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CARESOURCE INDIANA INC: Form 990, tax year 2020

View the entire original 990 at ProPublica ↗

Organization
CARESOURCE INDIANA INC (EIN 32-0121856)
Tax period
2020-01-01 to 2020-12-31
Filed
2021-11-11
IRS object ID
202103159349306365
Schema version
2020v4.1
Source
Download XML · Original 990 at ProPublica

Every field in the e-filed return. Faint text is the IRS element name, for citing.

Return header ReturnHeader

FieldValueIRS element (for citing)
Return2021-11-11T13:55:08-06:00ReturnTs
Tax Period End2020-12-31TaxPeriodEndDt
Return Type990ReturnTypeCd
Tax Period Begin2020-01-01TaxPeriodBeginDt

Filer Filer

FieldValueIRS element (for citing)
EIN320121856EIN

Business Name BusinessName

FieldValueIRS element (for citing)
Business Name Line1CareSource Indiana IncBusinessNameLine1Txt
FieldValueIRS element (for citing)
In Care Of% JANET FERNANDESInCareOfNm
Business Name ControlCAREBusinessNameControlTxt
Phone9375313027PhoneNum

US Address USAddress

FieldValueIRS element (for citing)
Address Line1135 N Pennsylvania St 1300AddressLine1Txt
CityIndianapolisCityNm
State AbbreviationINStateAbbreviationCd
ZIP46204ZIPCd

Business Officer BusinessOfficerGrp

FieldValueIRS element (for citing)
PersonLawrence SmartPersonNm
Person TitleCFOPersonTitleTxt
Phone9375313027PhoneNum
Signature2021-11-11SignatureDt

Signing Officer SigningOfficerGrp

Person Full Name PersonFullName

FieldValueIRS element (for citing)
Person FirstLawrencePersonFirstNm
Person LastSmartPersonLastNm
FieldValueIRS element (for citing)
SSN999009999SSN

Additional Filer Information AdditionalFilerInformation

Trusted Customer TrustedCustomerGrp

FieldValueIRS element (for citing)
Trusted Customer2TrustedCustomerCd
FieldValueIRS element (for citing)
Tax2020TaxYr
Build TS2022-09-23 18:48:47ZBuildTS

Form 990 IRS990

FieldValueIRS element (for citing)
Principal OfficerErhardt PreitauerPrincipalOfficerNm

