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CARESOURCE WEST VIRGINIA CO: Form 990, tax year 2019

View the entire original 990 at ProPublica ↗

Organization
CARESOURCE WEST VIRGINIA CO (EIN 47-3028244)
Tax period
2019-01-01 to 2019-12-31
Filed
2020-11-16
IRS object ID
202013219349302346
Schema version
2019v5.1
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)
Return2020-11-16T08:03:26-06:00ReturnTs
Tax Period End2019-12-31TaxPeriodEndDt
Return Type990ReturnTypeCd
Tax Period Begin2019-01-01TaxPeriodBeginDt

Filer Filer

FieldValueIRS element (for citing)
EIN473028244EIN

Business Name BusinessName

FieldValueIRS element (for citing)
Business Name Line1CareSource West Virginia CoBusinessNameLine1Txt
FieldValueIRS element (for citing)
In Care Of% JANET FERNANDESInCareOfNm
Business Name ControlCAREBusinessNameControlTxt
Phone9375313027PhoneNum

US Address USAddress

FieldValueIRS element (for citing)
Address Line1400 Washington St Suite 401AddressLine1Txt
CityCharlestonCityNm
State AbbreviationWVStateAbbreviationCd
ZIP25301ZIPCd

Business Officer BusinessOfficerGrp

FieldValueIRS element (for citing)
PersonDAVID W GOLTZPersonNm
Person TitleCFOPersonTitleTxt
Phone9375313027PhoneNum
Signature2020-11-13SignatureDt

Filing Security Information FilingSecurityInformation

IP Address IPAddress

FieldValueIRS element (for citing)
I Pv4 Address208.90.148.16IPv4AddressTxt
FieldValueIRS element (for citing)
Federal Original Submission Id31250220203215000000FederalOriginalSubmissionId
Federal Original Submission Id2020-11-16FederalOriginalSubmissionIdDt
Filing License TypePFilingLicenseTypeCd
At Submission Creation Device IdE5D0B402C5057AD00F81B6842CF73C21495794A5AtSubmissionCreationDeviceId
At Submission Filing Device Id8206126091B024FA09C0B25049ACF7F162FD2A36AtSubmissionFilingDeviceId
FieldValueIRS element (for citing)
Tax2019TaxYr
Build TS2021-01-29 14:40:06ZBuildTS

