2021-11-11T13:55:08-06:00 2020-12-31 990 2020-01-01 464991603 CareSource Kentucky Co % JANET FERNANDES CARE 9375313027 101 Enterprise Drive Frankfort KY 40601 Lawrence Smart CFO 9375313027 2021-11-11 Lawrence Smart 999009999 2 2020 2022-09-23 18:48:47Z X Erhardt Preitauer PO Box 8738 Dayton OH 45401 254549061 false X N/A X 2014 KY To Make a Lasting Difference in our members' lives by improving their health and well-being. CareSource Kentucky Co. is a nonprofit HMO licensed by the State of Kentucky. 3 0 0 0 0 0 0 236599250 254461958 469073 87103 0 0 237068323 254549061 0 0 0 0 0 0 0 0 0 211848520 244062173 211848520 244062173 25219803 10486888 70198631 77405583 40429451 47149515 29769180 30256068 X CareSource Kentucky 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 Kentucky Co. is a health maintenance organization licensed by the state of Kentucky and serves members through Marketplace plans. false false 206205677 254461958 CareSource Kentucky Co. ("CSKY"CareSource Kentucky") is a nonprofit organization established under the Commonwealth of Kentucky. CSKY was granted a Certificate of Authority by the Kentucky Department of Insurance ("KDOI"), allowing it to operate as a Health Maintenance Organization ("HMO"). On July 7, 2016, CSKY received a determination letter from the Internal Revenue Service, recognizing CSKY as an organization exempt from federal income tax under Section 501(c)(3) of the Internal Revenue Code, effective as of the date of CSKY's formation. CSKY 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. CSKY 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. CareSource Kentucky is accredited through the National Committee for Quality Assurance ("NCQA") for its Qualified Health Plan ("QHP"). Accreditation is the most comprehensive evaluation in the industry and the only assessment that bases results on clinical performance and consumer experience. CSKY 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. CSKY 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. CSKY'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 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 receive assistance through CSKY's many programs designed to remove barriers to health and well-being. CareSource Kentucky can, therefore, further its mission as a means of improving the health and well-being of Kentucky's low-income populations. 206205677 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 178 0 true 0 false false false false false false false false false false false false X 3 0 false false false false true false false true true false false true true true true true true false false false KY X JANET FERNANDES 9375313027 PO BOX 8738 Dayton OH 454018738 X Erhardt Preitauer President & CEO 5.0 55.0 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 Michael Taylor Pres, Market & Sec/Director 25.0 35.0 X 0 408959 363474 William Coffin Jr VP Mkt Finance & Treas/Dir 15.0 45.0 X 0 437494 295148 Kevin Brown Former Director 0.0 15.0 X 0 212500 0 Terence Rapoch Former Vice Chair 0.0 10.0 X 0 122500 0 0 6954803 7292118 0 true true false Express Scripts Inc 21653 Network Place CHICAGO IL 606730673 PHARMACY Services 79938708 Baptist Healthcare Sys Inc Affili 2701 Eastpoint Parkway LOUISVILLE KY 40223 Medical Services 37291815 University of Kentucky Hospital PO Box 3107 LEXINGTON KY 40588 Medical Services 19796610 Norton Hospitals Inc Related Orgs 224 E Broadway 5th Floor LOUISVILLE KY 40202 Medical Services 17492243 St Elizabeth Medical Ctr Inc Affi One Medical Village Drive EDGEWOOD KY 41017 Medical Services 15198582 195 0 STATE HEALTH INSURANCE EXCHANGE 524114 254461958 254461958 254461958 87103 87103 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 254549061 254461958 87103 0 0 0 0 0 0 0 0 0 0 0 206737 206737 188188 20193 167995 30682 506 30176 0 0 7531217 871806 6659411 1564641 40 1564601 2908531 1814 2906717 1543694 2344 1541350 0 815972 815972 24326 2408 21918 0 0 5503 5503 0 0 72162 4 