2011-11-11T09:56:16-05:00 2010-12-31 990 2010-01-01 383252216 CareSource Michigan CARE 9372243300 2900 West Road East Lansing MI 48823 L Tarlton Thomas III 2011-11-04 2010 2016-03-07 17:11:31Z Pamela B Morris PO Box 8738 Dayton OH 45401 93495581 false X www.caresource-michigan.com X 1995 MI To make a difference in the lives of underserved people by improving their health care. CareSource Michigan offers a full spectrum of services for Medicaid Managed Care Members. 6 4 0 0 0 0 0 0 116986915 92574132 1127468 918059 0 0 118114383 93492191 111621 142611 0 0 0 0 0 0 0 97718182 83046972 97829803 83189583 20284580 10302608 44481173 39362035 22872002 17450256 21609171 21911779 CARESOURCE MICHIGAN'S VISION IS TO BE AN INNOVATIVE LEADER IN THE MANAGEMENT OF QUALITY PUBLIC SECTOR HEALTH CARE PROGRAMS. THE ORGANIZATION'S MISSION IS TO MAKE A DIFFERENCE IN THE LIVES OF UNDERSERVED PEOPLE BY IMPROVING THEIR HEALTH CARE. CARESOURCE MICHIGAN CONSIDERS THE ORGANIZATION'S MISSION ITS "HEARTBEAT" AND IS PASSIONATELY EMBRACED BY ALL EMPLOYEES OF THE CARESOURCE FAMILY OF COMPANIES. CARESOURCE MICHIGAN IS A NONPROFIT INDEPENDENT MISSION-DRIVEN MEDICAID MANAGED CARE ORGANIZATION LICENSED BY THE STATE OF MICHIGAN. false false 78111381 142611 92574132 CareSource Michigan ("CSM") is a nonprofit Medicaid health maintenance organization (HMO) which received a Certificate of Authority from the State of Michigan. The organization provides services through a contract with the Michigan Department of Community Health. CareSource Michigan is URAC accredited as a health plan and health call center. The mission of CareSource Michigan is to make a difference in the lives of underserved people by improving their health care. CareSource Michigan combines the financing and delivery of health-care services to about 38,000 Medicaid beneficiaries in 31 Michigan counties. CareSource Michigan was originally founded as Community Choice Michigan by 16 of the state's Federally Qualified Health Centers ("FQHCs"). The FQHCs remain the primary providers of CareSource Michigan healthcare services that have historically provided care to medically underserved populations and to people in areas designated as medically underserved. Currently, the Medicaid populations served by the program include Temporary Assistance for Needy Families, and Aged, Blind and Disabled. In addition, CareSource Michigan has a contract with the Center for Medicare and Medicaid Services to operate a Dual Eligible Medicare advantage/special needs plan called CareSource Advantage available to those who are eligible for Medicare Part A and Part B, as well as Medicaid. At the core of its mission, CareSource Michigan focuses on prevention with a goal of improving member health, the quality of the health care, and accessibility of health care services for Medicaid consumers via an innovative health and wellness methodology. CareSource Michigan's network also includes many other primary care and specialist physicians, hospitals, nursing facilities, home health care agencies, and other medical providers who assist in the coordination of member care. In addition, CareSource Michigan offers 24 hour call center coverage to provide around the clock medical advice to help members access appropriate care when they need it. Transportation services for medical appointments are also provided. CareSource Michigan reaches out to members, in their homes and communities, through case management and outreach services, to assess needs and to initiate service plans. From high risk pregnancy to member education and advocacy, personal interaction proves crucial in coordinating the needed medical and community support services. Member and provider newsletters provide additional health information. In order to make a difference in the lives of underserved people by improving their health care, CareSource Michigan has provided benefits to its members above the Michigan Medicaid Managed Care covered services. CareSource Michigan does not charge co-pays for any covered services to our members. CareSource Michigan also provides full services coverage for members who are 21+ with no cost