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$52,362,618GrossReceiptsAmt
Group Return For AffiliatesfalseGroupReturnForAffiliatesInd
Organization501c3Yes (X)Organization501c3Ind
Website AddressN/AWebsiteAddressTxt
Type Of Organization CorpYes (X)TypeOfOrganizationCorpInd
Formation2015FormationYr
Legal Domicile StateWVLegalDomicileStateCd
Activity Or MissionTo 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.ActivityOrMissionDesc
Voting Members Governing Body3VotingMembersGoverningBodyCnt
Voting Members Independent0VotingMembersIndependentCnt
Total Employee0TotalEmployeeCnt
Total Volunteers0TotalVolunteersCnt
Total Gross UBI$0TotalGrossUBIAmt
Net Unrelated Bus Txbl Incm$0NetUnrelatedBusTxblIncmAmt
PY Contributions Grants$0PYContributionsGrantsAmt
CY Contributions Grants$0CYContributionsGrantsAmt
PY Program Service Revenue$50,427,213PYProgramServiceRevenueAmt
CY Program Service Revenue$51,977,728CYProgramServiceRevenueAmt
PY Investment Income$236,383PYInvestmentIncomeAmt
CY Investment Income$384,890CYInvestmentIncomeAmt
PY Other Revenue$0PYOtherRevenueAmt
CY Other Revenue$0CYOtherRevenueAmt
PY Total Revenue$50,663,596PYTotalRevenueAmt
CY Total Revenue$52,362,618CYTotalRevenueAmt
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$0PYSalariesCompEmpBnftPaidAmt
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$56,498,574PYOtherExpensesAmt
CY Other Expenses$51,529,493CYOtherExpensesAmt
PY Total Expenses$56,498,574PYTotalExpensesAmt
CY Total Expenses$51,529,493CYTotalExpensesAmt
PY Revenues Less Expenses-$5,834,978PYRevenuesLessExpensesAmt
CY Revenues Less Expenses$833,125CYRevenuesLessExpensesAmt
Total Assets BOY$25,009,769TotalAssetsBOYAmt
Total Assets EOY$27,324,026TotalAssetsEOYAmt
Total Liabilities BOY$21,951,252TotalLiabilitiesBOYAmt
Total Liabilities EOY$23,432,384TotalLiabilitiesEOYAmt
Net Assets Or Fund Balances BOY$3,058,517NetAssetsOrFundBalancesBOYAmt
Net Assets Or Fund Balances EOY$3,891,642NetAssetsOrFundBalancesEOYAmt
Info In Schedule O Part IIIYes (X)InfoInScheduleOPartIIIInd
MissionTO MAKE A LASTING DIFFERENCE IN OUR MEMBERS' LIVES BY IMPROVING THEIR HEALTH AND WELL-BEING. CARESOURCE WEST VIRGINIA CO PROVIDES LOW-COST COMPREHENSIVE HEALTH INSURANCE COVERAGE FOR UNINSURED INDIVIDUALS THROUGH A QUALIFIED HEALTH PLAN ON THE WEST VIRGINIA HEALTH INSURANCE MARKETPLACE.MissionDesc
Significant New Program SrvcfalseSignificantNewProgramSrvcInd
Significant ChangefalseSignificantChangeInd
Expense$43,645,109ExpenseAmt
Grant$0GrantAmt
Revenue$51,977,728RevenueAmt
DescCareSource 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 began offering a Qualified Health Plan ("QHP") on the West Virginia Health Insurance Marketplace beginning in January 2016, providing low-cost comprehensive coverage for uninsured individuals and families. CSWV is accredited for its QHP through the National Committee for Quality Assurance ("NCQA"). 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.Desc
Total Program Service Expenses$43,645,109TotalProgramServiceExpensesAmt
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 Document0IRPDocumentCnt
IRP Document W2 G0IRPDocumentW2GCnt
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 DocumentsYes (true)ChangeToOrgDocumentsInd
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 FldWVStatesWhereCopyOfReturnIsFldCd
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 & CEO/Former Dir5.055.0Yes (X)$0$3,061,457$1,899,707
David Goltz
Chief Financial Officer5.055.0Yes (X)$0$1,395,705$523,051
Jai Pillai
Chief Operating Officer3.057.0Yes (X)$0$837,370$495,728
David Finkel
Executive VP, Markets/Chair14.046.0Yes (X)$0$826,297$407,546Yes (X)
Daniel McCabe
Chief Administrative Officer2.066.0Yes (X)$0$737,231$410,495
L Tarlton Thomas III
Former Chief Operating Officer0.00.0$0$1,107,296$3,517Yes (X)
Michael Taylor
President, Market/Sec/Treas20.040.0Yes (X)$0$590,016$241,858Yes (X)
William Coffin
VP, Market Finance/Director10.050.0$0$524,876$144,232Yes (X)
Ellen Leffak
Former Director0.00.0$0$210,000$0Yes (X)
FieldValueIRS element (for citing)
Total Reportable Comp From Org$0TotalReportableCompFromOrgAmt
Tot Reportable Comp Rltd Org$9,290,248TotReportableCompRltdOrgAmt
Total Other Compensation$4,126,134TotalOtherCompensationAmt
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
WV University Hospitals Related O
PO Box 8034MORGANTOWNWV265068034Medical Services$15,772,301
United Hospital Center Inc Affili
327 Medical Park DriveBRIDGEPORTWV26330Medical Services$14,453,984
CVS Caremark
9501 E Shea Blvd MC 019SCOTTSDALEAZ85260Pharmacy Services$8,450,107
St Marys Medical Center Inc Affil
2900 1st Ave Ste H-08HUNTINGTONWV25702Medical Services$8,001,200
Herbert J Thomas Memorial Hospital
4605 Maccorkle Ave SWSOUTH CHARLESTONWV25309Medical Services$2,619,189
FieldValueIRS element (for citing)
Cntrct Rcvd Greater Than100 K32CntrctRcvdGreaterThan100KCnt
Total Contributions$0TotalContributionsAmt

Program Service Revenue ProgramServiceRevenueGrp

FieldValueIRS element (for citing)
DescFEDERAL HEALTH INSURANCE EXCHANGEDesc
Business524114BusinessCd
Total Revenue Column$51,977,728TotalRevenueColumnAmt
Related Or Exempt Func Income$51,977,728RelatedOrExemptFuncIncomeAmt
FieldValueIRS element (for citing)
Total Program Service Revenue$51,977,728TotalProgramServiceRevenueAmt

