MVP

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MVP - HYBRID (EPO) E3050215 Click here for the detailed plan summary.
This plan is an EPO (Exclusive Provider Organization) Hybrid (includes in-network deductible) with no out-of-network coverage and no referrals needed. There is a $1,000 (single) $2,500 (family) in-network deductible with an 80% coinsurance. It has a $30 primary & $50 specialist office visit copay. Inpatient hospital must meet deductible and coinsurance and a $200 copay for an emergency room visit. The prescription coverage is $10/$30/$50 with no deductible. Full time dependant coverage to age 23.
	Quarterly
	Sole Proprietor	Small Group
Employee	$1324.77	$1,153.92
Employee + One	$2,634.45	$2,292.81
Family	$3,555.03	$3,093.27
	Plan Selection	Plan Selection
	Instructions	Instructions
	Application	Application

MVP - (EPO) E3050127 Click here for the detailed plan summary.
This plan is an EPO (Exclusive Provider Organization) with no out-of-network coverage and no referrals needed. It has a $30 primary & $50 specialist office visit copay. In-patient hospital has a $500 copay, for an emergency room visit a $100 copay. The prescription coverage is $10/$30/$50 with no deductible. Full time dependant coverage to age 23.
	Quarterly
	Sole Proprietor	Small Group
Employee	$1,706.31	$1,485.69
Employee + One	$3,397.62	$2,956.41
Family	$4,582.65	$3,986.85
	Plan Selection	Plan Selection
	Instructions	Instructions
	Application	Application