to the member and no reimbursement for costs for services reduced/eliminated by the Michigan Department of Community Health, including some chiropractic visits, podiatric visits, hearing aids and vision. Collectively, the aforementioned activities and initiatives enhance access to comprehensive quality health care for everyone, especially those who are medically underserved. All told, in 2010, CareSource Michigan paid nine hundred sixty-eight thousand two hundred ninety-two dollars ($968,292) above the required Michigan Medicaid Managed Care program benefits in order make a difference in the lives of underserved people by improving their health care. In the spirit of CareSource Michigan's commitment to good corporate citizenship, its appointed trustees and committee members earn charitable credits for each meeting attended. At year-end, the trustees and committee members designate their credits to their IRC section 501(C)(3) charity of choice. Charitable Donations in the amount of $29,200 were paid or accrued in 2010 under this policy by the organization. Moreover, consistent with the Office of Financial and Insurance Regulation statutes, CareSource Michigan includes elected members from our enrolled population on the health plan board. These board members are not included in the aforementioned charitable contribution donations. 78111381 true false false true false false false false false false false false false true false false true false false false false false false false false false true false true false false false false false false false false false false false false false true false false false false true 1241 0 0 false false false false false false false false false false X 6 4 false false false false true true true true true false false true true true true true true true true false MI X JANET FERNANDES 9372243300 PO BOX 8738 Dayton OH 454018738 X John M Rockwood Jr 1.0 X 0 0 0 J Thomas Maultsby 1.0 X 0 0 0 R Daniel Sadlier 110 - 910 1.0 X 0 0 0 Karen Hamilton 1.0 X 0 0 0 Evonne Williams 1.0 X 0 0 0 Margaret Marchak 1.0 X 0 0 0 Pamela B Morris 60.0 X X 0 1761437 477210 Craig Thiele MD 60.0 X 0 429628 225643 Bobby Jones 60.0 X 0 422023 229173 Sharon Williams 60.0 X 0 271951 133552 L Tarlton Thomas III 60.0 X 220368 120706 Janet Grant 60.0 X 0 379402 99714 Pamela S Sedmak 0.0 X 0 215993 0 0 3700802 1285998 0 true true false Rx America 3011 W Grand Blvd 414 DETROIT MI 48202 Prescription Svcs 16257753 Lakeland Regional Health System 1234 Napier Ave SAINT JOSEPH MI 490852112 Medical Services 6317965 Spectrum Health Hospitals 100 Michigan St NE GRAND RAPIDS MI 495032560 Medical Services 6045176 Munson Medical Center 1105 6th St TRAVERSE CITY MI 49684 Medical Services 5481536 Bronson Methodist Hospital PO Box 77000 Dept 7792B DETROIT MI 48277 Medical Services 5344123 89 0 MEDICAID & MEDICARE 524114 92574132 92574132 92574132 921449 921449 0 0 3390 -3390 -3390 -3390 0 0 0 0 93492191 92574132 0 918059 142611 142611 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 67456 0 67456 0 271439 16463 254976 0 30098 1025 29073 0 0 0 0 0 0 0 1161156 620657 540499 0 207789 15854 191935 0 725030 60706 664324 0 259712 0 259712 0 0 0 0 0 492870 199 492671 0 202814 178431 24383 0 0 0 0 0 45692 30683 15009 0 29655 0 29655 0 0 0 561675 0 561675 51908 0 51908 FILING/BANK/MEMBERSHIPS 115949 4730 111219 MGMT FEES PAID TO CSMG/CSMS 5051951 3283222 1768729 MEDICAL EXPENSES 59795266 59795266 PHARMACY EXPENSES 13961534 13961534 BOARD EXPENSES 14978 0 14978 83189583 78111381 5078202 0 2402504 4951348 20658463 17021498 2833551 1743475 18586655 15645714 0 0 44481173 39362035 14640569 16714947 8231433 735309 22872002 17450256 X 21609171 21911779 21609171 21911779 44481173 39362035 X 10302608 -10000000 X false true true X false X 94707103 106165552 116343892 116986915 92574132 526777594 94707103 106165552 116343892 116986915 92574132 526777594 526777594 1095619 1346678 1139707 1138728 921449 5642181 1095619 1346678 1139707 1138728 921449 5642181 95802722 107512230 117483599 118125643 93495581 532419775 0.98940 0.98952 0.01060 0.01048 X false false false false false false true 50694 false false 50694 false