2025-02-03T09:13:50+00:00 2024-03-31 346565596 ERNST & YOUNG US LLP 18101 VON KARMAN AVENUE IRVINE CA 92612 990 2023-04-01 953258674 Inter-Valley Health Plan Inc INTE 9097843400 300 S PARK AVE PO BOX 6002 300 POMONA CA 917696002 Bruce Bowne CFO, VP of Finance 9097843400 2025-02-03 true Kara Adams P00023315 9497942300 2023-10-16 2023 2025-03-06 01:10:19Z MIKE NELSON 300 S PARK AVE PO BOX 6002 300 POMONA CA 917696002 1957842 false X WWW.IVHP.COM X 1979 CA INTER VALLEY HEALTH PLAN, INC. IS IN THE PROCESS OF WINDING DOWN OPERATIONS. IT WAS A FEDERALLY QUALIFIED HEALTH MAINTENANCE ORGANIZATION. IT PROVIDED A FULL RANGE OF MEDICAL SERVICES TO ELIGIBLE MEDICARE PARTICIPANTS. AT MARCH 31, 2024 THERE WERE 0 PARTICIPATING MEMBERS. 12 12 49 0 0 0 0 180655704 0 -315760 291614 1666228 180339944 1957842 0 0 8805627 504556 0 0 172796553 1113775 181602180 1618331 -1262236 339511 24687203 21896272 18414061 14818223 6273142 7078049 X INTER VALLEY HEALTH PLAN, INC. IS A FEDERALLY QUALIFIED HEALTH MAINTENANCE ORGANIZATION. IT PROVIDES A FULL RANGE OF MEDICAL SERVICES TO ELIGIBLE MEDICARE PARTICIPANTS. AT MARCH 31, 2024 THERE WERE 0 PARTICIPATING MEMBERS. false true 0 0 1666228 INTER VALLEY HEALTH PLAN, INC. IS A FEDERALLY QUALIFIED HEALTH MAINTENANCE ORGANIZATION. IT PROVIDES A FULL RANGE OF MEDICAL SERVICES TO ELIGIBLE MEDICARE PARTICIPANTS. AT MARCH 31, 2023 THERE WERE 0 PARTICIPATING MEMBERS. IVHP HAS ELECTED NOT TO CONTRACT WITH CMS EFFECTIVE JANUARY 1,2023 THEREFORE NOT OFFERING ANY MEDICAL COVERAGE TO MEMBERS. IVHP IS CURRENTLY IN PROCESS OF WINDING DOWN OPERATIONS. 0 false false false false false false false false false false false false false false false false false false false false false false false false false false false false true false false false false false false false false false false false false false false false false true 18 0 true 49 true false false false false false false false false X 12 12 true false false false false false false true true false false true true true true true true true true false CA X BRUCE BOWNE 9097843400 300 S PARK AVE STE 300 POMONA CA 917696002 CURTIS W MORRIS DIRECTOR- 2ND VICE CHAIR 1.0 0.0 X 0 0 0 DUANE STYLES MD DIRECTOR 1.0 0.0 X 0 0 0 ELMER PINEDA MD DIRECTOR 1.0 0.0 X 0 0 0 FRANK GARCIA DIRECTOR 1.0 0.0 X 0 0 0 JAN BROWN DIRECTOR 1.0 0.0 X 0 0 0 KEVIN MCCARTHY DIRECTOR 1.0 0.0 X 0 0 0 MELISSA VOLLARO DIRECTOR 1.0 0.0 X 0 0 0 PAUL ORR MD DIRECTOR 1.0 0.0 X 0 0 0 RAKESH SINHA MD DIRECTOR 1.0 0.0 X 0 0 0 RICHARD FASS DIRECTOR - 1ST VICE CHAIR 1.0 0.0 X 0 0 0 RICHARD YOCHUM DIRECTOR 1.0 0.0 X 0 0 0 SONJA STUMP DIRECTOR 1.0 0.0 X 0 0 0 Sunil Shivaram MD Director 1.0 0.0 X 0 0 0 BRUCE BOWNE CFO, VP FIN, TREAS 40.0 0.0 X 240440 0 47023 Michael Nelson President/CEO 