2024-11-13T12:14:11-06:00 2023-12-31 RSM US LLP 6 S PATTERSON BLVD DAYTON OH 45402 990 2023-01-01 311143265 CareSource Ohio Inc % JANET FERNANDES CARE 9372243300 PO Box 8738 Dayton OH 454018738 LAWRENCE SMART CFO 9372243300 2024-11-15 true true Karen O Crim P00368385 9372980201 2023 2024-10-15 13:58:12Z Stephen Ringel Same as C above Dayton OH 45401 12514637444 false X www.caresource.com X 1985 OH To make a lasting difference in our members' lives by improving their health and well-being. CareSource Ohio Inc. is a nonprofit HIC licensed by the state of Ohio. 3 0 0 0 0 0 0 0 10010802585 8448834545 53326439 76845424 0 0 10064129024 8525679969 55339483 2508586 0 0 0 0 0 0 0 9361889247 7982147617 9417228730 7984656203 646900294 541023766 2667085761 2226959848 1267345373 1407207336 1399740388 819752512 X CARESOURCE OHIO, INC.'S MISSION IS TO MAKE A LASTING DIFFERENCE IN 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) false false 6758164641 8448834545 CareSource Ohio, Inc. ("CSOH"), is a nonprofit organization established under the state law of Ohio. CSOH is a member of the CareSource group of nonprofit tax-exempt organizations (the "CareSource Public Charities"). (Continued on Schedule O) 6758164641 true false false true false false false false false false false false false false true true true 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 true 86 0 true 0 false false false false false false false false false false true false X 3 0 false false true false true true true true true false false true true true true true true false false false OH X JANET FERNANDES 9372243300 PO BOX 8738 Dayton OH 454018738 Erhardt Preitauer CEO (To 4/23) then Chair/Dir 8.0 52.0 X X 0 7982382 4047739 Richard Topping Secretary/Director (Eff 5/23) 8.0 52.0 X X 0 2429434 942437 Lawrence Smart CFO, Treasurer/Dir (Eff 5/23) 8.0 52.0 X X 0 2282374 712492 Scott Markovich Director (To 4/23) 8.0 52.0 X 0 2046512 861652 Stephen Ringel President, Director (To 4/23) 59.0 1.0 X X 0 1696129 634140 Jai Pillai Chief Operating Ofr (To 4/23) 8.0 52.0 X 0 1975288 15770 Stephanie Williams Dir (To 4/23) then Asst. Treas 10.0 50.0 X X 0 874375 548452 Daniel McCabe Former Chief Admin Officer 0.0 0.0 X 0 140542 0 William Coffin Jr Former VP Mkt Finance/Director 0.0 0.0 X 0 24304 0 0 19451340 7762682 0 true true false Ohio Hospital Association 155 East Broad St Suite 301 COLUMBUS OH 43215 Medical Services 1220204807 Express Scripts Inc 21653 Network Place CHICAGO IL 60673 Pharmacy Services 325454346 Akron Children's Health Collaborati One Perkins Square AKRON OH 44308 Medical Services 186626711 Dentaquest Group Inc 1800 West End Avenue Suite 102 NASHVILLE TN 37203 Medical Services 158616951 Future Age Inc 4229 Cranwood Parkway WARRENSVILLE HEIGHTS OH 441284012 Medical Services 45910222 55 0 MEDICAID 524114 7875375562 7875375562 PREMIUMS 524114 532637763 532637763 MEDICARE ADVANTAGE 524114 40821220 40821220 8448834545 67930620 67930620 0 0 0 0 0 3997872279 3988957475 8914804 8914804 8914804 0 0 0 0 0 0 0 0 0 0 8525679969 8448834545 76845424 2508586 2508586 0 0 0 0 0 0 0 0 0 0 3560060 102736 3457324 0 620780 0 620780 0 206136 2878 203258 0 0 1485628 0 1485628 0 235163052 15243698 219919354 0 21660321 28925 21631396 0 95505081 260673 95244408 0 0 0 12566149 0 12566149 0 2557137 397937 2159200 0 0 0 215186 0 215186 0 0 0 5086020 5086020 0 MEDICAL EXPENSES 6518209242 6518209242 0 0 ODM FRANCHISE FEE PASSTHROUGH 501957836 56565720 445392116 0 MGMT FEES CARESOURCE MGMT SVCS 474532500 88011725 386520775 0 PHARMACY EXPENSES 73183287 73183287 0 0 35639202 3649234 31989968 7984656203 6758164641 1226491562 0 X 0 0 519235273 283152770 0 0 442355993 960659348 0 0 0 0 0 0 0 0 6099158 8178241 0 0 1678795866 974969489 0 0 20599471 0 0 0 0 0 2667085761 2226959848 1188727467 1113661248 0 0 