Skip to content
Nonprofiteer
← THE HEALTH PLAN OF WEST VIRGINIA INC

Form 990 for tax year 2023

Filed by THE HEALTH PLAN OF WEST VIRGINIA INC.

Totals

Total revenue
$793,217,524
Total expenses
$780,774,378
Contributions and grants received
$0
Grants paid
$856,558
Program service revenue
$778,768,443
Investment income
$14,376,241
Other revenue
$72,840
Total assets, end of year
$452,146,751
Total liabilities, end of year
$145,077,868
Net assets or fund balances, end of year
$307,068,883
Program services expenses (Part IX)
$766,021,218
Management and general expenses
$14,753,160
Fundraising expenses
$0
Program service expenses (Part III)
$766,021,218

Program services were 98.1% of total expenses calculated — Part IX's program-services column over total expenses, both as filed.

Line items

Every line the filer filed in Parts VIII, IX and X, as filed and in filed order. Blank columns are left out, and the lines are not forced to add up to the totals above.

Revenue

Part VIII, the statement of revenue.

  • 2a · Program service revenue: MEDICARE

    total $534,486,134 · related or exempt $534,486,134

  • 2b · Program service revenue: MEDICAID

    total $135,193,385 · related or exempt $135,193,385

  • 2c · Program service revenue: COMMERCIAL HMO

    total $108,984,578 · related or exempt $108,984,578

  • 2d · Program service revenue: CLAIM PROCESSING

    total $104,346 · related or exempt $104,346

  • 3 · Investment income

    total $11,963,008 · excluded $11,963,008

  • 6a · Gross rents

    real property $47,843

  • 6b · Less rental expenses

    real property $0

  • 6c · Rental income or loss

    real property $47,843

  • 6d · Net rental income or loss

    total $47,843 · excluded $47,843

  • 7a · Gross sales of assets other than inventory

    securities $220,892,196

  • 7b · Less cost or other basis and sales expenses

    securities $218,478,963

  • 7c · Gain or loss

    securities $2,413,233

  • 7d · Net gain or loss

    total $2,413,233 · excluded $2,413,233

  • 11a · Other revenue: MISCELLANEOUS REVENUE

    total $24,997 · excluded $24,997

  • 11e · Other revenue, total

    $24,997

Functional expenses

Part IX, the statement of functional expenses.

  • 1 · Grants to domestic organizations and governments

    total $608,480 · program services $608,480

  • 2 · Grants to domestic individuals

    total $248,078 · program services $248,078

  • 4 · Benefits paid to or for members

    total $697,332,785 · program services $697,332,785

  • 5 · Compensation of officers, directors and key employees

    total $3,901,804 · program services $1,950,902 · management and general $1,950,902

  • 7 · Other salaries and wages

    total $20,252,513 · program services $15,681,350 · management and general $4,571,163

  • 8 · Pension plan contributions

    total $2,252,935 · program services $1,898,469 · management and general $354,466

  • 9 · Other employee benefits

    total $13,574,569 · program services $10,592,280 · management and general $2,982,289

  • 10 · Payroll taxes

    total $2,858,714 · program services $2,413,255 · management and general $445,459

  • 11b · Fees: legal

    total $469,067 · program services $332,366 · management and general $136,701

  • 11c · Fees: accounting

    total $2,574,728 · program services $2,307,503 · management and general $267,225

  • 11d · Fees: lobbying

    total $27,547 · program services $27,547

  • 11f · Fees: investment management

    total $630,283 · management and general $630,283

  • 11g · Fees: other

    total $12,797,520 · program services $12,222,758 · management and general $574,762

