2025-11-14T17:58:42-06:00 2024-12-31 420714325 RSM US LLP 6 S Patterson Blvd Dayton OH 45402 990 2024-01-01 472408339 CareSource Georgia Co CARE 9372243300 Po Box 8738 Dayton OH 454018738 Lawrence Smart CFO 9372243300 2025-11-14 1 0 Karen O Crim P00368385 9372980201 2024 2025-03-06 01:10:19Z Jason Bearden Same as C above Dayton OH 45401 2276298898 0 X N/A X 2014 GA To make a lasting difference in our members' lives by improving their health and well-being. CareSource Georgia Co. is a nonprofit HMO licensed by the state of Georgia. 3 1 0 0 0 0 0 0 1593070521 1459136627 15463008 8336335 0 0 1608533529 1467472962 0 0 0 0 0 0 0 0 0 1481484216 1412434190 1481484216 1412434190 127049313 55038772 549096937 657057031 347634600 399877552 201462337 257179479 X CareSource Georgia Co.'s mission is to make a lasting difference in our members' lives by improving their health and well-being. The organization's vision is to transform lives through innovative health and life services. (Continued on Schedule O)CareSource Georgia Co. is a health maintenance organization licensed by the state of Georgia and serves members through Marketplace, Medicaid, Dual Eligible Special Needs Plans, and the PeachCare for Kids and Planning for Healthy Babies programs. 0 0 1265127680 1459136627 CareSource Georgia Co. ("CSGA ") is a nonprofit corporation established under the state laws of Georgia. On July 18, 2017, CSGA received a determination letter from the Internal Revenue Service, recognizing CSGA as an organization exempt from federal income tax under Section 501(c)(3) of the Internal Revenue Code, effective as of the date of CSGA's formation. CSGA is a member of the CareSource group of nonprofit tax-exempt organizations (the "CareSource Public Charities"). (Continued on Schedule O)The sole member of the CareSource Public Charities is CareSource, an Ohio nonprofit corporation that is tax-exempt under section 501(c)(3) of the Internal Revenue Code of 1986 (the "Code"). The CareSource Public Charities' primary activity for the last three decades has been to provide nonprofit Medicaid, Medicare, and Marketplace health maintenance organization ("HMO") services.As a mission-driven organization, CSGA follows the guidance of the CareSource Public Charities and is focused on transforming health care with innovative programs that address the social determinants of health, health equity, prevention and access to care.CSGA began providing care to participants in its Medicaid HMO plan on July 1, 2017. CSGA serves individuals meeting the low-income thresholds for Medicaid eligibility. CSGA participates in the State of Georgia's Planning 4 Healthy Babies program, or P4HB, which is a demonstration waiver program for women meeting Medicaid income thresholds designed to help reduce the number of low-birth-weight babies born each year. Through the P4HB program, CSGA offers family planning services, health care coverage for certain pregnancy-related chronic conditions, and case management services to women at risk for a low-birth-weight delivery. CSGA launched a Marketplace plan in 2020, offering affordable individual and family plans tailored for any budget, as well as a Dual Eligible Special Needs Plan in 2021.Over the past few years, CareSource Georgia has partnered with Learning to Serve, a Georgia student scholarship organization designed to help students earn a scholarship to attend an accredited K-12 private school. In 2024 alone, CSGA contributed $632,500 to give Georgia fostering and adoptive families the help they needed to make the best decisions and help remove barriers to education for their children. Student scholarships are awarded on merit, namely community service, which the applicants are required to document within the application process. CSGA is the first nonprofit health care plan chosen to serve Georgia Medicaid and PeachCare for Kids Members enrolled in Georgia Families. We believe in people over profits, and we are committed to providing even more enhanced benefits to help improve the health