58035903 260844266 0 0 0 0 0 0 0 0 0 0 20582003 32701822 1267345373 1407207336 X 1399740388 819752512 0 0 1399740388 819752512 2667085761 2226959848 X 541023766 28551224 -1149562866 X false true X true false X 5280285 170984 0 0 0 5451269 8090874825 9247968015 9724963389 10010802585 8448834545 45523443359 0 0 0 8096155110 9248138999 9724963389 10010802585 8448834545 45528894628 0 0 0 45528894628 32102562 22656125 26291303 53326439 76845424 211221853 0 32102562 22656125 26291303 53326439 76845424 211221853 0 0 8128257672 9270795124 9751254692 10064129024 8525679969 45740116481 0.99538 0.99611 0.00462 0.00389 X false false false false false false true 129088 false true 283185 412273 false Form 990, Schedule C, Part II-B, Line 1g Lobbyists are retained to provide updates and represent the Organization's interests with federal and state legislators who deal with legislation related to Government sponsored health care programs. Form 990, Schedule C, Part II-B, Line 1i $283,185 is the allocable portion of the Organization's dues paid to Ohio Association of Health Plans, America's Health Insurance Plans, and other trade associations for lobbying and grassroots efforts conducted by the trade association on behalf of its members. 0 RELATED PARTY PAYABLE 32701822 32701822 X 8523340079 28551224 28551224 8494788855 30891114 30891114 8525679969 7983170559 7983170559 1485644 1485644 7984656203 FIN 48 (ASC 740) Footnote As outlined in CareSource's Audited Consolidated Financial Statements, which include the activity of CareSource Ohio Inc., the Company annually reviews its tax positions and has determined that there are no material uncertain tax positions that require recognition in the consolidated financial statements. Currently, tax years 2020-2022 are open for audit by the Internal Revenue Service. Form 990, Schedule D, Parts XI and XII The entity has separate audited financial statements prepared on a statutory ("STAT") basis in compliance with The National Association of Insurance Commissioners ("NAIC") requirements. The entity is also included in the consolidated audited financial statements of the member entity, CareSource, which are prepared on a GAAP basis. The 990 has been prepared consistent with the GAAP-basis financial statements. The amounts included on Schedule D, Part XI, Lines 2A & 4B and Part XII, Line 4B, are comprised of the STAT-to-GAAP adjustments. true The Salvation Army 440 West Nyack Road West Nyack NY 10994 135562351 501(C)(3) 15000 Community Reinvestment: Support to help address food insecurity and other programs to help low income families United Way of Summit & Medina 37 N High St Akron OH 44308 341169257 501(C)(3) 10000 Community Reinvestment: Sponsorship of four schools - Robinson CLC, Helen Arnold CLC, McEbright CLC, and North High School; Monthly bag placement at local pantries; Christmas Polar Express Event Bhutanese Community of Central Ohio 1925 E Dublin Granville Rd Suite 210 Columbus OH 43229 273514427 501(C)(3) 10000 Community Reinvestment: Wellness listening sessions with older Bhutanese; Free health clinics for refugees in Central Ohio who are either uninsured or underinsured; Annual Health & Wellness Fair Community Volunteer Council 1642 West Market St Warren OH 44485 341536774 501(C)(3) 10000 Community Reinvestment: Holiday grocery distribution for low income families; the "Big Give" blessing outreach at local supermarkets and neighborhood stores; Safe and fun activities for families and children Hocking Athens Perry Community Action (HAPCAP) 3 Cardaras Drive Glouster OH 45732 310718322 501(c)(3) 673920 Community Reinvestment: Food as Medicine and Bringing Healthy Home; Logan, OH Food Pantry; School-Based Food Pantry; Senior SNAP Outreach & Emergency Food Assistance; Statewide Doula Expansion Program Cleveland