2017-11-14T11:24:59-06:00 2016-12-31 990 2016-01-01 320121856 CareSource Indiana Inc % JANET FERNANDES CARE 9375313027 135 N Pennsylvania St 1300 Indianapolis IN 46204 L TARLTON THOMAS III EVP Operations & CFO 9375313027 2017-11-13 208.90.150.16 31270620173185000000 2017-11-14 P 2F1F6CC55A425429A1F7A24D1299F942B9A41484 2F1F6CC55A425429A1F7A24D1299F942B9A41484 2016 2017-02-10 21:41:12Z X Pamela B Morris PO Box 8738 Dayton OH 45401 94959613 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 is a Nonprofit Medicaid HMO licensed by the State of Indiana. 4 3 68 0 0 0 0 57071760 94923412 628 36201 0 0 57072388 94959613 5000 3000 0 0 0 293035 0 0 0 62812229 116108438 62817229 116404473 -5744841 -21444860 52383997 68699557 44288463 52048883 8095534 16650674 X TO MAKE A LASTING DIFFERENCE IN OUR MEMBERS LIVES BY IMPROVING THEIR HEALTH AND WELL-BEING. CARESOURCE INDIANA, INC. IS A NONPROFIT MEDICAID HEALTH MAINTENANCE ORGANIZATION LICENSED BY THE STATE OF INDIANA. false false 94430030 3000 95447251 CareSource Indiana Co. (CSIN or CareSource Indiana) is a non-profit organization established under the state law of Indiana. CSIN is a member of the CareSource Family of Companies' non-profit organizations. The mission of CareSource is to make a lasting difference in its members lives by improving their health and overall well-being. CSIN firmly adheres to this mission, which it terms as the organizations "heartbeat," by providing services that go well beyond the delivery of medical benefits. CSIN's membership includes: (1) Hoosier Healthwise (Medicaid) and Healthy Indiana Plan (HIP) Medicaid expansion consumers, (2) Medicare Advantage low-income consumers, and (3) a Qualified Health Plan offered through the Federal Health Insurance Exchange, providing low-cost comprehensive coverage for uninsured individuals and families. CareSource Indiana received interim accreditation through National Committee for Quality Assurance (NCQA) in 2015 for its Health Insurance Marketplace plan. NCQA accreditation is the most comprehensive evaluation in the industry and the only assessment that bases results on clinical performance and consumer experience. Pursuing NCQA Accreditation demonstrates CSIN's commitment to quality and improving the health and well-being of our members. CSIN focuses on prevention with a goal of improving member health, the quality of health care services received, and accessibility of health care services for its members. This is done through an innovative health and wellness methodology. CSIN has built a high performing provider network to operate as an HMO. This provider network relies heavily upon federally qualified health centers (FQHCs). FQHCs are generally health care providers that have been recognized by the federal government as providing care to populations that have limited access to medical treatment due to conditions such as poverty and geographic location. Recognized for a commitment to serving at-risk populations, beginning Jan. 1, 2017, CSIN began coordinating care for recipients of state supported programs that provide health services to recipients, through Hoosier Healthwise and HIP. Hoosier Healthwise is available to pregnant women and children and HIP covers adults 19 to 64 years of age whose incomes are less than 138% of the federal poverty level and do not meet certain eligibility requirements for other health coverage programs. CSIN offers two Medicare Advantage Plans in the State. CSIN primarily enrolls low-income individuals in these plans. CareSources Qualified Health Plan on the Health Insurance Marketplace primarily serves low-income individuals and was designed for those low-income adults who are recently uninsured or have never been insured. The plan is affordable, with low monthly premiums, low copays, low annual deductibles, and free generic prescriptions for some members. Members have the choice of buying dental and vision plans in addition to their medical plan. Members can receive assistance through CSINs many programs designed to remove barriers to health and well-being. CareSource Indiana can, therefore, further its mission as a means of improving the health and well-being of Indianas low-income populations. 