Liabilities / Assets
81st percentile
Higher debt load relative to assets than 81% of similar nonprofits.
Caresource
EIN 31-1143265 • 501(c)3 • Dayton, OH
Profile
Caresource's vision is to transform lives through innovative health and life services. The organization's mission is to make a lasting difference in our members' lives by improving their health and well-being. Caresource is a mission-driven medicaid health insuring corporation (commonly referred to as a health maintenance organization) licensed by the state of ohio.
Siviq Scores
Precomputed percentiles relative to similar nonprofits. These scores are descriptive rather than judgmental.
0.62x
Liabilities / Revenue
16th percentile
Higher debt load relative to revenue than 16% of similar nonprofits.
Net Margin
28th percentile
Higher net margin than 28% of similar nonprofits.
Top Officer Pay
94th percentile
Higher top officer pay than 94% of similar nonprofits.
Top officer pay equals 0.1% of source-year revenue.
Asset Growth
4th percentile
Faster asset growth than 4% of similar nonprofits.
Revenue Growth
11th percentile
Faster revenue growth than 11% of similar nonprofits.
Balance Sheet
Assets
Down$2,248,954,422
Down $418,131,339 (-16%) from 2022
Liabilities
Up$1,402,066,398
Up $134,721,025 (+11%) from 2022
Net Assets
Down$846,888,024
Down $552,852,364 (-39%) from 2022
Revenue
Down$8,559,845,484
Down $1,504,283,540 (-15%) from 2022
Expenses
Down$8,462,329,539
Down $954,899,191 (-10%) from 2022
Net Income
Down$97,515,945
Down $549,384,349 (-85%) from 2022
Trend Graphs
Filings
Most recent year
2024 • Form 990XML pending. An XML filing is linked for this year, but detailed extraction is still pending.
- Assets
- $2,248,954,422
- Liabilities
- $1,402,066,398
- Net assets
- $846,888,024
- Revenue
- $8,559,845,484
- Expenses
- $8,462,329,539
- Net income
- $97,515,945
Latest Detailed Filing
The latest 2024 filing currently has linked XML that has not been fully parsed yet. Showing the latest detailed filing from 2022 below.
Jump To
Filing Snapshot
- Filing Period
- Jan 1, 2022 to Dec 31, 2022
- Signed
- Nov 15, 2023
- Return Version
- 2022v5.0
- Gross Receipts
- $13,158,732,350
Mission and Program Overview
Mission
Caresource's vision is to transform lives through innovative health and life services. The organization's mission is to make a lasting difference in our members' lives by improving their health and well-being. Caresource is a mission-driven medicaid health insuring corporation (commonly referred to as a health maintenance organization) licensed by the state of ohio.
To make a lasting difference in our members' lives by improving their health and well-being. CareSource Ohio Inc. is a nonprofit HIC licensed by the state of Ohio.
Balance Sheet Detail
| Line | Beginning | End | Change |
|---|---|---|---|
| Assets | |||
| Investments in Publicly Traded Securities | $1,202,558,522 | $1,678,795,866 | ▲ $476,237,344 |
| Savings and Temporary Cash Investments | $796,922,915 | $519,235,273 | ▼ $277,687,642 |
| Accounts Receivable | $589,512,530 | $442,355,993 | ▼ $147,156,537 |
| Investments Program Related | $11,867,171 | $20,599,471 | ▲ $8,732,300 |
| Prepaid Expenses and Deferred Charges | $9,012,006 | $6,099,158 | ▼ $2,912,848 |
| Cash and Non-Interest-Bearing Accounts | $0 | $0 | → $0 |
| Other Notes and Loans Receivable, Net | $0 | $0 | → $0 |
| Pledges and Grants Receivable | $0 | $0 | → $0 |
| Receivable From Disqualified Prsn | $0 | $0 | → $0 |
| Receivables From Officers Etc | $0 | $0 | → $0 |
| Investments Other Securities | $0 | $0 | → $0 |
| Land, Buildings, and Equipment, Net | $0 | $0 | → $0 |
| Intangible Assets | $0 | $0 | → $0 |
| Inventories for Sale or Use | $0 | $0 | → $0 |
| Loans From Officers Directors | $0 | $0 | → $0 |
| Total Assets | $2,609,873,144 | $2,667,085,761 | ▲ $57,212,617 |
| Other Assets Total | $0 | $0 | → $0 |
| Liabilities | |||
| Accounts Payable and Accrued Expenses | $1,183,196,605 | $1,188,727,467 | ▲ $5,530,862 |
| Deferred Revenue | $262,744,244 | $58,035,903 | ▼ $204,708,341 |
| Other Liabilities | $14,669,830 | $20,582,003 | ▲ $5,912,173 |
| Grants Payable | $0 | $0 | → $0 |
| Mortgage Notes Payable Secured by Investment Property | $0 | $0 | → $0 |
| Unsecured Notes Loans Payable | $0 | $0 | → $0 |
| Escrow Account Liability | $0 | $0 | → $0 |
| Tax Exempt Bond Liabilities | $0 | $0 | → $0 |
| Total Liabilities | $1,460,610,679 | $1,267,345,373 | ▼ $193,265,306 |
| Net Assets / Fund Balance | |||
| Net Assets Without Donor Restrictions | $1,149,262,465 | $1,399,740,388 | ▲ $250,477,923 |
| Net Assets With Donor Restrictions | $0 | $0 | → $0 |
| Total Net Assets Fund Balance | $1,149,262,465 | $1,399,740,388 | ▲ $250,477,923 |
| Total Liabilities and Net Assets / Fund Balance | $2,609,873,144 | $2,667,085,761 | ▲ $57,212,617 |
Compensation and Service Providers
Board Members and Trustees
| Name | Title |
|---|---|
| Stephen Ringel | President Market, Director |
| Scott Markovich | EVP Markets & Products, Director |
| David Finkel | Former EVP Markets, Director |
| Stephanie Williams | SVP Ch Acty, Director (Eff 4/22) |
| William Coffin Jr | VP Mkt Finance, Director (To 4/22) |
| Daniel McCabe | Chief Admin Officer (To 4/22) |
| Erhardt Preitauer | Chief Executive Officer |
| Lawrence Smart | Chief Financial Officer |
| Jai Pillai | Chief Operating Officer |
Highest Paid Contractors
| Contractor | Services | Location | Compensation |
|---|---|---|---|
