2015-11-16T07:46:51-06:00 2014-12-31 560747981 DIXON HUGHES GOODMAN LLP PO BOX 1747 CHARLESTON WV 253261747 990 2014-01-01 550585592 THE HEALTH PLAN OF THE UPPER OHIO VALLEY INC HEAL 7406953585 52160 NATIONAL ROAD EAST ST CLAIRSVILLE OH 43950 JAMES M PENNINGTON CEO 7406953585 2015-09-23 1 SUSAN S DULL P00233523 3043430168 2014 2016-04-25 22:37:26Z THE HEALTH PLAN JAMES M PENNINGTON 52160 NATIONAL ROAD EAST ST CLAIRSVILLE OH 43950 690970251 0 X WWW.HEALTHPLAN.ORG X 1979 WV 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 HEALTH CARE PROFESSIONALS AND PARTNERS ACROSS THE COMMUNITY. 10 9 432 0 2225425 215786 0 0 366120962 384189943 7590425 10391820 37773 140637 373749160 394722400 243348 836403 334095564 343357648 12823911 16075721 0 0 0 13137032 23153713 360299855 383423485 13449305 11298915 245910719 259939459 54540354 64694414 191370365 195245045 X 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 HEALTH CARE PROFESSIONALS AND PARTNERS ACROSS THE COMMUNITY. 0 0 142472960 836403 135225547 THE PRIMARY EXEMPT PURPOSE OF THE HEALTH PLAN OF THE UPPER OHIO VALLEY, INC. IS TO OPERATE A STATE CERTIFIED, FEDERALLY QUALIFIED HEALTH MAINTENANCE ORGANIZATION (HMO) WHICH PROVIDES COMPREHENSIVE HEALTH CARE SERVICES ON A PREPAID BASIS. HEALTH COVERAGE INCLUDES INPATIENT, EMERGENCY ROOM, OUTPATIENT, DOCTOR ORDERED, PHYSICIAN, PHARMACY, MENTAL HEALTH, AND VISION SERVICES. THE NUMBER OF HMO MEMBERS AT DECEMBER 31, 2014 WAS 30,941. 94038283 107766192 THE HEALTH PLAN CONTINUES TO OFFER THE MEDICAID PROGRAM SERVICING 33,386 MEMBERS AT DECEMBER 31, 2014. HEALTH COVERAGE INCLUDES INPATIENT, OUTPATIENT, EMERGENCY ROOM, DOCTOR ORDERED, PHYSICIAN, AND VISION SERVICES. 144824114 138972779 THE HEALTH PLAN OF THE UPPER OHIO VALLEY, INC. CONTINUES TO OFFER A MEDICARE ADVANTAGE PROGRAM KNOWN AS SECURE CARE AND SECURE CARE SPECIAL NEEDS PLAN (SNP). THIS PRODUCT ENABLES THE MEDICARE AGE POPULATION TO SELECT SUPPLEMENTAL MEDICARE COVERAGE AT A MUCH LOWER COST DUE TO THEIR AGREEMENT TO UTILIZE THE HEALTH PLAN NETWORK. THE ENROLLMENT AT DECEMBER 31, 2014 FOR THIS PROGRAM WAS 12,133. HEALTH COVERAGE INCLUDES INPATIENT, OUTPATIENT, DOCTOR ORDERED, EMERGENCY ROOM, AND PHYSICIAN COVERAGE. PHARMACEUTICAL AND VISION SERVICES ARE OFFERED AS OPTIONS IN ADDITION TO THE STANDARD SERVICES LISTED ABOVE. 381335357 0 0 0 0 0 0 0 0 0 1 0 0 0 1 0 0 0 0 0 1 0 0 0 0 0 0 1 1 1 0 0 0 0 0 0 0 0 0 0 0 0 0 1 1 1 0 1 3327 0 432 1 1 1 0 0 0 0 0 0 0 X 10 9 0 0 0 0 0 0 0 1 1 0 0 1 1 1 1 1 1 1 1 0 X JEFFREY M KNIGHT CFO 7406957585 52160 NATIONAL ROAD EAST ST CLAIRSVILLE OH 43950 JOHN HOLLOWAY CHAIRMAN OF BOARD 1.00 0.00 X 6750 0 0 JOHN WRIGHT IV VICE CHAIRMAN OF BOARD 1.00 0.00 X 4500 0 0 ROBERT DUNLEVY DIRECTOR 1.00 0.00 X 4050 0 0 JERRY FISHER DIRECTOR 1.00 0.00 X 3600 0 0 FRANK JOANOU DIRECTOR 1.00 0.00 X 4050 0 0 KIKI MEHALLIS DIRECTOR 1.00 0.00 X 3150 0 0 CHARLES MONFRADI DIRECTOR 1.00 0.00 X 4300 0 0 CHARLES NEWMEYER DIRECTOR 1.00 0.00 X 2950 0 0 JAMES NEWTON DIRECTOR 1.00 0.00 X 4050 0 0 E PHILLIPS POLACK MD DIRECTOR 1.00 0.00 X 4300 0 0 NICK ZERVOS