2013-11-14T08:06:50-06:00 2012-12-31 990 2012-01-01 311143265 CareSource % JANET FERNANDES CARE 9372243300 PO Box 8738 Suite Dayton OH 454018738 L Tarlton Thomas III 2013-11-12 2012 2016-02-24 21:20:13Z Pamela B Morris Same as C above Dayton OH 45401 3459621242 false X www.caresource.com X 1985 OH To make a difference in the lives of underserved people by improving their health care. CareSource offers a full spectrum of services for Medicaid managed care members. 8 5 0 0 0 0 0 2707144733 3345474404 15617586 21884951 0 0 2722762319 3367359355 84750 65400 0 0 0 0 0 0 0 2592655525 3246675981 2592740275 3246741381 130022044 120617974 995546954 1002260430 585019612 465222035 410527342 537038395 CARESOURCE'S VISION IS TO BE AN INNOVATIVE LEADER IN THE MANAGEMENT OF QUALITY PUBLIC SECTOR HEALTH CARE PROGRAMS. THE ORGANIZATION'S MISSION IS TO MAKE A DIFFERENCE IN THE LIVES OF UNDERSERVED PEOPLE BY IMPROVING THEIR HEALTH CARE. CARESOURCE CONSIDERS THE ORGANIZATION'S MISSION ITS "HEARTBEAT" AND IT IS PASSIONATELY EMBRACED BY ALL EMPLOYEES OF THE CARESOURCE FAMILY OF COMPANIES. CARESOURCE IS A NONPROFIT INDEPENDENT MISSION-DRIVEN MEDICAID HEALTH INSURING CORPORATION (COMMONLY REFERRED TO AS A HEALTH MAINTENANCE ORGANIZATION OR HMO) LICENSED BY THE STATE OF OHIO. false false 3125973105 65400 3345474404 CareSource is a nonprofit Medicaid health insuring corporation with over 23 years' experience providing services to over 887,000 Medicaid members in Ohio. The organization provides services to Ohios Medicaid members through execution of an annual Provider Agreement with the Office of Medical Assistance ("OMA"), formerly known as the Ohio Department of Job and Family Services. CareSource has been accredited by two national organizations, NCQA and URAC. CareSource was awarded Medicaid HMO Commendable Health Plan Accreditation by the National Committee for Quality Assurance ("NCQA"). NCQA is a private, non-profit organization dedicated to transforming health care quality through measurement, transparency and accountability. They consistently raise the bar in health care demanding quality and improvement. Ohio, like other states, has put an increased focus on NCQA accreditation to ensure all Medicaid plans are ranked on a standard of quality and health outcomes. CareSource pursued NCQA accreditation in addition to maintaining its URAC accreditation for health plans and health call centers. Both entities demonstrate CareSource's commitment to providing quality to our membership and serve the health care needs of the underserved. In 1989, CareSource pioneered the state's first mandatory Medicaid managed care program in Ohio. The organization has experienced significant growth in the 23 years that it has operated and is now the second largest Medicaid managed care plan in the country. Over that time CareSource has garnered over 54% of the state wide managed care market share. CareSource spends over 96% of capitation revenue on program related expenses serving its Medicaid members. CareSource has the highest voluntary enrollment rate and the lowest voluntary disenrollment rate of all participating Medicaid Managed care plans in Ohio. Currently, the programs serve Covered Families and Children Medicaid, including Healthy Start and Healthy Families, and Aged, Blind or Disabled Medicaid members. In addition, CareSource has a contract with The Centers for Medicare and Medicaid Services ("CMS") to operate a Dual Eligible Medicare Advantage/Special Needs Plan called CareSource Advantage, available to those who are eligible for Medicare Part A and Part B, as well as Medicaid. At the core of its mission, CareSource focuses on prevention with a goal of improving member health, the quality of health care services received, and accessibility of health care services for Medicaid consumers via an innovative health and wellness methodology. CareSource has a broad, state-wide provider network including many primary care and specialist physicians, hospitals, nursing facilities, home health care agencies, and other medical providers who provide medical care as well as assist in the coordination of member care. In addition, CareSource offers 24 hour call center coverage to provide around the clock medical advice to help members access appropriate care when they need it. CareSource reaches out to members, in their homes and communities, through case management and outreach services, to assess needs and to help coordinate their care with the healthcare system. From high risk pregnancy to member education and advocacy, personal interaction proves crucial in coordinating the needed medical and community support services. Member and