US Address USAddress

FieldValueIRS element (for citing)
Address Line1PO Box 8738AddressLine1Txt
CityDaytonCityNm
State AbbreviationOHStateAbbreviationCd
ZIP45401ZIPCd
FieldValueIRS element (for citing)
Gross Receipts$751,111,177GrossReceiptsAmt
Group Return For AffiliatesfalseGroupReturnForAffiliatesInd
Organization501c3Yes (X)Organization501c3Ind
Website AddressN/AWebsiteAddressTxt
Type Of Organization CorpYes (X)TypeOfOrganizationCorpInd
Formation2004FormationYr
Legal Domicile StateINLegalDomicileStateCd
Activity Or MissionTo Make a Lasting Difference in our members' lives by improving their health and well-being. CareSource Indiana Inc. is a Nonprofit HMO licensed by the State of Indiana.ActivityOrMissionDesc
Voting Members Governing Body3VotingMembersGoverningBodyCnt
Voting Members Independent0VotingMembersIndependentCnt
Total Employee0TotalEmployeeCnt
Total Volunteers0TotalVolunteersCnt
Total Gross UBI$0TotalGrossUBIAmt
PY Contributions Grants$0PYContributionsGrantsAmt
CY Contributions Grants$0CYContributionsGrantsAmt
PY Program Service Revenue$640,981,578PYProgramServiceRevenueAmt
CY Program Service Revenue$750,157,227CYProgramServiceRevenueAmt
PY Investment Income$737,426PYInvestmentIncomeAmt
CY Investment Income$953,950CYInvestmentIncomeAmt
PY Other Revenue$0PYOtherRevenueAmt
CY Other Revenue$0CYOtherRevenueAmt
PY Total Revenue$641,719,004PYTotalRevenueAmt
CY Total Revenue$751,111,177CYTotalRevenueAmt
PY Grants And Similar Paid$0PYGrantsAndSimilarPaidAmt
CY Grants And Similar Paid$0CYGrantsAndSimilarPaidAmt
PY Benefits Paid To Members$0PYBenefitsPaidToMembersAmt
CY Benefits Paid To Members$0CYBenefitsPaidToMembersAmt
PY Salaries Comp Emp Bnft Paid$17,832,187PYSalariesCompEmpBnftPaidAmt
CY Salaries Comp Emp Bnft Paid$0CYSalariesCompEmpBnftPaidAmt
PY Total Prof Fndrsng Expns$0PYTotalProfFndrsngExpnsAmt
CY Total Prof Fndrsng Expns$0CYTotalProfFndrsngExpnsAmt
CY Total Fundraising Expense$0CYTotalFundraisingExpenseAmt
PY Other Expenses$577,104,137PYOtherExpensesAmt
CY Other Expenses$744,908,345CYOtherExpensesAmt
PY Total Expenses$594,936,324PYTotalExpensesAmt
CY Total Expenses$744,908,345CYTotalExpensesAmt
PY Revenues Less Expenses$46,782,680PYRevenuesLessExpensesAmt
CY Revenues Less Expenses$6,202,832CYRevenuesLessExpensesAmt
Total Assets BOY$241,392,526TotalAssetsBOYAmt
Total Assets EOY$327,554,719TotalAssetsEOYAmt
Total Liabilities BOY$155,583,746TotalLiabilitiesBOYAmt
Total Liabilities EOY$265,543,107TotalLiabilitiesEOYAmt
Net Assets Or Fund Balances BOY$85,808,780NetAssetsOrFundBalancesBOYAmt
Net Assets Or Fund Balances EOY$62,011,612NetAssetsOrFundBalancesEOYAmt
Info In Schedule O Part IIIYes (X)InfoInScheduleOPartIIIInd
MissionCareSource Indiana 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 Indiana Inc. is a health maintenance organization licensed by the state of Indiana and serves members through Marketplace, Medicaid, Healthy Indiana, and Hoosier Healthwise plans.MissionDesc
Significant New Program SrvcfalseSignificantNewProgramSrvcInd
Significant ChangefalseSignificantChangeInd
Expense$657,794,166ExpenseAmt
Revenue$750,157,227RevenueAmt
DescCareSource Indiana Inc. ("CSIN"CareSource Indiana") is a nonprofit organization established under the state law of Indiana. CSIN 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. CSIN 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. CSIN's membership includes: (1) Hoosier Healthwise (Medicaid) and Healthy Indiana Plan ("HIP") Medicaid expansion consumers, (2) Medicare Advantage low-income consumers, and (3) a Qualified Health Plan offered through the Federal Health Insurance Exchange, providing low-cost comprehensive coverage for uninsured individuals and families. CSIN is accredited through the National Committee for Quality Assurance ("NCQA") for its qualified Health Insurance Marketplace and Medicaid plans. Accreditation is the most comprehensive evaluation in the industry and the only assessment that bases results on clinical performance and consumer experience. CSIN 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. CSIN 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. Recognized for a commitment to serving at-risk populations, beginning Jan. 1, 2017, CSIN began coordinating care for recipients of state supported programs that provide health services to recipients, through Hoosier Healthwise and HIP. Hoosier Healthwise is available to pregnant women and children, and HIP covers adults 19 to 64 years of age whose incomes are less than 138% of the federal poverty level and do not meet certain eligibility requirements for other health coverage programs. CSIN offers two Medicare Advantage Plans in the State. CSIN primarily enrolls low-income individuals in these plans. CSIN'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 receive assistance through CSIN's many programs designed to remove barriers to health and well-being. CareSource Indiana can, therefore, further its mission as a means of improving the health and well-being of Indiana's low-income populations. In 2015, the CareSource Group created a pilot program called CareSource Life Services, which couples the largest low-income subsidy safety net, Medicaid, with a holistic approach to addressing economic well-being and social connectedness. Life Services coordinates a range of resources through community and employer partnerships. A key component of Life Services is JobConnect, an initiative that helps members to increase skills and attain connections to long-term employment. JobConnect is a program and member benefit designed to serve members that are seeking assistance with education and employment goals. JobConnect is a voluntary program that pairs interested members with a Life Coach that walks alongside them as they identify and address potential barriers to their goals. Once a member decides to participate in JobConnect, they work with a regionally-based Life Coach that helps the member identify resource strengths, educational and training goals, and employment opportunities. Prior to employment placement, assessments are completed that may indicate a need surrounding the social determinants of health such as: food stability, housing, child care, transportation, etc. Together with the member, Life Coaches are able to coordinate, refer, and connect members with community resources and partners that exist to meet particular needs. Once immediate needs are addressed and an educational/employment plan is created, the member sets goals and derives an action plan to accomplish their goals. Some members may be interested in a training program that better equips them for specific employment positions while others may be ready for the workforce and need preparation in the form of resume assistance, interview prep, soft skills, etc. Life Coaches seek to understand the job needs and preferences of members and prepare them for job attainment. The goal is to help members secure long-term employment by connecting them with employers that provide full-time hours, benefits, and the opportunity for growth. JobConnect is designed to work with members for up to 24 months to help members navigate the employment world while balancing their home life. In 2018, CSIN began serving members exiting state prisons through a unique pilot partnership with the Indiana Department of Corrections and the Indiana Family Social Services Administration. The program is designed to support the successful reentry of individuals returning from prisons. As a voluntary and transitional benefit, the program provides the following services: (1) Pre-release care coordination, including in-reach services to assist in transitional planning; (2) A network of community based substance use treatment providers across the State of Indiana; and (3) Access to recovery services including supported housing, employment services, peer-recovery, community-based care management, and life skills.Desc
Total Program Service Expenses$657,794,166TotalProgramServiceExpensesAmt
Described In Section501c3Yes (true)DescribedInSection501c3Ind
Schedule B RequiredfalseScheduleBRequiredInd
Political Campaign ActyfalsePoliticalCampaignActyInd
Lobbying ActivitiesYes (true)LobbyingActivitiesInd
Subject To Proxy TaxfalseSubjectToProxyTaxInd
Donor Advised FundfalseDonorAdvisedFundInd
Conservation EasementsfalseConservationEasementsInd
Collections Of ArtfalseCollectionsOfArtInd
Credit CounselingfalseCreditCounselingInd
Donor Rstr Or Quasi EndowmentsfalseDonorRstrOrQuasiEndowmentsInd
Report Land Building EquipmentfalseReportLandBuildingEquipmentInd
Report Investments Other SecfalseReportInvestmentsOtherSecInd
Report Program Related InvstfalseReportProgramRelatedInvstInd
Report Other AssetsfalseReportOtherAssetsInd
Report Other LiabilitiesYes (true)ReportOtherLiabilitiesInd
Include FIN48 FootnoteYes (true)IncludeFIN48FootnoteInd
Independent Audit Fincl StmtfalseIndependentAuditFinclStmtInd
Consolidated Audit Fincl StmtYes (true)ConsolidatedAuditFinclStmtInd
School OperatingfalseSchoolOperatingInd
Foreign OfficefalseForeignOfficeInd
Foreign ActivitiesfalseForeignActivitiesInd
More Than5000 K To OrgfalseMoreThan5000KToOrgInd
More Than5000 K To IndividualsfalseMoreThan5000KToIndividualsInd
Professional FundraisingfalseProfessionalFundraisingInd
Fundraising ActivitiesfalseFundraisingActivitiesInd
Gaming ActivitiesfalseGamingActivitiesInd
Operate HospitalfalseOperateHospitalInd
Grants To OrganizationsfalseGrantsToOrganizationsInd
Grants To IndividualsfalseGrantsToIndividualsInd
Schedule J RequiredYes (true)ScheduleJRequiredInd
Tax Exempt BondsfalseTaxExemptBondsInd
Engaged In Excess Benefit TransfalseEngagedInExcessBenefitTransInd
PY Excess Benefit TransfalsePYExcessBenefitTransInd
Loan OutstandingfalseLoanOutstandingInd
Grant To Related PersonfalseGrantToRelatedPersonInd
Business Rln With Org MemfalseBusinessRlnWithOrgMemInd
Business Rln With Fam MemfalseBusinessRlnWithFamMemInd
Business Rln With35 Ctrl EntfalseBusinessRlnWith35CtrlEntInd
Deductible Non Cash ContrifalseDeductibleNonCashContriInd
Deductible Art ContributionfalseDeductibleArtContributionInd
Terminate OperationsfalseTerminateOperationsInd
Partial LiquidationfalsePartialLiquidationInd
Disregarded EntityfalseDisregardedEntityInd
Related EntityYes (true)RelatedEntityInd
Related Organization Ctrl EntfalseRelatedOrganizationCtrlEntInd
Trnsfr Exmpt Non Chrtbl Rltd OrgfalseTrnsfrExmptNonChrtblRltdOrgInd
Activities Conducted PrtshpfalseActivitiesConductedPrtshpInd
Schedule O RequiredYes (true)ScheduleORequiredInd
IRP Document1235IRPDocumentCnt
IRP Document W2 G0IRPDocumentW2GCnt
Backup Wthld ComplianceYes (true)BackupWthldComplianceInd
Employee0EmployeeCnt
Unrelated Bus Incm Over LimitfalseUnrelatedBusIncmOverLimitInd
Foreign Financial AccountfalseForeignFinancialAccountInd
Prohibited Tax Shelter TransfalseProhibitedTaxShelterTransInd
Taxable Party NotificationfalseTaxablePartyNotificationInd
Nondeductible ContributionsfalseNondeductibleContributionsInd
Quid Pro Quo ContributionsfalseQuidProQuoContributionsInd
Form8282 Property Disposed OffalseForm8282PropertyDisposedOfInd
Rcv Fnds To Pay Prsnl Bnft CntrctfalseRcvFndsToPayPrsnlBnftCntrctInd
Pay Premiums Prsnl Bnft CntrctfalsePayPremiumsPrsnlBnftCntrctInd
Indoor Tanning ServicesfalseIndoorTanningServicesInd
Subj To Tax Rmnrtn Ex Prcht PymtfalseSubjToTaxRmnrtnExPrchtPymtInd
Subject To Excs Tax Net Invst IncfalseSubjectToExcsTaxNetInvstIncInd
Info In Schedule O Part VIYes (X)InfoInScheduleOPartVIInd
Governing Body Voting Members3GoverningBodyVotingMembersCnt
Independent Voting Member0IndependentVotingMemberCnt
Family Or Business RlnfalseFamilyOrBusinessRlnInd
Delegation Of Mgmt DutiesfalseDelegationOfMgmtDutiesInd
Change To Org DocumentsfalseChangeToOrgDocumentsInd
Material Diversion Or MisusefalseMaterialDiversionOrMisuseInd
Members Or StockholdersYes (true)MembersOrStockholdersInd
Election Of Board MembersYes (true)ElectionOfBoardMembersInd
Decisions Subject To ApprovafalseDecisionsSubjectToApprovaInd
Minutes Of Governing BodyYes (true)MinutesOfGoverningBodyInd
Minutes Of CommitteesYes (true)MinutesOfCommitteesInd
Officer Mailing AddressfalseOfficerMailingAddressInd
Local ChaptersfalseLocalChaptersInd
Form990 Provided To Gvrn BodyYes (true)Form990ProvidedToGvrnBodyInd
Conflict Of Interest PolicyYes (true)ConflictOfInterestPolicyInd
Annual Disclosure Covered PrsnYes (true)AnnualDisclosureCoveredPrsnInd
Regular Monitoring EnfrcYes (true)RegularMonitoringEnfrcInd
Whistleblower PolicyYes (true)WhistleblowerPolicyInd
Document Retention PolicyYes (true)DocumentRetentionPolicyInd
Compensation Process CEOfalseCompensationProcessCEOInd
Compensation Process OtherfalseCompensationProcessOtherInd
Investment In Joint VenturefalseInvestmentInJointVentureInd
States Where Copy Of Return Is FldINStatesWhereCopyOfReturnIsFldCd
Upon RequestYes (X)UponRequestInd

