Schedule J
(Form 990)
Department of the Treasury
Internal Revenue Service
Compensation Information
For certain Officers, Directors, Trustees, Key Employees, and Highest
Compensated Employees
SchJMediumBullet Complete if the organization answered "Yes" on Form 990, Part IV, line 23.
SchJMediumBullet Attach to Form 990.
SchJMediumBullet Information about Schedule J (Form 990) and its instructions is at www.irs.gov/form990.
OMB No. 1545-0047
2016
Open to Public Inspection
Name of the organization
KAISER FOUNDATION HEALTH PLAN INC
 
Employer identification number

94-1340523
Part I
Questions Regarding Compensation
Yes
No
1a
Check the appropiate box(es) if the organization provided any of the following to or for a person listed on Form
990, Part VII, Section A, line 1a. Complete Part III to provide any relevant information regarding these items.
b
If any of the boxes in line 1a are checked, did the organization follow a written policy regarding payment or reimbursement or provision of all of the expenses described above? If "No," complete Part III to explain .........
1b
Yes
 
2
Did the organization require substantiation prior to reimbursing or allowing expenses incurred by all
directors, trustees, officers, including the CEO/Executive Director, regarding the items checked in line 1a? ..
2
Yes
 
3
Indicate which, if any, of the following the filing organization used to establish the compensation of the
organization's CEO/Executive Director. Check all that apply. Do not check any boxes for methods
used by a related organization to establish compensation of the CEO/Executive Director, but explain in Part III.
4
During the year, did any person listed on Form 990, Part VII, Section A, line 1a, with respect to the filing organization or a related organization:
a
Receive a severance payment or change-of-control payment? .............
4a
Yes
 
b
Participate in, or receive payment from, a supplemental nonqualified retirement plan? .........
4b
Yes
 
c
Participate in, or receive payment from, an equity-based compensation arrangement? .........
4c
 
No
If "Yes" to any of lines 4a-c, list the persons and provide the applicable amounts for each item in Part III.
Only 501(c)(3), 501(c)(4), and 501(c)(29) organizations must complete lines 5-9.
5
For persons listed on Form 990, Part VII, Section A, line 1a, did the organization pay or accrue any
compensation contingent on the revenues of:
a
The organization? ....................
5a
 
No
b
Any related organization? .......................
5b
 
No
If "Yes," on line 5a or 5b, describe in Part III.
6
For persons listed on Form 990, Part VII, Section A, line 1a, did the organization pay or accrue any
compensation contingent on the net earnings of:
a
The organization? ..................
6a
 
No
b
Any related organization? ......................
6b
 
No
If "Yes," on line 6a or 6b, describe in Part III.
7
For persons listed on Form 990, Part VII, Section A, line 1a, did the organization provide any nonfixed
payments not described in lines 5 and 6? If "Yes," describe in Part III ............
7
Yes
 
8
Were any amounts reported on Form 990, Part VII, paid or accured pursuant to a contract that was
subject to the initial contract exception described in Regulations section 53.4958-4(a)(3)? If "Yes," describe
in Part III ..........................
8
Yes
 
9
If "Yes" on line 8, did the organization also follow the rebuttable presumption procedure described in Regulations section 53.4958-6(c)? .........................
9
Yes
 
For Paperwork Reduction Act Notice, see the Instructions for Form 990.
Cat. No. 50053T
Schedule J (Form 990) 2016
Page 2

Schedule J (Form 990) 2016
Page 2
Part II
Officers, Directors, Trustees, Key Employees, and Highest Compensated Employees. Use duplicate copies if additional space is needed.
For each individual whose compensation must be reported on Schedule J, report compensation from the organization on row (i) and from related organizations, described in the
instructions, on row (ii). Do not list any individuals that are not listed on Form 990, Part VII.
Note. The sum of columns (B)(i)-(iii) for each listed individual must equal the total amount of Form 990, Part VII, Section A, line 1a, applicable column (D) and (E) amounts for that individual.
(A) Name and Title (B) Breakdown of W-2 and/or 1099-MISC compensation (C) Retirement and other deferred compensation (D) Nontaxable
benefits		 (E) Total of columns
(B)(i)-(D) 		(F) Compensation in column (B) reported as deferred on prior Form 990
(i) Base
compensation 		(ii) Bonus & incentive
compensation 		(iii) Other reportable compensation
1Gregory Adams
EVP, Group President 		(i)