provider communication provides additional health information. In 2012, CareSource successfully responded to a request for proposal to serve Ohioans who are eligible for both Medicare and Medicaid under a dual eligible demonstration program named the MyCare Ohio program. CareSource will enter into a three way contract with Ohio and The Centers for Medicare and Medicaid Services and begin serving these new members in March 2014. In July 2012, CareSource launched a Medication Therapy Management program with Outcomes MTM. The Medication Therapy Management program engages community pharmacists to assist our members with their pharmacy and overall health care needs. Pharmacists provide complete medication reviews to help members with their medications. By providing this service, CareSource has decreased unnecessary hospitalizations and emergency room visits while improving the health of our members. In the first year, the MTM program serviced over 60,000 members. CareSource has provided enhanced benefits to its Members which are in addition to required benefits as defined by OMA for Ohio Medicaid Managed Care Plans. In order to ensure the Member is able to access the most appropriate medical care, CareSource provides transportation services to a medical provider's office. In addition, CareSource does not charge any Member a co-pay for any pharmacy product, dental visit, vision examination, vision hardware or non-emergent emergency room visits. CareSource provides administrative services at no charge to Montgomery County, Ohio's program called Montgomery County Care. Montgomery County Care provides ambulatory insurance to qualifying uninsured individuals living in Montgomery County. The health coverage includes primary care services and certain pharmacy products. Montgomery County and CareSource have served individuals living in Montgomery County with no health insurance since June, 2010. Finally, pregnant Members can participate in the "Babies First" Member Incentive Program to incentivize that moms-to-be receive early and on-going prenatal care. All told, in 2012, CareSource paid approximately Sixteen Million Eight-Hundred Dollars ($16,800,000) above the required Ohio Medicaid Managed Care Program Benefits in order to make a difference in the lives of underserved people by improving their health care. In support of CareSource's commitment to its charitable purposes, its appointed trustees and committee members earn charitable credits for each meeting attended. At year-end, the trustees and committee members designate their credits to their Internal Revenue Code Section 501(c)(3) tax exempt charity of choice. Charitable donations in the amount of $60,000 were paid or accrued in 2012 under this Policy by the organization. CareSource is a supported organization to The CareSource Foundation, a related Internal Revenue Code Section 501(c)(3) tax exempt organization. The CareSource Foundation provides opportunities to advance innovative solutions and address healthcare needs of the underserved through grants, outreach, medical expertise, strategic community partnerships and volunteerism. The Foundation funds responsive grants for targeted areas of need, which are given to individual non-profit organizations or a collaboration of non-profits through a single year grant. The CareSource Foundation also funds signature grants with numerous regional, state and/or national partners all focused on creating sustainable, high-impact change in one of two key areas: childhood obesity and programs to support basic health needs for the uninsured. 3125973105 true false false true false false false false false false false false false true true false true false false false false false false false false false true false true false false false false false false false true false false false false false true true false false false true 9841 0 0 false false false false false false false false false false X 8 5 false false false false true false false true true false false true true true true true true true true false OH X JANET FERNANDES 9372243300 PO BOX 8738 Dayton OH 454018738 X Michael E Ervin MD 1.0 2.0 X 0 0 0 William F Marsteller DC 1.0 1.0 X 0 0 0 Craig Brown 1.0 1.0 X 0 0 0 Morris L Brown MD 1.0 1.0 X 0 0 0 David T Miller 1.0 3.0 X 0 0 0 Ellen S Leffak 1.0 3.0 X 0 0 0 Lisa Kloppenberg 1.0 0.0 X 0 0 0 Pamela Morris 45.0 15.0 X X 1443134 0 2016078 Craig Thiele MD 45.0 15.0 X 940738 0 565026 Bobby Jones 45.0 15.0 X 0 447413 656767 L Tarlton Thomas III 45.0 15.0 X 557429 0 373277 Janet Grant 45.0 15.0 X 433058 0 381065 3374359 447413 3992213 4 false true true CVS Caremark 221 N Charles Lindbergh Dr SALT LAKE CITY UT 