2021-11-11T13:55:08-06:00 2020-12-31 990 2020-01-01 320121856 CareSource Indiana Inc % JANET FERNANDES CARE 9375313027 135 N Pennsylvania St 1300 Indianapolis IN 46204 Lawrence Smart CFO 9375313027 2021-11-11 Lawrence Smart 999009999 2 2020 2022-09-23 18:48:47Z Erhardt Preitauer PO Box 8738 Dayton OH 45401 751111177 false X N/A X 2004 IN To 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. 3 0 0 0 0 0 0 640981578 750157227 737426 953950 0 0 641719004 751111177 0 0 0 0 17832187 0 0 0 0 577104137 744908345 594936324 744908345 46782680 6202832 241392526 327554719 155583746 265543107 85808780 62011612 X CareSource 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. false false 657794166 750157227 CareSource 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. 657794166 true false false true false false false false false false false false false false true true false true false false false false false false false false false false false true false false false false false false false false false false false false false true false false false true 1235 0 true 0 false false false false false false false false false false false false X 3 0 false false false false true true false true true false false true true true true true true false false false IN X JANET FERNANDES 9375313027 PO BOX 8738 Dayton OH 454018738 X Erhardt Preitauer President & CEO 8.0 52.0 X 0 2239483 3719592 Jai Pillai Chief Operating Officer 5.0 55.0 X 0 1037573 910643 David Finkel Exec VP, Markets & Chair/Dir 10.0 50.0 X 0 736768 797538 David Goltz Chief Financial Officer 5.0 55.0 X 0 949833 574541 Daniel McCabe Chief Administrative Officer 1.0 59.0 X 0 809693 631182 Steve Smitherman Pres, Market & Sec/Director 59.0 1.0 X 0 510600 369355 William Coffin Jr VP Market Finance & Treas/Dir 15.0 45.0 X 0 437494 295148 Kevin Brown Former Director 0.0 15.0 X 0 212500 0 Patricia Martin Former Vice Chair 0.0 10.0 X 0 117500 0 0 7051444 7297999 0 true true false Express Scripts Inc 21653 Network Place CHICAGO IL 606730673 Pharmacy Services 171774796 Indiana University Health Related 950 N Meridian Street Suite 300 INDIANAPOLIS IN 46204 Medical Services 105000550 Community Health Network Related 7330 Shadeland Station Suite 200 INDIANAPOLIS IN 46256 Medical Services 44478681 St Vincent Hospital Health Care C 2001 W 86th Street INDIANAPOLIS IN 46260 Medical Services 31493579 Parkview Hospital Inc Related Or 11109 Parkview Plaza Drive FORT WAYNE IN 46845 Medical Services 24862417 40 0 MEDICAID 524114 444377635 444377635 PREMIUMS 524114 305311100 305311100 VETERANS REVENUE 524114 468492 468492 750157227 953950 953950 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 751111177 750157227 953950 0 0 0 0 0 0 0 0 0 0 0 530640 530640 94888 94888 57373 1333 56040 0 0 18228780 1598229 16630551 2048235 135 2048100 6078952 6871 6072081 4512312 4512312 0 2212765 2212765 96623 8035 88588 0 0 185134 185134 0 0 201275 17 201258 MEDICAL EXPENSES 533416013 533416013 PHARMACY EXPENSES 115745685 115745685 MGMT FEES CARESOURCE MGMT SVCS 49013760 6307121 42706639 HLTH INS PROVIDER & PCORI FEES 6906643 2783 6903860 5579267 707944 4871323 744908345 657794166 87114179 0 X 483400 0 120792806 273199992 0 0 99216664 41448356 0 0 0 0 0 0 0 0 60942 669264 0 0 20838714 12237107 0 0 0 0 0 0 0 0 241392526 327554719 79278236 97585964 0 0 75510780 146318623 0 0 0 0 0 0 0 0 0 0 794730 21638520 155583746 265543107 X 85808780 62011612 0 0 85808780 62011612 241392526 327554719 X 6202832 -30000000 X false true X true false X 0 0 0 0 0 0 95447251 358378523 793585249 640981578 750157227 2638549828 0 0 0 95447251 358378523 793585249 640981578 750157227 2638549828 0 0 0 2638549828 36201 236084 2122635 737426 953950 4086296 0 36201 236084 2122635 737426 953950 4086296 0 0 95483452 358614607 795707884 641719004 751111177 2642636124 0.99845 0.99839 0.00155 0.00161 X false false false false false false true 105871 false true 8875 114746 false Form 990, Schedule C, Part II-B, Line 1g Lobbyists 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. 