THE HEALTH PLAN OF WEST VIRGINIA INC: Form 990, tax year 2012

View the entire original 990 at ProPublica ↗

Organization
THE HEALTH PLAN OF WEST VIRGINIA INC (EIN 55-0585592)
Tax period
2012-01-01 to 2012-12-31
Filed
2013-11-15
IRS object ID
201323199349308877
Schema version
2012v2.1
Source
Download XML · Original 990 at ProPublica

Every field in the e-filed return. Faint text is the IRS element name, for citing.

Return header ReturnHeader

FieldValueIRS element (for citing)
Timestamp2013-11-15T15:40:51-06:00Timestamp
Tax Period End Date2012-12-31TaxPeriodEndDate

Preparer Firm PreparerFirm

Preparer Firm Business Name PreparerFirmBusinessName

FieldValueIRS element (for citing)
Business Name Line1ERNST & YOUNG US LLPBusinessNameLine1

Preparer Firm US Address PreparerFirmUSAddress

FieldValueIRS element (for citing)
Address Line1111 MONUMENT CIRCLE SUITE 2600AddressLine1
CityINDIANAPOLISCity
StateINState
ZIP Code46204ZIPCode
FieldValueIRS element (for citing)
Return Type990ReturnType
Tax Period Begin Date2012-01-01TaxPeriodBeginDate

Filer Filer

FieldValueIRS element (for citing)
EIN550585592EIN

Name Name

FieldValueIRS element (for citing)
Business Name Line1The Health Plan of the Upper Ohio Valley IncBusinessNameLine1
FieldValueIRS element (for citing)
In Care Of Name% Jeffrey KnightInCareOfName
Name ControlHEALNameControl
Phone7406953585Phone

US Address USAddress

FieldValueIRS element (for citing)
Address Line152160 National Road EastAddressLine1
Address Line2SuiteAddressLine2
CitySt ClairsvilleCity
StateOHState
ZIP Code43950ZIPCode

Officer Officer

FieldValueIRS element (for citing)
NameJEFF KNIGHTName
TitleTREASURER/CFOTitle
Date Signed2013-11-15DateSigned

Preparer Preparer

FieldValueIRS element (for citing)
Phone3176817000Phone
Date Prepared2013-11-15DatePrepared
FieldValueIRS element (for citing)
Tax Year2012TaxYear
Build TS2016-03-07 17:11:31ZBuildTS

Form 990 IRS990

FieldValueIRS element (for citing)
Name Of Principal Officer PersonJeffrey M KnightNameOfPrincipalOfficerPerson

Address Principal Officer US AddressPrincipalOfficerUS

FieldValueIRS element (for citing)
Address Line152160 National Rd EastAddressLine1
CitySt ClairsvilleCity
StateOHState
ZIP Code43950ZIPCode
FieldValueIRS element (for citing)
Gross Receipts783445095GrossReceipts
Group Return For AffiliatesfalseGroupReturnForAffiliates
Organization501cXOrganization501c
Web Sitewww.healthplan.orgWebSite
Type Of Organization CorporationXTypeOfOrganizationCorporation
Year Formation1979YearFormation
State Legal DomicileWVStateLegalDomicile
Activity Or Mission DescriptionThe Health Pan of the Upper Ohio Valley, Inc. provides HMO services to members.ActivityOrMissionDescription
Nbr Voting Members Governing Body14NbrVotingMembersGoverningBody
Nbr Independent Voting Members13NbrIndependentVotingMembers
Total Nbr Employees438TotalNbrEmployees
Total Nbr Volunteers0TotalNbrVolunteers
Total Gross UBI3167019TotalGrossUBI
Net Unrelated Business Txbl Income399565NetUnrelatedBusinessTxblIncome
Contributions Grants Prior Year0ContributionsGrantsPriorYear
Contributions Grants Current Year0ContributionsGrantsCurrentYear
Program Service Revenue Prior Year386827828ProgramServiceRevenuePriorYear
Program Service Revenue CY380022844ProgramServiceRevenueCY
Investment Income Prior Year9665124InvestmentIncomePriorYear
Investment Income Current Year10426040InvestmentIncomeCurrentYear
Other Revenue Prior Year5571104OtherRevenuePriorYear
Other Revenue Current Year6900OtherRevenueCurrentYear
Total Revenue Prior Year402064056TotalRevenuePriorYear
Total Revenue Current Year390455784TotalRevenueCurrentYear
Grants And Similar Amnts Prior Year187820GrantsAndSimilarAmntsPriorYear
Grants And Similar Amnts CY218128GrantsAndSimilarAmntsCY
Benefits Paid To Members Prior Year348015397BenefitsPaidToMembersPriorYear
Benefits Paid To Members CY353407846BenefitsPaidToMembersCY
Salaries Etc Prior Year17090680SalariesEtcPriorYear
Salaries Etc Current Year14568012SalariesEtcCurrentYear
Total Prof Fundrsng Exp Prior Year0TotalProfFundrsngExpPriorYear
Total Prof Fundrsng Exp CY0TotalProfFundrsngExpCY
Total Fundrsng Exp Current Year0TotalFundrsngExpCurrentYear
Other Expense Prior Year14326047OtherExpensePriorYear
Other Expenses Current Year13489803OtherExpensesCurrentYear
Total Expenses Prior Year379619944TotalExpensesPriorYear
Total Expenses Current Year381683789TotalExpensesCurrentYear
Revenues Less Expenses Prior Year22444112RevenuesLessExpensesPriorYear
Revenues Less Expenses CY8771995RevenuesLessExpensesCY
Total Assets BOY235646427TotalAssetsBOY
Total Assets EOY243107634TotalAssetsEOY
Total Liabilities BOY55924258TotalLiabilitiesBOY
Total Liabilities EOY53104045TotalLiabilitiesEOY
Net Assets Or Fund Balances BOY179722169NetAssetsOrFundBalancesBOY
Net Assets Or Fund Balances EOY190003589NetAssetsOrFundBalancesEOY
Mission DescriptionThe Health Plan of the Upper Ohio Valley Inc. provides HMO services to members.MissionDescription
Significant New Program ServicesfalseSignificantNewProgramServices
Significant ChangefalseSignificantChange
Expense180482130Expense
Grants218128Grants
Revenue169764222Revenue
DescriptionThe 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, 2012 was 40,425.Description

