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Nonprofiteer
← AVERA HEALTH PLANS INC

Form 990 for tax year 2022

Filed by AVERA HEALTH PLANS INC.

Totals

Total revenue
$337,041,127
Total expenses
$351,085,632
Contributions and grants received
$0
Grants paid
$575,000
Program service revenue
$335,376,997
Investment income
$1,664,130
Other revenue
$0
Total assets, end of year
$99,399,851
Total liabilities, end of year
$67,815,446
Net assets or fund balances, end of year
$31,584,405
Program services expenses (Part IX)
$320,046,900
Management and general expenses
$31,038,732
Fundraising expenses
$0
Program service expenses (Part III)
$320,046,900

Program services were 91.2% of total expenses calculated — Part IX's program-services column over total expenses, both as filed.

Line items

Every line the filer filed in Parts VIII, IX and X, as filed and in filed order. Blank columns are left out, and the lines are not forced to add up to the totals above.

Revenue

Part VIII, the statement of revenue.

  • 2a · Program service revenue: PREMIUM INCOME

    total $312,241,406 · related or exempt $312,241,406

  • 2b · Program service revenue: REIMBURSEMENTS BY UNINSURED PLANS

    total $14,778,920 · related or exempt $14,778,920

  • 2c · Program service revenue: COST CONTAINMENT ALLOCATIONS

    total $7,471,387 · related or exempt $7,471,387

  • 2d · Program service revenue: COB AND SUBROGATION

    total $495,956 · related or exempt $495,956

  • 2e · Program service revenue: NONMEMBER ADMIN SERVICES

    total $360,291 · unrelated business $360,291

  • 2f · All other program service revenue

    total $29,037 · related or exempt $32,317 · unrelated business -$3,280

  • 3 · Investment income

    total $1,825,467 · excluded $1,825,467

  • 7a · Gross sales of assets other than inventory

    securities $14,851,831

  • 7b · Less cost or other basis and sales expenses

    securities $15,013,168

  • 7c · Gain or loss

    securities -$161,337

  • 7d · Net gain or loss

    total -$161,337 · excluded -$161,337

Functional expenses

Part IX, the statement of functional expenses.

  • 1 · Grants to domestic organizations and governments

    total $575,000 · program services $575,000

  • 5 · Compensation of officers, directors and key employees

    total $2,591,384 · program services $917,699 · management and general $1,673,685

  • 7 · Other salaries and wages

    total $10,543,739 · program services $3,838,900 · management and general $6,704,839

  • 8 · Pension plan contributions

    total $417,715 · program services $165,952 · management and general $251,763

  • 9 · Other employee benefits

    total $1,749,332 · program services $995,330 · management and general $754,002

  • 10 · Payroll taxes

    total $864,898 · program services $312,624 · management and general $552,274

  • 11b · Fees: legal

    total $73,239 · management and general $73,239

  • 11c · Fees: accounting

    total $106,974 · management and general $106,974

  • 11f · Fees: investment management

    total $109,284 · management and general $109,284

  • 11g · Fees: other

    total $15,886,853 · program services $1,686,523 · management and general $14,200,330

  • 12 · Advertising and promotion

    total $1,558,001 · program services $8,748 · management and general $1,549,253

  • 13 · Office expenses

    total $817,771 · program services $319,118 · management and general $498,653

  • 14 · Information technology

    total $7,704 · management and general $7,704

  • 16 · Occupancy

    total $332,610 · management and general $332,610

  • 17 · Travel

    total $43,648 · program services $6,529 · management and general $37,119

  • 19 · Conferences, conventions and meetings

    total $9,781 · program services $3,178 · management and general $6,603

  • 22 · Depreciation, depletion and amortization

    total $325,998 · program services $325,998

  • 23 · Insurance

    total $135,610 · management and general $135,610

  • 24a · Other expenses: HOSPITAL AND MEDICAL

    total $297,265,618 · program services $297,265,618

  • 24b · Other expenses: CLAIMS ADJUSTMENT EXPEN

    total $9,967,133 · program services $9,967,133

  • 24c · Other expenses: PREMIUM TAXES

    total $3,455,777 · management and general $3,455,777

  • 24d · Other expenses: STATE AND FEDERAL ASSES

    total $203,712 · management and general $203,712

  • 24e · All other expenses

    total $4,043,851 · program services $3,658,550 · management and general $385,301

Balance sheet

Part X, book values.