20.0 0.0 X 0 0 0 PATRICIA JACOBSON VP HR, SECRETARY 40.0 0.0 X 285130 0 42530 SUSAN TENORIO COO 40.0 0.0 X 234622 0 45320 BILL CHEN CIO 40.0 0.0 X 122386 0 39097 KATHI CARRICK-SICKLER INTERIM MANAGER - CORPORATE SERVICES 40.0 0.0 X 110072 0 16297 TRINA ALEXANDER CLAIMS MANAGER 40.0 0.0 X 112429 0 21079 1105079 0 211346 6 false true true DESERT OASIS HEALTHCARE 275 N EL CIELO PALM SPRINGS CA 92262 MEDICAL SERVICE 312593 POMONA VALLEY HOSPITAL MEDICAL CENTER 1798 N GAREY AVE POMONA CA 91767 MEDICAL SERVICES & LEASED EMPLOYEES 265839 Wilson Elser Moskowitz Edelman and Dicker LLP 555 S Flower St Suite 2900 Los Angeles CA 900712407 Legal 137863 3 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 291614 0 0 291614 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 Other Program Revenue 900099 871084 871084 Pharmacy Rebates 524114 795144 795144 0 0 0 0 1666228 1957842 1666228 0 291614 234489 0 234489 0 219617 0 219617 0 14824 0 14824 0 35626 0 35626 0 295080 0 295080 0 11845 0 11845 0 11607 0 11607 0 491 0 491 0 7175 0 7175 0 93661 0 93661 0 100 0 100 0 177399 0 177399 0 OUTSIDE SERVICES 406569 0 406569 0 Utilities 59538 0 59538 0 Other Expenses 28360 0 28360 0 Taxes and Licenses 21350 0 21350 0 600 0 600 0 1618331 0 1618331 0 -50769 -17694 15032973 15957283 0 0 0 0 0 0 9704999 5956683 0 0 0 0 0 0 0 0 0 0 24687203 21896272 18414061 14818223 0 0 0 0 18414061 14818223 X 0 0 5647 5647 6267495 7072402 6273142 7078049 24687203 21896272 339511 465396 0 0 0 0 X false false false X X X X true false false false false false false false false PATRICIA JACOBSON VP HR, SECRETARY 96154 0 0 0 188976 0 9586 0 32944 0 327660 0 0 0 BRUCE BOWNE CFO, VP FIN, TREAS 12940 0 0 0 227500 0 11895 0 35128 0 287463 0 0 0 SUSAN TENORIO COO 20736 0 0 0 213886 0 9324 0 35996 0 279942 0 0 0 BILL CHEN CIO 48248 0 0 0 74138 0 8954 0 30143 0 161483 0 0 0 Schedule J, Part I, Line 4a Severance or change-of-control payment Due to the ceasing of operations, certain individuals listed on Form 990, Part VII, received severance payments. Bruce Bown $217,992 Susan Tenorio $213,358 Patricia Jacobson $184,416 Bill Chen $72,403 Trina Alexander $28,232 Kathi Carrick-Sickler $13,709 Schedule J, Part III MICHAEL NELSON, CEO IS A LEASED EMPLOYEE OF POMONA VALLEY HOSPITAL MEDICAL CENTER. INTER VALLEY HEALTH PLAN PAYS POMONA VALLEY HOSPITAL $21,500 A MONTH FOR HIS SERVICES. Form 990, Part III, Line 3 Significant changes in program services DUE TO THE TREND OF DECREASING REVENUE OVER THE PAST FEW YEARS THE BOARD VOTED TO NOT RENEW ITS MEDICARE ADVANTAGE CONTRACT FOR THE 2023 CONTRACT YEAR. AS SUCH IT SURRENDERED ITS KNOX KEENE LICENSE IN FEBRUARY 2023. Form 990, Part VI, Line 2 Family/business relationships amongst interested persons DIRECTOR