2014-11-17T17:03:44-06:00 2013-12-31 ERNST & YOUNG US LLP 111 MONUMENT CIRCULE SUITE 4000 INDIANAPOLIS IN 46204 990 2013-01-01 550585592 The Health Plan of the Upper Ohio Valley Inc % JEFFREY M KNIGHT HEAL 7406953585 52160 National Road East Suite St Clairsville OH 43950 JEFFREY M KNIGHT TREASURER 2014-11-17 2013 2015-11-30 17:44:51Z JEFFREY M KNIGHT 52160 NATIONAL ROAD EAST ST CLAIRSVILLE OH 43950 776086569 false X www.healthplan.org X 1979 WV THE HEALTH PLAN OF THE UPPER OHIO VALLEY, INC. PROVIDES HMO SERVICES TO MEMBERS. 14 13 429 0 2599032 881864 0 0 380022844 366120962 10426040 7590425 6900 37773 390455784 373749160 218128 243348 353407846 334095564 14568012 12823911 0 0 0 13489803 13137032 381683789 360299855 8771995 13449305 243107634 245910719 53104045 54540354 190003589 191370365 THE HEALTH PLAN OF THE UPPER OHIO VALLEY, INC. PROVIDES HMO SERVICES TO MEMBERS. false false 150122820 243348 152911518 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, 2013 WAS 35,874. 64260196 73524941 THE HEALTH PLAN CONTINUES TO OFFER THE MEDICAID PROGRAM SERVICING 29,595 MEMBERS AT DECEMBER 31, 2013. HEALTH COVERAGE INCLUDED INPATIENT, OUTPATIENT, EMERGENCY ROOM, DOCTOR ORDERED, PHYSICIAN, AND VISION SERVICES. 143815528 137085471 THE HEALTH PLAN OF THE UPPER OHIO VALLEY INC. CONTINUES TO OFFER A MEDICARE ADVANTAGE PROGRAM KNOWN AS SECURE CARE. THIS PRODUCT ENABLES THE MEDICARE AGE POPULATION TO SELECT SUPPLEMENTAL MEDICARE COVERAGE AT A MUCH LOWER PRICE BECAUSE THEY AGREE TO UNITLIZE THE HEALTH PLAN NETWORK. THE ENROLMENT AT DECEMBER 31, 2013 WAS 12,628. HEALTH COVERAGE INCLUDES INPATIENT, OUTPATIENT, DOCTOR ORDERED, EMEERGENCY ROOM, AND PHYSICIAN COVERAGE. PHARMACEUTICAL AND VISION SERVICES WERE OFFERED AS OPTIONS IN ADDITION TO THE SERVICES LISTED ABOVE. 358198544 false false false false false false false false false true false false false true false false false false false false false false false false false false false true true false false false false false false true false false false false false false true true true false true 3204 0 true 429 true true true false false false false false X 14 13 false false false false false false false true true false false true true true true true true true true false X JEFFREY M KNIGHT 7406957585 52160 NATIONAL ROAD EAST ST CLAIRSVILLE OH 43950 Charles Monfradi Director 1.0 0.0 X 6000 0 0 Charles Newmeyer Director 1.0 0.0 X 7000 0 0 James Newton Director 1.0 0.0 X 4500 0 0 E Phillip Polack MD Director 1.0 0.0 X 5400 0 0 John Schellhase Director 1.0 0.0 X 4500 0 0 John Wright IV Director 1.0 0.0 X 5450 0 0 Nick Zervos Director 1.0 0.0 X 6550 0 0 Philip D Wright President/CEO 40.0 X X 342797 0 26837 Frank Joanou Director 1.0 0.0 X 4950 0 0 Robert Dunlevy Director 1.0 0.0 X 5950 0 0 Jerry Fisher Director 1.0 0.0 X 5400 0 0 Roland Hobbs Director 1.0 0.0 X 4500 0 0 John Holloway Director 1.0 0.0 X 5500 0 0 Kiki Mehallis Director 