Medical Loss Ratio · West Virginia · 2024 reporting year · Health PLAN GRP · not-for-profit
The Health Plan of West Virginia, Inc.
In West Virginia, over the three-year window through 2024, The Health Plan of West Virginia, Inc. spent 106.1% of small group premiums on care, and 97.5% of large group premiums on care (its Medical Loss Ratio). It met the 80/20-rule floor in every market, so no rebate was owed.
Where each premium dollar went
The filled bar is the share of premiums spent on medical care + quality improvement — the three-year Medical Loss Ratio. The marker is the legal floor for that market (80% individual & small group, 85% large group). Below the floor, the insurer rebates the shortfall (floor − MLR), applied to that year's premium.
See what The Health Plan of West Virginia, Inc.sells on the marketplace — plan footprint and premium positioning — on its company profile, or browse all West Virginia marketplace plans. Complaint counts and loss ratios for The Health Plan of West Virginia, Inc. (NAIC 95677) are on its carrier quality profile.
RECORDED — the Medical Loss Ratio, the 80/85% standard, premium earned, and the rebate owed are CMS-published figures (the 2024 MLR reporting year, a three-year window through 2024; rebates are paid the following year). DERIVED — rebate as a share of premium, and the rebate per enrollee (rebate ÷ member-years).
Machine-readable: JSON-LD · Markdown · Source: CMS — Medical Loss Ratio (MLR) Public Use File, 2024 reporting year
What this is — and is not
This is how The Health Plan of West Virginia, Inc. spent premium dollars across its entire West Virginia book in each market — it is not a measure of a specific plan's quality, your denial odds, or whether the insurer is right for you, and it is not advice. A rebate, if owed, is a rule-based payment to policyholders (a check or premium credit) the following year. To compare plans, check eligibility, and enroll, go to HealthCare.gov.