2017-11-14T11:24:59-06:00 2016-12-31 990 2016-01-01 473028244 CareSource West Virginia Co % JANET FERNANDES CARE 9375313027 PO Box 8738 Dayton OH 454018738 L TARLTON THOMAS III EVP Operations & CFO 9375313027 2017-11-13 208.90.150.16 31883020173185000000 2017-11-14 P 2F1F6CC55A425429A1F7A24D1299F942B9A41484 2F1F6CC55A425429A1F7A24D1299F942B9A41484 2016 2017-02-10 21:41:12Z Pamela B Morris Same as C Above Dayton OH 45401 5404593 false X N/A X 2015 WV To Make a Lasting Difference in our members' lives by improving their health and well-being. CareSource West Virginia Co is a nonprofit medicaid HMO licensed by State of WV. 3 2 0 0 0 0 0 0 0 5403835 12 758 0 0 12 5404593 0 4000 0 0 0 0 0 0 0 343405 5943996 343405 5947996 -343393 -543403 4282431 7627426 125824 4014222 4156607 3613204 X TO MAKE A LASTING DIFFERENCE IN OUR MEMBERS LIVES BY IMPROVING THEIR HEALTH AND WELL-BEING. THE CARESOURCE WEST Virginia Marketplace PLAN WAS SUCCESSFULLY IMPLEMENTED WITH ENROLLMENT BEGINNING ON NOVEMBER 1, 2015, AND AN EFFECTIVE DATE OF JANUARY 1, 2016. false false 5084421 4000 5404835 CareSource West Virginia Co. ("CSWV") is a non-profit organization established under the state law of West Virginia. On August 30, 2017, CSWV received a determination letter from the Internal Revenue Service, recognizing CSWV as an organization exempt from federal income tax under Section 501(c)(3) of the Internal Revenue Code. CSWV 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. CSWV firmly adheres to this mission, which it terms as the organizations "heartbeat," by providing services that go well beyond the delivery of medical benefits. CSWV began offering a Qualified Health Plan on the West Virginia Health Insurance Marketplace beginning in January 2016, providing low-cost comprehensive coverage for uninsured individuals and families. CareSource West Virginia 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 CSWV's commitment to quality and improving the health and well-being of our members. CSWV 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. CSWV 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. CareSource West Virginia's 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 also receive assistance through CSWVs many programs designed to remove barriers to health and well-being. CSWV can, therefore, further its mission as a means of improving the health and well-being of West Virginias low-income populations. 5084421 true false false true false false false false false false false false false false false 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 104 0 0 false false false false false false false false false false X 3 2 false false false false true false false true true false false true true true true true true false false false WV X JANET FERNANDES 9375313027 PO BOX 8738 Dayton OH 454018738 J Thomas Maultsby Trustee 2.0 18.0 X 0 45625 0 Ellen S Leffak Trustee 2.0 18.0 X 0 116250 0 Pamela B Morris President/CEO/Board Chair 5.0 55.0 X X 0 2217770 587994 Craig Thiele MD Chief Medical Officer 8.0 52.0 X 0 594165 45447 Daniel McCabe Chief Administrative Officer 0.0 60.0 X 0 849388 130442 L Tarlton Thomas III EVP Operations & CFO 2.0 58.0 X 0 670319 153424 Bobby Jones to 62016 President Georgia Market 0.2 59.8 X 0 788788 151624 0 5282305 1068931 0 false true false Cabell Huntington Hospital Inc 134o Hal Greer Blvd HUNTINGTON WV 25701 Medical Services 1209359 Charleston Area Medical Center Inc 501 Morris St CHARLESTON WV 25326 Medical Services 1089673 CVS Caremark 9501 E Shea Blvd MC 143 SCOTTSDALE AZ 85260 Pharmacy Services 962880 Herbert J Thomas Memorial Hospital 4605 Maccorkle Ave SW SOUTH CHARLESTON WV 25309 Medical Services 289035 Presidio Excess Insurance Svcs Inc 199 Fremont Ave 11th Fl SAN FRANCISCO CA 94105 Reinsurance 199318 12 0 FEDERAL HEALTH INSURANCE EXCHANGE 524114 5403835 5403835 5403835 758 758 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 5404593 5403835 0 758 4000 4000 0 0 0 0 0 0 0 0 0 0 666 666 112583 464 112119 33983 167 33816 0 0 48070 1871 46199 90458 6 90452 160771 150 160621 0 0 4544 4544 0 0 2953 159 2794 0 0 0 0 MEDICAL 4162916 4162916 PHARMACY 880453 880453 MGMT FEES CARESOURCE MGMT GRP 160374 34210 126164 FILING/CLAIMS ADMIN 286225 25 286200 5947996 5084421 863575 0 4282377 6913265 0 0 0 0 54 714161 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 4282431 7627426 48317 1416932 0 0 77507 2597290 0 0 0 0 0 0 0 0 0 0 0 0 125824 4014222 X 4156607 3613204 0 0 0 0 4156607 3613204 4282431 7627426 -543403 X false true X true false X 0 0 0 0 0 0 5403835 5403835 0 0 0 0 0 0 0 5403835 5403835 0 0 0 5403835 12 758 770 0 12 758 770 0 0 0 0 0 12 5404593 5404605 X 0.00000 false false false false false false true 48547 false false 48547 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. 0 0 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 2015-2016 are open for audit by the Internal Revenue Service. false true false false false false true Pamela B Morris President/CEO/Board Chair 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 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 All compensation amounts reported on Schedule J, Part II for all listed persons are paid by CareSource Management Group Co., a related organization to CareSource West Virginia Co. 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 persons listed on Form 990, Part VII, Section A, line 1a are employees of CareSource Management Group Co, a related organization to CareSource West Virginia Co.: 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. 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 C, Question 19 The company's Form 990 is 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 West Virginia Secretary of State's website at www.sos.wv.gov/. CareSource Management Group Co PO Box 8738 Dayton OH 45401 311703368 Support Org OH 501(c)(3) 509(a)(3) I NA false CareSource Indiana Inc PO Box 8738 Dayton OH 45401 320121856 Medicaid HMO IN 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 Kentucky Co PO Box 8738 Dayton OH 45401 464991603 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 false false false false false false false false false false true false true true true true