Books In Care Of Detail BooksInCareOfDetail

FieldValueIRS element (for citing)
PersonJANET FERNANDESPersonNm
Phone9375313027PhoneNum

US Address USAddress

FieldValueIRS element (for citing)
Address Line1PO BOX 8738AddressLine1Txt
CityDaytonCityNm
State AbbreviationOHStateAbbreviationCd
ZIP454018738ZIPCd
FieldValueIRS element (for citing)
Info In Schedule O Part VIIYes (X)InfoInScheduleOPartVIIInd

Form990 Part VII Section A Form990PartVIISectionAGrp (9 entries)

TitleTitleTxtAverage Hours Per WeekAverageHoursPerWeekRtAverage Hours Per Week Rltd OrgAverageHoursPerWeekRltdOrgRtOfficerOfficerIndReportable Comp From OrgReportableCompFromOrgAmtReportable Comp From Rltd OrgReportableCompFromRltdOrgAmtOther CompensationOtherCompensationAmtIndividual Trustee Or DirectorIndividualTrusteeOrDirectorIndFormer Ofcr Director TrusteeFormerOfcrDirectorTrusteeInd
Erhardt Preitauer
President & CEO8.052.0Yes (X)$0$2,239,483$3,719,592
Jai Pillai
Chief Operating Officer5.055.0Yes (X)$0$1,037,573$910,643
David Finkel
Exec VP, Markets & Chair/Dir10.050.0$0$736,768$797,538Yes (X)
David Goltz
Chief Financial Officer5.055.0Yes (X)$0$949,833$574,541
Daniel McCabe
Chief Administrative Officer1.059.0Yes (X)$0$809,693$631,182
Steve Smitherman
Pres, Market & Sec/Director59.01.0$0$510,600$369,355Yes (X)
William Coffin Jr
VP Market Finance & Treas/Dir15.045.0$0$437,494$295,148Yes (X)
Kevin Brown
Former Director0.015.0$0$212,500$0Yes (X)
Patricia Martin
Former Vice Chair0.010.0$0$117,500$0Yes (X)
FieldValueIRS element (for citing)
Total Reportable Comp From Org$0TotalReportableCompFromOrgAmt
Tot Reportable Comp Rltd Org$7,051,444TotReportableCompRltdOrgAmt
Total Other Compensation$7,297,999TotalOtherCompensationAmt
Indiv Rcvd Greater Than100 K0IndivRcvdGreaterThan100KCnt
Former Ofcr Employees ListedYes (true)FormerOfcrEmployeesListedInd
Total Comp Greater Than150 KYes (true)TotalCompGreaterThan150KInd
Compensation From Other SrcsfalseCompensationFromOtherSrcsInd

Contractor Compensation ContractorCompensationGrp (5 entries)

Address Line1ContractorAddress/USAddress/AddressLine1TxtCityContractorAddress/USAddress/CityNmState AbbreviationContractorAddress/USAddress/StateAbbreviationCdZIPContractorAddress/USAddress/ZIPCdServicesServicesDescCompensationCompensationAmt
Express Scripts Inc
21653 Network PlaceCHICAGOIL606730673Pharmacy Services$171,774,796
Indiana University Health Related
950 N Meridian Street Suite 300INDIANAPOLISIN46204Medical Services$105,000,550
Community Health Network Related
7330 Shadeland Station Suite 200INDIANAPOLISIN46256Medical Services$44,478,681
St Vincent Hospital Health Care C
2001 W 86th StreetINDIANAPOLISIN46260Medical Services$31,493,579
Parkview Hospital Inc Related Or
11109 Parkview Plaza DriveFORT WAYNEIN46845Medical Services$24,862,417
FieldValueIRS element (for citing)
Cntrct Rcvd Greater Than100 K40CntrctRcvdGreaterThan100KCnt
Total Contributions$0TotalContributionsAmt

Program Service Revenue ProgramServiceRevenueGrp (3 entries)

DescDescBusinessBusinessCdTotal Revenue ColumnTotalRevenueColumnAmtRelated Or Exempt Func IncomeRelatedOrExemptFuncIncomeAmt
MEDICAID524114$444,377,635$444,377,635
PREMIUMS524114$305,311,100$305,311,100
VETERANS REVENUE524114$468,492$468,492
FieldValueIRS element (for citing)
Total Program Service Revenue$750,157,227TotalProgramServiceRevenueAmt

Investment Income InvestmentIncomeGrp

FieldValueIRS element (for citing)
Total Revenue Column$953,950TotalRevenueColumnAmt
Exclusion$953,950ExclusionAmt

