Civic Intelligence

Caresource West Virginia Co

990 • Fiscal year 2016 • EIN 47-3028244

Jan 01, 2016 to Dec 31, 2016 • Filed on Nov 13, 2017

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

76th percentile

0.53x

Higher debt load relative to assets than 76% of similar nonprofits.

2016 filings • 501(c)3 • $5M-$10M nonprofits • Source year 2016

Liabilities / Revenue

77th percentile

0.74x

Higher debt load relative to revenue than 77% of similar nonprofits.

2016 filings • 501(c)3 • $5M-$10M nonprofits • Source year 2016

Net Margin

20th percentile

-10%

Higher net margin than 20% of similar nonprofits.

2016 filings • 501(c)3 • $5M-$10M nonprofits • Source year 2016

Top Officer Pay

100th percentile

$2,805,764

Higher top officer pay than 100% of similar nonprofits.

Top officer pay equals 51.9% of source-year revenue.

2016 filings • 501(c)3 • $5M-$10M nonprofits • Source year 2016

Asset Growth

Score unavailable

No value available

No earlier valid filing was available within the previous three public years.

Source year 2016

Revenue Growth

Score unavailable

No value available

No earlier valid filing was available within the previous three public years.

Source year 2016

Assets

$7,627,426

No earlier filing loaded for comparison.

Net Assets

$3,613,204

No earlier filing loaded for comparison.

Liabilities

$4,014,222

No earlier filing loaded for comparison.

Revenue

$5,404,593

No earlier filing loaded for comparison.

Expenses

$5,947,996

No earlier filing loaded for comparison.

Net Income

-$543,403

No earlier filing loaded for comparison.

Historical Trend

Balance Sheet Trend

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

$150M$100M$50M$0Assets 2016: $7,627,426Liabilities 2016: $4,014,222Net Assets 2016: $3,613,2042016Assets 2017: $24,942,499Liabilities 2017: $16,049,004Net Assets 2017: $8,893,4952017Assets 2018: $25,009,769Liabilities 2018: $21,951,252Net Assets 2018: $3,058,5172018Assets 2019: $27,324,026Liabilities 2019: $23,432,384Net Assets 2019: $3,891,6422019Assets 2020: $26,367,795Liabilities 2020: $23,292,533Net Assets 2020: $3,075,2622020Assets 2021: $34,850,129Liabilities 2021: $31,995,473Net Assets 2021: $2,854,6562021Assets 2022: $47,704,956Liabilities 2022: $43,139,701Net Assets 2022: $4,565,2552022Assets 2023: $68,624,913Liabilities 2023: $57,127,379Net Assets 2023: $11,497,5342023Assets 2024: $139,591,982Liabilities 2024: $122,844,410Net Assets 2024: $16,747,5722024

Highlighted filing

2016

Assets$7,627,426
Liabilities$4,014,222
Net Assets$3,613,204

Operations Trend

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

$300M$200M$100M$0-$100MRevenue 2016: $5,404,593Expenses 2016: $5,947,996Net Income 2016: -$543,4032016Revenue 2017: $32,204,956Expenses 2017: $31,924,665Net Income 2017: $280,2912017Revenue 2018: $50,663,596Expenses 2018: $56,498,574Net Income 2018: -$5,834,9782018Revenue 2019: $52,362,618Expenses 2019: $51,529,493Net Income 2019: $833,1252019Revenue 2020: $53,733,424Expenses 2020: $54,549,804Net Income 2020: -$816,3802020Revenue 2021: $70,193,588Expenses 2021: $70,414,194Net Income 2021: -$220,6062021Revenue 2022: $82,246,044Expenses 2022: $80,534,117Net Income 2022: $1,711,9272022Revenue 2023: $103,332,039Expenses 2023: $96,431,596Net Income 2023: $6,900,4432023Revenue 2024: $214,719,988Expenses 2024: $209,483,593Net Income 2024: $5,236,3952024

Highlighted filing

2016

Revenue$5,404,593
Expenses$5,947,996
Net Income-$543,403
Jump To
Filing Snapshot
Filing Period
Jan 1, 2016 to Dec 31, 2016
Signed
Nov 13, 2017
Return Version
2016v3.1
Gross Receipts
$5,404,593
Mission and Program Overview

Mission

TO MAKE A LASTING DIFFERENCE IN OUR MEMBERS LIVES BY IMPROVING THEIR HEALTH AND WELL-BEING. THE CARESOURCE WEST Virginia Marketplace PLAN WAS SUCCESSFULLY IMPLEMENTED WITH ENROLLMENT BEGINNING ON NOVEMBER 1, 2015, AND AN EFFECTIVE DATE OF JANUARY 1, 2016.