Metropolitan School District 1111 Superior Ave E Suite 1800 Cleveland OH 44114 346000662 Cleveland 336960 Community Reinvestment: Cleveland School-Based Health Project Athens-Meigs Educational Service Center 21 Birge Drive Chauncey OH 45719 311599475 Athens/Meigs 210600 Community Reinvestment: Nelsonville School-Based Health Project Case Western Reserve University 11402 Bellflower Road Cleveland OH 44106 341018992 501(c)(3) 168480 Community Reinvestment: Intensive Home-Based Treatment ("IHBT") Ohio State Parks Foundation PO Box 403 Westerville OH 43086 862157935 501(c)(3) 168480 Community Reinvestment Harm Reduction Ohio 935 River Rd Suite G Granville OH 43023 825110907 501(c)(3) 168480 Community Reinvestment National African American Male Wellness Agency 2780 Airport Dr Columbus OH 43219 454831268 501(c)(3) 105300 Community Reinvestment: Statewide Doula Expansion Program Moses-Weitzman Health System Inc 635 Main Street Middletown CT 06457 850521893 501(c)(3) 105300 Community Reinvestment: Project ECHO Asian Services in Action Inc 370 East Market Street Akron OH 44304 341798850 501(c)(3) 105300 Community Reinvestment Birthing Beautiful Communities 3043 Superior Avenue Cleveland OH 44114 474453278 501(c)(3) 98982 Community Reinvestment NyNi Inc 6373 Fountains Blvd West Chester OH 45049 850863139 501(c)(3) 84240 Community Reinvestment: Statewide Doula Expansion Program Star House 1220 Corrugated Way Columbus OH 43201 471857320 501(c)(3) 63180 Community Reinvestment Passion Works 20 East State St Athens OH 45701 822288880 501(c)(3) 42120 Community Reinvestment Southeast Ohio Free Pharmacy DBA Rising Sun PO Box 193 Athens OH 45701 842852530 501(c)(3) 40014 Community Reinvestment Last Mile Food Rescue 1775 Mentor Ave Cincinnati OH 45213 834495745 501(c)(3) 36631 Community Reinvestment Environmental Health Watch 4600 Euclid Ave Suite 320-322 Cleveland OH 44103 341443935 501(c)(3) 30326 Community Reinvestment: African American Mental Health Group Therapy Greater Cleveland Food Bank Inc 13815 Coit Rd Cleveland OH 44110 341292848 501(c)(3) 25272 Community Reinvestment 4 1 Contribution Review The Organization may provide assistance to other Internal Revenue Code (IRC) Tax exempt organizations in the form of charitable contributions. These contributions are unrestricted funds available for use by the organization for the purpose the organization deems necessary. true true false false false false false false false Erhardt Preitauer CEO (To 4/23) then Chair/Dir 0 1320200 0 6194161 0 468021 0 4027671 0 20068 0 12030121 0 3950998 Richard Topping Secretary/Director (Eff 5/23) 0 569753 0 1738540 0 121141 0 913781 0 28656 0 3371871 0 920889 Lawrence Smart CFO, Treasurer/Dir (Eff 5/23) 0 587567 0 1571834 0 122973 0 692889 0 19603 0 2994866 0 887402 Scott Markovich Director (To 4/23) 0 524810 0 1411293 0 110409 0 832617 0 29035 0 2908164 0 824021 Stephen Ringel President, Director (To 4/23) 0 440712 0 1158022 0 97395 0 614537 0 19603 0 2330269 0 627302 Jai Pillai Chief Operating Ofr (To 4/23) 0 201797 0 1311318 0 462173 0 12209 0 3561 0 1991058 0 1021349 Stephanie Williams Dir (To 4/23) then Asst. Treas 0 358045 0 441980 0 74350 0 537620 0 10832 0 1422827 0 438762 Daniel McCabe Former Chief Admin Officer 0 0 0 0 0 140542 0 0 0 0 0 140542 0 0 William Coffin Jr Former VP Mkt Finance/Director 0 0 0 0 0 24304 0 0 0 0 0 24304 0 0 Form 990, Schedule J, Part I, Question 3 CareSource Management Services LLC, a related entity, utilizes a compensation committee, independent compensation consultant, compensation survey or study, review of form 990 of other organizations, and approval by the board or compensation committee comprised solely of independent directors. Form 990, Schedule J, Part I, Line 4a Jai Pillai, Daniel McCabe, 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, Richard Topping, Lawrence Smart, Scott Markovich, Stephen Ringel, and Stephanie 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 listed persons listed on Form 990, Part VII, Section A, participate in a long-term incentive plan of CSMS: Erhardt Preitauer, Richard Topping, Lawrence Smart, Scott Markovich, Stephen Ringel, and Stephanie Williams. 