Activity2 Activity2

FieldValueIRS element (for citing)
Expense48510668Expense
Revenue52737752Revenue
DescriptionThe Health Plan continueS to offer the Medicaid program servicing 27,050 members at December 31, 2012. Health Coverage included inpatient, outpatient, emergency room, doctor ordered, physician, AND vision SERVICES.Description

Activity3 Activity3

FieldValueIRS element (for citing)
Expense150696168Expense
Revenue154360751Revenue
DescriptionThe 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 utilize the Health Plan network. The enrollment at December 31, 2012 was 13,308. Health coverage includes inpatient, outpatient, doctor ordered, emergency room, and physician COVERAGE. Pharmaceutical and vision services were offered as options in addition to the services listed above.Description
FieldValueIRS element (for citing)
Total Program Service Expense379688966TotalProgramServiceExpense
Described In501 C3falseDescribedIn501C3
Schedule B RequiredfalseScheduleBRequired
Political ActivitiesfalsePoliticalActivities
Subject To Proxy TaxfalseSubjectToProxyTax
Donor Advised FundsfalseDonorAdvisedFunds
Conservation EasementsfalseConservationEasements
Collections Of ArtfalseCollectionsOfArt
Credit CounselingfalseCreditCounseling
Term Or Permanent EndowmentsfalseTermOrPermanentEndowments
Report Land Bldg EquiptrueReportLandBldgEquip
Report Invest Oth SecuritiesfalseReportInvestOthSecurities
Report Prog Rel InvestfalseReportProgRelInvest
Report Other AssetsfalseReportOtherAssets
Report Other LiabilitiestrueReportOtherLiabilities
Report Fin48 FootnotefalseReportFin48Footnote
Independent Audit Financial StmtfalseIndependentAuditFinancialStmt
Consolidated Audit Financial StmtfalseConsolidatedAuditFinancialStmt
SchoolfalseSchool
Foreign OfficefalseForeignOffice
Foreign ActivitiesfalseForeignActivities
More Than5000 K To OrganizationsfalseMoreThan5000KToOrganizations
More Than5000 K To IndividualsfalseMoreThan5000KToIndividuals
Professional FundraisingfalseProfessionalFundraising
Fundraising ActivitiesfalseFundraisingActivities
GamingfalseGaming
HospitalfalseHospital
Grants To OrganizationsfalseGrantsToOrganizations
Grants To IndividualstrueGrantsToIndividuals
Schedule J RequiredtrueScheduleJRequired
Tax Exempt BondsfalseTaxExemptBonds
Excess Benefit TransactiontrueExcessBenefitTransaction
Prior Excess Benefit TransactionfalsePriorExcessBenefitTransaction
Loan To Officer Or DQPfalseLoanToOfficerOrDQP
Grant To Related PersonfalseGrantToRelatedPerson
Bsnss Rltnshp With OrganizationfalseBsnssRltnshpWithOrganization
Bsnss Rltnshp Thru Family MemberfalseBsnssRltnshpThruFamilyMember
Officer Entity With Bsnss RltnshpfalseOfficerEntityWithBsnssRltnshp
Deductible Non Cash ContributionsfalseDeductibleNonCashContributions
Deductible Contributions Of ArtfalseDeductibleContributionsOfArt
TerminatedfalseTerminated
Partial LiquidationfalsePartialLiquidation
Disregarded EntityfalseDisregardedEntity
Related EntitytrueRelatedEntity
Related Org Controlled EntitytrueRelatedOrgControlledEntity
Activities Conducted PartnershipfalseActivitiesConductedPartnership
Schedule O RequiredtrueScheduleORequired
Number Forms Transmitted With10963179NumberFormsTransmittedWith1096
Number W2 G Included0NumberW2GIncluded
Compliance With Backup WitholdingtrueComplianceWithBackupWitholding
Number Of Employees438NumberOfEmployees
Employment Tax Returns FiledtrueEmploymentTaxReturnsFiled
Unrelated Business IncometrueUnrelatedBusinessIncome
Form990-T FiledtrueForm990-TFiled
Foreign Financial AccountfalseForeignFinancialAccount
Prohibited Tax Shelter TransfalseProhibitedTaxShelterTrans
Taxable Party NotificationfalseTaxablePartyNotification
Non Deductible ContributionsfalseNonDeductibleContributions
Indoor Tanning ServicesfalseIndoorTanningServices
Info In Schedule O Part VIXInfoInScheduleOPartVI
Nbr Voting Governing Body Members14NbrVotingGoverningBodyMembers
Number Independent Voting Members13NumberIndependentVotingMembers
Family Or Business RelationshipfalseFamilyOrBusinessRelationship
Delegation Of Management DutiesfalseDelegationOfManagementDuties
Changes To Organizing DocsfalseChangesToOrganizingDocs
Material Diversion Or MisusefalseMaterialDiversionOrMisuse
Members Or StockholdersfalseMembersOrStockholders
Election Of Board MembersfalseElectionOfBoardMembers
Decisions Subject To ApprovalfalseDecisionsSubjectToApproval
Minutes Of Governing BodytrueMinutesOfGoverningBody
Minutes Of CommitteestrueMinutesOfCommittees
Officer Mailing AddressfalseOfficerMailingAddress
Local ChaptersfalseLocalChapters
Form990 Provided To Governing BodytrueForm990ProvidedToGoverningBody
Conflict Of Interest PolicytrueConflictOfInterestPolicy
Annual Disclosure Covered PersonstrueAnnualDisclosureCoveredPersons
Regular Monitoring EnforcementtrueRegularMonitoringEnforcement
Whistleblower PolicyfalseWhistleblowerPolicy
Document Retention PolicytrueDocumentRetentionPolicy
Compensation Process CEOtrueCompensationProcessCEO
Compensation Process OthertrueCompensationProcessOther
Investment In Joint VenturefalseInvestmentInJointVenture
Upon RequestXUponRequest

