2016-11-14T14:50:51-06:00 2015-12-31 390758449 Wipfli LLP 10000 Innovation Drive Suite 250 Milwaukee WI 532264837 990 2015-01-01 270093404 Care Wisconsin Health Plan Inc CARE 6082400020 PO Box 14017 Madison WI 537080017 Janette Townsend CHIEF FINANCIAL OFFICER 6082400020 2016-11-14 1 Melissa Torgerson P00637070 4144319300 2016-11-14 2015 2017-02-10 21:41:12Z Karen Musser PO Box 14017 Madison WI 537080017 123315773 0 X www.carewisconsinhealthplan.org X 2004 WI CARE WISCONSIN HEALTH PLAN, INC. IS A NONPROFIT MANAGED CARE ORGANIZATION THAT MATCHES FRAIL SENIORS AND PEOPLE WITH PHYSICAL AND INTELLECTUAL DISABILITIES TO THE HEALTH CARE AND LONG-TERM SUPPORTS AND SERVICES THEY NEED. WE OFFER GOVERNMENT-FUNDED (MEDICARE AND MEDICAID) PROGRAMS AND PARTNER WITH PROVIDERS TO CREATE STRONG, LOCAL PROVIDER NETWORKS. WE ARE DEDICATED TO OUT MISSIONS AND VALUES: TO PROMOTE THE QUALITY OF LIFE OF OUR COMMUNITIES BY EMPOWERING OTHERS AND WORKING TOGETHER TO CREATIVELY SOLVE UNIQUE HEALTH AND LONG TERM CARE NEEDS. 8 7 0 7 0 0 0 0 102772504 119137950 495992 349850 5300 49395 103273796 119537195 0 0 0 0 0 0 0 0 0 111675335 109603532 111675335 109603532 -8401539 9933663 30042131 34840468 17405029 12666385 12637102 22174083 X CARE WISCONSIN HEALTH PLAN, INC. IS A NONPROFIT MANAGED CARE ORGANIZATION THAT MATCHES FRAIL SENIORS AND PEOPLE WITH PHYSICAL AND INTELLECTUAL DISABILITIES TO THE HEALTH CARE AND LONG-TERM SUPPORTS AND SERVICES THEY NEED. WE OFFER GOVERNMENT-FUNDED (MEDICARE AND MEDICAID) PROGRAMS AND PARTNER WITH PROVIDERS TO CREATE STRONG, LOCAL PROVIDER NETWORKS. WE ARE DEDICATED TO OUT MISSIONS AND VALUES: TO PROMOTE THE QUALITY OF LIFE OF OUR COMMUNITIES BY EMPOWERING OTHERS AND WORKING TOGETHER TO CREATIVELY SOLVE UNIQUE HEALTH AND LONG TERM CARE NEEDS. 0 0 90890999 0 105786193 Care Wisconsin Health Plan, Inc. (CWHP) offers Partnership, which provides health and long-term management and care services to the elderly and adults with disabilities. CHWP's Partnership's enrollment at the end of 2015 was 1,483 members. 11085160 0 13351757 CARE WISCONSIN HEALTH PLAN, INC. (CWHP) OFFERS MEDICAID SSI, A HEALTH INSURANCE PROGRAM FOR INDIVIDUALS WITH A DISABILITY WHO QUALIFY FOR FEDERAL SSI. THE SSI PROGRAM HAD 1,759 MEMBERS AS THE END OF 2015. 101976159 1 0 0 1 0 0 0 0 0 0 1 0 0 0 0 0 0 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 1 370 0 1 0 0 0 0 0 0 0 0 0 0 0 X 8 7 0 0 0 0 1 1 1 1 1 0 0 1 1 1 1 1 1 1 1 0 WI X Janette Townsend 6082453083 PO Box 14017 Madison WI 537080017 STEVE CABLE Director 1.00 1.00 X 0 0 0 Dennis Carlson - Thru 615 Director 1.00 X 0 0 0 Iris Christenson - Thru 115 Director 1.00 1.00 X 0 0 0 Denise DeLong Director 1.00 1.00 X 0 0 0 Glenn Johnston Director 1.00 1.00 X 0 0 0 Shawn Liverseed - Thru 1215 Director 1.00 1.00 X 0 0 0 Melvin McCartney Director 1.00 1.00 X 0 0 0 Robert Mucci Director 1.00 X 0 0 0 Andrea Paff - Thru 615 Director 1.00 1.00 X 0 0 0 Terrence Schadeberg - Thru 415 Director 1.00 1.00 X 0 0 0 Greg Thomas Director 1.00 1.00 X 0 0 0 Karen Musser President, CEO 1.00 40.00 X X 0 346540 35834 Ken Eimers COO, Secretary 1.00 40.00 X 0 239100 25456 Terry Metzger - Thru 715 