The Health Plan Of West Virginia Inc
- Assets
- $406.1m
- Revenue
- $789.2m
- Investments
- $53.6m
- Employees
- 721
- Location
- Wheeling, WV
- Founding
- 11/1979
- Data as of
- 12/2021
- EIN
- 55-0585592
Organization Overview
The Health Plan Of West Virginia Inc, operating under the name The Health Plan, is located in Wheeling, WV. The organization was established in 1979. According to its NTEE Classification (E31) the organization is classified as: Group Health Practices, under the broad grouping of Health Care and related organizations. As of 12/2021, Health Plan employed 721 individuals. This organization is an independent organization and not affiliated with a larger national or regional group of organizations. Health Plan is a 501(c)(4) and as such, is described as a "Civic League, Social Welfare Organization, and Local Association of Employees" by the IRS.
For the year ending 12/2021, Health Plan generated $789.2m in total revenue. This represents relatively stable growth, over the past 7 years the organization has increased revenue by an average of 8.9% each year. All expenses for the organization totaled $722.8m during the year ending 12/2021. While expenses have increased by 7.6% per year over the past 7 years. They've been increasing with an increasing level of total revenue. You can explore the organizations financials more deeply in the financial statements section below.
Since 2014, Health Plan has awarded 59 individual grants totaling $1,795,949. If you would like to learn more about the grant giving history of this organization, scroll down to the grant profile section of this page.
Form
990
Mission & Program ActivityExcerpts From the 990 Filing
TAX YEAR
2021
Describe the Organization's Mission:
Part 3 - Line 1
ESTABLISHED AS A COMMUNITY HEALTH ORGANIZATION, THE HEALTH PLAN DELIVERS A CLINICALLY-DRIVEN, TECHNOLOGY-ENHANCED, CUSTOMER-FOCUSED PLATFORM BY DEVELOPING AND IMPLEMENTING PRODUCTS AND SERVICES THAT MANAGE AND IMPROVE THE HEALTH AND WELL-BEING OF OUR MEMBERS. WE ACHIEVE THESE RESULTS THROUGH A TEAM OF HEALTHCARE PROFESSIONALS AND PARTNERS ACROSS OUR COMMUNITY.
Describe the Organization's Program Activity:
Part 3 - Line 4a
THE PRIMARY EXEMPT PURPOSE OF THE HEALTH PLAN OF WEST VIRGINIA, INC. (THE HEALTH PLAN) IS TO OPERATE A STATE CERTIFIED, FEDERALLY QUALIFIED HEALTH MAINTENANCE ORGANIZATION (HMO) WHICH PROVIDES COMPREHENSIVE HEALTH CARE SERVICES ON A PREPAID BASIS. THE NUMBER OF COMMERCIAL HMO MEMBERS AT DECEMBER 31, 2021 WAS 22,216.
THE HEALTH PLAN OFFERS A MANAGED CARE PROGRAM FOR MOUNTAIN HEALTH TRUST (MHT), WEST VIRGINIA'S MEDICAID PROGRAM. AT DECEMBER 31, 2021, THE HEALTH PLAN'S MHT PLAN SERVICED 125,121 MEMBERS WITH 55,966 MEMBERS ENROLLED FROM THE EXPANSION POPULATION, 52,979 MEMBERS ENROLLED FOR THE TEMPORARY ASSISTANCE FOR NEEDY FAMILIES (TANF) POPULATION, 11,396 MEMBERS ENROLLED FROM THE SUPPLEMENTAL SECURITY INCOME (SSI) POPULATION, AND 4,780 MEMBERS ENROLLED FROM THE WV CHILDREN'S HEALTH INSURANCE PROGRAM (WVCHIP).
THE HEALTH PLAN OFFERS A MEDICARE ADVANTAGE PROGRAM KNOWN AS SECURE CARE AND A PROGRAM FOR MEMBERS ELIGIBLE FOR BOTH MEDICARE AND MEDICAID KNOWN AS A MEDICARE DUAL SPECIAL NEEDS PLAN (DSNP). SECURE CARE ENABLES THE MEDICARE ELIGIBLE POPULATION TO SELECT MEDICARE COVERAGE AT A MUCH LOWER COST DUE TO THEIR AGREEMENT TO UTILIZE THE HEALTH PLAN NETWORK AND WITH PLAN OPTIONS FOR EXPANDED BENEFITS SUCH AS DENTAL, VISION, HEARING, TELEHEALTH, GYM MEMBERSHIPS, COVERAGE FOR "OVER-THE-COUNTER" ITEMS, IN-HOME MEAL DELIVERY AFTER HOSPITAL STAYS, AND ROUTINE TRANSPORTATION TO HEALTH-RELATED LOCATIONS. ENROLLMENT AT DECEMBER 31, 2021 FOR THESE PROGRAMS INCLUDED 10,408 MEMBERS.