| Express Scripts Inc | Pharmacy Services | 21653 Network Place, Chicago, IL 60673 | $2,225,846,692 |
| Ohio Hospital Association | Medical Services | 155 East Broad St Suite 301, Columbus, OH 43215 | $598,713,692 |
| Childrens Hosp Phys Healthcare Ne | Medical Services | 700 Childrens Drive, Columbus, OH 43205 | $469,559,910 |
| DentaQuest Group Inc | Medical Services | 465 Medford Street, Charlestown, MA 02129 | $187,170,924 |
| The MetroHealth System | Medical Services | PO Box 931311, Cleveland, OH 44193 | $61,430,887 |
Revenue and Support
Revenue Composition
- Contributions and Grants
- $0
- Program Service Revenue
- $10,010,802,585
- Investment Income
- $53,326,439
- Other Revenue
- $0
- Change in Net Assets
- $646,900,294
Audited Revenue Reconciliation
- Revenue per Audited Statements
- $10,064,129,024
- Revenue Not Reported on Form 990
- $766,427,533
- Total Revenue per Audited Statements
- $10,830,556,557
- Total Revenue per Form 990
- $10,064,129,024
Expenses and Functional Allocation
Major Expense Lines
| Line Item | Amount |
|---|---|
| Other Expenses | $9,361,889,247 |
| Grants and Similar Amounts Paid | $55,339,483 |
| Professional Fundraising Fees | $0 |
| Salaries, Compensation, and Employee Benefits | $0 |
| Total Fundraising Expense | $0 |
Functional Expense Allocation
| Line Item | Program | Management | Fundraising | Total |
|---|---|---|---|---|
| Fees for Services Other | $21,815,502 | $250,143,304 | $0 | $271,958,806 |
| Office Expenses | $1,546,393 | $105,543,495 | $0 | $107,089,888 |
| Grants to Domestic Orgs | $55,339,483 | - | - | $55,339,483 |
| Other Expenses | $8,122,623 | $36,439,387 | $0 | $44,562,010 |
| Occupancy | $0 | $16,035,830 | $0 | $16,035,830 |
| All Other Expenses | $2,964,616 | $7,254,999 | - | $10,219,615 |
| Advertising | $24,686 | $9,451,544 | $0 | $9,476,230 |
| Fees for Services Legal | $115,667 | $6,307,999 | $0 | $6,423,666 |
| Insurance | $0 | $6,276,339 | $0 | $6,276,339 |
| Travel | $364,208 | $2,321,894 | $0 | $2,686,102 |
| Fees for Service Investment Mgmnt Fees | $0 | $1,014,710 | $0 | $1,014,710 |
| Fees for Services Lobbying | $3,846 | $381,137 | $0 | $384,983 |
| Interest | $0 | $256,405 | $0 | $256,405 |
| Fees for Services Accounting | $0 | $230,992 | $0 | $230,992 |
| Total Functional Expenses | $8,543,954,801 | $873,273,929 | $0 | $9,417,228,730 |
Audited Expense Reconciliation
| Line Item | Amount |
|---|---|
| Total Expenses per Audited Statements | $10,182,592,003 |
| Expenses per Audited Statements | $9,417,228,730 |
| Total Expenses per Form 990 | $9,417,228,730 |
| Expenses Not Reported on Form 990 | $765,363,273 |
International Activity
Grant and Assistance Recipients
| Recipient | Location | Category | Purpose | Amount |
|---|---|---|---|---|
| Ronald McDonald House Charities Dayton | Dayton, OH | 501(c)(3) | Support construction of new housing facility and donation to Ronald McDonald Care Mobile | $13,833,684 |
| One Fifteen Recovery | Dublin, OH | 501(c)(3) | Provide services including the research, planning, strategy, innovation, development and implementation of an integrated substance use disorder hybrid care model with associated technology to identified geographies; deploy care advocate services in connection with CareSource and partner resources; ingest and analyze key data sets to identify care gaps and improve quality; and recommend and scope novel technology and/or care advancement for members | $2,496,603 |
| Children's Hospital Medical Center of Akron | Akron, OH | 501(c)(3) | Support the implementation of a closed loop referral system that will enable the organization to track and monitor patient impact and improve efficiency of patient treatment plans | $2,300,000 |
| Dayton Children's Hospital | Dayton, OH | 501(c)(3) | Support a new Behavioral Health Building in Dayton, Ohio to increase the number of behavioral health inpatient beds currently available and allow for expansion of specialized program development | $2,000,000 |
| Corporation for Supportive Housing | New York, NY | 501(c)(3) | Continued support of the Fresh Start housing program to house and support members in the community of Franklin County, Ohio that are homeless and have challenges with mental health issues or substance use | $1,500,000 |
| Ohio Association of Health Plans Inc | Columbus, OH | 501(c)(6) | Collaborative investment among the MCOs to invest in The Ronald McDonald House | $1,362,240 |
| People Working Cooperatively | Cincinnati, OH | 501(c)(3) | Support the Healthy at Home program to improve health for low income individuals & families through home repairs that have health implications and fall prevention curriculum | $1,250,000 |
| Ohio District 5 Area Agency on Aging Foundation | Ontario, OH | 501(c)(3) | Support expansion of the HEMEN (Helping Elderly Meet Essential Needs) and Community Health Worker programs to reach vulnerable individuals of all ages, demographics, and communities within the nine-county region | $1,000,000 |
| The Cleveland Clinic Foundation | Independence, OH | 501(c)(3) | Continued expansion of a virtual emergency medicine initiative at the Cleveland Clinic Foundation | $1,000,000 |
| Children's Hospital Medical Center | Cincinnati, OH | 501(c)(3) | Eliminate systemic inequities in health outcomes for children and adolescents within the 8-County region of Southwest Ohio | $800,000 |
| Hocking Athens Perry Community Action | Glouster, OH | 501(c)(3) | Food purchases to bolster food sourcing efforts | $700,000 |