(ii)		 895,570
-------------
0 		1,220,621
-------------
0 		341,459
-------------
0 		661,797
-------------
0 		26,228
-------------
0 		3,145,675
-------------
0 		0
-------------
0
2Ramon F Baez
Director 		(i)

(ii)		 141,676
-------------
0 		0
-------------
0 		10,915
-------------
0 		0
-------------
0 		0
-------------
0 		152,591
-------------
0 		0
-------------
0
3Mary Ann Barnes
Region President - Hawaii 		(i)

(ii)		 424,596
-------------
0 		217,060
-------------
0 		478,847
-------------
0 		138,731
-------------
0 		20,310
-------------
0 		1,279,544
-------------
0 		306,640
-------------
0
4Anthony Barrueta
SVP, Government Relations 		(i)

(ii)		 441,713
-------------
0 		593,635
-------------
0 		40,975
-------------
0 		249,714
-------------
0 		19,732
-------------
0 		1,345,769
-------------
0 		863
-------------
0
5Raymond Baxter
SVP, CB Research & Hlth Policy 		(i)

(ii)		 342,974
-------------
0 		906,714
-------------
0 		42,645
-------------
0 		51,878
-------------
0 		17,870
-------------
0 		1,362,081
-------------
0 		0
-------------
0
6Robert Beltch
Chief Audit Executive 		(i)

(ii)		 310,265
-------------
0 		234,995
-------------
0 		320,963
-------------
0 		99,984
-------------
0 		21,068
-------------
0 		987,275
-------------
0 		221,770
-------------
0
7Vanessa Benavides
SVP, Chief Comp & Priv Officer 		(i)

(ii)		 383,496
-------------
0 		150,000
-------------
0 		87,047
-------------
0 		170,663
-------------
0 		19,085
-------------
0 		810,291
-------------
0 		22,145
-------------
0
8Regina M Benjamin MD MBA
Director 		(i)

(ii)		 189,500
-------------
0 		0
-------------
0 		7,678
-------------
0 		0
-------------
0 		0
-------------
0 		197,178
-------------
0 		0
-------------
0
9Charles Bevilacqua
SVP, HP Products, Svc & Admin 		(i)

(ii)		 520,619
-------------
0 		612,929
-------------
0 		21,840
-------------
0 		186,194
-------------
0 		20,908
-------------
0 		1,362,490
-------------
0 		0
-------------
0
10Maryann Bodayle
Assistant Secretary 		(i)

(ii)		 149,101
-------------
0 		14,912
-------------
0 		2,238
-------------
0 		24,809
-------------
0 		8,720
-------------
0 		199,780
-------------
0 		0
-------------
0
11Debora Lynn Catsavas
SVP, HR - NCAL 		(i)

(ii)		 375,332
-------------
0 		428,943
-------------
0 		112,699
-------------
0 		164,389
-------------
0 		15,932
-------------
0 		1,097,295
-------------
0 		0
-------------
0
12Thomas W Chapman EDD
Director 		(i)

(ii)		 0
-------------
0 		0
-------------
0 		513,713
-------------
0 		0
-------------
0 		0
-------------
0 		513,713
-------------
0 		448,199
-------------
0
13Bechara Choucair
SVP,Community Health & Benefit 		(i)

(ii)		 28,846
-------------
0 		450,000
-------------
0 		1,661
-------------
0 		13,174
-------------
0 		1,155
-------------
0 		494,836
-------------
0 		0
-------------
0
14Benjamin Chu
EVP,GP & Region President SCAL 		(i)

(ii)		 271,507
-------------
0 		1,812,183
-------------
0 		288,076
-------------
0 		156,196
-------------
0 		8,233
-------------
0 		2,536,195
-------------
0 		0
-------------
0
15Charles Columbus
SVP, Chief HR Officer 		(i)