The Books Are In Care Of TheBooksAreInCareOf

FieldValueIRS element (for citing)
Name PersonJeffrey KnightNamePerson
Telephone Number7406957585TelephoneNumber

Address US AddressUS

FieldValueIRS element (for citing)
Address Line152160 National Road EastAddressLine1
CitySt ClairsvilleCity
StateOHState
ZIP Code43950ZIPCode

Form990 Part VII Section A Form990PartVIISectionA (26 entries)

TitleTitleAverage Hours Per WeekAverageHoursPerWeekIndividual Trustee Or DirectorIndividualTrusteeOrDirectorReportable Comp From OrganizationReportableCompFromOrganizationReportable Comp From Related OrgsReportableCompFromRelatedOrgsOther CompensationOtherCompensationOfficerOfficerKey EmployeeKeyEmployeeHighest Compensated EmployeeHighestCompensatedEmployee
Robert Dunlevy
Director1.0X600000
JERRY FISHER
Director1.0X540000
Roland Hobbs
Director1.0X540000
John Holloway
Director1.0X495000
Frank Joanou
Director1.0X540000
Kiki Mehallis
Director1.0X540000
Charles Monfradi
Director1.0X600000
Charles Newmeyer
Director1.0X450000
James Newton
Director1.0X495000
E Phillip Polack MD
Director1.0X495000
John Schellhase
Director1.0X600000
John Wright IV
Director1.0X540000
Nick Zervos
Director1.0X660000
Philip D Wright
President / CEO40.0X380937025000X
Jeffrey M Knight
Treasurer / CFO40.0179071018040X
Patricia M Fast
Vice President / Operations40.0232385022628X
E David Mathieu
Vice President / Marketing40.0227966022628X
Robert C Kota
General Counsel40.0219837021202X
Robert Roset
Chief Information Officer40.0226147022587X
Kenneth Allen
Medical Director40.0235193023444X
Mark Kenamond
Medical Director40.0223530022414X
Steven Halverson
Director of Underwriting40.0122620011761X
Thomas Samol
DIRECTOR OF GOV'T PROGRAMS40.0116348011325X
Denise Knight
DIRECTOR OF FINANCE40.0114077011706X
Jennifer Ault
Director of Utilization Review40.0108514010813X
Stephen Neal
Director of Pharmacy Services40.0128342012805X
FieldValueIRS element (for citing)
Total Reportable Comp From Org2585917TotalReportableCompFromOrg
Total Reportable Comp Frm Rltd Orgs0TotalReportableCompFrmRltdOrgs
Total Other Compensation236353TotalOtherCompensation
Number Individuals GT100 K13NumberIndividualsGT100K
Formers ListedfalseFormersListed
Total Comp GT150 KtrueTotalCompGT150K
Compensation From Other SourcesfalseCompensationFromOtherSources
Number Of Contractors GT100 K0NumberOfContractorsGT100K
Fundraising Events0FundraisingEvents
Noncash Contributions0NoncashContributions
Total Contributions0TotalContributions

Program Service Revenue ProgramServiceRevenue (5 entries)