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Board, Officers & Key Employees
| Name (title) | Role | Hours | Compensation |
|---|---|---|---|
David Thomas Director - Sales National | 40 | $636,922 | |
Jeffrey Knight President & COO | Officer | 40 | $515,646 |
James Pennington President/ceo (former) | 0 | $498,625 | |
Ed Kairis MD Mmm Chief Medical Officer | Officer | 40 | $443,878 |
Richard Legg SVP - Sales & Account Management | Officer | 40 | $331,644 |
Ryan Ralston Chief Financial Officer | Officer | 40 | $297,272 |
Outside Vendors & Contractors
| Vendor Name (Service) | Service Year | Compensation |
|---|---|---|
Scion Dental Llc Dental Claims Processing And Administrat | 12/30/21 | $20,154,833 |
Evicore Healthcare Msi Llc Medical Benefit Management Services | 12/30/21 | $4,762,728 |
Beecher Evergreen Managed Care Reinsurance Broker | 12/30/21 | $2,007,268 |
Liberty Dental Plan Corporation Dental Plan Benefits For Medicare And Ds | 12/30/21 | $1,540,393 |
Milliman Inc Actuarial Consultant | 12/30/21 | $1,627,315 |
Financial Statements
| Statement of Revenue | |
|---|---|
| Federated campaigns | $0 |
| Membership dues | $0 |
| Fundraising events | $0 |
| Related organizations | $0 |
| Government grants | $0 |
| All other contributions, gifts, grants, and similar amounts not included above | $0 |
| Noncash contributions included in lines 1a–1f | $0 |
| Total Revenue from Contributions, Gifts, Grants & Similar | $0 |
| Total Program Service Revenue | $781,679,902 |
| Investment income | $4,511,420 |
| Tax Exempt Bond Proceeds | $0 |
| Royalties | $0 |
| Net Rental Income | $42,552 |
| Net Gain/Loss on Asset Sales | $2,966,441 |
| Net Income from Fundraising Events | $0 |
| Net Income from Gaming Activities | $0 |
| Net Income from Sales of Inventory | $0 |
| Miscellaneous Revenue | $0 |
| Total Revenue | $789,215,656 |
| Statement of Expenses | |
|---|---|
| Grants and other assistance to domestic organizations and domestic governments. | $587,486 |
| Grants and other assistance to domestic individuals. | $247,051 |
| Grants and other assistance to Foreign Orgs/Individuals | $0 |
| Benefits paid to or for members | $656,328,334 |
| Compensation of current officers, directors, key employees. | $3,194,026 |
| Compensation of current officers, directors, key employees. | $1,597,013 |
| Compensation to disqualified persons | $0 |
| Other salaries and wages | $14,467,434 |
| Pension plan accruals and contributions | $1,953,880 |
| Other employee benefits | $11,096,687 |
| Payroll taxes | $2,839,523 |
| Fees for services: Management | $0 |
| Fees for services: Legal | $298,373 |
| Fees for services: Accounting | $1,903,419 |
| Fees for services: Lobbying | $48,100 |
| Fees for services: Fundraising | $0 |
| Fees for services: Investment Management | $618,740 |
| Fees for services: Other | $10,121,377 |
| Advertising and promotion | $1,824,778 |
| Office expenses | $1,979,737 |
| Information technology | $4,354,764 |
| Royalties | $0 |
| Occupancy | $1,229,569 |
| Travel | $228,875 |
| Payments of travel or entertainment expenses for any federal, state, or local public officials | $0 |
| Conferences, conventions, and meetings | $211,190 |
| Interest | $324,781 |
| Payments to affiliates | $0 |
| Depreciation, depletion, and amortization | $1,464,095 |
| Insurance | $1,142,984 |
| All other expenses | $0 |
| Total functional expenses | $722,817,093 |
| Balance Sheet | |
|---|---|