  • 12 · Advertising and promotion

    total $4,305,029 · program services $4,294,142 · management and general $10,887

  • 13 · Office expenses

    total $2,374,614 · program services $1,913,248 · management and general $461,366

  • 14 · Information technology

    total $6,876,719 · program services $6,212,566 · management and general $664,153

  • 16 · Occupancy

    total $1,190,007 · program services $754,051 · management and general $435,956

  • 17 · Travel

    total $364,543 · program services $293,676 · management and general $70,867

  • 19 · Conferences, conventions and meetings

    total $301,201 · program services $167,900 · management and general $133,301

  • 20 · Interest

    total $351,115 · program services $263,336 · management and general $87,779

  • 22 · Depreciation, depletion and amortization

    total $1,983,056 · program services $1,487,292 · management and general $495,764

  • 23 · Insurance

    total $1,532,772 · program services $1,140,808 · management and general $391,964

  • 24a · Other expenses: BROKER EXPENSE

    total $1,731,485 · program services $1,731,485

  • 24b · Other expenses: NET REINSURANCE EXPENSE

    total $1,655,292 · program services $1,655,292

  • 24c · Other expenses: MISCELLANEOUS EXPENSES

    total $459,994 · program services $372,121 · management and general $87,873

  • 24d · Other expenses: PREMIUM TAX EXPENSE

    total $119,528 · program services $119,528

Balance sheet

Part X, book values.

  • 2 · Savings and temporary cash investments

    beginning of year $63,184,590 · end of year $28,711,967

  • 4 · Accounts receivable

    beginning of year $30,242,070 · end of year $36,320,258

  • 10a · Land, buildings and equipment: cost or other basis

    $14,968,599

  • 10b · Land, buildings and equipment: accumulated depreciation

    $7,302,412

  • 10c · Land, buildings and equipment, net

    beginning of year $7,967,844 · end of year $7,666,187

  • 11 · Investments: publicly traded securities

    beginning of year $258,787,423 · end of year $320,946,651

  • 12 · Investments: other securities

    beginning of year $47,224,759 · end of year $56,314,738

  • 15 · Other assets

    beginning of year $2,266,210 · end of year $2,186,950

  • 17 · Accounts payable and accrued expenses

    beginning of year $126,556,561 · end of year $133,755,638

  • 19 · Deferred revenue

    beginning of year $1,614,257 · end of year $1,793,752

  • 25 · Other liabilities

    beginning of year $8,451,685 · end of year $9,528,478

  • 29 · Capital stock, trust principal or current funds

    beginning of year $272,550,393 · end of year $306,568,883

  • 30 · Paid-in or capital surplus, or land, building or equipment fund

    beginning of year $0 · end of year $0

  • 31 · Retained earnings, endowment or other funds

    beginning of year $500,000 · end of year $500,000

Mission and programs · 2023

Mission

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.

  • 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.

    Expenses $107,215,036 · Grants $856,558 · Revenue $109,088,924

  • 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).

    Expenses $525,807,882 · Revenue $534,486,134

  • 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.

    Expenses $132,998,300 · Revenue $135,193,385

As filed on the 2023 return. The filer continues this part on Schedule O, which is not shown here.

Listed in Part VII

  • Jeffrey Knight

    PRESIDENT & CEO

    Total calculated
    $733,175
    From this org
    $686,899
    From related orgs
    $0
    Other
    $46,276
    Hours/week
    40 + 1 related

    Schedule J breakdown matched by us

    Base
    $549,136
    Bonus
    $136,538
    Other
    $1,225
    Deferred
    $22,304
    Nontaxable benefits
    $23,972
    Filer's total
    $733,175

  • Ryan Ralston

    VP - CFO

    Total calculated
    $474,899
    From this org
    $412,620
    From related orgs
    $0
    Other
    $62,279
    Hours/week
    40 + 1 related

    Schedule J breakdown matched by us

    Base
    $347,599
    Bonus
    $64,481
    Other
    $540
    Deferred
    $24,466
    Nontaxable benefits
    $37,813
    Filer's total
    $474,899

  • Ed Kairis MD Mmm

    CHIEF MEDICAL OFFICER (THRU 09/23)

