SCHEDULE R
(Form 990)
Department of the Treasury
Internal Revenue Service
Related Organizations and Unrelated Partnerships
MediumBulletComplete if the organization answered "Yes" on Form 990, Part IV, line 33, 34, 35b, 36, or 37.
MediumBulletAttach to Form 990.
MediumBullet Go to www.irs.gov/Form990 for instructions and the latest information.

OMB No. 1545-0047
2021
Open to Public Inspection
Name of the organization
KAISER FOUNDATION HEALTH PLAN INC
 
Employer identification number

94-1340523
Part I
Identification of Disregarded Entities. Complete if the organization answered "Yes" on Form 990, Part IV, line 33.
(a)
Name, address, and EIN (if applicable) of disregarded entity


(b)
Primary activity


 		(c)
Legal domicile (state
or foreign country)

 		(d)
Total income


 		(e)
End-of-year assets


 		(f)
Direct controlling
entity
(1) KP CAL LLC
ONE KAISER PLAZA 15L
OAKLAND,CA94612
20-2712661 		HEALTH CARE CA 0 0 NA
 
(2) ORDWAY INTERNATIONAL LTD
ONE KAISER PLAZA 15L
OAKLAND,CA94612
 HOLDING CO. BD 18,500 9,633,765 NA
 
(3) ORDWAY INDEMNITY LTD
ONE KAISER PLAZA 15L
OAKLAND,CA94612
90-0031974 		INSURANCE BD 6,994,455 42,899,194 ORDWAY INT'L
 
(4) RAINBOW DIALYSIS LLC
ONE KAISER PLAZA 15L
OAKLAND,CA94612
27-0473737 		Health Care DE 8,548,143 8,027,618 NA
 




Part II
Identification of Related Tax-Exempt Organizations. Complete if the organization answered "Yes" on Form 990, Part IV, line 34 because it had one or more related tax-exempt organizations during the tax year.
(a)
Name, address, and EIN of related organization


(b)
Primary activity


 		(c)
Legal domicile (state
or foreign country)

 		(d)
Exempt Code section


 		(e)
Public charity status
(if section 501(c)(3))

 		(f)
Direct controlling
entity

 		(g)
Section 512(b)(13) controlled entity?
Yes No
(1)KAISER FOUNDATION HOSPITALS
ONE KAISER PLAZA 15L

