Peak Health

What Peak Health does

Peak Health is a provider-owned health insurer and third-party administrator headquartered in Morgantown, West Virginia, founded in 2021 by WVU Health System. The company operates two licensed entities: Peak Health Insurance Corporation, a West Virginia-licensed accident and sickness insurer offering the Peak Advantage Medicare Advantage PPO plan, and Peak Health, LLC, a third-party administrator licensed in West Virginia, Pennsylvania, and Kentucky that administers self-insured employer health plans. Ownership is held jointly by three not-for-profit health systems: WVU Health System, Marshall Health Network, and Valley Health, with Mountain Health Network having previously joined as a co-owner, creating a structurally aligned payer-provider model.

The company serves two primary customer segments: Medicare-eligible seniors in West Virginia (and now expanding into Pennsylvania) through the Peak Advantage MA PPO plan, and self-insured employer groups, principally large health systems, through administrative services only contracts. Its largest accounts are WVU Medicine (approximately 32,000 employees and dependents on the ASO plan since January 2023) and Valley Health (approximately 8,000 employees added in 2024). Total membership reached nearly 50,000 across commercial and Medicare Advantage plans by mid-2024, with Medicare Advantage enrollment tripling to over 10,000 members for the 2026 plan year.

Peak Health's technology foundation is built on Epic EHR integration for claims processing and provider-payer interoperability, the MyPeak member portal accessible via Epic MyChart, a provider portal, and a member cost-transparency tool. National provider access is delivered through an Aetna First Health Network partnership covering all 50 states. Revenue derives from CMS-paid Medicare Advantage premiums and per-employee ASO administrative fees, with the provider-led model demonstrating a 12% premium reduction for WVU Medicine employees versus the prior Highmark commercial plan. The company employs approximately 100 staff across Morgantown and Bridgeport offices and earned the Press Ganey 2025 Human Experience Pinnacle of Excellence Award for top CAHPS ratings in the Local PPO category.

Name

Peak Health

Legal name

Peak Health Insurance Corporation

Website

https://peakhealth.org

Company type

Private

Founded year

2021

Operating status

Operating

Headcount range

101–250 employees

Short description

Peak Health is a provider-owned health insurer and third-party administrator headquartered in Morgantown, West Virginia, jointly owned by WVU Medicine, Marshall Health Network, and Valley Health. It offers Medicare Advantage PPO plans and self-insured employer administration to nearly 50,000 members across West Virginia and Pennsylvania.

Ownership category

akta.pro rank

Product category

Health Insurance

NAICS

Direct Health and Medical Insurance Carriers (524114), Pharmacy Benefit Management and Other Third Party Administration of Insurance and Pension Funds (524292)

SIC

Hospital & Medical Service Plans (6324), Insurance Agents, Brokers & Service (6411)

akta.pro primary industry

Medicare Advantage (MA) Plans (FSAIAGAA)

akta.pro secondary industries

Large Group Health Insurance (Mid-Market & National Accounts) (FSAIAFAE), MA Chronic Condition Management & Supplemental Benefits (SSBCI) (HLAEACAI), MA Care Coordination & Utilization Management (UM) Programs (HLAEACAK)

Keywords

• Health insurance plans
• Medicare Advantage plans
• Self-insured employer administration
• Third-party administrator services
• Provider-led insurance

Headquarters

HQ city

Morgantown

HQ country

United States

HQ region

North America

Offices3 records

Markets served

GTM type

B2B and B2C

Offering type

Services

Cost components

Personnel, Operations, Technology or R&D, Marketing or Sales, Infrastructure

Revenue model

1. Medicare Advantage Premiums: Revenue from Medicare Advantage plan premiums paid by the federal government (CMS) and Medicare-eligible members for providing healthcare coverage
2. Third-Party Administration Fees: Claims processing and administrative services fees charged to self-insured employer groups (WVU Health System, Valley Health, and other partner health systems) instead of commercial carriers
3. Self-Funded Employer Administration: Administrative services for self-insured employer groups including claims administration, provider network management, and wellness program coordination