(ii)		 541,459
-------------
0 		939,929
-------------
0 		46,332
-------------
0 		403,457
-------------
0 		33,312
-------------
0 		1,964,489
-------------
0 		0
-------------
0
16Patrick Courneya
EVP, Chief Medical Officer 		(i)

(ii)		 473,417
-------------
0 		389,924
-------------
0 		42,919
-------------
0 		491,572
-------------
0 		19,451
-------------
0 		1,417,283
-------------
0 		0
-------------
0
17Thomas Curtin
SVP, Natl Sales & Acct Mgmt 		(i)

(ii)		 376,392
-------------
0 		418,435
-------------
0 		36,077
-------------
0 		152,379
-------------
0 		25,616
-------------
0 		1,008,899
-------------
0 		0
-------------
0
18Dennis L Dabney
SVP, LABOR RELATIONS 		(i)

(ii)		 350,635
-------------
0 		370,395
-------------
0 		164,277
-------------
0 		127,993
-------------
0 		24,966
-------------
0 		1,038,266
-------------
0 		90,248
-------------
0
19Richard Daniels
EVP, CIO 		(i)

(ii)		 684,663
-------------
0 		907,109
-------------
0 		195,044
-------------
0 		355,738
-------------
0 		31,621
-------------
0 		2,174,175
-------------
0 		101,730
-------------
0
20Mick Diede
SVP, Chief Actuary 		(i)

(ii)		 387,687
-------------
0 		394,591
-------------
0 		38,078
-------------
0 		144,795
-------------
0 		19,229
-------------
0 		984,380
-------------
0 		0
-------------
0
21George Disalvo
SVP, CFO - SCAL 		(i)

(ii)		 525,787
-------------
0 		496,295
-------------
0 		41,017
-------------
0 		223,282
-------------
0 		17,695
-------------
0 		1,304,076
-------------
0 		0
-------------
0
22Karen Emmons
VP, Research and Dir, KFRI 		(i)

(ii)		 243,970
-------------
0 		124,978
-------------
0 		14,799
-------------
0 		-39,392
-------------
0 		21,622
-------------
0 		365,977
-------------
0 		0
-------------
0
23Jeffrey E Epstein
Director 		(i)

(ii)		 199,500
-------------
0 		0
-------------
0 		7,371
-------------
0 		0
-------------
0 		0
-------------
0 		206,871
-------------
0 		0
-------------
0
24Jerry C Fleming
SVP, Health Reform Implement 		(i)

(ii)		 0
-------------
0 		117,651
-------------
0 		474,644
-------------
0 		-9,018
-------------
0 		0
-------------
0 		583,277
-------------
0 		468,718
-------------
0
25Diane Gage-Lofgren
SVP, Brand Mgmt & Comm 		(i)

(ii)		 0
-------------
0 		0
-------------
0 		127,244
-------------
0 		35,063
-------------
0 		0
-------------
0 		162,307
-------------
0 		127,244
-------------
0
26Daniel Garcia
SVP, Chief Compliance Officer 		(i)

(ii)		 274,311
-------------
0 		828,960
-------------
0 		34,324
-------------
0 		-13,502
-------------
0 		15,672
-------------
0 		1,139,765
-------------
0 		0
-------------
0
27Sandra Golze
Assistant Secretary - NCAL 		(i)

(ii)		 257,586
-------------
0 		216,688
-------------
0 		93,057
-------------
0 		150,338
-------------
0 		21,090
-------------
0 		738,759
-------------
0 		43,838
-------------
0
28Mitchell Goodstein
SVP, Actuarial, U/W & Pricing 		(i)

(ii)		 0
-------------
0 		156,270
-------------
0 		0
-------------
0 		0
-------------
0 		0
-------------
0 		156,270
-------------
0 		0
-------------
0
29J Eugene Grisby III PhD
Director 		(i)

(ii)		 0
-------------
0 		0
-------------
0 		27,039
-------------
0 		0
-------------
0 		0
-------------
0 		27,039
-------------
0 		27,039
-------------
0
30Ron Groepper
SVP & Area Manager 		(i)