    Total calculated
    $436,280
    From this org
    $402,896
    From related orgs
    $0
    Other
    $33,384
    Hours/week
    40 + 1 related

    Schedule J breakdown matched by us

    Base
    $304,183
    Bonus
    $69,694
    Other
    $29,019
    Deferred
    $23,092
    Nontaxable benefits
    $10,292
    Filer's total
    $436,280

  • Jamie Leary

    CHIEF LEGAL COUNCIL

    Total calculated
    $356,962
    From this org
    $332,288
    From related orgs
    $0
    Other
    $24,674
    Hours/week
    40 + 1 related

    Schedule J breakdown matched by us

    Base
    $289,046
    Bonus
    $42,000
    Other
    $1,242
    Deferred
    $23,092
    Nontaxable benefits
    $1,582
    Filer's total
    $356,962

  • Richard Legg Svp - Sales

    & ACCOUNT MANAGEMENT (THRU 06/23)

    Total calculated
    $348,664
    From this org
    $331,527
    From related orgs
    $0
    Other
    $17,137
    Hours/week
    40 + 1 related

    Schedule J breakdown matched by us

    Base
    $137,677
    Bonus
    $27,583
    Other
    $166,267
    Deferred
    $11,033
    Nontaxable benefits
    $6,104
    Filer's total
    $348,664

  • Kenneth Bryan

    CHIEF INFORMATION OFFICER

    Total calculated
    $337,555
    From this org
    $289,873
    From related orgs
    $0
    Other
    $47,682
    Hours/week
    40 + 1 related

    Schedule J breakdown matched by us

    Base
    $248,944
    Bonus
    $37,365
    Other
    $3,564
    Deferred
    $20,000
    Nontaxable benefits
    $27,682
    Filer's total
    $337,555

  • Antoinette Geyer

    SVP PROVIDER DELIVERY SERVICES

    Total calculated
    $317,447
    From this org
    $285,042
    From related orgs
    $0
    Other
    $32,405
    Hours/week
    40 + 1 related

    Schedule J breakdown matched by us

    Base
    $236,420
    Bonus
    $47,380
    Other
    $1,242
    Deferred
    $18,952
    Nontaxable benefits
    $13,453
    Filer's total
    $317,447

  • E David Mathieu Svp -

    UNDERWRITING & REGULATORY SERVICES

    Total calculated
    $304,831
    From this org
    $258,833
    From related orgs
    $0
    Other
    $45,998
    Hours/week
    40 + 1 related

    Schedule J breakdown matched by us

    Base
    $231,302
    Bonus
    $23,340
    Other
    $4,191
    Deferred
    $18,672
    Nontaxable benefits
    $27,326
    Filer's total
    $304,831

  • Robert Cross

    MEDICAL DIRECTOR

    Total calculated
    $296,156
    From this org
    $251,373
    From related orgs
    $0
    Other
    $44,783
    Hours/week
    40 + 1 related

    Schedule J breakdown matched by us

    Base
    $236,236
    Bonus
    $11,429
    Other
    $3,708
    Deferred
    $17,797
    Nontaxable benefits
    $26,986
    Filer's total
    $296,156

  • Robert J Roset

    SVP - IT OPERATIONS & QUALITY

    Total calculated
    $279,273
    From this org
    $247,235
    From related orgs
    $0
    Other
    $32,038
    Hours/week
    40 + 1 related

    Schedule J breakdown matched by us

    Base
    $234,109
    Bonus
    $11,320
    Other
    $1,806
    Deferred
    $18,767
    Nontaxable benefits
    $13,271
    Filer's total
    $279,273

  • Christina Donohue

    SVP MHT

    Total calculated
    $274,703
    From this org
    $240,051
    From related orgs
    $0
    Other
    $34,652
    Hours/week
    40 + 1 related

