Civic Intelligence

Caresource Ohio Inc.

990 • Fiscal year 2018 • EIN 31-1143265

Jan 01, 2018 to Dec 31, 2018 • Filed on Nov 13, 2019

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

72nd percentile

0.53x

Higher debt load relative to assets than 72% of similar nonprofits.

2018 filings • 501(c)3 • $1B+ nonprofits • Source year 2018

Liabilities / Revenue

11th percentile

0.12x

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

2018 filings • 501(c)3 • $1B+ nonprofits • Source year 2018

Net Margin

20th percentile

1.0%

Higher net margin than 20% of similar nonprofits.

2018 filings • 501(c)3 • $1B+ nonprofits • Source year 2018

Top Officer Pay

85th percentile

$4,552,103

Higher top officer pay than 85% of similar nonprofits.

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

2018 filings • 501(c)3 • $1B+ nonprofits • Source year 2018

Asset Growth

13th percentile

-2.3%

Faster asset growth than 13% of similar nonprofits.

2018 filings • 501(c)3 • $1B+ nonprofits • Annualized from 2017 to 2018

Revenue Growth

59th percentile

8.3%

Faster revenue growth than 59% of similar nonprofits.

2018 filings • 501(c)3 • $1B+ nonprofits • Annualized from 2017 to 2018

Assets

Down

$1,807,957,209

Down $42,852,980 (-2.3%) from 2017

Net Assets

Up

$854,696,804

Up $35,778,339 (+4.4%) from 2017

Liabilities

Down

$953,260,405

Down $78,631,319 (-7.6%) from 2017

Revenue

Up

$7,819,337,654

Up $598,471,388 (+8.3%) from 2017

Expenses

Up

$7,743,280,827

Up $552,770,004 (+7.7%) from 2017

Net Income

Up

$76,056,827

Up $45,701,384 (+151%) from 2017

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

2018

Assets$1,807,957,209
Liabilities$953,260,405
Net Assets$854,696,804

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

2018

Revenue$7,819,337,654
Expenses$7,743,280,827
Net Income$76,056,827
Jump To
Filing Snapshot
Filing Period
Jan 1, 2018 to Dec 31, 2018
Signed
Nov 13, 2019
Return Version
2018v3.1
Gross Receipts
$8,003,852,258
Mission and Program Overview

Mission

Caresource 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. (continued on schedule o)

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$756,561,461$938,678,229▲ $182,116,768
Accounts Receivable$360,501,417$577,346,188▲ $216,844,771
Savings and Temporary Cash Investments$605,808,308$279,744,753▼ $326,063,555
Cash and Non-Interest-Bearing Accounts$128,198,496$7,739,460▼ $120,459,036
Prepaid Expenses and Deferred Charges$452,181$4,168,201▲ $3,716,020
Investments Program Related$-711,674$280,378▲ $992,052
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$1,850,810,189$1,807,957,209▼ $42,852,980
Other Assets Total$0$0→ $0
Liabilities
Accounts Payable and Accrued Expenses$953,529,808$916,911,802▼ $36,618,006
Deferred Revenue$56,151,193$18,950,321▼ $37,200,872
Other Liabilities$22,210,723$17,398,282▼ $4,812,441
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$1,031,891,724$953,260,405▼ $78,631,319
Net Assets / Fund Balance
Unrestricted Net Assets$818,918,465$854,696,804▲ $35,778,339
Permanently Rstr Net Assets$0$0→ $0
Temporarily Rstr Net Assets$0$0→ $0
Total Net Assets Fund Balance$818,918,465$854,696,804▲ $35,778,339
Total Liabilities and Net Assets / Fund Balance$1,850,810,189$1,807,957,209▼ $42,852,980

Asset Categories

AssetBook ValueDepreciationBasis
Other Land Buildings-$118,845$118,845
Compensation and Service Providers

Employees

NameTitleFull / Part TimeOtherTotal
Michael E Ervin MDChairperson/TrusteePT$125,000$125,000
Ellen S LeffakTrusteePT$110,000$110,000
Craig J BrownVice Chairperson/TrusteePT$92,500$92,500
William F Marsteller DCSecretary/Treasurer/TrusteePT$42,500$42,500
David Kaelber MDTrusteePT$35,000$35,000
David T MillerTrusteePT$35,000$35,000
Gary L Leroy MDTrusteePT$30,000$30,000

Board Members and Trustees

NameTitle
Stephen RingelPresident, Market
Erhardt H PreitauerCEO/Trustee From 05/18
Pamela B MorrisCEO/Trustee To 05/18
Douglas A FecherTrustee
Daniel J McCabeChief Administrative Officer
David W GoltzChief Financial Officer
Jai P PillaiChief Operating Ofr From 09/18
L Tarlton Thomas IIIChief Operating Ofr To 09/18

Highest Paid Contractors

ContractorServicesLocationCompensation
CVS CaremarkPharmacy Services9501 E Shea Blvd MC 19, Scottsdale, AZ 85260$1,936,870,635
Nationwide Childrens HospitalCapitation/Medical700 Childrens Dr, Columbus, OH 43205$473,321,581
University Hospitals of ClevelandMedical Services11100 Euclid Avenue, Cleveland, OH 44106$239,077,815
The MetroHealth SystemMedical Services2500 MetroHealth Dr, Cleveland, OH 44109$219,074,335
Children's Hospital Medical CenterMedical Services3333 Burnet Avenue, Cincinnati, OH 45229-3039$210,714,952
Revenue and Support