and well-being of our Members. Members enrolled in our Georgia Families plan have access to the following services:(1) Earning rewards each year for completing healthy activities,(2) Dental benefits for kids and adults,(3) Vision benefits,(4) A personal life coach for up to 24 months, help finding a job, and rides to job training and interviews. Job coaches help with interview practice and resumes and provide support after starting a new job,(5) Free memberships to youth organizations and sports physicals,(6) Free breast pumps, free pregnancy tests through a pharmacist, baby showers and help with childcare,(7) CareSource 24, the 24/7/365 Nurse Advice Line and Telehealth RelyMD to access a doctor 24/7/365 using a smartphone or computer, (8) A bank account from Fifth Third Bank with no monthly service charge, no balance requirement, no overdraft fees and a debit card for purchases, (9) Medication therapy management,(10) Help with asthma, ADHD, autism, behavioral health, high blood pressure, chronic kidney disease and more, and (11) Transportation to doctor visits, WIC office, food pantries, education and jobs, and CareSource events. 1265127680 1 0 0 1 0 0 0 0 0 0 0 0 0 0 1 1 1 1 0 0 0 0 0 0 0 0 0 0 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 1 0 0 0 1 10 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 X 3 1 0 0 0 0 1 1 1 1 1 0 0 1 1 1 1 1 1 0 0 0 X Lawrence Smart 9372243300 PO Box 8738 Dayton OH 454018378 Erhardt Preitauer Chair/Director 8.00 52.00 X X 0 6076721 6124441 Lawrence Smart CFO, Treasurer/Director 8.00 52.00 X X 0 1657234 1813852 Veda Johnson Director 1.00 0.00 X 0 1000 0 Richard Topping Secretary (To 5/31) 8.00 52.00 X 0 2659280 831276 Jason Bearden President 30.00 30.00 X 0 988498 397522 Stephanie Williams Assistant Treasurer 10.00 50.00 X 0 936707 1020408 Edward Stubbers Secretary (Eff 6/1) 8.00 52.00 X 0 1060829 1137246 Jai Pillai Former Chief Operating Ofr 0.00 0.00 X 0 244761 0 0 13625030 11324745 0 1 1 0 Express Scripts Inc One Express Way St Louis MO 63121 Pharmacy Services 165728336 Scion Dental N92 W14612 Anthony Avenue Menomonee Falls WI 53051 Medical Services 65322184 Superior Vision Services Inc 939 Elkridge Landing 200 Linthicum MD 21090 Medical Services 3059399 Georgia Department of Public Health 2 Peachtree Street NW 15th Fl Atlanta GA 30303 Medical Services 2695443 National Imaging Associates Inc 140100 Magellan Plaza Maryland Heights MO 63043 Medical Services 757681 7 Medicaid 524114 1231208647 1231208647 State Health Insurance Exchange 524114 227774606 227774606 Medicare Advantage 524114 153374 153374 1459136627 8336295 8336295 808825976 808825936 40 40 40 1467472962 1459136627 0 8336335 185877 185877 554839 554839 30516 30516 107615 107615 27980393 94982 27885411 3294451 3294451 6340095 21055 6319040 19828730 19828730 3197607 3197607 820538 820538 534556 534556 Medical Expenses 1096645206 1096645206 Pharmacy Expenses 145951504 145951504 Mgmt Fees CareSource Mg 93124143 20713753 72410390 Claims Processing Admin 7710306 1701180 6009126 6127814 6127814 1412434190 1265127680 147306510 0 121001065 115958276 314867960 443075431 160533 478661 113067379 97544663 549096937 657057031 214622434 268575447 118667267 118502359 14344899 12799746 347634600 399877552 X 201462337 257179479 201462337 257179479 549096937 657057031 55038772 678370 0 X 0 1 X 1 0 X 882554030 1262629760 1552371235 1593070521 1459136627 6749762173 882554030 1262629760 1552371235 1593070521 1459136627 6749762173 0 0 0 6749762173 505487 235442 4590668 15463008 8336295 29130900 505487 235442 4590668 15463008 8336295 29130900 883059517 1262865202 1556961903 1608533529 1467472922 6778893073 0.99570 0.99640 0.00430 0.00360 X 0 0 0 0 0 0 0 0 1 61032 61032 0 Part II-B, Line 1: Form 990, Schedule C, Part II-B, Line 1i $61,032 is the allocable portion of the Organization's dues paid to various trade associations for lobbying and grassroots efforts conducted by the trade association on behalf of its members. 