    Schedule J breakdown matched by us

    Base
    $222,376
    Bonus
    $16,444
    Other
    $1,231
    Deferred
    $18,000
    Nontaxable benefits
    $16,652
    Filer's total
    $274,703

  • David Thomas Director -

    SALES NATIONAL (THRU 06/23)

    Total calculated
    $269,612
    From this org
    $238,363
    From related orgs
    $0
    Other
    $31,249
    Hours/week
    40 + 1 related

    Schedule J breakdown matched by us

    Base
    $104,697
    Bonus
    $121,534
    Other
    $12,132
    Deferred
    $13,440
    Nontaxable benefits
    $17,809
    Filer's total
    $269,612

  • Larry Welling

    DIRECTOR - IT SOFTWARE

    Total calculated
    $260,131
    From this org
    $221,126
    From related orgs
    $0
    Other
    $39,005
    Hours/week
    40 + 1 related

    Schedule J breakdown matched by us

    Base
    $153,444
    Bonus
    $67,682
    Other
    $0
    Deferred
    $12,360
    Nontaxable benefits
    $26,645
    Filer's total
    $260,131

  • Ryan Jewell

    SVP SALES & ACCOUNT MGMT

    Total calculated
    $258,785
    From this org
    $225,283
    From related orgs
    $0
    Other
    $33,502
    Hours/week
    40 + 1 related

    Schedule J breakdown matched by us

    Base
    $206,333
    Bonus
    $18,512
    Other
    $438
    Deferred
    $10,360
    Nontaxable benefits
    $23,142
    Filer's total
    $258,785

  • Charles F Lucas

    VP, IT SOFTWARE DEVELOPMENT

    Total calculated
    $245,232
    From this org
    $216,820
    From related orgs
    $0
    Other
    $28,412
    Hours/week
    40 + 1 related

    Schedule J breakdown matched by us

    Base
    $197,765
    Bonus
    $18,948
    Other
    $107
    Deferred
    $15,860
    Nontaxable benefits
    $12,552
    Filer's total
    $245,232

  • John Wright IV

    MEMBER

    Total calculated
    $23,000
    From this org
    $23,000
    From related orgs
    $0
    Other
    $0
    Hours/week
    1 + 1 related

  • Denise D Pentino

    CHAIR OF THE BOARD

    Total calculated
    $21,000
    From this org
    $21,000
    From related orgs
    $0
    Other
    $0
    Hours/week
    1 + 1 related

  • Wesley Nickell

    VICE CHAIR OF THE BOARD

    Total calculated
    $20,000
    From this org
    $20,000
    From related orgs
    $0
    Other
    $0
    Hours/week
    1 + 1 related

  • Susan Buchanan CPA

    SECRETARY

    Total calculated
    $17,500
    From this org
    $17,500
    From related orgs
    $0
    Other
    $0
    Hours/week
    1 + 1 related

  • Lea Ridenhour

    MEMBER

    Total calculated
    $17,500
    From this org
    $17,500
    From related orgs
    $0
    Other
    $0
    Hours/week
    1 + 1 related

  • Mark Lancellotti

    MEMBER

    Total calculated
    $17,500
    From this org
    $17,500
    From related orgs
    $0
    Other
    $0
    Hours/week
    1 + 1 related

  • Joseph G Donzella Do

    MEMBER

    Total calculated
    $17,500
    From this org
    $17,500
    From related orgs
    $0
    Other
    $0
    Hours/week
    1 + 1 related

  • Maninder Singh Bedi MD

    MEMBER

    Total calculated
    $12,500
    From this org
    $12,500
    From related orgs
    $0
    Other
    $0
    Hours/week
    1 + 1 related

  • William D Cronin

    MEMBER

    Total calculated
    $10,000
    From this org
    $10,000
    From related orgs
    $0
    Other
    $0
    Hours/week
    1 + 1 related

Compensation is as filed in Part VII: reportable pay from this organization and from related organizations, other compensation, and hours per week. The total, marked calculated, is our sum of the three dollar columns, with a blank column counted as $0; the form itself has no total. On a Form 990-EZ the columns are Part IV's instead, and on a Form 990-PF Part VIII's — compensation, contributions to benefit plans, and expense account — and the total sums those. A Schedule J breakdown is as filed: base pay, bonus, other, deferred compensation and nontaxable benefits from this organization, with any from related organizations beside each, and the filer's own total. It is shown with the Part VII listing of the same name on the same return. The form gives no key between the two, so that pairing is ours, and is marked matched by us.

