2024-11-13T12:29:14-06:00 2023-12-31 RSM US LLP 6 S PATTERSON BLVD DAYTON OH 45402 990 2023-01-01 320121856 CareSource Indiana Inc % JANET FERNANDES CARE 9372243300 PO Box 8738 Dayton OH 454018738 Lawrence Smart CFO 9372243300 2024-11-15 true true Karen O Crim P00368385 9372980201 2023 2024-10-15 13:58:12Z Steve Smitherman Same as C above Dayton OH 45401 1439244947 false X N/A X 2004 IN To Make a Lasting Difference in our members' lives by improving their health and well-being. CareSource Indiana, Inc. is a Nonprofit HMO licensed by the State of Indiana. 3 0 0 0 0 0 0 0 1029880554 1200967368 6233053 17700384 0 0 1036113607 1218667752 0 0 0 0 0 0 0 0 0 1049992612 1112999592 1049992612 1112999592 -13879005 105668160 478256817 463855622 407715332 303059245 70541485 160796377 X CARESOURCE INDIANA, INC.'S MISSION IS TO MAKE A LASTING DIFFERENCE IN 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) false false 964835396 1200967368 CareSource Indiana, Inc. ("CSIN") is a nonprofit organization established under the state law of Indiana. On February 2, 2007, CSIN received a determination letter from the Internal Revenue Service, recognizing CSIN as an organization exempt from federal income tax under Section 501(c)(3) of the Internal Revenue Code, effective as of the date of CSIN's formation. CSIN is a member of the CareSource group of nonprofit tax-exempt organizations (the "CareSource Public Charities"). (Continued on Schedule O) 964835396 true false false true false false false false false false false false false false true true true 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 11 0 true 0 false false false false false false false false false false true false X 3 0 false false true false true true true true true false false true true true true true true false false false IN X JANET FERNANDES 9372243300 PO BOX 8738 Dayton OH 454018738 Erhardt Preitauer Pres/CEO to 4/23 then Chr/Dir 8.0 52.0 X X 0 7982382 4047739 Richard Topping Secretary (Eff 5/23) 8.0 52.0 X 0 2429434 942437 Lawrence Smart CFO, Treasurer/Dir (Eff 5/23) 8.0 52.0 X X 0 2282374 712492 Scott Markovich Director (To 5/23) 8.0 52.0 X 0 2046512 861652 Jai Pillai Chief Operating Ofr (To 4/23) 8.0 52.0 X 0 1975288 15770 Steve Smitherman President (Eff 5/23), Director 59.0 1.0 X X 0 1087503 550961 Stephanie Williams Dir (To 4/23) then Asst Treas 10.0 50.0 X X 0 874375 548452 Daniel McCabe Former Chief Admin Officer 0.0 0.0 X 0 140542 0 William Coffin Jr Former VP Mkt Finance/Director 0.0 0.0 X 0 24304 0 0 18842714 7679503 0 true true false Express Scripts Inc 21653 Network Place CHICAGO IL 60673 Pharmacy Services 238867254 Scion Dental N92 W14612 Anthony Avenue MENOMONEE FALLS WI 53051 Medical Services 23754870 LCP Transportation LLC 4308 Guion Rd INDIANAPOLIS IN 46254 Transportation Svcs 3876771 Superior Vision Services Inc 939 Elkridge Landing 200 LINTHICUM MD 21090 Medical Services 3723702 Axial Healthcare Management Inc 209 10th Avenue South Suite 350 NASHVILLE TN 37203 Medical Services 3223514 7 0 MEDICAID 524114 724012756 724012756 FEDERAL HEALTH INSURANCE EXCHANGE 524114 468094839 468094839 MEDICARE ADVANTAGE 524114 8859773 8859773 1200967368 18026945 18026945 0 0 0 0 0 220250634 220577195 -326561 -326561 -326561 0 0 0 0 0 0 0 0 0 0 1218667752 1200967368 17700384 0 0 0 0 0 0 0 0 0 0 0 419895 18053 401842 0 425687 4825 420862 0 23242 245 22997 0 0 225833 0 225833 0 33104618 1733178 31371440 0 5430062 46034 5384028 0 18594024 25617 18568407 0 0 0 2500523 0 2500523 0 483522 60370 423152 0 0 0 3893872 0 3893872 0 0 0 621465 0 621465 0 MEDICAL EXPENSES 767340738 767340738 0 0 PHARMACY EXPENSES 183985118 183985118 0 0 MGMT FEES CARESOURCE MGMT SVCS 77468283 10949696 66518587 0 HLTH INS PROVIDER & PCORI FEES 13687189 0 13687189 4795521 671522 4123999 1112999592 964835396 