Civic Intelligence

Caresource Ohio Inc.

990 • Fiscal year 2015 • EIN 31-1143265

Jan 01, 2015 to Dec 31, 2015 • Filed on Nov 11, 2016

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

64th percentile

0.48x

Higher debt load relative to assets than 64% of similar nonprofits.

2015 filings • 501(c)3 • $1B+ nonprofits • Source year 2015

Liabilities / Revenue

10th percentile

0.14x

Higher debt load relative to revenue than 10% of similar nonprofits.

2015 filings • 501(c)3 • $1B+ nonprofits • Source year 2015

Net Margin

26th percentile

3.0%

Higher net margin than 26% of similar nonprofits.

2015 filings • 501(c)3 • $1B+ nonprofits • Source year 2015

Top Officer Pay

98th percentile

$7,862,820

Higher top officer pay than 98% of similar nonprofits.

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

2015 filings • 501(c)3 • $1B+ nonprofits • Source year 2015

Asset Growth

43rd percentile

2.9%

Faster asset growth than 43% of similar nonprofits.

2015 filings • 501(c)3 • $1B+ nonprofits • Annualized from 2014 to 2015

Revenue Growth

88th percentile

24%

Faster revenue growth than 88% of similar nonprofits.

2015 filings • 501(c)3 • $1B+ nonprofits • Annualized from 2014 to 2015

Assets

Up

$1,831,803,361

Up $52,436,830 (+2.9%) from 2014

Net Assets

Up

$949,129,854

Up $181,342,345 (+24%) from 2014

Liabilities

Down

$882,673,507

Down $128,905,515 (-13%) from 2014

Revenue

Up

$6,202,791,309

Up $1,199,715,324 (+24%) from 2014

Expenses

Up

$6,013,922,970

Up $1,170,264,561 (+24%) from 2014

Net Income

Up

$188,868,339

Up $29,450,763 (+18%) from 2014

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

2015

Assets$1,831,803,361
Liabilities$882,673,507
Net Assets$949,129,854

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

2015

Revenue$6,202,791,309
Expenses$6,013,922,970
Net Income$188,868,339
Jump To
Filing Snapshot
Filing Period
Jan 1, 2015 to Dec 31, 2015
Signed
Nov 11, 2016
Return Version
2015v2.1
Gross Receipts
$6,531,587,542
Mission and Program Overview

Mission

CareSource Ohio, Inc.'s mission is to make a lasting difference in our members' lives by improving their health and well-being. The organization's vision is to transform lives through innovative health and life services. (Continued on Schedule O)CareSource Ohio, Inc. is a health insuring corporation licensed by the state of Ohio and serves members through Dual Eligible Special Needs, Marketplace, Medicaid, Medicare Advantage, and MyCare Ohio plans.

To make a lasting difference in our members' lives by improving their health and well-being. CareSource offers services for Medicaid, Medicare and Federal Exchange members.

Balance Sheet Detail
LineBeginningEndChange
Assets
Investments in Publicly Traded Securities$728,944,833$946,273,493▲ $217,328,660
Savings and Temporary Cash Investments$795,483,491$469,798,068▼ $325,685,423
Accounts Receivable$250,602,921$329,251,678▲ $78,648,757
Cash and Non-Interest-Bearing Accounts$2,637,331$85,443,635▲ $82,806,304
Prepaid Expenses and Deferred Charges$1,019,286$379,495▼ $639,791
Investments Program Related$678,669$246,787▼ $431,882
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
Intangible Assets$0$0→ $0
Inventories for Sale or Use$0$0→ $0
Loans From Officers Directors$0$0→ $0
Total Assets$1,779,366,531$1,831,803,361▲ $52,436,830
Other Assets Total$0$410,205▲ $410,205
Liabilities
Accounts Payable and Accrued Expenses$962,459,747$800,879,673▼ $161,580,074
Deferred Revenue$25,406,577$59,729,340▲ $34,322,763
Other Liabilities$23,712,698$22,064,494▼ $1,648,204
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$1,011,579,022$882,673,507▼ $128,905,515
Net Assets / Fund Balance
Unrestricted Net Assets$767,787,509$949,129,854▲ $181,342,345
Permanently Rstr Net Assets$0$0→ $0
Temporarily Rstr Net Assets$0$0→ $0
Total Net Assets Fund Balance$767,787,509$949,129,854▲ $181,342,345
Total Liabilities and Net Assets / Fund Balance$1,779,366,531$1,831,803,361▲ $52,436,830
Compensation and Service Providers

