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Nonprofiteer
← CARESOURCE WEST VIRGINIA CO

Form 990 for tax year 2024

Filed by CARESOURCE WEST VIRGINIA CO.

Totals

Total revenue
$214,719,988
Total expenses
$209,483,593
Contributions and grants received
$0
Grants paid
$0
Program service revenue
$209,575,028
Investment income
$5,144,960
Other revenue
$0
Total assets, end of year
$139,591,982
Total liabilities, end of year
$122,844,410
Net assets or fund balances, end of year
$16,747,572
Program services expenses (Part IX)
$178,283,735
Management and general expenses
$31,199,858
Fundraising expenses
$0
Program service expenses (Part III)
$178,283,735

Program services were 85.1% of total expenses calculated — Part IX's program-services column over total expenses, both as filed.

Line items

Every line the filer filed in Parts VIII, IX and X, as filed and in filed order. Blank columns are left out, and the lines are not forced to add up to the totals above.

Revenue

Part VIII, the statement of revenue.

  • 2a · Program service revenue: Federal Health Insurance Exchange

    total $209,575,028 · related or exempt $209,575,028

  • 3 · Investment income

    total $5,144,910 · excluded $5,144,910

  • 7a · Gross sales of assets other than inventory

    securities $587,272,948

  • 7b · Less cost or other basis and sales expenses

    securities $587,272,898

  • 7c · Gain or loss

    securities $50

  • 7d · Net gain or loss

    total $50 · excluded $50

Functional expenses

Part IX, the statement of functional expenses.

  • 11b · Fees: legal

    total $69,879 · management and general $69,879

  • 11c · Fees: accounting

    total $214,396 · program services $12,633 · management and general $201,763

  • 11d · Fees: lobbying

    total $3,298 · management and general $3,298

  • 11f · Fees: investment management

    total $20,206 · management and general $20,206

  • 11g · Fees: other

    total $11,405,764 · program services $243,759 · management and general $11,162,005

  • 12 · Advertising and promotion

    total $432,230 · management and general $432,230

  • 13 · Office expenses

    total $2,788,153 · program services $1,257 · management and general $2,786,896

  • 16 · Occupancy

    total $293,510 · management and general $293,510

  • 17 · Travel

    total $83,816 · management and general $83,816

  • 20 · Interest

    total $3,951 · management and general $3,951

  • 23 · Insurance

    total $121,590 · management and general $121,590

  • 24a · Other expenses: Medical

    total $159,242,040 · program services $159,242,040

  • 24b · Other expenses: Pharmacy

    total $17,372,046 · program services $17,372,046

  • 24c · Other expenses: Mgmt Fees CareSource Mg

    total $9,896,812 · program services $1,297,093 · management and general $8,599,719

  • 24d · Other expenses: Hlth Ins Provider & PCO

    total $6,614,149 · management and general $6,614,149

  • 24e · All other expenses

    total $921,753 · program services $114,907 · management and general $806,846

Balance sheet

Part X, book values.

  • 2 · Savings and temporary cash investments

    beginning of year $39,080,381 · end of year $27,589,386

  • 4 · Accounts receivable

    beginning of year $3,098,483 · end of year $6,077,103

  • 11 · Investments: publicly traded securities

    beginning of year $26,446,049 · end of year $105,925,493

  • 17 · Accounts payable and accrued expenses

    beginning of year $17,793,378 · end of year $46,387,370

  • 19 · Deferred revenue

    beginning of year $38,272,901 · end of year $75,124,876

  • 25 · Other liabilities

    beginning of year $1,061,100 · end of year $1,332,164

  • 27 · Net assets without donor restrictions

    beginning of year $11,497,534 · end of year $16,747,572

Mission and programs · 2024

Mission

CareSource West Virginia Co.'s mission is to make a lasting difference in our members' lives by improving their health and well-being. The organization's vision is to transform lives through innovative health and life services. (Continued on Schedule O)CareSource West Virginia Co. is a health maintenance organization licensed by the state of West Virginia and serves members through marketplace plans.

Activities or mission (Part I)

To make a lasting difference in our members' lives by improving their health and well-being. CareSource West Virginia Co. is a nonprofit HMO licensed by the state of West Virginia.