Pricing tiers

Go-to-market motion2 records

Distribution channels4 records

Marketing channels5 records

Core offering

Peak Health is a provider-led health insurance company headquartered in Morgantown, West Virginia, offering Medicare Advantage PPO plans (Peak Advantage) for seniors and Administrative Services Only (ASO) administration for self-insured employer groups. Owned jointly by three not-for-profit health systems (WVU Health System, Marshall Health Network, and Valley Health), the company processes claims, manages provider networks, and operates member and provider digital portals integrated with Epic EHR.

Product overview

Peak Health is a provider-led health insurance company offering a portfolio of insurance products and administrative services. The core products include Peak Advantage Medicare Advantage PPO plans and ASO (Administrative Services Only) plans for self-insured employers. These are supported by the MyPeak digital member portal accessible via web and Epic MyChart integration, provider network access through a combination of local WV/VA providers and the Aetna First Health national network, and wellness programs like MyPARK Pass for member fitness benefits. The company was founded in 2021 and serves approximately 50,000 members across commercial and Medicare Advantage plans.

Differentiator

Problem solved

Functional benefit

Products and services

• Peak Advantage Medicare Advantage PPO Plan A Medicare Advantage PPO plan offered by Peak Health Insurance Corporation under a CMS contract, providing Medicare Part C coverage for seniors aged 65+ across West Virginia and Pennsylvania, with access to a local provider network including WVU Medicine and Marshall Health.
• ASO (Administrative Services Only) Self-Insured Employer Plans Administrative services for self-insured employers including claims processing, benefits management, provider network access, and wellness program coordination. Peak Health acts as third-party administrator in place of commercial carriers for employer groups such as WVU Medicine, Valley Health, Mountain Health Network, and Marshall Health.
• MyPeak Member Portal A members-only digital portal providing 24-hour access to account information, personalized health data, plan benefits, claim statements, ID cards, cost transparency tools, and plan-related documents. Accessible via web browser and Epic MyChart mobile app integration.
• Peak Provider Portal

Quantifiable outcome

• 12% premium reduction for WVU Medicine employees vs previous Highmark plan
• +3 more outcomes

Named customers4 records

Segments4 records

Ideal customer profiles3 records

Technology focussed No

API detail

Has API

No

API docs

API detail

Core technology

AI maturity

App detail

Integration2 records

Feature3 records

Partnerships

Six partnerships are on record, tiered minor and core.

• Mylan ParkminorStrategic or Co-development Partner · 24 June 2024Mylan Park partnership provides Peak Health members free access to Aquatic Center and fitness facilities through MyPARK Pass program. The Aquatic Center was renamed Peak Health Aquatic Center at Mylan Park and Track Complex renamed Peak Health Track and Field Complex. Up to four beneficiaries per family can be added to the membership.
• Valley HealthcoreStrategic or Co-development Partner · 27 January 2023Valley Health, a six-hospital system serving Northern Shenandoah Valley of Virginia and Eastern Panhandle of West Virginia, joined as fourth owner in January 2023. Peak Health anticipated serving up to 8,000 Valley Health employees starting January 1, 2024. CEO Mark Nantz stated the partnership brings providers closer to premium payers.
• WVU Health System (WVU Medicine)coreStrategic or Co-development Partner · 15 February 2022WVU Health System is the founding owner of Peak Health, having invested $15 million in startup costs and approximately $10 million annually for operations. The health system provides 32,000 employees as initial captive market. Albert L. Wright, Jr. serves as Board Chair of Peak Health while also President and CEO of WVU Health System. The integrated model allows providers and payers to align financially.
• Marshall HealthcoreStrategic or Co-development Partner · 15 February 2022Marshall Health, the clinical enterprise of Marshall University and Joan C. Edwards School of Medicine, joined as a founding owner in February 2022. Provides 400 providers across 75 specialty areas. CEO Beth L. Hammers stated the partnership creates jobs and keeps economic resources in West Virginia.
• Mountain Health NetworkcoreStrategic or Co-development Partner · 15 February 2022Mountain Health Network, a West Virginia not-for-profit health delivery system including Cabell Huntington Hospital, St. Mary's Medical Center, and Hoops Family Children's Hospital, joined as founding owner providing coverage across 23 counties.
• Aetna's First Health NetworkcoreChannel Partner/ Reseller/ DistributorPeak Health partnered with Aetna's First Health Network to provide national provider network access in all 50 states, complementing the local West Virginia service area. This allows access for members regardless of residence through the First Health Complementary Network.