To Make a Lasting Difference in our members' lives by improving their health and well-being. CareSource West Virginia Co is a nonprofit medicaid HMO licensed by State of WV.

Balance Sheet Detail
LineBeginningEndChange
Assets
Cash and Non-Interest-Bearing Accounts$4,282,377$6,913,265▲ $2,630,888
Accounts Receivable$54$714,161▲ $714,107
Savings and Temporary Cash Investments$0$0→ $0
Other Notes and Loans Receivable, Net$0$0→ $0
Pledges and Grants Receivable$0$0→ $0
Receivable From Disqualified Prsn$0$0→ $0
Receivables From Officers Etc$0$0→ $0
Investments Other Securities$0$0→ $0
Investments Program Related$0$0→ $0
Investments in Publicly Traded 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
Prepaid Expenses and Deferred Charges$0$0→ $0
Total Assets$4,282,431$7,627,426▲ $3,344,995
Other Assets Total$0$0→ $0
Liabilities
Deferred Revenue$77,507$2,597,290▲ $2,519,783
Accounts Payable and Accrued Expenses$48,317$1,416,932▲ $1,368,615
Grants Payable$0$0→ $0
Mortgage Notes Payable Secured by Investment Property$0$0→ $0
Unsecured Notes Loans Payable$0$0→ $0
Other Liabilities$0$0→ $0
Escrow Account Liability$0$0→ $0
Tax Exempt Bond Liabilities$0$0→ $0
Total Liabilities$125,824$4,014,222▲ $3,888,398
Net Assets / Fund Balance
Unrestricted Net Assets$4,156,607$3,613,204▼ $543,403
Permanently Rstr Net Assets$0$0→ $0
Temporarily Rstr Net Assets$0$0→ $0
Total Net Assets Fund Balance$4,156,607$3,613,204▼ $543,403
Total Liabilities and Net Assets / Fund Balance$4,282,431$7,627,426▲ $3,344,995
Compensation and Service Providers

Employees

NameTitleOtherTotal
Ellen S LeffakTrustee$116,250$116,250
J Thomas MaultsbyTrustee$45,625$45,625

Board Members and Trustees

NameTitle
Pamela B MorrisPresident/CEO/Board Chair
Bobby Jones to 62016President Georgia Market
Daniel McCabeChief Administrative Officer
Craig Thiele MDChief Medical Officer
L Tarlton Thomas IIIEVP Operations & CFO

Highest Paid Contractors

ContractorServicesLocationCompensation
Cabell Huntington Hospital IncMedical Services134o Hal Greer Blvd, Huntington, WV 25701$1,209,359
Charleston Area Medical Center IncMedical Services501 Morris St, Charleston, WV 25326$1,089,673
CVS CaremarkPharmacy Services9501 E Shea Blvd MC 143, Scottsdale, AZ 85260$962,880
Herbert J Thomas Memorial HospitalMedical Services4605 Maccorkle Ave SW, South Charleston, WV 25309$289,035
Presidio Excess Insurance Svcs IncReinsurance199 Fremont Ave 11th Fl, San Francisco, CA 94105$199,318
Revenue and Support

Revenue Composition

Contributions and Grants
$0
Program Service Revenue
$5,403,835
Investment Income
$758
Other Revenue
$0
Change in Net Assets
$-543,403
Expenses and Functional Allocation

Major Expense Lines

Line ItemAmount
Other Expenses$5,943,996
Grants and Similar Amounts Paid$4,000
Professional Fundraising Fees$0
Salaries, Compensation, and Employee Benefits$0
Total Fundraising Expense$0

Functional Expense Allocation

Line ItemProgramManagementFundraisingTotal
Other Expenses$25$286,200-$286,225
Office Expenses$150$160,621-$160,771
Fees for Services Accounting$464$112,119-$112,583
Advertising$6$90,452-$90,458
Fees for Services Other$1,871$46,199-$48,070
Fees for Services Lobbying$167$33,816-$33,983
Occupancy-$4,544-$4,544
Grants to Domestic Orgs$4,000--$4,000
Conferences and Meetings$159$2,794-$2,953
Fees for Services Legal-$666-$666
Total Functional Expenses$5,084,421$863,575$0$5,947,996
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
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
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 B, Question 11B

The Form 990 was provided to the organization's Finance 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, 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 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, 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 990 is available for public inspection upon request. The company's Form 990 is also available on the U.S. nonprofit database website at www.guidestar.org. The Company's statutory financial statements are available on the SNL Financial LC website at www.snl.com for a nominal fee. The company's articles of incorporation are available on the West Virginia Secretary of State's website at www.sos.wv.gov/.