DescriptionDescriptionBusiness CodeBusinessCodeTotal Revenue ColumnTotalRevenueColumnRelated Or Exempt Function IncomeRelatedOrExemptFunctionIncomeUnrelated Business RevenueUnrelatedBusinessRevenueExclusionExclusionAmount
HMO Program5241141697573221697573220$0
Medicaid Program52411452737752527377520$0
Medicare Program5241141543607511543607510$0
Claims Processing524292316701903167019$0
All other program service revenue000$0
FieldValueIRS element (for citing)
Total Program Service Revenue380022844TotalProgramServiceRevenue

Investment Income InvestmentIncome

FieldValueIRS element (for citing)
Total Revenue Column5934103TotalRevenueColumn
Exclusion$5,934,103ExclusionAmount

Income From Invest Bond Proceeds IncomeFromInvestBondProceeds

FieldValueIRS element (for citing)
Total Revenue Column0TotalRevenueColumn

Royalties Revenue RoyaltiesRevenue

FieldValueIRS element (for citing)
Total Revenue Column0TotalRevenueColumn

Gross Rents GrossRents

FieldValueIRS element (for citing)
Real2000Real

Rental Income Or Loss RentalIncomeOrLoss

FieldValueIRS element (for citing)
Real2000Real
Personal0Personal

Net Rental Income Or Loss NetRentalIncomeOrLoss

FieldValueIRS element (for citing)
Total Revenue Column2000TotalRevenueColumn
Related Or Exempt Function Income2000RelatedOrExemptFunctionIncome

Gross Amount Sales Assets GrossAmountSalesAssets

FieldValueIRS element (for citing)
Securities397481248Securities

Less Cost Oth Basis Sales Expenses LessCostOthBasisSalesExpenses

FieldValueIRS element (for citing)
Securities392989311Securities

Gain Or Loss GainOrLoss

FieldValueIRS element (for citing)
Securities4491937Securities

Net Gain Or Loss Investments NetGainOrLossInvestments

FieldValueIRS element (for citing)
Total Revenue Column4491937TotalRevenueColumn
Exclusion$4,491,937ExclusionAmount
FieldValueIRS element (for citing)
Fundraising Direct Expenses0FundraisingDirectExpenses

Net Income From Fundraising Events NetIncomeFromFundraisingEvents

FieldValueIRS element (for citing)
Total Revenue Column0TotalRevenueColumn

Net Income From Gaming NetIncomeFromGaming

FieldValueIRS element (for citing)
Total Revenue Column0TotalRevenueColumn

Net Income Or Loss NetIncomeOrLoss

FieldValueIRS element (for citing)
Total Revenue Column0TotalRevenueColumn

Other Revenue Misc OtherRevenueMisc

FieldValueIRS element (for citing)
DescriptionMiscellaneous RevenueDescription
Total Revenue Column4900TotalRevenueColumn
Related Or Exempt Function Income4900RelatedOrExemptFunctionIncome
Unrelated Business Revenue0UnrelatedBusinessRevenue
Exclusion$0ExclusionAmount
FieldValueIRS element (for citing)
Total Other Revenue4900TotalOtherRevenue

Total Revenue TotalRevenue

FieldValueIRS element (for citing)
Total Revenue Column390455784TotalRevenueColumn
Related Or Exempt Function Income376862725RelatedOrExemptFunctionIncome
Unrelated Business Revenue3167019UnrelatedBusinessRevenue
Exclusion$10,426,040ExclusionAmount

Grants To Domestic Orgs GrantsToDomesticOrgs

FieldValueIRS element (for citing)
Total0Total
Program Services0ProgramServices

Grants To Domestic Individuals GrantsToDomesticIndividuals

FieldValueIRS element (for citing)
Total218128Total
Program Services218128ProgramServices

Foreign Grants ForeignGrants

FieldValueIRS element (for citing)
Total0Total
Program Services0ProgramServices

Benefits To Members BenefitsToMembers

FieldValueIRS element (for citing)
Total353407846Total
Program Services353407846ProgramServices

Comp Current Officers Directors CompCurrentOfficersDirectors

FieldValueIRS element (for citing)
Total2173959Total
Program Services2173959ProgramServices
Management And General0ManagementAndGeneral
Fundraising0Fundraising

Comp Disqual Persons CompDisqualPersons

FieldValueIRS element (for citing)
Total0Total
Program Services0ProgramServices
Management And General0ManagementAndGeneral
Fundraising0Fundraising

Other Salaries And Wages OtherSalariesAndWages

FieldValueIRS element (for citing)
Total6990967Total
Program Services4726498ProgramServices
Management And General2264469ManagementAndGeneral
Fundraising0Fundraising

Pension Plan Contributions PensionPlanContributions

FieldValueIRS element (for citing)
Total1473128Total
Program Services1473128ProgramServices
Management And General0ManagementAndGeneral
Fundraising0Fundraising

Other Employee Benefits OtherEmployeeBenefits

FieldValueIRS element (for citing)
Total2712089Total
Program Services2712089ProgramServices
Management And General0ManagementAndGeneral
Fundraising0Fundraising