| Premier Health Partners | Dayton, OH | 501(c)(3) | Support The Promise to Hope Program, which will provide expecting and new mothers with access to vital resources and care necessary to recover from opiate addiction and SUD by connecting women to treatment, housing options, and community resources | $518,100 |
| Five Rivers Health Centers | Dayton, OH | 501(c)(3) | Support initiatives to promote optimal health outcomes for pregnant women, infants, and members with a diagnosis of Diabetes | $500,000 |
| Homefull | Dayton, OH | 501(c)(3) | Support the Health, Food, and Jobs facility, which provides locally and minority-operated essential services including the Regional Food Hub, Farmers Market, and Community Education Center | $500,000 |
| The United Way of Greater Dayton Area | Dayton, OH | 501(c)(3) | Increase in service provision in the areas of youth education (childcare), adult education, system navigation and mental health support | $500,000 |
| B Riley Sober House | Cleveland, OH | 501(c)(3) | Support the effort to address health disparities in Behavioral Health and substance use by the acquisition of a new recovery house for LGBTQIA, 55+ adults with a substance use diagnosis participating in an outpatient drug and alcohol treatment program | $441,585 |
| Children's Hunger Alliance | Columbus, OH | 501(c)(3) | Secure childcare center partner participation in the meal expansion program, additional warehouse space for food storage, expand healthy meals to children on weekends, and increase access to nutritious food to mitigate inequities in health outcomes | $400,000 |
| Westcare Ohio Inc | Las Vegas, NV | 501(c)(3) | Support the expansion project for the East End Community Service Facility, which will have space to add a new health clinic, workforce training center, and Family Services | $400,000 |
| Kettering Medical Center | Miamisburg, OH | 501(c)(3) | Tuition costs for students enrolled in medical programs | $380,000 |
| The Foodbank Inc | Dayton, OH | 501(c)(3) | Address and combat food insecurity | $371,675 |
| Girls Health Period | Cincinnati, OH | 501(c)(3) | Enrich the lives of students in education, sports, and career by providing menstrual products, underwear, sports bras, and period education | $350,000 |
| Behavioral Healthcare Partners of Central Ohio Inc | Newark, OH | 501(c)(3) | Assist in expanding behavioral healthcare by use of a Mobile Urgent Care vehicle and engage populations traditionally underserved in these regions | $333,333 |
| Cleveland VA Medical Research & Education Foundati | Cleveland, OH | 501(c)(3) | Support a multi-disciplinary approach to delineate why military veteran patients experience Parkinson falls and what can be done to mitigate falls | $320,000 |
| Boys & Girls Club of Dayton Inc | Dayton, OH | 501(c)(3) | Support programming to youth grades K-12 through quality, structured, and developmentally appropriate programs to promote academic success, healthy lifestyles, good character, & citizenship | $300,000 |
| Greater Cleveland Food Bank Inc | Cleveland, OH | 501(c)(3) | Support continuation of a community-academic collaboration between Case Western Reserve University, Greater Cleveland Food Bank, & Better Health Partnerships Pathway HUB | $295,000 |
| American Academy of Pediatrics Ohio Chapter | Columbus, OH | 501(c)(3) | Support the Store-It-Safe Youth Suicide Prevention Program, which aims to prevent suicide by reducing access to in-home lethal means and increasing discussions on youth mental health concerns by providers in multidisciplinary settings | $250,000 |
| Birthing Beautiful Communities | Cleveland, OH | 501(c)(3) | Provide comprehensive maternal care to 100 high risk black women | $250,000 |
| Connect Our Kids | Falls Church, VA | 501(c)(3) | Fund the Connect Our Kids technology platform ("Connections Toolkit"), which contains a suite of tools to reduce the complexities of family search and engagement | $250,000 |
| National Center for Urban Solutions Tech | Columbus, OH | 501(c)(3) | Workforce Development | $250,000 |
| The Hope Center for Families | Dayton, OH | 501(c)(2) | Help the organization deliver educational and wraparound social services to children and families living in poverty | $250,000 |
| Project Ujima Inc | Akron, OH | 501(c)(3) | Serve pregnant and new mothers and their children up to the age of 1 in the Greater Akron area with a focus on decreasing infant mortality by (1) providing space and a structured process to enable pregnant and new mothers to receive the educational, social, and emotional support needed to ensure healthy moms and babies; and (2) coordinating and providing racial equity programming, including race dialogues, to increase cultural responsiveness of providers and decrease racial inequities that contribute to the high infant mortality rates of African American babies | $205,000 |
| Edwins Leadership & Restaurant Institute | Cleveland, OH | 501(c)(3) | Cover some of the cost of the tuition-free education program offered to formerly incarcerated adults to establish a foundation in the culinary and hospitality industries and provide a support network necessary for long-term success | $200,000 |
| El Centro de Servicios Sociales Inc | Lorain, OH | 501(c)(3) | Support the new facility which will provide space for additional services related to physical and mental health and bilingual services to the Latino community | $200,000 |