Employees

NameTitleOtherTotal
Ellen S LeffakTrustee$77,500$77,500
Michael E Ervin MDChairman/Trustee$60,000$60,000
Craig BrownVice Chairperson/Trustee$40,000$40,000
William F Marsteller DCSecretary/Treasurer/Trustee$37,500$37,500
David Kaelber MDTrustee$32,500$32,500
Gary L Leroy MDTrustee$30,000$30,000

Board Members and Trustees

NameTitle
Pamela B MorrisPresident & CEO; Trustee
Stephen RingelPresident Ohio Market
David T MillerTrustee
Douglas A FecherTrustee
L Tarlton Thomas IIIChief Financial Officer
Craig Thiele MDChief Medical Officer
Bobby JonesChief Operating Officer

Highest Paid Contractors

ContractorServicesLocationCompensation
CVS CaremarkPharmacy Services221 N Charles Lindbergh Dr, Salt Lake City, UT 84116$1,542,848,834
Nationwide Childrens Hosp Prtnrs 4Capitation/Medical700 Childrens Dr, Columbus, OH 43205$372,712,766
Cleveland Clinic Found Consol EntiMedical Services9500 Euclid Ave, Cleveland, OH 44195$286,084,528
Univ Hospitals of Cleveland CONSOLMedical Services11100 Euclid Ave, Cleveland, OH 44106$245,118,573
The Metrohealth SystemMedical Services2500 Metrohealth Drive, Cleveland, OH 44109$178,091,560
Revenue and Support

Revenue Composition

Contributions and Grants
$0
Program Service Revenue
$6,170,508,774
Investment Income
$32,282,535
Other Revenue
$0
Change in Net Assets
$188,868,339
Expenses and Functional Allocation

Major Expense Lines

Line ItemAmount
Other Expenses$6,013,857,470
Grants and Similar Amounts Paid$65,500
Professional Fundraising Fees$0
Salaries, Compensation, and Employee Benefits$0
Total Fundraising Expense$0

Functional Expense Allocation

Line ItemProgramManagementFundraisingTotal
Fees for Services Other$22,478,771$70,438,092-$92,916,863
Office Expenses$498,374$20,778,184-$21,276,558
Information Technology$1,303$14,990,941-$14,992,244
Fees for Services Accounting$647,899$13,072,002-$13,719,901
All Other Expenses$52,867$9,059,256-$9,112,123
Occupancy-$5,222,848-$5,222,848
Other Expenses$26,762$5,073,581-$5,100,343
Fees for Services Legal-$4,329,657-$4,329,657
Travel$2,062,269$1,287,044-$3,349,313
Advertising$109,055$2,786,023-$2,895,078
Conferences and Meetings$585,962$635,164-$1,221,126
Insurance-$1,139,266-$1,139,266
Fees for Services Lobbying$21,979$145,748-$167,727
Interest-$122,953-$122,953
Grants to Domestic Orgs$65,500--$65,500
Total Functional Expenses$5,745,820,630$268,102,340$0$6,013,922,970
International Activity

Grant and Assistance Recipients

RecipientLocationCategoryPurposeAmount
Wright State University FoundationDayton, OH501(c)(3)General Support$22,500
Children's Medical Center of DaytonDayton, OH501(c)(3)General Support$12,500
Miami Valley Womens CenterDayton, OH509(a)(1)General Support$12,000
Juvenile Diabetes Research FoundationCincinnati, OH501(c)(3)General Support$7,000
Fundraising, Events, and Gaming
Fundraising activities
No
Gaming activities
No
Professional fundraiser used
No