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 2023 for both deferred compensation arrangements include the following: Erhardt Preitauer $1,820,312, Richard Topping $450,394, Lawrence Smart $450,852, Scott Markovich $409,557, Stephen Ringel $289,366, and Stephanie Williams $233,747. 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, Richard Topping, Lawrence Smart, Scott Markovich, Stephen Ringel, Jai Pillai, and Stephanie Williams. 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. Form 990, Part III, Question 1 (Continued) CARESOURCE OHIO, INC. IS A HEALTH INSURING CORPORATION LICENSED BY THE STATE OF OHIO AND SERVES MEMBERS THROUGH DUAL ELIGIBLE SPECIAL NEEDS, MARKETPLACE, MEDICAID, MEDICARE ADVANTAGE, AND MYCARE OHIO PLANS. Form 990, Part III, Question 4a (Continued) 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, CSOH 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. CSOH serves nearly 1.4 million Members in Ohio. CSOH'S membership includes: (1) Medicaid consumers, including families with low income, children, pregnant women, adoption and children in foster care, those who are aged, blind or disabled, (2) Medicaid consumers who are eligible for Home and Community Based services through execution of an annual Provider Agreement with the Ohio Department of Medicaid ("ODM"), (3) Dually eligible consumers for Medicare and Medicaid through Ohio's Dual Demonstration program, MyCare, (4) Medicare Advantage consumers, and (5) a Qualified Health Plan offered through the Federal Health Insurance Marketplace, providing low-cost comprehensive coverage for individuals and families. Medicaid: Our Members get all medically-necessary, Medicaid-covered services at no cost. Examples include preventive check-ups, inpatient and outpatient hospital services, and dental care. Members enrolled in our Ohio Medicaid plans have access to the following services: (1) Rewards programs, (2) One-on-one coaching for up to 24 months with a certified Life Coach, (3) Telehealth to talk to a doctor 24/7/365 using a smartphone or computer, (4) Large provider network for easy access to care, (5) Transportation to and from appointments, food pantries, pharmacies, WIC offices and County Department of Job and Family Services (CDJFS) appointments, (6) Vision and dental care, including checkups and teeth cleanings. Members can also get an allowance for a large selection of eyeglasses and an allowance for contact lenses and fitting, (7) Bank account from Fifth Third Bank with no monthly service charge, no balance requirement, no overdraft fees and a debit card for purchases, (8) Behavioral health resources that support the health of mind, body and spirit, (9) A team of nurses who can answer health questions 24/7/365, (10) Disease management programs, (11) Local care managers to coordinate health care needs and help connect Members to community resources such as utility assistance, housing and food banks, and (12) CareSource mobile app for access to Member ID card, "how-to" videos and a quick search for doctors. MyCare Ohio: Plans contract with both Medicare and Ohio Medicaid to provide benefits of both programs to its Members in 12 Ohio counties. To improve the way Medicare and Ohio Medicaid benefits work together, Members must enroll in a MyCare Ohio plan. The plan is for people with disabilities, older adults and individuals who need behavioral health services. CareSource Marketplace: Marketplace plans are available in 86 counties in Ohio. CSOH's 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 a fitness program. There are no lifetime maximums for most benefits, no medical review for enrollment, and we cover an extensive list of prescription drugs. Members enrolled in our Ohio Marketplace 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. CareSource Dual Advantage: This is a $0 premium plan that combines the benefits of Medicare and Medicaid into one convenient plan and offers more benefits not covered by either Medicare or Medicaid alone. Members enrolled in our Ohio Dual Advantage plans have access to the following services: (1) $6,000 annual limit for preventive and comprehensive dental care through DentaQuest, (2) $1,000 Flex annual allowance to use toward dental, hearing, and vision, (3) Unlimited transportation to health-related appointments including gym, pharmacy, and grocery, (4) $150 monthly allowances for over-the-counter (OTC) items and healthy food at participating retailers, (5) Two meals per day for 14 days after observation or inpatient stay, (6) TruHearing Advanced Level hearing aids, one per ear every three years, (7) Silver&Fit gym membership, home fitness kit, digital workouts, and online resources, (8) Routine vision exam, $450 annual allowance for glasses and/or contacts through EyeMed, (9) BrainHQ online brain health improvement tool, (10) Personal Emergency Response System (PERS) that connects the member to 24-hour help with the push of a button, and (11) 60 hours per year for companion care services. Form 990, Part VI, Section A, Question 4 The amended bylaws included the following changes: (1) The CEO of the sole member is a director with voting rights so long as he/she holds that position with the sole member (2) Updated the terms of directors to one year coinciding with the calendar year (3) Updated that the officers of the corporation are appointed by the board at the annual meeting, with the exception of the Chair, who shall be designated by office, and members may be removed by the Chair or board (4) Added that the Chief Executive Officer of the Corporation's sole member shall serve as Chair and removed that the chair will participate as ex officio member of committees (5) Added a section titled "Assistant Officers" that allows the board to appoint assistant officers (6) Added "Article V - Committeesestablished that the Audit Committee, Risk Committee and Compensation Committee of the sole member have full authority to act on behalf of the Corporation with duties, responsibilities, and membership to be defined by each committee's charter (7) Changed that the Code of Regulations may be amended by the board. Form 990, Part VI, Section A, Question 6 CareSource is the member of CareSource Ohio, Inc. CareSource is a nonprofit corporation that is exempt from federal income taxation under Internal Revenue Code ("IRC") Section 501(c)(3). Form 990, Part VI, Section A, Question 7a CARESOURCE, THE SOLE MEMBER OF CARESOURCE OHIO, INC., HAS THE AUTHORITY TO APPOINT CARESOURCE OHIO, INC.'S BOARD. Form 990, Part VI, Section A, Question 7b The Audit Committee, Risk Committee, and Compensation Committee of CareSource, the sole member of CareSource Ohio, Inc., have full authority as committees to act on behalf of CareSource Ohio, Inc. to the extent permitted by applicable law. Each Committee's duties, responsibilities, and membership shall be defined by the respective Committee's charter. Form 990, Part VI, Section B, Question 11B The Form 990 was provided to each voting member of the filing organization's governing body for review prior to filing. Additionally, the Form 990 was reviewed by CareSource's Audit Committee, VP Treasury, Internal Tax Department, and Internal General Counsel as well as