2016-11-15T02:05:23-06:00 2015-12-31 990 2015-01-01 464991603 CareSource Kentucky Co % JANET FERNANDES CARE 9375313027 PO Box 8738 Dayton OH 454018738 L TARLTON THOMAS III EVP Operations & CFO 9375313027 2016-11-11 2015 2017-02-10 21:41:12Z Pamela B Morris Same as C Above Dayton OH 45401 9995816 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 medicaid HMO licensed by the State of KY. 3 2 0 0 0 0 0 0 0 9995816 0 0 0 0 0 9995816 2000 4000 0 0 0 0 0 0 0 330656 14085439 332656 14089439 -332656 -4093623 3793709 12638298 126365 6814577 3667344 5823721 X TO MAKE A LASTING DIFFERENCE IN OUR MEMBERS LIVES BY IMPROVING THEIR HEALTH AND WELL-BEING. CARESOURCE KENTUCKY CO WAS INCORPORATED ON 3/4/2014 AND ENTERED THE KENTUCKY HEALTH BENEFIT EXCHANGE IN 2014 WITH ITS QUALIFIED HEALTH PLAN, CARESOURCE JUST4ME. false false 10850003 4000 9995816 CareSource Kentucky Co. (CSKY) is a non-profit organization established under the state law 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. CSKY is a member of the CareSource group of non-profit organizations (the "CareSource Family of Companies"). The CareSource Family of Companies primary activity for the last twenty-five years has been to provide non-profit Medicaid health maintenance organization services. The mission of CSKY is to make a lasting difference in its members lives by improving their health and overall well-being. The Organization firmly adheres to this mission, which it terms as the organizations "heartbeat," by providing services that go well beyond the delivery of medical benefits. In an effort to help improve the health and overall well-being of a new segment of the low-income population, the CareSource Family of Companies established CSKY. Despite health care reform, the CareSource Family of Companies were concerned that many low-income individuals remained uninsured or underinsured. Furthermore, the CareSource Family of Companies realized that it was uniquely positioned to address this problem due to its extensive experience in providing managed care to low-income individuals. Effective January 1, 2015, CSKY started offering insurance policies to individuals signing up for coverage on the state based Kynect exchange (Kynect). CareSource Kentucky has approval to operate a Qualified Health Plan (QHP) in the Commonwealth of Kentucky, which allows CSKY to offer individual health insurance policies on Kynect. CSKYs Just4Me plan is an affordable plan offered through Kynect. It targets the vulnerable segment of the low-income population not eligible for Medicaid benefits. Through its subsidy program, the Just4Me Plan will ensure that all individuals experiencing economic hardship will be able to afford access to health care, even if not meeting the strict requirements for Medicaid eligibility. Importantly, CSKYs Just4Me Plan has already achieved interim accreditation from the National Committee on Quality Assurance (the "NCQA"). NCQA is a private, nonprofit organization dedicated to improving health care quality. NCQA accreditation is the most comprehensive evaluation in the industry and the only assessment that bases results on clinical performance and consumer experience. Pursuing NCQA Accreditation demonstrates CSKYs commitment to quality and improving the health and well-being of our members. Furthermore, CSKY has built a high-performing provider network to operate the Just4Me Plan as an HMO. This provider network relies heavily upon federally qualified health centers (FQHC). 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. Under federal law, the Just4Me Plan must be made available to all who qualify. True to CSKYs charitable purpose, the plan primarily serves low-income individuals. Just4Me Plan members have free access to a nursing hotline twenty-four (24) hours a day, seven (7) days a week. These nurses review a members symptoms, offer guidance on when to seek medical care, explain any conditions a member has been recently diagnosed with, provide education on over-the-counter medications, and help members prepare a list of questions prior to a visit with their doctor. These services are designed to significantly improve the overall well-being of CSKYs low-income members. Ultimately, CSKYs Just4Me Plan has allowed the CareSource Family of Companies to further its mission by reaching a vulnerable segment of Kentuckys low-income population. Consequently, more individuals can now receive assistance through the Organizations many programs designed to remove barriers to health and well-being. CSKY will, therefore, further the CareSource Family of Companies mission as a means of improving the health and well-being of Kentuckys low-income population. 