MVP Group Paperwork
MAIL, EMAIL OR FAX COMPLEED FORMS: to MVP NH SALES
Mail: MVP Health Care Attn: Sales - 33 South Commercial Street Suite 303, Manchester, NH 03101
Email: NHSales@MVPHealthcare.com Fax: 603-647-9607.
*Please write clearly on all faxed forms. This will ensure correct loading of information.
Group Setup Agreement (must be signed by group and broker)
MVP Enrollment/Change Form (new employee, reinstating an employee, adding a dependent, removing a dependent...)
Health Benefit Administrator On-line Guide – (Introductory information to assist the HBA manage the group via MVP’s website) do not return this form with your Set Up Paperwork. It is to remind you to contact MVP to get your online password.
Waiver (For Employees covered elsewhere or waiving coverage)
Student Waiver (For fulltime College Students to ensure access to additional student coverage)
HBA Must Complete & Sign, to the best of their ability, Section “9” of each application.
Important Information
NO BINDER CHECK IS NEEDED WITH ENROLLMENT PAPERWORK THE AMOUNT WILL APPEAR ON THE GROUP’S FIRST BILL
MVP Contact Information
MVP Health Care
33 South Commercial Street Suite 303, Manchester, NH 03101
Office: 603-647-7181
Peter Whitehouse, Regional Sales Manager: 603-629-1928
Pwhitehouse@mvphealthcare.com
Anne Norris, Sr. Sales Executive 603-629-1927
Anorris@mvphealthcare.com
Jennifer Sullivan, Sales Rep: 603-629-1935
Jsullivan@mvphealthcare.com
Lisa Combs-Fortier, Sales Associate: 603-629-1929
Lcombs-fortier@mvphealthcare.com
MVP WEBSITE: www.MVPHealthcare.com
Group Service Center: 1-800-825-5687, Option 5
They are able to answer your general questions on billing, enrollment, products and claims.
Employer Account Services (EAS): Contact them for all non-urgent enrollment status/eligibility/ID Card questions at EASeligibility@mvphealthcare.com
Member Services: 1-888-687-6277 (1888-mvp-mbrs) Contact them for Urgent Claims, Pharmacy, Coverage and products questions
ALWAYS INCLUDE THE GROUP ID NUMBER AND IF POSSIBLE, THE MEMBER’S ID NUMBER WHEN CORRESPONDING WITH MVP ON ANY GROUP AND MEMBER ISSUES.
MVP Will only release group and member information to the HBA of the group, or to the Broker of Record of the group. If there is a change or addition to any of these contacts, please notify your MVP Representative as soon as possible.
