2025-11-17T14:23:28-06:00 2024-12-31 135565207 KPMG LLP 17802 IH-10 SUITE 101 SAN ANTONIO TX 78257 990 2024-01-01 472532880 COMMUNITYCARE GOVERNMENT PROGRAMS INC COMM 9185945295 TWO WEST SECOND STREET SUITE 100 TULSA OK 74103 JOSIAH SUTTON CEO 9185945295 2025-11-17 1 0 LAUREN E GRAHAM P02261524 2102279272 2025-11-12 2024 2025-03-06 01:10:19Z JOSIAH SUTTON TWO WEST SECOND STREET SUITE 100 TULSA OK 74103 478118635 0 X N/A X 2015 OK COMMUNITYCARE IS A HEALTH MAINTENANCE ORGANIZATION DEDICATED TO MEDICARE ADVANTAGE AND WITH THE GOAL OF IMPROVING THE HEALTH OF ITS MEMBERS. 12 11 0 0 0 0 0 0 436860115 473612259 3315565 1794269 0 0 440175680 475406528 0 0 390981232 422702660 0 0 0 0 0 49508679 64870696 440489911 487573356 -314231 -12166828 68027137 73158256 19850336 35308778 48176801 37849478 X TO SERVE OKLAHOMANS WITH LOCAL, PERSONALIZED AND COMPASSIONATE SERVICES IN PURSUIT OF EVERY MEMBER'S OPTIMAL HEALTH AND WELLBEING. 0 0 462927329 473612259 COMMUNITYCARE IS A HEALTH MAINTENANCE ORGANIZATION DEDICATED TO MEDICARE ADVANTAGE AND WITH THE GOAL OF IMPROVING THE HEALTH OF ITS MEMBERS. IN 2024, THE COMPANY HAD 33,420 MEMBERS ENROLLED, WITH AN AVERAGE NUMBER OF WEEKLY CALLS OF 1,876 TO ASSIST AND COORDINATE MEMBER'S NEEDS. THE COMPANY PAID 1,055,651 MEDICAL CLAIMS WHICH TOTALED 135,064,870. SUPPLEMENTAL BENEFITS THAT INCLUDE DENTAL, HEARING AND SOME OVER THE COUNTER ITEMS TOTALED 11,863,946 AND PHARMACY CLAIMS TOTALED 128,461,685. THE COMPANY'S MEDICARE ADVANTAGE PRESCRIPTION DRUG PLAN HAS RECEIVED THE HIGHEST CUSTOMER SATISFACTION RATINGS FOR MEDICARE ADVANTAGE PLANS IN THE STATE OF OKLAHOMA. COMMUNITYCARE PARTICIPATES IN THE STARS PROGRAM WHICH TRACKS THE TYPES OF SERVICES OUR MEMBERS RECEIVE AND IDENTIFIES AREAS WHERE OUTREACH TO MEMBERS ENSURES THEY ARE RECEIVING THE CARE THEY NEED. SOME OF THESE PROGRAMS INCLUDE THE FOLLOWING:1) COMMUNITYCARE OFFERS AN ONLINE HEALTH RISK ASSESSMENT DESIGNED TO GIVE MEMBERS A BETTER IDEA OF THEIR OVERALL PHYSICAL, MENTAL, AND EMOTIONAL HEALTH. THERE ARE ALSO FREE ONLINE WELLNESS TOOLS SUCH AS HOW-TO GUIDES, ARTICLES AND HEALTHY RECIPES.2) COMMUNITYCARE CONDUCTS OUTREACH VIA TEXT AND PHONE TO MEMBERS TO EDUCATE ON VARIOUS CANCER SCREENINGS, DIABETIC CARE MANAGEMENT AND MEDICATION ADHERENCE TOPICS.3) COMMUNITYCARE ALSO PERFORMS HOME ASSESSMENTS, PROVIDES EDUCATION AT ITS SENIOR CENTER, AND OPERATES A MEDICATION THERAPY MANAGEMENT PROGRAM 462927329 0 0 0 0 0 0 0 0 0 0 1 0 0 1 0 1 0 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 1 0 0 0 0 0 0 0 0 0 0 0 0 0 X 12 11 1 0 0 0 1 1 1 1 1 0 0 0 1 1 1 1 1 0 0 0 X SHIRLEY TWILLEY 9185945325 TWO WEST SECOND STREET SUITE 100 TULSA OK 74103 CARL B BEAUDRY DIRECTOR 0.10 X 0 0 0 RAYMOND R BROUILLETTE DIRECTOR (FROM 5/9/2024) 0.10 X 0 0 0 COLLIN R HENRY JD DIRECTOR 0.10 X 0 0 0 BARRY LEE STEICHEN DIRECTOR 0.10 X 0 0 0 THOMAS EDWARD RITCHIE DIRECTOR 0.10 X 0 0 0 FRANK XAVIER HENKE IV DIRECTOR 0.10 X 0 0 0 THEODORE RAYMOND MUNDT DIRECTOR 0.10 X 0 0 0 KEVIN J JOSEPH MD DIRECTOR 0.10 X 0 0 0 SCOTT V PTACNIK DIRECTOR 0.10 X 0 0 0 HEATHER B SCHNEIDER DIRECTOR (FROM 6/28/2024) 0.10 X 0 0 0 CLIFF A ROBERTSON MD DIRECTOR 0.10 X 0 0 0 REBECCA A TUCKER DIRECTOR (UNTIL 2/2/2024) 0.10 X 0 0 0 JONATHAN W SOHN DIRECTOR (UNTIL 6/28/2024) 0.10 X 0 0 0 ROBERT L BUSH PRESIDENT & CEO (UNTIL 9/20/2024) 40.00 X X 0 1617297 195353 JOSIAH SUTTON PRESIDENT & CEO (FROM 9/20/2024) 40.00 X X 0 470842 49200 ANDREW G HILL SVP GENERAL COUNSEL 40.00 X 0 287894 49379 NANCY HORSTMAN SR. VP & CFO 40.00 X 0 433906 56991 TERRY L MILLS MD SR. VP & CHIEF MEDICAL OFF 40.00 X 0 540604 196317 RUSTY D WYRICK SR. VP & CHIEF INFOMRATION 40.00 X 0 343932 48803 MICHELLE LANG VP OPERATIONS 40.00 X 0 226055 28107 0 3920530 624150 0 0 1 0 COMMUNITYCARE HMO INC TWO WEST SECOND STREET SUITE 100 TULSA OK 74103 MANAGEMENT FEE 43843025 1 PREMIUM INCOME 524298 472972007 472972007 REINSURANCE RECOVERIES 524298 640252 640252 473612259 1756155 1756155 2750221 2712107 38114 38114 38114 475406528 473612259 0 1794269 422702660 422702660 10473041 10473041 86978 86978 4089286 4089286 158928 158928 2387920 2387920 249077 249077 448217 448217 226398 226398 744000 744000 1213205 1213205 528784 528784 CLAIMS ADJUSTMENTS 34287669 34287669 CHANGE IN RESERVES 5937000 5937000 COMMISSIONS 3582341 3582341 OTHER EXPENSE 248335 248335 209517 209517 487573356 462927329 24646027 0 13997731 -2893762 43210010 65500574 10819396 10551444 68027137 73158256 19850336 35308778 19850336 35308778 X 0 0 46000000 46000000 2176801 -8150522 48176801 37849478 68027137 73158256 X -12166828 51752 1787753 X 0 1 X 1 0 0 BONDS 10551444 C 10551444 CLAIMS UNPAID 17847133 UNPAID CLAIM ADJUSTMENT 913788 GENERAL EXPENSES DUE OR ACCRUED 16291497 PREMIUMS RECEIVED IN ADVANCE 255452 FEDERAL INCOME TAX PAYABLE 908 35308778 474022276 0 474022276 1384252 1384252 475406528 486189104 0 486189104 1384252 1384252 487573356 PART XI, LINE 4B - OTHER ADJUSTMENTS: REINSURANCE RECOVERIES RECLASS 640,252. INTEREST ON SURPLUS NOTE 744,000. PART XII, LINE 4B - OTHER ADJUSTMENTS: REINSURANCE RECOVERIES RECLASS 640,252. INTEREST ON SURPLUS NOTE 744,000. 1 1 0 0 0 0 0 0 0 ROBERT L BUSH PRESIDENT & CEO (UNTIL 9/20/2024) 0 622816 0 111780 0 882701 0 169550 0 25803 0 1812650 0 0 TERRY L MILLS MD SR. VP & CHIEF MEDICAL OFF 0 131459 0 0 0 409145 0 176753 0 19564 0 736921 0 0 JOSIAH SUTTON PRESIDENT & CEO (FROM 9/20/2024) 0 410789 0 59513 0 540 0 23190 0 26010 0 520042 0 0 NANCY HORSTMAN SR. VP & CFO 0 409761 0 20921 0 3224 0 33284 0 23707 0 490897 0 0 RUSTY D WYRICK SR. VP & CHIEF INFOMRATION 0 295141 0 47981 0 810 0 23000 0 25803 0 392735 0 0 ANDREW G HILL SVP GENERAL COUNSEL 0 252199 0 35209 0 486 0 23000 0 26379 0 337273 0 0 MICHELLE LANG VP OPERATIONS 0 178021 0 47121 0 913 0 18016 0 10091 0 254162 0 0 PART I, LINES 4A-B THE OFFICERS ARE ENTITLED TO A SEVERANCE BENEFIT FROM A RELATED ORGANIZATION. THE PAYOUT OF SUCH BENEFIT IS REMOTE AS IT IS EFFECTIVE ONLY FOR A TERMINATION OF EMPLOYMENT WITHOUT CAUSE, FOR GOOD REASON, OR DUE TO CHANGE OF CONTROL. IF TRIGGERED, THE EXECUTIVE WOULD BE PAID HIS/HER BASE SALARY FOR A PERIOD OF 6 MONTHS NOT TO INCLUDE ANY INCENTIVE COMPENSATION, OR ANY OTHER PAID BENEFITS OUTSIDE OF COBRA. THE FOLLOWING OFFICER RECEIVED A PAYMENT UNDER THE PLAN IN THE CURRENT YEAR: ROBERT L. BUSH THE OFFICERS PARTICIPATE IN A RELATED ORGANIZATION'S SUPPLEMENTAL RETIREMENT PLAN WHICH MEETS THE REQUIREMENTS OF IRC SECTION 457 AND IRC SECTION 409A. THE PLAN PROVIDES FOR COMPENSATION TO BE DEFERRED AND PAID UPON THE OCCURRENCE OF CERTAIN EVENTS SUCH AS TERMINATION, DISABILITY, OR DEATH. PARTICIPATION IN THE PLAN IS LIMITED TO AND IS SUBJECT TO THE APPROVAL OF THE RELATED ORGANIZATION'S BOARD OF DIRECTORS. THE PLAN ALLOWS THE OFFICERS BOTH ELECTIVE AND NON-ELECTIVE DEFERRALS. THE RELATED ORGANIZATION MAKES ANNUAL NON-ELECTIVE CONTRIBUTIONS BETWEEN 5% AND 10% OF BASE SALARY DEPENDING ON THE EXECUTIVE'S LEVEL OF POSITION. FORM 990, PART VI, SECTION A, LINE 2 THE DIRECTORS OF COMMUNITYCARE HMO, INC., A RELATED TAXABLE CORPORATION, ARE ALSO THE DIRECTORS OF COMMUNITYCARE GOVERNMENT PROGRAM, INC. DUE TO THIS OVERLAPPING BOARD, THERE IS A BUSINESS RELATIONSHIP BETWEEN AND AMONG THE DIRECTORS. FORM 990, PART VI, SECTION A, LINE 6 SAINT FRANCIS HOSPITAL, INC. AND ST. JOHN HEALTH SYSTEM, INC. ARE THE MEMBERS OF THE ORGANIZATION. FORM 990, PART VI, SECTION A, LINE 7A AS MEMBERS, SAINT FRANCIS HOSPITAL, INC. AND ST. JOHN HEALTH SYSTEM MAY APPOINT AND REMOVE ANY OR ALL OF ITS DIRECTORS. FORM 990, PART VI, SECTION A, LINE 7B THE MEMBERS DETERMINE THE NUMBER OF DIRECTORS. ANY PROPOSED LIQUIDATION OF THE CORPORATION MUST BE APPROVED IN WRITING BY THE MEMBERS. THE BYLAWS MAY BE AMENDED OR REPEALED ONLY BY UNANIMOUS CONSENT OF THE MEMBERS. FORM 990, PART VI, SECTION B, LINE 11B THE COMPANY'S TAX ADVISORS, KPMG, PREPARED THE 990 FILING, THE COMPANY CFO REVIEWED THE FILING AND THE CFO WILL PROVIDE AN UPDATE TO THE BOARD AT THE NEXT BOARD MEETING AND WILL MAKE AVAILABLE THE FILING TO ANY MEMBER. FORM 990, PART VI, SECTION B, LINE 12C ALL COMMUNITYCARE WORKFORCE MEMBERS ATTEST ANNUALLY THAT THEY HAVE READ AND UNDERSTAND THE CODE OF EXCELLENCE, INCLUDING THE WRITTEN CONFLICT OF INTEREST POLICY. A SEPARATE ANNUAL ATTESTATION IS COMPLETED BY EVERY COMMUNITYCARE WORKFORCE MEMBER CONFIRMING THEY DO NOT HAVE ANY CONFLICTS OF INTEREST. ANY ACTUAL OR PERCEIVED CONFLICTS OF INTEREST MUST BE DISCLOSED ON THIS ATTESTATION AND ARE REVIEWED BY THE CHIEF COMPLIANCE & RISK OFFICER. APPROPRIATE ACTION, INCLUDING IMPLEMENTATION OF A MANAGEMENT PLAN TO ELIMINATE THE DISCLOSED CONFLICT OF INTEREST ARE PUT INTO PLACE BY THE CHIEF COMPLIANCE & RISK OFFICER. FORM 990, PART VI, SECTION C, LINE 19 THE ORGANIZATION'S FINANCIAL STATEMENTS ARE AVAILABLE TO THE PUBLIC THROUGH THE NAIC WEBSITE. THE ORGANIZATION DOES NOT MAKE ITS GOVERNING DOCUMENTS OR CONFLICT OF INTEREST POLICY AVAILABLE TO THE PUBLIC. FORM 990, PART XI, LINE 9: CHANGE IN NONADMITTED ASSETS 1,787,753. COMMUNITYCARE HMO INC TWO WEST SECOND STREET SUITE 100 TULSA OK 74103 731433979 INSURANCE OK N/A C 0 COMMUNITYCARE MANAGED HEALTHCARE PLANS OF OKLAHOMA TWO WEST SECOND STREET SUITE 100 TULSA OK 74103 731513383 INSURANCE OK N/A C 0 COMMUNITYCARE LIFE & HEALTH INSURANCE CO TWO WEST SECOND STREET SUITE 100 TULSA OK 74103 731580741 INSURANCE OK N/A C 0 HOSPITAL CLAIMS INC TWO WEST SECOND STREET SUITE 100 TULSA OK 74103 363683174 INSURANCE DE N/A C 0 WORKNET INC TWO WEST SECOND STREET SUITE 100 TULSA OK 74103 731488665 INSURANCE OK N/A C 0 PREFERRED COMMUNITY CHOICE PPO INC TWO WEST SECOND STREET SUITE 100 TULSA OK 74103 731451360 INSURANCE OK N/A C 0 EXCELCARE INC TWO WEST SECOND STREET SUITE 100 TULSA OK 74103 363668948 INSURANCE DE N/A C 0 COMMUNITYCARE INSURANCE AGENCY TWO WEST SECOND STREET SUITE 100 TULSA OK 74103 461389531 INSURANCE OK N/A C 0 0 0 0 0 0 0 0 0 0 0 0 0 1 1 1 1 0 0 0