an external CPA firm and legal counsel. Form 990, Part VI, Section B, Question 12C Annually, each director, principal officer, and member of a committee with board-delegated powers ("interested person") shall confirm that they have received a copy of the CareSource Conflicts of Interest policy and have read, understood, and agree to comply with the policy. Interested Persons have an obligation to immediately report any Conflicts of Interest (including any relationships, positions, or circumstances that could contribute to a Conflict of Interest). All relevant information reported through the Conflict-of-Interest Policy will be sent to the Chairman of the Board for review. If the Interested Person with the Conflict of Interest is the Chairman of the Board, then the required disclosure must be provided to the Chief Legal Officer of CareSource. If it is not entirely clear whether a Conflict of Interest exists, then the person with the potential conflict must disclose the circumstances to CareSource's Chief Legal Officer. The Chief Legal Officer will consult with the Corporation's Corporate Compliance Officer or the Chairman of the Board to determine whether there exists a Conflict of Interest that is subject to this policy. Before Board action or other action by the organization on a Transaction that involves a Conflict of Interest, an Interested Person who knows he or she has a Conflict of Interest must have disclosed to the Board all facts material to the Conflict of Interest. The Chairman of the Board may postpone Board or other corporate action on a Transaction until the Interested Person provides written information relating to the Conflict of Interest. An Interested Person who knows he or she has a Conflict of Interest must not participate in the Board's discussion of the Transaction except to disclose material facts and respond to questions. The Interested Person must not attempt to influence the Board's action on the Transaction, either at or outside the meeting. Prior to voting, the Board must be given an opportunity to discuss the Transaction without the person who has the Conflict of Interest being present. A Transaction involving a Conflict of Interest may be approved by the Board if the material facts as to the Transaction and the Conflict of Interest are fully disclosed or known to the Board and the Board in good faith determines after reasonable investigation that (a) the Board is aware of all material facts concerning the Transaction and the Interested person's interest in the Transaction; (b) the organization is entering into the Transaction for its own benefit; (c) the Transaction is fair and reasonable as to the organization; and (d) the organization could not have obtained a more advantageous arrangement with reasonable effort under the circumstances. The Person with the Conflict of Interest must not vote on the Transaction and must not be present in the room when the vote is taken. Form 990, Part VI, Section C, Question 17 A copy of Form 990 is not required to be filed with the state of Ohio. CareSource Ohio, Inc. does, however, file the Ohio Annual Report with the Ohio Attorney General. Therefore, Ohio is listed on Form 990, Part VI, Section C, Question 17. Form 990, Part VI, Section C, Question 19 The company's Form 1023 is available for public inspection upon request, and Form 990 is available for public inspection upon request in accordance with IRC Section 6104(d). Statutory financial statements for the organization are available on the Ohio Department of Insurance's website at www.ins.ohio.gov. The company's Form 990 is available on the U.S. nonprofit database website at www.guidestar.org. The company's Articles of Incorporation are available on the Ohio Secretary of State's website at www.sos.state.oh.us. Form 