Form 990 for tax year 2022

Revenue

Part VIII, the statement of revenue.

• 2a · Program service revenue: STATE HEALTH INSURANCE EXCHANGE

  total $232,548,073 · related or exempt $232,548,073

• 2b · Program service revenue: MEDICARE ADVANTAGE

  total $125,910 · related or exempt $125,910

• 2c · Program service revenue: MEDICAID

  total $42,766 · related or exempt $42,766

• 3 · Investment income

  total $723,427 · excluded $723,427

• 4 · Income from investment of tax-exempt bond proceeds

  total $0

• 5 · Royalties

  total $0

• 6c · Rental income or loss

  real property $0 · personal property $0

• 6d · Net rental income or loss

  total $0

• 7d · Net gain or loss

  total $0

• 8a · Fundraising events: gross income

  $0

• 8b · Fundraising events: direct expenses

  $0

• 8c · Net income from fundraising events

  total $0

• 9a · Gaming: gross income

  $0

• 9b · Gaming: direct expenses

  $0

• 9c · Net income from gaming

  total $0

• 10a · Gross sales of inventory

  $0

• 10b · Cost of goods sold

  $0

• 10c · Net income from sales of inventory

  total $0

• 11e · Other revenue, total

  $0

Functional expenses

Part IX, the statement of functional expenses.

• 1 · Grants to domestic organizations and governments

  total $0

• 2 · Grants to domestic individuals

  total $0

• 3 · Grants to foreign organizations and individuals

  total $0

• 4 · Benefits paid to or for members

  total $0

• 5 · Compensation of officers, directors and key employees

  total $0

• 6 · Compensation of disqualified persons

  total $0

• 7 · Other salaries and wages

  total $0

• 8 · Pension plan contributions

  total $0

• 9 · Other employee benefits

  total $0

• 10 · Payroll taxes

  total $0

• 11a · Fees: management

  total $0

• 11b · Fees: legal

  total $104,971 · program services $11,722 · management and general $93,249 · fundraising $0

• 11c · Fees: accounting

  total $117,637 · program services $0 · management and general $117,637 · fundraising $0

• 11d · Fees: lobbying

  total $30,015 · program services $254 · management and general $29,761 · fundraising $0

• 11e · Fees: professional fundraising services

  total $0

• 11f · Fees: investment management

  total $3,400 · program services $0 · management and general $3,400 · fundraising $0

• 11g · Fees: other

  total $9,299,566 · program services $380,747 · management and general $8,918,819 · fundraising $0

• 12 · Advertising and promotion

  total $1,095,501 · program services $135 · management and general $1,095,366 · fundraising $0

• 13 · Office expenses

  total $4,004,482 · program services $25,999 · management and general $3,978,483 · fundraising $0

• 14 · Information technology

  total $0

• 15 · Royalties

  total $0

• 16 · Occupancy

  total $609,808 · program services $0 · management and general $609,808 · fundraising $0

• 17 · Travel

  total $76,727 · program services $11,246 · management and general $65,481 · fundraising $0

• 18 · Travel or entertainment for public officials

  total $0

• 19 · Conferences, conventions and meetings

  total $0

• 20 · Interest

  total $4,582 · program services $0 · management and general $4,582 · fundraising $0

• 21 · Payments to affiliates

  total $0

• 22 · Depreciation, depletion and amortization

  total $0

• 23 · Insurance

  total $91,914 · program services $0 · management and general $91,914 · fundraising $0

• 24a · Other expenses: MEDICAL EXPENSES

  total $139,525,795 · program services $139,525,795 · management and general $0 · fundraising $0

• 24b · Other expenses: PHARMACY EXPENSES

  total $65,375,458 · program services $65,375,458 · management and general $0 · fundraising $0

• 24c · Other expenses: MGMT FEES CARESOURCE MGMT SVCS

  total $13,593,208 · program services $2,246,269 · management and general $11,346,939 · fundraising $0

• 24d · Other expenses: HLTH INS PROVIDER & PCORI FEES

  total $2,465,057 · program services $34,846 · management and general $2,430,211

• 24e · All other expenses

  total $1,500,052 · program services $237,393 · management and general $1,262,659

Balance sheet

Part X, book values.