Treasurer & CFAO 1.00 40.00 X 0 137921 19150 Amy Ackerman VP - Human Resources 1.00 40.00 X 0 163864 14735 Susan Crowley VP - Government Services 1.00 40.00 X 0 178111 24904 CHRISTINE BRIESKE Director of Partnership Program 1.00 40.00 X 0 119853 13298 Ruth Christensen Director of Health Plan Svcs 1.00 40.00 X 0 128901 12418 Rebecca Dorscheid Director of Finance 1.00 40.00 X 0 131468 6133 Myra Enloe VP - Performance Excellence 1.00 40.00 X 0 146271 7277 0 1592029 159205 0 0 1 0 UW Hospitals and Clinics 600 Highland Ave Madison WI 53792 Acute and primary services 6276790 St Mary's Hospital PO Box 681090 Milwaukee WI 53268 Acute and primary services 3269910 Meriter Hospital Inc 202 S Park Street Madison WI 53715 Acute and primary services 2891887 Community Living Alliance Inc 1414 MacArthur Road Madison WI 53714 LTC Member Services 2115402 Bethesda Lutheran Communities Inc 600 Hoffmann Drive Watertown WI 53094 LTC Member Services 2087454 136 Medicare/Medicaid 624100 114324191 114324191 WI Family Care Partnership Progra 624100 4642845 4642845 Insurance Recoveries 624100 170914 170914 119137950 481109 481109 3647319 3778578 -131259 -131259 -131259 49395 49395 49395 119537195 119137950 0 399245 X 270690 270690 85569 85569 3003 3003 97549748 96768574 781174 290674 290674 3046 3046 198165 198165 Allocated Adminstration 15528979 10445924 5083055 Deferred Tax Expense 790000 790000 Bad Debt Expense 125000 125000 reversal of Premium Res -5241342 -5241342 109603532 101976159 7627373 0 10704523 16434026 2149027 2467186 15274 58168 503682 229622 0 274060 16043890 15593028 1129417 14000 30042131 34840468 17398508 12659390 6521 6995 17405029 12666385 X 12637102 22174083 12637102 22174083 30042131 34840468 9933663 -396682 0 X 0 1 X 1 1 1 X 79423175 93759812 92933503 102772504 119137950 488026944 79423175 93759812 92933503 102772504 119137950 488026944 0 0 0 488026944 449670 400461 417679 446732 481109 2195651 449670 400461 417679 446732 481109 2195651 79872845 94160273 93351182 103219236 119619059 490222595 0.99550 0.99490 0.00450 0.00510 X 0 0 0 0 0 0 0 0 1 85569 85569 0 Part II-B, Line 1: NATIONAL HEALTH POLICY GROUP ($30,319) AND THE WISCONSIN ASSOCIATION OF HEALTH PLANS ($55,250) REPRESENT SNP AND THE UNIQUE NEEDS OF SNP MEMBERS. MICHAEL BLUMENFELD IS RESPONSIBLE FOR AWARENESS AND REPRESENTATION OF THE MANAGED-CARE ORGANIZATIONS AND MEMBERS OF MEDICAID FUNDED LONG-TERM CARE PROGRAMS. THESE AMOUNTS INCLUDE THE LOBBY PORTION OF DUES TO AHA AND WHA OR AAHSA AND WAAHSA. 503682 229622 274060 274060 119137510 -396682 -396682 119534192 3003 3003 119537195 109600529 0 109600529 3003 3003 109603532 0 0 0 0 0 0 0 0 0 Karen Musser President, CEO 0 344127 0 0 0 2413 0 9033 0 26801 0 382374 0 0 Ken Eimers COO, Secretary 0 237602 0 0 0 1498 0 4450 0 21006 0 264556 0 0 Terry Metzger - Thru 715 Treasurer & CFAO 0 137740 0 0 0 181 0 3769 0 15381 0 157071 0 0 Amy Ackerman VP - Human Resources 0 163659 0 0 0 205 0 4977 0 9758 0 178599 0 0 Susan Crowley VP - Government Services 0 177083 0 0 0 1028 0 5440 0 19464 0 203015 0 0 Myra Enloe VP - Performance Excellence 0 145507 0 0 0 764 0 4445 0 2832 0 153548 0 0 Form 990, Part VI, Section