Investment Income InvestmentIncomeGrp

FieldValueIRS element (for citing)
Total Revenue Column$384,890TotalRevenueColumnAmt
Exclusion$384,890ExclusionAmt

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$52,362,618TotalRevenueColumnAmt
Related Or Exempt Func Income$51,977,728RelatedOrExemptFuncIncomeAmt
Exclusion$384,890ExclusionAmt

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$18,649TotalAmt
Management And General$18,649ManagementAndGeneralAmt

Fees For Services Accounting FeesForServicesAccountingGrp

FieldValueIRS element (for citing)
Total$42,056TotalAmt
Management And General$42,056ManagementAndGeneralAmt

Fees For Services Lobbying FeesForServicesLobbyingGrp

FieldValueIRS element (for citing)
Total$16,000TotalAmt
Management And General$16,000ManagementAndGeneralAmt

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$1,270,788TotalAmt
Program Services$306,502ProgramServicesAmt
Management And General$964,286ManagementAndGeneralAmt

Advertising AdvertisingGrp

FieldValueIRS element (for citing)
Total$237,009TotalAmt
Management And General$237,009ManagementAndGeneralAmt

Office Expenses OfficeExpensesGrp

FieldValueIRS element (for citing)
Total$621,445TotalAmt
Program Services$4,181ProgramServicesAmt
Management And General$617,264ManagementAndGeneralAmt

Information Technology InformationTechnologyGrp

FieldValueIRS element (for citing)
Total$0TotalAmt

Royalties RoyaltiesGrp

FieldValueIRS element (for citing)
Total$0TotalAmt

Occupancy OccupancyGrp

FieldValueIRS element (for citing)
Total$159,020TotalAmt
Management And General$159,020ManagementAndGeneralAmt

Travel TravelGrp

FieldValueIRS element (for citing)
Total$0TotalAmt

Pymt Travel Entrtnmnt Pub Ofcl PymtTravelEntrtnmntPubOfclGrp

FieldValueIRS element (for citing)
Total$0TotalAmt

Conferences Meetings ConferencesMeetingsGrp

FieldValueIRS element (for citing)
Total$52,048TotalAmt
Program Services$2,386ProgramServicesAmt
Management And General$49,662ManagementAndGeneralAmt

Interest InterestGrp

FieldValueIRS element (for citing)
Total$543,657TotalAmt
Management And General$543,657ManagementAndGeneralAmt

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$0TotalAmt

Other Expenses OtherExpensesGrp (4 entries)

DescDescTotalTotalAmtProgram ServicesProgramServicesAmtManagement And GeneralManagementAndGeneralAmt
MEDICAL$36,941,802$36,941,802
PHARMACY$6,098,100$6,098,100
MGMT FEES CARESOURCE MGMT GRP$2,926,163$292,138$2,634,025
HLTH INS PROVIDER & PCORI FEES$2,594,634$2,594,634

All Other Expenses AllOtherExpensesGrp

FieldValueIRS element (for citing)
Total$8,122TotalAmt
Management And General$8,122ManagementAndGeneralAmt

Total Functional Expenses TotalFunctionalExpensesGrp

FieldValueIRS element (for citing)
Total$51,529,493TotalAmt
Program Services$43,645,109ProgramServicesAmt
Management And General$7,884,384ManagementAndGeneralAmt
Fundraising$0FundraisingAmt
FieldValueIRS element (for citing)
Info In Schedule O Part XYes (X)InfoInScheduleOPartXInd

Cash Non Interest Bearing CashNonInterestBearingGrp

FieldValueIRS element (for citing)
BOY$100,000BOYAmt
EOY$100,000EOYAmt

Savings And Temp Cash Invst SavingsAndTempCashInvstGrp

FieldValueIRS element (for citing)
BOY$22,931,230BOYAmt
EOY$23,938,785EOYAmt

Pledges And Grants Receivable PledgesAndGrantsReceivableGrp

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

Accounts Receivable AccountsReceivableGrp

FieldValueIRS element (for citing)
BOY$1,978,539BOYAmt
EOY$3,285,241EOYAmt

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$0BOYAmt
EOY$0EOYAmt

Land Bldg Equip Basis Net LandBldgEquipBasisNetGrp

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

Investments Pub Traded Sec InvestmentsPubTradedSecGrp

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

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$25,009,769BOYAmt
EOY$27,324,026EOYAmt