148164196 0 X 0 0 168650926 154743604 0 0 2540700 54699249 0 0 0 0 0 0 0 0 762743 75590 0 0 305287448 254337179 0 0 1015000 0 0 0 0 0 478256817 463855622 137116539 134495335 0 0 242263771 162629383 0 0 0 0 0 0 0 0 0 0 28335022 5934527 407715332 303059245 X 70541485 160796377 0 0 70541485 160796377 478256817 463855622 X 105668160 3028788 -18442056 X false true X true false X 0 0 0 0 0 0 640981578 750157227 989801374 1029880554 1200967368 4611788101 0 0 0 640981578 750157227 989801374 1029880554 1200967368 4611788101 0 0 0 4611788101 737426 953950 406768 6233053 17700384 26031581 0 737426 953950 406768 6233053 17700384 26031581 0 0 641719004 751111177 990208142 1036113607 1218667752 4637819682 0.99439 0.99752 0.00561 0.00248 X false false false false false false true 8582 false true 37902 46484 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. Form 990, Schedule C, Part II-B, Line 1i $37,902 is the allocable portion of the Organization's dues paid to Indiana Association of Health Plans and America's Health Insurance Plans for lobbying and grassroots efforts conducted by the trade association on behalf of its members. 0 RELATED PARTY PAYABLE 5934527 5934527 X 1211291527 3028788 3028788 1208262739 10405013 10405013 1218667752 1108879887 1108879887 4119705 4119705 1112999592 FIN 48 (ASC 740) Footnote As outlined in CareSource's Audited Consolidated Financial Statements, which include the activity of CareSource Indiana, 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 2020-2022 are open for audit by the Internal Revenue Service. 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 2A & 4B and Part XII, Line 4b, are comprised of the STAT-to-GAAP adjustments. true true false false false false false false false Erhardt Preitauer Pres/CEO to 4/23 then Chr/Dir 0 1320200 0 6194161 0 468021 0 4027671 0 20068 0 12030121 0 3950998 Richard Topping Secretary (Eff 5/23) 0 569753 0 1738540 0 121141 0 913781 0 28656 0 3371871 0 920889 Lawrence Smart CFO, Treasurer/Dir (Eff 5/23) 0 587567 0 1571834 0 122973 0 692889 0 19603 0 2994866 0 887402 Scott Markovich Director (To 5/23) 0 524810 0 1411293 0 110409 0 832617 0 29035 0 2908164 0 824021 Jai Pillai Chief Operating Ofr (To 4/23) 0 201797 0 1311318 0 462173 0 12209 0 3561 0 1991058 0 1021349 Steve Smitherman President (Eff 5/23), Director 0 385976 0 619906 0 81621 0 532198 0 18763 0 1638464 0 467350 Stephanie Williams Dir (To 4/23) then Asst Treas 0 358045 0 441980 0 74350 0 537620 0 10832 0 1422827 0 438762 Daniel McCabe Former Chief Admin Officer 0 0 0 0 0 140542 0 0 0 0 0 140542 0 0 William Coffin Jr Former VP Mkt Finance/Director 0 0 0 0 0 24304 0 0 0 0 0 24304 0 0 Form 990, Schedule J, Part I, Question 3 CareSource Management Services LLC, a related entity, utilizes a compensation committee, independent compensation consultant, compensation survey or study, review of form 990 of other organizations, and approval by the board or compensation committee comprised solely of independent directors. Form 990, Schedule J, Part I, Line 4a Jai Pillai, Daniel McCabe, and William Coffin, Jr. received severance payments that are properly reported on Schedule J, Part II, Column B(iii). Form 990, Schedule J, Part I, Question 4b The following listed persons listed on Form 990, Part VII, Section A, participate in a supplemental nonqualified retirement plan of CSMS: Erhardt Preitauer, Richard Topping, Lawrence Smart, Scott Markovich, Steve Smitherman, and Stephanie Williams. 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 CSMS: Erhardt Preitauer, Richard Topping, Lawrence Smart, Scott Markovich, Steve Smitherman, and Stephanie Williams. 