2026-08-13T12:44:20+00:00 2026-03-31 346565596 ERNST & YOUNG US LLP 18101 VON KARMAN AVENUE IRVINE CA 92612 990 2025-04-01 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 2026-08-13 true KARA ADAMS P00023315 9497942300 2026-08-12 2025 2025-03-06 01:10:19Z MIKE NELSON 300 S PARK AVE PO BOX 6002 300 POMONA CA 917696002 4867608 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, 2026 THERE WERE 0 PARTICIPATING MEMBERS. 12 12 0 0 0 0 3145348 0 0 329641 1718085 1413298 4175 1742939 4867608 0 0 0 0 0 0 0 0 0 673430 2472773 673430 2472773 1069509 2394835 17589268 21456479 8988303 10460679 8600965 10995800 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, 2026 THERE WERE 0 PARTICIPATING MEMBERS. false true 109873 0 4175 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. 109873 false true 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 false false false false true 2 0 true 0 false false false false false false false false X 12 12 true false false false false false false true true false false false true true true true true true false false false 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 CHAIR 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 BRUCE BOWNE CFO, VP FIN, TREAS 13.0 0.0 X 113822 0 0 MICHAEL NELSON PRESIDENT/CEO 5.0 0.0 X 59000 0 0 SUSAN TENORIO SECRETARY 2.0 0.0 X 16500 0 0 189322 0 0 0 false false true SHELL LAW & TAX LLC 1805 NW PLATTE ROAD UNIT 110 RIVERSIDE MO 64150 LEGAL AND CONSULTING SERVICES 204492 POMONA VALLEY HOSPITAL MEDICAL CENTER 1798 N GAREY AVE POMONA CA 91767 MEDICAL SERVICES & LEASED EMPLOYEES 204263 2 3145348 3145348 0 0 0 0 0 1324779 1324779 0 0 393306 0 393306 393306 393306 0 REFUND OF DEPOSIT 900099 4175 4175 0 0 0 0 4175 4867608 4175 0 1718085 0 0 14574 14574 10815 10815 3848 3848 0 0 0 0 3578 3578 1162000 1162000 32545 32545 OTHER PROFESSIONAL FEES 1072578 1072578 MEDICARE ADJUSTMENT 109873 109873 OUTSIDE SERVICES 62200 62200 EQUIPMENT 570 570 192 0 192 0 2472773 109873 2362900 0 0 0 17564093 20453962 0 0 25175 1002517 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 17589268 21456479 8988303 10460679 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 8988303 10460679 0 0 0 0 X 0 0 5647 5647 8595318 10990153 8600965 10995800 17589268 21456479 2394835 0 X false false false RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED false false false false false false false false false BRUCE BOWNE CFO, VP FIN, TREAS 113822 0 0 0 0 0 0 0 0 0 113822 0 0 0 SUSAN TENORIO SECRETARY 16500 0 0 0 0 0 0 0 0 0 16500 0 0 0 MICHAEL NELSON PRESIDENT/CEO 59000 0 0 0 0 0 0 0 0 0 59000 0 0 0 SCHEDULE J, PART III COMPENSATION FROM AN UNRELATED ORGANIZATION OR INDIVIDUAL AS PART OF THE WIND DOWN OF INTER VALLEY AS A CORPORATION IT RELEASED ALL OF ITS EMPLOYEES OVER 12 MONTHS COMPLETING THIS IN SPRING 2023. IN ORDER TO COMPLETE THOSE FUNCTIONS STILL REQUIRED BY IVHP AS A CORPORATION IT ENTERED INTO A CONTRACT WITH AN UNRELATED ORGANIZATION TO PROVIDE SERVICES. THESE INCLUDES SERVICES FOR ACTING OFFICERS OF THE IVHP CORPORATION. WHILE IVHP REIMBURSES THE UNRELATED ORGANIZATION AS A TOTAL MONTHLY INVOICE, THESE COSTS ARE REFLECTED IN PART VII, SECTION A AND SCHEDULE J, PART II. SCHEDULE J, PART II COMPENSATION FROM AN UNRELATED ORGANIZATION OR INDIVIDUAL NAME - BRUCE BOWNE, COMPENSATION FROM UNRELATED ORGANIZATION - 113822, NAME OF UNRELATED ORGANIZATION - , TYPE OF COMPENSATION - SCHEDULE J, PART II COMPENSATION FROM AN UNRELATED ORGANIZATION OR INDIVIDUAL NAME - SUSAN TENORIO, COMPENSATION FROM UNRELATED ORGANIZATION - 16500, NAME OF UNRELATED ORGANIZATION - , TYPE OF COMPENSATION - SCHEDULE J, PART II COMPENSATION FROM AN UNRELATED ORGANIZATION OR INDIVIDUAL NAME - MICHAEL NELSON, COMPENSATION FROM UNRELATED ORGANIZATION - 59000, NAME OF UNRELATED ORGANIZATION - , TYPE OF COMPENSATION - 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 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.