Civic Intelligence

Caresource Ohio Inc.

990 • Fiscal year 2020 • EIN 31-1143265

Jan 01, 2020 to Dec 31, 2020 • Filed on Nov 11, 2021

PO Box 8738Dayton, OH 45401-8738

(937) 531-3027

Siviq Scores

Precomputed percentiles for this filing year versus similar nonprofits in the same peer cohort.

Liabilities / Assets

73rd percentile

0.57x

Higher debt load relative to assets than 73% of similar nonprofits.

2020 filings • 501(c)3 • $1B+ nonprofits • Source year 2020

Liabilities / Revenue

11th percentile

0.15x

Higher debt load relative to revenue than 11% of similar nonprofits.

2020 filings • 501(c)3 • $1B+ nonprofits • Source year 2020

Net Margin

30th percentile

1.8%

Higher net margin than 30% of similar nonprofits.

2020 filings • 501(c)3 • $1B+ nonprofits • Source year 2020

Top Officer Pay

90th percentile

$5,959,075

Higher top officer pay than 90% of similar nonprofits.

Top officer pay equals 0.1% of source-year revenue.

2020 filings • 501(c)3 • $1B+ nonprofits • Source year 2020

Asset Growth

87th percentile

27%

Faster asset growth than 87% of similar nonprofits.

2020 filings • 501(c)3 • $1B+ nonprofits • Annualized from 2019 to 2020

Revenue Growth

82nd percentile

14%

Faster revenue growth than 82% of similar nonprofits.

2020 filings • 501(c)3 • $1B+ nonprofits • Annualized from 2019 to 2020

Assets

Up

$2,518,378,621

Up $710,421,412 (+39%) from 2018

Net Assets

Up

$1,083,876,383

Up $229,179,579 (+27%) from 2018

Liabilities

Up

$1,434,502,238

Up $481,241,833 (+50%) from 2018

Revenue

Up

$9,272,879,618

Up $1,453,541,964 (+19%) from 2018

Expenses

Up

$9,110,417,960

Up $1,367,137,133 (+18%) from 2018

Net Income

Up

$162,461,658

Up $86,404,831 (+114%) from 2018

Historical Trend

Balance Sheet Trend

The highlighted filing sits inside the broader history for assets, liabilities, and net assets.

$3.0B$2.0B$1.0B$0Assets 2010: $727,319,843Liabilities 2010: $437,242,213Net Assets 2010: $290,077,6302010Assets 2011: $995,546,954Liabilities 2011: $585,019,612Net Assets 2011: $410,527,3422011Assets 2012: $1,002,260,430Liabilities 2012: $465,222,035Net Assets 2012: $537,038,3952012Assets 2013: $1,207,421,554Liabilities 2013: $592,703,556Net Assets 2013: $614,717,9982013Assets 2014: $1,779,366,531Liabilities 2014: $1,011,579,022Net Assets 2014: $767,787,5092014Assets 2015: $1,831,803,361Liabilities 2015: $882,673,507Net Assets 2015: $949,129,8542015Assets 2017: $1,850,810,189Liabilities 2017: $1,031,891,724Net Assets 2017: $818,918,4652017Assets 2018: $1,807,957,209Liabilities 2018: $953,260,405Net Assets 2018: $854,696,8042018Assets 2020: $2,518,378,621Liabilities 2020: $1,434,502,238Net Assets 2020: $1,083,876,3832020Assets 2021: $2,609,873,144Liabilities 2021: $1,460,610,679Net Assets 2021: $1,149,262,4652021Assets 2022: $2,667,085,761Liabilities 2022: $1,267,345,373Net Assets 2022: $1,399,740,3882022Assets 2024: $2,248,954,422Liabilities 2024: $1,402,066,398Net Assets 2024: $846,888,0242024

Highlighted filing

2020

Assets$2,518,378,621
Liabilities$1,434,502,238
Net Assets$1,083,876,383

Operations Trend

Revenue, expenses, and net income across loaded years, with this filing highlighted.