Payroll Taxes PayrollTaxes

FieldValueIRS element (for citing)
Total1217869Total
Program Services1217869ProgramServices
Management And General0ManagementAndGeneral
Fundraising0Fundraising

Fees For Services Management FeesForServicesManagement

FieldValueIRS element (for citing)
Total0Total
Program Services0ProgramServices
Management And General0ManagementAndGeneral
Fundraising0Fundraising

Fees For Services Legal FeesForServicesLegal

FieldValueIRS element (for citing)
Total30522Total
Program Services18297ProgramServices
Management And General12225ManagementAndGeneral
Fundraising0Fundraising

Fees For Services Accounting FeesForServicesAccounting

FieldValueIRS element (for citing)
Total752593Total
Program Services752593ProgramServices
Management And General0ManagementAndGeneral
Fundraising0Fundraising

Fees For Services Lobbying FeesForServicesLobbying

FieldValueIRS element (for citing)
Total0Total
Program Services0ProgramServices
Management And General0ManagementAndGeneral
Fundraising0Fundraising

Fees For Services Prof Fundraising FeesForServicesProfFundraising

FieldValueIRS element (for citing)
Total0Total
Fundraising0Fundraising

Fees For Services Invst Mgmnt Fees FeesForServicesInvstMgmntFees

FieldValueIRS element (for citing)
Total823790Total
Program Services823790ProgramServices
Management And General0ManagementAndGeneral
Fundraising0Fundraising

Fees For Services Other FeesForServicesOther

FieldValueIRS element (for citing)
Total1932412Total
Program Services1777636ProgramServices
Management And General154776ManagementAndGeneral
Fundraising0Fundraising

Advertising Advertising

FieldValueIRS element (for citing)
Total1299718Total
Program Services1299718ProgramServices
Management And General0ManagementAndGeneral
Fundraising0Fundraising

Office Expenses OfficeExpenses

FieldValueIRS element (for citing)
Total2676361Total
Program Services2675304ProgramServices
Management And General1057ManagementAndGeneral
Fundraising0Fundraising

Information Technology InformationTechnology

FieldValueIRS element (for citing)
Total1796668Total
Program Services1768976ProgramServices
Management And General27692ManagementAndGeneral
Fundraising0Fundraising

Royalties Royalties

FieldValueIRS element (for citing)
Total0Total
Program Services0ProgramServices
Management And General0ManagementAndGeneral
Fundraising0Fundraising

Occupancy Occupancy

FieldValueIRS element (for citing)
Total530198Total
Program Services530198ProgramServices
Management And General0ManagementAndGeneral
Fundraising0Fundraising

Travel Travel

FieldValueIRS element (for citing)
Total169819Total
Program Services169819ProgramServices
Management And General0ManagementAndGeneral
Fundraising0Fundraising

Travel Entrtnmnt Public Officials TravelEntrtnmntPublicOfficials

FieldValueIRS element (for citing)
Total0Total
Program Services0ProgramServices
Management And General0ManagementAndGeneral
Fundraising0Fundraising

Conferences Meetings ConferencesMeetings

FieldValueIRS element (for citing)
Total128836Total
Program Services124683ProgramServices
Management And General4153ManagementAndGeneral
Fundraising0Fundraising

Interest Interest

FieldValueIRS element (for citing)
Total0Total
Program Services0ProgramServices
Management And General0ManagementAndGeneral
Fundraising0Fundraising

Payments To Affiliates PaymentsToAffiliates

FieldValueIRS element (for citing)
Total0Total
Program Services0ProgramServices
Management And General0ManagementAndGeneral
Fundraising0Fundraising

Depreciation Depletion DepreciationDepletion

FieldValueIRS element (for citing)
Total694224Total
Program Services691909ProgramServices
Management And General2315ManagementAndGeneral
Fundraising0Fundraising

Insurance Insurance

FieldValueIRS element (for citing)
Total292790Total
Program Services292790ProgramServices
Management And General0ManagementAndGeneral
Fundraising0Fundraising

Other Expenses OtherExpenses (4 entries)

DescriptionDescriptionTotalTotalProgram ServicesProgramServicesManagement And GeneralManagementAndGeneralFundraisingFundraising
Broker Expense1605058160505800
Premium Tax Expense68407968407900
Loss Adjustment Expense-48914-4891400
Unrelated Business Tax12164901216490

Total Functional Expenses TotalFunctionalExpenses

FieldValueIRS element (for citing)
Total381683789Total
Program Services379095453ProgramServices
Management And General2588336ManagementAndGeneral
Fundraising0Fundraising

