Plan Details
Plan Limitations
- The Health Benefit Alliance program manages the efficient and cost effective delivery of healthcare through pre authorization requirements for certain services and prescriptions, formulary management and other cost containment protocols as outlined in the Schedules of Benefits.
- MVP Limited Day Medical℠ Plans provide comprehensive and affordable health coverage for HBA participants. To ensure affordability, HBA plans contain limits that differ from other “traditional” carrier plans.
Day limits for coverages
Chemotherapy and Radiation excluded in Essential Value and BRONZE plans
Kidney Dialysis excluded in Essential Value and BRONZE plans
Specialty Rx excluded in Essential Value and BRONZE plans
Maternity excluded in Essential Value and BRONZE plans
Underwriting Guidelines
Minimum Participation Requirements
- Minimum Employer Size: Two (2) Eligible Employees, both or which must actively enroll for coverage (eligible groups must be valid employers and have at least one common-law employee participating all times)
- 25% of eligible employees if MVP Ultra Plan(s) are not offered
If MVP Ultra Plan(s) are offered:
- MVP Ultra Plan(s) or PPO must be accompanied by at least one (1) Limited Day Medical plan
- 50% of eligible employees must enroll in an HBA plan offering
"Qualified Waivers"
Employees with health insurance coverage elsewhere are excluded from the minimum participation calculation
- Group health Questionnaire (GHQ)
- No Minimum Employer Contribution Requirement
- Eligible Employees
- HBA Plans available to full-time, part-time and seasonal employees
Dental and Vision
Helps provide the peace of mind that comes from knowing you’ll have help with both routine and unexpected expenses