false 0 RELATED PARTY PAYABLE 735309 735309 true The CareSource Foundation PO Box 8738 Dayton OH 45401 562582561 509(a)(3) 113411 Grant Funding 13 0 Contribution Review Schedule I, Part I, Question 2 The company may provide assistance to other Internal Revenue Code tax exempt charitable organizations in the form of charitable contributions. These contributions are unrestricted funds available for use by the charitable organization for the purpose the charitable organization deems necessary. In 2010, the company made distributions to The CareSource Foundation, a 501(c)(3) organization in furtherance of its tax exempt purpose, by providing grants to Michigan based tax exempt charitable organizations. The CareSource Foundation monitors use of the grants awarded as part of its annual review process once grants have been approved. Contributions on Behalf of Board Members Schedule I, Part II In the spirit of CareSource Michigan's commitment to its charitable purposes, its appointed trustees and committee members earn charitable credits for each meeting attended. At year-end, the trustees and committee members designate their credits to their internal revenue code section 501(c)(3) tax exempt charity of choice. Charitable Donations in the amount of $29,200 were paid or accrued in 2010 under this policy by the organization and are represented on Schedule I in the form of general support contributions. X X X X X X true true false false false false true false false Pamela B Morris 0 574739 0 988634 0 198064 0 460939 0 16271 0 2238647 0 698767 Craig Thiele MD 0 310800 0 118000 0 828 0 204634 0 21009 0 655271 0 118000 Bobby Jones 0 307109 0 101250 0 13664 0 215278 0 13895 0 651196 0 101250 Janet Grant 0 207893 0 83825 0 87684 0 86899 0 12815 0 479116 0 83825 Sharon Williams 0 193055 0 63806 0 15090 0 118371 0 15181 0 405503 0 63806 L Tarlton Thomas III 169882 46256 4230 101844 18862 341074 46256 Pamela S Sedmak 0 0 0 0 0 215993 0 0 0 0 0 215993 0 0 Officer Compensation Schedule J, Part II The following corporate officers are employees of CareSource Management Group, Co., a related organization to CareSource Michigan: Bobby Jones and Sharon Williams. All compensation amounts reported on Schedule J, Part II, for these individuals are paid by CareSource Management Group Co. The compensation amounts for the remaining listed persons listed on Schedule J, Part II are paid by CareSource Management Services Co, also a related organization to CareSource Michigan. Deferred Compensation Schedule J, Part I, Question 4b The following listed persons listed in Form 990, Part VII, Section A, participate in a supplemental nonqualified retirement plan of a related entity, CareSource Management Services Co.: Craig Thiele MD, L Tarlton Thomas III, and Janet Grant. 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.: Bobby Jones and Sharon Williams. 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 corporate officer , Pamela Morris, participated in a separate supplemental retirement plan and received payment from the plan in 2010. Payment in the amount of $579,734 is included in Part VII and Schedule J, Part II. Payments contingent on net earnings Schedule J, Part I, Question 6b The following listed persons listed in Form 990, Part VII, Section A, line 1a are employees of CareSource Management Services Co, a related organization to CareSource Michigan: Craig Thiele MD, L Tarlton Thomas III and Janet Grant. Corporate Officers Bobby Jones and Sharon Williams are employees of CareSource Management Group Co, also a related organization to CareSource Michigan. 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 individual's calendar year regular earnings. Corporate Officer Pamela B Morris is eligible for a performance bonus as part of her compensation package. Severance Payment Schedule J, Part I, question 4a During 2010, a severance payment in the amount of $215,993 was paid to the former CFO, Pamela S Sedmak. Form 990 Review 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 CFO, an outside CPA firm, outside counsel, and by general counsel prior to filing with the IRS. Conflict of Interest Policy 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 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. Compensation Review Part VI, Section B, Questions 15a and 15b 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 Independent Board members' decision and rationale are captured in minutes that are prepared and signed in a contemporaneous substantiation of the deliberation and decisional process of the Independent Board. 