10850003 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 236 0 0 false false false false false false false false false false X 3 2 false false false false true false false true true false false true true true true true true true true false KY X JANET FERNANDES 9375313027 PO BOX 8738 Dayton OH 454018738 J Thomas Maultsby Chairman; Trustee 1.0 5.0 X 0 36250 0 Kevin R Brown Vice Chair/Trustee 1.0 3.0 X 0 43750 0 Pamela B Morris President & CEO; Trustee 5.0 55.0 X X 0 5908941 1953879 Craig Thiele MD Chief Medical Officer 5.0 55.0 X 0 1514932 385779 Bobby Jones Chief Operating Officer 5.0 55.0 X 0 1744871 468397 L Tarlton Thomas III Chief Financial Officer 5.0 55.0 X 0 1235678 405217 0 10484422 3213272 0 false true false CVS Caremark 221 N Charles Lindergh Dr SALT LAKE CITY UT 84116 PHARMACY Services 2422757 Norton Hospital Inc 4001 Dutchmans Ln LOUISVILLE KY 40207 Medical Services 2131129 KentuckyOne Health Medical Group CO PO Box 2328 LONDON KY 40743 Medical Services 1562421 Community Medical Associates PO Box 950202 LOUISVILLE KY 40295 Medical Services 635996 St Elizabeth Healthcare Center Inc PO Box 636324 CINCINNATI OH 45263 Medical Services 530355 11 0 STATE HEALTH INSURANCE EXCHANGE 524114 9995816 9995816 0 9995816 0 0 0 0 0 0 0 0 0 0 0 9995816 9995816 0 4000 4000 0 0 0 0 0 0 0 0 0 0 2791 2791 96522 37234 59288 22525 9724 12801 0 0 332852 45578 287274 857456 39235 818221 969263 2017 967246 30761 1 30760 0 9043 9043 39331 29865 9466 0 5783 3025 2758 0 0 0 2108 2108 MEDICAL EXPENSES 7920467 7920467 PHARMACY EXPENSES 2315716 2315716 FEES AND ASSESSMENTS 543850 433 543417 MGMT FEES CARESOURCE MGMT GRP 884521 442708 441813 52450 52450 14089439 10850003 3239436 0 2722414 11374892 71221 0 0 0 1000074 1263406 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 3793709 12638298 73988 2760479 0 0 0 3744859 0 0 0 0 0 0 0 0 0 0 52377 309239 126365 6814577 X 3667344 5823721 0 0 0 0 3667344 5823721 3793709 12638298 X -4093623 6250000 X false true X true false X 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 X 0.00000 false false false false false false true 30033 false false 30033 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. 0 RELATED PARTY PAYABLE 309239 309239 X FIN 48 (ASC 740) Footnote The separate company financial statements summarize ASC 740 as follows: The Organization annually reviews its tax positions and has determined that there are no material uncertain tax positions that require recognition in the financial statements. Currently, tax years 2014-2015 are open for audit by the Internal Revenue Service. false true false false false false true Pamela B Morris President & CEO; Trustee 1019059 0 731250 0 4158632 0 1941125 0 12754 0 7862820 0 4525138 Craig Thiele MD Chief Medical Officer 0 373480 0 175589 0 965863 0 355192 0 30587 0 1900711 0 1019433 Bobby Jones Chief Operating Officer 0 486827 0 196371 0 1061673 0 446768 0 21629 0 2213268 0 1084400 L Tarlton Thomas III Chief Financial Officer 0 388782 0 153120 0 693776 0 379212 0 26005 0 1640895 0 767570 Form 990, Schedule J, Part II All compensation amounts reported on Schedule J, Part II for all listed persons are paid by CareSource Management Group Co., a related organization to CareSource Kentucky Co. Form 990, Schedule J, Part I, Line 4b The following listed persons listed on Form 990, Part VII, Section A, participate in a supplemental nonqualified retirement plan of a related entity, CareSource Management Group Co. (CSMG): Pamela B Morris, Craig Thiele MD, Bobby Jones, 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 entity, CareSource Management Group Co.: Pamela B Morris, Craig Thiele MD, Bobby Jones, and L Tarlton Thomas III. 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 2015 for both deferred compensation arrangements include the following: Pamela B Morris $4,958,965; Craig Thiele MD $1,077,692; Bobby Jones $1,200,070 and L Tarlton Thomas III $824,923. Form 990, Schedule J, Part I, Line 6b The following listed persons listed on Form 990, Part VII, Section A, line 1a are employees of CareSource Management Group Co, a related organization to CareSource Kentucky Co.: Pamela B Morris, Craig Thiele MD, Bobby Jones, and L Tarlton Thomas III. 