Accounts Payable Accr Expnss AccountsPayableAccrExpnssGrp

FieldValueIRS element (for citing)
BOY$8,139,979BOYAmt
EOY$7,992,366EOYAmt

Grants Payable GrantsPayableGrp

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

Deferred Revenue DeferredRevenueGrp

FieldValueIRS element (for citing)
BOY$12,848,379BOYAmt
EOY$9,422,779EOYAmt

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$962,894BOYAmt
EOY$6,017,239EOYAmt

Total Liabilities TotalLiabilitiesGrp

FieldValueIRS element (for citing)
BOY$21,951,252BOYAmt
EOY$23,432,384EOYAmt
FieldValueIRS element (for citing)
Organization Follows FASB117Yes (X)OrganizationFollowsFASB117Ind

No Donor Restriction Net Assets NoDonorRestrictionNetAssetsGrp

FieldValueIRS element (for citing)
BOY$3,058,517BOYAmt
EOY$3,891,642EOYAmt

Donor Restriction Net Assets DonorRestrictionNetAssetsGrp

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

Total Net Assets Fund Balance TotalNetAssetsFundBalanceGrp

FieldValueIRS element (for citing)
BOY$3,058,517BOYAmt
EOY$3,891,642EOYAmt

Tot Liab Net Assets Fund Balance TotLiabNetAssetsFundBalanceGrp

FieldValueIRS element (for citing)
BOY$25,009,769BOYAmt
EOY$27,324,026EOYAmt
FieldValueIRS element (for citing)
Reconcilation Revenue Expnss$833,125ReconcilationRevenueExpnssAmt
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 Minus3 Years$5,403,835CurrentTaxYearMinus3YearsAmt
Current Tax Year Minus2 Years$32,166,127CurrentTaxYearMinus2YearsAmt
Current Tax Year Minus1 Year$50,427,213CurrentTaxYearMinus1YearAmt
Current Tax Year$51,977,728CurrentTaxYearAmt
Total$139,974,903TotalAmt

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$0CurrentTaxYearMinus4YearsAmt
Current Tax Year Minus3 Years$5,403,835CurrentTaxYearMinus3YearsAmt
Current Tax Year Minus2 Years$32,166,127CurrentTaxYearMinus2YearsAmt
Current Tax Year Minus1 Year$50,427,213CurrentTaxYearMinus1YearAmt
Current Tax Year$51,977,728CurrentTaxYearAmt
Total$139,974,903TotalAmt

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$139,974,903PublicSupportTotal509Amt

Gross Investment Income509 GrossInvestmentIncome509Grp

FieldValueIRS element (for citing)
Current Tax Year Minus4 Years$12CurrentTaxYearMinus4YearsAmt
Current Tax Year Minus3 Years$758CurrentTaxYearMinus3YearsAmt
Current Tax Year Minus2 Years$38,829CurrentTaxYearMinus2YearsAmt
Current Tax Year Minus1 Year$236,383CurrentTaxYearMinus1YearAmt
Current Tax Year$384,890CurrentTaxYearAmt
Total$660,872TotalAmt

Post1975 UBTI Post1975UBTIGrp

FieldValueIRS element (for citing)
Total$0TotalAmt

Investment Income And UBTI InvestmentIncomeAndUBTIGrp

FieldValueIRS element (for citing)
Current Tax Year Minus4 Years$12CurrentTaxYearMinus4YearsAmt
Current Tax Year Minus3 Years$758CurrentTaxYearMinus3YearsAmt
Current Tax Year Minus2 Years$38,829CurrentTaxYearMinus2YearsAmt
Current Tax Year Minus1 Year$236,383CurrentTaxYearMinus1YearAmt
Current Tax Year$384,890CurrentTaxYearAmt
Total$660,872TotalAmt

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$12CurrentTaxYearMinus4YearsAmt
Current Tax Year Minus3 Years$5,404,593CurrentTaxYearMinus3YearsAmt
Current Tax Year Minus2 Years$32,204,956CurrentTaxYearMinus2YearsAmt
Current Tax Year Minus1 Year$50,663,596CurrentTaxYearMinus1YearAmt
Current Tax Year$52,362,618CurrentTaxYearAmt
Total$140,635,775TotalAmt
FieldValueIRS element (for citing)
First5 Years509Yes (X)First5Years509Ind
Public Support CY5090.00000PublicSupportCY509Pct