(ii)		 402,614
-------------
0 		189,581
-------------
0 		282,491
-------------
0 		107,530
-------------
0 		22,927
-------------
0 		1,005,143
-------------
0 		0
-------------
0
31George Halvorson
Chairman 		(i)

(ii)		 0
-------------
0 		0
-------------
0 		37,258
-------------
0 		4,120
-------------
0 		0
-------------
0 		41,378
-------------
0 		17,548
-------------
0
32Leslie S Heisz
Director 		(i)

(ii)		 199,500
-------------
0 		0
-------------
0 		15,618
-------------
0 		0
-------------
0 		0
-------------
0 		215,118
-------------
0 		0
-------------
0
33David Hoffmeister
Director 		(i)

(ii)		 214,500
-------------
0 		0
-------------
0 		11,309
-------------
0 		0
-------------
0 		0
-------------
0 		225,809
-------------
0 		0
-------------
0
34Kendall Hunter
SVP, Health Ins Exchange Opns 		(i)

(ii)		 92,521
-------------
0 		258,909
-------------
0 		87,945
-------------
0 		4,651
-------------
0 		5,988
-------------
0 		450,014
-------------
0 		27,388
-------------
0
35Judith A Johansen JD
Director 		(i)

(ii)		 227,000
-------------
0 		0
-------------
0 		13,707
-------------
0 		0
-------------
0 		0
-------------
0 		240,707
-------------
0 		0
-------------
0
36Laurel Junk
VP, Chief Procurement Officer 		(i)

(ii)		 402,573
-------------
0 		219,416
-------------
0 		18,458
-------------
0 		124,775
-------------
0 		12,138
-------------
0 		777,360
-------------
0 		0
-------------
0
37Kim J Kaiser
Director 		(i)

(ii)		 204,500
-------------
0 		0
-------------
0 		12,047
-------------
0 		0
-------------
0 		0
-------------
0 		216,547
-------------
0 		0
-------------
0
38David Kvancz
VP, Natl Pharmacy Pgms & Svcs 		(i)

(ii)		 0
-------------
0 		0
-------------
0 		435,604
-------------
0 		16,744
-------------
0 		0
-------------
0 		452,348
-------------
0 		0
-------------
0
39Kathryn Lancaster
EVP & CFO 		(i)

(ii)		 823,192
-------------
0 		1,486,990
-------------
0 		371,044
-------------
0 		570,456
-------------
0 		18,145
-------------
0 		3,269,827
-------------
0 		15,594
-------------
0
40Janet Liang
Regional President - NCAL 		(i)

(ii)		 576,297
-------------
0 		618,759
-------------
0 		191,234
-------------
0 		360,441
-------------
0 		28,803
-------------
0 		1,775,534
-------------
0 		0
-------------
0
41Donna Lynne
EVP, GP & Region Pres - CO 		(i)

(ii)		 250,147
-------------
0 		1,703,753
-------------
0 		3,260,111
-------------
0 		120,565
-------------
0 		10,818
-------------
0 		5,345,394
-------------
0 		2,322,965
-------------
0
42Philip A Marineau
Director 		(i)

(ii)		 222,000
-------------
0 		0
-------------
0 		7,371
-------------
0 		0
-------------
0 		0
-------------
0 		229,371
-------------
0 		0
-------------
0
43Gerald Mccall
SVP Operations 		(i)

(ii)		 490,970
-------------
0 		329,171
-------------
0 		142,006
-------------
0 		153,233
-------------
0 		27,346
-------------
0 		1,142,726
-------------
0 		40,991
-------------
0
44Thomas Meier
SVP, Corporate Treasurer 		(i)

(ii)		 382,345
-------------
0 		523,823
-------------
0 		144,650
-------------
0 		111,392
-------------
0 		27,372
-------------
0 		1,189,582
-------------
0 		42,160
-------------
0
45Julie Miller-Phipps
Regional President - SCAL 		(i)

(ii)		 506,896
-------------
0 		302,297
-------------
0 		288,321
-------------
0 		192,552
-------------
0 		17,806
-------------
0 		1,307,872
-------------
0 		0
-------------
0
46Christopher Ohman
VP, Health Plan Expansion 		(i)