  • 2 · Savings and temporary cash investments

    beginning of year -$589,128 · end of year $14,247,874

  • 11 · Investments: publicly traded securities

    beginning of year $72,998,737 · end of year $54,653,032

  • 15 · Other assets

    beginning of year $17,442,476 · end of year $30,498,945

  • 17 · Accounts payable and accrued expenses

    beginning of year $6,532,186 · end of year $5,253,626

  • 19 · Deferred revenue

    beginning of year $3,428,348 · end of year $3,392,787

  • 25 · Other liabilities

    beginning of year $46,225,402 · end of year $59,169,033

  • 29 · Capital stock, trust principal or current funds

    beginning of year $100 · end of year $100

  • 30 · Paid-in or capital surplus, or land, building or equipment fund

    beginning of year $54,079,053 · end of year $72,302,146

  • 31 · Retained earnings, endowment or other funds

    beginning of year -$20,413,004 · end of year -$40,717,841

Mission and programs · 2022

Mission

AVERA IS A HEALTH MINISTRY ROOTED IN THE GOSPEL. OUR MISSION IS TO MAKE A POSITIVE IMPACT IN THE LIVES AND HEALTH OF PERSONS AND COMMUNITIES BY PROVIDING QUALITY SERVICES GUIDED BY CHRISTIAN VALUES.

Activities or mission (Part I)

PROVIDE LOW-COST, HIGH QUALITY HEALTH PLAN COVERAGE.

  • AS AN ESSENTIAL COMPONENT OF THE AVERA HEALTH INTEGRATED DELIVERY PLAN, AVERA HEALTH PLANS (AHP) PROVIDES COVERAGE AND CONDUCTS OTHER ACTIVITIES THAT INCREASE THE HEALTH OF THE COMMUNITY IN ITS SERVICE AREA. AHP CONDUCTS SUBSTANTIALLY ALL OF ITS ACTIVITIES WITHIN THE SERVICE AREA OF AVERA HEALTH BUT DOES CONDUCT A SMALL PORTION BEYOND THE AVERA HEALTH SERVICE AREA TO FULFILL ITS MISSION OF MAKING A POSITIVE IMPACT IN THE COMMUNITIES IT SERVES BY ENSURING ADEQUATE RURAL HEALTH CARE IS AVAILABLE. AHP PROVIDES HEALTH INSURANCE COVERAGE TO AN UNDERSERVED POPULATION INCLUDING ELDERLY AND LOW INCOME, HIGH RISK AND MEDICALLY UNDERSERVED PERSONS. OF THE 80,000 TOTAL MEMBERS SERVED IN 2022, 10,182 OF THESE MEMBERS WERE MEDICARE SUPPLEMENT MEMBERS AND APPROXIMATELY 40% CONSISTS OF INDIVIDUALS OR EMPLOYEES OF SMALL GROUPS. APPROXIMATELY 21,200 MEMBERS ARE INDIVIDUALS AND MORE THAN 90.9% OF THE HEALTH CARE EXCHANGE ENROLLEES IN THE INDIVIDUAL CATEGORY WERE ELIGIBLE TO RECEIVE AN ADVANCE PREMIUM TAX CREDIT, WHICH MEANS THEY WERE BELOW 400% OF THE FEDERAL POVERTY LIMIT. AVERA HEALTH PLANS IS FURTHER DISTINGUISHED FROM THE FOR-PROFIT PLANS BY ITS PARTICIPATION IN THE FEDERAL HEALTH INSURANCE EXCHANGE/MARKETPLACE. AHP HAS AFFORDABLE, COMMUNITY-RATED PREMIUMS WHICH ARE MARKET COMPETITIVE, AND THEY DO NOT COVER AHP'S COSTS INCLUDING CLAIMS AND ADMINISTRATIVE EXPENSES. NET MEDICAL AND PHARMACY CLAIMS EXPENSE RESULTED IN A MEDICAL INCOME RATIO (MIR) AVERAGE OF 93% FOR 2022. SIGNIFICANT FINANCIAL SUPPORT BY AVERA HEALTH (501(C)(3)) ALLOWS AHP TO REMAIN FINANCIALLY VIABLE.AHP ALSO SPONSORS HEALTH EDUCATION OPEN FORUMS, OPEN HOUSES, AND WEBINARS THAT ARE OPEN TO THE PUBLIC.