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 I, Line 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 trustees. CSMG 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, Part VI, Section B, Question 11B The Form 990 was provided to the organization's Finance committee, and was reviewed during the course of a special board meeting 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 the Form 990. The Form 990 was reviewed by the CEO, CFO, VP, Treasury, an outside CPA firm, outside legal counsel, and by general counsel prior to filing with the IRS. Form 990, Part VI, Section B, Question 12C Annually, each trustee, principal officer and member of a committee with Board-delegated powers ("interested person") shall sign a statement which affirms that such person a) has received a copy of the conflicts of interest policy, b) has read and understands the policy, c) has agreed to comply with the policy, and d) understands that the organization is a charitable organization and that in order to maintain its federal tax exemption it must engage primarily in activities which accomplish one or more of its tax-exempt purposes. 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 trustee has no vote on the matter involved with the conflict of interest. At the beginning of each Board Meeting and Committee Meeting, the Board Members and Committee Members are asked to disclose if they have a Conflict of Interest on any item contained in the agenda. In addition, the Board Members and Committee Members are also asked to inform the board chair if a Conflict of Interest arises during the course of the Board or Committee Meeting. When such a conflict is disclosed, then the procedure outlined above is implemented. In addition, a Conflict of Interest Schedule is kept with respect to each declared Conflict of Interest during the course of a Board or Committee meeting. On an annual basis, the Nominating and Governance Committee reviews each Conflict of Interest raised by a Board or Committee Member. Also, the Nominating and Governance Committee conducts a bi-annual evaluation of the Board Members' performance during the course of the Board Meetings and Committee Meetings. The review includes but is not limited to the Board Member's engagement, participation, contributions to board business, attendance, and any absence from a meeting due to a conflict of interest. The Conflicts of Interest declared by the Board Members are reviewed on an annual basis by the Nominating and Governance Committee to make sure all policies on Conflict of Interest are adhered to by the Boards, the Committees and the Individual Board or Committee Member. Form 990, Part VI, Section B, Q 15A and 15B; Schedule J, Part 1, Q 3 The Executive Compensation Committee consists of Board Members who are Independent. The process used to determine compensation for the individuals listed on Part VII and Schedule J, Part II include a review by the Independent Board Members after they have received a report of comparability data prepared by an independent company 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 signed within 30 days of the Executive Compensation Committee Meeting. The Executive Compensation Consultant does no other business with the CareSource Family of Companies other than determining the reasonableness of compensation. This compensation consultant's independence is reviewed on an annual basis. This process is followed with respect to all employed corporate officers and the top executives of the CareSource Family of Companies, in order to establish reasonable executive compensation. Form 990, Part VI, Section C, Question 19 The company's Form 990 is available for public inspection upon request. The company's Form 990 is also available on the U.S. nonprofit database website at www.guidestar.org. 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 (1) Change in Net Assets: Capital Contribution from parent Organization CareSource Management Group Co in December, 2015 in the amount of $6,250,000. CareSource Management Group Co PO Box 8738 Dayton OH 45401 311703368 Support Org OH 501(c)(3) 509(a)(3) I NA false CareSource Indiana Inc PO Box 8738 Dayton OH 45401 320121856 Medicaid HMO IN 501(c)(3) 509(a)(2) CSMG false CareSource Georgia Co PO Box 8738 Dayton OH 45401 472408339 Medicaid HMO GA 501(c)(3) 509(a)(2) CSMG false CareSource North Carolina Co (11-25-15) PO Box 8738 Dayton OH 45401 811593512 Medicaid HMO NC 501(c)(3) 509(a)(2) CSMG false CareSource West Virginia Co (1-30-15) PO Box 8738 Dayton OH 45401 473028244 Exchange HMO WV 501(c)(3) 509(a)(2) CSMG false CareSource Life Services Co (12-23-15) PO Box 8738 Dayton OH 45401 811602217 Member Svcs OH 501(c)(3) 509(a)(2) CSMG false CareSource Management Services Co PO Box 8738 Dayton OH 454018738 311703371 Adm Mgmt Svcs OH NA C Corp 0 0 false false false true false false false false false false false false false false true false true true true true