72158 MEDICAL EXPENSES 146780781 146780781 PHARMACY EXPENSES 56413410 56413410 MGMT FEES CARESOURCE MGMT SVCS 16350395 1916663 14433732 HLTH INS PROVIDER & PCORI FEES 7858473 7858473 1767461 195708 1571753 244062173 206205677 37856496 0 X 500000 0 30611114 59893526 0 0 39087517 12569127 0 0 0 0 0 0 0 0 0 131550 0 0 0 4811380 0 0 0 0 0 0 0 0 70198631 77405583 31895168 37474909 0 0 7588721 8236923 0 0 0 0 0 0 0 0 0 0 945562 1437683 40429451 47149515 X 29769180 30256068 0 0 29769180 30256068 70198631 77405583 X 10486888 -10000000 X false true X true false X 0 0 0 0 0 0 31664913 102021012 277797319 236599250 254461958 902544452 0 0 0 31664913 102021012 277797319 236599250 254461958 902544452 0 0 0 902544452 4467 65361 313271 469073 87103 939275 0 4467 65361 313271 469073 87103 939275 0 0 31669380 102086373 278110590 237068323 254549061 903483727 0.99896 0.00000 0.00104 0.00000 X false false false false false false true 55126 false true 6240 61366 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 $6,240 is the allocable portion of the Organization's dues paid to the Kentucky Association of Health Plans for lobbying and grassroots efforts conducted by the trade association on behalf of its members. 0 RELATED PARTY PAYABLE 1437683 1437683 X FIN 48 (ASC 740) Footnote As outlined in CareSource's Audited Consolidated Financial Statements, which include the activity of CareSource Kentucky 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. 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 Michael Taylor Pres, Market & Sec/Director 0 258049 0 148864 0 2046 0 332167 0 31307 0 772433 0 148864 William Coffin Jr VP Mkt 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 Terence Rapoch Former Vice Chair 0 122500 0 0 0 0 0 0 0 0 0 122500 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, Michael Taylor 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 Management Services LLC ("CSMS"), a disregarded entity of CareSource: Erhardt Preitauer, Jai Pillai, David Finkel, David Goltz, Daniel McCabe, and Michael Taylor. 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, Michael Taylor $152,855 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 Kentucky Co.: Erhardt Preitauer, Jai Pillai, David Finkel, David Goltz, Daniel McCabe, Michael Taylor, 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 All compensation amounts reported on Schedule J, Part II for all listed persons are paid by CareSource Management Services LLC ("CSMS"), a disregarded entity of CareSource, a related organization to CareSource Kentucky Co. Compensation paid to the CEO is pursuant to the terms of a written employment agreement between Mr. Preitauer and CareSource. Form 990, Part V, Line 1a In early 2020, CSKY changed the payer of its provider claims payments, resulting in a reduction of the number of Forms 1099 that were reported on Form 990, Part V, Line 1A. Form 990, Part VI, Section A, Question 6 CareSource is the sole member of CareSource Kentucky 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 Kentucky Secretary of State's website at www.sos.ky.gov. Form 990, Part XI, Line 9 Change in Net Assets is Inclusive of the Following: (1) Return of Capital Contribution from CareSource ($10,000,000). CareSource PO Box 8738 Dayton OH 45401 311703368 SUPPORTING OH 501(c)(3) 509(a)(3)II NA false CareSource Indiana Inc 135 N Pennsylvania St 1300 Indianapolis IN 46204 320121856 Medicaid HMO IN 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 The CareSource Foundation PO Box 8738 Dayton OH 45401 562582561 Supporting OH 501(c)(3) 509(A)(3) I CareSource 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 CSH C Corp Kids' CareAlliance Co PO Box 8738 Dayton OH 45401 854038326 Inactive OH CSMSH LLC C Corp CareSource Oklahoma Health Plan Co 14201 Wireless Way Suite D-100 Oklahoma City OK 73134 854038326 Inactive OK CSOKH LLC C Corp false true false false false false false false false false false true true false true true true true