The Health Plan Of West Virginia Inc

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.

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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Outside Vendors & Contractors

Vendor Name (Service)Compensation
Evicore Healthcare Msi Llc
Medical Benefit Management Services
$4,762,728
Milliman Inc
Actuarial Consultant
$1,627,315
Scion Dental Llc
Dental Claims Processing And Administrat
$20,154,833
Beecher Evergreen Managed Care
Reinsurance Broker
$2,007,268
Liberty Dental Plan Corporation
Dental Plan Benefits For Medicare And Ds
$1,540,393
View All Vendors

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

Grants Awarded

Over the last fiscal year, The Health Plan Of West Virginia Inc has awarded $567,486 in support to 20 organizations.

Grant RecipientAmount

UNIVERSITY PHYSICIANS AND SURGEONS INC

Org PageRecipient Profile

Huntington, WV

PURPOSE: MARSHALL PROJECT HOPE PLAYGROUND

$50,000

Wheeling, WV

PURPOSE: PROVIDE ASSISTANCE TO VICTIMS OF DOMESTIC VIOLENCE

$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

ST JAMES EVANGELICAL LUTHERAN CHURCH

Org PageRecipient Profile

Wheeling, WV

PURPOSE: FOOD PANTRY

$30,000

ST LUKES EPISCOPAL CHURCH

PURPOSE: FOOD PANTRY

$30,000

HOUSE OF THE CARPENTER LLC

Org PageRecipient Profile

Wheeling, WV

PURPOSE: FOOD PANTRY

$30,000
View Grant Profile

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 OrganizationAmount
West Virginia United Health System Inc

Morgantown, WV

PURPOSE: Support

$15,000
View Grant Recipient Profile

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