1.0 0.0 X 4950 0 0 Jeffrey M Knight Treasurer/CFO 40.0 0.0 X 162692 0 19142 Patricia M Fast Vice President/Operations 40.0 0.0 X 198282 0 23533 E David Mathieu Vice President/Marketing 40.0 0.0 X 207753 0 26329 Robert C Kota General Counsel 40.0 0.0 X 188481 0 21615 Robert Roset Chief Information Officer 40.0 0.0 X 199108 0 23494 Kenneth Allen Medical Director 40.0 0.0 X 223551 0 25746 Mark Kenamond Medical Director 40.0 0.0 X 216452 0 22150 Jennifer Ault Director of Utilization Review 40.0 0.0 X 104644 0 1484 Stephen Neal Director of Pharmacy Services 40.0 0.0 X 116409 0 1337 Eric Petho Director of Comp Services 40.0 0.0 X 102828 0 1876 Steven Halverson Director of Underwriting 40.0 0.0 X 117519 0 1857 Thomas Samol Director of Gov't Programs 40.0 0.0 X 108506 0 1337 2359672 0 196737 13 false true false 0 0 0 0 HMO PROGRAM 524114 152911518 152911518 0 0 MEDICAID PROGRAM 524114 73524941 73524941 0 0 MEDICARE PROGRAM 524114 137085471 137085471 0 0 CLAIMS PROCESSING 524292 2599032 0 2599032 0 All other program service revenue 0 0 0 0 366120962 5940476 5940476 0 0 12000 12000 0 12000 12000 403987358 402337409 1649949 1649949 1649949 0 0 0 MISCELLANEOUS REVENUE 25773 25773 0 0 25773 373749160 363559703 2599032 7590425 0 0 243348 243348 0 0 334095564 334095564 1925066 1925066 0 0 12289 12289 0 0 3829344 2397659 1431685 0 1394142 1394142 0 0 4525534 4525534 0 0 1137536 1137536 0 0 0 0 0 0 334125 320643 13482 0 990963 990963 0 0 0 0 0 0 0 0 854400 854400 0 0 1631906 1503143 128763 0 875493 873523 1970 0 2717868 2705040 12828 0 1617659 1592029 25630 0 0 0 0 0 572762 572762 0 0 148945 148825 120 0 0 0 0 0 128620 126980 1640 0 0 0 0 0 0 0 0 0 622123 620158 1965 0 315064 315064 0 0 BROKER EXPENSE 1543336 1543336 0 0 PREMIUM TAX EXPENSE 551950 551950 0 0 LOSS ADJUSTMENT EXPENSE -4788 -4788 0 0 UNRELATED BUSINESS TAX 236606 0 236606 0 360299855 358445166 1854689 0 0 0 0 12557896 15586021 0 0 7655302 4662029 0 0 0 0 0 0 0 0 0 0 9999347 4528917 5780779 5470430 215816609 218475288 0 0 0 0 0 0 1297048 1716951 243107634 245910719 49632021 49091639 0 0 2576292 2322375 0 0 0 0 0 0 0 0 0 0 895732 3126340 53104045 54540354 X 189453589 190820365 0 0 550000 550000 190003589 191370365 243107634 245910719 X 13449305 -3915585 -8166944 X false true X true false 800000 800000 7581901 3248403 4333498 1617446 1280514 336932 5470430 0 Federal income taxes 219274 Post Retirement Benefit Obligation 2907066 3126340 true MEDICAL STUDENT SCHOLARSHIPS 15 243348 FMV tuition paid Description of Organization's Procedures for Monitoring the Use of Grants 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 expense reimbursements are made directly to the student. The grant term is open until the student graduates. X true true X X X false false false false false false false false false Philip D Wright President/CEO 320456 0 17240 0 5101 0 25500 0 1337 0 369634 0 0 0 Jeffrey M Knight Treasurer/CFO 