2015-11-16T12:12:48-06:00 2014-12-31 990 2014-01-01 320121856 CareSource Indiana Inc % JANET FERNANDES CARE 9375313027 PO Box 8738 Dayton OH 454018738 L Tarlton Thomas III CFO 2015-11-16 2014 2016-02-25 16:41:14Z Pamela B Morris Same as C Above Dayton OH 45401 1947 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 2 0 0 0 -323400 0 0 3225 743 0 1204 0 0 3225 1947 5000 3000 0 0 0 0 0 0 0 41129 320400 46129 323400 -42904 -321453 1570139 2974336 8311 733961 1561828 2240375 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. true false 242363 3000 743 CareSource's mission is to make a lasting difference in our members' lives by improving their health and well-being. At CareSource, we take our mission to heart. In fact, we call the Company mission our "heartbeat." It is the essence of our company and our unwavering dedication. It is a hallmark of CareSource's success. CareSource's health plans are founded on the principles of quality and service delivered with compassion and understanding. CareSource goes the extra mile to ensure members receive the highest quality of care. CareSource Indiana is pursuing National Committee for Quality Assurance (NCQA) health plan accreditation for its Just4Me plan. NCQA is a private, nonprofit organization dedicated to improving health care quality. 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 CareSource Indiana's commitment to quality and improving the health and well being of our members. 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 Just4Me members via an innovative health and wellness methodology. CareSource has a broad network of providers who provide medical services as well as assist in the coordination of member care. CareSource Indiana's Just4Me plan 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. The CareSource Just4Me plan was successfully implemented with enrollment beginning for CareSource Indiana on October 1, 2014 with an effective date of January 1, 2015. Form 990-T has been filed for 2014 reflecting expenses related to CareSource Just4Me. CareSource Indiana has no revenue to report in 2014 related to Just4Me. 242363 true false false false 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 0 0 0 false false false false false false false false false false X 4 2 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 1.0 4.0 X 0 6250 0 Kevin R Brown Trustee 1.0 2.0 X 0 43750 0 Steven Smitherman to 1214 Trustee 1.0 0.0 X 0 0 0 Pamela B Morris President/CEO/TRUSTEE 2.0 58.0 X X 0 1844762 1298775 Craig Thiele MD Chief Medical Officer 2.0 58.0 X 0 674507 307473 Bobby Jones Chief Operating Officer 2.0 58.0 X 0 752934 358224 L Tarlton Thomas III Chief Financial Officer 2.0 58.0 X 0 534616 292101 0 3856819 2256573 0 false true false 0 0 COORDINATION OF BENEFIT RECOVERIES 524114 743 743 743 1204 1204 0 0 0 0 0 0 0 0 0 0 1947 743 0 1204 3000 3000 0 0 0 0 0 0 0 0 0 0 401 401 2013 2013 0 0 0 0 3534 3534 51274 434 50840 3527 3527 0 19998 19998 10609 10609 0 2573 2455 118 245 245 0 0 187 187 FILING FEES/DUES 2054 345 1709 MGMT FEES CARESOURCE MGMT GRP 223985 221986 1999 323400 242363 81037 0 570139 973187 1000000 1000000 0 0 0 1001149 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1570139 2974336 8311 4533 0 0 0 611820 0 0 0 0 0 0 0 0 0 0 0 117608 8311 733961 X 1561828 2240375 0 0 0 0 1561828 2240375 1570139 2974336 X -321453 1000000 X false true X true false X 0 0 0 0 0 0 67660 27769 10202 3225 743 109599 0 0 0 67660 27769 10202 3225 743 109599 0 0 0 109599 16836 250 620 0 1204 18910 0 16836 250 620 0 1204 18910 0 0 84496 28019 10822 3225 1947 128509 0.85285 0.97669 0.14715 0.02331 X 0 RELATED PARTY PAYABLE 117608 117608 FIN 48 (ASC 740) Footnote The audited consolidated GAAP financial statements summarize ASC 740 as follows: 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 2011-2014 are open for audit by the Internal Revenue Service. false true false false false false true false false Pamela B Morris President/CEO/TRUSTEE 0 889936 0 630300 0 324526 0 1276851 0 21924 0 3143537 0 925059 Craig Thiele MD Chief Medical Officer 0 384233 0 162759 0 127515 0 279028 0 28445 0 981980 0 162759 Bobby Jones Chief Operating Officer 0 435731 0 165814 0 151389 0 333072 0 25152 0 1111158 0 165814 L Tarlton Thomas III Chief Financial Officer 0 331728 0 124338 0 78550 0 265974 0 26127 0 826717 0 124338 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 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.: Pamela B Morris, Craig Thiele MD, Bobby Jones and L Tarlton Thomas III. 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, Bobby Jones and L Tarlton Thomas III. Amounts accrued in 2014 for both deferred compensation arrangements include: Pamela B Morris $842,344; Craig Thiele MD $204,536; L Tarlton Thomas III $164,602 and Bobby Jones $253,377. 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 Indiana, Inc.: Craig Thiele MD, Bobby Jones and L Tarlton Thomas III. All of these officers 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. Listed Person Pamela B Morris is an employee of CareSource Management Group Co, a related organization to CareSource Indiana, Inc., and Ms. Morris is eligible for a performance bonus as part of her compensation package. 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. Form 990, 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 legal counsel, and by general counsel prior to filing 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 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 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 III, Line 2; Form 990, Part V, Line 3B CareSource Indiana, Inc. (CareSource Indiana), a part of the CareSource Family of Companies (CareSource), is a leading nonprofit managed care organization that has been living its mission to make a lasting difference in our members' lives by improving their health and well-being. CareSource Indiana began offering Just4Me, a Qualified Health Plan on the Health Insurance Marketplace on 1-1-15, providing low-cost comprehensive coverage for individuals and families. To date, the plan serves more than 20,000 members in the state. Form 990, Part XI, Line 9 (1) Change in Net Assets: Distribution to parent Organization CareSource Management Group Co in December, 2014 in the amount of $1,000,000. 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 (3414) PO Box 8738 Dayton OH 45401 464991603 Exchange HMO KY 501(c)(3) 509(a)(2) NA false CareSource Georgia Co (112414) PO Box 8738 Dayton OH 45401 472408339 Medicaid HMO GA 501(C)(3) 509(a)(2) NA 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 false false true false