  • CareSource West Virginia Co. ("CSWV") is a nonprofit organization established under the state law of West Virginia. On August 30, 2017, CSWV received a determination letter from the Internal Revenue Service, recognizing CSWV as an organization exempt from federal income tax under Section 501(c)(3) of the Internal Revenue Code, effective as of the date of CSWV's formation. CSWV is a member of the CareSource group of nonprofit tax-exempt organizations (the "CareSource Public Charities"). (Continued on Schedule O)The sole member of the CareSource Public Charities is CareSource, an Ohio nonprofit corporation that is tax-exempt under section 501(c)(3) of the Internal Revenue Code of 1986 (the "Code"). The CareSource Public Charities' primary activity for the last three decades has been to provide nonprofit Medicaid, Medicare, and Marketplace health maintenance organization ("HMO") services. As a mission-driven organization, CSWV follows the guidance of the CareSource Public Charities and is focused on transforming health care with innovative programs that address the social determinants of health, health equity, prevention and access to care. CSWV is accredited for its Qualified Health Plan ("QHP") through the National Committee for Quality Assurance ("NCQA"). Accreditation is the most comprehensive evaluation in the industry and the only assessment that bases results on clinical performance and consumer experience. The CSWV Marketplace-qualified dental, vision and fitness plans cover more than the essential health benefits. They offer adult dental through DentaQuest, adult vision through EyeMed, and the Active&Fit program. There are no lifetime maximums for most benefits, no medical review for enrollment, and CSWV covers an extensive list of prescription drugs. Members enrolled in our CSWV plans have access to the following services: (1) $0 copay telehealth office visits via Teladoc with 24/7 access to U.S.-licensed physicians,(2) Ambulatory patient services (outpatient care), (3) Emergency services,(4) Hospitalization, (5) Pregnancy, maternity and newborn care (both before and after birth),(6) Breastfeeding coverage,(7) Mental health and substance use disorder services, including behavioral health treatment (this includes counseling and psychotherapy),(8) Prescription drugs, (9) Rehabilitative and habilitative services and devices, (10) Laboratory services, (11) Preventive and wellness services and chronic disease management,(12) Pediatric services, including dental and vision care, and (13) Birth control coverage. CSWV focuses on prevention with a goal of improving Member health, the quality of health care services received, and accessibility of health care services for its Members. This is done through an innovative health and wellness methodology. CSWV has built a high-performing provider network to operate as a Health Maintenance Organization ("HMO"). This provider network relies heavily upon Federally Qualified Health Centers ("FQHCs"). FQHCs are generally health care providers that have been recognized by the federal government as providing care to populations that have limited access to medical treatment due to conditions such as poverty and geographic location. CSWV's QHP on the Health Insurance Marketplace primarily serves low-income individuals and was designed for those low-income adults who are recently uninsured or have never been insured. The plan is affordable, with a majority of Members qualifying for subsidies to lower their monthly premiums or out-of-pocket costs. Members have the choice of buying plans with only the essential health benefits, or ones that also include adult dental, vision, and fitness supplemental benefits. Members can also receive assistance through CSWV's many programs designed to remove barriers to health and well-being. CSWV can, therefore, further its mission as a means of improving the health and well-being of West Virginia's low-income populations.

    Expenses $178,283,735 · Revenue $209,575,028

As filed on the 2024 return. The filer continues this part on Schedule O, which is not shown here.

Listed in Part VII

  • Erhardt Preitauer

    Chair/Director

    Total calculated
    $12,201,162
    From this org
    $0
    From related orgs
    $6,076,721
    Other
    $6,124,441
    Hours/week
    8 + 52 related

    Schedule J breakdown matched by us

    Base
    $0 + $1,407,328 related
    Bonus
    $0 + $2,654,031 related
    Other
    $0 + $2,015,362 related
    Deferred
    $0 + $6,101,217 related
    Nontaxable benefits
    $0 + $23,224 related
    Filer's total
    $0 + $12,201,162 related

  • Richard Topping

    Secretary/Director (To 5/31)

    Total calculated
    $3,490,556
    From this org
    $0
    From related orgs
    $2,659,280
    Other
    $831,276
    Hours/week
    8 + 52 related

    Schedule J breakdown matched by us

    Base
    $0 + $279,104 related
    Bonus
    $0 + $561,640 related
    Other
    $0 + $1,818,536 related
    Deferred
    $0 + $815,252 related
    Nontaxable benefits
    $0 + $16,024 related
    Filer's total
    $0 + $3,490,556 related