    Expenses $320,046,900 · Grants $575,000 · Revenue $335,019,986

As filed on the 2022 return. The filer continues this part on Schedule O, which is not shown here.

Listed in Part VII

  • Bob Sutton

    PRESIDENT

    Total calculated
    $2,133,816
    From this org
    $0
    From related orgs
    $2,078,032
    Other
    $55,784
    Hours/week
    1 + 40 related

    Schedule J breakdown matched by us

    Base
    $0 + $2,064,357 related
    Bonus
    $0
    Other
    $0 + $13,675 related
    Deferred
    $0 + $15,250 related
    Nontaxable benefits
    $0 + $40,534 related
    Filer's total
    $0 + $2,133,816 related

  • Julie Lautt

    SEC/TREASURER

    Total calculated
    $1,103,540
    From this org
    $0
    From related orgs
    $1,086,452
    Other
    $17,088
    Hours/week
    1 + 40 related

    Schedule J breakdown matched by us

    Base
    $0 + $1,075,517 related
    Bonus
    $0 + $460 related
    Other
    $0 + $10,475 related
    Deferred
    $0 + $15,250 related
    Nontaxable benefits
    $0 + $1,838 related
    Filer's total
    $0 + $1,103,540 related

  • Doug Ekeren

    DIRECTOR

    Total calculated
    $750,622
    From this org
    $0
    From related orgs
    $704,190
    Other
    $46,432
    Hours/week
    1 + 40 related

    Schedule J breakdown matched by us

    Base
    $0 + $686,463 related
    Bonus
    $0 + $725 related
    Other
    $0 + $17,002 related
    Deferred
    $0 + $15,250 related
    Nontaxable benefits
    $0 + $31,182 related
    Filer's total
    $0 + $750,622 related

  • Debra Muller

    DIRECTOR; CEO

    Total calculated
    $600,251
    From this org
    $576,242
    From related orgs
    $0
    Other
    $24,009
    Hours/week
    40

    Schedule J breakdown matched by us

    Base
    $561,510
    Bonus
    $460
    Other
    $14,272
    Deferred
    $8,829
    Nontaxable benefits
    $15,180
    Filer's total
    $600,251

  • Gary Gaspar

    DIRECTOR UNTIL 02/2022

    Total calculated
    $0
    Hours/week
    1

  • Dr Clark Likness

    DIRECTOR

    Total calculated
    $0
    Hours/week
    1

  • Michael Bender

    DIRECTOR

    Total calculated
    $0
    Hours/week
    1

  • Clark Sinclair

    DIRECTOR

    Total calculated
    $0
    Hours/week
    1

  • Andrew Ellsworth

    DIRECTOR; PHYSICIAN

    Total calculated
    $251,918
    From this org
    $0
    From related orgs
    $200,589
    Other
    $51,329
    Hours/week
    1 + 40 related

    Schedule J breakdown matched by us

    Base
    $0 + $177,311 related
    Bonus
    $0 + $22,426 related
    Other
    $0 + $852 related
    Deferred
    $0 + $10,665 related
    Nontaxable benefits
    $0 + $40,664 related
    Filer's total
    $0 + $251,918 related

  • Rich Korman

    VICE PRESIDENT

    Total calculated
    $845,312
    From this org
    $0
    From related orgs
    $798,780
    Other
    $46,532
    Hours/week
    1 + 40 related

    Schedule J breakdown matched by us

    Base
    $0 + $783,792 related
    Bonus
    $0
    Other
    $0 + $14,988 related
    Deferred
    $0 + $15,250 related
    Nontaxable benefits
    $0 + $31,282 related
    Filer's total
    $0 + $845,312 related

  • Dr Preston Renshaw

    CMO

    Total calculated
    $466,096
    From this org
    $412,626
    From related orgs
    $0
    Other
    $53,470
    Hours/week
    40

    Schedule J breakdown matched by us

    Base
    $410,000
    Bonus
    $240
    Other
    $2,386
    Deferred
    $15,250
    Nontaxable benefits
    $38,220
    Filer's total
    $466,096

  • Jordan Anderson

    VICE PRESIDENT OF SALES

    Total calculated
    $381,015
    From this org
    $327,325
    From related orgs
    $0
    Other
    $53,690
    Hours/week
    40