94430030 true false false true false false false false false false false false false false true true false true false false false false false false false false false false false true false false false false false false false false false false false false false true false false false true 1088 0 68 true false false false false false false false false false false X 4 3 false false false false true true false true true false false true true true true true true true true false IN X JANET FERNANDES 9375313027 PO BOX 8738 Dayton OH 454018738 J Thomas Maultsby Chair/Sec/Treas/Trustee 5.0 15.0 X X 0 45625 0 Kevin R Brown Trustee 4.0 16.0 X 0 55625 0 Patricia Martin Trustee 4.0 6.0 X 0 40000 0 Pamela B Morris President/CEO/TRUSTEE 8.0 52.0 X X 0 2217770 587994 Craig Thiele MD Chief Medical Officer 8.0 52.0 X 0 594165 45447 Daniel McCabe Chief Administrative Officer 3.0 57.0 X 0 849388 130442 L Tarlton Thomas III EVP Operations & CFO 8.0 52.0 X 0 670319 153424 Bobby Jones to 62016 President Georgia Market 0.2 59.8 X 0 788788 151624 Steve Smitherman VP/Executive Director 60.0 0.0 X 283480 0 19442 283480 5261680 1088373 2 false true false Indiana Univ Health Inc Related O 950 N Meridian St 800 INDIANAPOLIS IN 46204 Medical Services 33900514 CVS Caremark 9501 E Shea Blvd MC 143 SCOTTSDALE AZ 85260 Pharmacy Services 27309871 Parkview Hospital Related Orgs 11109 Parkview Plaza Dr FORT WAYNE IN 46845 Medical Services 6244886 Memorial Hospital South Bend Rela 615 N Michigan Street SOUTH BEND IN 46601 Medical Services 3977847 Hendricks County Hospital 1000 E Main Street DANVILLE IN 46122 Medical Services 1521626 90 0 COORDINATION OF BENEFIT RECOVERIES 524114 73 73 FEDERAL HEALTH INSURANCE EXCHANGE 524114 94923339 94923339 94923412 36201 36201 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 94959613 94923412 36201 3000 3000 0 0 0 293035 31714 261321 0 0 0 0 0 0 36107 36107 1051134 27992 1023142 69944 2802 67142 0 0 4303253 336892 3966361 2881673 390 2881283 1698359 50893 1647466 2564 2564 0 409412 409412 158218 5295 152923 0 132072 5742 126330 1412 1412 0 0 0 FEES AND ASSESSMENTS 3247341 1320 3246021 MGMT FEES CARESOURCE MGMT GRP 8985699 929233 8056466 MEDICAL EXPENSE 68998772 68998772 PHARMACY EXPENSE 24035985 24035985 96493 96493 116404473 94430030 21974443 0 42997543 53167714 1500000 2000000 0 0 7886454 13531843 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 52383997 68699557 13433800 49254779 0 0 30109313 0 0 0 0 0 0 0 0 0 0 0 745350 2794104 44288463 52048883 X 8095534 16650674 0 0 0 0 8095534 16650674 52383997 68699557 X -21444860 30000000 X false true X true false X 0 0 0 0 0 0 10202 3225 743 57071760 95447251 152533181 0 0 0 10202 3225 743 57071760 95447251 152533181 0 0 0 152533181 620 0 1204 628 36201 38653 0 620 0 1204 628 36201 38653 0 0 10822 3225 1947 57072388 95483452 152571834 0.99975 0.99995 0.00025 0.00005 X false false false false false false true 110544 false true 2625 113169 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 $2,625 is the allocable portion of the Organization's dues paid to Indiana Association of Health Plans for lobbying and grassroots efforts conducted by the trade association on behalf of its members. 0 RELATED PARTY PAYABLE 2794104 2794104 FIN 48 (ASC 740) Footnote 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 2013-2016 are open for audit by the Internal Revenue Service. X X X X X false true false false false true true Pamela B Morris President/CEO/TRUSTEE 0 1111003 0 1100000 0 6767 0 583885 0 4109 0 2805764 0 1100000 Craig Thiele MD Chief Medical Officer 0 388964 0 201534 0 3667 0 16282 0 29165 0 639612 0 201534 Daniel McCabe Chief Administrative Officer 0 375456 0 188793 0 285139 0 108106 0 22336 0 979830 0 0 L Tarlton Thomas III EVP Operations & CFO 0 441888 0 213325 0 15106 0 127900 0 25524 0 823743 0 213325 Steve Smitherman VP/Executive Director 199540 0 77350 0 6590 0 6021 0 13421 0 302922 0 0 0 Bobby Jones to 62016 President Georgia Market 0 512721 0 248392 0 27675 0 136978 0 14646 0 940412 0 248392 Form 990, Schedule J, Part II Compensation amounts reported on Schedule J, Part II for listed person Steven Smitherman is paid by CareSource Indiana, Inc. Compensation amounts for the remaining listed persons on Schedule J, Part II are paid by CareSource Management Group Co., a related organization to CareSource Indiana, Inc. Form 990, Schedule J, Part I, Line 4b The following listed persons listed on Form 990, Part VII, Section A, participate in a supplemental nonqualified retirement plan of a related entity, CareSource Management Group Co. (CSMG): Pamela B Morris, Craig Thiele MD, Daniel McCabe, L Tarlton Thomas III and Bobby Jones. Amounts are accrued monthly for plan participants. The plans provide compensation to the participants after a vesting period, and the funds are available