Total Joint Costs TotalJointCosts

FieldValueIRS element (for citing)
Total0Total

Cash Non Interest Bearing CashNonInterestBearing

FieldValueIRS element (for citing)
BOY0BOY
EOY0EOY

Savings And Temp Cash Investments SavingsAndTempCashInvestments

FieldValueIRS element (for citing)
BOY11935577BOY
EOY12557896EOY

Pledges And Grants Receivable PledgesAndGrantsReceivable

FieldValueIRS element (for citing)
BOY0BOY
EOY0EOY

Accounts Receivable AccountsReceivable

FieldValueIRS element (for citing)
BOY5975181BOY
EOY7655302EOY

Receivables From Officers Etc ReceivablesFromOfficersEtc

FieldValueIRS element (for citing)
BOY0BOY
EOY0EOY

Receivables From Disqual Persons ReceivablesFromDisqualPersons

FieldValueIRS element (for citing)
BOY0BOY
EOY0EOY

Other Notes Loans Receivable Net OtherNotesLoansReceivableNet

FieldValueIRS element (for citing)
BOY0BOY
EOY0EOY

Inventories For Sale Or Use InventoriesForSaleOrUse

FieldValueIRS element (for citing)
BOY0BOY
EOY0EOY

Prepaid Expenses Deferred Charges PrepaidExpensesDeferredCharges

FieldValueIRS element (for citing)
BOY0BOY
EOY0EOY
FieldValueIRS element (for citing)
Land Buildings Equipment Basis9928594LandBuildingsEquipmentBasis
Land Bldg Equipment Accum Deprec4147815LandBldgEquipmentAccumDeprec

Land Buildings Equipment Basis Net LandBuildingsEquipmentBasisNet

FieldValueIRS element (for citing)
BOY6374560BOY
EOY5780779EOY

Investments Pub Traded Securities InvestmentsPubTradedSecurities

FieldValueIRS element (for citing)
BOY209782606BOY
EOY215816609EOY

Investments Other Securities InvestmentsOtherSecurities

FieldValueIRS element (for citing)
BOY0BOY
EOY0EOY

Investments Program Related InvestmentsProgramRelated

FieldValueIRS element (for citing)
BOY0BOY
EOY0EOY

Intangible Assets IntangibleAssets

FieldValueIRS element (for citing)
BOY0BOY
EOY0EOY

Other Assets Total OtherAssetsTotal

FieldValueIRS element (for citing)
BOY1578503BOY
EOY1297048EOY

Total Assets TotalAssets

FieldValueIRS element (for citing)
BOY235646427BOY
EOY243107634EOY

Accounts Payable Accrued Expenses AccountsPayableAccruedExpenses

FieldValueIRS element (for citing)
BOY52004927BOY
EOY49632021EOY

Grants Payable GrantsPayable

FieldValueIRS element (for citing)
BOY0BOY
EOY0EOY

Deferred Revenue DeferredRevenue

FieldValueIRS element (for citing)
BOY3108358BOY
EOY2576292EOY

Tax Exempt Bond Liabilities TaxExemptBondLiabilities

FieldValueIRS element (for citing)
BOY0BOY
EOY0EOY

Escrow Account Liability EscrowAccountLiability

FieldValueIRS element (for citing)
BOY0BOY
EOY0EOY

Loans From Officers Directors LoansFromOfficersDirectors

FieldValueIRS element (for citing)
BOY0BOY
EOY0EOY

Mort Notes Pybl Secured Invest Prop MortNotesPyblSecuredInvestProp

FieldValueIRS element (for citing)
BOY0BOY
EOY0EOY

Unsecured Notes Loans Payable UnsecuredNotesLoansPayable

FieldValueIRS element (for citing)
BOY0BOY
EOY0EOY

Other Liabilities OtherLiabilities

FieldValueIRS element (for citing)
BOY810973BOY
EOY895732EOY

Total Liabilities TotalLiabilities

FieldValueIRS element (for citing)
BOY55924258BOY
EOY53104045EOY
FieldValueIRS element (for citing)
Do Not Follow SFAS117XDoNotFollowSFAS117

Cap Stck Trst Prin Current Funds CapStckTrstPrinCurrentFunds

FieldValueIRS element (for citing)
BOY179172169BOY
EOY189453589EOY

Paid In Cap Srpls Land Bldg Eqp Fund PaidInCapSrplsLandBldgEqpFund

FieldValueIRS element (for citing)
BOY0BOY
EOY0EOY

Retained Earnings Endowment Etc RetainedEarningsEndowmentEtc

FieldValueIRS element (for citing)
BOY550000BOY
EOY550000EOY

Total Net Assets Fund Balances TotalNetAssetsFundBalances

FieldValueIRS element (for citing)
BOY179722169BOY
EOY190003589EOY

Total Liab Net Assets Fund Balances TotalLiabNetAssetsFundBalances

FieldValueIRS element (for citing)
BOY235646427BOY
EOY243107634EOY
FieldValueIRS element (for citing)
Info In Schedule O Part XIXInfoInScheduleOPartXI
Reconcilation Revenue Expenses8771995ReconcilationRevenueExpenses
Reconcilation Other Changes1509425ReconcilationOtherChanges
Method Of Accounting AccrualXMethodOfAccountingAccrual
Accountant Compile Or ReviewfalseAccountantCompileOrReview
FS AuditedtrueFSAudited

FS Audited Basis FSAuditedBasis

FieldValueIRS element (for citing)
Financial Statement SeparateXFinancialStatementSeparate
FieldValueIRS element (for citing)
Audit CommitteetrueAuditCommittee
Federal Grant Audit RequiredfalseFederalGrantAuditRequired