    Schedule J breakdown matched by us

    Base
    $196,982
    Bonus
    $129,903
    Other
    $440
    Deferred
    $15,250
    Nontaxable benefits
    $38,440
    Filer's total
    $381,015

  • Christopher Jessen

    CFO

    Total calculated
    $323,528
    From this org
    $269,568
    From related orgs
    $0
    Other
    $53,960
    Hours/week
    40

    Schedule J breakdown matched by us

    Base
    $266,822
    Bonus
    $0
    Other
    $2,746
    Deferred
    $13,970
    Nontaxable benefits
    $39,990
    Filer's total
    $323,528

  • Lisa Carlson

    COO

    Total calculated
    $262,679
    From this org
    $216,806
    From related orgs
    $0
    Other
    $45,873
    Hours/week
    40

    Schedule J breakdown matched by us

    Base
    $216,088
    Bonus
    $0
    Other
    $718
    Deferred
    $10,332
    Nontaxable benefits
    $35,540
    Filer's total
    $262,678

  • Greg Jasmer

    CAO

    Total calculated
    $273,828
    From this org
    $225,483
    From related orgs
    $0
    Other
    $48,345
    Hours/week
    40

    Schedule J breakdown matched by us

    Base
    $224,336
    Bonus
    $240
    Other
    $907
    Deferred
    $10,385
    Nontaxable benefits
    $37,960
    Filer's total
    $273,828

  • Luke Merkel

    DIRECTOR OF PHARMACY

    Total calculated
    $247,585
    From this org
    $199,747
    From related orgs
    $0
    Other
    $47,838
    Hours/week
    40

    Schedule J breakdown matched by us

    Base
    $199,328
    Bonus
    $0
    Other
    $419
    Deferred
    $10,537
    Nontaxable benefits
    $37,301
    Filer's total
    $247,585

  • Renee Schroeder

    MEDICAL DIRECTOR

    Total calculated
    $311,995
    From this org
    $268,033
    From related orgs
    $0
    Other
    $43,962
    Hours/week
    40

    Schedule J breakdown matched by us

    Base
    $267,121
    Bonus
    $0
    Other
    $912
    Deferred
    $5,562
    Nontaxable benefits
    $38,400
    Filer's total
    $311,995

  • Jill Jaacks

    DIR. OF OPERATIONS UNTIL 10/2022

    Total calculated
    $248,544
    From this org
    $216,801
    From related orgs
    $0
    Other
    $31,743
    Hours/week
    40

    Schedule J breakdown matched by us

    Base
    $99,795
    Bonus
    $116,556
    Other
    $450
    Deferred
    $11,076
    Nontaxable benefits
    $20,667
    Filer's total
    $248,544

  • Ann Deweerd

    DIR. OF SELF-FUNDED UNTIL 10/2022

    Total calculated
    $246,794
    From this org
    $208,022
    From related orgs
    $0
    Other
    $38,772
    Hours/week
    40

    Schedule J breakdown matched by us

    Base
    $91,716
    Bonus
    $115,973
    Other
    $333
    Deferred
    $10,761
    Nontaxable benefits
    $28,011
    Filer's total
    $246,794

  • Anthony Pistono

    DIRECTOR OF RISK MGMT

    Total calculated
    $198,973
    From this org
    $156,352
    From related orgs
    $0
    Other
    $42,621
    Hours/week
    40

    Schedule J breakdown matched by us

    Base
    $154,146
    Bonus
    $0
    Other
    $2,206
    Deferred
    $8,210
    Nontaxable benefits
    $34,411
    Filer's total
    $198,973

Compensation is as filed in Part VII: reportable pay from this organization and from related organizations, other compensation, and hours per week. The total, marked calculated, is our sum of the three dollar columns, with a blank column counted as $0; the form itself has no total. On a Form 990-EZ the columns are Part IV's instead, and on a Form 990-PF Part VIII's — compensation, contributions to benefit plans, and expense account — and the total sums those. A Schedule J breakdown is as filed: base pay, bonus, other, deferred compensation and nontaxable benefits from this organization, with any from related organizations beside each, and the filer's own total. It is shown with the Part VII listing of the same name on the same return. The form gives no key between the two, so that pairing is ours, and is marked matched by us.