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 performance period, they forfeit any amounts accrued under this plan. Employees must be employed on the date which the long-term incentive plan is paid, which in no event is later than March 15th. Exceptions to this general statement include death, disability, or a qualified retirement, which may result in prorated payment. Amounts paid or accrued in 2023 for both deferred compensation arrangements include the following: Erhardt Preitauer $1,820,312, Richard Topping $450,394, Lawrence Smart $450,852, Scott Markovich $409,557, Steve Smitherman $246,880, and Stephanie Williams $233,747. Form 990, Schedule J, Part I, Question 6b The following persons listed on Form 990, Part VII, Section A, Line 1a are or were employees of CSMS: Erhardt Preitauer, Richard Topping, Lawrence Smart, Scott Markovich, Jai Pillai, Steve Smitherman, and Stephanie Williams. All of these listed persons are or were eligible for a performance bonus as part of their compensation packages. The amount of this Annual Incentive Plan ("AIP") bonus is based on the degree of achievement of the Companies' goals and the Individual's goals, which is ultimately documented in the year end performance management process. 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 II All compensation amounts reported on Schedule J, Part II for all listed persons are paid by CSMS. Form 990, Part III, Question 1 (Continued) CARESOURCE INDIANA, INC. IS A HEALTH MAINTENANCE ORGANIZATION LICENSED BY THE STATE OF INDIANA AND SERVES MEMBERS THROUGH MARKETPLACE, MEDICAID, DUAL ELIGIBLE SPECIAL NEEDS, HEALTHY INDIANA, AND HOOSIER HEALTHWISE PLANS. Form 990, Part III, Question 4a (Continued) 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, CSIN 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. CSIN has served Hoosiers since 2016 with CareSource Marketplace and Medicare Advantage health plans. In 2017, CSIN was selected to serve Healthy Indiana Plan ("HIP") and Hoosier Healthwise ("HHW") Members. Since then, the health plan has launched a number of innovative programs including the CareSource Re-entry Program to ensure the successful transition of justice-involved individuals back into communities, as well as initiatives to remove barriers to health care, housing, employment, and maternal and infant health and to improve health equity. The State of Indiana requires all Medicaid plans to offer certain benefits, however we offer so much more. Members enrolled in our CSIN plans have access to the following services: (1) Life Coaches who work with Members to connect them to community resources, provide support with educational & employment goals, and help coordinate rides to non-medical appointments in the community, (2) CareSource24, nurse advice line, (3) Care managers who can assist with housing, medical equipment, utilities and other urgent basic needs, (4) Free or discounted cell phone program to contact CareSource24 and the Customer Care Advocacy Team, (5) Rewards programs for all Members, (6) A free message three times per week, timed to the due date or baby's birth date, through pregnancy and up until the baby's first birthday, (7) One-on-one medication review and consultation with the pharmacist to ensure medications are appropriate and safe, (8) Telemedicine access to a doctor using a phone or computer, (9) A bank account from Fifth Third Bank with no monthly service charge, no balance requirement, no overdraft fees and a debit card for purchases, (10) CareSource mobile app for access to Member ID card, "how-to" videos and a quick search for doctors, and (11) Programs for asthma, ADHD, addiction, autism, behavioral health, chronic kidney disease and more. Part VI, Section A, Question 4 The amended bylaws included the following changes: (1) Updated the number of board members from three to five to a total of three to nine members (2) Added a section titled "General Powers" that outlines that the board