CONFLICT OF INTEREST POLICY AND DISCLOSURE QUESTIONNAIRE WHICH ALL MEMBERS OF THE BOARD OF DIRECTORS, OFFICERS AND MEMBERS OF EXECUTIVE MANAGEMENT OF EVERY ENTITY UNDER SCAN GROUP ARE REQUIRED TO COMPLETE AND SIGN. IN ADDITION, THERE IS ANNUAL MANDATORY COMPLIANCE EDUCATION AND TRAINING AND SCAN'S COMPLIANCE DEPARTMENT IS RESPONSIBLE FOR ENFORCEMENT OF SCAN'S ROBUST COMPLIANCE PROGRAM, INCLUDING SCAN'S CODE OF CONDUCT AND COMPLIANCE-RELATED POLICIES AND PROCEDURES. MEMBERS OF ALL THE EXECUTIVE TEAMS ALSO HAVE RESPONSIBILITY FOR ENFORCEMENT. THE LEGAL DEPARTMENT OF SCAN GROUP REVIEWS ALL CONTRACTUAL RELATIONSHIPS ENTERED INTO BY THE ORGANIZATION AND GENERAL COUNSEL IS RESPONSIBLE FOR MONITORING THE CONFLICT OF INTEREST QUESTIONNAIRE. THE LEGAL DEPARTMENT OF SCAN GROUP MONITORS AND ENFORCES ADHERENCE TO THESE POLICIES ON AN ONGOING BASIS. FORM 990, PART VI, SECTION B, LINE 15 THE PROCESS FOR DETERMINING COMPENSATION FOR KAREN SCHULTE (PRESIDENT SCAN HEALTH PLAN TEXAS), OFFICERS AND SENIOR VICE PRESIDENT OF SCAN HEALTH PLAN TEXAS IS CONDUCTED BY THE HUMAN RESOURCES DEPARTMENT OF SCAN GROUP AND CHIEF EXECUTIVE OFFICER (CEO) OF SCAN HEALTH PLAN, WITH THE APPROVAL OF THE COMPENSATION COMMITTEE OF THE BOARD OF DIRECTORS OF SCAN GROUP. ALL OF THE VOTING MEMBERS OF THE COMPENSATION COMMITTEE ARE INDEPENDENT DIRECTORS. IN DETERMINING EACH EMPLOYEE'S COMPENSATION, THE HUMAN RESOURCES DEPARTMENT AND COMPENSATION COMMITTEE WORK WITH AND RELY UPON THE COUNSEL AND EXPERTISE OF AN OUTSIDE COMPENSATION CONSULTANT WITH WELL-ESTABLISHED EXPERIENCE AND EXPERTISE IN THE AREA OF NONPROFIT HEALTH CARE ORGANIZATIONS, EXECUTIVE COMPENSATION, AND COMPLIANCE WITH THE INTERMEDIATE SANCTIONS REQUIREMENTS APPLICABLE TO SUCH COMPENSATION. THE COMPENSATION CONSULTANT PROVIDES AN EXECUTIVE COMPENSATION REPORT TO THE HUMAN RESOURCES DEPARTMENT EACH YEAR WHICH FURNISHES THE BASIS FOR THE DETERMINATION OF EACH EMPLOYEE'S COMPENSATION PACKAGE DURING THE FOLLOWING YEAR. THE EXECUTIVE COMPENSATION REPORT IS BASED ON A REVIEW OF THE EXECUTIVE COMPENSATION PRACTICES OF A VARIETY OF ORGANIZATIONS CONSIDERED COMPARABLE TO SCAN HEALTH PLAN BASED ON VARIOUS METRICS. THE CHIEF EXECUTIVE OFFICER (CEO) MAKES A RECOMMENDATION TO THE COMPENSATION COMMITTEE WITH RESPECT TO EACH EMPLOYEE'S COMPENSATION PACKAGE IN LIGHT OF THE