DIRECTOR 1.00 0.00 X 4500 0 0 PHILIP D WRIGHT PRESIDENT/CEO RTD 6.30.14 40.00 0.00 X 369838 0 21706 JAMES PENNINGTON PRESIDENT/CEO APPTD 7.1.14 40.00 0.00 X 202295 0 3753 JEFFREY M KNIGHT CFO 40.00 0.00 X 171829 0 30297 PATRICIA M FAST VP - OPERATIONS 40.00 0.00 X 204285 0 44831 E DAVID MATHIEU VP - MARKETING 40.00 0.00 X 215305 0 34807 ROBERT J ROSET CIO 40.00 0.00 X 204996 0 38681 MARK KENAMOND MEDICAL DIRECTOR 40.00 0.00 X 212500 0 7565 ROBERT C KOTA GENERAL COUNSEL 40.00 0.00 X 128614 0 26205 KENNETH ALLEN MEDICAL DIRECTOR 40.00 0.00 X 147424 0 8803 STEVEN HALVERSON DIRECTOR OF UNDERWRITING 40.00 0.00 X 116269 0 17872 STEPHEN NEAL DIRECTOR OF PHARMACY 40.00 0.00 X 114682 0 24934 THOMAS MINTON DIRECTOR OF NETWORK DEVELOPMENT 40.00 0.00 X 109705 0 24615 2243942 0 284069 15 0 1 0 0 MEDICARE 524114 138972779 138972779 HMO 524114 135225547 135225547 MEDICAID 524114 107766192 107766192 CLAIMS PROCESSING 524292 2225425 2225425 384189943 5436919 5436919 13500 0 13500 13500 13500 296267851 4934901 291334284 4913567 4933567 21334 4954901 4954901 MISCELLANEOUS REVENUE 900099 127137 127137 127137 394722400 382105155 2225425 10391820 543048 543048 293355 293355 343357648 343357648 2457759 2457759 7457570 5672933 1784637 988159 988159 3988221 3988221 1184012 1184012 2319015 2304474 14541 1013779 1013779 903539 903539 2299217 2161515 137702 1247468 1247468 4661916 4641950 19966 1737093 1711463 25630 589942 589942 199392 199344 48 119772 119772 1152 1152 553078 550938 2140 308594 308594 ACA HEALTH INSURANCE FE 4811747 4811747 BROKER COMMISSION EXPEN 1492766 1492766 PREMIUM TAX EXPENSE 519788 519788 LOSS ADJUSTMENT EXPENSE 271991 271991 103464 103464 383423485 381335357 2088128 0 15586021 24975801 4662029 14336188 10200679 4880726 5470430 5319953 218475288 213886500 1716951 1421017 245910719 259939459 49091639 59317918 2322375 2384101 3126340 2992395 54540354 64694414 X 190820365 194695045 0 0 550000 550000 191370365 195245045 245910719 259939459 X 11298915 -12735963 5311728 X 0 1 X 1 0 800000 800000 7721974 3513980 4207994 1678705 1366746 311959 5319953 FEDERAL INCOME TAXES 16510 POST RETIREMENT BENEFIT OBLIGATION 2975885 2992395 EAST ASIA & PACIFIC BOND INVESTMENT SECURITIES 2638241 EUROPE BOND INVESTMENT SECURITIES 4481866 NORTH AMERICA BOND INVESTMENT SECURITIES 1287301 SOUTH AMERICA BOND INVESTMENT SECURITIES 296097 NORTH AMERICA STOCK INVESTMENT SECURITIES 358309 EUROPE STOCK INVESTMENT SECURITIES 884840 MIDDLE EAST & NORTH AFRICA STOCK INVESTMENT SECURITIES 569719 0 0 0 0 0 0 10516373 0 10516373 0 0 0 0 0 0 1 WEST LIBERTY UNIVERSITY 101 FACULTY DRIVE WHEELING WV 26003 556000822 GOVTL 250000 DONATION WEST VIRGINIA UNIVERSITY PO BOX 6201 MORGANTOWN WV 26506 556000842 GOVTL 250000 DONATION UNITED WAY OF THE UPPER OHIO VALLEY 51 11TH STREET WHEELING WV 26003 550479446 501(C)(3) 5000 DONATION OHIO CANCER RESEARCH ASSOC 50 WEST BROAD STREET NO 1132 COLUMBUS OH 43215 311038309 501(C)(3) 5000 DONATION YMCA OF WHEELING 55 LOUNEZ AVENUE WHEELING WV 26003 550357071 501(C)(3) 25000 DONATION 5 0 MEDICAL STUDENT SCHOLARSHIPS 22 