0 RELATED PARTY PAYABLE 21638520 21638520 X FIN 48 (ASC 740) Footnote As 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. false true false false false false false false false Erhardt Preitauer President & CEO 0 1195469 0 1041550 0 2464 0 3687463 0 32129 0 5959075 0 1041550 Jai Pillai Chief Operating Officer 0 576277 0 300000 0 161296 0 886239 0 24404 0 1948216 0 300000 David Finkel Exec VP, Markets & Chair/Dir 0 510907 0 221045 0 4816 0 776964 0 20574 0 1534306 0 221045 David Goltz Chief Financial Officer 0 603324 0 286058 0 60451 0 552051 0 22490 0 1524374 0 286058 Daniel McCabe Chief Administrative Officer 0 448738 0 216350 0 144605 0 602044 0 29138 0 1440875 0 216350 Steve Smitherman Pres, Market & Sec/Director 0 309881 0 136192 0 64527 0 334214 0 35141 0 879955 0 136192 William Coffin Jr VP Market Finance & Treas/Dir 0 311522 0 120500 0 5472 0 266010 0 29138 0 732642 0 120500 Kevin Brown Former Director 0 212500 0 0 0 0 0 0 0 0 0 212500 0 0 Patricia Martin Former Vice Chair 0 117500 0 0 0 0 0 0 0 0 0 117500 0 0 Form 990, Schedule J, Part I, Question 3 The 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 4b The 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 6b The 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 II Compensation 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. Form 990, Part V, Lines 1a & 2a In 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 6 CareSource 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 7a CareSource, the sole member of CareSource Indiana, Inc., has the authority to appoint CareSource Indiana, Inc.'s board. 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 B, Q15A & 15B The 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 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 Indiana Secretary of State's website at www.in.gov/SOS/ for a nominal fee. Form 990, Part XI, Line 9 Change in Net Assets is Inclusive of the Following: (1) Return of Capital Contribution from CareSource ($ 30,000,000). CareSource PO Box 8738 Dayton OH 45401 311703368 Supporting OH 501(c)(3) 509(a)(3)II NA false CareSource Kentucky Co 101 Enterprise Drive Frankfort KY 40601 464991603 Exchange HMO KY 501(c)(3) 509(a)(2) CARESOURCE false CareSource Georgia Co 600 Galleria Pkwy 400 Atlanta GA 30339 472408339 Medicaid HMO GA 501(C)(3) 509(a)(2) CARESOURCE false CareSource West Virginia Co 400 Washington St 401 Charleston WV 25301 473028244 Exchange HMO WV 501(c)(3) 509(a)(2) CARESOURCE false CareSource Life Services Co PO Box 8738 Dayton OH 45401 811602217 Inactive OH 501(c)(3) 509(a)(2) CARESOURCE false CareSource Ohio Inc PO Box 8738 Dayton OH 45401 311143265 Medicaid HMO OH 501(c)(3) 509(A)(2) CareSource false The CareSource Foundation PO Box 8738 Dayton OH 45401 562582561 Supporting OH 501(c)(3) 509(A)(3) i CareSource false CareSource Mgmt Grp Fdn (Dissolved 720) PO Box 8738 Dayton OH 45401 814170497 Grantmaking OH NA C Corp CareSource Virginia Co PO Box 8738 Dayton OH 45401 811727271 Inactive VA NA C Corp CareSource Arkansas Health Plan Co 300 Spring Bldg Ste 900 Little Rock AR 72201 844476729 Inactive AR NA C Corp Kids' CareAlliance Co PO Box 8738 Dayton OH 45401 854038326 Inactive OH NA C Corp CareSource Oklahoma Health Plan Co 14201 Wireless Way Suite D-100 Oklahoma City OK 73134 854038326 Inactive OK NA C Corp false true false false true false false false false false false true true false true true true true