153930 0 8222 0 540 0 17266 0 1876 0 181834 0 0 0 Patricia M Fast Vice President/Operations 181382 0 10313 0 6587 0 21657 0 1876 0 221815 0 0 0 E David Mathieu Vice President/Marketing 190758 0 10313 0 6682 0 21657 0 4672 0 234082 0 0 0 Robert C Kota General Counsel 168787 0 9656 0 10038 0 20278 0 1337 0 210096 0 0 0 Robert Roset Chief Information Officer 186509 0 10294 0 2305 0 21618 0 1876 0 222602 0 0 0 Kenneth Allen Medical Director 210087 0 10671 0 2793 0 22409 0 3337 0 249297 0 0 0 Mark Kenamond Medical Director 203901 0 10229 0 2322 0 21480 0 670 0 238602 0 0 0 COMPENSATION PROVIDED BY ORGANIZATION Schedule J, Part I, Line 1a A portion of a health club membership was paid for the following: Robert Roset, E. David Mathieu, Robert Kota and Steve Neal. This benefit was treated as taxable income for all. Eric M Bush Son of CEO 12289 Employee providing general mai false PROCESS USED TO REVIEW THE FORM 990 FORM 990, PART VI, LINE 11B THE CFO AND CONTROLLER REVIEW THE 990 FOR REASONABLENESS COMPARED TO THE INTERNAL FINANCIAL STATEMENTS. THE CFO PROVIDES COPIES TO THE FINANCE COMMITTEE WHICH IS A SUBSET OF THE BOARD OF DIRECTORS PRIOR TO FILING THE RETURN. MONITORING AND ENFORCEMENT OF COMPLIANCE WITH CONFLICT OF INTEREST POLICY FORM 990, PART VI, LINE 12C CONFLICT OF INTEREST STATEMENTS ARE SIGNED ON AN ANNUAL BASIS AND MAINTAINED BY THE HUMAN RESOURCES DEPARTMENT. PROCESS FOR DETERMINING COMPENSATION FORM 990, PART VI, LINE 15 COMPENSATION IS REVIEWED ANNUALLY BY THE PRESIDENT. HE UTILIZES THE WARREN SURVEY INFORMATION BY POSITION FOR EXECUTIVE AND SENIOR MANAGEMENT AND MAKES RECOMMENDATIONS TO THE BOARD OF DIRECTORS' PERSONNEL COMMITTEE. THE COMPENSATION COMMITTEE THEN PRESENTS THE PREFERRED COMPENSATION CHANGES TO THE BOARD OF DIRECTORS FOR APPROVAL. PROCESS FOR MAKING DOCUMENTS AVAILABLE TO THE PUBLIC FORM 990, PART VI, LINE 19 These documents are available upon request to the CFO. OTHER CHANGES IN NET ASSETS OR FUND BALANCES FORM 990, PART XI, LINE 9 Change in non-admitted assets: (6,386,674) and cumulative effect of change in accounting principles (1,780,270). HOMETOWN HEALTH PLAN 100 LILLIAN GISH BLVD MASSILLON OH 44647 341523541 INSURANCE OH 501(c)(4) N/A HPUOV true THP INSURANCE COMPANY 1137 VANVOORHIS RD CHELSEA SQUARE S MORGANTOWN WV 26505 550765726 INSURANCE WV NA C Corp -12282195 30360184 1.00000 true HP Agency Inc 52160 NATIONAL ROAD EAST ST CLAIRSVILLE OH 43950 341764520 SVC TO SELF-INS OH NA C Corp -24217 240064 1.00000 true HOMETOWN HHP SERVICES CORP 100 LILLIAN GISH BLVD MASSILLON OH 44647 341588625 SVC TO SELF-INS OH NA C Corp -32858 892587 1.00000 true false true false false false false false false false false false false true true true false false false false THP INSURANCE COMPANY m 4836151 ADMIN. ALLOCATI HP AGENCY m 2845974 ADMIN. ALLOCATI HOMETOWN HHP SERVICES INC m 186953 ADMIN. ALLOCATI THP INSURANCE COMPANY b 12000000 CAPITAL CONTRIB