| Greater Dayton Area Hospital Association | Dayton, OH | 501(c)(6) | Startup funds needed to become the lead agency supporting Healthy Beginnings at Home in Montgomery County, which provides housing assistance to pregnant people and improves health outcomes | $200,000 |
| La Soupe Inc | Milford, OH | 501(c)(3) | Address and combat food insecurity in the Greater Cincinnati area | $200,000 |
| Health Care Access Now | Cincinnati, OH | 501(c)(3) | Establish new and build upon existing partnerships with coalitions within communities of color (especially the African American, Asian, Latinx, and Indigenous) and recruit students from these communities for the training program | $180,000 |
| Habitat for Humanity of Ohio Inc | Columbus, OH | 501(c)(3) | Provide critical home repairs/handicapped accessibility modifications for homeowners who are at or below 50% of the area median income | $150,000 |
| United Way of Greater Cleveland | Cleveland, OH | 501(c)(3) | Pilot project entitled Nutrition Solution, an expanded home-delivered meal service that combines medically tailored meals ("MTMs"), nutrition education, and weekly wellness calls | $150,000 |
| Ohio Optometric Foundation | Worthington, OH | 501(c)(3) | Support the In-School Eye Exam Program and the organization's ability to serve as many children as possible in need of optometric services | $125,000 |
| Catholic Social Services of the Miami Valley | Dayton, OH | 501(c)(3) | Support the food pantry and the construction of new pantry space that will provide loading doors, refrigeration, and an open shopping space as well as meeting space for programs and classes that are handicap accessible | $100,000 |
| Harm Reduction Ohio | Granville, OH | 501(c)(3) | Install 'naloxboxesor harm reduction vending machines in six counties in Ohio and supplies for the boxes | $100,000 |
| Shoes 4 The Shoeless Inc | Kettering, OH | 501(c)(3) | Provide funding for socks & shoes for children in need and a delivery truck for these activities | $100,000 |
| Ohio Access to Justice Foundation | Columbus, OH | 501(c)(3) | Provide direct civil legal services to low-income Ohioans | $75,000 |
| Homeless Hookup | Cleveland, OH | 501(c)(3) | Support the Mobile Hygiene Bus that can go anywhere to give out free food, clothes, haircuts, showers, Narcan and other resources needed during all phases of a person's journey in life | $69,200 |
| Community Shelter Board | Columbus, OH | 501(c)(3) | Provide flexible funds to support the provision of homeless and housing programs for families and individuals experiencing homelessness, including outreach to people living on the street, emergency shelter when needed, temporary utility and rent assistance, and referrals to rapid re-housing programs, connecting them to shelter and housing | $65,000 |
| Project Milk Mission | Akron, OH | 501(c)(3) | Provide evidence-based, culturally competent prenatal and postpartum clinical and counseled lactation care via telehealth technology | $56,430 |
| Habitat for Humanity of SE Ohio | Millfield, OH | 501(c)(3) | Equipment purchase & Food as Medicine Program | $55,000 |
| CelebrateOne | Columbus, OH | 501(c)(3) | Enroll 90 pregnant women meeting the target population over the next year in the following counties that are all part of the Ohio Equity Institute (counties which have the greatest racial disparities in infant mortality): Summit County, Franklin County, Montgomery County, and Hamilton County | $50,000 |
| FutureReady Columbus | Columbus, OH | 501(c)(3) | Support Prenatal to age-5 children. | $50,000 |
| The Breathing Association | Columbus, OH | 501(c)(3) | Support an 8-Month Course for expectant Moms | $34,500 |
| Franklinton Development Assoc dba FUEL FRANKLINTON | Columbus, OH | 501(c)(3) | Support the Financial Life-skills Program | $30,000 |
| Dress Right Dress Inc | Kingston, OH | 501(c)(3) | Assist with expanding and providing services in Seneca County, Ohio and surrounding areas by placing a Resource Center, Staff, and a larger Volunteer and Community Partnership base | $25,000 |
| Women Just Like Me | Gahanna, OH | 501(c)(3) | Assist marginalized communities facing barriers to receive parent support services inclusive of prenatal education, early childhood education for families with children ages 0-5 years, and mental health education for mothers | $16,000 |
| Best Buddies International Inc | Miami, FL | 501(c)(3) | Expand Best Buddies Friendship Chapters | $15,000 |
| Research America | Arlington, VA | 501(c)(3) | Adolescent Well-Visit Focus Groups | $14,200 |
| Fostering Further | Pataskala, OH | 501(c)(3) | Support the Starting Strong programs | $10,000 |
| LEAD Training | Lebanon, OH | 501(c)(3) | Supplement academic training with the vital tools necessary for low-income students to create a better pathway out of poverty for themselves and their families | $10,000 |
| Mental Health & Addiction Advocacy Coalition | Cleveland, OH | 501(c)(3) | Develop and distribute a research project that will identify areas of racial and ethnic inequity in Ohio's community Behavioral Health system, examine solutions, and make recommendations | $10,000 |
| Ohio Newsboys Association Inc | Columbus, OH | 501(c)(3) | Provide new school clothing for children in need | $10,000 |
| The Christ College of Nursing & Health Sciences | Cincinnati, OH | 501(c)(3) | Purchase new and updated equipment | $10,000 |
| Planned Parenthood of Southwest Ohio Region | Cincinnati, OH | 501(c)(3) | Camp Movement, Enrichment, Empowerment ("MEE") | $7,500 |