293355 FMV TUITION PAID PART I, LINE 2: THE HPUOV MEDICAL STUDENT (DOCTORS/NURSES) SCHOLARSHIP PROGRAM BEGAN IN THE FALL OF 2009. MEDICAL STUDENTS SUBMIT SCHOLARSHIP APPLICATIONS TO A SUB-COMMITTEE OF THE BOARD. THESE APPLICATIONS ARE REVIEWED BY THE SUB-COMMITTEE BASED ON THE STUDENT'S FINANCIAL NEED. THE PREFERRED APPLICANTS ARE RECOMMENDED TO THE FULL BOARD, WHICH APPROVES ANY SCHOLARSHIP AWARDS. THE TUITION PAYMENTS ARE MADE DIRECTLY TO THE SCHOOL, AND BOOK EXPENSES ARE REIMBURSED DIRECTLY TO THE STUDENTS. THE GRANT TERM IS OPEN UNTIL THE STUDENT GRADUATES. X X X 1 1 X X X X 1 0 0 0 0 0 0 0 0 PHILIP D WRIGHT PRESIDENT/CEO RTD 6.30.14 201313 0 16896 0 151629 0 14846 0 6860 0 391544 0 0 0 JAMES PENNINGTON PRESIDENT/CEO APPTD 7.1.14 200762 0 0 0 1533 0 315 0 3438 0 206048 0 0 0 JEFFREY M KNIGHT CFO 158000 0 13289 0 540 0 11042 0 19255 0 202126 0 0 0 PATRICIA M FAST VP - OPERATIONS 182904 0 14125 0 7256 0 25576 0 19255 0 249116 0 0 0 E DAVID MATHIEU VP - MARKETING 192928 0 14125 0 8252 0 15552 0 19255 0 250112 0 0 0 ROBERT J ROSET CIO 188676 0 14118 0 2202 0 19426 0 19255 0 243677 0 0 0 MARK KENAMOND MEDICAL DIRECTOR 206087 0 4091 0 2322 0 688 0 6877 0 220065 0 0 0 ROBERT C KOTA GENERAL COUNSEL 117591 0 3862 0 7161 0 18202 0 8003 0 154819 0 0 0 KENNETH ALLEN MEDICAL DIRECTOR 140684 0 4268 0 2472 0 800 0 8003 0 156227 0 0 0 PART I, LINE 1A PER WRITTEN EMPLOYMENT AGREEMENT EXECUTED FOR CEO. PART I, LINE 4A PHILIP WRIGHT - $148,872 SEVERANCE PAYMENT UPON RETIREMENT. FORM 990, PART VI, SECTION B, LINE 11 THE CFO AND THE CONTROLLER REVIEW THE FORM 990 FOR REASONABLENESS COMPARED TO THE INTERNAL FINANCIAL STATEMENTS. THE CFO PORVIDES COPIES TO THE BOARD OF DIRECTORS PRIOR TO FILING THE RETURN. FORM 990, PART VI, SECTION B, LINE 12C CONFLICT OF INTEREST STATEMENTS ARE SIGNED ON AN ANNUAL BASIS AND MAINTAINED BY THE HUMAN RESOURCES DEPARTMENT. FORM 990, PART VI, SECTION B, LINE 15 THE BOARD OF DIRECTORS AND/OR IMMEDIATE SUPERVISOR REVIEWS PERFORMANCE. THE BOARD APPROVES COMPENSATION FOR THE CEO, THE CEO APPROVES ALL OTHERS' COMPENSATION. OUTSIDE SURVEY TOOLS HAVE BEEN REFERENCED TO AID IN COMPENSATION DETERMINATION. FORM 990, PART VI, SECTION C, LINE 19 THESE DOCUMENTS ARE FILED WITH THE DEPARTMENT OF INSURANCE AND ARE AVAILABLE UPON REQUEST. FORM 990, PART XI, LINE 9: CHANGE IN NONADMITTED ASSETS 5,311,728. HOMETOWN HEALTH PLAN 100 LILLIAN GISH BLVD MASSILLON OH 44647 341523541 INSURANCE OH 501(C)(4) N/A HPUOV 1 THP INSURANCE COMPANY 1137 VANVOORHIS RD CHELSEA SQUARE S MORGANTOWN WV 26505 550765726 INSURANCE WV N/A C -11843449 34801870 1.00000 1 HP AGENCY INC 52160 NATIONAL ROAD EAST ST CLAIRSVILLE OH 43950 341764520 SVC TO SELF-INS OH N/A C -522411 465955 1.00000 1 HOMETOWN HHP SERVICES CORP 100 LILLIAN GISH BLVD MASSILLON OH 44647 341588625 SVC TO SELF-INS OH N/A C -288196 713150 1.00000 1 0 1 0 0 0 0 0 0 0 0 0 1 0 1 1 0 0 0 0 THP INSURANCE COMPANY L 4978291 ADMIN ALLOCATION HP AGENCY L 3248342 ADMIN ALLOCATION HOMETOWN HHP SERVICES INC L 301695 ADMIN ALLOCATION THP INSURANCE COMPANY B 15000000 CAPITAL CONTRIBUTION