Filing and Contact Details

Filer

Filer Name
CareSource West Virginia Co
EIN
47-3028244
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
2017-11-13

Organization Details

Principal Officer
Pamela B Morris
Formed
2015
Legal Domicile
Wv
Voting Board Members
3
Independent Board Members
2
Employees
0
Volunteers
0
Supplemental Narrative

Financial Statement Notes

FIN 48 (ASC 740) Footnote

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 2015-2016 are open for audit by the Internal Revenue Service.

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IRS990/Desc0CareSource West Virginia Co. ("CSWV") is a non-profit organization established under the state law of West Virginia. On August 30, 2017, CSWV received a determination letter from the Internal Revenue Service, recognizing CSWV as an organization exempt from federal income tax under Section 501(c)(3) of the Internal Revenue Code. CSWV is a member of the CareSource Family of Companies' non-profit organizations. The mission of CareSource is to make a lasting difference in its members lives by improving their health and overall well-being. CSWV firmly adheres to this mission, which it terms as the organizations "heartbeat," by providing services that go well beyond the delivery of medical benefits. CSWV began offering a Qualified Health Plan on the West Virginia Health Insurance Marketplace beginning in January 2016, providing low-cost comprehensive coverage for uninsured individuals and families. CareSource West Virginia received interim accreditation through National Committee for Quality Assurance (NCQA) in 2015 for its Health Insurance Marketplace plan. NCQA accreditation is the most comprehensive evaluation in the industry and the only assessment that bases results on clinical performance and consumer experience. Pursuing NCQA Accreditation demonstrates CSWV's commitment to quality and improving the health and well-being of our members. CSWV focuses on prevention with a goal of improving member health, the quality of health care services received, and accessibility of health care services for its members. This is done through an innovative health and wellness methodology. CSWV has built a high performing provider network to operate as an HMO. This provider network relies heavily upon federally qualified health centers (FQHCs). FQHCs are generally health care providers that have been recognized by the federal government as providing care to populations that have limited access to medical treatment due to conditions such as poverty and geographic location. CareSource West Virginia's Qualified Health Plan on the Health Insurance Marketplace primarily serves low-income individuals and was designed for those low-income adults who are recently uninsured or have never been insured. The plan is affordable, with low monthly premiums, low copays, low annual deductibles, and free generic prescriptions for some members. Members have the choice of buying dental and vision plans in addition to their medical plan. Members can also receive assistance through CSWVs many programs designed to remove barriers to health and well-being. CSWV can, therefore, further its mission as a means of improving the health and well-being of West Virginias low-income populations.
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IRS990/Form990PartVIISectionAGrp/TitleTxt0Trustee
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IRS990/Form990PartVIISectionAGrp/TitleTxt3Chief Medical Officer
IRS990/Form990PartVIISectionAGrp/TitleTxt4Chief Administrative Officer
IRS990/Form990PartVIISectionAGrp/TitleTxt5EVP Operations & CFO
IRS990/Form990PartVIISectionAGrp/TitleTxt6President Georgia Market
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IRS990/MissionDesc0TO MAKE A LASTING DIFFERENCE IN OUR MEMBERS LIVES BY IMPROVING THEIR HEALTH AND WELL-BEING. THE CARESOURCE WEST Virginia Marketplace PLAN WAS SUCCESSFULLY IMPLEMENTED WITH ENROLLMENT BEGINNING ON NOVEMBER 1, 2015, AND AN EFFECTIVE DATE OF JANUARY 1, 2016.
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IRS990/OperateHospitalInd0false
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IRS990/OtherExpensesGrp/Desc0MEDICAL
IRS990/OtherExpensesGrp/Desc1PHARMACY
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IRS990/OtherExpensesGrp/Desc3FILING/CLAIMS ADMIN
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IRS990/PrincipalOfficerNm0Pamela B Morris
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IRS990/ProgramServiceRevenueGrp/Desc0FEDERAL HEALTH INSURANCE EXCHANGE
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IRS990ScheduleA/Total509Grp/CurrentTaxYearMinus4YearsAmt00
IRS990ScheduleA/Total509Grp/TotalAmt05403835
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IRS990ScheduleA/TotalSupportCalendarYearGrp/CurrentTaxYearMinus1YearAmt012
IRS990ScheduleA/TotalSupportCalendarYearGrp/CurrentTaxYearMinus2YearsAmt00
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IRS990ScheduleC/SupplementalInformationDetail/ExplanationTxt0Lobbyists are retained to provide updates and represent the Organization's interests with federal and state legislators who deal with legislation related to Government sponsored health care programs.
IRS990ScheduleC/SupplementalInformationDetail/FormAndLineReferenceDesc0Form 990, Schedule C, Part II-B, Line 1g

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