Plan Details

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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 BRONZE+ & GOLD plans


Kidney Dialysis excluded in BRONZE+ & GOLD plans


Specialty Rx excluded in BRONZE+ & GOLD plans


Note that all of the above are covered in the MVP plan

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:

"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
  • 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

Dental and Vision

Helps provide the peace of mind that comes from knowing you’ll have help with both routine and unexpected expenses

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