EXECUTIVE COMPENSATION REPORT. AT THE COMPENSATION COMMITTEE MEETING ADDRESSING SUCH MATTERS, QUESTIONS ARE ASKED OF, AND ANSWERED BY, THE COMPENSATION CONSULTANT, REGARDING THEIR REPORT AND OTHER MATTERS RELEVANT TO THE COMPENSATION PACKAGE; PURSUANT TO THEIR DELIBERATIONS, THE COMPENSATION COMMITTEE MAKES A DECISION REGARDING THE COMPENSATION PACKAGE FOR SUCH EMPLOYEES FOR THE FOLLOWING YEAR. THE MINUTES OF THE COMPENSATION COMMITTEE FOR THIS MEETING ARE PREPARED SUBSTANTIALLY CONTEMPORANEOUSLY AND SUBSTANTIATE SUCH DELIBERATION AND DECISIONS. THE OUTSIDE COMPENSATION CONSULTANT PROVIDING THE EXECUTIVE COMPENSATION REPORT AND GUIDANCE RELATED TO THE 2023 SALARY PACKAGE WAS SULLIVAN COTTER. FORM 990, PART VI, SECTION C, LINE 19 SCAN HEALTH PLAN TEXAS, INC'S GOVERNING DOCUMENTS AND CONFLICT OF INTEREST POLICY WERE NOT MADE AVAILABLE TO THE PUBLIC. SCAN HEALTH PLAN TEXAS, INC FILED THE 2023 AUDITED STATUTORY-BASIS FINANCIAL STATEMENTS WITH THE TEXAS DEPARTMENT OF INSURANCE (DOI). SCAN HEALTH PLAN TEXAS, INC'S TAX RETURNS ARE AVAILABLE UPON REQUEST. FORM 990, PART VI, SECTION B, LINE 13 AND 14 SCAN HEALTH PLAN TEXAS ADOPTED THE FOLLOWING POLICIES OF SCAN GROUP: WHISTLEBLOWER POLICY, DOCUMENT RETENTION, AND DESTRUCTION POLICY. FORM 990, PART IX, LINE 11G PREMIUM DEFICIENCY RESERVE: PROGRAM SERVICE EXPENSES 494,532. MANAGEMENT AND GENERAL EXPENSES 0. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 494,532. OUTSIDE SERVICES: PROGRAM SERVICE EXPENSES 1,965,177. MANAGEMENT AND GENERAL EXPENSES 100,166. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 2,065,343. SCAN GROUP 3800 KILROY AIRPORT WAY SUITE 100 LONG BEACH CA 90806 953826037 ADMIN SUPPORT CA 501(C)(3) 12B, II N/A 0 THE SCAN FOUNDATION 3800 KILROY AIRPORT WAY SUITE 100 LONG BEACH CA 90806 450552845 GRANT MAKING CA 501(C)(3) 12B, II SCAN GROUP 1 SCAN HEALTH PLAN 3800 KILROY AIRPORT WAY SUITE 100 LONG BEACH CA 90806 953858259 MEDICARE ADVANTAGE CA 501(C)(3) 10 SCAN GROUP 1 SCAN HEALTH PLAN NEVADA INC 3800 KILROY AIRPORT WAY SUITE 100 LONG BEACH CA 90806 854288083 MEDICARE ADVANTAGE NV 501(C)(4) SCAN GROUP 1 SCAN DESERT HEALTH PLAN INC 3800 KILROY AIRPORT WAY SUITE 100 LONG BEACH CA 90806 854275186 MEDICARE ADVANTAGE AZ 501(C)(4) SCAN GROUP 1 HEALTHCARE IN ACTION 3800 KILROY AIRPORT WAY SUITE 100 LONG BEACH CA 90806 871858798 