Civic Intelligence

Caresource West Virginia Co

990 • Fiscal year 2020 • EIN 47-3028244

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

400 Washington St E Ste 401Charleston, WV 25301

(937) 531-3027

Siviq Scores

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

Liabilities / Assets

88th percentile

0.88x

Higher debt load relative to assets than 88% of similar nonprofits.

2020 filings • 501(c)3 • $50M-$100M nonprofits • Source year 2020

Liabilities / Revenue

51st percentile

0.43x

Higher debt load relative to revenue than 51% of similar nonprofits.

2020 filings • 501(c)3 • $50M-$100M nonprofits • Source year 2020

Net Margin

28th percentile

-1.5%

Higher net margin than 28% of similar nonprofits.

2020 filings • 501(c)3 • $50M-$100M nonprofits • Source year 2020

Top Officer Pay

100th percentile

$5,959,075

Higher top officer pay than 100% of similar nonprofits.

Top officer pay equals 11.1% of source-year revenue.

2020 filings • 501(c)3 • $50M-$100M nonprofits • Source year 2020

Asset Growth

14th percentile

-3.5%

Faster asset growth than 14% of similar nonprofits.

2020 filings • 501(c)3 • $50M-$100M nonprofits • Annualized from 2019 to 2020

Revenue Growth

51st percentile

2.6%

Faster revenue growth than 51% of similar nonprofits.

2020 filings • 501(c)3 • $50M-$100M nonprofits • Annualized from 2019 to 2020

Assets

Down

$26,367,795

Down $956,231 (-3.5%) from 2019

Net Assets

Down

$3,075,262

Down $816,380 (-21%) from 2019

Liabilities

Down

$23,292,533

Down $139,851 (-0.6%) from 2019

Revenue

Up

$53,733,424

Up $1,370,806 (+2.6%) from 2019

Expenses

Up

$54,549,804

Up $3,020,311 (+5.9%) from 2019

Net Income

Down

-$816,380

Down $1,649,505 (-198%) from 2019

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

2020

Assets$26,367,795
Liabilities$23,292,533
Net Assets$3,075,262

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

2020

Revenue$53,733,424
Expenses$54,549,804
Net Income-$816,380
Jump To
Filing Snapshot
Filing Period
Jan 1, 2020 to Dec 31, 2020
Signed
Nov 11, 2021
Return Version
2020v4.1
Gross Receipts
$53,733,424
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 mem- bers' lives by improving their health and well-being. CareSource West Virginia Co is a nonprofit HMO licensed by the State of West Virginia.

Balance Sheet Detail
LineBeginningEndChange
Assets
Savings and Temporary Cash Investments$23,938,785$22,231,065▼ $1,707,720
Accounts Receivable$3,285,241$2,212,178▼ $1,073,063
Investments in Publicly Traded Securities$0$1,924,552▲ $1,924,552
Cash and Non-Interest-Bearing Accounts$100,000$0▼ $100,000
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
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$27,324,026$26,367,795▼ $956,231
Other Assets Total$0$0→ $0
Liabilities
Deferred Revenue$9,422,779$9,297,543▼ $125,236
Accounts Payable and Accrued Expenses$7,992,366$7,196,283▼ $796,083
Other Liabilities$6,017,239$6,798,707▲ $781,468
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$23,432,384$23,292,533▼ $139,851
Net Assets / Fund Balance
Net Assets Without Donor Restrictions$3,891,642$3,075,262▼ $816,380
Net Assets With Donor Restrictions$0$0→ $0
Total Net Assets Fund Balance$3,891,642$3,075,262▼ $816,380
Total Liabilities and Net Assets / Fund Balance$27,324,026$26,367,795▼ $956,231
Compensation and Service Providers

Board Members and Trustees

NameTitle
David FinkelExec VP, Markets & Chair/Director
Erhardt PreitauerPresident & CEO
Michael TaylorPres, Market & Secretary/Director
William Coffin JrVP Mkt Finance & Treas/Director
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$9,309,584
Cabell Huntington Hospital IncMedical Services1600 Medical Center Dr, Huntington, WV 25701$4,797,658
Wheeling Hospital IncMedical Services1 Medical Park, Wheeling, WV 26003$966,903
CVS CaremarkPharmacy ServicesPO Box 840688, Dallas, TX 75284-0688$709,221
Weirton Medical CenterMedical Services601 Colliers Way, Weirton, WV 26062$525,412
Revenue and Support

Revenue Composition

Contributions and Grants
$0
Program Service Revenue
$53,637,788
Investment Income
$95,636
Other Revenue
$0
Change in Net Assets
$-816,380
Expenses and Functional Allocation

Major Expense Lines

Line ItemAmount
Other Expenses$54,549,804
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
Other Expenses$397,180$1,856,198-$1,856,198
Fees for Services Other$67,718$1,306,004-$1,373,722
Office Expenses-$509,373-$509,373
Interest-$495,000-$495,000
All Other Expenses$36,672$319,391-$356,063
Information Technology$7,103$317,954-$325,057
Advertising-$243,605-$243,605
Occupancy-$165,534-$165,534
Fees for Services Accounting-$71,395-$71,395
Fees for Services Legal-$37,075-$37,075
Insurance-$15,286-$15,286
Travel$409$12,164-$12,573
Fees for Services Lobbying-$4,764-$4,764
Total Functional Expenses$45,923,004$8,626,800$0$54,549,804
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$6,798,707
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 sole member of CareSource West Virginia Co. CareSource is recognized as 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). 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/.

Form 990, Part VI, Section A, Question 7A

Caresource, the sole member of caresource west virginia, co., has the authority to appoint caresource west virginia co.'s board.

Filing and Contact Details

Filer

Filer Name
CareSource West Virginia Co
EIN
47-3028244
In Care Of
% JANET FERNANDES
Phone
9375313027
Address
400 Washington St E Ste 401, Charleston, WV 25301

Signing Officer

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

Organization Details

Principal Officer
Erhardt Preitauer
Formed
2015
Legal Domicile
Wv
Voting Board Members
3
Independent Board Members
0
Employees
0
Volunteers
0
Supplemental Narrative

Additional Explanations

Form 990, Part V, Line 1A

In late 2019, CSWV 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.

Financial Statement Notes

FIN 48 (ASC 740) Footnote

As outlined in CareSource's Audited Consolidated Financial Statements, which include the activity of CareSource West Virginia Co.: 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 West Virginia Co. ("CSWV") is a nonprofit 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, effective as of the date of CSWV's formation. CSWV is a member of the CareSource group of nonprofit organizations (the "CareSource Group"). The mission of the CareSource Group is to make a lasting difference in its members' lives by improving their health and well-being. CSWV firmly adheres to this mission, which it terms as the organization's "heartbeat," by providing services that go well beyond the delivery of medical benefits. CSWV is accredited for its Qualified Health Plan ("QHP") through the National Committee for Quality Assurance ("NCQA"). Accreditation is the most comprehensive evaluation in the industry and the only assessment that bases results on clinical performance and consumer experience. 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 a Health Maintenance Organization ("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 QHP 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 a majority of members qualifying for subsidies to lower their monthly premiums or out of pocket costs. Members have the choice of buying plans with only the essential health benefits, or ones that also include adult dental, vision, and fitness supplemental benefits. Members can also receive assistance through CSWV's 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 Virginia's low-income populations.
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IRS990/Form990PartVIISectionAGrp/TitleTxt0President & CEO
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IRS990/MissionDesc0CareSource West Virginia Co.'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 West Virginia Co. is a health maintenance organization licensed by the state of West Virginia and serves members through Marketplace plans.
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