Schedule J

Answered yes

  • 1a · Housing allowance or residence for personal use
  • 1b · Written policy on the line-1a expenses
  • 2 · Substantiation required before reimbursing expenses
  • 3 · Compensation committee
  • 3 · Written employment contract
  • 3 · Compensation survey or study
  • 3 · Approval by the board or compensation committee
  • 4a · Severance or change-of-control payment
  • 5a · Pay contingent on this organization's revenues
  • 5b · Pay contingent on a related organization's revenues
  • 6a · Pay contingent on this organization's net earnings
  • 6b · Pay contingent on a related organization's net earnings
  • 7 · Other non-fixed payments

Answered no

  • 4b · Supplemental nonqualified retirement plan
  • 4c · Equity-based compensation arrangement
  • 8 · Paid under the initial-contract exception

The filer's explanations (Part III)

PART I, LINE 1A
DR. KAIRIS HAS A MONTHLY RELOCATION STIPEND PAID THROUGH THE NORMAL PAYROLL PROCESS.
PART I, LINE 4A
RICHARD LEGG RECEIVED A SEVERANCE PAYMENT IN THE AMOUNT OF $144,036 IN 2023.
PART I, LINE 5
SALES TEAM MEMBERS RECEIVE SALES COMMISSIONS BASED ON NEW BUSINESS SALES AND CLIENT RETENTION.
PART I, LINE 6
BONUS PAYMENTS ARE BASED ON THE ACHIEVEMENT OF INDIVIDUAL AND STRATEGIC PLAN GOALS AND THE COMPANY'S (CONSOLIDATED) OVERALL FINANCIAL GOALS. THE AMOUNTS ARE DISCRETIONARY AND ARE NOT FIXED.
PART I, LINE 7
BONUS PAYMENTS ARE BASED ON THE ACHIEVEMENT OF INDIVIDUAL AND STRATEGIC PLAN GOALS AND THE COMPANY'S (CONSOLIDATED) OVERALL FINANCIAL GOALS. THE AMOUNTS ARE DISCRETIONARY AND ARE NOT FIXED.

Part I's answers as filed. A line not listed was left unanswered; on lines 1a and 3 that means the box was not checked.

Grants on this return

The 10 largest by cash amount. The API serves every itemized grant.

Taxable family on this return

Schedule R Parts I, III and IV, as filed. These record ownership and control, not shared board members or money moved.

Related corporations and trusts

Part IV: related organizations taxable as a corporation or trust.

  • THP INSURANCE COMPANY

    C · INSURANCE AND THIRD PARTY ADMINISTRATOR · WV · 100% owned · share of income $45,867,629 · share of assets $75,557,450 · controlled entity

    Directly controlled by THE HEALTH PLAN OF WEST VIRGINIA INC

  • HOMETOWN HHP SERVICES CORPORATION

    C · THIRD-PARTY ADMINISTRATOR · OH · 100% owned · share of income $1,296,329 · share of assets $4,249,050 · controlled entity

    Directly controlled by THE HEALTH PLAN OF WEST VIRGINIA INC

Provenance

Return type
form_990
Tax year
2023
Filed
30 September 2024
IRS schema version
2023v5.1
Source object
202412789349301326

Check it against the return as filed: the GivingTuesday Data Lake hosts a public copy of the original XML.

The source document this was parsed from is served over the API, which is where bulk and document access live.