to the participants after they retire or resign from the organization. The plans provide for normal terms and conditions contained in a standard nonqualified retirement plan. The following listed persons listed on Form 990, Part VII, Section A, participate in a long-term incentive plan of a related entity, CareSource Management Group Co.: Pamela B Morris, Craig Thiele MD, Daniel McCabe, L Tarlton Thomas III, and Bobby Jones. The plan provides compensation to the participants based on annual and long-term goals. The long-term incentive plan will pay out if these goals, or a subset of these goals, are achieved over a three year period. If a participant leaves their employment prior to this three year vesting period, they forfeit any amounts accrued under this plan. Amounts paid and accrued in 2016 for both deferred compensation arrangements include the following: Pamela B Morris $567,500; Daniel McCabe $91,944; L Tarlton Thomas III $112,000; and Bobby Jones $121,381. Form 990, Schedule J, Part I, Line 6b The following listed person listed on Form 990, Part VII, Section A, line 1a is an employee of CareSource Indiana, Inc.: Steve Smitherman. The following listed persons listed on Form 990, Part VII, Section A, line 1a are employees of CareSource Management Group Co, a related organization to CareSource Indiana, Inc.: Pamela B Morris, Craig Thiele MD, Daniel McCabe, L Tarlton Thomas III, and Bobby Jones. All of these listed persons are eligible for a performance bonus as part of their compensation packages. The performance bonus is contingent on a combination of both company performance and individual performance against goals. The performance management process documents the company goals and individual goals, the corresponding potential performance bonus, and the progress/outcomes. The performance bonus is based on the employee's calendar year regular earnings. performance bonus is based on the employee's calendar year regular earnings. Form 990, Schedule J, Part I, Line 3 The process the Organization goes through to establish the reasonable executive compensation is the same for all the CareSource Family of Companies. The organization utilizes a compensation committee, independent compensation consultant, CEO written employment contract, compensation survey or study, review of Form 990 of other organizations, and approval by the board or executive compensation committee comprised solely of independent trustees. CSMG has in place Clawback provisions within its executive compensation plans that generally require executives to pay back compensation to CSMG in the event a subsequent legal, accounting, regulatory or compliance issue is discovered over which the executive had direct responsibility and control during the executive's employment. Form 990, Part VI, Section B, Question 11B The Form 990 was provided to the organization's Finance committee 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 for their review prior to the time of filing Form 990. The Form 990 was reviewed by the CEO, CFO, VP Treasury, an outside CPA firm, outside legal counsel, and by general counsel prior to filing Form 990 with the IRS. Form 990, Part VI, Section B, Question 12C Annually, each trustee, principal officer and member of a committee with Board-delegated powers ("interested person") shall sign a statement which affirms that such person a) has received a copy of the conflicts of interest policy, b) has read and understands the policy, c) has agreed to comply with the policy, and d) understands that the organization is a charitable organization and that in order to maintain its federal tax exemption it must engage primarily in activities which accomplish one or more of its tax-exempt purposes. In connection with any actual or possible conflicts of interest, an interested person must disclose the existence of his or her financial or conflict of interest and must be given the opportunity to disclose all material facts to the directors and members of committees with Board delegated powers considering the proposed transaction or arrangement. After disclosure of the financial interest and all material facts, and after any discussion with the interested person, he/she shall leave the Board or committee meeting while the determination of a conflict of interest is discussed and voted upon. The remaining Board or committee members shall decide if a conflict of interest exists. An interested person may make a presentation at the Board or committee meeting, but