Scale indicators6 records

Recent moves10 records

Expansion highlights6 records

Broad incumbents

• Humana: One of the largest Medicare Advantage insurers in the United States with a national PPO and HMO footprint. Major incumbent competitor in the West Virginia and Pennsylvania MA markets where Peak Health is expanding.
• Highmark Blue Cross Blue Shield West Virginia: Dominant commercial insurer in West Virginia and Pennsylvania with established Medicare Advantage, ASO, and individual products. The incumbent against which Peak Health is competing and the natural benchmark for its premium savings claims.
• CareFirst BlueCross BlueShield: Major Mid-Atlantic Blue Cross Blue Shield licensee serving Maryland, the District of Columbia, and portions of Virginia. Broad incumbent competitor for employer and MA business in the same regional footprint as Peak Health's expansion.

Direct peers

• Geisinger Health Plan: Provider-owned health insurance plan operated by Geisinger Health System in Pennsylvania, offering Medicare Advantage, commercial, and ASO products. Direct structural analog as a health-system-led regional payer in an adjacent geography to Peak Health's Pennsylvania expansion.
• SelectHealth (Intermountain Healthcare): Provider-owned health plan owned by Intermountain Healthcare, offering Medicare Advantage, individual, and employer plans in Utah and Idaho. Highly comparable to Peak Health as a health-system-sponsored payer with deep provider integration and a regional footprint.
• Sentara Health Plans: Health-plan arm of Sentara Healthcare, a Virginia-based integrated delivery system offering Medicare Advantage and commercial plans. Comparable as a provider-sponsored regional plan in the Mid-Atlantic, with overlap in West Virginia and Virginia geographies.
• UPMC Health Plan: Provider-owned health plan affiliated with UPMC, offering Medicare Advantage, commercial, and ASO products across Pennsylvania and surrounding states. Direct competitor in the regional provider-led payer model, with significantly greater scale but the same fundamental approach.
• Health Alliance Plan (Henry Ford Health): Provider-affiliated health plan owned by Henry Ford Health System in Michigan offering commercial, Medicare Advantage, and ASO products. Comparable as a health-system-led regional payer with similar integrated model, though at greater scale.

Others

• Aetna (CVS Health): National health insurer that owns the First Health Network — the network partner Peak Health uses to provide national in-network coverage. Both a distribution partner and a broader competitor offering commercial and Medicare Advantage products.

Regional players

• Optima Health (Sentara): Virginia-based health plan owned by Sentara offering commercial and Medicare Advantage products. Comparable regional provider-sponsored payer operating in an adjacent market with overlapping geography into West Virginia.

Market position

Weaknesses5 records

Competitive moat6 records

Key risks6 records

Key highlights7 records

Customer concentration

• Facebookfacebook.com/profile.php
• LinkedInlinkedin.com/company/peakhealthplan

Compliance5 records

Revenue estimate

Valuation estimate

Number of profiles

Profiles4 records

Funding overview

Funding rounds

Investors

Funding detail is available on the Subscription and Enterprise plan.Contact sales →

M&A

Investments

M&A and investment is available on the Subscription and Enterprise plan.Contact sales →

Frequently asked questions about Peak Health