Incm From Invest Bond Proceeds IncmFromInvestBondProceedsGrp

FieldValueIRS element (for citing)
Total Revenue Column$0TotalRevenueColumnAmt

Royalties Revenue RoyaltiesRevenueGrp

FieldValueIRS element (for citing)
Total Revenue Column$0TotalRevenueColumnAmt

Rental Income Or Loss RentalIncomeOrLossGrp

FieldValueIRS element (for citing)
Real$0RealAmt
Personal$0PersonalAmt

Net Rental Income Or Loss NetRentalIncomeOrLossGrp

FieldValueIRS element (for citing)
Total Revenue Column$0TotalRevenueColumnAmt

Net Gain Or Loss Investments NetGainOrLossInvestmentsGrp

FieldValueIRS element (for citing)
Total Revenue Column$0TotalRevenueColumnAmt
FieldValueIRS element (for citing)
Fundraising Gross Income$0FundraisingGrossIncomeAmt
Fundraising Direct Expenses$0FundraisingDirectExpensesAmt

Net Incm From Fundraising Evt NetIncmFromFundraisingEvtGrp

FieldValueIRS element (for citing)
Total Revenue Column$0TotalRevenueColumnAmt
FieldValueIRS element (for citing)
Gaming Gross Income$0GamingGrossIncomeAmt
Gaming Direct Expenses$0GamingDirectExpensesAmt

Net Income From Gaming NetIncomeFromGamingGrp

FieldValueIRS element (for citing)
Total Revenue Column$0TotalRevenueColumnAmt
FieldValueIRS element (for citing)
Gross Sales Of Inventory$0GrossSalesOfInventoryAmt
Cost Of Goods Sold$0CostOfGoodsSoldAmt

Net Income Or Loss NetIncomeOrLossGrp

FieldValueIRS element (for citing)
Total Revenue Column$0TotalRevenueColumnAmt
FieldValueIRS element (for citing)
Other Revenue Total$0OtherRevenueTotalAmt

Total Revenue TotalRevenueGrp

FieldValueIRS element (for citing)
Total Revenue Column$751,111,177TotalRevenueColumnAmt
Related Or Exempt Func Income$750,157,227RelatedOrExemptFuncIncomeAmt
Exclusion$953,950ExclusionAmt

Grants To Domestic Orgs GrantsToDomesticOrgsGrp

FieldValueIRS element (for citing)
Total$0TotalAmt

Grants To Domestic Individuals GrantsToDomesticIndividualsGrp

FieldValueIRS element (for citing)
Total$0TotalAmt

Foreign Grants ForeignGrantsGrp

FieldValueIRS element (for citing)
Total$0TotalAmt

Benefits To Members BenefitsToMembersGrp

FieldValueIRS element (for citing)
Total$0TotalAmt

Comp Current Ofcr Directors CompCurrentOfcrDirectorsGrp

FieldValueIRS element (for citing)
Total$0TotalAmt

Comp Disqual Persons CompDisqualPersonsGrp

FieldValueIRS element (for citing)
Total$0TotalAmt

Other Salaries And Wages OtherSalariesAndWagesGrp

FieldValueIRS element (for citing)
Total$0TotalAmt

Pension Plan Contributions PensionPlanContributionsGrp

FieldValueIRS element (for citing)
Total$0TotalAmt

Other Employee Benefits OtherEmployeeBenefitsGrp

FieldValueIRS element (for citing)
Total$0TotalAmt

Payroll Taxes PayrollTaxesGrp

FieldValueIRS element (for citing)
Total$0TotalAmt

Fees For Services Management FeesForServicesManagementGrp

FieldValueIRS element (for citing)
Total$0TotalAmt

Fees For Services Legal FeesForServicesLegalGrp

FieldValueIRS element (for citing)
Total$530,640TotalAmt
Management And General$530,640ManagementAndGeneralAmt

Fees For Services Accounting FeesForServicesAccountingGrp

FieldValueIRS element (for citing)
Total$94,888TotalAmt
Management And General$94,888ManagementAndGeneralAmt

Fees For Services Lobbying FeesForServicesLobbyingGrp

FieldValueIRS element (for citing)
Total$57,373TotalAmt
Program Services$1,333ProgramServicesAmt
Management And General$56,040ManagementAndGeneralAmt

Fees For Services Prof Fundraising FeesForServicesProfFundraising

FieldValueIRS element (for citing)
Total$0TotalAmt

Fees For Srvc Invst Mgmnt Fees FeesForSrvcInvstMgmntFeesGrp

FieldValueIRS element (for citing)
Total$0TotalAmt

Fees For Services Other FeesForServicesOtherGrp

FieldValueIRS element (for citing)
Total$18,228,780TotalAmt
Program Services$1,598,229ProgramServicesAmt
Management And General$16,630,551ManagementAndGeneralAmt

Advertising AdvertisingGrp

FieldValueIRS element (for citing)
Total$2,048,235TotalAmt
Program Services$135ProgramServicesAmt
Management And General$2,048,100ManagementAndGeneralAmt

Office Expenses OfficeExpensesGrp

FieldValueIRS element (for citing)
Total$6,078,952TotalAmt
Program Services$6,871ProgramServicesAmt
Management And General$6,072,081ManagementAndGeneralAmt

Information Technology InformationTechnologyGrp

FieldValueIRS element (for citing)
Total$4,512,312TotalAmt
Management And General$4,512,312ManagementAndGeneralAmt

Royalties RoyaltiesGrp

FieldValueIRS element (for citing)
Total$0TotalAmt

Occupancy OccupancyGrp

FieldValueIRS element (for citing)
Total$2,212,765TotalAmt
Management And General$2,212,765ManagementAndGeneralAmt

Travel TravelGrp

FieldValueIRS element (for citing)
Total$96,623TotalAmt
Program Services$8,035ProgramServicesAmt
Management And General$88,588ManagementAndGeneralAmt

Pymt Travel Entrtnmnt Pub Ofcl PymtTravelEntrtnmntPubOfclGrp

FieldValueIRS element (for citing)
Total$0TotalAmt

Conferences Meetings ConferencesMeetingsGrp

FieldValueIRS element (for citing)
Total$0TotalAmt

Interest InterestGrp

FieldValueIRS element (for citing)
Total$185,134TotalAmt
Management And General$185,134ManagementAndGeneralAmt

Payments To Affiliates PaymentsToAffiliatesGrp

FieldValueIRS element (for citing)
Total$0TotalAmt

Depreciation Depletion DepreciationDepletionGrp

FieldValueIRS element (for citing)
Total$0TotalAmt

Insurance InsuranceGrp

FieldValueIRS element (for citing)
Total$201,275TotalAmt
Program Services$17ProgramServicesAmt
Management And General$201,258ManagementAndGeneralAmt

Other Expenses OtherExpensesGrp (4 entries)

DescDescTotalTotalAmtProgram ServicesProgramServicesAmtManagement And GeneralManagementAndGeneralAmt
MEDICAL EXPENSES$533,416,013$533,416,013
PHARMACY EXPENSES$115,745,685$115,745,685
MGMT FEES CARESOURCE MGMT SVCS$49,013,760$6,307,121$42,706,639
HLTH INS PROVIDER & PCORI FEES$6,906,643$2,783$6,903,860

All Other Expenses AllOtherExpensesGrp

FieldValueIRS element (for citing)
Total$5,579,267TotalAmt
Program Services$707,944ProgramServicesAmt
Management And General$4,871,323ManagementAndGeneralAmt