(ii)		 338,930
-------------
0 		319,117
-------------
0 		39,407
-------------
0 		123,060
-------------
0 		29,969
-------------
0 		850,483
-------------
0 		0
-------------
0
47Donald Orndoff
SVP, NFS 		(i)

(ii)		 418,115
-------------
0 		491,764
-------------
0 		25,961
-------------
0 		185,822
-------------
0 		30,493
-------------
0 		1,152,155
-------------
0 		0
-------------
0
48Wade Overgaard
SVP, Health Plan Ops - CA 		(i)

(ii)		 507,682
-------------
0 		621,259
-------------
0 		692,660
-------------
0 		161,755
-------------
0 		29,942
-------------
0 		2,013,298
-------------
0 		519,769
-------------
0
49Cynthia Overmyer
SVP, Internal Audit 		(i)

(ii)		 0
-------------
0 		34,692
-------------
0 		127,076
-------------
0 		-6,012
-------------
0 		0
-------------
0 		155,756
-------------
0 		119,896
-------------
0
50Christine Paige
SVP, Marketing & Internet Svcs 		(i)

(ii)		 372,885
-------------
0 		312,471
-------------
0 		100,632
-------------
0 		150,896
-------------
0 		20,140
-------------
0 		957,024
-------------
0 		21,668
-------------
0
51Edward Pei
Director 		(i)

(ii)		 214,000
-------------
0 		0
-------------
0 		12,739
-------------
0 		18,000
-------------
0 		0
-------------
0 		244,739
-------------
0 		0
-------------
0
52Margaret E Porfido JD
Director 		(i)

(ii)		 229,500
-------------
0 		0
-------------
0 		17,858
-------------
0 		0
-------------
0 		0
-------------
0 		247,358
-------------
0 		0
-------------
0
53J Neal Purcell
Director 		(i)

(ii)		 0
-------------
11,000 		0
-------------
0 		18,192
-------------
16,808 		0
-------------
0 		0
-------------
0 		18,192
-------------
27,808 		18,192
-------------
0
54Frank Richardson
Assistant Secretary - HI 		(i)

(ii)		 215,458
-------------
0 		82,062
-------------
0 		11,585
-------------
0 		100,219
-------------
0 		25,788
-------------
0 		435,112
-------------
0 		0
-------------
0
55Rochelle Roth
Assistant Secretary 		(i)

(ii)		 178,161
-------------
0 		71,788
-------------
0 		24,645
-------------
0 		99,908
-------------
0 		17,958
-------------
0 		392,460
-------------
0 		0
-------------
0
56Michael Rowe
SVP, CFO - NCAL 		(i)

(ii)		 587,510
-------------
0 		699,374
-------------
0 		22,808
-------------
0 		182,556
-------------
0 		24,666
-------------
0 		1,516,914
-------------
0 		0
-------------
0
57Jacqueline Sellers
Assistant Secretary 		(i)

(ii)		 195,357
-------------
0 		60,644
-------------
0 		9,121
-------------
0 		75,309
-------------
0 		12,779
-------------
0 		353,210
-------------
0 		0
-------------
0
58Richard Shannon MD
Director 		(i)

(ii)		 212,000
-------------
0 		0
-------------
0 		0
-------------
0 		0
-------------
0 		0
-------------
0 		212,000
-------------
0 		0
-------------
0
59James Simpson
SVP, Finance - BU & ROC 		(i)

(ii)		 368,952
-------------
0 		430,444
-------------
0 		36,240
-------------
0 		173,898
-------------
0 		23,964
-------------
0 		1,033,498
-------------
0 		0
-------------
0
60Arthur Southam
EVP, Health Plan Operations 		(i)

(ii)		 851,992
-------------
0 		1,521,837
-------------
0 		401,806
-------------
0 		438,204
-------------
0 		26,212
-------------
0 		3,240,051
-------------
0 		7,159
-------------
0
61Deborah Stokes
SVP,Corporate Controller & CAO 		(i)

