Avera Health Plans Inc
- Assets
- $94.1m
- Revenue
- $342.3m
- Investments
- $0.0
- Employees
- 201
- Location
- Sioux Falls, SD
- Founding
- 08/2016
- Data as of
- 12/2023
- EIN
- 46-0451539
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 12/2023, Avera Health Plans Inc employed 201 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 12/2023, Avera Health Plans Inc generated $342.3m in total revenue. This organization has experienced exceptional growth, as over the past 9 years, it has increased revenue by an average of 26.6% each year . All expenses for the organization totaled $331.0m during the year ending 12/2023. While expenses have increased by 22.3% per year over the past 9 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.
Form
990
Mission & Program ActivityExcerpts From the 990 Filing
TAX YEAR
2023
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 75,000 TOTAL MEMBERS SERVED IN 2023, 9,749 OF THESE MEMBERS WERE MEDICARE SUPPLEMENT MEMBERS AND APPROXIMATELY 40% CONSISTS OF INDIVIDUALS OR EMPLOYEES OF SMALL GROUPS. APPROXIMATELY 21,486 MEMBERS ARE INDIVIDUALS AND MORE THAN 94.2% 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 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 86.2% FOR 2023. 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.
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Board, Officers & Key Employees
| Name (title) | Role | Hours | Compensation |
|---|---|---|---|
Bob Sutton President (until Aug 2023) | OfficerTrustee | 1 | $0 |
Julie Lautt Sec/treasurer | OfficerTrustee | 1 | $0 |
Douglas Ekeren Director | Trustee | 1 | $0 |
Debra Muller Director; CEO (until Aug 2023) | OfficerTrustee | 40 | $618,225 |
Dr Clark Likness Director (until Aug 2023) | Trustee | 1 | $0 |
Michael Bender Director | Trustee | 1 | $0 |
Outside Vendors & Contractors
| Vendor Name (Service) | Service Year | Compensation |
|---|---|---|
Brown & Brown Rs Insurance Services Llc Consulting Services | 12/30/23 | $4,026,519 |
Healthedge Software Inc Contracted Services | 12/30/23 | $1,914,708 |
Mutual Med Insurance Svc Llc Commissions | 12/30/23 | $1,117,087 |
James D Leach Law Office Trust Account Legal | 12/30/23 | $850,000 |
Zelis Payments Holdings Llc Contracted Services | 12/30/23 | $856,409 |
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 | $339,904,335 |
| Investment income | $3,132,806 |
| Tax Exempt Bond Proceeds | $0 |
| Royalties | $0 |
| Net Rental Income | $0 |
| Net Gain/Loss on Asset Sales | -$694,914 |
| Net Income from Fundraising Events | $0 |
| Net Income from Gaming Activities | $0 |
| Net Income from Sales of Inventory | $0 |
| Miscellaneous Revenue | $0 |
| Total Revenue | $342,342,227 |
| Statement of Expenses | |
|---|---|
| Grants and other assistance to domestic organizations and domestic governments. | $600,000 |
| Grants and other assistance to domestic individuals. | $0 |
| Grants and other assistance to Foreign Orgs/Individuals | $0 |
| Benefits paid to or for members | $0 |
| Compensation of current officers, directors, key employees. | $2,468,269 |
| Compensation of current officers, directors, key employees. | $1,746,984 |
| Compensation to disqualified persons | $0 |
| Other salaries and wages | $12,214,534 |
| Pension plan accruals and contributions | $469,109 |
| Other employee benefits | $2,082,968 |
| Payroll taxes | $929,574 |
| Fees for services: Management | $0 |
| Fees for services: Legal | $604,312 |
| Fees for services: Accounting | $109,170 |
| Fees for services: Lobbying | $0 |
| Fees for services: Fundraising | $0 |
| Fees for services: Investment Management | $116,778 |
| Fees for services: Other | $15,852,667 |
| Advertising and promotion | $2,029,021 |
| Office expenses | $949,641 |
| Information technology | $3,260 |
| Royalties | $0 |
| Occupancy | $327,127 |
| Travel | $37,318 |
| Payments of travel or entertainment expenses for any federal, state, or local public officials | $0 |
| Conferences, conventions, and meetings | $2,927 |
| Interest | $0 |
| Payments to affiliates | $0 |
| Depreciation, depletion, and amortization | $332,830 |
| Insurance | $168,997 |
| All other expenses | $5,479,944 |
| Total functional expenses | $331,043,313 |
| Balance Sheet | |
|---|---|
| Cash—non-interest-bearing | $0 |
| Savings and temporary cash investments | $9,644,486 |
| Pledges and grants receivable | $0 |
| Accounts receivable, net | $0 |
| Loans from Officers, Directors, or Controlling Persons | $0 |
| Loans from Disqualified Persons | $0 |
| Notes and loans receivable | $0 |
| Inventories for sale or use | $0 |
| Prepaid expenses and deferred charges | $0 |
| Net Land, buildings, and equipment | $0 |
| Investments—publicly traded securities | $74,032,567 |
| Investments—other securities | $0 |
| Investments—program-related | $0 |
| Intangible assets | $0 |
| Other assets | $10,456,809 |
| Total assets | $94,133,862 |
| Accounts payable and accrued expenses | $5,992,786 |
| Grants payable | $0 |
| Deferred revenue | $2,879,530 |
| Tax-exempt bond liabilities | $0 |
| Escrow or custodial account liability | $0 |
| Loans and other payables to any current Officer, Director, or Controlling Person | $0 |
| Secured mortgages and notes payable | $0 |
| Unsecured mortgages and notes payable | $0 |
| Other liabilities | $38,410,056 |
| Total liabilities | $47,282,372 |
| Net assets without donor restrictions | $0 |
| Net assets with donor restrictions | $0 |
| Capital stock or trust principal, or current funds | $100 |
| Paid-in or capital surplus, or land, building, or equipment fund | $72,005,762 |
| Retained earnings, endowment, accumulated income, or other funds | -$25,154,372 |
| Total liabilities and net assets/fund balances | $94,133,862 |