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. Governing Documents 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 also available on the U.S. nonprofit database website at www.guidestar.org. Financial Statements for the organization are available at the Office of Financial and Insurance Regulation website at www.michigan.gov/dleg. The company's articles of incorporation are available on the Michigan Department of Energy, Labor and Economic Growth website at www.dleg.state.mi.us/bcs_corp/sr_corp.asp. Avg Hours Per Week Devoted to Related Organizations Part VII, Section A, Avg Hours per week devoted to related organizations The following listed persons split their time between all the entities of the CareSource family of companies: Pamela Morris, Craig Thiele MD, L Tarlton Thomas III, Janet Grant, and Bobby Jones. The total hours worked by each listed person exceeds 60 hours per week for the combined CareSource companies, and as a general practice is allocated among the following entities: CareSource, 70%; CareSource Michigan, 10%; CareSource Management Group Co, 10%; The CareSource Foundation, 4%; CareSource Indiana, Inc and CareSource Illinois, 2%; CareSource Insurance LLC, 2%; and CareSource Management Services Co, 2%. Corporate Officer Sharon Williams devotes 100% of her time to CareSource Michigan. Governing Body Members Part VI, Section A, Questions 7a and 7b In accordance with Michigan Law, MCL Law 500.3511, one-third (1/3) of the Board of Directors of CareSource Michigan shall consist of adult enrollees (Michigan Medicaid Members) of CareSource Michigan who are not compensated officers, employees, stockholders or who own more than five percent (5%) of the organization's shares or other individuals responsible for the conduct of, or financially interested in, the organization's affairs. The enrollee Board Members shall be elected by simple plurality of voting subscribers. Each subscriber shall have one (1) vote. In addition, the non-enrollee board members are elected by the Member, CareSource Management Group Co., a related federally tax exempt supporting organization. Change in Net Assets Part XI, Line 5 CareSource Michigan made a $10,000,000 dividend distribution to CareSource Management Group, its controlling member, on October 1, 2010. HOURS DEVOTED FOR RELATED ORGANIZATION FORM 990 PART VII NAME:John M Rockwood Jr TITLE:Chairperson/Trustee HOURS: HOURS DEVOTED FOR RELATED ORGANIZATION FORM 990 PART VII NAME:J Thomas Maultsby TITLE:Vice Chairperson/Trustee HOURS:3 HOURS DEVOTED FOR RELATED ORGANIZATION FORM 990 PART VII NAME:R Daniel Sadlier (1/10 - 9/10) TITLE:Vice Chairperson/Trustee HOURS: HOURS DEVOTED FOR RELATED ORGANIZATION FORM 990 PART VII NAME:Karen Hamilton TITLE:Trustee - Enrollee HOURS: HOURS DEVOTED FOR RELATED ORGANIZATION FORM 990 PART VII NAME:Evonne Williams TITLE:Trustee - Enrollee HOURS: HOURS DEVOTED FOR RELATED ORGANIZATION FORM 990 PART VII NAME:Margaret Marchak TITLE:Trustee HOURS: HOURS DEVOTED FOR RELATED ORGANIZATION FORM 990 PART VII NAME:Craig Thiele MD TITLE:Chief Medical Officer HOURS: CareSource Management Group Co PO Box 8738 Dayton OH 45401 311703368 Support Org OH 501(C)(3) 509(a)(3) I NA CareSource Indiana Inc PO Box 8738 Dayton OH 45401 320121856 Medicaid HMO IN 501(c)(3) 509(a)(2) NA The CareSource Foundation PO Box 8738 Dayton OH 45401 562582561 Grant Giving OH 501(C)(3) 509(A)(3) I CareSource CareSource Illinois PO Box 8738 Dayton OH 45401 272202797 Inactive IL Not Determined NA CareSource Management Services Co PO Box 8738 Dayton OH 454018738 311703371 Adm Mgmt Svcs OH NA C Corp 0 0 0.00000 false true false false false false false false false false false false true false true false false false