RICHARD YOCHUM AND CEO MICHAEL NELSON - Business relationship Form 990, Part VI, Line 11b Review of form 990 by governing body The CFO performs a review of the Form 990 and the Board receives a copy prior to filing. Form 990, Part VI, Line 12c Conflict of interest policy IN ACCORDANCE WITH IVHP CONFLICT OF INTEREST POLICY, ALL MEMBERS OF THE BOARD, COMMITTEES, OFFICERS, EXECUTIVE STAFF, DIRECTORS AND MEDICAL DIRECTORS, INDEPENDENT CONTRACTORS AND CONSULTANTS WHO ARE REQUESTED TO DO SO BY THE BOARD, AND OTHER MANAGEMENT NOT PREVIOUSLY MENTIONED, SHALL DISCLOSE ANY POTENTIAL CONFLICTS OF INTEREST THROUGH THE PLAN'S CONFLICT OF INTEREST DISCLOSURE STATEMENT. THIS DISCLOSURE SHOULD OCCUR IN A TIMELY MANNER AS SOON AS PRACTICABLE WHENEVER ANY MATTER COVERED UNDER THIS POLICY ARISES, BUT WILL BE REQUIRED UPON TAKING OFFICE AND AT LEAST ANNUALLY. THE BOARD, WITH THE ASSISTANCE OF A BOARD COMMITTEE AND/OR THE CEO, WILL EVALUATE THE DISCLOSURES OF BOARD MEMBERS AND OFFICERS AS APPROPRIATE AND WILL DETERMINE ON A CASE-BY-CASE BASIS WHETHER THE ACTIVITIES DISCLOSED CONSTITUTE A POTENTIAL CONFLICT AND, IF SO, HOW TO RESOLVE THE CONFLICT. EACH DIRECTOR, OFFICER, MEMBER OF MANAGEMENT, KEY EMPLOYEE AND MEMBER OF A COMMITTEE WITH BOARD-DELEGATED POWERS SHALL UPON APPOINTMENT AND AT LEAST ANNUALLY THEREAFTER SIGN A COPY OF THE ATTACHED "STATEMENT PERTAINING TO THE CONFLICT OF INTEREST POLICY." IF A DIRECTOR, OFFICER, KEY EMPLOYEE OR COMMITTEE MEMBER BECOMES AWARE THAT A POTENTIAL OR APPARENT CONFLICT MAY EXIST WHICH IS NOT DISCLOSED ON SUCH A STATEMENT, IT SHALL BE THE RESPONSIBILITY OF THE INTERESTED PERSON TO DISCLOSE THE POTENTIAL CONFLICT TO THE PRESIDENT AND TO THE BOARD AND/OR COMMITTEE, AS APPROPRIATE, AS SET FORTH ABOVE, PRIOR TO ANY BOARD OR COMMITTEE DISCUSSIONS OR ACTION WITH RESPECT TO THE RELEVANT TRANSACTION OR ARRANGEMENT, AND IF RELEVANT, TO LEAVE THE MEETING DURING THE DISCUSSION AND VOTE ON THE TRANSACTION OR ARRANGEMENT. Form 990, Part VI, Line 15a Process to establish compensation of top management official ANNUALLY, THE COMPENSATION COMMITTEE, AN INDEPENDENT COMMITTEE OF THE BOARD OF DIRECTORS, REVIEWS THE COMPENSATION OF THE CEO AND ALL OTHER EMPLOYEES THAT ARE REPORTED INDIVIDUALLY ON THE 990 RETURN. THE COMMITTEE MEETS WITH OUTSIDE CONSULTANTS AND USES COMPENSATION SURVEYS AND OTHER INFORMATION TO TEST THE REASONABLENESS OF THE COMPENSATION OF ALL THE POSITIONS. CONTEMPORANEOUS MINUTES OF THE DEBATE AND DECISIONS ARE KEPT OF THE MEETINGS. THE PROCESS WAS LAST COMPLETED IN 2023. Form 990, Part VI, Line 19 Required documents available to the public THE ORGANIZATION'S GOVERNING DOCUMENTS, CONFLICT OF INTEREST POLICY, AND FINANCIAL STATEMENTS ARE AVAILABLE TO THE PUBLIC UPON REQUEST.