MORGANTOWN, W.Va. — Peak Health, a Morgantown-based, health system-owned insurance company formed in 2021 by WVU Medicine, Marshall Health Network, and Valley Health, is entering the ACA Marketplace.
Their entrance happens as CareSource exits the marketplace, and estimates say there could be up to 16,000 CareSource customers who are looking for plans during open enrollment that continues through January 15, 2027.
On WAJR’s “Talk of the Town,” President Amos Ross said prior to 2021 they were buying coverage from other vendors and wanted to upgrade plans Peak Health would offer based on those experiences. By January of 2023, Peak Health insurance was available to WVU Medicine employees, and the growth has continued.
“It’s a more integrated, a more transparent model, and then from there we launched Medicare in 2024, and I’m pleased to say we’ve been the fastest-growing Medicaid plan over the last couple of years,” Ross said.
Peak Health has about 85,000 commercial and Medicare Advantage members across the state and counting. Peak Health will soon be the plan offered to the 10,000 employees of the Independence Health System in addition to the customers added from the ACA Marketplace.
“By the time we’re at this point next year we’ll have about 110,000 members at that point,” Ross said. “We’re continuing to grow pretty rapidly and looking for places to expand strategically and where it makes sense.”
The abrupt exit of CareSource was brought to Peak Health executives, who were able to compress a process that would normally take 18 months into less than a year. Ross said those offerings will be updated and improved for coming years.
“We have a Bronze Plan, a Silver Plan, and a Gold Plan this year,” Ross said. “But, I think in future years you’ll see us try to introduce some additional plans that will try to solve what we think are key issues that West Virginians face when they purchase insurance on the exchange.”
Ross said Peak Health could assume the operations of the Public Employees Insurance Agency (PEIA) gradually. Any deal involving PEIA would have to be initiated by the state and carefully built to meet the needs of the plan participants.
“Particularly the retiree group for PEIA that Peak would maybe have the potential to bid on and win that business,” Ross said. “I think some of the other stuff would require some conversations that are focused and intentional.”
Ross said the company also plans to open additional Peak Health Member Service Centers. The first center opened in the Morgantown corporate headquarters, giving members a place to come with questions. The center provides direct access to pharmacists and staff that answer questions about care and billing.
“That’s a model you’ll see Peak Health continue to expand on in future years,” Ross said. “To provide those community access points where people can go in and have a conversation.”