0 Related party payable 12799746 12799746 X 1478782544 11370561 11370561 1467411983 60979 60979 1467472962 1423714682 11280491 11280491 1412434191 0 1412434191 Part X, Line 2: As outlined in CareSource's Audited Consolidated Financial Statements, which include the activity of CareSource Georgia 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 2021-2023 are open for audit by the Internal Revenue Service. Part XI, Line 2d - Other Adjustments: STAT-to-GAAP Adjustment Part XII, Line 2d - Other Adjustments: STAT-to-GAAP Adjustment Form 990, Schedule D, Parts XI and XII: The entity has separate audited financial statements prepared on a statutory ("STAT") basis in compliance with The National Association of Insurance Commissioners ("NAIC") requirements. The entity is also included in the consolidated audited financial statements of the member entity, CareSource, which are prepared on a GAAP basis. The 990 has been prepared consistent with the GAAP-basis financial statements. The amounts included on Schedule D, Part XI, Lines 2D and Part XII, Line 2D, are comprised of the STAT-to-GAAP adjustments. 1 1 0 0 0 0 0 0 0 Erhardt Preitauer Chair/Director 0 1407328 0 2654031 0 2015362 0 6101217 0 23224 0 12201162 0 3942595 Richard Topping Secretary (To 5/31) 0 279104 0 561640 0 1818536 0 815252 0 16024 0 3490556 0 1122987 Lawrence Smart CFO, Treasurer/Director 0 589886 0 570124 0 497224 0 1794168 0 19684 0 3471086 0 656889 Edward Stubbers Secretary (Eff 6/1) 0 452231 0 322470 0 286128 0 1117562 0 19684 0 2198075 0 441638 Stephanie Williams Assistant Treasurer 0 368179 0 362976 0 205552 0 1003011 0 17397 0 1957115 0 479710 Jason Bearden President 0 381655 0 336608 0 270235 0 366192 0 31330 0 1386020 0 490945 Jai Pillai Former Chief Operating Ofr 0 0 0 0 0 244761 0 0 0 0 0 244761 0 0 Veda Johnson Director 0 0 0 0 0 1000 0 0 0 0 0 1000 0 0 Form 990, Schedule J, Part I, Question 3: CareSource Management Services LLC ("CSMS"), a related entity, utilizes a compensation committee, independent compensation consultant, compensation survey or study, and review of Form 990 of other organizations. Form 990, Schedule J, Part I, Question 4a: CSMS made severance payments to Richard Topping and Jai Pillai during the calendar year. The payments are included in Part VII, Column E and it is reported on Schedule J, Part II, Column B(iii). The terms and conditions of the confidential severance agreements are available to the Internal Revenue Service upon request. Form 990, Schedule J, Part I, Question 4b: CSMS provides certain corporate officers, directors, key employees, and highly compensated executives with a supplemental nonqualified retirement plan. Amounts are accrued monthly for plan participants. The plan provides 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 plan provides for normal terms and conditions contained in a standard nonqualified retirement plan. The following listed person was paid under the plan in 2024: Richard Topping $39,893. The payment is included in Part VII, Column E and it is reported on Schedule J, Part II, Column B(iii). CSMS provides certain corporate officers, directors, key employees, and highly compensated executives with a long-term incentive plan. The plan provides compensation to the participants based on annual and long-term goals. The plan will pay out if these goals, or a subset of these goals, are achieved over a three-year period. The amounts are subject to forfeiture if certain employment conditions and vesting periods are not met. Amounts are included in Part VII, Column F and reported on Schedule J, Part II, Column C when accrued and included in Part VII, Column E and reported on Schedule J, Part II, Column B(iii) in the year paid. The following listed persons participated in and were paid under the plan in 2024: Erhardt Preitauer $1,516,425; Lawrence Smart $371,773; Richard Topping $774,290; Edward Stubbers $188,273; Jason Bearden $187,560; and Stephanie Williams $128,076. CSMS provides certain corporate officers, directors, key employees, and highly compensated executives with a management incentive plan. The plan