BENEFIT PLANS
MVP PLAN
COMPLIANT MINIMUM VALUE PLANSS
MVP PLAN PRICING
DEDUCTIBLE
$8,150 per enrollee, per year
Max Out-of-Pocket
$16,300 per enrollee, per year
In-network Coverage For Medical Benefits, No Out-of-network Coverage Options
Plan Does Not Cover Spouses
Children may be covered for additional expense.
Generic | Preferred Brand Drugs Only
Selecting This Plan Requires A Separate Form To Be
Completed By Enrollee
Failure to submit form in a timely manner will delay coverage availability
MVP PLAN PRICING IS DEPENDENT ON PROCESS OF UNDERWRITING. SO PLANS MAY RANGE FROM
$500 – $600 PER MONTH, PER EMPLOYEE
BY LAW, EMPLOYEES WOULD PAY NO MORE THAN 9.78% OF LOWEST PAID EMPLOYEE’S MONTHLY WAGES.
EXPLANATION OF
PLAN BENEFITS
MVP Plans essentially amount to a standard Bronze Level major medical insurance plan. These plans have a high deductible and very minimal coverage for the majority of healthcare services that patients use the most. These plans are expensive for both the employer and the employee as the employer must pay the majority of the monthly premium ($600 or more per month) and the employee must pay the entire deductible ($8150) before almost any services are covered.
National Health Benefits offers employers and employees this option to maintain compliance with the ACA and to ensure that costly fines can be avoided. However, we also offer our partnership with HealthShare Connection to give companies a better solution to their healthcare needs. We aim to educate your workforce about the MVP Plan as well as other, more affordable options during the Open Enrollment period to help them understand how their healthcare options can work in their favor.
MVP PLAN BENEFITS OUTLINE
| MAJOR MEDICAL BENEFITS | NETWORK | NON-NETWORK |
|---|---|---|
| Prescription Drug Coverage | Deductible | Not Covered |
| Major Medical Benefits | Deductible | Not Covered |
| PPO (Preferred Provider Organization) | CIGNA | Aetna | Not Covered |
| Doctor Office Visit (Per Visit PCP, Urgent Care Specialist) | Deductible | Not Covered |
| Preventative Care Treatment | 100% Benefit | Not Covered |
| RX Coverage (Generic & Preferred Brand Drugs Only) | Deductible | Not Covered |
| All Impatient hospital Services | Deductible | Not Covered |
| Mental Behavioral health & Substance Abuse, Disorder Outpatient Services | Deductible | Not Covered |
| Imaging (CT | PET Scans, MRI’s) | Deductible | Not Covered |
| Rehabilitative Speech Therapy | Deductible | Not Covered |
| Laboratory Outpatient & Professional Services | Deductible | Not Covered |
| X-rays & Diagnostic Imaging | Deductible | Not Covered |
| Skilled Nursing Facility | Deductible | Not Covered |
| Out-patient Facility Fee | Deductible | Not Covered |
| Outpatient Surgery Physician | Surgical Services | Deductible | Not Covered |
| Maximum Lifetime Benefit | Unlimited | Unlimited |
AVAILABILITY
This plan is only available as an individual plan for employees of ALE’s. This plan is not available to be purchased as a stand alone product for individual contractors or companies with 49 or fewer employees. Additionally, spouses are not eligible for coverage on this plan. This is a plan for an individual employee and their dependents (children).
GOVERNMENT SUBSIDIES
Offering this plan to employees of Applicable Large Employers satisfies the Tax B requirement of the Affordable Care Act. However, employees will no longer be eligible for government subsidies they may be currently offered through the Open Market if they are currently participating in a government sponsored plan.
AFFORDABILITY CLAUSE
This MVP Plan is affordable under the Affordable Care Act with the employees portion of MVP premium totaling 9.78% of a monthly amount determined as the federal poverty level for a single individual for the applicable calendar year divided by 12. This amount increases each year according to the federal poverty scale.
BASIC PLAN
Preventative Health & Wellness
Our most affordable monthly plan includes in-office, preventative health and wellness and our full Telehealth suite of services. All of our plans (including this one include Minimum Essential Coverage with ACA compliance. Prescription discounts are also included.
HEALTHSHARE PLAN
Medical Cost-sharing Membership
This is National Health’s newest and most comprehensive plan available for an extremely low cost! It includes all Mega Plan coverages as well as extended medical care including: surgery and hospitalization care, accident care, as well as cancer, stroke, and maternity care options.
MEGA PLAN
Out-Patient, Vision & Dental
Our most popular plan combines affordability with moderate healthcare coverage for the cost-conscious customer. This plan offers Vision and Dental Coverage, along with Doctors and Specialist visits, Out-Patient Testing , Lab Work and Urgent Care coverage.