has power to manage the Corporation except as otherwise reserved to the sole member (3) Removed the requirement for the directors to be elected at the annual meeting (4) Updated that the Corporation's sole member has the power to elect and remove members of the board and that the Chief Executive Officer of the sole member shall be a Director with voting rights (5) Updated the terms of directors to one year coinciding with the calendar year (6) Removed that a telegram is a valid form of communication and updated that a notice for a called meeting must be accompanied by confirmation of receipt by the recipient (7) Simplified the wording about what constitutes a quorum (8) Simplified the requirements for receipt of electronic communication (9) Updated the means by which a meeting can be held (10) Added Article II, Section 6 named "Presumed Assent" to outline that a director is presumed to have assented to action unless his/her contrary vote is recorded (11) Added Article II, Section 7 named "Conduct of Meetings" establishing the chair of the committee sets the order of business for meetings (12) Clarified wording indicating that the key officers of the Corporation are to be appointed by the board at the annual meeting, with the exception of the Chair, who shall be designated by office, and officers may be removed by the Chair (13) Added Article III, Section 2 named "Chair" that adds the Chair of the Corporation will preside at all meetings and perform all necessary duties expected of presiding officers (14) Added Article III, Section 3 named "President" indicating that the President will manage all affairs of the business and perform all duties that are required of him/her (15) Added Article III, Section 4 named "Treasurer" indicating duties that the officer is responsible for such as receiving money due to the Corporation and that the officer may be responsible for additional duties assigned by the President (16) Added Article III, Section 5 named "Secretary" indicating duties expected of the officer such as keeping minutes of meetings and that additional responsibilities may be assigned by the President (17) Added Article III, Section 6 named "Assistant Officers" indicating that the board may appoint assistant officers when deemed necessary (18) Added "Article IV - Committeesestablished that the Audit Committee, Risk Committee and Compensation Committee of the sole member have full authority to act on behalf of the Corporation with duties, responsibilities, and membership to be defined by each committee's charter (19) Simplified terms related to indemnification adding that a director is an authorized party of the Corporation and that funds can be paid to an employee with the stipulation they must be repaid if certain legal conditions are not met (20) Changed adoption of bylaws from "adopted by the Directors" to "adopted by the Corporation's sole member and Corporation's Directors." Form 990, Part VI, Section A, Question 6 CareSource is the sole member of CareSource Indiana, Inc. CareSource is recognized as exempt from Federal Income Taxation under Internal Revenue Code ("IRC") Section 501(c)(3). Form 990, Part VI, Section A, Question 7a CareSource, the sole member of CareSource Indiana, Inc., has the authority to appoint CareSource Indiana, Inc.'s board. Form 990, Part VI, Section A, Question 7b The Audit Committee, Risk Committee, and Compensation Committee of CareSource, the sole member of CareSource Indiana, Inc., have full authority as committees to act on behalf of CareSource Indiana, 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, Question 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, Question 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, Question 19 The 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 