2013-09-10T15:15:19-05:00 2012-12-31 390758449 WIPFLI LLP 10000 INNOVATION DRIVE SUITE 250 MILWAUKEE WI 532264837 990 2012-01-01 270093404 CARE WISCONSIN HEALTH PLAN INC CARE 6082400020 PO BOX 14017 MADISON WI 537080017 KAREN MUSSER 6082400020 2013-09-10 1 JAY ADKISSON CPA P01360892 4144319300 2013-08-20 2012 2016-02-24 21:20:13Z KAREN MUSSER PO BOX 14017 MADISON WI 537080017 99384532 0 X WWW.CAREWISCONSINHEALTHPLAN.ORG X 2004 WI CARE WISCONSIN HEALTH PLAN, INC. IS A HEALTH MAINTENANCE ORGANIZATION. ITS PRIMARY PURPOSE IS PROVIDING HEALTH AND LONG-TERM MANAGEMENT AND CARE SERVICES TO ELIGIBLE MEMBERS. 5 4 0 4 0 0 0 0 79423175 93759812 579419 543707 0 0 80002594 94303519 0 0 64633573 0 0 731079 0 0 0 18346459 87140873 82980032 87871952 -2977438 6431567 20697967 25467439 10453737 8791642 10244230 16675797 CARE WISCONSIN HEALTH PLAN, INC. (CWHP) PROVIDES HEALTH AND LONG-TERM MAINTENANCE ORGANIZATION INSURANCE TO NURSING HOME ELIGIBLE MEMBERS UNDER THE STATE OF WISCONSIN FAMILY CARE PARTNERSHIP PROGRAM. CWHPS' ENROLLMENT AT THE END OF 2012 WAS 1,318 MEMBERS. 0 0 85799817 93903058 CARE WISCONSIN HEALTH PLAN, INC. (CWHP) IS A HEALTH MAINTENANCE ORGANIZATION UNDER SECTION 613 OF THE WISCONSIN STATUTES. IT HAS BEEN FORMED FOR THE PRIMARY PURPOSE OF PROVIDING HEALTH AND LONG-TERM MANAGEMENT AND CARE SERVICES TO THE ELDERLY AND ADULTS WITH DISABILITIES UNDER A HEALTH MAINTENANCE ORGANIZATION LICENSE ISSUED BY THE WISCONSIN OFFICE OF THE COMMISSIONER OF INSURANCE. CHWP'S ENROLLMENT AT THE END OF 2012 WAS 1,318 MEMBERS. 85799817 1 0 0 1 0 0 0 0 0 0 0 0 0 0 1 1 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 1 289 0 1 0 0 0 0 0 0 0 0 0 0 0 X 5 4 0 0 0 0 0 0 0 1 1 0 0 1 1 1 1 1 1 1 1 0 X TERRY METZGER 6082453066 PO BOX 14017 MADISON WI 537080017 X STEVE CABLE 1.00 X 0 0 0 DENNIS CARLSON 1.00 X 0 0 0 ROBERT MUCCI 1.00 X 0 0 0 PEG SMELSER 1.00 X 0 0 0 KAREN MUSSER 1.00 X X 0 255113 20721 KEN EIMERS 1.00 X X 0 199132 20007 TERRY METZGER 1.00 X X 0 163878 17890 0 618123 58618 0 0 1 0 UNIVERSITY OF WISCONSIN HOSPITALS AND CL 600 HIGHLAND AVE MADISON WI 53792 ACUTE AND PRIMARY SERVICES 5013667 MERITER HOSPITAL INC 202 S PARK STREET MADISON WI 53715 ACUTE AND PRIMARY SERVICES 3453527 COMMUNITY LIVING ALLIANCE INC 1414 MACARTHUR ROAD MADISON WI 53714 LONG TERM CARE SERVICES 3218410 ST MARY'S HOSPITAL PO BOX 681090 MILWAUKEE WI 53268 ACUTE AND PRIMARY SERVICES 3031181 UNIVERSITY OF WISCONSIN MEDICAL FOUNDATI PO BOX 44287 MADISON WI 53744 ACUTE AND PRIMARY SERVICES 1567694 101 MEDICARE/MEDICAID 624100 89251089 89251089 WI FAMILY CARE PARTNERSHIP PROGRA 624100 4359869 4359869 INSURANCE PREMIUMS 624100 148854 148854 93759812 400461 400461 5224259 5081013 143246 143246 143246 94303519 93903058 0 400461 X 552112 552112 178967 178967 218927 218927 33266 33266 62488 62488 55526256 55487280 38976 386559 386559 539854 269463 270391 ALLOCATED ADMINSTRATION 16269469 15875892 393577 MEDICAL EQUIP/SUPPLIES 12953431 12953431 DEFERRED TAX EXPENSE 583000 583000 ASSESSMENTS 296710 296710 270913 96113 174800 87871952 85799817 2072135 0 5746929 9293639 547739 1878671 13938721 14295129 464578 0 20697967 25467439 10448997 8759652 4740 13568 0 18422 10453737 