Fundraising and Gaming Totals

Line ItemAmount
Professional Fundraising Fees$0
Political and Lobbying Activity
Political campaign activity
No
Lobbying activity
Yes
Subject to proxy tax
No
Insider Transactions and Loans

Interested-Person Transactions

Interested PartyRelationshipDescriptionShared RevenueAmount
The Metrohealth CorporationDavid Kaelber CMI OfficerProvides Healthcare Svc to orgNo$178,091,560
Dayton Children's Medical CenterDavid Miller CFOProvides Healthcare Svc to orgNo$52,891,446
Community Health Center DaytonGary L Leroy MD PhysicianProvides Healthcare Svc to orgNo$1,549,120

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$22,064,494
Governance and Compliance

Governance Checklist

Compiled or reviewed by an accountant
No
Annual disclosure for covered persons
Yes
Audit committee
Yes
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
Yes
Other officer compensation reviewed
Yes
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 B, Question 11B

The Form 990 was provided to the organization's Finance committee, and was reviewed during the course of a special board meeting 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 the Form 990. The Form 990 was reviewed by the CEO, CFO, VP, Treasury, an outside CPA firm, outside legal counsel, and by general counsel prior to filing with the IRS.

Form 990, Part VI, Section B, Question 12C

Annually, each trustee, principal officer and member of a committee with Board-delegated powers ("interested person") shall sign a statement which affirms that such person a) has received a copy of the conflicts of interest policy, b) has read and understands the policy, c) has agreed to comply with the policy, and d) understands that the organization is a charitable organization and that in order to maintain its federal tax exemption it must engage primarily in activities which accomplish one or more of its tax-exempt purposes. 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 trustee has no vote on the matter involved with the conflict of interest. At the beginning of each Board Meeting and Committee Meeting, the Board Members and Committee Members are asked to disclose if they have a Conflict of Interest on any item contained in the agenda. In addition, the Board Members and Committee Members are also asked to inform the board chair if a Conflict of Interest arises during the course of the Board or Committee Meeting. When such a conflict is disclosed, then the procedure outlined above is implemented. In addition, a Conflict of Interest Schedule is kept with respect to each declared Conflict of Interest during the course of a Board or Committee meeting. On an annual basis, the Nominating and Governance Committee reviews each Conflict of Interest raised by a Board or Committee Member. Also, the Nominating and Governance Committee conducts a bi-annual evaluation of the Board Members' performance during the course of the Board Meetings and Committee Meetings. The review includes but is not limited to the Board Member's engagement, participation, contributions to board business, attendance, and any absence from a meeting due to a conflict of interest. The Conflicts of Interest declared by the Board Members are reviewed on an annual basis by the Nominating and Governance Committee to make sure all policies on Conflict of Interest are adhered to by the Boards, the Committees and the Individual Board or Committee Member.

Form 990, Part VI, Section B, Q 15A and 15B; Schedule J, Part I

The Executive Compensation Committee consists of Board Members who are Independent. The process used to determine compensation for the individuals listed on Part VII and Schedule J, Part II include a review by the Independent Board Members after they have received a report of comparability data prepared by an independent company surveying data for comparable organizations' reasonable compensation. The comparability data is presented to the Independent Board members in a written document in advance of the meeting and the independent comparability study is presented by the author of the study during the course of the meeting. In addition, the minutes of each meeting are prepared, distributed and signed within 30 days of the Executive Compensation Committee Meeting. The Executive Compensation Consultant does no other business with the CareSource Family of Companies other than determining the reasonableness of compensation. This compensation consultant's independence is reviewed on an annual basis. This process is followed with respect to all employed corporate officers and the top executives of the CareSource Family of Companies, in order to establish reasonable executive compensation.