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$32,000DirectContactLegislatorsAmt
Rallies DemonstrationsfalseRalliesDemonstrationsInd
Other ActivitiesfalseOtherActivitiesInd
Total Lobbying Expenditures$32,000TotalLobbyingExpendituresAmt
Not Described Section501c3falseNotDescribedSection501c3Ind

Supplemental Information Detail SupplementalInformationDetail

FieldValueIRS element (for citing)
Form And Line ReferenceForm 990, Schedule C, Part II-B, Line 1gFormAndLineReferenceDesc
ExplanationLobbyists 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.ExplanationTxt

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$6,017,239Amt
FieldValueIRS element (for citing)
Total Liability$6,017,239TotalLiabilityAmt
Footnote TextYes (X)FootnoteTextInd

Supplemental Information Detail SupplementalInformationDetail

FieldValueIRS element (for citing)
Form And Line ReferenceFIN 48 (ASC 740) FootnoteFormAndLineReferenceDesc
ExplanationAs outlined in the CareSource Management Group Co.'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 2016-2019 are open for audit by the Internal Revenue Service.ExplanationTxt

Schedule J IRS990ScheduleJ

FieldValueIRS element (for citing)
Severance PaymentYes (true)SeverancePaymentInd
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/Former Dir$0$1,026,966$0$1,250,500$0$783,991$0$1,863,100$0$36,607$0$4,961,164$0$1,163,393
David Goltz
Chief Financial Officer$0$555,838$0$215,000$0$624,867$0$502,115$0$20,936$0$1,918,756$0$325,000
Jai Pillai
Chief Operating Officer$0$469,413$0$237,500$0$130,457$0$480,287$0$15,441$0$1,333,098$0$237,500
David Finkel
Executive VP, Markets/Chair$0$433,074$0$167,500$0$225,723$0$389,425$0$18,121$0$1,233,843$0$0
Daniel McCabe
Chief Administrative Officer$0$419,863$0$164,136$0$153,232$0$383,840$0$26,655$0$1,147,726$0$164,136
Michael Taylor
President, Market/Sec/Treas$0$238,033$0$181,948$0$170,035$0$210,664$0$31,194$0$831,874$0$168,198
William Coffin
VP, Market Finance/Director$0$301,199$0$98,746$0$124,931$0$123,296$0$20,936$0$669,108$0$0
L Tarlton Thomas III
Former Chief Operating Officer$0$20,184$0$0$0$1,087,112$0$1,305$0$2,212$0$1,110,813$0$481,103
Ellen Leffak
Former Director$0$210,000$0$0$0$0$0$0$0$0$0$210,000$0$0

Supplemental Information Detail SupplementalInformationDetail (5 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 Management Group Co. ("CSMG"), a related organization, has in place Clawback provisions within its executive compensation plans that generally require executives to pay back compensation to CSMG 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 4aL Tarlton Thomas III received a severance payment that is properly reported on Schedule J, Part II, Column B(iii).
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, CSMG: Erhardt Preitauer, David Goltz, Jai Pillai, David Finkel, Daniel McCabe, Michael Taylor, William Coffin, and L Tarlton Thomas III. 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, CSMG: Erhardt Preitauer, David Goltz, Jai Pillai, David Finkel, 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 2019 for both deferred compensation arrangements include the following: Erhardt Preitauer $1,381,150, David Goltz $501,682, Jai Pillai $263,728, David Finkel $328,471, Daniel McCabe $260,419, Michael Taylor $214,925, William Coffin $60,555, and L Tarlton Thomas III $746,689.
Form 990, Schedule J, Part I, Question 6bThe following listed persons listed on Form 990, Part VII, Section A, line 1a are employees of CSMG, a related organization to CareSource West Virginia Co.: Erhardt Preitauer, David Goltz, Jai Pillai, David Finkel, Daniel McCabe, Michael Taylor, and William Coffin. 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 IIAll compensation amounts reported on Schedule J, Part II for all listed persons are paid by CSMG, a related organization to CareSource West Virginia Co. Compensation paid to the CEO is pursuant to the terms of a written employment agreement between Mr. Preitauer and CSMG.