Schedule D IRS990ScheduleD

FieldValueIRS element (for citing)
Art Public Exhibition AmtsArtPublicExhibitionAmts
Held Works Of Art AmtsHeldWorksOfArtAmts
Current Year Minus3 YearsCurrentYearMinus3Years
Current Year Minus4 YearsCurrentYearMinus4Years

Land Land

FieldValueIRS element (for citing)
Other Cost Or Other Basis800000OtherCostOrOtherBasis
Book Value800000BookValue

Buildings Buildings

FieldValueIRS element (for citing)
Other Cost Or Other Basis7580554OtherCostOrOtherBasis
Depreciation2958903Depreciation
Book Value4621651BookValue
FieldValueIRS element (for citing)
Leasehold ImprovementsLeaseholdImprovements

Equipment Equipment

FieldValueIRS element (for citing)
Other Cost Or Other Basis1548040OtherCostOrOtherBasis
Depreciation1188912Depreciation
Book Value359128BookValue
FieldValueIRS element (for citing)
Other Land BuildingsOtherLandBuildings
Total Of Book Value Land Buildings5780779TotalOfBookValueLandBuildings
Federal Income Tax Liability0FederalIncomeTaxLiability

Other Liabilities OtherLiabilities (2 entries)

DescriptionDescriptionAmountAmount
Federal income taxes$121,649
Post Retirement Benefit Obligation$774,083
FieldValueIRS element (for citing)
Total Of Amounts895732TotalOfAmounts

Schedule I IRS990ScheduleI

FieldValueIRS element (for citing)
Records MaintainedtrueRecordsMaintained

Form990 Schedule I Part III Form990ScheduleIPartIII

FieldValueIRS element (for citing)
Type Of GrantMedical Student ScholarshipsTypeOfGrant
Number Of Recipients11NumberOfRecipients
Amount Of Non Cash Assistance218128AmountOfNonCashAssistance
Method Of ValuationFMVMethodOfValuation
Description Of Non Cash Assistancetuition paidDescriptionOfNonCashAssistance

Form990 Schedule I Part IV Form990ScheduleIPartIV

FieldValueIRS element (for citing)
IdentifierForm 990, Schedule IIdentifier
Return ReferenceDescription of Organization's Procedures for Monitoring the Use of GrantsReturnReference
ExplanationThe 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 needs. The preferred applicants are recommended to the full board, which then 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.Explanation

Schedule J IRS990ScheduleJ

FieldValueIRS element (for citing)
Club Dues Or FeesXClubDuesOrFees
Written Policy Re T And E ExpensestrueWrittenPolicyReTAndEExpenses
Substantiation RequiredtrueSubstantiationRequired
Compensation CommitteeXCompensationCommittee
Compensation SurveyXCompensationSurvey
Board Or Committee ApprovalXBoardOrCommitteeApproval
Severance PaymentfalseSeverancePayment
Supplemental Nonqual Retire PlanfalseSupplementalNonqualRetirePlan
Equity Based Comp ArrangementfalseEquityBasedCompArrangement
Comp Based On Revenue Of Filing OrgfalseCompBasedOnRevenueOfFilingOrg
Comp Based On Revenue Related OrgsfalseCompBasedOnRevenueRelatedOrgs
Comp Based Net Earnings Filing OrgfalseCompBasedNetEarningsFilingOrg
Comp Based Net Earnings Relate OrgsfalseCompBasedNetEarningsRelateOrgs
Any Non Fixed PaymentsfalseAnyNonFixedPayments
Initial Contract ExceptionfalseInitialContractException

Form990 Schedule J Part II Form990ScheduleJPartII (8 entries)

TitleTitleBase Compensation Filing OrgBaseCompensationFilingOrgComp Based On Related OrgsCompBasedOnRelatedOrgsBonus Filing OrgBonusFilingOrgBonus Related OrgsBonusRelatedOrgsOther Compensation Filing OrgOtherCompensationFilingOrgOther Compensation Related OrgsOtherCompensationRelatedOrgsDeferred Comp Filing OrgDeferredCompFilingOrgDeferred Comp Related OrgsDeferredCompRelatedOrgsNontaxable Benefits Filing OrgNontaxableBenefitsFilingOrgNontaxable Benefits Related OrgsNontaxableBenefitsRelatedOrgsTotal Compensation Filing OrgTotalCompensationFilingOrgTotal Compensation Related OrgsTotalCompensationRelatedOrgsComp Report Prior990 Filing OrgCompReportPrior990FilingOrgComp Report Prior990 Related OrgsCompReportPrior990RelatedOrgs
Philip D Wright
President / CEO34357303347503889025000000405937000
Jeffrey M Knight
Treasurer / CFO1627280159650378018040000197111000
Patricia M Fast
Vice President / Operations20454702002507813022628000255013000
E David Mathieu
Vice President / Marketing20454702002503394022628000250594000
Robert C Kota
General Counsel19190501889309039021202000241039000
Robert Roset
Chief Information Officer20417401998901984022587000248734000
Kenneth Allen
Medical Director21220302101201978023444000258637000
Mark Kenamond
Medical Director20396001957000022414000245944000