Form 990, Part VI, Section C, Question 19

The company's Form 1023 and Form 990 are available for public inspection upon request. 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
EIN
31-1143265
In Care Of
% JANET FERNANDES
Phone
9375313027
Address
PO Box 8738, Dayton, OH 45401-8738

Signing Officer

Name
L Tarlton Thomas Iii
Title
EVP Operations & CFO
Phone
9375313027
Signed
2016-11-11

Organization Details

Principal Officer
Pamela B Morris
Formed
1985
Legal Domicile
Oh
Voting Board Members
9
Independent Board Members
5
Employees
0
Volunteers
0
Supplemental Narrative

Additional Explanations

Form 990, Part XI, Line 9

Change in net assets is inclusive of the following: (1) change in investment in subsidiary ($2,431,882).

Financial Statement Notes

ASC 740 Comment

The Organization annually reviews its tax positions and has determined that there are no material uncertain tax positions that require recognition in the organization's financial statements. As of this filing, tax years 2012-2014 are open for audit by the Internal Revenue Service. CareSource has been recognized by the Internal Revenue Service as a tax-exempt nonprofit corporation and a public charity under Sections 501(c)(3) and 509(a)(2), respectively, of the Internal Revenue Code, and as such, is treated as exempt from federal income taxes. The organization is not subject to unrelated business income tax this year.

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IRS990/Desc0CareSource, a leading nonprofit managed care organization based in Dayton, Ohio, has been living its mission to make a lasting difference in our members' lives by improving their health and well-being for more than 26 years. CareSource serves more than 1,300,000 million Medicaid members in Ohio. CareSource's spectrum of those served include: (1) Medicaid consumers, including families with low income, children, pregnant women, those who are aged, blind or disabled, and those who are eligible for Home and Community Based services through execution of an annual Provider Agreement with the Ohio Department of Medicaid (ODM), (2) Dually eligible consumers for Medicaid and Medicare through Ohio's Dual Demonstration program, MyCare, and (3) Qualified Health Plans, called CareSource Just4Me, offered through the Federal Health Insurance Exchange, providing low-cost comprehensive coverage for uninsured individuals and families. CareSource 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. CareSource's years of experience in managing Medicaid managed care programs and member focused approach to care, have allowed CareSource the opportunity to forge strong, positive regulatory relationships with state agencies, including departments of insurance. In Ohio, CareSource has earned over 53% of the statewide managed care market share, with the highest voluntary enrollment rate and the lowest voluntary disenrollment rate of all participating Medicaid Managed care plans. CareSource 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. This is done through an innovative health and wellness methodology. CareSource has a broad, statewide network of more than 80,000 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 for CareSources Medicaid, MyCare and Just4Me members. Additionally, CareSource offers 24-hour nurse call center services staffed by Registered Nurses, to help members access appropriate care and divert unnecessary emergency department visits. CareSource's commitment to quality is demonstrated through the organization's National Committee for Quality Assurance (NCQA) and URAC accreditations. CareSource is Accredited for the Medicaid HMO Health plan by NCQA. NCQA is a private, nonprofit organization dedicated to transforming health care quality through measurement, transparency and accountability. NCQA consistently raises the bar on health care plan performance by continually increasing quality improvement standards. CareSource maintained its URAC full accreditation for compliance with health utilization management and health call center. Accreditation by both NCQA and URAC demonstrate CareSource's commitment to quality and enhances CareSource's ability to improve the health and well-being of those we serve. CareSource's community-based care coordination program serves members who have the greatest need for case management services. Members receive enhanced care management services based on their complex physical, behavioral and social health needs. CareSource's community-based team of nurses, social workers and Community Health Workers, works in the community to guide members through the complex and often-confusing medical and social service systems. CareSource collaborates with community partners and providers such as the Area Agencies on Aging, Community Mental Health Centers, local pharmacies, and Federally Qualified Health Centers to ensure members receive the services they need. CareSource also participates in the MyCare program as part of Ohio's Dual Demonstration program. CareSource entered into a three-way contract with Ohio Medicaid and the Centers
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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
2020Facts available. Structured filing facts are available, but richer extracted sections are limited.$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