Total Functional Expenses TotalFunctionalExpensesGrp

FieldValueIRS element (for citing)
Total$744,908,345TotalAmt
Program Services$657,794,166ProgramServicesAmt
Management And General$87,114,179ManagementAndGeneralAmt
Fundraising$0FundraisingAmt
FieldValueIRS element (for citing)
Info In Schedule O Part XYes (X)InfoInScheduleOPartXInd

Cash Non Interest Bearing CashNonInterestBearingGrp

FieldValueIRS element (for citing)
BOY$483,400BOYAmt
EOY$0EOYAmt

Savings And Temp Cash Invst SavingsAndTempCashInvstGrp

FieldValueIRS element (for citing)
BOY$120,792,806BOYAmt
EOY$273,199,992EOYAmt

Pledges And Grants Receivable PledgesAndGrantsReceivableGrp

FieldValueIRS element (for citing)
BOY$0BOYAmt
EOY$0EOYAmt

Accounts Receivable AccountsReceivableGrp

FieldValueIRS element (for citing)
BOY$99,216,664BOYAmt
EOY$41,448,356EOYAmt

Receivables From Officers Etc ReceivablesFromOfficersEtcGrp

FieldValueIRS element (for citing)
BOY$0BOYAmt
EOY$0EOYAmt

Rcvbl From Disqualified Prsn RcvblFromDisqualifiedPrsnGrp

FieldValueIRS element (for citing)
BOY$0BOYAmt
EOY$0EOYAmt

Oth Notes Loans Receivable Net OthNotesLoansReceivableNetGrp

FieldValueIRS element (for citing)
BOY$0BOYAmt
EOY$0EOYAmt

Inventories For Sale Or Use InventoriesForSaleOrUseGrp

FieldValueIRS element (for citing)
BOY$0BOYAmt
EOY$0EOYAmt

Prepaid Expenses Defrd Charges PrepaidExpensesDefrdChargesGrp

FieldValueIRS element (for citing)
BOY$60,942BOYAmt
EOY$669,264EOYAmt

Land Bldg Equip Basis Net LandBldgEquipBasisNetGrp

FieldValueIRS element (for citing)
BOY$0BOYAmt
EOY$0EOYAmt

Investments Pub Traded Sec InvestmentsPubTradedSecGrp

FieldValueIRS element (for citing)
BOY$20,838,714BOYAmt
EOY$12,237,107EOYAmt

Investments Other Securities InvestmentsOtherSecuritiesGrp

FieldValueIRS element (for citing)
BOY$0BOYAmt
EOY$0EOYAmt

Investments Program Related InvestmentsProgramRelatedGrp

FieldValueIRS element (for citing)
BOY$0BOYAmt
EOY$0EOYAmt

Intangible Assets IntangibleAssetsGrp

FieldValueIRS element (for citing)
BOY$0BOYAmt
EOY$0EOYAmt

Other Assets Total OtherAssetsTotalGrp

FieldValueIRS element (for citing)
BOY$0BOYAmt
EOY$0EOYAmt

Total Assets TotalAssetsGrp

FieldValueIRS element (for citing)
BOY$241,392,526BOYAmt
EOY$327,554,719EOYAmt

Accounts Payable Accr Expnss AccountsPayableAccrExpnssGrp

FieldValueIRS element (for citing)
BOY$79,278,236BOYAmt
EOY$97,585,964EOYAmt

Grants Payable GrantsPayableGrp

FieldValueIRS element (for citing)
BOY$0BOYAmt
EOY$0EOYAmt

Deferred Revenue DeferredRevenueGrp

FieldValueIRS element (for citing)
BOY$75,510,780BOYAmt
EOY$146,318,623EOYAmt

Tax Exempt Bond Liabilities TaxExemptBondLiabilitiesGrp

FieldValueIRS element (for citing)
BOY$0BOYAmt
EOY$0EOYAmt

Escrow Account Liability EscrowAccountLiabilityGrp

FieldValueIRS element (for citing)
BOY$0BOYAmt
EOY$0EOYAmt

Loans From Officers Directors LoansFromOfficersDirectorsGrp

FieldValueIRS element (for citing)
BOY$0BOYAmt
EOY$0EOYAmt

Mortg Notes Pybl Scrd Invst Prop MortgNotesPyblScrdInvstPropGrp

FieldValueIRS element (for citing)
BOY$0BOYAmt
EOY$0EOYAmt

Unsecured Notes Loans Payable UnsecuredNotesLoansPayableGrp

FieldValueIRS element (for citing)
BOY$0BOYAmt
EOY$0EOYAmt

Other Liabilities OtherLiabilitiesGrp

FieldValueIRS element (for citing)
BOY$794,730BOYAmt
EOY$21,638,520EOYAmt

Total Liabilities TotalLiabilitiesGrp

FieldValueIRS element (for citing)
BOY$155,583,746BOYAmt
EOY$265,543,107EOYAmt
FieldValueIRS element (for citing)
Organization Follows FASB117Yes (X)OrganizationFollowsFASB117Ind

No Donor Restriction Net Assets NoDonorRestrictionNetAssetsGrp

FieldValueIRS element (for citing)
BOY$85,808,780BOYAmt
EOY$62,011,612EOYAmt

Donor Restriction Net Assets DonorRestrictionNetAssetsGrp

FieldValueIRS element (for citing)
BOY$0BOYAmt
EOY$0EOYAmt

Total Net Assets Fund Balance TotalNetAssetsFundBalanceGrp

FieldValueIRS element (for citing)
BOY$85,808,780BOYAmt
EOY$62,011,612EOYAmt

Tot Liab Net Assets Fund Balance TotLiabNetAssetsFundBalanceGrp

FieldValueIRS element (for citing)
BOY$241,392,526BOYAmt
EOY$327,554,719EOYAmt
FieldValueIRS element (for citing)
Info In Schedule O Part XIYes (X)InfoInScheduleOPartXIInd
Reconcilation Revenue Expnss$6,202,832ReconcilationRevenueExpnssAmt
Other Changes In Net Assets-$30,000,000OtherChangesInNetAssetsAmt
Method Of Accounting AccrualYes (X)MethodOfAccountingAccrualInd
Accountant Compile Or ReviewfalseAccountantCompileOrReviewInd
FS AuditedYes (true)FSAuditedInd

FS Audited Basis FSAuditedBasisGrp

FieldValueIRS element (for citing)
Consol And Sep Basis Fincl StmtYes (X)ConsolAndSepBasisFinclStmtInd
FieldValueIRS element (for citing)
Audit CommitteeYes (true)AuditCommitteeInd
Federal Grant Audit RequiredfalseFederalGrantAuditRequiredInd

Schedule A IRS990ScheduleA

FieldValueIRS element (for citing)
Publicly Supported Org509a2Yes (X)PubliclySupportedOrg509a2Ind

Gifts Grants Contris Rcvd509 GiftsGrantsContrisRcvd509Grp

FieldValueIRS element (for citing)
Current Tax Year Minus4 Years$0CurrentTaxYearMinus4YearsAmt
Current Tax Year Minus3 Years$0CurrentTaxYearMinus3YearsAmt
Current Tax Year Minus2 Years$0CurrentTaxYearMinus2YearsAmt
Current Tax Year Minus1 Year$0CurrentTaxYearMinus1YearAmt
Current Tax Year$0CurrentTaxYearAmt
Total$0TotalAmt

