The Health Plan Of West Virginia Inc
- Assets
- $452.1m
- Revenue
- $793.2m
- Investments
- $56.3m
- Employees
- 650
- Location
- Wheeling, WV
- Founding
- 11/1979
- Data as of
- 12/2023
- 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 12/2023, Health Plan employed 650 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 12/2023, Health Plan generated $793.2m in total revenue. This represents relatively stable growth, over the past 8 years the organization has increased revenue by an average of 7.8% each year. All expenses for the organization totaled $780.8m during the year ending 12/2023. While expenses have increased by 7.6% per year over the past 8 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 96 individual grants totaling $3,020,665. 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
2023
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 VIRGINA, 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, 2023 WAS 19,140.
THE HEALTH PLAN OFFERS A MANAGED CARE PROGRAM FOR MOUNTAIN HEALTH TRUST (MHT), WEST VIRGINIA'S MEDICAID PROGRAM. AT DECEMBER 31, 2023, THE HEALTH PLAN'S MHT PLAN SERVICED 108,341 MEMBERS WITH 46,576 MEMBERS ENROLLED FROM THE EXPANSION POPULATION, 46,167 MEMBERS ENROLLED FOR THE TEMPORARY ASSISTANCE FOR NEEDY FAMILIES (TANF) POPULATION, 10,361 MEMBERS ENROLLED FROM THE SUPPLEMENTAL SECURITY INCOME (SSI) POPULATION, AND 5,237 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, 2023 FOR THESE PROGRAMS INCLUDED 8,322 MEMBERS.
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Board, Officers & Key Employees
| Name (title) | Role | Hours | Compensation |
|---|---|---|---|
Jeffrey Knight President & CEO | Officer | 40 | $686,899 |
Ryan Ralston VP - CFO | Officer | 40 | $412,620 |
Ed Kairis MD Mmm Chief Medical Officer (thru 09/23) | Officer | 40 | $402,896 |
Jamie Leary Chief Legal Council | Officer | 40 | $332,288 |
Richard Legg Svp - Sales & Account Management (thru 06/23) | Officer | 40 | $331,527 |
Kenneth Bryan Chief Information Officer | Officer | 40 | $289,873 |
Outside Vendors & Contractors
| Vendor Name (Service) | Service Year | Compensation |
|---|---|---|
Scion Dental Llc Dental Claims Processing And Administrat | 12/30/23 | $26,053,105 |
Evicore Healthcare Msi Llc Medical Benefit Management Services | 12/30/23 | $4,844,242 |
Incomm Healthcare & Affinity Inc Member Incentive Cards For Achieving Hea | 12/30/23 | $4,564,090 |
Milliman Inc Actuarial Services | 12/30/23 | $3,734,147 |
Optuminsight Inc Medical Management Services | 12/30/23 | $1,946,373 |
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 | $778,768,443 |
| Investment income | $11,963,008 |
| Tax Exempt Bond Proceeds | $0 |
| Royalties | $0 |
| Net Rental Income | $47,843 |
| Net Gain/Loss on Asset Sales | $2,413,233 |
| Net Income from Fundraising Events | $0 |
| Net Income from Gaming Activities | $0 |
| Net Income from Sales of Inventory | $0 |
| Miscellaneous Revenue | $0 |
| Total Revenue | $793,217,524 |
| Statement of Expenses | |
|---|---|
| Grants and other assistance to domestic organizations and domestic governments. | $608,480 |
| Grants and other assistance to domestic individuals. | $248,078 |
| Grants and other assistance to Foreign Orgs/Individuals | $0 |
| Benefits paid to or for members | $697,332,785 |
| Compensation of current officers, directors, key employees. | $3,901,804 |
| Compensation of current officers, directors, key employees. | $1,950,902 |
| Compensation to disqualified persons | $0 |
| Other salaries and wages | $20,252,513 |
| Pension plan accruals and contributions | $2,252,935 |
| Other employee benefits | $13,574,569 |
| Payroll taxes | $2,858,714 |
| Fees for services: Management | $0 |
| Fees for services: Legal | $469,067 |
| Fees for services: Accounting | $2,574,728 |
| Fees for services: Lobbying | $27,547 |
| Fees for services: Fundraising | $0 |
| Fees for services: Investment Management | $630,283 |
| Fees for services: Other | $12,797,520 |
| Advertising and promotion | $4,305,029 |
| Office expenses | $2,374,614 |
| Information technology | $6,876,719 |
| Royalties | $0 |
| Occupancy | $1,190,007 |
| Travel | $364,543 |
| Payments of travel or entertainment expenses for any federal, state, or local public officials | $0 |
| Conferences, conventions, and meetings | $301,201 |
| Interest | $351,115 |
| Payments to affiliates | $0 |
| Depreciation, depletion, and amortization | $1,983,056 |
| Insurance | $1,532,772 |
| All other expenses | $0 |
| Total functional expenses | $780,774,378 |
| Balance Sheet | |
|---|---|
| Cash—non-interest-bearing | $0 |
| Savings and temporary cash investments | $28,711,967 |
| Pledges and grants receivable | $0 |
| Accounts receivable, net | $36,320,258 |
| 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 | $7,666,187 |
| Investments—publicly traded securities | $320,946,651 |
| Investments—other securities | $56,314,738 |
| Investments—program-related | $0 |
| Intangible assets | $0 |
| Other assets | $2,186,950 |
| Total assets | $452,146,751 |
| Accounts payable and accrued expenses | $133,755,638 |
| Grants payable | $0 |
| Deferred revenue | $1,793,752 |
| 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 | $9,528,478 |
| Total liabilities | $145,077,868 |
| Net assets without donor restrictions | $0 |
| Net assets with donor restrictions | $0 |
| Capital stock or trust principal, or current funds | $306,568,883 |
| 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 | $452,146,751 |
Grants Awarded
Over the last fiscal year, The Health Plan Of West Virginia Inc has awarded $608,480 in support to 16 organizations.
| Grant Recipient | Amount |
|---|---|
CAMPBELLS CREEK CHURCH PURPOSE: FOOD PANTRY | $40,000 |
CATHOLIC CHARITIES WEST VIRGINIA INC PURPOSE: FOOD PANTRY | $40,000 |
HOUSE OF THE CARPENTER LLC PURPOSE: FOOD PANTRY | $40,000 |
CHRISTIAN HELP INC PURPOSE: FOOD PANTRY | $40,000 |
HUNTINGTON CITY MISSION PURPOSE: FOOD PANTRY | $40,000 |
MOUNTAINEER FOOD BANK INC PURPOSE: FOOD PANTRY | $54,994 |