  • Edward Stubbers

    Secretary/Director (Eff 6/1)

    Total calculated
    $2,198,075
    From this org
    $0
    From related orgs
    $1,060,829
    Other
    $1,137,246
    Hours/week
    8 + 52 related

    Schedule J breakdown matched by us

    Base
    $0 + $452,231 related
    Bonus
    $0 + $322,470 related
    Other
    $0 + $286,128 related
    Deferred
    $0 + $1,117,562 related
    Nontaxable benefits
    $0 + $19,684 related
    Filer's total
    $0 + $2,198,075 related

  • Lawrence Smart

    CFO, Treasurer/Director

    Total calculated
    $3,471,086
    From this org
    $0
    From related orgs
    $1,657,234
    Other
    $1,813,852
    Hours/week
    8 + 52 related

    Schedule J breakdown matched by us

    Base
    $0 + $589,886 related
    Bonus
    $0 + $570,124 related
    Other
    $0 + $497,224 related
    Deferred
    $0 + $1,794,168 related
    Nontaxable benefits
    $0 + $19,684 related
    Filer's total
    $0 + $3,471,086 related

  • Stephanie Williams

    Assistant Treasurer

    Total calculated
    $1,957,115
    From this org
    $0
    From related orgs
    $936,707
    Other
    $1,020,408
    Hours/week
    10 + 50 related

    Schedule J breakdown matched by us

    Base
    $0 + $368,179 related
    Bonus
    $0 + $362,976 related
    Other
    $0 + $205,552 related
    Deferred
    $0 + $1,003,011 related
    Nontaxable benefits
    $0 + $17,397 related
    Filer's total
    $0 + $1,957,115 related

  • Michael Taylor

    President

    Total calculated
    $1,072,596
    From this org
    $0
    From related orgs
    $789,227
    Other
    $283,369
    Hours/week
    30 + 30 related

    Schedule J breakdown matched by us

    Base
    $0 + $314,736 related
    Bonus
    $0 + $247,993 related
    Other
    $0 + $226,498 related
    Deferred
    $0 + $264,723 related
    Nontaxable benefits
    $0 + $18,646 related
    Filer's total
    $0 + $1,072,596 related

  • Jai Pillai

    Former Chief Operating Ofr

    Total calculated
    $244,761
    From this org
    $0
    From related orgs
    $244,761
    Other
    $0
    Hours/week
    0

    Schedule J breakdown matched by us

    Base
    $0
    Bonus
    $0
    Other
    $0 + $244,761 related
    Deferred
    $0
    Nontaxable benefits
    $0
    Filer's total
    $0 + $244,761 related

Compensation is as filed in Part VII: reportable pay from this organization and from related organizations, other compensation, and hours per week. The total, marked calculated, is our sum of the three dollar columns, with a blank column counted as $0; the form itself has no total. On a Form 990-EZ the columns are Part IV's instead, and on a Form 990-PF Part VIII's — compensation, contributions to benefit plans, and expense account — and the total sums those. A Schedule J breakdown is as filed: base pay, bonus, other, deferred compensation and nontaxable benefits from this organization, with any from related organizations beside each, and the filer's own total. It is shown with the Part VII listing of the same name on the same return. The form gives no key between the two, so that pairing is ours, and is marked matched by us.

Schedule J

Answered yes

  • 4a · Severance or change-of-control payment
  • 4b · Supplemental nonqualified retirement plan

Answered no

  • 4c · Equity-based compensation arrangement
  • 5a · Pay contingent on this organization's revenues
  • 5b · Pay contingent on a related organization's revenues
  • 6a · Pay contingent on this organization's net earnings
  • 6b · Pay contingent on a related organization's net earnings
  • 7 · Other non-fixed payments
  • 8 · Paid under the initial-contract exception

The filer's explanations (Part III)

