Caresource Kentucky Co

TO MAKE A LASTING DIFFERENCE IN OUR MEMBERS' LIVES BY IMPROVING THEIR HEALTH AND WELL-BEING. CARESOURCE KENTUCKY CO. IS A NONPROFIT HMO LICENSED BY THE STATE OF KENTUCKY.

CARESOURCE KENTUCKY CO. ("CSKY"CARESOURCE KENTUCKY") IS A NONPROFIT ORGANIZATION ESTABLISHED UNDER THE COMMONWEALTH OF KENTUCKY. CSKY WAS GRANTED A CERTIFICATE OF AUTHORITY BY THE KENTUCKY DEPARTMENT OF INSURANCE ("KDOI"), ALLOWING IT TO OPERATE AS A HEALTH MAINTENANCE ORGANIZATION ("HMO"). ON JULY 7, 2016, CSKY RECEIVED A DETERMINATION LETTER FROM THE INTERNAL REVENUE SERVICE, RECOGNIZING CSKY AS AN ORGANIZATION EXEMPT FROM FEDERAL INCOME TAX UNDER SECTION 501(C)(3) OF THE INTERNAL REVENUE CODE, EFFECTIVE AS OF THE DATE OF CSKY'S FORMATION. CSKY IS A MEMBER OF THE CARESOURCE GROUP OF NONPROFIT ORGANIZATIONS (THE "CARESOURCE GROUP"). THE MISSION OF THE CARESOURCE GROUP IS TO MAKE A LASTING DIFFERENCE IN ITS MEMBERS' LIVES BY IMPROVING THEIR HEALTH AND WELL-BEING. CSKY FIRMLY ADHERES TO THIS MISSION, WHICH IT TERMS AS THE ORGANIZATION'S "HEARTBEAT," BY PROVIDING SERVICES THAT GO WELL BEYOND THE DELIVERY OF MEDICAL BENEFITS. CSKY SERVES MEMBERS THROUGH THE FOLLOWING: (1) A QUALIFIED HEALTH PLAN OFFERED THROUGH THE FEDERAL HEALTH INSURANCE MARKETPLACE, PROVIDING LOW-COST COMPREHENSIVE COVERAGE FOR INDIVIDUALS AND FAMILIES; (2) MEDICARE ADVANTAGE, CONTRACTING WITH MEDICARE TO PROVIDE ALL PART A AND PART B BENEFITS; AND (3) DUAL ELIGIBLE SPECIAL NEEDS PLANS (D-SNPS), ENROLLING INDIVIDUALS WHO ARE ENTITLED TO BOTH MEDICARE (TITLE XVIII) AND MEDICAL ASSISTANCE FROM A STATE PLAN UNDER MEDICAID (TITLE XIX). CARESOURCE KENTUCKY IS ACCREDITED THROUGH THE NATIONAL COMMITTEE FOR QUALITY ASSURANCE ("NCQA") FOR ITS QUALIFIED HEALTH PLAN ("QHP"). ACCREDITATION IS THE MOST COMPREHENSIVE EVALUATION IN THE INDUSTRY AND THE ONLY ASSESSMENT THAT BASES RESULTS ON CLINICAL PERFORMANCE AND CONSUMER EXPERIENCE. CSKY 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. CSKY HAS BUILT A HIGH-PERFORMING PROVIDER NETWORK TO OPERATE AS AN 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. CSKY'S QUALIFIED HEALTH PLAN 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 RECEIVE ASSISTANCE THROUGH CSKY'S MANY PROGRAMS DESIGNED TO REMOVE BARRIERS TO HEALTH AND WELL-BEING, AND IN ADDITION CASE MANAGEMENT SERVICES ARE AVAILABLE TO ALL MEMBERS WHO ARE AT RISK FOR SUBSTANCE USE DISORDER. CARESOURCE KENTUCKY CAN, THEREFORE, FURTHER ITS MISSION AS A MEANS OF IMPROVING THE HEALTH AND WELL-BEING OF KENTUCKY'S LOW-INCOME POPULATIONS.