OAKLAND,CA94612
94-1105628 		HEALTH CARE CA 501(c)(3) 3 NA
 
 
No
(2)KAISER FOUNDATION HEALTH PLAN OF CO
ONE KAISER PLAZA 15L

OAKLAND,CA94612
84-0591617 		HEALTH CARE CO 501(c)(3) 10 KFHP INC
 
Yes
 
(3)KAISER FOUNDATION HEALTH PLAN OF GA INC
ONE KAISER PLAZA 15L

OAKLAND,CA94612
58-1592076 		HEALTH CARE GA 501(c)(3) 10 KFHP INC
 
Yes
 
(4)KAISER FOUNDATION HEALTH PLAN OF THE MAS
ONE KAISER PLAZA 15L

OAKLAND,CA94612
52-0954463 		HEALTH CARE MD 501(c)(3) 10 KFHP INC
 
Yes
 
(5)KAISER FOUNDATION HEALTH PLAN OF THE NW
ONE KAISER PLAZA 15L

OAKLAND,CA94612
93-0798039 		HEALTH CARE OR 501(c)(3) 10 KFHP INC
 
Yes
 
(6)KAISER FDN HEALTH PLAN OF WASHINGTON
ONE KAISER PLAZA 15L

OAKLAND,CA94612
91-0511770 		HEALTH CARE WA 501(c)(3) 3 KFHPW HLDING
 
Yes
 
(7)KAISER HOSPITAL ASSET MANAGEMENT INC
ONE KAISER PLAZA 15L

OAKLAND,CA94612
94-3299125 		ASSET MGMT CA 501(c)(3) 12-I KFH
 
Yes
 
(8)KAISER HEALTH PLAN ASSET MANAGEMENT INC
ONE KAISER PLAZA 15L

OAKLAND,CA94612
94-3299124 		ASSET MGMT CA 501(c)(3) 12-I KFHP INC
 
Yes
 
(9)CAMP BOWIE SERVICE CENTER
ONE KAISER PLAZA 15L

OAKLAND,CA94612
94-3299123 		ADMIN CA 501(c)(3) 12-I KFHP INC
 
Yes
 
(10)LOKAHI ASSURANCE LTD
ONE KAISER PLAZA 15L

OAKLAND,CA94612
91-2171891 		WC PLACEMENT HI 501(c)(3) 12-I KFHP INC
 
Yes
 
(11)1800 HARRISON FOUNDATION
ONE KAISER PLAZA 15L

OAKLAND,CA94612
94-3317484 		FINANCING CA 501(c)(3) 12-I KFHP INC
 
Yes
 
(12)KAISER HOSPITAL ASSISTANCE CORPORATION
ONE KAISER PLAZA 15L

OAKLAND,CA94612
31-1779500 		FINANCING CA 501(c)(3) 12-I KFH
 
Yes
 
(13)KAISER HEALTH ALTERNATIVES
ONE KAISER PLAZA 15L

OAKLAND,CA94612
93-0954562 		HEALTH CARE OR 501(C)(3) 10 KFHP INC
 
Yes
 
(14)KP BERNARD J TYSON SCHOOL OF MEDICINE
ONE KAISER PLAZA 15L

OAKLAND,CA94612
81-4053028 		MEDICAL EDU CA 501(C)(3) 2 KFH
 
Yes
 
(15)KFHPW HOLDINGS
ONE KAISER PLAZA 15L

OAKLAND,CA94612
93-0480268 		HEALTH CARE WA 501(C)(3) 12-I KFHP INC
 
Yes
 
(16)GROUP HEALTH NORTHWEST
ONE KAISER PLAZA 15L

OAKLAND,CA94612
91-1216856 		INACTIVE WA 501(C)(3) 12-I KFHP OF WA
 
Yes
 
(17)KAISER FDN FOR THE ADV OF INTEGRATED HC
ONE KAISER PLAZA 15L

OAKLAND,CA94612
82-3819611 		ADVOCACY CA 501(C)(4) N/A KFHP INC
 
Yes
 
(18)GROUP HEALTH OF WASHINGTON
ONE KAISER PLAZA 15L

OAKLAND,CA94612
91-1314907 		INACTIVE WA 501(c)(3) 12-I KFHP OF WA
 
Yes
 
For Paperwork Reduction Act Notice, see the Instructions for Form 990.
Cat. No. 50135Y
Schedule R (Form 990) 2021
Schedule R (Form 990) 2021
Page 2
Part III
Identification of Related Organizations Taxable as a Partnership. Complete if the organization answered "Yes" on Form 990, Part IV, line 34, because it had one or more related organizations treated as a partnership during the tax year.
(a)
Name, address, and EIN of
related organization



 		(b)
Primary activity




 		(c)
Legal
domicile
(state or foreign
country)


 		(d)
Direct controlling
entity



 		(e)
Predominant income(related, unrelated, excluded from tax under sections 512-514)

(f)
Share of total income




 		(g)
Share of end-of-year
assets



 		(h)
Disproprtionate allocations?




 		(i)
Code V-UBI
amount in box 20 of
Schedule K-1
(Form 1065)
 		(j)
General or
managing
partner?



 		(k)
Percentage
ownership
Yes No Yes No
(1) NXT CAP SR FD ILLC

191 N WACKER DR 1200
CHICAGO,IL60606
37-1651297 		INVESTMENT DE NA
  		NONE 0 0     0      












Part IV
Identification of Related Organizations Taxable as a Corporation or Trust. Complete if the organization answered "Yes" on Form 990, Part IV, line 34 because it had one or more related organizations treated as a corporation or trust during the tax year.
(a)
Name, address, and EIN of
related organization
 		(b)
Primary activity
 		(c)
Legal
domicile
(state or foreign
country)
 		(d)
Direct controlling
entity
 		(e)
Type of entity
(C corp, S corp,
or trust) 		(f)
Share of total income
 		(g)
Share of end-of-year
assets
 		(h)
Percentage
ownership
 		(i)
Section 512(b)(13) controlled entity?
Yes No
(1) OAK TREE ASSURANCE LTD

ONE KAISER PLAZA 15L
OAKLAND,CA94612
03-0329760 		INSURANCE VT NA
  		C CORP 3,341,315 117,509,156 100.000 % Yes  
(2) KAISER PERMANENTE INSURANCE COMPANY