provides compensation to the participants based on certain financial measurements of the Company, which are calculated annually. The plan will pay out if the targets are achieved over a three-year period. If a participant leaves their employment prior to this three-year performance period, they may be entitled to a pro-rated payment if the targets are achieved over the three-year period. Amounts are included in Part VII, Column F and reported on Schedule J, Part II, Column C when accrued and included in Part VII, Column E and reported on Schedule J, Part II, Column B(iii) in the year paid. No amounts were paid in 2024 under the plan. Form 990 , Schedule J, Part II: All compensation amounts reported on Schedule J, Part II for all listed persons are paid by CSMS. Form 990, Part VI, Section A, line 6 CareSource is the sole member of CareSource Georgia Co. CareSource is recognized as exempt from federal income taxation under Internal Revenue Code ("IRC") Section 501(c)(3). Form 990, Part VI, Section A, line 7a CareSource, the sole member of CareSource Georgia Co., has the authority to appoint CareSource Georgia Co.'s board. Form 990, Part VI, Section A, line 7b The Audit Committee, Risk Committee, and Compensation Committee of CareSource, the sole member of CareSource Georgia Co., have full authority as committees to act on behalf of CareSource Georgia Co. to the extent permitted by applicable law. Each Committee's duties, responsibilities, and membership shall be defined by the respective Committee's charter. Form 990, Part VI, Section B, line 11b The Form 990 was provided to each voting member of the filing organization's governing body for review prior to filing. Additionally, the Form 990 was reviewed by CareSource's Audit Committee, VP Treasury, Internal Tax Department, and Internal General Counsel as well as an external CPA firm and legal counsel. Form 990, Part VI, Section B, line 12c Annually, each director, principal officer, and member of a committee with board-delegated powers ("interested person") shall confirm that they have received a copy of the CareSource Conflicts of Interest policy and have read, understood, and agree to comply with the policy. Interested Persons have an obligation to immediately report any Conflicts of Interest (including any relationships, positions, or circumstances that could contribute to a Conflict of Interest). All relevant information reported through the Conflict-of-Interest Policy will be sent to the Chairman of the Board for review. If the Interested Person with the Conflict of Interest is the Chairman of the Board, then the required disclosure must be provided to the Chief Legal Officer of CareSource. If it is not entirely clear whether a Conflict of Interest exists, then the person with the potential conflict must disclose the circumstances to CareSource's Chief Legal Officer. The Chief Legal Officer will consult with the Corporation's Corporate Compliance Officer or the Chairman of the Board to determine whether there exists a Conflict of Interest that is subject to this policy. Before Board action or other action by the organization on a Transaction that involves a Conflict of Interest, an Interested Person who knows he or she has a Conflict of Interest must have disclosed to the Board all facts material to the Conflict of Interest. The Chairman of the Board may postpone Board or other corporate action on a Transaction until the Interested Person provides written information relating to the Conflict of Interest. An Interested Person who knows he or she has a Conflict of Interest must not participate in the Board's discussion of the Transaction except to disclose material facts and respond to questions. The Interested Person must not attempt to influence the Board's action on the Transaction, either at or outside the meeting. Prior to voting, the Board must be given an opportunity to discuss the Transaction without the person who has the Conflict of Interest being present. A Transaction involving a Conflict of Interest may be approved