Revenue Composition

Contributions and Grants
$114,330
Program Service Revenue
$7,762,642,282
Investment Income
$56,581,042
Other Revenue
$0
Change in Net Assets
$76,056,827
Expenses and Functional Allocation

Major Expense Lines

Line ItemAmount
Other Expenses$7,743,250,827
Grants and Similar Amounts Paid$30,000
Professional Fundraising Fees$0
Salaries, Compensation, and Employee Benefits$0
Total Fundraising Expense$0

Functional Expense Allocation

Line ItemProgramManagementFundraisingTotal
Fees for Services Other$38,701,178$112,917,389-$151,618,567
Office Expenses$568,865$39,383,394-$39,952,259
Information Technology-$26,691,387-$26,691,387
Occupancy$20,455$18,162,005-$18,182,460
Other Expenses$91,224,722$16,439,872-$16,439,872
Advertising$38,815$6,539,459-$6,578,274
Travel$1,764,257$2,887,171-$4,651,428
All Other Expenses$364,363$3,045,799-$3,410,162
Insurance-$1,530,518-$1,530,518
Fees for Services Accounting-$1,342,864-$1,342,864
Fees for Services Legal-$1,239,430-$1,239,430
Fees for Services Lobbying$4,074$218,577-$222,651
Interest-$127,877-$127,877
Grants to Domestic Orgs$30,000--$30,000
Total Functional Expenses$7,313,579,360$429,701,467$0$7,743,280,827
International Activity

Grant and Assistance Recipients

RecipientLocationCategoryPurposeAmount
Wright State University FoundationDayton, OH501(c)(3)General Support$25,000
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$17,398,282
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 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 Management Group Co. ("CSMG") is the member of CareSource. CSMG is a nonprofit corporation that is exempt from federal income taxation under section 501(c)(3) of the Internal Revenue Code of 1986.

Form 990, Part VI, Section B, Question 11B

The Form 990 was provided to all individuals whose names have been submitted to the Ohio Department of Insurance as the new governing board of CareSource. These individuals shall comprise the governing board of CareSource upon approval by the Department of Insurance, which is anticipated by the end of 2019. Additionally, the Form 990 was provided to all members of the CareSource Management Group Co.s Finance Committee as well as all members of the governing board of CareSource Management Group Co., a nonprofit corporation that is exempt from federal income taxation under section 501(c)(3) of the Code and the member of CareSource for Ohio corporate law purposes. Finally, as part of the return preparation process, the Form 990 was reviewed by CareSources CEO, CFO, VP Treasury, Director Treasury, an outside CPA firm, outside legal counsel, and by internal counsel prior to filing Form 990 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 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, and memorialized in meeting minutes, 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 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
EIN
31-1143265
In Care Of
% JANET FERNANDES
Phone
9375313027
Address
PO Box 8738, Dayton, OH 45401-8738

Signing Officer

Name
David W Goltz
Title
CFO
Phone
9375313027
Signed
2019-11-13

Organization Details

Principal Officer
Erhardt Preitauer
Formed
1985
Legal Domicile
Oh
Voting Board Members
9
Independent Board Members
5
Employees
0
Volunteers
0
Supplemental Narrative

Additional Explanations

Form 990, Part III, Question 2

See Attachment 2 for a description of CareSource's Behavioral Health Program, which began in 2018.

Form 990, Part XI, Line 9

Change in net assets is inclusive of the following: (1) change in investment in subsidiary ($1,007,948).

Financial Statement Notes

FIN 48 (ASC 740) Footnote

As outlined in the CareSource Management Group Co.'s Audited Consolidated Financial Statements, which include the activity of CareSource: 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 2015-2018 are open for audit by the Internal Revenue Service.

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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 members' lives by improving their health and well-being for more than 29 years. CareSource serves 1.32 million members in Ohio. CareSource'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, (5) a Qualified Health Plan offered through the Federal Health Insurance Marketplace, providing low-cost comprehensive coverage for individuals and families, and (6) Community Transition Program consumers who are transitioning from the Ohio Department of Rehabilitation and Correction back to the community through a grant from the Ohio Department of Mental Health and Addiction Services. CareSource Program Services: 1) CareSource Ohio Medicaid: 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 it the opportunity to forge strong, positive regulatory relationships with state agencies, including departments of insurance. CareSource has earned 53% 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. 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. CareSource has made an organizational commitment to make evidence-based investments towards improving health outcomes for members. CareSource'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 measureable positive impacts in the health of the communities we serve. CareSource 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. CareSource has a broad, statewide network of more than 34,000 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, CareSource incentivizes certain providers through a value based incentive model. CareSource focuses efforts on creating incentives and reimbursement options to support models that recognize quality at the provider level. CareSource created a program that provides additional incentives to providers for delivering quality based services that impact Healthcare Effectiveness Data and Information Set (HEDIS) measures. CareSource created a shared savings model that rewards providers for attaining quality targets while sharing savings
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Document Assets

No mirrored PDF or thumbnail assets are attached yet.

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
2018Detailed filing. Detailed filing data is available for this year.$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
Peer Organizations

Similar nonprofits based on the same Siviq industry and scale cohort. 2018 filings • 501(c)3 • $1B+ nonprofits