ONE KAISER PLAZA 15L
OAKLAND,CA94612
94-3203402 		INSURANCE CA NA
  		C CORP 173,557,538 230,952,093 100.000 % Yes  
(3) KAISER PERMANENTE INTERNATIONAL

ONE KAISER PLAZA 15L
OAKLAND,CA94612
94-3245176 		CONSULTING CA NA
  		C CORP 0 0   Yes  
(4) GROUP HEALTH SERVICES INC

ONE KAISER PLAZA 15L
OAKLAND,CA94612
91-1392222 		INACTIVE WA NA
  		C CORP 0 0   Yes  
(5) KFHP OF WASHINGTON OPTIONS INC

ONE KAISER PLAZA 15L
OAKLAND,CA94612
91-1467158 		INSURANCE WA NA
  		C CORP 0 0   Yes  




Schedule R (Form 990) 2021
Schedule R (Form 990) 2021
Page 3
Part V
Transactions With Related Organizations. Complete if the organization answered "Yes" on Form 990, Part IV, line 34, 35b, or 36.
Note. Complete line 1 if any entity is listed in Parts II, III, or IV of this schedule.
Yes
No
1 During the tax year, did the orgranization engage in any of the following transactions with one or more related organizations listed in Parts II-IV?
a Receipt of (i) interest, (ii) annuities, (iii) royalties, or (iv) rent from a controlled entity .....................
1a
Yes
 
b Gift, grant, or capital contribution to related organization(s) ............................
1b
Yes
 
c Gift, grant, or capital contribution from related organization(s) ............................
1c
Yes
 
d Loans or loan guarantees to or for related organization(s) ............................
1d
Yes
 
e Loans or loan guarantees by related organization(s) ............................
1e
Yes
 
f Dividends from related organization(s) ............................
1f
 
No
g Sale of assets to related organization(s) ............................
1g
 
No
h Purchase of assets from related organization(s) ............................
1h
Yes
 
i Exchange of assets with related organization(s) ............................
1i
Yes
 
j Lease of facilities, equipment, or other assets to related organization(s) .......................
1j
Yes
 
k Lease of facilities, equipment, or other assets from related organization(s) ......................
1k
Yes
 
l Performance of services or membership or fundraising solicitations for related organization(s) .....................
1l
Yes
 
m Performance of services or membership or fundraising solicitations by related organization(s) .................
1m
Yes
 
n Sharing of facilities, equipment, mailing lists, or other assets with related organization(s) ...................
1n
Yes
 
o Sharing of paid employees with related organization(s) ............................
1o
Yes
 
p Reimbursement paid to related organization(s) for expenses ............................
1p
Yes
 
q Reimbursement paid by related organization(s) for expenses ............................
1q
Yes
 
r Other transfer of cash or property to related organization(s) ............................
1r
Yes
 
s Other transfer of cash or property from related organization(s) ............................
1s
Yes
 
2
If the answer to any of the above is "Yes," see the instructions for information on who must complete this line, including covered relationships and transaction thresholds.
(a)
Name of related organization 		(b)
Transaction
type (a-s) 		(c)
Amount involved 		(d)
Method of determining amount involved
(1) KAISER FOUNDATION HOSPITALS