(ii)		 42,705
-------------
0 		395,366
-------------
0 		65,873
-------------
0 		2,147
-------------
0 		1,773
-------------
0 		507,864
-------------
0 		0
-------------
0
62Wayne Swafford
VP, Natl Facilities Svc - ROC 		(i)

(ii)		 236,064
-------------
0 		129,545
-------------
0 		39,021
-------------
0 		117,459
-------------
0 		29,405
-------------
0 		551,494
-------------
0 		0
-------------
0
63Paul M Swenson
SVP & Chief Strategy Officer 		(i)

(ii)		 543,997
-------------
0 		508,966
-------------
0 		46,327
-------------
0 		151,503
-------------
0 		27,344
-------------
0 		1,278,137
-------------
0 		0
-------------
0
64Cynthia A Telles PhD
Director 		(i)

(ii)		 203,000
-------------
9,500 		0
-------------
0 		11,309
-------------
0 		0
-------------
0 		0
-------------
0 		214,309
-------------
9,500 		0
-------------
0
65Bernard Tyson
Chairman & CEO 		(i)

(ii)		 1,274,847
-------------
0 		6,056,494
-------------
0 		1,198,157
-------------
0 		686,080
-------------
0 		34,105
-------------
0 		9,249,683
-------------
0 		0
-------------
0
66Alfonse Upshaw
SVP,Corporate Controller & CAO 		(i)

(ii)		 330,597
-------------
0 		250,737
-------------
0 		35,278
-------------
0 		83,390
-------------
0 		24,924
-------------
0 		724,926
-------------
0 		0
-------------
0
67Cesar Villalpando
SVP, Enterprise Shared Svcs 		(i)

(ii)		 508,219
-------------
0 		496,428
-------------
0 		40,864
-------------
0 		279,929
-------------
0 		23,712
-------------
0 		1,349,152
-------------
0 		0
-------------
0
68Eugene Washington MD
Director 		(i)

(ii)		 186,176
-------------
0 		0
-------------
0 		450
-------------
0 		0
-------------
0 		0
-------------
0 		186,626
-------------
0 		0
-------------
0
69Herman Weil
SVP, Federal & State Programs 		(i)

(ii)		 0
-------------
0 		72,926
-------------
0 		69,552
-------------
0 		0
-------------
0 		0
-------------
0 		142,478
-------------
0 		55,591
-------------
0
70Jed Weissberg
SVP, Quality & Care Del Excel 		(i)

(ii)		 0
-------------
0 		151,929
-------------
0 		4,425
-------------
0 		-2,107
-------------
0 		0
-------------
0 		154,247
-------------
0 		0
-------------
0
71Gay Westfall
SVP, SPECIAL PROJECTS 		(i)

(ii)		 303,596
-------------
0 		282,804
-------------
0 		288,588
-------------
0 		85,854
-------------
0 		16,742
-------------
0 		977,584
-------------
0 		0
-------------
0
72John Yamamoto
Assistant Secretary 		(i)

(ii)		 328,654
-------------
0 		220,856
-------------
0 		94,235
-------------
0 		131,602
-------------
0 		64,230
-------------
0 		839,577
-------------
0 		26,910
-------------
0
73Hong-Sze Yu
Assistant Secretary 		(i)

(ii)		 219,652
-------------
0 		68,784
-------------
0 		15,909
-------------
0 		104,663
-------------
0 		22,269
-------------
0 		431,277
-------------
0 		0
-------------
0
74Carlos Zaragoza
Assistant Secretary 		(i)

(ii)		 142,121
-------------
0 		182,257
-------------
0 		84,289
-------------
0 		8,121
-------------
0 		12,234
-------------
0 		429,022
-------------
0 		0
-------------
0
75Victoria Zatkin
VP, Off of Brd & Corp Gov Svcs 		(i)

(ii)		 25,068
-------------
0 		99,763
-------------
0 		91,952
-------------
0 		1,394
-------------
0 		334
-------------
0 		218,511
-------------
0 		85,158
-------------
0
76Mark Zemelman
SVP, General Counsel & Secy 		(i)

