2025-11-14T17:58:41-06:00 2024-12-31 420714325 RSM US LLP 6 S Patterson Blvd Dayton OH 45402 990 2024-01-01 311143265 CareSource Ohio Inc 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 Stephen Ringel Same as C above Dayton OH 454018738 15396375429 0 X www.caresource.com X 1985 OH To make a lasting difference in our members' lives by improving their health and well-being. CareSource Ohio Inc. is a nonprofit HIC licensed by the state of Ohio. 3 0 0 0 0 0 0 0 8448834545 8501413223 76845424 58432261 0 0 8525679969 8559845484 2508586 0 0 0 0 0 0 0 0 7982147617 8462329539 7984656203 8462329539 541023766 97515945 2226959848 2248954422 1407207336 1402066398 819752512 846888024 X CareSource Ohio, Inc.'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 Ohio, Inc. is a health insuring corporation licensed by the state of Ohio and serves members through Dual Eligible Special Needs, Marketplace, Medicaid, Medicare Advantage, and MyCare Ohio plans. 0 0 7299118538 8501413223 CareSource Ohio, Inc. ("CSOH"), is a nonprofit organization established under the state law of Ohio. CSOH 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, CSOH 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. CSOH serves nearly 1.2 million Members in Ohio. CSOH'S membership includes: (1) Medicaid consumers, including families with low income, children, pregnant women, adoption and children in foster care, those who are aged, blind or disabled, (2) Medicaid consumers who are eligible for Home and Community Based services through execution of an annual Provider Agreement with the Ohio Department of Medicaid ("ODM"), (3) Dually eligible consumers for Medicare and Medicaid through Ohio's Dual Demonstration program, MyCare, (4) Medicare Advantage consumers, and (5) a Qualified Health Plan offered through the Federal Health Insurance Marketplace, providing low-cost comprehensive coverage for individuals and families. Medicaid: Our Members get all medically-necessary, Medicaid-covered services at no cost. Examples include preventive check-ups, inpatient and outpatient hospital services, and dental care. Members enrolled in our Ohio Medicaid plans have access to the following services: (1) Rewards programs, (2) One-on-one coaching for up to 24 months with a certified Life Coach, (3) Telehealth to talk to a doctor 24/7/365 using a smartphone or computer,(4) Large provider network for easy access to care,(5) Transportation to and from appointments, food pantries, pharmacies, WIC offices and County Department of Job and Family Services (CDJFS) appointments, (6) Vision and dental care, including checkups and teeth cleanings. Members can also get an allowance for a large selection of eyeglasses and an allowance for contact lenses and fitting, (7) Behavioral health resources that support the health of mind, body and spirit,(8) A team of nurses who can answer health questions 24/7/365, (9) Disease management programs, (10) Local care managers to coordinate health care needs and help connect members to community resources such as utility assistance, housing and food banks, and(11) CareSource mobile app for access to member ID card, "how-to" videos and a quick search for doctors. MyCare Ohio: Plans contract with both Medicare and Ohio Medicaid to provide benefits of both programs to its Members in 12 Ohio counties. To improve the way Medicare and Ohio Medicaid benefits work together, Members must enroll in a MyCare Ohio plan. The plan is for people with disabilities, older adults and individuals who need behavioral health services. CareSource Marketplace: Marketplace plans are available in 86 counties in Ohio. CSOH's Marketplace-qualified Vision and Fitness plans cover more than the essential health benefits. They offer adult vision through EyeMed, and a fitness program. There are no lifetime maximums for most benefits, no medical review for enrollment, and we cover an extensive list of prescription drugs. Members enrolled in our Ohio Marketplace plans have access to the following services: (1) $0 copay telehealth office visits via Teladoc with 24/7 access to U.S.