84116 Pharmacy Services 740640784 Nationwide Childrens Hosp Prtnrs 4 700 Childrens Dr COLUMBUS OH 43205 Capitation/Medical 277847211 Cleveland Clinic Found Consol Enti 9500 Euclid Ave CLEVELAND OH 44195 Medical Services 171255209 The Metrohealth System 2500 Metrohealth Dr CLEVELAND OH 44109 Medical Services 120103262 Univ Hospitals of Cleveland CONSOL 11100 Euclid Ave CLEVELAND OH 44106 Medical Services 119952962 1618 0 MEDICAID & MEDICARE 524114 3345474404 3345474404 3345474404 20129113 20129113 0 0 0 0 0 90482725 3535000 90161887 2100000 320838 1435000 1755838 1755838 0 0 0 0 3367359355 3345474404 21884951 65400 65400 0 0 0 0 0 0 0 0 0 0 0 0 1232721 1232721 355212 56369 298843 227022 18076 208946 0 83097 83097 28129446 10782085 17347361 921679 63881 857798 9412624 792777 8619847 11751995 11751995 0 8254440 8254440 2394394 1590063 804331 0 968750 506467 462283 720189 720189 0 0 1195815 1195815 MEDICAL EXPENSE 2432153472 2432153472 PHARMACY EXPENSE 624566432 624566432 MGMT FEES TO CSMG/CSMS 117918676 55265146 62653530 AMORTIZATION BONDS 5652251 5652251 737766 112937 624829 3246741381 3125973105 120768276 0 144107 5986544 410480260 257207688 0 0 132711078 175476722 0 0 0 0 0 0 0 0 63250 69527 1603006 1603006 2100000 396466199 561965068 0 0 678507 1554881 0 0 52903553 0 995546954 1002260430 521961421 452161702 0 0 1785000 0 55944100 0 0 0 0 0 0 0 0 0 5329091 13060333 585019612 465222035 X 410527342 537038395 0 0 0 0 410527342 537038395 995546954 1002260430 X 120617974 5066886 0 0 0 826193 X X false true X true false X 0 0 0 0 0 0 1777551102 2295286751 2364449472 2707144733 3345474404 12489906462 0 0 0 1777551102 2295286751 2364449472 2707144733 3345474404 12489906462 0 0 0 12489906462 15118278 11648372 13462665 16017679 20129113 76376107 0 15118278 11648372 13462665 16017679 20129113 76376107 0 0 1792669380 2306935123 2377912137 2723162412 3365603517 12566282569 0.99392 0.99323 0.00608 0.00677 X false true false false false false true 414985 false true 66119 481104 false false Lobbying Activities Form 990, Schedule C, Part II-B, Line 1B Staff attended functions and meetings with government officials and legislators to discuss public health care programs. Lobbying Activity with Legislators 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 public health care programs. Trade Association Dues attributable to Lobbying Form 990, Schedule C, Part II-B, Line 1i $66,119 is the allocable portion of the Organization's dues paid to America's Health Insurance Plans, Association for Community Affiliated Plans and other Trade Associations for lobbying and grassroots efforts conducted by the trade association on behalf of its members. 0 0 1484161 0 RELATED PARTY PAYABLE 13060333 13060333 X FIN 48 (ASC 74) Footnote Schedule D, Part X, Line 2 The Organization annually reviews its tax positions and has determined that there are no material uncertain tax positions that require recognition in the consolidated financial statements. As of this filing, tax years 2010-2012 are open for audit by the Internal Revenue Service. true House of Bread 9 Orth Ave Dayton OH 45406 311076425 509(a)(1) 5250 General Support St Vincent dePaul Dayton 1333 Edwin C Moses 308 Dayton OH 45417 311132259 509(a)(1) 5250 General Support Culture Works 126 N Main St 210 Dayton OH 45402 237412338 509(a)(2) 5900 Parking Spaces; general United Way of the Greater Dayton Area 33 W 1st St Dayton OH 45402 310536658 509(a)(1) 23000 General Support 4 0 Contribution Review Schedule I, Part I, Question 2 The company may provide assistance to other Internal Revenue Code tax exempt charitable organizations in the form of charitable contributions. These contributions are unrestricted funds available for use by the charitable organization for the purpose the charitable organization deems necessary. The company is a supported organization to The CareSource Foundation, a related 501(C)(3) tax exempt organization, and will distribute funds to The CareSource Foundation in furtherance of its tax exempt purpose. The CareSource Foundation monitors use of these grants as part of its annual review process once grants have been approved. Contributions on Behalf of Board Members Schedule I, Part II In support of CareSource's commitment to its charitable purposes, its appointed trustees and committee members earn charitable credits for each meeting attended. At year-end, the trustees and committee members designate their credits to their Internal Revenue Code Section 501(c)(3) tax exempt charity of choice. Charitable donations in the amount of $60,000 were paid or accrued in 2012 under this Policy by the organization and are represented on Schedule I in the form of