(ii)		 547,086
-------------
0 		839,524
-------------
0 		243,563
-------------
0 		339,949
-------------
0 		30,025
-------------
0 		2,000,147
-------------
0 		0
-------------
0
Schedule J (Form 990) 2016
Page 3

Schedule J (Form 990) 2016
Page 3
Part III
Supplemental Information
Provide the information, explanation, or descriptions required for Part I, lines 1a, 1b, 3, 4a, 4b, 4c, 5a, 5b, 6a, 6b, 7, and 8, and for Part II. Also complete this part for any additional information.
Return Reference Explanation
Schedule J, Part I, Line 1 FIRST CLASS TRAVEL: FIRST CLASS TRAVEL IS PERMISSIBLE AS AN ORDINARY BUSINESS EXPENSE FOR ALL BOARD OF DIRECTORS, CHIEF EXECUTIVE OFFICER, THIRTEEN OTHER OFFICERS, AND ONE KEY EMPLOYEE AS APPROVED BY THE COMPENSATION COMMITTEE, CHIEF EXECUTIVE OFFICER, OR CHIEF HUMAN RESOURCES OFFICER. THE VALUE OF THESE CHARGES ARE NOT INCLUDED IN THE RECIPIENTS COMPENSATION. TRAVEL FOR COMPANIONS: AS APPROVED BY SENIOR MANAGEMENT INFREQUENTLY WHERE BUSINESS REQUIREMENT DICTATES. THE VALUE OF THESE CHARGES ARE NOT INCLUDED IN THE RECIPIENTS COMPENSATION. PERSONAL SERVICES: CAR AND SECURITY SERVICE IS APPROVED FOR SENIOR MANAGEMENT IN CONNECTION WITH BUSINESS RELATED TRAVEL. CEO'S NONBUSINESS TRANSPORTATION IS BOARD APPROVED AND INCLUDED IN COMPENSATION. TAX INDEMNIFICATION AND GROSS-UP PAYMENTS: LIMITED TO PARTIAL TAX GROSS-UP UNDER RELOCATION POLICY, CEO TRANSPORTATION AND SECURITY, AND AS APPROVED ON A LIMITED BASIS BY SENIOR MANAGEMENT. THESE PAYMENTS ARE INCLUDED IN COMPENSATION. HOUSING ALLOWANCE: PROVIDED ON A LIMITED BASIS TO FOUR OFFICERS AND ONE KEY EMPLOYEE FOR RELOCATION IN CONFORMITY WITH THE LAW. PROVIDED ON A LIMITED BASIS AS COMPENSATION.
Schedule J, Part I, Line 3 - METHODS USED TO ESTABLISH COMPENSATION OF CEO/EXECUTIVE DIRECTOR - Kaiser Foundation Health Plan, Inc. used one or more of the methods described below to establish the top management officials' compensation: - Compensation committee - Independent compensation consultant - Form 990 of other organizations - Written employment contract - Compensation survey or study, and - Approval by the board or compensation committee of a related organization.
Schedule J, Part I, Line 4A - Severance Payments - DAVID KVANCZ 435,375 LISTED PERSONS PARTICIPATED IN ARRANGEMENTS ENTITLING THEM TO SEVERANCE BENEFITS IN THE EVENT OF TERMINATION BY THE ORGANIZATION WITHOUT CAUSE OR DUE TO JOB ELIMINATION. DEPENDING ON POSITION LEVEL, TENURE, AND TERMINATION REASON, SEVERANCE BENEFITS PAYABLE UNDER THESE ARRANGEMENTS PROVIDE FOR PAY AND HEALTH BENEFITS CONTINUATION PLUS PAYMENT OF ACCRUED OBLIGATIONS. IN ADDITION, FOR SOME OF THE LISTED PERSONS, SEVERANCE BENEFITS PAYABLE INCLUDE PRORATED INCENTIVE AWARDS FOR PERFORMANCE PERIODS NOT YET ENDED. NONE OF THE LISTED PERSONS PARTICIPATED IN ARRANGEMENTS ENTITLING THEM TO CHANGE-OF-CONTROL PAYMENTS.
