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FA-02 Legacy-Legacy Foundation-PacificSource

On May 5, 2025, Legacy Health and Legacy Foundation withdrew its CCO Form A submission filed with the CCO Form A Review program for the proposed transfer of Legacy Health’s 50% member interest in PacificSource. OHA therefore stopped its review and will not issue a decision for this proposed transaction. OHA will no longer accept public comments and all planned listening sessions have been cancelled. 

For any questions, email CCO.FormA@oha.oregon.gov.

OHA Publications

Letters sent to the Community Advisory Councils

OHA sent letters to the CCO Community Advisory Councils in each CCO region affected by the proposed transaction with information about the public listening sessions and the transaction review. The listening sessions mentioned in the letters are cancelled because the transaction is withdrawn.

Transaction Materials

Exhibit 1- Legacy Health Organizational Chart
Exhibit 2- PacificSource Organizational Chart
Exhibit 3- Post-Closing Organizational Chart

Exhibit 9- Foundation Workgroup



Request for Information Document Index

Request for Information Privilege Log

Request for Information Confidentiality Log

Exhibit 1 - Foundation Transfer Calculation [Redacted]
Exhibit 10 - PacificSource Organizational Chart

Exhibit 11 - PacificSource GAAP Financial Statements 

FY2021 PacificSource GAAP Financial Statements [Redacted]

FY2022 PacificSource GAAP Financial Statements  [Redacted]

FY2023 PacificSource GAAP Financial Statements  [Redacted]

Exhibit 12 - PacificSource Medicare Advantage Service Area

Exhibit 13 - PacificSource Community Solutions Medicaid Enrollment 

Exhibit 14 - Past transactions where Legacy Health (or an affiliate) was a party

Exhibit 15 - Post-Closing Organizational Chart

Exhibit 16 - "A Generational Opportunity to Advance Health Equity in Oregon and SW Washington" Report
Exhibit 18 - MOU Between Legacy Health and Legacy Health Foundation [Redacted]
​​Exhibit 23 - Plans by Market and Portfolio 

2024 and 2025 Medicare Plans by Market and Portfolio ​

Exhibit 24 - OHSU-Legacy Transaction Update [Redacted]

Exhibit 25 - Legacy Health and OHSU Network Grid

Exhibit 26 - PacificSource Legacy Health Agreements [Redacted]

Exhibit 27 - PacificSource Legacy Health Additional Agreements [Redacted]

Exhibit 28 - PacificSource Commercial Budgeted Projections 2025-2027 [Redacted]

Exhibit 29 - PacificSource Medicare and Medicaid Oregon Projections [Redacted]

Exhibit 30 - RBC Estimates 2023-2026 [Fully Redacted]

Exhibit 31 - Financial Projections for OHSU-Legacy Transaction [Redacted]

Exhibit 32 - Health Share and PacificSource Agreements [Redacted]

Exhibit 35 - Foundation Board Data Room Materials

Legacy Health Foundation Restated Articles of Incorporation 
Bylaws of Legacy Health Foundation [Redacted]​

​​Legacy Health Foundation Board Roster [Redacted]
Pacific Health Associates, Legacy Health, and PacificSource Organizational Chart 
PacificSource Restated Articles of Incorporation 
Bylaws of PacificSource [Redacted]
PacificSource Certificate of Existence 

PacificSource Pace, LLC Operating Agreement [Redacted]

PacificSource Pace, LLC Articles of Organization

PacificSource Pace, LLC Certificate of Existence 

PacificSource Health Plans Restated Articles of Incorporation 

PacificSource Health Plans Bylaws [Redacted]

PacificSource Health Plans Certificate of Existence 

PacificSource Properties, LLC Operating Agreement [Redacted]

PacificSource Properties, LLC Articles of Organization 

PacificSource Properties, LLC Certificate of Existence 

PacificSource Administrators, Inc. Bylaws [Redacted]

PacificSource Administrators, Inc. Certificate of Existence

PacificSource Administrators, Inc. Articles of Incorporation 

PacificSource Administrators, Inc. and PacificSource Self-Insurance Administrators, Inc. Merger

PacificSource Assurance, Inc. Certificate of Existence 

Primary Health, Inc. Bylaws [Redacted]

Primary Health, Inc. and PacificSource Assurance, Inc. Articles of Conversion 

PacificSource PCHP Articles of Incorporation 

PacificSource PCHP and Springfield Health Plans, Inc. Articles of Merger

PacificSource Community Health Plans Bylaws [Redacted]

PacificSource Community Health Plans Certificate of Existence 

Conners Group Articles of Incorporation 

Conners Group Bylaws [Redacted]

Conners Group and PacificSource Community Solutions, Inc. Articles of Merger

PacificSource Community Solutions Certificate of Existence 

FY2021 PacificSource GAAP Financial Statements [Redacted]

FY2022 PacificSource GAAP Financial Statements [Redacted]

FY22 Legacy Health Foundation Form 990

FY23 Legacy Health Foundation Form 990

Legacy Health Mission and Vision 

PacificSource Administrators, Inc. Registered TPA License  (Idaho)

PacificSource Community Health Plans Certificate of Authority (Montana)

PacificSource Administrators, Inc. Insurance License (Oregon) 

PacificSource Administrators, Inc. Insurance License (Washington) ​

PacificSource Community Health Plans Certificate of Authority (Idaho) 

PacificSource Community Health Plans Certificate of Authority (Montana) 

PacificSource Community Health Plans Certificate of Authority (Oregon) 

PacificSource Community Health Plans Certificate of Registration (Washington)

PacificSource Community Solutions Insurance License (Oregon) 

PacificSource Health Plans Certificate of Authority (Idaho) 

PacificSource Health Plans Certificate of Authority (Montana)

PacificSource Health Plans Insurance License (Oregon)

PacificSource Health Plans Certificate of Authority (Oregon) 

PacificSource Health Plans Certificate of Registration (Washington) 

Exhibit 36 - Legacy Health Correspondence Re: PacificSource [Redacted]

Exhibit 37 - Legacy Health Board Materials [Redacted]

Exhibit 39 - FY24 Financial Forcast LRFP [Redacted]​
 



One Page Transaction Summary