• 1 · Cash, non-interest-bearing

  beginning of year $0 · end of year $0

• 2 · Savings and temporary cash investments

  beginning of year $69,400,046 · end of year $26,831,546

• 3 · Pledges and grants receivable

  beginning of year $0 · end of year $0

• 4 · Accounts receivable

  beginning of year $9,333,599 · end of year $4,386,998

• 5 · Loans and receivables from officers and key people

  beginning of year $0 · end of year $0

• 6 · Loans and receivables from disqualified persons

  beginning of year $0 · end of year $0

• 7 · Other notes and loans receivable

  beginning of year $0 · end of year $0

• 8 · Inventories for sale or use

  beginning of year $0 · end of year $0

• 9 · Prepaid expenses and deferred charges

  beginning of year $13,814 · end of year $13,305

• 10c · Land, buildings and equipment, net

  beginning of year $0 · end of year $0

• 11 · Investments: publicly traded securities

  beginning of year $3,679,777 · end of year $33,912,392

• 12 · Investments: other securities

  beginning of year $0 · end of year $0

• 13 · Investments: program-related

  beginning of year $0 · end of year $0

• 14 · Intangible assets

  beginning of year $0 · end of year $0

• 15 · Other assets

  beginning of year $0 · end of year $0

• 17 · Accounts payable and accrued expenses

  beginning of year $38,765,980 · end of year $33,251,589

• 18 · Grants payable

  beginning of year $0 · end of year $0

• 19 · Deferred revenue

  beginning of year $12,538,784 · end of year $4,830,910

• 20 · Tax-exempt bond liabilities

  beginning of year $0 · end of year $0

• 21 · Escrow or custodial account liability

  beginning of year $0 · end of year $0

• 22 · Loans and payables to officers and key people

  beginning of year $0 · end of year $0

• 23 · Secured mortgages and notes payable

  beginning of year $0 · end of year $0

• 24 · Unsecured notes and loans payable

  beginning of year $0 · end of year $0

• 25 · Other liabilities

  beginning of year $1,506,975 · end of year $1,904,144

• 27 · Net assets without donor restrictions

  beginning of year $29,615,497 · end of year $25,157,598

• 28 · Net assets with donor restrictions

  beginning of year $0 · end of year $0

The filer's explanations (Part III)

Form 990, Schedule J, Part I, Question 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 compensation committee comprised solely of independent directors. CareSource Management Services LLC ("CSMS"), a related organization, has in place Claw back provisions within its executive compensation plans that generally require executives to pay back compensation to CSMS 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, Schedule J, Part I, Line 4a

Daniel McCabe, David Finkel, and William Coffin, Jr. received severance payments that are properly reported on Schedule J, Part II, Column B(iii).

Form 990, Schedule J, Part I, Question 4b

The following listed persons listed on Form 990, Part VII, Section A, participate in a supplemental nonqualified retirement plan of CSMS: Erhardt Preitauer, Jai Pillai, Lawrence Smart, Scott Markovich, Stephanie Williams, and Michael Taylor. 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 CSMS: Erhardt Preitauer, Jai Pillai, Lawrence Smart, Scott Markovich, Stephanie Williams, and Michael Taylor. 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 performance period, they forfeit any amounts accrued under this plan. Employees must be employed on the date which the long-term incentive plan is paid, which in no event is later than March 15th. Exceptions to this general statement include death, disability, or a qualified retirement, which may result in prorated payment. Amounts paid or accrued in 2022 for both deferred compensation arrangements include the following: Erhardt Preitauer $2,272,354, Jai Pillai $375,388, Lawrence Smart $554,835, Scott Markovich $517,955, Stephanie Williams $288,979, and Michael Taylor $255,192.

Form 990, Schedule J, Part I, Question 6b

The following persons listed on Form 990, Part VII, Section A, line 1a are or were employees of CSMS: Erhardt Preitauer, Jai Pillai, Lawrence Smart, Scott Markovich, Daniel McCabe, Stephanie Williams, Michael Taylor, William Coffin Jr, and David Finkel. All of these listed persons are or were eligible for a performance bonus as part of their compensation packages. The amount of this Annual Incentive Plan ("AIP") bonus is based on the degree of achievement of the Companies' goals and the Individual's goals, which is ultimately documented in the year end performance management process. 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 II

All compensation amounts reported on Schedule J, Part II for all listed persons are paid by CSMS. Compensation paid to the CEO is pursuant to the terms of a written employment agreement between Mr. Preitauer and CSMS.

Related partnerships

Part III: related organizations taxable as a partnership, with the filer's share.

• CSMS Holding LLC (To 122822)

  N/A · Holding Co · DE

  Directly controlled by NA

• CareSource Diversity & Social Impact Inv

  N/A · Investing · IN

  Directly controlled by NA

• CareSource Iowa Opportunity Investment

  N/A · Investing · IA

  Directly controlled by NA

Related corporations and trusts

Part IV: related organizations taxable as a corporation or trust.

• CareSource Virginia Co

  C Corp · No Activity · VA

  Directly controlled by NA

• CareSource Arkansas Health Plan Co

  C Corp · COA Insurance · AR

  Directly controlled by NA

• Kids' CareAlliance Co

  C Corp · No Activity · OH

  Directly controlled by NA

• CareSource Oklahoma Health Plan Co

  C Corp · HMO Ins Plan · OK

  Directly controlled by NA

• CareSource Kansas LLC

  C Corp · HMO Ins Plan · KS

  Directly controlled by NA

• CareSource PASSE LLC

  C Corp · RBPO Ins Plan · AR

  Directly controlled by NA

• Columbus Organization Holdings LLC

  C Corp · Holding Co · DE

  Directly controlled by NA

• Healthedge-Columbus Holdings LLC

  C Corp · Holding Co · DE

  Directly controlled by NA

• CareSource Tennessee Co

  C Corp · COA Insurance · TN

  Directly controlled by NA

• Columbus Medical Services Inc

  C Corp · No Activity · MD

  Directly controlled by NA

• CareSource North Carolina Co

  C Corp · HMO Ins Plan · NC

  Directly controlled by NA

• CareSource Iowa Co (Inc 31822)

  C Corp · HMO Ins Plan · IA

  Directly controlled by NA

• CareSource Florida Co (Inc 8422)

  C Corp · HMO Ins Plan · FL

  Directly controlled by NA

• CareSource Bayou Health LLC(Inc 72222)

  C Corp · HMO Ins Plan · TX

  Directly controlled by NA