990, Part XI, Line 9 OTHER CHANGES IN NET ASSETS CONSIST OF (1) A WRITE OFF OF ADVANCES PAID TO BEHAVIORAL HEALTH PROVIDERS OF $437,133 AND (2) A DISTRIBUTION TO CARESOURCE OF $1,150,000,000. The CareSource Foundation PO Box 8738 Dayton OH 454018738 562582561 Grantmaking OH 501(c)(3) 509(a)(3)II CareSource false CareSource PO Box 8738 Dayton OH 454018738 311703368 Supporting OH 501(c)(3) 509(a)(3)II NA false CareSource Indiana Inc PO Box 8738 Dayton OH 454018738 320121856 HMO Ins Plan IN 501(c)(3) 509(A)(2) CareSource false CareSource Georgia Co PO Box 8738 Dayton OH 454018738 472408339 HMO Ins Plan GA 501(c)(3) 509(A)(2) CareSource false CareSource West Virginia Co PO Box 8738 Dayton OH 454018738 473028244 HMO Ins Plan WV 501(c)(3) 509(A)(2) CareSource false CareSource Kentucky Co PO Box 8738 Dayton OH 454018738 464991603 HMO Ins Plan KY 501(c)(3) 509(A)(2) CareSource false CareSource Life Services Co PO Box 8738 Dayton OH 454018738 811602217 No Activity OH 501(c)(3) 509(A)(2) CareSource false CareSource Diversity & Social Impact Inv 50 East 91st Street Suite 213 Indianapolis IN 462401555 871811106 Investing DE NA N/A CareSource Midwest Fund LLC 415 12th Ave SE Cedar Rapids IA 524012449 883585337 Investing DE NA N/A ImagineCare Holdings LLC PO Box 8738 Dayton OH 454018738 932340017 Holding Co DE NA N/A HAP Empowered Holding LLC PO Box 8738 Dayton OH 454018738 923877012 Holding Co DE NA N/A CareSource Bayou Holding LLC PO Box 8738 Dayton OH 454018738 883042610 Holding Co DE NA N/A CareSource Virginia Co PO Box 8738 Dayton OH 454018738 811727271 No Activity VA NA C Corp CareSource Arkansas Health Plan Co PO Box 8738 Dayton OH 454018738 844476729 COA Insurance AR NA C Corp Kids' CareAlliance Co PO Box 8738 Dayton OH 454018738 854022039 No Activity OH NA C Corp CareSource Oklahoma Health Plan Co PO Box 8738 Dayton OH 454018738 854038326 HMO Ins Plan OK NA C Corp CareSource Kansas LLC PO Box 8738 Dayton OH 454018738 873411276 HMO Ins Plan KS NA C Corp CareSource North Carolina Co PO Box 8738 Dayton OH 454018738 873079479 HMO Ins Plan NC NA C Corp CareSource PASSE LLC PO Box 8738 Dayton OH 454018738 863112470 RBPO Ins Plan AR NA C Corp Columbus Organization Holdings LLC PO Box 8738 Dayton OH 454018738 814132952 Holding Co DE NA C Corp Healthedge-Columbus Holdings LLC PO Box 8738 Dayton OH 454018738 814132842 Holding Co DE NA C Corp CareSource Tennessee Co PO Box 8738 Dayton OH 454018738 874254502 COA Insurance TN NA C Corp Columbus Medical Services Inc PO Box 8738 Dayton OH 454018738 300975112 No Activity MD NA C Corp CareSource Iowa Co PO Box 8738 Dayton OH 454018738 881429834 HMO Ins Plan IA NA C Corp CareSource Florida Co PO Box 8738 Dayton OH 454018738 883601120 HMO Ins Plan FL NA C Corp CareSource Bayou Health LLC PO Box 8738 Dayton OH 454018738 883401520 HMO Ins Plan TX NA C Corp CareSource Military & Veterans Co PO Box 8738 Dayton OH 454018738 932552094 Tricare CPD OH NA C Corp HAP CareSource New Center One Ste 110 3031 W Grand Detroit MI 482023033 383123777 HMO Ins Plan MI NA C Corp CareSource Reinsurance II LLC PO Box 8738 Dayton OH 454018738 872901879 Captive Ins MT NA C Corp GCRE Protected Cell No 3 - CS LLC PO Box 8738 Dayton OH 454018738 933077861 Captive Ins MT NA C Corp false false false false false false false false false false false true true false true false true false PART III, RELATED ORGANIZATIONS TAXABLE AS A PARTNERSHIP - ADDITIONAL INFO 1) ImagineCare Holdings LLC (EIN: 93-2340017) was incorporated 07/12/2023 2) HAP Empowered Holding LLC (EIN: 92-3877012) was incorporated 04/19/2023 PART IV, RELATED ORGANIZATIONS TAXABLE AS A CORP - ADDITIONAL INFORMATION 1) CareSource Military & Veterans Co. (EIN: 93-2552094) was incorporated 07/21/2023 2) GCRE Protected Cell No. 3 - CS LLC (EIN: 93-3077861) was incorporated 08/22/2023