$15B$10B$5.0B$0Expenses 2010: $2,266,629,8192010Expenses 2011: $2,592,740,2752011Expenses 2012: $3,246,741,3812012Revenue 2013: $3,643,754,539Expenses 2013: $3,509,005,034Net Income 2013: $134,749,5052013Revenue 2014: $5,003,075,985Expenses 2014: $4,843,658,409Net Income 2014: $159,417,5762014Revenue 2015: $6,202,791,309Expenses 2015: $6,013,922,970Net Income 2015: $188,868,3392015Revenue 2017: $7,220,866,266Expenses 2017: $7,190,510,823Net Income 2017: $30,355,4432017Revenue 2018: $7,819,337,654Expenses 2018: $7,743,280,827Net Income 2018: $76,056,8272018Revenue 2020: $9,272,879,618Expenses 2020: $9,110,417,960Net Income 2020: $162,461,6582020Revenue 2021: $9,756,197,809Expenses 2021: $9,704,199,278Net Income 2021: $51,998,5312021Revenue 2022: $10,064,129,024Expenses 2022: $9,417,228,730Net Income 2022: $646,900,2942022Revenue 2024: $8,559,845,484Expenses 2024: $8,462,329,539Net Income 2024: $97,515,9452024

Highlighted filing

2020

Revenue$9,272,879,618
Expenses$9,110,417,960
Net Income$162,461,658
Jump To
Filing Snapshot
Filing Period
Jan 1, 2020 to Dec 31, 2020
Signed
Nov 11, 2021
Return Version
2020v4.1
Gross Receipts
$9,602,607,274
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 HMO licensed by the state of Ohio.

Balance Sheet Detail
LineBeginningEndChange
Assets
Savings and Temporary Cash Investments$506,326,870$1,211,528,818▲ $705,201,948
Accounts Receivable$695,286,837$664,247,851▼ $31,038,986
Investments in Publicly Traded Securities$764,274,266$617,868,325▼ $146,405,941
Prepaid Expenses and Deferred Charges$3,876,296$24,328,600▲ $20,452,304
Cash and Non-Interest-Bearing Accounts$19,591,932$0▼ $19,591,932
Other Notes and Loans Receivable, Net$0$405,027▲ $405,027
Investments Program Related$392,941$0▼ $392,941
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$1,989,749,142$2,518,378,621▲ $528,629,479
Other Assets Total$0$0→ $0
Liabilities
Accounts Payable and Accrued Expenses$1,010,976,945$1,260,671,424▲ $249,694,479
Deferred Revenue$13,806,569$155,246,639▲ $141,440,070
Other Liabilities$46,877,823$18,584,175▼ $28,293,648
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$1,071,661,337$1,434,502,238▲ $362,840,901
Net Assets / Fund Balance
Net Assets Without Donor Restrictions$918,087,805$1,083,876,383▲ $165,788,578
Net Assets With Donor Restrictions$0$0→ $0
Total Net Assets Fund Balance$918,087,805$1,083,876,383▲ $165,788,578
Total Liabilities and Net Assets / Fund Balance$1,989,749,142$2,518,378,621▲ $528,629,479
Compensation and Service Providers

Employees

NameTitleFull / Part TimeOtherTotal
Craig BrownDirector (To 6/20)PT$120,000$120,000
Michael Ervin MDChairperson/Director (To 6/20)PT$105,000$105,000
David MillerDirector (To 6/20)PT$105,000$105,000

Board Members and Trustees

NameTitle
David FinkelEVP Mkt & Chair/Director (Frm 6/20)
Erhardt PreitauerCEO & Director (To 6/20)
David Kaelber MDDirector (To 6/20)
Douglas FecherDirector (To 6/20)
Ellen LeffakDirector (To 6/20)
Gary L LeRoy MDDirector (To 6/20)
William F MarstellerDirector (To 6/20)
Stephen RingelPres, Mkt & Sec/Director (Frm 6/20)
William Coffin JrVP Mkt Fin, Trs/Director (Frm 6/20)
Daniel McCabeChief Administrative Officer
David GoltzChief Financial Officer
Jai PillaiChief Operating Officer

Highest Paid Contractors

ContractorServicesLocationCompensation
Express Scripts IncPharmacy Services21653 Network Place, Chicago, IL 60673-0673$2,173,499,170
Childrens Hospital Physicians NetMedical Services700 Childrens Drive, Columbus, OH 43205-3205$312,858,055
The MetroHealth SystemMedical Services2500 MetroHealth Drive, Cleveland, OH 44109$254,139,270
The Cleveland Clinic FoundationMedical Services9500 Euclid Avenue, Cleveland, OH 44195$232,102,301
Ohio State University HospitalsMedical Services410 W 10th Ave, Columbus, OH 43210$211,123,131
Revenue and Support