| Cash—non-interest-bearing | $0 |
| Savings and temporary cash investments | $17,403,641 |
| Pledges and grants receivable | $0 |
| Accounts receivable, net | $30,707,607 |
| Loans from Officers, Directors, or Controlling Persons | $0 |
| Loans from Disqualified Persons | $0 |
| Notes and loans receivable | $0 |
| Inventories for sale or use | $0 |
| Prepaid expenses and deferred charges | $0 |
| Net Land, buildings, and equipment | $7,625,827 |
| Investments—publicly traded securities | $294,014,165 |
| Investments—other securities | $53,578,743 |
| Investments—program-related | $0 |
| Intangible assets | $0 |
| Other assets | $2,774,134 |
| Total assets | $406,104,117 |
| Accounts payable and accrued expenses | $109,793,148 |
| Grants payable | $0 |
| Deferred revenue | $1,451,951 |
| Tax-exempt bond liabilities | $0 |
| Escrow or custodial account liability | $0 |
| Loans and other payables to any current Officer, Director, or Controlling Person | $0 |
| Secured mortgages and notes payable | $0 |
| Unsecured mortgages and notes payable | $0 |
| Other liabilities | $17,512,333 |
| Total liabilities | $128,757,432 |
| Net assets without donor restrictions | $0 |
| Net assets with donor restrictions | $0 |
| Capital stock or trust principal, or current funds | $276,846,685 |
| Paid-in or capital surplus, or land, building, or equipment fund | $0 |
| Retained earnings, endowment, accumulated income, or other funds | $500,000 |
| Total liabilities and net assets/fund balances | $406,104,117 |
Grants Awarded
Over the last fiscal year, The Health Plan Of West Virginia Inc has awarded $567,486 in support to 20 organizations.
| Grant Recipient | Amount |
|---|---|
Wheeling, WV PURPOSE: PROVIDE ASSISTANCE TO VICTIMS OF DOMESTIC VIOLENCE | $50,000 |
Huntington, WV PURPOSE: MARSHALL PROJECT HOPE PLAYGROUND | $50,000 |
Morgantown, WV PURPOSE: SUPPORT MENTAL HEALTH PROGRAMMING WITHIN THE WVU DEPARTMENT OF INTERCOLLEGIATE ATHLETICS BY PROVIDING FOR THE ENHANCEMENT OF PSYCHOLOGICAL SERVICES FOR WVU STUDENT-ATHLETES. | $35,000 |
Wheeling, WV PURPOSE: FOOD PANTRY | $30,000 |
Wheeling, WV PURPOSE: FOOD PANTRY | $30,000 |
Wheeling, WV PURPOSE: FOOD PANTRY | $30,000 |
Grants Recieved
Over the last fiscal year, we have identified 1 grants that The Health Plan Of West Virginia Inc has recieved totaling $15,000.
| Awarding Organization | Amount |
|---|---|
West Virginia United Health System Inc Morgantown, WV PURPOSE: Support | $15,000 |
Peer Organizations
| Organization Name | Assets | Revenue |
|---|---|---|
Delta Dental Plan Of Virginia Roanoke, VA | $184,676,642 | $753,977,588 |
Wellspan Medical Group York, PA | $140,592,269 | $745,783,571 |
The Health Plan Of West Virginia Inc Wheeling, WV | $406,104,117 | $789,215,656 |
St Lukes Physician Group Inc Allentown, PA | $77,606,071 | $634,645,551 |
Lehigh Valley Physician Group Allentown, PA | $433,846,962 | $621,243,367 |
Mount Carmel Health Plan Inc Columbus, OH | $483,267,404 | $579,951,393 |
Childrens Health Care Associates Inc Philadelphia, PA | $189,904,169 | $296,151,416 |
Johns Hopkins Community Physicians Inc Baltimore, MD | $80,055,420 | $292,035,143 |
University Physicians & Surge Ons Inc Huntington, WV | $136,768,311 | $240,542,935 |
Lancaster General Medical Group East Petersburg, PA | $36,228,576 | $121,615,307 |
Childrens Surgical Associates Ltd Philadelphia, PA | $115,762,399 | $134,726,812 |
St Paul Place Specialists Inc Baltimore, MD | $16,847,824 | $118,131,477 |