| Rocking Horse Children's Health Center | Springfield, OH | 501(c)(3) | Cost of Poverty Experience ("COPE") training for staff | $6,200 |
Fundraising, Events, and Gaming
- Fundraising activities
- No
- Gaming activities
- No
- Professional fundraiser used
- No
Fundraising and Gaming Totals
| Line Item | Amount |
|---|---|
| Fundraising Direct Expenses | $0 |
| Fundraising Gross Income | $0 |
| Gaming Direct Expenses | $0 |
| Gaming Gross Income | $0 |
| Professional Fundraising Fees | $0 |
Political and Lobbying Activity
- Political campaign activity
- No
- Lobbying activity
- Yes
- Subject to proxy tax
- No
Insider Transactions and Loans
Loans and Receivables
| Line Item | Beginning | End | Change |
|---|---|---|---|
| Loans from Officers, Directors, Trustees, and Key Employees | $0 | $0 | → $0 |
| Receivables from Disqualified Persons | $0 | $0 | → $0 |
| Receivables from Officers, Directors, Trustees, and Key Employees | $0 | $0 | → $0 |
Debt and Bond Financing
Other Reported Liabilities
| Liability | Amount |
|---|---|
| Related Party Payable | $20,582,003 |
Governance and Compliance
Governance Checklist
- Compiled or reviewed by an accountant
- No
- Annual disclosure for covered persons
- Yes
- Audit committee
- Yes
- Backup withholding compliance
- Yes
- Business relationship with 35% controlled entity
- No
- Business relationship with family members
- No
- Business relationship with organization members
- No
- Material changes to governing documents
- No
- Compensation from other sources disclosed
- No
- CEO compensation reviewed
- No
- Other officer compensation reviewed
- No
- Conflict-of-interest policy
- Yes
- Audited financial statements prepared
- Yes
- Key decisions subject to board approval
- No
- Management duties delegated
- No
Governance Explanations
Form 990, Part VI, Section A, Question 6
“CareSource is the member of CareSource Ohio, Inc. CareSource is a nonprofit corporation that is exempt from federal income taxation under Internal Revenue Code ("IRC") Section 501(c)(3).”
Form 990, Part VI, Section A, Question 7A
“Caresource, the sole member of caresource ohio, inc., has the authority to appoint caresource ohio, inc.'s board and officers.”
Form 990, Part VI, Section B, Question 11B
“The Form 990 was provided to the following individuals for review prior to the time of filing: The organization's Audit Committee and each voting member of the governing body; the CEO, CFO, and VP Treasury; the internal Tax Department and an outside CPA firm; and internal general counsel and outside legal counsel.”
Form 990, Part VI, Section B, Question 12C
“Annually, each director, principal officer, and member of a committee with board-delegated powers ("interested person") shall confirm that they have received a copy of the CareSource Conflicts of Interest policy and have read, understood, and agree to comply with the policy. Interested Persons have an obligation to immediately report any Conflicts of Interest (including any relationships, positions, or circumstances that could contribute to a Conflict of Interest). All relevant information reported through the Conflict of Interest Policy will be sent to the Chairman of the Board for review. If the Interested Person with the Conflict of Interest is the Chairman of the Board, then the required disclosure must be provided to the Chief Legal Officer of CareSource. If it is not entirely clear whether a Conflict of Interest exists, then the person with the potential conflict must disclose the circumstances to CareSource's Chief Legal Officer. The Chief Legal Officer will consult with the Corporation's Corporate Compliance Officer or the Chairman of the Board to determine whether there exists a Conflict of Interest that is subject to this policy. Before Board action or other action by the organization on a Transaction that involves a Conflict of Interest, an Interested Person who knows he or she has a Conflict of Interest must have disclosed to the Board all facts material to the Conflict of Interest. The Chairman of the Board may postpone Board or other corporate action on a Transaction until the Interested Person provides written information relating to the Conflict of Interest. An Interested Person who knows he or she has a Conflict of Interest must not participate in the Board's discussion of the Transaction except to disclose material facts and respond to questions. The Interested Person must not attempt to influence the Board's action on the Transaction, either at or outside the meeting. Prior to voting, the Board must be given an opportunity to discuss the Transaction without the person who has the Conflict of Interest being present. A Transaction involving a Conflict of Interest may be approved by the Board if the material facts as to the Transaction and the Conflict of Interest are fully disclosed or known to the Board and the Board in good faith determines after reasonable investigation that (a) the Board is aware of all material facts concerning the Transaction and the Interested person's interest in the Transaction; (b) the organization is entering into the Transaction for its own benefit; (c) the Transaction is fair and reasonable as to the organization; and (d) the organization could not have obtained a more advantageous arrangement with reasonable effort under the circumstances. The Person with the Conflict of Interest must not vote on the Transaction and must not be present in the room when the vote is taken.”