Schedule J, Part I, Line 4B - Supplemental NonQualified Retirement Plan Payments - Gregory Adams $292,234 Mary Ann Barnes 446,577 Anthony Barrueta 863 Robert Beltch 280,584 Benjamin Chu 275,641 Dennis L. Dabney 123,168 Richard Daniels 161,600 Jerry C Fleming 468,718 Sandra Golze 56,755 Kendall Hunter 77,755 Kathryn Lancaster 322,425 Donna Lynne 3,229,867 Gerald Mccall 110,466 Thomas Meier 105,522 Julie Miller-Phipps 107,654 Wade Overgaard 667,549 Cynthia Overmyer 119,896 Christine Paige 79,032 Arthur Southam 352,920 Deborah Stokes 59,716 Bernard Tyson 815,201 Gay Westfall 246,046 John Yamamoto 76,678 Carlos Zaragoza 43,573 Victoria Zatkin 85,158 Mark Zemelman 197,189 SOME OF THE PARTICIPANTS LISTED IN SCHEDULE J, PART II PARTICIPATED IN NONQUALIFIED SUPPLEMENTAL RETIREMENT PLANS. UNDER THESE PLANS, THE ORGANIZATION MAKES ANNUAL CONTRIBUTIONS TO A NOTIONAL ACCOUNT ON BEHALF OF EACH PARTICIPANT. CONTRIBUTIONS VARY BY POSITION, LEVEL AND PAY, AND VEST OVER TIME BASED ON AGE AND/OR SERVICE. PARTICIPANT ACCOUNTS ARE CREDITED WITH A FIXED RATE OF INTEREST, INVESTED IN AVAILABLE MUTUAL FUNDS OR A COMBINATION OF BOTH. CERTAIN OFFICERS ACCRUE A BENEFIT THAT VESTS BASED ON AGE AND SERVICE AND TARGETS A PERCENTAGE OF FINAL AVERAGE PAY LESS PRIOR PLAN OFFSETS. UNVESTED AMOUNTS ARE SUBJECT TO RISK OF FORFEITURE.
Schedule J, Part I, Line 7 - Non-Fixed Payments - THE ORGANIZATION PROVIDED NON-FIXED PAYMENTS TO SOME OF THE PERSONS LISTED. PAYMENTS WERE MADE UNDER INCENTIVE PLANS, BASED ON ATTAINMENT OF ORGANIZATIONAL PERFORMANCE GOALS AND INDIVIDUAL PERFORMANCE, DESIGNED TO SUPPORT THE ORGANIZATION'S MISSION TO PROVIDE HIGH-QUALITY, AFFORDABLE CARE AND IMPROVE THE HEALTH OF ITS MEMBERS AND THE COMMUNITIES IT SERVES. THE PLANS' ORGANIZATIONAL PERFORMANCE GOALS INCLUDED: QUALITY OF CARE AND SERVICE, MEMBERSHIP GROWTH, OPERATING INCOME, PER MEMBER EXPENSE TREND, AND COMMUNITY BENEFIT. PLAN DESIGNS, PERFORMANCE, AND PAYOUT LEVELS, AS WELL AS INDIVIDUAL PAYMENTS TO CERTAIN PERSONS, WERE REVIEWED AND APPROVED BY THE COMPENSATION COMMITTEE OF THE BOARD OF DIRECTORS, COMPRISED OF INDEPENDENT DIRECTORS.
Schedule J, Part I, Line 8 Certain amounts reported in Form 990, Part VII, were paid or accrued pursuant to a contract that was subject to the initial contract exception described in Regulations section 53.4958-4(a)(3). Fixed payments were paid to or accrued for THREE OFFICERS and TWO KEY EMPLOYEES in 2016.
Schedule J, Part II, Column C The actuarial value for some individuals' defined benefit plan declined in 2016, resulting in negative values in column (C) in some instances.
Schedule J, Part II, Column F Amounts included in Schedule J, Part II, Column F include amounts previously reported as deferred compensation, as well as, distributions from a 457(b) plan that were previously reported as reportable compensation in accordance with Form 990 Instructions.
Schedule J (Form 990) 2016
Additional Data


Software ID:  
Software Version: