Attach to Form 990 or Form 990-EZ.
Go to
www.irs.gov/Form990 for instructions and the latest information.
| (i) Name of supported organization | (ii) EIN | (iii) Type of organization (described on lines 1- 10 above (see instructions)) | (iv) Is the organization listed in your governing document? | (v) Amount of monetary support (see instructions) | (vi) Amount of other support (see instructions) | |
|---|---|---|---|---|---|---|
| Yes | No | |||||
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Total |
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Calendar year
(or fiscal year beginning in)
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(a) 2019 | (b) 2020 | (c) 2021 | (d) 2022 | (e) 2023 | (f) Total | |
|---|---|---|---|---|---|---|---|
| 1 | Gifts, grants, contributions, and membership fees received. (Do not include any "unusual grant.") .. | ||||||
| 2 | Tax revenues levied for the organization's benefit and either paid to or expended on its behalf .... | ||||||
| 3 | The value of services or facilities furnished by a governmental unit to the organization without charge.. | ||||||
| 4 | Total. Add lines 1 through 3 | ||||||
| 5 | The portion of total contributions by each person (other than a governmental unit or publicly supported organization) included on line 1 that exceeds 2% of the amount shown on line 11, column (f) .. | ||||||
| 6 | Public support. Subtract line 5 from line 4. | ||||||
Calendar year
(or fiscal year beginning in)
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(a) 2019 | (b) 2020 | (c) 2021 | (d) 2022 | (e) 2023 | (f) Total | |
|---|---|---|---|---|---|---|---|
| 7 | Amounts from line 4.. | ||||||
| 8 | Gross income from interest, dividends, payments received on securities loans, rents, royalties and income from similar sources... | ||||||
| 9 | Net income from unrelated business activities, whether or not the business is regularly carried on.. | ||||||
| 10 | Other income. Do not include gain or loss from the sale of capital assets (Explain in Part VI.).. | ||||||
| 11 | Total support. Add lines 7 through 10 | ||||||
Calendar year (or fiscal
year beginning in) ![]() |
(a) 2019 | (b) 2020 | (c) 2021 | (d) 2022 | (e) 2023 | (f) Total | |
|---|---|---|---|---|---|---|---|
| 1 | Gifts, grants, contributions, and membership fees received. (Do not include any "unusual grants.") . | 0 | 0 | 0 | 0 | 0 | 0 |
| 2 | Gross receipts from admissions, merchandise sold or services performed, or facilities furnished in any activity that is related to the organization's tax-exempt purpose | 693,101,343 | 882,554,030 | 1,262,629,760 | 1,552,371,235 | 1,593,070,521 | 5,983,726,889 |
| 3 | Gross receipts from activities that are not an unrelated trade or business under section 513 ..... | 0 | |||||
| 4 | Tax revenues levied for the organization's benefit and either paid to or expended on its behalf... | 0 | |||||
| 5 | The value of services or facilities furnished by a governmental unit to the organization without charge | 0 | |||||
| 6 | Total. Add lines 1 through 5 | 693,101,343 | 882,554,030 | 1,262,629,760 | 1,552,371,235 | 1,593,070,521 | 5,983,726,889 |
| 7a | Amounts included on lines 1, 2, and 3 received from disqualified persons | 0 | |||||
| b | Amounts included on lines 2 and 3 received from other than disqualified persons that exceed the greater of $5,000 or 1% of the amount on line 13 for the year. | 0 | |||||
| c | Add lines 7a and 7b.. | 0 | |||||
| 8 | Public support. (Subtract line 7c from line 6.) | 5,983,726,889 | |||||
Calendar year
(or fiscal year beginning in)
![]() |
(a) 2019 | (b) 2020 | (c) 2021 | (d) 2022 | (e) 2023 | (f) Total | |
|---|---|---|---|---|---|---|---|
| 9 | Amounts from line 6... | 693,101,343 | 882,554,030 | 1,262,629,760 | 1,552,371,235 | 1,593,070,521 | 5,983,726,889 |
| 10a | Gross income from interest, dividends, payments received on securities loans, rents, royalties and income from similar sources.. | 866,789 | 505,487 | 235,442 | 4,590,668 | 15,463,008 | 21,661,394 |
| b | Unrelated business taxable income (less section 511 taxes) from businesses acquired after June 30, 1975. | 0 | |||||
| c | Add lines 10a and 10b. | 866,789 | 505,487 | 235,442 | 4,590,668 | 15,463,008 | 21,661,394 |
| 11 | Net income from unrelated business activities not included on line 10b, whether or not the business is regularly carried on. | 0 | |||||
| 12 | Other income. Do not include gain or loss from the sale of capital assets (Explain in Part VI.) .. | 0 | |||||
| 13 | Total support. (Add lines 9, 10c, 11, and 12.).. | 693,968,132 | 883,059,517 | 1,262,865,202 | 1,556,961,903 | 1,608,533,529 | 6,005,388,283 |
| Section A - Adjusted Net Income | (A) Prior Year |
(B) Current Year (optional) |
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| 1 | Net short-term capital gain | 1 | ||||
| 2 | Recoveries of prior-year distributions | 2 | ||||
| 3 | Other gross income (see instructions) | 3 | ||||
| 4 | Add lines 1 through 3 | 4 | ||||
| 5 | Depreciation and depletion | 5 | ||||
| 6 | Portion of operating expenses paid or incurred for production or collection of gross income or for management, conservation, or maintenance of property held for production of income (see instructions) | 6 | ||||
| 7 | Other expenses (see instructions) | 7 | ||||
| 8 | Adjusted Net Income (subtract lines 5, 6 and 7 from line 4) | 8 | ||||
| Section B - Minimum Asset Amount | (A) Prior Year |
(B) Current Year (optional) |
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| 1 | Aggregate fair market value of all non-exempt-use assets (see instructions for short tax year or assets held for part of year): | 1 | ||||
| a | Average monthly value of securities | 1a | ||||
| b | Average monthly cash balances | 1b | ||||
| c | Fair market value of other non-exempt-use assets | 1c | ||||
| d | Total (add lines 1a, 1b, and 1c) | 1d | ||||
| e |
Discount claimed for blockage or other factors (explain in detail in Part VI): |
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| 2 | Acquisition indebtedness applicable to non-exempt use assets | 2 | ||||
| 3 | Subtract line 2 from line 1d | 3 | ||||
| 4 | Cash deemed held for exempt use. Enter 0.015 of line 3 (for greater amount, see instructions). | 4 | ||||
| 5 | Net value of non-exempt-use assets (subtract line 4 from line 3) | 5 | ||||
| 6 | Multiply line 5 by 0.035 | 6 | ||||
| 7 | Recoveries of prior-year distributions | 7 | ||||
| 8 | Minimum Asset Amount (add line 7 to line 6) | 8 | ||||
| Section C - Distributable Amount | Current Year | |||||
| 1 | Adjusted net income for prior year (from Section A, line 8, Column A) | 1 | ||||
| 2 | Enter 85% of line 1 | 2 | ||||
| 3 | Minimum asset amount for prior year (from Section B, line 8, Column A) | 3 | ||||
| 4 | Enter greater of line 2 or line 3 | 4 | ||||
| 5 | Income tax imposed in prior year | 5 | ||||
| 6 | Distributable Amount. Subtract line 5 from line 4, unless subject to emergency temporary reduction (see instructions) | 6 | ||||
| Section D - Distributions | Current Year | |
|---|---|---|
| 1 Amounts paid to supported organizations to accomplish exempt purposes | 1 | |
|
2
Amounts paid to perform activity that directly furthers exempt purposes of supported organizations, in excess of income from activity |
2 | |
| 3 Administrative expenses paid to accomplish exempt purposes of supported organizations | 3 | |
| 4 Amounts paid to acquire exempt-use assets | 4 | |
| 5 Qualified set-aside amounts (prior IRS approval required - provide details in Part VI) | 5 | |
| 6 Other distributions (describe in Part VI). See instructions | 6 | |
| 7Total annual distributions. Add lines 1 through 6. | 7 | |
|
8
Distributions to attentive supported organizations to which the organization is responsive (provide details in Part VI). See instructions |
8 | |
| 9 Distributable amount for 2023 from Section C, line 6 | 9 | |
| 10 Line 8 amount divided by Line 9 amount | 10 | |
| Section E - Distribution Allocations (see instructions) |
(i) Excess Distributions |
(ii) Underdistributions Pre-2023 |
(iii) Distributable Amount for 2023 |
|
|---|---|---|---|---|
| 1 Distributable amount for 2023 from Section C, line 6 | ||||
|
2
Underdistributions, if any, for years prior to 2023 (reasonable cause required-- explain in Part VI).
See instructions. |
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| 3 Excess distributions carryover, if any, to 2023: | ||||
| a From 2018....... | ||||
| b From 2019....... | ||||
| c From 2020....... | ||||
| d From 2021....... | ||||
| e From 2022....... | ||||
| fTotal of lines 3a through e | ||||
| g Applied to underdistributions of prior years | ||||
| h Applied to 2023 distributable amount | ||||
|
i
Carryover from 2018 not applied (see instructions) |
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| j Remainder. Subtract lines 3g, 3h, and 3i from line 3f. | ||||
| 4Distributions for 2023 from Section D, line 7: | ||||
| $ | ||||
| a Applied to underdistributions of prior years | ||||
| b Applied to 2023 distributable amount | ||||
| c Remainder. Subtract lines 4a and 4b from line 4. | ||||
|
5
Remaining underdistributions for years prior to 2023, if any. Subtract lines 3g and 4a from line 2. If the amount is greater than zero, explain in Part VI. See instructions. |
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6
Remaining underdistributions for 2023. Subtract lines 3h and 4b from line 1. If the amount is greater than zero, explain in Part VI. See instructions. |
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7 Excess distributions carryover to 2024. Add lines 3j and 4c. |
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| 8 Breakdown of line 7: | ||||
| a Excess from 2019..... | ||||
| b Excess from 2020..... | ||||
| c Excess from 2021..... | ||||
| d Excess from 2022..... | ||||
| e Excess from 2023..... | ||||
| Facts And Circumstances Test |
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| Return Reference | Explanation |
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| Software ID: | |
| Software Version: |
| Return Reference | Explanation |
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| Form 990, Part III, Question 1 (Continued) | CARESOURCE GEORGIA CO. IS A HEALTH MAINTENANCE ORGANIZATION LICENSED BY THE STATE OF GEORGIA AND SERVES MEMBERS THROUGH MARKETPLACE, MEDICAID, DUAL ELIGIBLE SPECIAL NEEDS PLANS, AND THE PEACHCARE FOR KIDS AND PLANNING FOR HEALTHY BABIES PROGRAMS. |
| 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, CSGA 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. CSGA began providing care to participants in its Medicaid HMO plan on July 1, 2017. CSGA serves individuals meeting the low-income thresholds for Medicaid eligibility. CSGA participates in the State of Georgia's Planning 4 Healthy Babies program, or P4HB, which is a demonstration waiver program for women meeting Medicaid income thresholds designed to help reduce the number of low-birth-weight babies born each year. Through the P4HB program, CSGA offers family planning services, health care coverage for certain pregnancy-related chronic conditions, and case management services to women at risk for a low-birth-weight delivery. CSGA launched a Marketplace plan in 2020, offering affordable individual and family plans tailored for any budget, as well as a Dual Eligible Special Needs Plan in 2021. CSGA is the first nonprofit health care plan chosen to serve Georgia Medicaid and PeachCare for Kids Members enrolled in Georgia Families. We believe in people over profits, and we are committed to providing even more enhanced benefits to help improve the health and well-being of our Members. Members enrolled in our Georgia Families plan have access to the following services: (1) Earning rewards each year for completing healthy activities, (2) Dental benefits for kids and adults, (3) Vision benefits, (4) A personal life coach for up to 24 months, help finding a job, and rides to job training and interviews. Job coaches help with interview practice and resumes and provide support after starting a new job, (5) Free memberships to youth organizations and sports physicals, (6) Free breast pumps, free pregnancy tests through a pharmacist, baby showers and help with childcare, (7) CareSource 24, the 24/7/365 Nurse Advice Line and Telehealth RelyMD to access a doctor 24/7/365 using a smartphone or computer, (8) A bank account from Fifth Third Bank with no monthly service charge, no balance requirement, no overdraft fees and a debit card for purchases, (9) Medication therapy management, (10) Help with asthma, ADHD, autism, behavioral health, high blood pressure, chronic kidney disease and more, and (11) Transportation to doctor visits, WIC office, food pantries, education and jobs, and CareSource events. |
| Form 990, Part VI, Section A, Question 4 | The amended bylaws included the following changes: (1) Updated the number of board members from three to five to a total of three to nine members (2) Added Article I, Section 2 I named "General Powers" clarifying that the power of the corporation shall be managed by the Board, other than where reserved to the sole member (3) Updated that the Corporation's sole member has the power to elect and remove members of the board and that the Chief Executive Officer of the sole member shall be a Director with voting rights (4) Updated the terms of directors to one year coinciding with the calendar year (5) Simplified who can call a meeting, removed telegram as a means of communication, and added that a meeting may be attended in-person, over the phone or remotely (6) Added Article II, Section 6 named "Presumed Assent" to indicate that a director is presumed to have assented to action unless contrary vote is recorded (7) Added Article II, Section 7 named "Conduct of Meetings" establishing the chair of the committee sets the order of business for meetings (8) Clarified wording to indicate that the key officers of the Corporation are to be appointed by the board at the annual meeting, with the exception of the Chair, who shall be designated by office, and officers may be removed by the Chair (9) Renamed Article III, Section 2 to "Chairadded that the CEO of the Corporation's sole member shall serve as chair and that he/she shall preside at all meetings and perform all reasonable duties expected of him/her (10) Added that the President will manage all affairs of the business and perform all duties that are required of him/her (11) Added Article III, Section 4 named "Treasurer" indicating duties that the officer is responsible for such as receiving money due to the Corporation and that the officer may be responsible for additional duties assigned by the President (12) Added Article III, Section 5 named "Secretary" indicating duties expected of the officer such as keeping minutes of meetings and that additional responsibilities may be assigned by the President (13) Added Article III, Section 6 named "Assistant Officers" indicating that the board may appoint assistant officers when deemed necessary (14) Established 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 (15) Simplified the terms related to indemnification adding that a director is an authorized party of the Corporation and that funds can be paid to an employee with the stipulation they must be repaid if certain legal conditions are not met (16) Updated the wording to state that the articles may be amended by the board. |
| Form 990, Part VI, Section A, Question 6 | CareSource is the sole member of CareSource Georgia Co. CareSource is recognized as 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 Georgia Co., has the authority to appoint CareSource Georgia Co.'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 Georgia Co., have full authority as committees to act on behalf of CareSource Georgia Co. 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 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). The company's Form 990 is also available on the U.S. nonprofit database website at www.guidestar.org. The Company's statutory financial statements are available on the SNL Financial LC website at www.snl.com for a nominal fee. The company's articles of incorporation are available on the Georgia Secretary of State's website at www.sos.ga.gov. |
| Form 990, Part XI, Question 9 | Other changes in net assets consists of a distribution to CareSource in the amount of $25,123,502. |
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