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Schedule I
(Form 990)
Department of the Treasury
Internal Revenue Service
Grants and Other Assistance to Organizations,
Governments and Individuals in the United States
Complete if the organization answered "Yes," on Form 990, Part IV, line 21 or 22.
lBullet Attach to Form 990.
lBullet Go to www.irs.gov/Form990 for the latest information.
OMB No. 1545-0047
2020
Open to Public
Inspection
Name of the organization
KAISER FOUNDATION HEALTH PLAN OF GEORGIAINC
 
Employer identification number
58-1592076
Part I
General Information on Grants and Assistance
1
Does the organization maintain records to substantiate the amount of the grants or assistance, the grantees' eligibility for the grants or assistance, and
the selection criteria used to award the grants or assistance? ........................
2
Describe in Part IV the organization's procedures for monitoring the use of grant funds in the United States.
Part II
Grants and Other Assistance to Domestic Organizations and Domestic Governments. Complete if the organization answered "Yes" on Form 990, Part IV, line 21, for any recipient
that received more than $5,000. Part II can be duplicated if additional space is needed.
(a) Name and address of organization
or government		 (b) EIN (c) IRC section
(if applicable)		 (d) Amount of cash grant (e) Amount of non-cash
assistance		 (f) Method of valuation
(book, FMV, appraisal,
other)		 (g) Description of
noncash assistance		 (h) Purpose of grant
or assistance
(1) ATLANTA BELTLINE PARTNERSHIP INC
112 KROG ST NE 14
ATLANTA,GA30307 		56-2464486 501(c)(3) 50,000       Sponsorships
(2) ATLANTA COMMUNITY FOOD BANK
732 JOSEPH E LOWERY BLVD NW
ATLANTA,GA30318 		58-1376648 501(c)(3) 275,000       Project Support
(3) ATLANTA VOLUNTEER LAWYERS FOUNDATION
235 PEACHTREE ST NE 1750
ATLANTA,GA30303 		58-1364400 501(c)(3) 50,000       Project Support
(4) ATLANTA WOMEN'S FOUNDATION INC
3355 LENOX ROAD 850
ATLANTA,GA30326 		58-2389721 501(c)(3) 25,000       Sponsorships
(5) CHRIS KIDS INC
1017 FAYETTEVILLE ROAD SE
ATLANTA,GA30316 		58-1430183 501(c)(3) 50,000       Project Support
(6) EARTHSHARE OF GEORGIA
100 PEACHTREE ST NW 1960
ATLANTA,GA30303 		58-2022001 501(c)(3) 27,000       Sponsorships
(7) EMORY HEALTHCARE INC
1364 Clifton Rd NE
ATLANTA,GA30322 		58-2137993 501(c)(3) 5,000,000       Project Support
(8) FIRST STEP STAFFING
236 AUBURN AVE NE 203
ATLANTA,GA30303 		20-8038859 501(c)(3) 35,000       Project Support
(9) GEORGIA CAMPAIGN FOR ADOLESCENT POWER
1718 PEACHTREE ST NW465
ATLANTA,GA30309 		31-1520709 501(c)(3) 45,000       Project Support
(10) GEORGIA HEALTH NEWS
2635 RANGEWOOD CT
ATLANTA,GA30345 		27-3543332 501(c)(3) 15,000       Project Support
(11) GEORGIA STATE UNIVERSITY FOUNDATION
PO BOX 399
ATLANTA,GA30302 		58-6033185 501(c)(3) 50,000       Nursing Program Scholarship
(12) GEORGIA WATCH
55 MARIETTA ST NW 903
ATLANTA,GA30303 		16-1639971 501(c)(3) 20,000       Project Support
(13) GROVE PARK FOUNDATION INC SUBTOTAL
1562 DONALD LEE HOLLOWELL PKWY
ATLANTA,GA30318 		82-1913260 501(c)(3) 650,000       Project Support
(14) GWINNETT TECH FOUNDATION
5150 SUGARLOAF PKWY
LAWRENCEVILLE,GA30043 		58-2106879 501(c)(3) 50,000       Nursing Program Scholarship
(15) HERITAGE FUND OF ATLANTA MEDICAL ASSOC
PO BOX 4421
ATLANTA,GA30302 		58-2372394 501(c)(3) 10,000       Sponsorships
(16) INITIATIVE FOR AFFORDABLE HOUSING INC