Form 990, Part VI, Section C, Question 17
“A copy of Form 990 is not required to be filed with the state of Ohio. CareSource Ohio, Inc. does, however, file the Ohio Annual Report with the Ohio Attorney General. Therefore, Ohio is listed on Form 990, Part VI, Section C, Question 17.”
Form 990, Part VI, Section C, Question 19
“The company's Form 1023 is available for public inspection upon request, and Form 990 is available for public inspection upon request in accordance with IRC Section 6104(d). Statutory financial statements for the organization are available on the Ohio Department of Insurance's website at www.ins.ohio.gov. The company's Form 990 is available on the U.S. nonprofit database website at www.guidestar.org. The company's Articles of Incorporation are available on the Ohio Secretary of State's website at www.sos.state.oh.us.”
Filing and Contact Details
Filer
- Filer Name
- CareSource Ohio Inc
- EIN
- 31-1143265
- In Care Of
- % JANET FERNANDES
- Phone
- 9372243300
- Address
- PO Box 8738, Dayton, OH 45401-8738
Signing Officer
- Name
- Lawrence Smart
- Title
- CFO
- Phone
- 9372243300
- Signed
- 2023-11-15
- Discuss with paid preparer
- Yes
Organization Details
- Principal Officer
- Erhardt Preitauer
- Formed
- 1985
- Legal Domicile
- Oh
- Voting Board Members
- 3
- Independent Board Members
- 0
- Employees
- 0
- Volunteers
- 0
Preparer
- Firm
- Rsm US Llp
- Address
- 6 S PATTERSON BLVD, DAYTON, OH 45402
- Preparer
- Karen O Crim
- Phone
- 9372980201
Supplemental Narrative
Additional Explanations
Form 990, Part III, Question 1 (Continued)
“Caresource ohio, inc. Is a health insurance company licensed by the state of ohio and serves members through dual eligible special needs, marketplace, medicaid, medicare advantage, and mycare ohio plans.”
Form 990, Part XI, Line 9
“Other changes in Net Assets is (A) a write off of advances paid to behavioral health providers of $118,524 and (B) dividend to CareSource of $275,000,000.”
Financial Statement Notes
FIN 48 (ASC 740) Footnote
“As outlined in CareSource's Audited Consolidated Financial Statements, which include the activity of CareSource Ohio Inc.: The Company annually reviews its tax positions and has determined that there are no material uncertain tax positions that require recognition in the consolidated financial statements. Currently, tax years 2019-2021 are open for audit by the Internal Revenue Service.”
Form 990, Schedule D, Parts XI and XII
“The entity has separate audited financial statements prepared on a statutory ("STAT") basis in compliance with The National Association of Insurance Commissioners ("NAIC") requirements. The entity is also included in the consolidated audited financial statements of the parent entity, CareSource, which are prepared on a GAAP basis. The 990 has been prepared consistent with the GAAP-basis financial statements. The amounts included on Schedule D, Part XI and XII, Lines 2d, are comprised of the GAAP-to-STAT adjustments.”
Raw XML AppendixShowing 400 of 1,625 raw XML fields
This appendix keeps the raw XML leaves available for debugging and edge-case review. The human report above is the primary experience.
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| IRS990/Desc | 0 | CareSource Ohio, Inc. ("CSOH"), a leading nonprofit managed care organization based in Dayton, Ohio, has been living its mission to make a lasting difference in members' lives by improving their health and well-being for more than thirty-three years. CSOH serves more than 1.5 million members in Ohio. CSOH'S membership includes: (1) Medicaid consumers, including families with low income, children, pregnant women, adoption and foster kids, those who are aged, blind or disabled, (2) Medicaid consumers who are eligible for Home and Community Based services through execution of an annual Provider Agreement with the Ohio Department of Medicaid ("ODM"), (3) Dually eligible consumers for Medicare and Medicaid through Ohio's Dual Demonstration program, MyCare, (4) Medicare Advantage consumers, and (5) a Qualified Health Plan offered through the Federal Health Insurance Marketplace, providing low-cost comprehensive coverage for individuals and families. CSOH Program Services: 1) CareSource Ohio Medicaid: CareSource Ohio, Inc. pioneered Ohio's first mandatory Medicaid managed care program in 1989 and is now one of the largest Medicaid managed care plans in the country. CSOH's years of experience in managing Medicaid