after such presentation, he/she shall leave the meeting during the discussion of, and the vote on, the transaction or arrangement that results in the conflict of interest. The conflicted trustee has no vote on the matter involved with the conflict of interest. At the beginning of each Board Meeting and Committee Meeting, the Board Members and Committee Members are asked to disclose if they have a Conflict of Interest on any item contained in the agenda. In addition, the Board Members and Committee Members are also asked to inform the board chair if a Conflict of Interest arises during the course of the Board or Committee Meeting. When such a conflict is disclosed, then the procedure outlined above is implemented. In addition, a Conflict of Interest Schedule is kept with respect to each declared Conflict of Interest during the course of a Board or Committee meeting. On an annual basis, the Nominating and Governance Committee reviews each Conflict of Interest raised by a Board or Committee Member. Also, the Nominating and Governance Committee conducts a bi-annual evaluation of the Board Members' performance during the course of the Board Meetings and Committee Meetings. The review includes but is not limited to the Board Member's engagement, participation, contributions to board business, attendance, and any absence from a meeting due to a conflict of interest. The Conflicts of Interest declared by the Board Members are reviewed on an annual basis by the Nominating and Governance Committee, and memorialized in meeting minutes, to make sure all policies on Conflict of Interest are adhered to by the Boards, the Committees and the Individual Board or Committee Member. Form 990, Part VI, Section B, Q 15A and 15B; Schedule J, Part 1, Q 3 The Executive Compensation Committee consists of Board Members who are Independent. The process used to determine compensation for the individuals listed on Part VII and Schedule J, Part II include a review by the Independent Board Members after they have received a report of comparability data prepared by an independent company surveying data for comparable organizations' reasonable compensation. The comparability data is presented to the Independent Board members in a written document in advance of the meeting and the independent comparability study is presented by the author of the study during the course of the meeting. In addition, the minutes of each meeting are prepared, distributed and signed within 30 days of the Executive Compensation Committee Meeting. The Executive Compensation Consultant does no other business with the CareSource Family of Companies other than determining the reasonableness of compensation. This compensation consultant's independence is reviewed on an annual basis. This process is followed with respect to all employed corporate officers and the top executives of the CareSource Family of Companies, in order to establish reasonable executive compensation. Form 990, Part VI, Section C, Question 19 The company's Form 1023 and Form 990 are available for public inspection upon request. The company's Form 990 is also available on the U.S. nonprofit database website at www.guidestar.org. The Company's 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 (1) Change in Net Assets: Capital Contribution from parent Organization CareSource Management Group Co during 2016 in the amount of $30,000,000. CareSource Management Group Co PO Box 8738 Dayton OH 45401 311703368 Support Org OH 501(c)(3) 509(a)(3) I NA false CareSource Kentucky Co PO Box 8738 Dayton OH 45401 464991603 Exchange HMO KY 501(c)(3) 509(a)(2) CSMG false CareSource Georgia Co PO Box 8738 Dayton OH 45401 472408339 Medicaid HMO GA 501(C)(3) 509(a)(2) CSMG false CareSource West Virginia Co PO Box 8738 Dayton OH 45401 473028244 Exchange HMO WV 501(c)(3) 509(a)(2) CSMG false CareSource Life Services Co PO Box 8738 Dayton OH 45401 811602217 Inactive OH 501(c)(3) 509(a)(2) CSMG false CareSource North Carolina Co PO Box 8738 Dayton OH 45401 811593512 Inactive NC 501(c)(3) 509(a)(2) CSMG false CareSource Virginia Co (12016) PO Box 8738 Dayton OH 45401 811727271 Medicaid HMO VA 501(c)(3) 509(a)(2) CSMG false CareSource Mgmt Grp Foundation (82016) PO Box 8738 Dayton OH 45401 814170497 Inactive OH 501(c)(3) 509(a)(2) CSMG false CareSource Management Services Co PO Box 8738 Dayton OH 454018738 311703371 Adm Mgmt Svcs OH NA C Corp 0 0 false false false true false false false false false false false false false true false true true true true