PO BOX 885
SCOTTDALE,GA30079 		58-1932474 501(c)(3) 15,000       Project Support
(17) JUNIOR ACHIEVEMENT OF GEORGIA
460 ABERNATHY RD NE
ATLANTA,GA30328 		58-0598050 501(c)(3) 20,000       Project Support
(18) MARTIN LUTHER KING JR CENTER FOR
449 Auburn Ave NE
Atlanta,GA30312 		58-1030989 501(c)(3) 15,000       Sponsorships
(19) OPEN HAND ATLANTA INC
181 ARMOUR DRIVE NE
ATLANTA,GA30324 		58-1816778 501(c)(3) 50,000       Project Support
(20) PARK PRIDE ATLANTA INC
233 PEACHTREE ST NE1600
ATLANTA,GA30303 		58-1883895 501(c)(3) 30,000       Project Support
(21) PEDESTRIANS EDUCATING DRIVERS ON SAFETY
233 PEACHTREE ST NE1220
ATLANTA,GA30303 		58-2267503 501(c)(3) 15,000       Project Support
(22) PIEDMONT PARK CONSERVANCY INC
PO BOX 7795
ATLANTA,GA30357 		58-1551369 501(c)(3) 60,000       Sponsorships
(23) SAINT JOSEPH'S MERCY CARE SERVICES INC
424 DECATUR ST
ATLANTA,GA30312 		58-1752700 501(c)(3) 35,000       Project Support
(24) SENIOR CITIZEN SERVICES
1705 COMMERCE DR NW
ATLANTA,GA30318 		58-0960309 501(c)(3) 25,000       Project Support
(25) SHELTERING ARMS THE
385 CENTENNIAL OLYMPIC PARK DR
ATLANTA,GA30313 		58-0566236 501(c)(3) 60,000       Project Support
(26) THE CHILDREN'S MUSEUM OF ATLANTA
275 CENTENNIAL OLYMPIC PK DR NW
ATLANTA,GA30313 		58-1785484 501(c)(3) 65,000       Project Support
(27) UNITED WAY OF GREATER ATLANTA
40 COURTLAND ST NE300
ATLANTA,GA30303 		58-0566194 501(c)(3) 225,000       Project Support
(28) WESTSIDE FUTURE FUND
PO Box 92273
ATLANTA,GA30314 		47-3015082 501(c)(3) 225,000       Project Support
(29) WOODRUFF ARTS CENTER
1280 Peachtree St NE
Atlanta,GA30309 		58-0633971 501(c)(3) 99,000       Sponsorships
(30) YEAR UP INC
730 PEACHTREE ST 900
ATLANTA,GA30308 		04-3534407 501(c)(3) 25,000       Project Support
(31) YMCA OF METROPOLITAN ATLANTA
569 MLK Jr Dr NW
ATLANTA,GA30314 		58-0666253 501(c)(3) 225,000       Project Support
(32) YWCA OF GREATER ATLANTA
957 N HIGHLAND AVE NE
ATLANTA,GA30306 		58-0593442 501(c)(3) 25,000       Sponsorships
2
Enter total number of section 501(c)(3) and government organizations listed in the line 1 table ................. Bullet Image
32
3
Enter total number of other organizations listed in the line 1 table ........................ . Bullet Image
0
For Paperwork Reduction Act Notice, see the Instructions for Form 990.
Cat. No. 50055P
Schedule I (Form 990) 2020
Page 2

Schedule I (Form 990) 2020
Page 2
Part III
Grants and Other Assistance to Domestic Individuals. Complete if the organization answered "Yes" on Form 990, Part IV, line 22.
Part III can be duplicated if additional space is needed.
(a) Type of grant or assistance (b) Number of
recipients		 (c) Amount of
cash grant		 (d) Amount of
noncash assistance		 (e) Method of valuation (book,
FMV, appraisal, other)		 (f) Description of noncash assistance
(1)
(2)
(3)
(4)
(5)
(6)
(7)
Part IV
Supplemental Information. Provide the information required in Part I, line 2; Part III, column (b); and any other additional information.
Return Reference Explanation
SCHEDULE I, PART I, LINE 2 PROCEDURES FOR MONITORING THE USE OF GRANTS At the end of their funding cycle, grantees are required to submit a final report which delineates accomplishments related to stated objectives. Large grants (typically over $100K) may require quarterly progress reports.
Schedule I (Form 990) 2020



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