managed care programs and member-focused approach to care have allowed it the opportunity to forge strong, positive regulatory relationships with state agencies, including departments of insurance. CSOH has earned 51.2% of the statewide Medicaid managed care market share, with the highest voluntary enrollment rate and the lowest voluntary disenrollment rate of all Ohio participating Medicaid Managed care plans. CSOH focuses on prevention with a goal of improving member health, the quality of health care services received, and accessibility of health care services for Medicaid members. CSOH has made an organizational commitment to make evidence-based investments towards improving health outcomes for members. CSOH's approach is one that blends the recommendations of the Triple Aim framework and principles of population health management best practice, while leveraging emerging technological and analytic solutions to make measurable positive impacts in the health of the communities we serve. CSOH also has significant focus on creating social based partnerships with providers and community organizations to support a longitudinal health management effort for members. Providers have the most control and influence on members and thus provide the best opportunity to help capitalize on cost, quality, and experience. Partnering with providers allows us to collaborate on population health strategies such as emergency department diversion, patient-centered medical home implementation, and performance management. Engaging our high-risk members' primary care and specialty providers is particularly critical to achieving successful care management. CSOH has a broad, statewide network of more than 52,000 providers, including primary care and specialist physicians, hospitals, nursing facilities, home health care agencies and other medical providers who provide medical services as well as assist in the coordination of member care. To further drive quality and achieve health outcomes targets, CSOH incentivizes certain providers through a value-based incentive model. CSOH focuses efforts on creating incentives and reimbursement options to support models that recognize quality at the provider level. CSOH created a program that provides additional incentives to providers for delivering quality based services that impact Healthcare Effectiveness Data and Information Set ("HEDIS") measures. CSOH created a shared savings model that rewards providers for attaining quality targets while sharing savings. In this particular model, CSOH established "filters" such that providers have to meet or exceed quality metrics before being eligible to share in cost savings. Value-based incentive models ultimately result in improved member health outcomes as providers |
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| IRS990/NetGainOrLossInvestmentsGrp/ExclusionAmt | 0 | 5758170 |
| IRS990/NetGainOrLossInvestmentsGrp/TotalRevenueColumnAmt | 0 | 5758170 |
| IRS990/NetIncmFromFundraisingEvtGrp/TotalRevenueColumnAmt | 0 | 0 |
| IRS990/NetIncomeFromGamingGrp/TotalRevenueColumnAmt | 0 | 0 |
| IRS990/NetIncomeOrLossGrp/TotalRevenueColumnAmt | 0 | 0 |
| IRS990/NetRentalIncomeOrLossGrp/TotalRevenueColumnAmt | 0 | 0 |
| IRS990/NetUnrlzdGainsLossesInvstAmt | 0 | -121303843 |
| IRS990/NoDonorRestrictionNetAssetsGrp/BOYAmt | 0 | 1149262465 |
| IRS990/NoDonorRestrictionNetAssetsGrp/EOYAmt | 0 | 1399740388 |
| IRS990/NondeductibleContributionsInd | 0 | false |
| IRS990/OccupancyGrp/FundraisingAmt | 0 | 0 |
| IRS990/OccupancyGrp/ManagementAndGeneralAmt | 0 | 16035830 |
| IRS990/OccupancyGrp/ProgramServicesAmt | 0 | 0 |
| IRS990/OccupancyGrp/TotalAmt | 0 | 16035830 |
| IRS990/OfficeExpensesGrp/FundraisingAmt | 0 | 0 |
| IRS990/OfficeExpensesGrp/ManagementAndGeneralAmt | 0 | 105543495 |
| IRS990/OfficeExpensesGrp/ProgramServicesAmt | 0 | 1546393 |
| IRS990/OfficeExpensesGrp/TotalAmt | 0 | 107089888 |
| IRS990/OfficerMailingAddressInd | 0 | false |
| IRS990/OperateHospitalInd | 0 | false |
| IRS990/Organization501c3Ind | 0 | X |
| IRS990/OrganizationFollowsFASB117Ind | 0 | X |
| IRS990/OtherAssetsTotalGrp/BOYAmt | 0 | 0 |
| IRS990/OtherAssetsTotalGrp/EOYAmt | 0 | 0 |
| IRS990/OtherChangesInNetAssetsAmt | 0 | -275118528 |
| IRS990/OtherEmployeeBenefitsGrp/TotalAmt | 0 | 0 |
| IRS990/OtherExpensesGrp/Desc | 0 | MEDICAL EXPENSES |
| IRS990/OtherExpensesGrp/Desc | 1 | PHARMACY EXPENSES |
| IRS990/OtherExpensesGrp/Desc | 2 | MGMT FEES CARESOURCE MGMT SVCS |