 H 187,853 PER AGREEMENT
(2) KAISER FOUNDATION HOSPITALS

 L 4,504,606,461 PER AGREEMENT
(3) KAISER FOUNDATION HOSPITALS

 M 24,672,999,815 PER AGREEMENT
(4) KAISER FOUNDATION HOSPITALS

 P 4,500,492,886 PER AGREEMENT
(5) KAISER FOUNDATION HOSPITALS

 Q 8,203,030,594 PER AGREEMENT
(6) KAISER FOUNDATION HOSPITALS

 R 27,925,223,027 PER AGREEMENT
(7) KAISER FOUNDATION HOSPITALS

 S 115,756,470 PER AGREEMENT
(8) KAISER FDN HEALTH PLAN OF COLORADO

 B 94,531 PER AGREEMENT
(9) KAISER FDN HEALTH PLAN OF COLORADO

 C 897,341 PER AGREEMENT
(10) KAISER FDN HEALTH PLAN OF COLORADO

 L 185,998,262 PER AGREEMENT
(11) KAISER FDN HEALTH PLAN OF COLORADO

 M 295,085,412 PER AGREEMENT
(12) KAISER FDN HEALTH PLAN OF COLORADO

 P 62,919,458 PER AGREEMENT
(13) KAISER FDN HEALTH PLAN OF COLORADO

 Q 92,469,143 PER AGREEMENT
(14) KAISER FDN HEALTH PLAN OF COLORADO

 R 183,925,089 PER AGREEMENT
(15) KAISER FDN HEALTH PLAN OF COLORADO

 S 57,380,491 PER AGREEMENT
(16) KAISER FDN HEALTH PLAN OF GEORGIA INC

 C 520,311 PER AGREEMENT
(17) KAISER FDN HEALTH PLAN OF GEORGIA INC

 L 121,181,683 PER AGREEMENT
(18) KAISER FDN HEALTH PLAN OF GEORGIA INC

 M 318,436,824 PER AGREEMENT
(19) KAISER FDN HEALTH PLAN OF GEORGIA INC

 P 53,834,025 PER AGREEMENT
(20) KAISER FDN HEALTH PLAN OF GEORGIA INC

 Q 217,062,631 PER AGREEMENT
(21) KAISER FDN HEALTH PLAN OF GEORGIA INC

 R 376,003,757 PER AGREEMENT
(22) KAISER FDN HEALTH PLAN OF GEORGIA INC

 S 28,497,101 PER AGREEMENT
(23) KFHP OF THE MID-ATLANTIC STATES INC

 L 287,778,224 PER AGREEMENT
(24) KFHP OF THE MID-ATLANTIC STATES INC

 M 594,954,034 PER AGREEMENT
(25) KFHP OF THE MID-ATLANTIC STATES INC

 P 92,407,414 PER AGREEMENT
(26) KFHP OF THE MID-ATLANTIC STATES INC

 Q 180,433,045 PER AGREEMENT
(27) KFHP OF THE MID-ATLANTIC STATES INC

 R 404,758,034 PER AGREEMENT
(28) KFHP OF THE MID-ATLANTIC STATES INC

 S 112,236,439 PER AGREEMENT
(29) KAISER FDN HEALTH PLAN OF THE NORTHWEST

 A 128 PER AGREEMENT
(30) KAISER FDN HEALTH PLAN OF THE NORTHWEST

 L 253,967,079 PER AGREEMENT
(31) KAISER FDN HEALTH PLAN OF THE NORTHWEST

 M 348,803,922 PER AGREEMENT
(32) KAISER FDN HEALTH PLAN OF THE NORTHWEST

 P 97,318,511 PER AGREEMENT
(33) KAISER FDN HEALTH PLAN OF THE NORTHWEST

 Q 56,751,117 PER AGREEMENT
(34) KAISER FDN HEALTH PLAN OF THE NORTHWEST

 R 335,033,445 PER AGREEMENT
(35) KAISER FDN HEALTH PLAN OF THE NORTHWEST

 S 79,375,758 PER AGREEMENT
(36) KAISER FDN HEALTH PLAN OF WASHINGTON

 C 435,380 PER AGREEMENT
(37) KAISER FDN HEALTH PLAN OF WASHINGTON

 L 81,051,951 PER AGREEMENT
(38) KAISER FDN HEALTH PLAN OF WASHINGTON

 M 28,995,674 PER AGREEMENT
(39) KAISER FDN HEALTH PLAN OF WASHINGTON

 P 50,697,176 PER AGREEMENT
(40) KAISER FDN HEALTH PLAN OF WASHINGTON

 Q 72,355,691 PER AGREEMENT
(41) KAISER FDN HEALTH PLAN OF WASHINGTON

 R 984,589 PER AGREEMENT
(42) CAMP BOWIE SERVICE CENTER

 L 63,356,018 PER AGREEMENT
(43) CAMP BOWIE SERVICE CENTER

 M 13,882,859 PER AGREEMENT
(44) CAMP BOWIE SERVICE CENTER

 P 22,991,751 PER AGREEMENT
(45) CAMP BOWIE SERVICE CENTER

 Q 15,648,056 PER AGREEMENT
(46) CAMP BOWIE SERVICE CENTER

 R 42,326,496 PER AGREEMENT
(47) CAMP BOWIE SERVICE CENTER

 S 17,134,261 PER AGREEMENT