Gross Receipts Admissions GrossReceiptsAdmissionsGrp

FieldValueIRS element (for citing)
Current Tax Year Minus4 Years$95,447,251CurrentTaxYearMinus4YearsAmt
Current Tax Year Minus3 Years$358,378,523CurrentTaxYearMinus3YearsAmt
Current Tax Year Minus2 Years$793,585,249CurrentTaxYearMinus2YearsAmt
Current Tax Year Minus1 Year$640,981,578CurrentTaxYearMinus1YearAmt
Current Tax Year$750,157,227CurrentTaxYearAmt
Total$2,638,549,828TotalAmt

Gross Receipts Non Unrlt Bus GrossReceiptsNonUnrltBusGrp

FieldValueIRS element (for citing)
Total$0TotalAmt

Tax Rev Levied Orgnztnl Bnft509 TaxRevLeviedOrgnztnlBnft509Grp

FieldValueIRS element (for citing)
Total$0TotalAmt

Govt Furn Srvc Fclts Vl509 GovtFurnSrvcFcltsVl509Grp

FieldValueIRS element (for citing)
Total$0TotalAmt

Total509 Total509Grp

FieldValueIRS element (for citing)
Current Tax Year Minus4 Years$95,447,251CurrentTaxYearMinus4YearsAmt
Current Tax Year Minus3 Years$358,378,523CurrentTaxYearMinus3YearsAmt
Current Tax Year Minus2 Years$793,585,249CurrentTaxYearMinus2YearsAmt
Current Tax Year Minus1 Year$640,981,578CurrentTaxYearMinus1YearAmt
Current Tax Year$750,157,227CurrentTaxYearAmt
Total$2,638,549,828TotalAmt

Amounts Rcvd Dsqlfy Person AmountsRcvdDsqlfyPersonGrp

FieldValueIRS element (for citing)
Total$0TotalAmt

Substantial Contributors Amt SubstantialContributorsAmtGrp

FieldValueIRS element (for citing)
Total$0TotalAmt

Subst And Dsqlfy Prsns Tot SubstAndDsqlfyPrsnsTotGrp

FieldValueIRS element (for citing)
Total$0TotalAmt
FieldValueIRS element (for citing)
Public Support Total509$2,638,549,828PublicSupportTotal509Amt

Gross Investment Income509 GrossInvestmentIncome509Grp

FieldValueIRS element (for citing)
Current Tax Year Minus4 Years$36,201CurrentTaxYearMinus4YearsAmt
Current Tax Year Minus3 Years$236,084CurrentTaxYearMinus3YearsAmt
Current Tax Year Minus2 Years$2,122,635CurrentTaxYearMinus2YearsAmt
Current Tax Year Minus1 Year$737,426CurrentTaxYearMinus1YearAmt
Current Tax Year$953,950CurrentTaxYearAmt
Total$4,086,296TotalAmt

Post1975 UBTI Post1975UBTIGrp

FieldValueIRS element (for citing)
Total$0TotalAmt

Investment Income And UBTI InvestmentIncomeAndUBTIGrp

FieldValueIRS element (for citing)
Current Tax Year Minus4 Years$36,201CurrentTaxYearMinus4YearsAmt
Current Tax Year Minus3 Years$236,084CurrentTaxYearMinus3YearsAmt
Current Tax Year Minus2 Years$2,122,635CurrentTaxYearMinus2YearsAmt
Current Tax Year Minus1 Year$737,426CurrentTaxYearMinus1YearAmt
Current Tax Year$953,950CurrentTaxYearAmt
Total$4,086,296TotalAmt

Net Income From Other UBI NetIncomeFromOtherUBIGrp

FieldValueIRS element (for citing)
Total$0TotalAmt

Other Income509 OtherIncome509Grp

FieldValueIRS element (for citing)
Total$0TotalAmt

Total Support Calendar Year TotalSupportCalendarYearGrp

FieldValueIRS element (for citing)
Current Tax Year Minus4 Years$95,483,452CurrentTaxYearMinus4YearsAmt
Current Tax Year Minus3 Years$358,614,607CurrentTaxYearMinus3YearsAmt
Current Tax Year Minus2 Years$795,707,884CurrentTaxYearMinus2YearsAmt
Current Tax Year Minus1 Year$641,719,004CurrentTaxYearMinus1YearAmt
Current Tax Year$751,111,177CurrentTaxYearAmt
Total$2,642,636,124TotalAmt
FieldValueIRS element (for citing)
Public Support CY5090.99845PublicSupportCY509Pct
Public Support PY5090.99839PublicSupportPY509Pct
Investment Income CY0.00155InvestmentIncomeCYPct
Investment Income PY0.00161InvestmentIncomePYPct
Thirty Thr Pct Suprt Tests CY509Yes (X)ThirtyThrPctSuprtTestsCY509Ind

Schedule C IRS990ScheduleC

FieldValueIRS element (for citing)
Total Grassroots LobbyingTotalGrassrootsLobbyingGrp
Total Direct LobbyingTotalDirectLobbyingGrp
Total Lobbying ExpendTotalLobbyingExpendGrp
Other Exempt Purpose ExpendOtherExemptPurposeExpendGrp
Total Exempt Purpose ExpendTotalExemptPurposeExpendGrp
Lobbying Nontaxable AmountLobbyingNontaxableAmountGrp
Grassroots NontaxableGrassrootsNontaxableGrp
Tot Lbbyng Grassroot Mns Non TxTotLbbyngGrassrootMnsNonTxGrp
Tot Lbby Expend Mns Lbbyng Non TxTotLbbyExpendMnsLbbyngNonTxGrp
VolunteersfalseVolunteersInd
Paid Staff Or ManagementfalsePaidStaffOrManagementInd
Media AdvertisementsfalseMediaAdvertisementsInd
Mailings MembersfalseMailingsMembersInd
Publications Or BroadcastfalsePublicationsOrBroadcastInd
Grants Other OrganizationsfalseGrantsOtherOrganizationsInd
Direct Contact LegislatorsYes (true)DirectContactLegislatorsInd
Direct Contact Legislators$105,871DirectContactLegislatorsAmt
Rallies DemonstrationsfalseRalliesDemonstrationsInd
Other ActivitiesYes (true)OtherActivitiesInd
Other Activities$8,875OtherActivitiesAmt
Total Lobbying Expenditures$114,746TotalLobbyingExpendituresAmt
Not Described Section501c3falseNotDescribedSection501c3Ind

Supplemental Information Detail SupplementalInformationDetail (2 entries)

Form And Line ReferenceFormAndLineReferenceDescExplanationExplanationTxt
Form 990, Schedule C, Part II-B, Line 1gLobbyists 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.
Form 990, Schedule C, Part II-B, Line 1i$8,875 is the allocable portion of the Organization's dues paid to Indiana Association of Health Plans for lobbying and grassroots efforts conducted by the trade association on behalf of its members.