Schedule J

Answered yes

  • 4a · Severance or change-of-control payment
  • 7 · Other non-fixed payments

Answered no

  • 4b · Supplemental nonqualified retirement plan
  • 4c · Equity-based compensation arrangement
  • 5a · Pay contingent on this organization's revenues
  • 5b · Pay contingent on a related organization's revenues
  • 6a · Pay contingent on this organization's net earnings
  • 6b · Pay contingent on a related organization's net earnings
  • 8 · Paid under the initial-contract exception

The filer's explanations (Part III)

PART I, LINE 3
THE PRESIDENT'S COMPENSATION IS PAID BY A RELATED ORGANIZATION, AVERA HEALTH. AVERA HEALTH PLANS, INC. RELIED ON THE RELATED ORGANIZATION FOR DETERMINING THE COMPENSATION FOR THE PRESIDENT USING THE METHODS DESCRIBED IN PART I, LINE 3.
PART I, LINE 4A
JILL JAACKS RECEIVED A SEVERANCE PAYMENT OF $116,556. ANN DEWEERD RECEIVED A SEVERANCE PAYMENT OF $115,973.
PART I, LINE 7
A FORMULA IS USED TO DETERMINE BONUSES PAID FOR NEW SALES AND RETENTION.

Part I's answers as filed. A line not listed was left unanswered; on lines 1a and 3 that means the box was not checked.

Grants on this return

Related organizations on this return

Schedule R Part II: tax-exempt organizations related to the filer by control. It does not record shared board members or money.

Taxable family on this return

Schedule R Parts I, III and IV, as filed. These record ownership and control, not shared board members or money moved.

Related partnerships

Part III: related organizations taxable as a partnership, with the filer's share.

  • BROOKINGS HEALTH SYSTEM - AVERA HME LLC

    HEALTHCARE SERVICES · SD

  • AVERA HOME MEDICAL EQUIPMENT OF LAKES REGIONAL HEALTHCARE LLC

    MEDICAL SERVICES - HOME MEDICAL EQUIPMENT · IA

  • AVERA HOME MEDICAL EQUIPMENT OF SPENCER HOSPITAL LLC

    MEDICAL SERVICES - HOME MEDICAL EQUIPMENT · SD

  • SURGICAL ASSOCIATES ENDOSCOPY CLINIC LLC

    SURGICAL ASSOCIATES · SD

  • AVERA HOME MEDICAL EQUIPMENT OF SIOUX CENTER LLC

    MEDICAL SERVICES - HOME MEDICAL EQUIPMENT · IA

  • HEART HOSPITAL OF SOUTH DAKOTA LLC

    HEALTHCARE SERVICES · SD

  • AVERA HOME MEDICAL EQUIPMENT OF FLOYD VALLEY HOSPITAL LLC

    MEDICAL SERVICES - HOME MEDICAL EQUIPMENT · IA

  • CARAVAN HEALTH ACO 15 LLC DBA PRAIRIE VISTA CARE ORGANIZATION

    ACCOUNTABLE CARE ORGANIZATION · MO

  • CARAVAN HEALTH ACO 41 LLC DBA PRAIRIE VIEW CARE ORGANIZATION

    ACCOUNTABLE CARE ORGANIZATION · MO

Related corporations and trusts

Part IV: related organizations taxable as a corporation or trust.

  • ACCOUNTS MANAGEMENT INC

    C · COLLECTION AGENCY · SD

  • AVERA PROPERTY INSURANCE INC

    C · INSURANCE · SD

  • VALLEY HEALTH SERVICES

    C · PROPERTY HOLDING COMPANY · SD

  • ALUCENT BIOMEDICAL INC

    C · BIOTECH RESEARCH · SD

  • SOUTH DAKOTA STATE MEDICAL HOLDING COMPANYINC

    C · INSURANCE · SD

  • DAKOTACARE ADMINISTRATIVE SERVICESINC

    C · INSURANCE · SD

  • KORE CARES IN HOME SERVICES LLC

    S · IN-HOME CARE SERVICES · SD

  • ALUCENT AUSTRALIA PTY LTD

    BIOTECH RESEARCH · AS

Provenance

Return type
form_990
Tax year
2022
Filed
26 October 2023
IRS schema version
2022v5.0
Source object
202323039349300932

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