by the Board if the material facts as to the Transaction and the Conflict of Interest are fully disclosed or known to the Board and the Board in good faith determines after reasonable investigation that (a) the Board is aware of all material facts concerning the Transaction and the Interested person's interest in the Transaction; (b) the organization is entering into the Transaction for its own benefit; (c) the Transaction is fair and reasonable as to the organization; and (d) the organization could not have obtained a more advantageous arrangement with reasonable effort under the circumstances. The Person with the Conflict of Interest must not vote on the Transaction and must not be present in the room when the vote is taken. Form 990, Part VI, Section C, line 19 CareSource Georgia Co.'s ("the Company") 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 Georgia Secretary of State's website at www.sos.ga.gov. CareSource PO Box 8738 Dayton OH 454018738 311703368 Supporting OH 501(c)(3) Line 12b, II N/A 0 CareSource Indiana Inc PO Box 8738 Dayton OH 454018738 320121856 HMO Ins Plan IN 501(c)(3) Line 10 CareSource 0 CareSource West Virginia PO Box 8738 Dayton OH 454018738 473028244 HMO Ins Plan WV 501(c)(3) Line 10 CareSource 0 CareSource Kentucky Co Po Box 8738 Dayton OH 454018738 464991603 HMO Ins Plan KY 501(c)(3) Line 10 CareSource 0 CareSource Life Services Co (Dissolved 111524) PO Box 8738 Dayton OH 454018738 811602217 No activity OH 501(c)(3) Line 10 CareSource 0 CareSource Ohio Inc PO Box 8738 Dayton OH 454018738 311143265 HIC Ins Plan OH 501(c)(3) Line 10 CareSource 0 The CareSource Foundation PO Box 8738 Dayton OH 454018738 562582561 Grantmaking OH 501(c)(3) Line 12b, II CareSource 0 CareSource Diversity & Social Impact Investment Fund LLC 50 East 91st Street Suite 213 Indianapolis IN 46240 871811106 Investing DE N/A 0 0 CareSource Midwest Fund LLC 415 12th Ave SE Cedar Rapids IA 52401 883585337 Investing DE N/A 0 0 ImagineCare Holdings LLC PO Box 8738 Dayton OH 454018738 932340017 Holding Co DE N/A 0 0 HAP Empowered Holding LLC PO Box 8738 Dayton OH 454018738 923877012 Holding Co DE N/A 0 0 CareSource Bayou Holding LLC PO Box 8738 Dayton OH 454018738 883042610 Holding Co DE N/A 0 0 CareSource Virginia Co (Dissolved 101724) PO Box 8738 Dayton OH 454018738 811727271 No activity VA N/A C 0 CareSource Arkansas Health Plan Co PO Box 8738 Dayton OH 454018738 844476729 COA Insurance AR N/A C 0 Kids' CareAlliance Co (Dissolved 111324) PO Box 8738 Dayton OH 454018738 854022039 No activity OH N/A C 0 CareSource Oklahoma Health Plan Co PO Box 8738 Dayton OH 454018738 854038326 HMO Ins Plan OK N/A C 0 CareSource Kansas LLC PO Box 8738 Dayton OH 454018738 873411276 HMO Ins Plan KS N/A C 0 CareSource Passe LLC PO Box 8738 Dayton OH 454018738 863112470 RBPO Ins Plan AR N/A C 0 Columbus Organization Holdings LLC PO Box 8738 Dayton OH 454018738 814132952 Holding Co DE N/A C 0 CareSource Tennessee Co PO Box 8738 Dayton OH 454018738 874254502 COA Insurance TN N/A C 0 Columbus Medical Services Inc PO Box 8738 Dayton OH 454018738 300975112 No activity MD N/A C 0 CareSource North Carolina Co PO Box 8738 Dayton OH 454018738 873079479 HMO Ins Plan NC N/A C 0 CareSource Iowa Co (Dissolved 112624) PO Box 8738 Dayton OH 454018738 881429834 HMO Ins Plan IA N/A C 0 CareSource Florida Co PO Box 8738 Dayton OH 454018738 883601120 HMO Ins Plan FL N/A C 0 CareSource Bayou Health LLC PO Box 8738 Dayton OH 454018738 883401520 HMO Ins Plan TX N/A C 0 CareSource Military & Veterans Co PO Box 8738 Dayton OH 454018738 932552094 Tricare CPD OH N/A C 0 GCRE Protected Cell No 3 - CS LLC PO Box 8738 Dayton OH 454018738 933077861 Captive Ins MT N/A C 0 HAP CareSource New Center One Ste 110 3031 W Grand Detroit MI 48202 383123777 HMO Ins Plan MI N/A C 0 CareSource Reinsurance II LLC PO Box 8738 Dayton OH 454018738 872901879 Captive Ins MT N/A C 0 GCRE Protected Cell No 2 - MS LLC (Incorporated 42524) PO Box 8738 Dayton OH 454018738 992726467 Captive Ins MT N/A C 0 0 0 0 0 0 0 0 0 0 0 0 0 1 1 0 1 0 1 0