Schedule D IRS990ScheduleD

FieldValueIRS element (for citing)
Art Public Exhibition AmountsArtPublicExhibitionAmountsGrp
Held Works ArtHeldWorksArtGrp
CY Minus3 Yr Endwmt FundCYMinus3YrEndwmtFundGrp
CY Minus4 Yr Endwmt FundCYMinus4YrEndwmtFundGrp
LandLandGrp
BuildingsBuildingsGrp
Leasehold ImprovementsLeaseholdImprovementsGrp
EquipmentEquipmentGrp
Other Land BuildingsOtherLandBuildingsGrp
Federal Income Tax Liability$0FederalIncomeTaxLiabilityAmt

Other Liabilities Org OtherLiabilitiesOrgGrp

FieldValueIRS element (for citing)
DescRELATED PARTY PAYABLEDesc
Amt$21,638,520Amt
FieldValueIRS element (for citing)
Total Liability$21,638,520TotalLiabilityAmt
Footnote TextYes (X)FootnoteTextInd

Supplemental Information Detail SupplementalInformationDetail

FieldValueIRS element (for citing)
Form And Line ReferenceFIN 48 (ASC 740) FootnoteFormAndLineReferenceDesc
ExplanationAs outlined in CareSource's Audited Consolidated Financial Statements, which include the activity of CareSource Indiana 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 2017-2019 are open for audit by the Internal Revenue Service.ExplanationTxt

Schedule J IRS990ScheduleJ

FieldValueIRS element (for citing)
Severance PaymentfalseSeverancePaymentInd
Supplemental Nonqual Rtr PlanYes (true)SupplementalNonqualRtrPlanInd
Equity Based Comp ArrngmfalseEquityBasedCompArrngmInd
Comp Based On Revenue Of Flng OrgfalseCompBasedOnRevenueOfFlngOrgInd
Comp Bsd On Rev Related OrgsfalseCompBsdOnRevRelatedOrgsInd
Comp Bsd Net Earns Flng OrgfalseCompBsdNetEarnsFlngOrgInd
Comp Bsd Net Earns Rltd OrgsfalseCompBsdNetEarnsRltdOrgsInd
Any Non Fixed PaymentsfalseAnyNonFixedPaymentsInd
Initial Contract ExceptionfalseInitialContractExceptionInd

Rltd Org Officer Trst Key Empl RltdOrgOfficerTrstKeyEmplGrp (9 entries)

TitleTitleTxtBase Compensation Filing OrgBaseCompensationFilingOrgAmtCompensation Based On Rltd OrgsCompensationBasedOnRltdOrgsAmtBonus Filing OrganizationBonusFilingOrganizationAmountBonus Related OrganizationsBonusRelatedOrganizationsAmtOther Compensation Filing OrgOtherCompensationFilingOrgAmtOther Compensation Rltd OrgsOtherCompensationRltdOrgsAmtDeferred Compensation Flng OrgDeferredCompensationFlngOrgAmtDeferred Comp Rltd OrgsDeferredCompRltdOrgsAmtNontaxable Benefits Filing OrgNontaxableBenefitsFilingOrgAmtNontaxable Benefits Rltd OrgsNontaxableBenefitsRltdOrgsAmtTotal Compensation Filing OrgTotalCompensationFilingOrgAmtTotal Compensation Rltd OrgsTotalCompensationRltdOrgsAmtComp Report Prior990 Filing OrgCompReportPrior990FilingOrgAmtComp Report Prior990 Rltd OrgsCompReportPrior990RltdOrgsAmt
Erhardt Preitauer
President & CEO$0$1,195,469$0$1,041,550$0$2,464$0$3,687,463$0$32,129$0$5,959,075$0$1,041,550
Jai Pillai
Chief Operating Officer$0$576,277$0$300,000$0$161,296$0$886,239$0$24,404$0$1,948,216$0$300,000
David Finkel
Exec VP, Markets & Chair/Dir$0$510,907$0$221,045$0$4,816$0$776,964$0$20,574$0$1,534,306$0$221,045
David Goltz
Chief Financial Officer$0$603,324$0$286,058$0$60,451$0$552,051$0$22,490$0$1,524,374$0$286,058
Daniel McCabe
Chief Administrative Officer$0$448,738$0$216,350$0$144,605$0$602,044$0$29,138$0$1,440,875$0$216,350
Steve Smitherman
Pres, Market & Sec/Director$0$309,881$0$136,192$0$64,527$0$334,214$0$35,141$0$879,955$0$136,192
William Coffin Jr
VP Market Finance & Treas/Dir$0$311,522$0$120,500$0$5,472$0$266,010$0$29,138$0$732,642$0$120,500
Kevin Brown
Former Director$0$212,500$0$0$0$0$0$0$0$0$0$212,500$0$0
Patricia Martin
Former Vice Chair$0$117,500$0$0$0$0$0$0$0$0$0$117,500$0$0

Supplemental Information Detail SupplementalInformationDetail (4 entries)

Form And Line ReferenceFormAndLineReferenceDescExplanationExplanationTxt
Form 990, Schedule J, Part I, Question 3The process the Organization goes through to establish the reasonable executive compensation is the same for all the CareSource Family of Companies. The organization utilizes a compensation committee, independent compensation consultant, CEO written employment contract, compensation survey or study, review of Form 990 of other organizations, and approval by the board or executive compensation committee comprised solely of independent directors. CareSource, a related organization, has in place Clawback provisions within its executive compensation plans that generally require executives to pay back compensation to CareSource in the event a subsequent legal, accounting, regulatory or compliance issue is discovered over which the executive had direct responsibility and control during the executive's employment.
Form 990, Schedule J, Part I, Question 4bThe following listed persons listed on Form 990, Part VII, Section A, participate in a supplemental nonqualified retirement plan of a related organization, CareSource: Erhardt Preitauer, Jai Pillai, David Finkel, David Goltz, Daniel McCabe, Steve Smitherman, and William Coffin Jr. Amounts are accrued monthly for plan participants. The plans provide compensation to the participants after a vesting period, and the funds are available to the participants after they retire or resign from the organization. The plans provide for normal terms and conditions contained in a standard nonqualified retirement plan. The following listed persons listed on Form 990, Part VII, Section A, participate in a long-term incentive plan of a related organization, CareSource: Erhardt Preitauer, Jai Pillai, David Finkel, David Goltz, Daniel McCabe, and Steve Smitherman. The plan provides compensation to the participants based on annual and long-term goals. The long-term incentive plan will pay out if these goals, or a subset of these goals, are achieved over a three year period. If a participant leaves their employment prior to this three year vesting period, they forfeit any amounts accrued under this plan. Amounts paid and accrued in 2020 for both deferred compensation arrangements include the following: Erhardt Preitauer $1,866,617, Jai Pillai $425,122, David Finkel $375,369, David Goltz $587,531, Daniel McCabe $359,195, Steve Smitherman $163,370 and William Coffin Jr. $64,603.
Form 990, Schedule J, Part I, Question 6bThe following listed persons listed on Form 990, Part VII, Section A, Line 1a are employees of CareSource Management Services LLC ("CSMS"), a disregarded entity of CareSource, a related organization to CareSource Indiana, Inc.: Erhardt Preitauer, Jai Pillai, David Finkel, David Goltz, Daniel McCabe, Steve Smitherman, and William Coffin, Jr. All of these listed persons are eligible for a performance bonus as part of their compensation packages. The performance bonus is contingent on a combination of both company performance and individual performance against goals. The performance management process documents the company goals and individual goals, the corresponding potential performance bonus, and the progress/outcomes. The performance bonus is based on the employee's calendar year regular earnings.
Form 990, Schedule J, Part IICompensation amounts for the listed persons on Schedule J, Part II are paid by CareSource Management Services LLC ("CSMS"), a disregarded entity of CareSource, a related organization to CareSource Indiana, Inc. Compensation paid to the CEO is pursuant to the terms of a written employment agreement between Mr. Preitauer and CareSource.