(48) 1800 HARRISON FOUNDATION

 A 3,526,957 PER AGREEMENT
(49) KAISER FDN FOR THE ADV OF INTEGRATED HC

 Q 88,000 PER AGREEMENT
(50) KAISER FDN FOR THE ADV OF INTEGRATED HC

 S 156,784 PER AGREEMENT
(51) KAISER PERMANENTE INSURANCE COMPANY

 A 145,785 PER AGREEMENT
(52) KAISER PERMANENTE INSURANCE COMPANY

 L 176,591,421 PER AGREEMENT
(53) KAISER PERMANENTE INSURANCE COMPANY

 M 146,547,711 PER AGREEMENT
(54) KAISER PERMANENTE INSURANCE COMPANY

 P 22,854,197 PER AGREEMENT
(55) KAISER PERMANENTE INSURANCE COMPANY

 Q 46,542,073 PER AGREEMENT
(56) KAISER PERMANENTE INSURANCE COMPANY

 R 9,712,834 PER AGREEMENT
(57) KAISER PERMANENTE INSURANCE COMPANY

 S 499,814 PER AGREEMENT
(58) LOKAHI ASSURANCE LTD

 L 47,286,781 PER AGREEMENT
(59) LOKAHI ASSURANCE LTD

 M 166,942,672 PER AGREEMENT
(60) LOKAHI ASSURANCE LTD

 Q 196,559,669 PER AGREEMENT
(61) LOKAHI ASSURANCE LTD

 R 2,700,295 PER AGREEMENT
(62) LOKAHI ASSURANCE LTD

 S 5,942,853 PER AGREEMENT
(63) KAISER PERMANENTE INTERNATIONAL

 P 80,270 PER AGREEMENT
(64) KAISER PERMANENTE INTERNATIONAL

 Q 468,453 PER AGREEMENT
(65) KAISER HOSPITAL ASSET MANAGEMENT INC

 P 93,696 PER AGREEMENT
(66) KAISER HEALTH PLAN ASSET MANAGEMENT INC

 H 2,193,444 PER AGREEMENT
(67) KAISER HEALTH PLAN ASSET MANAGEMENT INC

 K 66,100,768 PER AGREEMENT
(68) KAISER HEALTH PLAN ASSET MANAGEMENT INC

 P 1,442,279 PER AGREEMENT
(69) KAISER HEALTH PLAN ASSET MANAGEMENT INC

 Q 7,404,727 PER AGREEMENT
(70) KAISER HEALTH PLAN ASSET MANAGEMENT INC

 R 648,440 PER AGREEMENT
(71) KAISER HEALTH PLAN ASSET MANAGEMENT INC

 S 66,607,110 PER AGREEMENT
(72) OAK TREE ASSURANCE LTD

 L 966,381 PER AGREEMENT
(73) OAK TREE ASSURANCE LTD

 M 302,919 PER AGREEMENT
(74) OAK TREE ASSURANCE LTD

 P 2,144,790 PER AGREEMENT
(75) OAK TREE ASSURANCE LTD

 Q 2,077,599 PER AGREEMENT
Schedule R (Form 990) 2021
Schedule R (Form 990) 2021
Page 4
Part VI
Unrelated Organizations Taxable as a Partnership. Complete if the organization answered "Yes" on Form 990, Part IV, line 37.
Provide the following information for each entity taxed as a partnership through which the organization conducted more than five percent of its activities (measured by total assets or gross revenue) that was not a related organization. See instructions regarding exclusion for certain investment partnerships.
(a)
Name, address, and EIN of entity 		(b)
Primary activity 		(c)
Legal domicile
(state or foreign
country) 		(d)
Predominant income (related, unrelated, excluded from tax under sections 512-514)

(e)
Are all partners
section
501(c)(3)
organizations? 		(f)
Share of total income




 		(g)
Share of
end-of-year
assets 		(h)
Disproprtionate allocations? 		(i)
Code V-UBI
amount in box 20
of Schedule K-1
(Form 1065) 		(j)
General or
managing
partner? 		(k)
Percentage
ownership
Yes No Yes No Yes No






























Schedule R (Form 990) 2021
Schedule R (Form 990) 2021
Page 5
Part VII
Supplemental Information
Provide additional information for responses to questions on Schedule R. See instructions.
Return Reference Explanation
Schedule R (Form 990) 2021

Additional Data


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