-licensed physicians, (2) Ambulatory patient services (outpatient care), (3) Emergency services,(4) Hospitalization, (5) Pregnancy, maternity and newborn care (both before and after birth), (6) Breastfeeding coverage,(7) Mental health and substance use disorder services, including behavioral health treatment (this includes counseling and psychotherapy), (8) Prescription drugs,(9) Rehabilitative and habilitative services and devices, (10) Laboratory services,(11) Preventive and wellness services and chronic disease management, (12) Pediatric services, including dental and vision care, and (13) Birth control coverage. CareSource Dual Advantage: This is a $0 premium plan that combines the benefits of Medicare and Medicaid into one convenient plan and offers more benefits not covered by either Medicare or Medicaid alone. Members enrolled in our Ohio Dual Advantage plans have access to the following services: (1) $6,000 annual limit for preventive and comprehensive dental care through DentaQuest, (2) $1,000 Flex annual allowance to use toward dental, hearing, and vision, (3) Unlimited transportation to health-related appointments including gym, pharmacy, and grocery, (4) $150 monthly allowances for over-the-counter (OTC) items and healthy food at participating retailers, (5) Two meals per day for 14 days after observation or inpatient stay, (6) TruHearing Advanced Level hearing aids, one per ear every three years, (7) Silver&Fit gym membership, home fitness kit, digital workouts, and online resources, (8) Routine vision exam, $450 annual allowance for glasses and/or contacts through EyeMed, (9) BrainHQ online brain health improvement tool, (10) Personal Emergency Response System (PERS) that connects the member to 24-hour help with the push of a button, and (11) 60 hours per year for companion care services. 2024 Highlights We are committed to working every day alongside providers and community partners to make a difference in the lives of our Members as well as communities across the state. One of the handful of ways CSOH supported the whole health of Ohioans in 2024 was through the Outcomes Acceleration for Kids ("OAK") Initiative.OAK is a new program, used as an illustration that Medicaid-managed care is shifting its focus to positive health outcomes instead of the business of care. It was introduced as an innovative program, a partnership among children's hospitals, Medicaid-managed care plans, and the Ohio Department of Medicaid. OAK is a rapid-cycle improvement project, which improves coordination of communication between evolvements in the clinical setting and Medicaid-managed care. It focuses on well care instead of sick care, follow-up care for families after leaving the emergency department, and access to life-saving care for children with sickle cell disease. CSOH invested over $1,125,000 in 2024 under this program. 7299118538 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 98 0 1 0 0 0 0 0 0 0 0 0 0 0 1 0 X 3 0 0 0 0 0 1 1 1 1 1 0 0 1 1 1 1 1 1 0 0 0 OH X Lawrence Smart 9372243300 PO Box 8738 Dayton OH 454018738 Erhardt Preitauer Chair/Director 8.00 52.00 X X 0 6076721 6124441 Richard Topping Secretary/Director (To 5/31) 8.00 52.00 X X 0 2659280 831276 Edward Stubbers Secretary/Director (Eff 6/1) 8.00 52.00 X X 0 1060829 1137246 Lawrence Smart CFO, Treasurer/Director 8.00 52.00 X X 0 1657234 1813852 Stephen Ringel President 59.00 1.00 X 0 1163559 440637 Stephanie Williams Assistant Treasurer 10.00 50.00 X 0 936707 1020408 Jai Pillai Former Chief Operating Ofr 0.00 0.00 X 0 244761 0 0 13799091 11367860 0 1 1 0 Ohio Hospital Association 155 East Broad St Suite 301 Columbus OH 43215 Medical Services 1006545324 Express Scripts Inc 21653 Network Place Chicago IL 60673 Pharmacy Services 378539411 Childrens Hospital and Physicians Health 700 Childrens Drive Columbus OH 43205 Medical Services 330862997 DentaQuest Group Inc 1800 West End Avenue Suite 102 Nashville TN 37203 Medical Services 229618039 Akron Children's Health Collaborative One Perkins Square Akron OH 44308 Medical Services 108271007 90 Medicaid 524114 7733441018 7733441018 Premiums 524114 699224842 699224842 Medicare Advantage 524114 68511960 68511960 Capitation Write-Off 524114 235403 235403 8501413223 58517472 58517472 6836444734 6836529945 -85211 -85211 -85211 8559845484 8501413223 0 58432261 2080681 2080681 1127789 1127789 153375 153375 922345 922345 238117336 14637738 223479598 7774474 7774474 108957802 108957802 11519056 11519056 3606593 3606593 205086 205086 5059589 5059589 Medical Expenses 6986707321 6986707321 Mgmt Fees CareSource Mg 486579530 99828878 386750652 ODM Franchise Fee Passt 433039417 55077752 377961665 Pharmacy Expenses 139297563 139297563 37181582 