A, line 6 Care Wisconsin First, Inc. a Wisconsin nonprofit 501(c)(3) corporation is the sole member of the organization. Form 990, Part VI, Section A, line 7a Each year at its annual meeting, Care Wisconsin First, Inc. as the sole member of the organization, shall elect the directors according the organizations bylaws. Form 990, Part VI, Section A, line 7b The following actions require the prior authorization or approval of Care Wisconsin First, Inc. as its sole member: A. Merger, conversion into a stock or mutual corporation, or voluntary dissolution of the Corporation; B. Amendment or restatement of the Articles of Incorporation of the Corporation or of the Bylaws, except as provided in Article XIII; C. A transfer or other disposition of all, or substantially all, the property and assets of the Corporation; or, D. The establishment, formation, acquisition, merger, consolidation or dissolution of any subsidiary corporation of the Corporation. E. Any action that would affect the tax-exempt status of either the Corporation or the Voting Member. F. Action on any matter that is determined to be under the control of the Voting Member under the Articles of Incorporation, these Bylaws, or Chapter 613 of the Wisconsin Statutes. Form 990, Part VI, Section B, line 11 THE CHIEF FINANCIAL OFFICER PERFORMS AN EXTENSIVE REVIEW PRIOR TO FILING THE FORM 990 WITH THE INTERNAL REVENUE SERVICE. PRIOR TO FILING THE 990 WITH THE IRS, THE FORM IS MADE AVAILABLE TO THE MEMBERS OF THE BOARD. Form 990, Part VI, Section B, line 12c Each year, all board members and executive team members must sign the conflict of interest document to certify that they are in compliance. Form 990, Part VI, Section B, line 15 ALL WAGES ARE PAID BY CARE WISCONSIN FIRST INC. WHICH IS THEN REIMBURSED BY CARE WISCONSIN HEALTH PLAN, INC. THE FOLLOWING DESCRIBES HOW CARE WISCONSIN FIRST, INC. DETERMINES ITS SALARY AND WAGES. FOR THE EXECUTIVE TEAM, A CONSULTANT HELPS WITH REVIEWING THE MARKET DATA FOR SIMILAR ORGANIZATIONS FOR DETERMINING THE APPROPRIATE PAY RANGES AND PAY RATES FOR THE INCUMBENTS. THE CONSULTANT WILL MAKE THE RECOMMENDATION FOR THE COMPENSATION TO THE CEO, FOR THE EXECUTIVE TEAM MEMBERS, WHO THEN REVIEWS AND APPROVES. FOR THE CEO'S COMPENSATION, THE BOARD RECEIVES THE RECOMMENDATION FROM THE CONSULTANT AND WILL REVIEW AND APPROVE. Form 990, Part VI, Section C, line 19 Records are made available to the public upon request by mailing to Care Wisconsin Health Plan, Inc. C/O CFO, PO Box 14017, Madison, WI 53708-0017. Form 990, Part IX, line 11g Other Fees: Program service expenses 0. Management and general expenses 781,174. Fundraising expenses 0. Total expenses 781,174. Purchased Services: Program service expenses 80,578,901. Management and general expenses 0. Fundraising expenses 0. Total expenses 80,578,901. Medical Equip/supplies - Members: Program service expenses 16,189,673. Management and general expenses 0. Fundraising expenses 0. Total expenses 16,189,673. Care Wisconsin First Inc PO Box 14017 Madison WI 53708 391245329 Care Management WI 501(c)(3) Line 9 N/A 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1 1 0 0 0 0