Revenue Composition

Contributions and Grants
$170,984
Program Service Revenue
$9,247,968,012
Investment Income
$24,740,622
Other Revenue
$0
Change in Net Assets
$162,461,658
Expenses and Functional Allocation

Major Expense Lines

Line ItemAmount
Other Expenses$9,109,445,237
Grants and Similar Amounts Paid$972,723
Professional Fundraising Fees$0
Salaries, Compensation, and Employee Benefits$0
Total Fundraising Expense$0

Functional Expense Allocation

Line ItemProgramManagementFundraisingTotal
Fees for Services Other$35,817,657$215,760,246-$251,577,903
Office Expenses$15,958,944$67,745,255-$83,704,199
Other Expenses$17,093,497$43,281,007-$60,374,504
All Other Expenses$3,169,235$17,277,748-$20,446,983
Occupancy$2,753,712$13,769,614-$16,523,326
Fees for Services Legal$101,268$7,965,270-$8,066,538
Advertising$56,684$7,881,264-$7,937,948
Insurance$44,295$3,265,347-$3,309,642
Grants to Domestic Orgs$972,723--$972,723
Travel$157,122$569,875-$726,997
Fees for Services Accounting-$478,651-$478,651
Interest-$339,643-$339,643
Fees for Services Lobbying$7,250$224,751-$232,001
Total Functional Expenses$8,388,805,749$721,612,211$0$9,110,417,960
International Activity

Grant and Assistance Recipients

RecipientLocationCategoryPurposeAmount
Invictus Development GroupDayton, OH501(c)(3)Covid Response$400,000
NATIONWIDE CHILDREN'S HOSPITALColumbus, OH501(c)(3)Covid Response$361,600
Fundraising, Events, and Gaming
Fundraising activities
No
Gaming activities
No
Professional fundraiser used
No

Fundraising and Gaming Totals

Line ItemAmount
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 ItemBeginningEndChange
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

LiabilityAmount
Related Party Payable$18,584,175
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
Yes
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 4

CareSource Ohio Inc. filed amended Codes of Regulations, effective June 26, 2020 and amended Articles of Incorporation, effective July 1, 2020. Copies of the Amended Codes and Articles were submitted to the Internal Revenue Services in August of 2020. The Amended Articles of Incorporation included the following changes: (1) Changed the name of the organization to CareSource Ohio Inc., (2) Changed the business location to the "City of Dayton, County of Montgomery, Ohio.", (3) Updated the Purpose to include a provision outlining treatment of Net Proceeds from a liquidity event, (4) Updated the sole member to "CareSource" formerly known as CareSource Management Group, Co., (5) Updated the dissolution provision such that all remaining assets upon dissolution are distributed to the sole member, (6) Established the Location and (3) above as Permanent Principles, and (7) Added an Amendment provision to establish that only with sole member approval can the Articles be amended. The Amended Codes of Regulations included the following changes: (1) Established the corporate headquarters and principal place of business as the "Dayton Area", (2) Updated the number of Directors on the Board to be not less than three or more than nine, (3) Updated the Qualifications, Nominations, Vacancies and Removal provisions for Directors to be determined/dictated by the sole member, (4) Removed term limits for directors (5) Made a number of minor modifications to the Article relating to Meetings of Directors, (6) Defined roles and duties of the organization officers: Chair, President, Treasurer and Secretary, (7) Removed Article relating to Duty of the Board and duties relating to appointing trustees of other related CareSource organizations, (8) Removed Article related to Powers of Trustees (oversight of Corporate Property, Gifts, Management and Disbursements, (9) Removed Conflict of Interest policy from being directly included in the Articles (policy is kept separately), (10) Updated Dissolution provision such that all remaining assets upon dissolution are distributed to the sole member, and (11) Established the Dissolution Article as a permanent provision.

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 B, Question 11B

The Form 990 was provided to the organization's Audit Committee for their review of the return prior to the time of filing Form 990. The Form 990 was made available to each voting member of the governing body of the organization for their review prior to the time of filing Form 990. The Form 990 was reviewed by the CEO, CFO, VP Treasury, Director Tax, Manager Tax, an outside CPA Firm, outside legal counsel, and by general counsel prior to filing Form 990 with the IRS.