Schedule O IRS990ScheduleO

Supplemental Information Detail SupplementalInformationDetail (8 entries)

Form And Line ReferenceFormAndLineReferenceDescExplanationExplanationTxt
Form 990, Part V, Lines 1a & 2aIn early 2020, CSIN 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. Also, effective January 1, 2020, all employees of CSIN were transferred to CareSource Management Services LLC ("CSMS LLC"), a single member limited liability company, which is treated as a disregarded entity for federal income tax purposes. All items for CSMS LLC are reported under CareSource, the ultimate sole member of CSMS LLC.
Form 990, Part VI, Section A, Questions 6CareSource is the sole member of CareSource Indiana, Inc. CareSource is recognized as exempt from Federal Income Taxation under Internal Revenue Code ("IRC") Section 501(c)(3).
Form 990, Part VI, Section A, Question 7aCareSource, the sole member of CareSource Indiana, Inc., has the authority to appoint CareSource Indiana, Inc.'s board.
Form 990, Part VI, Section B, Question 11BThe 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 12CAnnually, 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 B, Q15A & 15BThe Compensation Committee consists of Board Members who are Independent. The Compensation Committee establishes the Company's general compensation philosophy and oversees and approves the development, adoption and implementation of compensation plans and programs for the company's officers and executives. The Compensation Committee receives a Report of comparability data prepared by an independent compensation consultant 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 approved at the next regularly scheduled Compensation Committee meeting. The Compensation Consultant does no other business with the CareSource Family of Companies other than determining the reasonableness of compensation. At least annually, the Compensation Committee assesses the work of the compensation consultants.
Form 990, Part VI, Section C, Question 19The 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 Indiana Secretary of State's website at www.in.gov/SOS/ for a nominal fee.
Form 990, Part XI, Line 9Change in Net Assets is Inclusive of the Following: (1) Return of Capital Contribution from CareSource ($ 30,000,000).

Schedule R IRS990ScheduleR

Id Related Tax Exempt Org IdRelatedTaxExemptOrgGrp (7 entries)

Address Line1USAddress/AddressLine1TxtCityUSAddress/CityNmState AbbreviationUSAddress/StateAbbreviationCdZIPUSAddress/ZIPCdEINEINPrimary ActivitiesPrimaryActivitiesTxtLegal Domicile StateLegalDomicileStateCdExempt Code SectionExemptCodeSectionTxtPublic Charity StatusPublicCharityStatusTxtBusiness Name Line1DirectControllingEntityName/BusinessNameLine1TxtControlled OrganizationControlledOrganizationInd
CareSource
PO Box 8738DaytonOH45401311703368SupportingOH501(c)(3)509(a)(3)IINAfalse
CareSource Kentucky Co
101 Enterprise DriveFrankfortKY40601464991603Exchange HMOKY501(c)(3)509(a)(2)CARESOURCEfalse
CareSource Georgia Co
600 Galleria Pkwy 400AtlantaGA30339472408339Medicaid HMOGA501(C)(3)509(a)(2)CARESOURCEfalse
CareSource West Virginia Co
400 Washington St 401CharlestonWV25301473028244Exchange HMOWV501(c)(3)509(a)(2)CARESOURCEfalse
CareSource Life Services Co
PO Box 8738DaytonOH45401811602217InactiveOH501(c)(3)509(a)(2)CARESOURCEfalse
CareSource Ohio Inc
PO Box 8738DaytonOH45401311143265Medicaid HMOOH501(c)(3)509(A)(2)CareSourcefalse
The CareSource Foundation
PO Box 8738DaytonOH45401562582561SupportingOH501(c)(3)509(A)(3) iCareSourcefalse

Id Related Org Txbl Corp Tr IdRelatedOrgTxblCorpTrGrp (5 entries)

Address Line1USAddress/AddressLine1TxtCityUSAddress/CityNmState AbbreviationUSAddress/StateAbbreviationCdZIPUSAddress/ZIPCdEINEINPrimary ActivitiesPrimaryActivitiesTxtLegal Domicile StateLegalDomicileStateCdBusiness Name Line1DirectControllingEntityName/BusinessNameLine1TxtEntity TypeEntityTypeTxt
CareSource Mgmt Grp Fdn (Dissolved 720)
PO Box 8738DaytonOH45401814170497GrantmakingOHNAC Corp
CareSource Virginia Co
PO Box 8738DaytonOH45401811727271InactiveVANAC Corp
CareSource Arkansas Health Plan Co
300 Spring Bldg Ste 900Little RockAR72201844476729InactiveARNAC Corp
Kids' CareAlliance Co
PO Box 8738DaytonOH45401854038326InactiveOHNAC Corp
CareSource Oklahoma Health Plan Co
14201 Wireless Way Suite D-100Oklahoma CityOK73134854038326InactiveOKNAC Corp
FieldValueIRS element (for citing)
Receipt Of Int Annts Rnts RyltsfalseReceiptOfIntAnntsRntsRyltsInd
Gift Grnt Or Cap Contri To Oth OrgYes (true)GiftGrntOrCapContriToOthOrgInd
Gift Grnt Cap Contri From Oth OrgfalseGiftGrntCapContriFromOthOrgInd
Loans Or Guarantees To Other OrgfalseLoansOrGuaranteesToOtherOrgInd
Loans Or Guarantees From Oth OrgYes (true)LoansOrGuaranteesFromOthOrgInd
Asset Sale To Other OrgfalseAssetSaleToOtherOrgInd
Asset Purchase From Other OrgfalseAssetPurchaseFromOtherOrgInd
Asset ExchangefalseAssetExchangeInd
Rental Of Facilities To Oth OrgfalseRentalOfFacilitiesToOthOrgInd
Rental Of Fclts From Oth OrgfalseRentalOfFcltsFromOthOrgInd
Perform Of Services For Oth OrgfalsePerformOfServicesForOthOrgInd
Perform Of Services By Other OrgYes (true)PerformOfServicesByOtherOrgInd
Sharing Of FacilitiesYes (true)SharingOfFacilitiesInd
Paid Employees SharingfalsePaidEmployeesSharingInd
Reimbursement Paid To Other OrgYes (true)ReimbursementPaidToOtherOrgInd
Reimbursement Paid By Other OrgYes (true)ReimbursementPaidByOtherOrgInd
Transfer To Other OrgYes (true)TransferToOtherOrgInd
Transfer From Other OrgYes (true)TransferFromOtherOrgInd