Avera Health Plans Inc

Organization Overview

Avera Health Plans Inc is located in Sioux Falls, SD. The organization was established in 2016. According to its NTEE Classification (E80) the organization is classified as: Health (General & Financing), under the broad grouping of Health Care and related organizations. As of 12/2021, Avera Health Plans Inc employed 180 individuals. This organization is an independent organization and not affiliated with a larger national or regional group of organizations. Avera Health Plans Inc is a 501(c)(4) and as such, is described as a "Civic League, Social Welfare Organization, and Local Association of Employees" by the IRS.

For the year ending 12/2021, Avera Health Plans Inc generated $344.8m in total revenue. This organization has experienced exceptional growth, as over the past 7 years, it has increased revenue by an average of 35.6% each year . All expenses for the organization totaled $383.3m during the year ending 12/2021. While expenses have increased by 32.3% per year over the past 7 years. They've been increasing with an increasing level of total revenue. You can explore the organizations financials more deeply in the financial statements section below.

Mission & Program ActivityExcerpts From the 990 Filing

TAX YEAR

2021

Describe the Organization's Mission:

Part 3 - Line 1

PROVIDE LOW-COST, HIGH QUALITY HEALTH PLAN COVERAGE.

Describe the Organization's Program Activity:

Part 3 - Line 4a

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 89,000 TOTAL MEMBERS SERVED IN 2021, 10,283 OF THESE MEMBERS WERE MEDICARE SUPPLEMENT MEMBERS AND APPROXIMATELY 33.3% CONSISTS OF INDIVIDUALS OR EMPLOYEES OF SMALL GROUPS. APPROXIMATELY 21,600 MEMBERS ARE INDIVIDUALS AND MORE THAN 93.2% 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 FOR-PROFIT PLANS BY ITS PARTICIPATION IN THE FEDERAL HEALTH INSURANCE EXCHANGE/MARKETPLACE. AHP HAS AFFORDABLE, COMMUNITY-RATED REMIUMSWHICH ARE MARKET COMPETITIVE, AND THAT DO NOT COVER AHP'S COSTS. NET MEDICAL AND PHARMACY CLAIMS EXPENSE RESULTED IN A MEDICAL INCOME RATIO (MIR) AVERAGE OF 102% FOR 2021. SIGNIFICANT FINANCIAL SUPPORT BY AVERA HEALTH (501(C)(3)) ALLOWS AHP TO REMAIN FINANCIALLY VIABLE.IN ADDITION TO PROVIDING LOW-COST INSURANCE COVERAGE, AHP CONDUCTS FREE AND/OR LOW COST MEDICAL SCREENINGS AT THE LOCATION OF ITS EMPLOYER GROUPS FOR THE BENEFIT OF ALL EMPLOYEES. AHP ALSO SPONSORS HEALTH EDUCATION OPEN FORUMS, OPEN HOUSES, AND WEBINARS THAT ARE OPEN TO THE PUBLIC.


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Board, Officers & Key Employees

Name (title)Compensation
Debra Muller
CEO
$553,955
Dr Preston Renshaw
Cmo
$397,883
Jordan Anderson
Vice President Of Sales
$303,226
Christopher Jessen
CFO
$249,519
Renee Schroeder
Medical Director
$234,439
Shellie Reitzel
Director Of Sales Until 05/2021
$213,628

Outside Vendors & Contractors

Vendor Name (Service)Compensation
Beecher Evergreen Mgd Care
Consulting Services
$3,781,601
Mutual Med Insurance Svc Llc
Commissions
$1,337,607
Flextech Inc
Consulting Services
$3,514,836
Healthedge Software Inc
Contracted Services
$2,688,059
Milliman
Actuarial Services
$1,027,547
View All Vendors

Financial Statements

Statement of Revenue
Federated campaigns$0
Membership dues$0
Fundraising events$0
Related organizations$0
Government grants $0
All other contributions, gifts, grants, and similar amounts not included above$0
Noncash contributions included in lines 1a–1f $0
Total Revenue from Contributions, Gifts, Grants & Similar$0
Total Program Service Revenue$335,626,713
Investment income $2,051,362
Tax Exempt Bond Proceeds $0
Royalties $0
Net Rental Income $0
Net Gain/Loss on Asset Sales $7,136,496
Net Income from Fundraising Events $0
Net Income from Gaming Activities $0
Net Income from Sales of Inventory $0
Miscellaneous Revenue$0
Total Revenue $344,814,571

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