| IRS990/OtherExpensesGrp/Desc | 3 | CLAIMS PROCESSING ADMIN EXP |
| IRS990/OtherExpensesGrp/FundraisingAmt | 0 | 0 |
| IRS990/OtherExpensesGrp/FundraisingAmt | 1 | 0 |
| IRS990/OtherExpensesGrp/FundraisingAmt | 2 | 0 |
| IRS990/OtherExpensesGrp/ManagementAndGeneralAmt | 0 | 0 |
| IRS990/OtherExpensesGrp/ManagementAndGeneralAmt | 1 | 0 |
| IRS990/OtherExpensesGrp/ManagementAndGeneralAmt | 2 | 431615894 |
| IRS990/OtherExpensesGrp/ManagementAndGeneralAmt | 3 | 36439387 |
| IRS990/OtherExpensesGrp/ProgramServicesAmt | 0 | 6463114713 |
| IRS990/OtherExpensesGrp/ProgramServicesAmt | 1 | 1895033275 |
| IRS990/OtherExpensesGrp/ProgramServicesAmt | 2 | 95509789 |
| IRS990/OtherExpensesGrp/ProgramServicesAmt | 3 | 8122623 |
| IRS990/OtherExpensesGrp/TotalAmt | 0 | 6463114713 |
| IRS990/OtherExpensesGrp/TotalAmt | 1 | 1895033275 |
| IRS990/OtherExpensesGrp/TotalAmt | 2 | 527125683 |
| IRS990/OtherExpensesGrp/TotalAmt | 3 | 44562010 |
| IRS990/OtherLiabilitiesGrp/BOYAmt | 0 | 14669830 |
| IRS990/OtherLiabilitiesGrp/EOYAmt | 0 | 20582003 |
| IRS990/OtherRevenueTotalAmt | 0 | 0 |
| IRS990/OtherSalariesAndWagesGrp/TotalAmt | 0 | 0 |
| IRS990/OthNotesLoansReceivableNetGrp/BOYAmt | 0 | 0 |
| IRS990/OthNotesLoansReceivableNetGrp/EOYAmt | 0 | 0 |
| IRS990/PartialLiquidationInd | 0 | false |
| IRS990/PaymentsToAffiliatesGrp/TotalAmt | 0 | 0 |
| IRS990/PayPremiumsPrsnlBnftCntrctInd | 0 | false |
| IRS990/PayrollTaxesGrp/TotalAmt | 0 | 0 |
| IRS990/PensionPlanContributionsGrp/TotalAmt | 0 | 0 |
| IRS990/PledgesAndGrantsReceivableGrp/BOYAmt | 0 | 0 |
| IRS990/PledgesAndGrantsReceivableGrp/EOYAmt | 0 | 0 |
| IRS990/PoliticalCampaignActyInd | 0 | false |
| IRS990/PrepaidExpensesDefrdChargesGrp/BOYAmt | 0 | 9012006 |
| IRS990/PrepaidExpensesDefrdChargesGrp/EOYAmt | 0 | 6099158 |
| IRS990/PrincipalOfficerNm | 0 | Erhardt Preitauer |
| IRS990/ProfessionalFundraisingInd | 0 | false |
| IRS990/ProgramServiceRevenueGrp/BusinessCd | 0 | 524114 |
| IRS990/ProgramServiceRevenueGrp/BusinessCd | 1 | 524114 |
| IRS990/ProgramServiceRevenueGrp/BusinessCd | 2 | 524114 |
| IRS990/ProgramServiceRevenueGrp/Desc | 0 | MEDICAID |
| IRS990/ProgramServiceRevenueGrp/Desc | 1 | PREMIUMS |
| IRS990/ProgramServiceRevenueGrp/Desc | 2 | MEDICARE ADVANTAGE |
| IRS990/ProgramServiceRevenueGrp/RelatedOrExemptFuncIncomeAmt | 0 | 9237051917 |
| IRS990/ProgramServiceRevenueGrp/RelatedOrExemptFuncIncomeAmt | 1 | 724988560 |
| IRS990/ProgramServiceRevenueGrp/RelatedOrExemptFuncIncomeAmt | 2 | 48762108 |
| IRS990/ProgramServiceRevenueGrp/TotalRevenueColumnAmt | 0 | 9237051917 |
| IRS990/ProgramServiceRevenueGrp/TotalRevenueColumnAmt | 1 | 724988560 |
| IRS990/ProgramServiceRevenueGrp/TotalRevenueColumnAmt | 2 | 48762108 |
| IRS990/ProhibitedTaxShelterTransInd | 0 | false |
| IRS990/PYBenefitsPaidToMembersAmt | 0 | 0 |
| IRS990/PYContributionsGrantsAmt | 0 | 0 |
| IRS990/PYExcessBenefitTransInd | 0 | false |
| IRS990/PYGrantsAndSimilarPaidAmt | 0 | 0 |
| IRS990/PYInvestmentIncomeAmt | 0 | 31234420 |
| IRS990/PymtTravelEntrtnmntPubOfclGrp/TotalAmt | 0 | 0 |
| IRS990/PYOtherExpensesAmt | 0 | 9704199278 |
| IRS990/PYOtherRevenueAmt | 0 | 0 |
| IRS990/PYProgramServiceRevenueAmt | 0 | 9724963389 |
| IRS990/PYRevenuesLessExpensesAmt | 0 | 51998531 |
| IRS990/PYSalariesCompEmpBnftPaidAmt | 0 | 0 |
| IRS990/PYTotalExpensesAmt | 0 | 9704199278 |
| IRS990/PYTotalProfFndrsngExpnsAmt | 0 | 0 |
| IRS990/PYTotalRevenueAmt | 0 | 9756197809 |
| IRS990/QuidProQuoContributionsInd | 0 | false |
| IRS990/RcvblFromDisqualifiedPrsnGrp/BOYAmt | 0 | 0 |
| IRS990/RcvblFromDisqualifiedPrsnGrp/EOYAmt | 0 | 0 |
| IRS990/RcvFndsToPayPrsnlBnftCntrctInd | 0 | false |
| IRS990/ReceivablesFromOfficersEtcGrp/BOYAmt | 0 | 0 |
| IRS990/ReceivablesFromOfficersEtcGrp/EOYAmt | 0 | 0 |
| IRS990/ReconcilationRevenueExpnssAmt | 0 | 646900294 |
| IRS990/RegularMonitoringEnfrcInd | 0 | true |
| IRS990/RelatedEntityInd | 0 | true |
| IRS990/RelatedOrganizationCtrlEntInd | 0 | false |
| IRS990/RentalIncomeOrLossGrp/PersonalAmt | 0 | 0 |
| IRS990/RentalIncomeOrLossGrp/RealAmt | 0 | 0 |
| IRS990/ReportInvestmentsOtherSecInd | 0 | false |
| IRS990/ReportLandBuildingEquipmentInd | 0 | false |
| IRS990/ReportOtherAssetsInd | 0 | false |
| IRS990/ReportOtherLiabilitiesInd | 0 | true |
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Peer Organizations
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New York, NY
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