Schedule O IRS990ScheduleO

Supplemental Information Detail SupplementalInformationDetail (5 entries)

Form And Line ReferenceFormAndLineReferenceDescExplanationExplanationTxt
Form 990, Part VI, Section A, Question 4CareSource West Virginia Co. filed amended ByLaws effective January 1, 2019. The amended ByLaws include the following changes: (1) The independence requirement for Directors was removed; (2) Term Limits for any Director who holds the Director position by virtue of his/her employment with CareSource were removed; (3) The difference between Board Officers and Corporate Officers was explained; (4) The term of Board officers was changed from 1 year to 2 years; (5) Corporate Officers titles, terms, and duties were identified; (6) It was established that the Corporation's Committees operate at the holding company level through CareSource Management Group Co., the sole member of the Corporation; and (7) The recipient of proceeds upon dissolution was changed from The CareSource Foundation to the CareSource Management Group Foundation, provided CareSource Management Group Foundation is exempt from federal income taxation under Section 501(c)(3) of the Internal Revenue Code at the time of any such distribution.
Form 990, Part VI, Section A, Question 6CareSource Management Group Co ("CSMG") is the sole member of CareSource West Virginia Co. CSMG is recognized as exempt from federal income taxation under Internal Revenue Code ("IRC") Section 501(c)(3).
Form 990, Part VI, Section B, Question 11BThe Form 990 was provided to the organization's Finance committee for their review of the return prior to the time of filing Form 990. The Form 990 was made available to each voting member of the governing body of the organization for their review prior to the time of filing Form 990. The Form 990 was reviewed by the CEO, CFO, VP Treasury, Director 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 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 West Virginia Secretary of State's website at www.sos.wv.gov/.

Schedule R IRS990ScheduleR

Id Related Tax Exempt Org IdRelatedTaxExemptOrgGrp (5 entries)

Address Line1USAddress/AddressLine1TxtCityUSAddress/CityNmState AbbreviationUSAddress/StateAbbreviationCdZIPUSAddress/ZIPCdEINEINPrimary ActivitiesPrimaryActivitiesTxtLegal Domicile StateLegalDomicileStateCdExempt Code SectionExemptCodeSectionTxtPublic Charity StatusPublicCharityStatusTxtBusiness Name Line1DirectControllingEntityName/BusinessNameLine1TxtControlled OrganizationControlledOrganizationInd
CareSource Management Group Co
PO Box 8738DaytonOH45401311703368SupportingOH501(c)(3)509(a)(3)IINAfalse
CareSource Indiana Inc
135 N Pennsylvania St 1300IndianapolisIN46204320121856Medicaid HMOIN501(c)(3)509(a)(2)CSMGfalse
CareSource Georgia Co
600 Galleria Pkwy 400AtlantaGA30339472408339Medicaid HMOGA501(c)(3)509(a)(2)CSMGfalse
CareSource Kentucky Co
10200 Forest Green Blvd 400LouisvilleKY40223464991603Exchange HMOKY501(c)(3)509(a)(2)CSMGfalse
CareSource Life Services Co
PO Box 8738DaytonOH45401811602217InactiveOH501(c)(3)509(a)(2)CSMGfalse

Id Related Org Txbl Corp Tr IdRelatedOrgTxblCorpTrGrp (3 entries)

Address Line1USAddress/AddressLine1TxtCityUSAddress/CityNmState AbbreviationUSAddress/StateAbbreviationCdZIPUSAddress/ZIPCdEINEINPrimary ActivitiesPrimaryActivitiesTxtLegal Domicile StateLegalDomicileStateCdBusiness Name Line1DirectControllingEntityName/BusinessNameLine1TxtEntity TypeEntityTypeTxtShare Of Total IncomeShareOfTotalIncomeAmtShare Of EOY AssetsShareOfEOYAssetsAmtOwnershipOwnershipPctControlled OrganizationControlledOrganizationInd
CareSource Management Services Co
PO Box 8738DaytonOH454018738311703371Adm Mgmt SvcsOHNAC Corp$0$00.00000false
CareSource Mgmt Grp Foundation
PO Box 8738DaytonOH45401814170497GrantmakingOHNAC Corp$0$00.00000false
CareSource Virginia Co
PO Box 8738DaytonOH45401811727271InactiveVANAC Corp$0$00.00000false
FieldValueIRS element (for citing)
Receipt Of Int Annts Rnts RyltsfalseReceiptOfIntAnntsRntsRyltsInd
Gift Grnt Or Cap Contri To Oth OrgfalseGiftGrntOrCapContriToOthOrgInd
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 OrgfalsePerformOfServicesByOtherOrgInd
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