Schedule L IRS990ScheduleL

Schedule O IRS990ScheduleO

General Explanation GeneralExplanation (5 entries)

IdentifierIdentifierReturn ReferenceReturnReferenceExplanationExplanation
Form 990, Part VI, Line 11bProcess used to review the Form 990The CFO and Controller review the 990 for reasonableness compared to the internal financial statements. The CFO provides copies to the Board of Directors prior to filing the return.
Form 990, Part VI, Line 12cMonitoring and enforcement of compliance with conflict of interest policyConflict of interest statements are signed on an annual basis and maintained by the Human Resource Department.
Form 990, Part VI, Line 15Process for determining compensationCompensation 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 Personnel Committee then presents the preferred compansation changes to the Board of Directors for approval.
Form 990, Part VI, Line 19Process for making documents available to the publicThese documents are available upon request to the CFO.
Other changes in net assets or fund balancesForm 990, Part XI, line 9Change in non-admitted assets: (2,918,911) and change in net unrealized gain on investment of $4,428,336.

Schedule R IRS990ScheduleR

Form990 Schedule R Part II Form990ScheduleRPartII

Name Of Disregarded Entity NameOfDisregardedEntity

FieldValueIRS element (for citing)
Business Name Line1Hometown Health PlanBusinessNameLine1

Address US AddressUS

FieldValueIRS element (for citing)
Address Line1100 Lillian Gish BlvdAddressLine1
CityMassillonCity
StateOHState
ZIP Code44647ZIPCode
FieldValueIRS element (for citing)
EIN341523541EIN
Primary ActivitiesInsurancePrimaryActivities
Legal Domicile StateOHLegalDomicileState
Exempt Code Section501(c)(4)ExemptCodeSection
Public Charity StatusN/APublicCharityStatus

Direct Controlling Entity Name DirectControllingEntityName

FieldValueIRS element (for citing)
Business Name Line1HPUOVBusinessNameLine1
FieldValueIRS element (for citing)
Controlled OrgtrueControlledOrg

Form990 Schedule R Part IV Form990ScheduleRPartIV (3 entries)

Address Line1AddressUS/AddressLine1CityAddressUS/CityStateAddressUS/StateZIP CodeAddressUS/ZIPCodeEINEINPrimary ActivityPrimaryActivityLegal Domicile StateLegalDomicileStateBusiness Name Line1DirectControllingEntityName/BusinessNameLine1Type Of EntityTypeOfEntityShare Of Total IncomeShareOfTotalIncomeShare Of EOY AssetsShareOfEOYAssetsPercentage OwnershipPercentageOwnership
THP INSURANCE COMPANY
1137 VanVoorhis Rd Chelsea Square SMorgantownWV26505550765726InsuranceWVNAC CORP-7366683282146591.00000
HP AGENCY INC
52160 National Road EastSt ClairsvilleOH43950341764520SVC TO SELF-INSOHNAC CORP-992771920451.00000
HOMETOWN HHP SERVICES CORP
100 Lillian Gish BlvdMassillonOH44647341588625SVC TO SELF-INSOHNAC CORP-474289171151.00000
FieldValueIRS element (for citing)
Receipt Of Int Ann Rents RoyaltiesfalseReceiptOfIntAnnRentsRoyalties
Gift Grant Or Cap Contr To Other OrgtrueGiftGrantOrCapContrToOtherOrg
Gift Grant Or Cap Contr Fr Other OrgfalseGiftGrantOrCapContrFrOtherOrg
Loans Or Guarantees To Other OrgfalseLoansOrGuaranteesToOtherOrg
Loans Or Guarantees From Other OrgfalseLoansOrGuaranteesFromOtherOrg
Sale Of Assets To Other OrgfalseSaleOfAssetsToOtherOrg
Purchase Of Assets From Other OrgfalsePurchaseOfAssetsFromOtherOrg
Exchange Of AssetsfalseExchangeOfAssets
Rental Of Facilities To Other OrgsfalseRentalOfFacilitiesToOtherOrgs
Rental Of Facilities Fr Other OrgsfalseRentalOfFacilitiesFrOtherOrgs
Perform Of Services For Other OrgsfalsePerformOfServicesForOtherOrgs
Perform Of Services By Other OrgstruePerformOfServicesByOtherOrgs
Sharing Of FacilitiestrueSharingOfFacilities
Sharing Of Paid EmployeestrueSharingOfPaidEmployees
Reimbursement Paid To Other OrgfalseReimbursementPaidToOtherOrg
Reimbursement Paid By Other OrgfalseReimbursementPaidByOtherOrg
Other Transfer To Other OrgfalseOtherTransferToOtherOrg
Other Transfer From Other OrgfalseOtherTransferFromOtherOrg

Transactions Related Orgs Table TransactionsRelatedOrgsTable (4 entries)

Transaction TypeTransactionTypeAmount InvolvedAmountInvolvedMethod Of Amt DeterminationMethodOfAmtDetermination
THP Insurance Company
m4680321Admin. Allocati
HP Agency
m3382904Admin. Allocati
Hometown HHP Services Inc
m194633Admin. Allocati
THP Insurance Company
b5000000Capital Conrtib

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