Indiana Secretary of State's website at www.in.gov/SOS/ for a nominal fee. Form 990, Part XI, Line 9 OTHER CHANGES IN NET ASSETS CONSISTS OF A DISTRIBUTION TO CARESOURCE IN THE AMOUNT OF $18,442,056. CareSource PO Box 8738 Dayton OH 454018738 311703368 Supporting OH 501(c)(3) 509(a)(3)II NA false CareSource Kentucky Co PO Box 8738 Dayton OH 454018738 464991603 HMO Ins Plan KY 501(c)(3) 509(a)(2) CARESOURCE false CareSource Georgia Co PO Box 8738 Dayton OH 454018738 472408339 HMO Ins Plan GA 501(C)(3) 509(a)(2) CARESOURCE false CareSource West Virginia Co PO Box 8738 Dayton OH 454018738 473028244 HMO Ins Plan WV 501(c)(3) 509(a)(2) CARESOURCE false CareSource Life Services Co PO Box 8738 Dayton OH 454018738 811602217 No Activity OH 501(c)(3) 509(a)(2) CARESOURCE false CareSource Ohio Inc PO Box 8738 Dayton OH 454018738 311143265 HIC Ins Plan OH 501(c)(3) 509(A)(2) CareSource false The CareSource Foundation PO Box 8738 Dayton OH 454018738 562582561 Grantmaking OH 501(c)(3) 509(A)(3)II CareSource false CareSource Diversity & Social Impact Inv 50 East 91st Street Suite 213 Indianapolis IN 462401555 871811106 Investing DE NA N/A CareSource Midwest Fund LLC 415 12th Ave SE Cedar Rapids IA 524012449 883585337 Investing DE NA N/A ImagineCare Holdings LLC PO Box 8738 Dayton OH 454018738 932340017 Holding Co DE NA N/A HAP Empowered Holding LLC PO Box 8738 Dayton OH 454018738 923877012 Holding Co DE NA N/A CareSource Bayou Holding LLC PO Box 8738 Dayton OH 454018738 883042610 Holding Co DE NA N/A CareSource Virginia Co PO Box 8738 Dayton OH 454018738 811727271 No Activity VA NA C Corp CareSource Arkansas Health Plan Co PO Box 8738 Dayton OH 454018738 844476729 COA Insurance AR NA C Corp Kids' CareAlliance Co PO Box 8738 Dayton OH 454018738 854022039 No Activity OH NA C Corp CareSource Oklahoma Health Plan Co PO Box 8738 Dayton OH 454018738 854038326 HMO Ins Plan OK NA C Corp CareSource Kansas LLC PO Box 8738 Dayton OH 454018738 873411276 HMO Ins Plan KS NA C Corp CareSource North Carolina Co PO Box 8738 Dayton OH 454018738 873079479 HMO Ins Plan NC NA C Corp CareSource PASSE LLC PO Box 8738 Dayton OH 454018738 863112470 RBPO Ins Plan AR NA C Corp Columbus Organization Holdings LLC PO Box 8738 Dayton OH 454018738 814132952 Holding Co DE NA C Corp Healthedge-Columbus Holdings LLC PO Box 8738 Dayton OH 454018738 814132842 Holding Co DE NA C Corp CareSource Tennessee Co PO Box 8738 Dayton OH 454018738 874254502 COA Insurance TN NA C Corp Columbus Medical Services Inc PO Box 8738 Dayton OH 454018738 300975112 No Activity MD NA C Corp CareSource Iowa Co PO Box 8738 Dayton OH 454018738 881429834 HMO Ins Plan IA NA C Corp CareSource Florida Co PO Box 8738 Dayton OH 454018738 883601120 HMO Ins Plan FL NA C Corp CareSource Bayou Health LLC PO Box 8738 Dayton OH 454018738 883401520 HMO Ins Plan TX NA C Corp CareSource Military & Veterans Co PO Box 8738 Dayton OH 454018738 932552094 Tricare CPD OH NA C Corp GCRE Protected Cell No 3 - CS LLC PO Box 8738 Dayton OH 454018738 933077861 Captive Ins MT NA C Corp HAP CareSource New Center One Ste 110 3031 W Grand Detroit MI 482023033 383123777 HMO Ins Plan MI NA C Corp CareSource Reinsurance II LLC PO Box 8738 Dayton OH 454018738 872901879 Captive Ins MT NA C Corp false false false false true false false false false false false true true false true false true false PART III, RELATED ORGANIZATIONS TAXABLE AS A PARTNERSHIP - ADDITIONAL INFO 1) IMAGINECARE HOLDINGS LLC (EIN: 93-2340017) WAS INCORPORATED 07/12/2023 2) HAP EMPOWERED HOLDING LLC (EIN: 92-3877012) WAS INCORPORATED 04/19/2023 PART IV, RELATED ORGANIZATIONS TAXABLE AS A CORP - ADDITIONAL INFORMATION 1) CARESOURCE MILITARY & VETERANS CO (EIN: 93-2552094) WAS INCORPORATED 07/21/2023 2) GCRE PROTECTED CELL NO. 3 - CS LLC (EIN: 93-3077861) WAS INCORPORATED 08/22/2023