8791642 X 10244230 16675797 10244230 16675797 20697967 25467439 6431567 0 X X 0 1 X 1 1 1 X 57465779 67378340 70713147 79423175 93759812 368740253 57465779 67378340 70713147 79423175 93759812 368740253 0 0 0 368740253 691250 591307 517442 449670 400461 2650130 691250 591307 517442 449670 400461 2650130 58157029 67969647 71230589 79872845 94160273 371390383 0.99290 0.99070 0.00710 0.00930 X 0 0 0 0 0 0 0 0 1 33268 33268 0 EXPLANATION OF LOBBYING ACTIVITIES: PART II-B, LINE 1: NATIONAL HEALTH POLICY GROUP ($28,712) REPRESENTS SNP'S (SPECIAL NEEDS PLANS) AND THE UNIQUE NEEDS OF SNP MEMBERS. MICHAEL BLUMENFELD ($4,556)IS RESPONSIBLE FOR AWARENESS AND REPRESENTATION OF THE MANAGED-CARE ORGANIZATIONS AND MEMBERS OF MEDICAID FUNDED LONG-TERM CARE PROGRAMS. 0 DEFERRED TAX LIABILITY 18422 18422 X 94241031 0 94241031 62488 62488 94303519 87809464 0 87809464 62488 62488 87871952 DESCRIPTION OF UNCERTAIN TAX POSITIONS UNDER FIN 48: PART X, LINE 2: IN ORDER TO ACCOUNT FOR ANY UNCERTAIN TAX POSITIONS, THE COMPANY DETERMINES WHETHER IT IS MORE LIKELY THAN NOT THAT A TAX POSITION WILL BE SUSTAINED UPON EXAMINATION OF THE TECHNICAL MERITS OF THE POSITION, ASSUMING THE TAXING AUTHORITY HAS FULL KNOWLEDGE OF ALL INFORMATION. IF THE TAX POSITION DOES NOT MEET THE MORE-LIKELY-THAN-NOT RECOGNITION THRESHOLD, THE BENEFIT OF THAT POSITION IS NOT RECOGNIZED IN THE CONSOLIDATED FINANCIAL STATEMENTS. THE COMPANY RECORED NO ASSETS OR LIABILITIES RELATED TO UNCERTAIN TAX POSITIONS IN 2012 OR 2011. TAX RETURNS FOR TAX YEARS 2009 AND BEYOND REMAIN SUBJECT TO EXAMINATION BY THE APPLICABLE TAXING AUTHORITIES. 0 0 0 0 0 0 0 0 0 KAREN MUSSER 0 253412 0 0 0 1701 0 6814 0 13907 0 275834 0 0 KEN EIMERS 0 198332 0 0 0 800 0 5002 0 15005 0 219139 0 0 TERRY METZGER 0 163650 0 0 0 228 0 4632 0 13258 0 181768 0 0 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. AT THE NEXT BOARD MEETING KEY COMPONENTS OF THE 990 RETURN ARE DISCUSSED. 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 TERRY METZGER, PO BOX 14017, MADISON, WI 53708-0017. COMPENSATION FROM A RELATED ORGANIZATION: FORM 990, PART VII, SECTION A, LINE 1A THE FOLLOWING INDIVIDUALS EARNED WAGES FROM A RELATED ORGANIZATION: KAREN MUSSER, CEO OF CARE WISCONSIN FIRST INC, EARNED $255,113 IN W-2 WAGES AND WORKED ON AVERAGE 40 HOURS PER WEEK RELATED TO THIS POSITION. KEN EIMERS, COO OF CARE WISCONSIN FIRST INC, EARNED $199,132 IN W-2 WAGES AND WORKED ON AVERAGE 40 HOURS PER WEEK RELATED TO THIS POSITION. TERRY METZGER, CFO & CAO OF CARE WISCONSIN FIRST INC, EARNED $163,878 IN W-2 WAGES AND WORKED ON AVERAGE 40 HOURS PER WEEK RELATED TO THIS POSITION. OTHER FEES FORM 990, PART IX, LINE 11G OTHER FEES: PROGRAM SERVICE EXPENSES 0. MANAGEMENT AND GENERAL EXPENSES 38,976. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 38,976. PURCHASED SERVICES: PROGRAM SERVICE EXPENSES 55,487,280. MANAGEMENT AND GENERAL EXPENSES 0. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 55,487,280. FORM 990, PART XII, LINE 2C: THE PROCESS HAS NOT CHANGED SINCE THE PRIOR YEAR. CARE WISCONSIN FIRST INC PO BOX 14017 MADISON WI 53708 391245329 CARE MANAGEMENT WI 501(C)(3) LINE 9 N/A 0 0 1 0 0 0 0 0 0 0 0 0 0 1 1 1 0 0 0 0