Civic Intelligence

Caresource Ohio Inc.

990 • Fiscal year 2021 • EIN 31-1143265

Jan 01, 2021 to Dec 31, 2021 • Filed on Nov 15, 2022

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

78th percentile

0.56x

Higher debt load relative to assets than 78% of similar nonprofits.

2021 filings • 501(c)3 • $1B+ nonprofits • Source year 2021

Liabilities / Revenue

12th percentile

0.15x

Higher debt load relative to revenue than 12% of similar nonprofits.

2021 filings • 501(c)3 • $1B+ nonprofits • Source year 2021

Net Margin

14th percentile

0.5%

Higher net margin than 14% of similar nonprofits.

2021 filings • 501(c)3 • $1B+ nonprofits • Source year 2021

Top Officer Pay

96th percentile

$10,823,391

Higher top officer pay than 96% of similar nonprofits.

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

2021 filings • 501(c)3 • $1B+ nonprofits • Source year 2021

Asset Growth

17th percentile

3.6%

Faster asset growth than 17% of similar nonprofits.

2021 filings • 501(c)3 • $1B+ nonprofits • Annualized from 2020 to 2021

Revenue Growth

27th percentile

5.2%

Faster revenue growth than 27% of similar nonprofits.

2021 filings • 501(c)3 • $1B+ nonprofits • Annualized from 2020 to 2021

Assets

Up

$2,609,873,144

Up $91,494,523 (+3.6%) from 2020

Net Assets

Up

$1,149,262,465

Up $65,386,082 (+6.0%) from 2020

Liabilities

Up

$1,460,610,679

Up $26,108,441 (+1.8%) from 2020

Revenue

Up

$9,756,197,809

Up $483,318,191 (+5.2%) from 2020

Expenses

Up

$9,704,199,278

Up $593,781,318 (+6.5%) from 2020

Net Income

Down

$51,998,531

Down $110,463,127 (-68%) from 2020

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

2021

Assets$2,609,873,144
Liabilities$1,460,610,679
Net Assets$1,149,262,465

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

2021

Revenue$9,756,197,809
Expenses$9,704,199,278
Net Income$51,998,531
Jump To
Filing Snapshot
Filing Period
Jan 1, 2021 to Dec 31, 2021
Signed
Nov 15, 2022
Return Version
2021v4.2
Gross Receipts
$9,974,447,719
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
Investments in Publicly Traded Securities$617,463,298$1,202,558,522▲ $585,095,224
Savings and Temporary Cash Investments$1,211,528,818$796,922,915▼ $414,605,903
Accounts Receivable$664,247,851$589,512,530▼ $74,735,321
Investments Program Related$405,027$11,867,171▲ $11,462,144
Prepaid Expenses and Deferred Charges$24,328,600$9,012,006▼ $15,316,594
Other Notes and Loans Receivable, Net$405,027$0▼ $405,027
Cash and Non-Interest-Bearing Accounts$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$2,518,378,621$2,609,873,144▲ $91,494,523
Other Assets Total$0$0→ $0
Liabilities
Accounts Payable and Accrued Expenses$1,260,671,424$1,183,196,605▼ $77,474,819
Deferred Revenue$155,246,639$262,744,244▲ $107,497,605
Other Liabilities$18,584,175$14,669,830▼ $3,914,345
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$1,434,502,238$1,460,610,679▲ $26,108,441
Net Assets / Fund Balance
Net Assets Without Donor Restrictions$1,083,876,383$1,149,262,465▲ $65,386,082
Net Assets With Donor Restrictions$0$0→ $0
Total Net Assets Fund Balance$1,083,876,383$1,149,262,465▲ $65,386,082
Total Liabilities and Net Assets / Fund Balance$2,518,378,621$2,609,873,144▲ $91,494,523
Compensation and Service Providers

Board Members and Trustees

NameTitle
Scott MarkovichEVP Markets & Chair (Eff 4/21)
David FinkelEVP, Markets & Chair (To 4/21)
Stephen RingelPresident, Market & Secretary
Daniel McCabeChief Administrative Officer
Erhardt PreitauerChief Executive Officer
Lawrence SmartChief Financial Ofr (Eff 1/21)
David GoltzChief Financial Ofr (To 1/21)
Jai PillaiChief Operating Officer
Pamela MorrisFormer Chief Executive Officer
William Coffin JrVP, Mkt Finance & Treasurer

Highest Paid Contractors

ContractorServicesLocationCompensation
Express Scripts IncPharmacy Services21653 Network Place, Chicago, IL 60673$2,340,046,485
Ohio Hospital AssociationMedical Services155 East Broad St Suite 301, Columbus, OH 43215$480,857,886
Childrens Hosp Phys Healthcare NeMedical Services700 Childrens Drive, Columbus, OH 43205$459,689,908
DentaQuest Group IncMedical Services465 Medford Street, Charlestown, MA 02129$186,470,491
The MetroHealth SystemMedical ServicesPO Box 931311, Cleveland, OH 44193$46,454,614
Revenue and Support