Form 990, Schedule J, Part I, Question 3:
CareSource Management Services LLC ("CSMS"), a related entity, utilizes a compensation committee, independent compensation consultant, compensation survey or study, and review of Form 990 of other organizations.
Form 990, Schedule J, Part I, Question 4a:
CSMS made severance payments to Richard Topping and Jai Pillai during the calendar year. The payments are included in Part VII, Column E and it is reported on Schedule J, Part II, Column B(iii). The terms and conditions of the confidential severance agreements are available to the Internal Revenue Service upon request.
Form 990, Schedule J, Part I, Question 4b:
CSMS provides certain corporate officers, directors, key employees, and highly compensated executives with a supplemental nonqualified retirement plan. Amounts are accrued monthly for plan participants. The plan provides 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 plan provides for normal terms and conditions contained in a standard nonqualified retirement plan. The following listed person was paid under the plan in 2024: Richard Topping $39,893. The payment is included in Part VII, Column E and it is reported on Schedule J, Part II, Column B(iii). CSMS provides certain corporate officers, directors, key employees, and highly compensated executives with a long-term incentive plan. The plan provides compensation to the participants based on annual and long-term goals. The plan will pay out if these goals, or a subset of these goals, are achieved over a three-year period. The amounts are subject to forfeiture if certain employment conditions and vesting periods are not met. Amounts are included in Part VII, Column F and reported on Schedule J, Part II, Column C when accrued and included in Part VII, Column E and reported on Schedule J, Part II, Column B(iii) in the year paid. The following listed persons participated in and were paid under the plan in 2024: Erhardt Preitauer $1,516,425; Lawrence Smart $371,773; Richard Topping $774,290; Edward Stubbers $188,273; Michael Taylor $157,713; and Stephanie Williams $128,076. CSMS provides certain corporate officers, directors, key employees, and highly compensated executives with a management incentive plan. The plan provides compensation to the participants based on certain financial measurements of the Company, which are calculated annually. The plan will pay out if the targets are achieved over a three-year period. If a participant leaves their employment prior to this three-year performance period, they may be entitled to a pro-rated payment if the targets are achieved over the three-year period. Amounts are included in Part VII, Column F and reported on Schedule J, Part II, Column C when accrued and included in Part VII, Column E and reported on Schedule J, Part II, Column B(iii) in the year paid. No amounts were paid in 2024 under the plan.
Form 990, Schedule J, Part II:
All compensation amounts reported on Schedule J, Part II for all listed persons are paid by CSMS.

Part I's answers as filed. A line not listed was left unanswered; on lines 1a and 3 that means the box was not checked.

Grants on this return

No itemized grants to organizations on this return.

Related organizations on this return

Schedule R Part II: tax-exempt organizations related to the filer by control. It does not record shared board members or money.

Taxable family on this return

Schedule R Parts I, III and IV, as filed. These record ownership and control, not shared board members or money moved.

Related partnerships

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

  • CareSource Midwest Fund LLC

    Investing · DE

  • CareSource Diversity & Social Impact Investment Fund LLC

    Investing · DE

  • CareSource Bayou Holding LLC

    Holding Co · DE

  • HAP Empowered Holding LLC

    Holding Co · DE

  • ImagineCare Holdings LLC

    Holding Co · DE

Related corporations and trusts

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

  • CareSource Virginia Co (Dissolved 101724)

    C · No activity · VA

  • CareSource Arkansas Health Plan Co

    C · COA Insurance · AR

  • Kids' CareAlliance Co (Dissolved 111324)

    C · No activity · OH

  • CareSource Oklahoma Health Plan Co

    C · HMO Ins Plan · OK

  • CareSource Kansas LLC

    C · HMO Ins Plan · KS

  • CareSource Passe LLC

    C · RBPO Ins Plan · AR

  • Columbus Organization Holdings LLC

    C · Holding Co · DE

  • CareSource Tennessee Co

    C · COA Insurance · TN

  • Columbus Medical Services Inc

    C · No activity · MD

  • CareSource North Carolina Co

    C · HMO Ins Plan · NC

  • CareSource Iowa Co (Dissolved 112624)

    C · HMO Ins Plan · IA

  • CareSource Florida Co

    C · HMO Ins Plan · FL

  • CareSource Bayou Health LLC

    C · HMO Ins Plan · TX

  • CareSource Military & Veterans Co

    C · Tricare CPD · OH

  • GCRE Protected Cell No 3 - CS LLC

    C · Captive Ins · MT

  • HAP CareSource

    C · HMO Ins Plan · MI

  • CareSource Reinsurance II LLC

    C · Captive Ins · MT

  • GCRE Protected Cell No 2 - MS LLC (Incorporated 42524)

    C · Captive Ins · MT

Provenance

Return type
form_990
Tax year
2024
Filed
14 November 2025
IRS schema version
2024v5.2
Source object
202523189349315287

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