3569286 33612296 8462329539 7299118538 1163211001 0 283152770 675689600 960659348 521847490 8178241 14382261 974969489 1037035071 2226959848 2248954422 1113661248 1214583070 260844266 182768131 32701822 4715197 1407207336 1402066398 X 819752512 846888024 819752512 846888024 2226959848 2248954422 X 97515945 9391507 -79771940 X 0 1 X 1 0 X 170984 170984 9247968015 9724963389 10010802585 8448834545 8501413223 45933981757 9248138999 9724963389 10010802585 8448834545 8501413223 45934152741 0 0 0 45934152741 22656125 26291303 53326439 76845424 58517472 237636763 22656125 26291303 53326439 76845424 58517472 237636763 9270795124 9751254692 10064129024 8525679969 8559930695 46171789504 0.99490 0.99540 0.00510 0.00460 X 0 0 0 0 0 0 0 0 1 306750 306750 0 Part II-B, Line 1: $306,750 is the allocable portion of the Organization's dues paid to Ohio Association of Health Plans, America's Health Insurance Plans, and other trade associations for lobbying and grassroots efforts conducted by the trade association on behalf of its members. 0 Related Party Payable 4715197 4715197 X 8557528289 0 8557528289 2317195 2317195 8559845484 8461064442 0 8461064442 1265097 1265097 8462329539 Part X, Line 2: As outlined in CareSource's Audited Consolidated Financial Statements, which include the activity of CareSource Ohio Inc.: The Company annually reviews its tax positions and has determined that there are no material uncertain tax positions that require recognition in the consolidated financial statements. Currently, tax years 2021-2023 are open for audit by the Internal Revenue Service. Part XI, Line 4b - Other Adjustments: STAT-to-GAAP Adjustment Part XII, Line 4b - 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 4b and Part XII, Line 4B, 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/Director (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/Director (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 Stephen Ringel President 0 441077 0 397715 0 324767 0 420953 0 19684 0 1604196 0 591125 Jai Pillai Former Chief Operating Ofr 0 0 0 0 0 244761 0 0 0 0 0 244761 0 0 Form 990, Schedule J, Part I, Line 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, Line 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, Line 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; Stephen Ringel $227,166; 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 Ohio, Inc. CareSource is a nonprofit corporation that is 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 Ohio, Inc., has the authority to appoint CareSource Ohio, Inc.'s board of directors. Form 990, Part VI, Section A, line 7b The Audit Committee, Risk Committee, and Compensation Committee of CareSource, the sole member of CareSource Ohio, Inc., have full authority as committees to act on behalf of CareSource Ohio, Inc. 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 Ohio Inc.'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). Statutory financial statements for the organization are available on the Ohio Department of Insurance's website at www.ins.ohio.gov. The Company's Form 990 is available on the U.S. nonprofit database website at www.guidestar.org. The Company's Articles of Incorporation are available on the Ohio Secretary of State's website at www.sos.state.oh.us. Form 990, Part XI, line 9: Write-off of advances to behavioral health providers 120,710. Distribution to CareSource -80,000,000. Refund of Charitable Contribution Paid in 2022 107,350. Form 990, Part VI, Section C, Question 17 A copy of Form 990 is not required to be filed with the state of Ohio. CareSource Ohio, Inc. does, however, file the Ohio Annual Report with the Ohio Attorney General. Therefore, Ohio is listed on Form 990, Part VI, Section C, Question 17. The CareSource Foundation PO Box 8738 Dayton OH 454018738 562582561 Grantmaking OH 501(c)(3) Line 12b, II CareSource 0 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 Georgia Inc PO Box 8738 Dayton OH 454018738 472408339 HMO Ins Plan GA 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 West Virginia PO Box 8738 Dayton OH 454018738 473028244 HMO Ins Plan WV 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 Diversity & Social Impact Investment 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 HMO Ins Plan 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 Accident and Health; Life Ins 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