Revenue Composition

Contributions and Grants
$0
Program Service Revenue
$9,724,963,389
Investment Income
$31,234,420
Other Revenue
$0
Change in Net Assets
$51,998,531
Expenses and Functional Allocation

Major Expense Lines

Line ItemAmount
Other Expenses$9,704,199,278
Grants and Similar Amounts Paid$0
Professional Fundraising Fees$0
Salaries, Compensation, and Employee Benefits$0
Total Fundraising Expense$0

Functional Expense Allocation

Line ItemProgramManagementFundraisingTotal
Fees for Services Other$168,223,569$70,264,614-$238,488,183
Office Expenses$1,342,004$100,879,760-$102,221,764
Other Expenses$45,879,363$1,496,848-$47,376,211
Occupancy-$18,918,123-$18,918,123
Advertising$9,768$8,732,024-$8,741,792
All Other Expenses-$8,502,341-$8,502,341
Fees for Services Legal$43,759$7,477,871-$7,521,630
Insurance-$4,301,285-$4,301,285
Interest-$1,017,041-$1,017,041
Fees for Services Accounting-$830,019-$830,019
Travel$74,378$652,276-$726,654
Fees for Services Lobbying$4,029$250,148-$254,177
Total Functional Expenses$9,464,421,325$239,777,953$0$9,704,199,278
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$14,669,830
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.

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 form 990: the organization's audit committee, each voting member of the governing body of the organization, the ceo, cfo, vp treasury, director tax, manager tax, an outside cpa firm, outside legal counsel, and general 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 CareSource 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 of CareSource 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 Interest person's interest in the Transaction; (b) CareSource is entering into the Transaction for its own benefit; (c) the Transaction is fair and reasonable as to CareSource; and (d) CareSource 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 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
9375313027
Address
PO Box 8738, Dayton, OH 45401-8738

Signing Officer

Name
Lawrence Smart
Title
CFO
Phone
9375313027
Signed
2022-11-15
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 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

Other changes in Net Assets is a write off of advances paid to behavioral health providers of $772,952.

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 2018-2020 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 thirty-one 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 50.7% 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 cont
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IRS990/Form990PartVIISectionAGrp/PersonNm1Jai Pillai
IRS990/Form990PartVIISectionAGrp/PersonNm2Daniel McCabe
IRS990/Form990PartVIISectionAGrp/PersonNm3Stephen Ringel
IRS990/Form990PartVIISectionAGrp/PersonNm4David Finkel
IRS990/Form990PartVIISectionAGrp/PersonNm5David Goltz
IRS990/Form990PartVIISectionAGrp/PersonNm6Scott Markovich
IRS990/Form990PartVIISectionAGrp/PersonNm7Lawrence Smart
IRS990/Form990PartVIISectionAGrp/PersonNm8William Coffin Jr
IRS990/Form990PartVIISectionAGrp/PersonNm9Pamela Morris
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IRS990/Form990PartVIISectionAGrp/TitleTxt2Chief Administrative Officer
IRS990/Form990PartVIISectionAGrp/TitleTxt3President, Market & Secretary
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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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IRS990/OfficeExpensesGrp/ProgramServicesAmt01342004
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IRS990/OperateHospitalInd0false
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IRS990/OrganizationFollowsFASB117Ind0X
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IRS990/OtherChangesInNetAssetsAmt0772952
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IRS990/OtherExpensesGrp/Desc1PHARMACY EXPENSES
IRS990/OtherExpensesGrp/Desc2MGMT FEES CARESOURCE MGMT SVCS
IRS990/OtherExpensesGrp/Desc3CLAIMS PROCESSING ADMIN EXP
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IRS990ScheduleA/GiftsGrantsContrisRcvd509Grp/CurrentTaxYearMinus2YearsAmt05280285
IRS990ScheduleA/GiftsGrantsContrisRcvd509Grp/CurrentTaxYearMinus3YearsAmt0114330
IRS990ScheduleA/GiftsGrantsContrisRcvd509Grp/CurrentTaxYearMinus4YearsAmt08170454
IRS990ScheduleA/GiftsGrantsContrisRcvd509Grp/TotalAmt013736053
IRS990ScheduleA/GovtFurnSrvcFcltsVl509Grp/TotalAmt00
IRS990ScheduleA/GrossInvestmentIncome509Grp/CurrentTaxYearAmt026291303

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
2021Detailed filing. Detailed filing data is available for this year.$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