MEDICARE ADVANTAGE CA 501(C)(3) 10 SCAN GROUP 1 SCAN HEALTH PLAN NEW MEXICO INC 3800 KILROY AIRPORT WAY SUITE 100 LONG BEACH CA 90806 920651838 MEDICARE ADVANTAGE NM 501(C)(4) SCAN GROUP 1 RESIDENTIALIST HOUSECALL LLC 4190 CITY AVE STE 528 PHILADELPHIA PA 19131 474320252 HEALTHCARE PA N/A 0 0 SCAN HEALTHCHECK ASSESSMENT CENTERS INC 3800 KILROY AIRPORT WAY SUITE 100 LONG BEACH CA 90806 462962358 HEALTHCARE CA N/A C 1 HEALTHCARE IN ACTION MEDICAL GROUP 3800 KILROY AIRPORT WAY SUITE 100 LONG BEACH CA 90806 871942811 HEALTHCARE CA N/A C 1 WELCOME HEALTH INC 3800 KILROY AIRPORT WAY SUITE 100 LONG BEACH CA 90806 863730275 MANAGEMENT CA N/A C 1 WELCOME HEALTH MEDICAL GROUP 3800 KILROY AIRPORT WAY SUITE 100 LONG BEACH CA 90806 872705807 HEALTHCARE CA N/A C 1 WELCOME HEALTH OF CALIFORNIA INC 3800 KILROY AIRPORT WAY SUITE 100 LONG BEACH CA 90806 920363899 HEALTHCARE CA N/A C 1 THE RESIDENTIALIST GROUP INC 3800 KILROY AIRPORT WAY SUITE 100 LONG BEACH CA 90806 330969912 MANAGEMENT CA N/A C 1 HOUSECALLS DOCTORS MEDICAL GROUP INC 3800 KILROY AIRPORT WAY SUITE 100 LONG BEACH CA 90806 043644245 HEALTHCARE CA N/A C 1 RESIDENTIALIST HOUSECALL MEDICAL GROUP PC 4190 CITY AVE SUITE 528 PHILADELPHIA PA 19131 474053626 HEALTHCARE PA N/A C 1 PROSPER SERVICES LLC 3800 KILROY AIRPORT WAY SUITE 100 LONG BEACH CA 90806 872979343 MANAGEMENT DE N/A C 1 MYPLACE GREATER LA PACE INC 3800 KILROY AIRPORT WAY SUITE 100 LONG BEACH CA 90806 881512241 HEALTHCARE CA N/A C 1 MYPLACE SOUTH LA PACE INC 3800 KILROY AIRPORT WAY SUITE 100 LONG BEACH CA 90806 923486437 HEALTHCARE CA N/A C 1 MYPLACE CARE PARTNERS PC 121 S MOUNTAIN VIEW AVE LOS ANGELES CA 90057 932403550 HEALTHCARE CA N/A C 1 SCAN CALIFORNIA MANAGEMENT COMPANY 3800 KILROY AIRPORT WAY SUITE 100 LONG BEACH CA 90806 462951831 MANAGEMENT CA N/A C 1 PREVENT TRG HOLDINGS INC 3800 KILROY AIRPORT WAY SUITE 100 LONG BEACH CA 90806 880965994 MANAGEMENT DE N/A C 1 0 0 1 0 0 0 0 0 0 0 0 0 0 0 0 1 1 0 0 SCAN GROUP C 3900000 BOOK VALUE SCAN GROUP P 346551 BOOK VALUE SCAN HEALTH PLAN P 1713525 BOOK VALUE PART V, LINE 2: THE PERCENTAGE OF ALLOCATION TO AFFILIATED COMPANIES IS DETERMINED BASED ON ESTIMATED PERCENTAGE OF TIME WORKED, PERCENTAGE OF HEADCOUNTS, PERCENTAGE OF SCAN MEMBERSHIP, AND/OR THE PERCENTAGE OF BID SUBMISSION, AS APPROPRIATE BASED ON THE NATURE OF THE EXPENSE.