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 sign a statement which affirms that such person has reviewed the Statement of Ethical Behavior and Conflict of Interest and Conflicts of Interest Corporate Governance Principles. In connection with any actual or possible conflicts of interest, an interested person must disclose the existence of his or her financial or conflict of interest and must be given the opportunity to disclose all material facts to the directors and members of committees with Board delegated powers considering the proposed transaction or arrangement. After disclosure of the financial interest and all material facts, and after any discussion with the interested person, he/she shall leave the Board or committee meeting while the determination of a conflict of interest is discussed and voted upon. The remaining Board or committee members shall decide if a conflict of interest exists. An interested person may make a presentation at the Board or committee meeting, but after such presentation, he/she shall leave the meeting during the discussion of, and the vote on, the transaction or arrangement that results in the conflict of interest. The conflicted director has no vote on the matter involved with the conflict of interest.

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.

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.

Filing and Contact Details

Filer

Filer Name
CareSource Ohio Inc
EIN
31-1143265
In Care Of
% JANET FERNANDES
Phone
9375313027
Address
PO Box 8738, Dayton, OH 45401-8738

Signing Officer

Name
Lawrence Smart
Title
CFO
Phone
9375313027
Signed
2021-11-11

Organization Details

Principal Officer
Erhardt Preitauer
Formed
1985
Legal Domicile
Oh
Voting Board Members
3
Independent Board Members
0
Employees
0
Volunteers
0
Supplemental Narrative

Additional Explanations

Form 990, Part V, Line 1A

In early 2020, CSOH changed the payer of its provider claims payments, resulting in a reduction of the number of Forms 1099 that were reported on Form 990, Part V, Line 1A.

Form 990, Part XI, Line 9

Change in net assets is inclusive of the following: (1) change in investment in subsidiary ($2,392,943) and (2) write off of advances paid to Behavioral Health providers ($4,058,495). The CareSource Foundation was a subsidiary of CareSource Ohio, Inc. for the first half of 2020. Effective July 1, 2020, CareSource became the sole member of The CareSource Foundation. This restructuring is reflected in the change in investment in subsidiary of ($2,392,943) as outlined on Form 990, Part XI, Line 9.

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 2017-2019 are open for audit by the Internal Revenue Service.

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IRS990/Desc0CareSource 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 30 years. CSOH serves more than 1.4 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 continue to
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IRS990/MissionDesc0CareSource Ohio Inc.'s mission is to make a lasting difference in members' lives by improving their health and well-being. The organization's vision is to transform lives through innovative health and life services. CareSource Ohio Inc. is a health maintenance organization licensed by the state of Ohio and serves members through Dual Eligible Special Needs, Marketplace, Medicaid, Medicare Advantage, and MyCare Ohio plans.
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Document Assets

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Filings

Balance SheetOperations
YearAssetsLiabilitiesNet AssetsRevenueExpensesNet Income
2024XML pending. An XML filing is linked for this year, but detailed extraction is still pending.$2,249$1,402$847$8,560$8,462$97.5
2022Facts available. Structured filing facts are available, but richer extracted sections are limited.$2,667$1,267$1,400$10,064$9,417$647
2021XML pending. An XML filing is linked for this year, but detailed extraction is still pending.$2,610$1,461$1,149$9,756$9,704$52.0
2020Detailed filing. Detailed filing data is available for this year.$2,518$1,435$1,084$9,273$9,110$162
2018XML pending. An XML filing is linked for this year, but detailed extraction is still pending.$1,808$953$855$7,819$7,743$76.1
2017XML pending. An XML filing is linked for this year, but detailed extraction is still pending.$1,851$1,032$819$7,221$7,191$30.4
2015Detailed filing. Detailed filing data is available for this year.$1,832$883$949$6,203$6,014$189
2014Detailed filing. Detailed filing data is available for this year.$1,779$1,012$768$5,003$4,844$159
2013Detailed filing. Detailed filing data is available for this year.$1,207$593$615$3,644$3,509$135
2012Facts available. Structured filing facts are available, but richer extracted sections are limited.$1,002$465$537$3,247
2011Facts available. Structured filing facts are available, but richer extracted sections are limited.$996$585$411$2,593
2010Facts available. Structured filing facts are available, but richer extracted sections are limited.$727$437$290$2,267