general support contributions. X X X X X X false true false false false false true false false Pamela Morris 697133 0 487080 0 258921 0 1995427 0 20651 0 3459212 0 487080 0 Craig Thiele MD 361439 0 146831 0 432468 0 536304 0 28722 0 1505764 0 394726 0 Bobby Jones 0 359674 0 74673 0 13066 0 632006 0 24761 0 1104180 0 74673 L Tarlton Thomas III 236776 0 92007 0 228646 0 349353 0 23924 0 930706 0 223717 0 Janet Grant 265011 0 102791 0 65256 0 376938 0 4127 0 814123 0 102791 0 Officer Compensation Schedule J, Parts I and II The following corporate officer is an employee of CareSource Management Group Co., a related organization to CareSource: Bobby Jones. All compensation amounts reports on Schedule J, Part II for Mr. Jones are paid by CareSource Management Group Co. The compensation amounts for the remaining listed persons listed on Schedule J, Part II are paid by CareSource Management Services Co., an unrelated organization to CareSource. The process the organization goes through to establish the reasonable executive compensation is the same as other CareSource entities. The company utilizes a compensation committee, an independent compensation consultant, CEO written employment contract, compensation survey or study, and approval by the board or compensation committee comprised solely of independent trustees. Deferred Compensation Schedule J, Part I, Question 4b The following corporate officer listed in Form 990, Part VII, Section A, participates in a supplemental nonqualified retirement plan of a related entity, CareSource Management Group Co.: Bobby Jones. 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. Payments contingent on Net Earnings Schedule J, Part I, Question 6b The following corporate officer listed in Form 990, Part VII, Section A, line 1a is an employee of CareSource Management Group Co, a related organization to CareSource: Bobby Jones. Mr. Jones is eligible for a performance bonus as part of his compensation package. 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. CareSource Management Services Co Employer of Officers 1413736 Admin Mgmt Svcs to Org false Dayton PrimaryUrgent CareProv Med Trustee Morris L Brown MD 128773 Provides Healthcare Svc to org false Form 990 Review Part VI, Section B, Question 11a The 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 and was reviewed during the course of a special board meeting prior to the time of filing the Form 990. The Form 990 was reviewed by the CEO, CFO, an outside CPA firm, outside counsel, and by General Counsel prior to filing with the IRS. Conflict of Interest Policy 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. Compensation Review Part VI, Section B, Questions 15a and 15b; Schedule J, Part I, Question 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 Independent Board members' decision and rationale are captured in minutes that are prepared and signed in a contemporaneous substantiation of the deliberation and decisional process of the Independent Board. 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. Governing Documents Part VI, Section C, Question 19 The company's Form 1023 and Form 990 are available for public inspection upon request. 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. Reconciliation of Net Assets Part XI, Line 5 Change in net assets is inclusive of the following: (1) change in investment in subsidiary of ($1,210,580), (2) Sale of collateralized mortgage obligations of $1,898, (3)Unrealized loss on bond sale (available for sale) of $133,373 and (4) In-kind contributions of $5,400, for a total change in net assets of $826,193. Avg Hours per Week Devoted to Related Organizations Part VII, Section A, Avg Hours per Week Devoted to Related Organizations The following listed persons split their time between all the entities of the CareSource family of companies: Pamela Morris, Craig Thiele MD, L Tarlton Thomas III, Janet Grant, and Bobby Jones. The total hours worked by each listed person exceeds 60 hours per week for the combined CareSource family of companies, and as a general practice is allocated among the following entities: CareSource, 75%; CareSource Management Group Co, CareSource Reinsurance LLC and CareSource Insurance LLC 23%; The CareSource Foundation, CareSource Indiana, Inc., CareSource Illinois, and CareSource Management Services Co, 2%. The CareSource Foundation PO Box 8738 Dayton OH 45401 562582561 Grant Giving OH 501(c)(3) 509(a)(3) I NA false CareSource Management Group Co PO Box 8738 Dayton OH 45401 311703368 Support Org OH 501(c)(3) 509(a)(3) I NA false false true false false false false false false true false false false true false true false true false