New York Small Group Bronze Plans

MVP Health Care non-standard plans for small businesses, part of MVP’s suite of Premier plans offered on New York State of Health.

View all MVP Employer Plans

MVP EPO Bronze 2 NY-EPO-SB-002 (2022)

State New York
Plan Type EPO
Exchange Off
Metal Level Bronze
Annual In-Network Deductible (Single/Family) $6,000 / $12,000
Annual Out-of-Network Deductible N/A
Annual In-Network Out-of-Pocket Limit (Single/Family) $8,400 / $16,800
Annual Out-of-Network Out-of-Pocket Limit N/A
Primary Care Visit $35 copay ($0 copay first 3 visits)
Specialist Visit $60 copay
ER $350 copay Deductible applies.
Urgent Care $60 copay Deductible applies.
Generic Rx Coverage (Tier 1) $10 copay Deductible applies. 30 day retail/90 day mail order.
Preferred Rx Coverage (Tier 2) $40 copay Deductible applies. 30 day retail/90 day mail order. $100 max out of pocket on 30 day supply of Insulin
Non Preferred Rx Coverage (Tier 3) $60 copay Deductible applies. 30 day retail/90 day mail order.
Rx Formulary 2022 MVP Marketplace Formulary (PDF)
Rx Drug Search Pharmacy Information for New York’s Prescription Drug Program
Find a Doctor Doctor Search
Summary of Benefits and Coverage (SBC) Click here to open detailed plan benefit information
Plan Overview Click here to open the plan overview document
Plan Highlights Cigna national network, pediatric dental, savings at preferred provider facilities, 20% discount on CVS brand health-related items
Well-Being Features $600 WellBeing Rewards
Availability January 1, 2022

MVP EPO Bronze 3 HDHP NY-EPOH-SB-003 (2022)

State New York
Plan Type EPO
Exchange Off
Metal Level Bronze
Annual In-Network Deductible (Single/Family) $6,200 / $12,400
Annual Out-of-Network Deductible N/A
Annual In-Network Out-of-Pocket Limit (Single/Family) $6,900 / $13,800
Annual Out-of-Network Out-of-Pocket Limit N/A
Primary Care Visit $30 copay
Specialist Visit $50 copay
ER $300 copay Deductible applies.
Urgent Care $50 copay Deductible applies.
Generic Rx Coverage (Tier 1) $10 copay Deductible applies. 30 day retail/90 day mail order; preventive drugs deductible waived.
Preferred Rx Coverage (Tier 2) $40 copay Deductible applies. 30 day retail/90 day mail order. $100 max out of pocket on 30 day supply of Insulin; preventive drugs deductible waived
Non Preferred Rx Coverage (Tier 3) $60 copay Deductible applies. 30 day retail/90 day mail order; preventive drugs deductible waived.
Rx Formulary 2022 MVP Marketplace Formulary (PDF)
Rx Drug Search Pharmacy Information for New York’s Prescription Drug Program
Find a Doctor Doctor Search
Summary of Benefits and Coverage (SBC) Click here to open detailed plan benefit information
Plan Overview Click here to open the plan overview document
Plan Highlights Cigna national network, pediatric dental, savings at preferred provider facilities, 20% discount on CVS brand health-related items
Well-Being Features $600 WellBeing Rewards
Availability January 1, 2022

MVP EPO Bronze 5 HDHP NY-EPOH-SB-005 (2022)

State New York
Plan Type EPO
Exchange Off
Metal Level Bronze
Annual In-Network Deductible (Single/Family) $6,250 / $12,500
Annual Out-of-Network Deductible N/A
Annual In-Network Out-of-Pocket Limit (Single/Family) $6,900 / $13,800
Annual Out-of-Network Out-of-Pocket Limit N/A
Primary Care Visit $5 copay
Specialist Visit 50% coinsurance
ER $100 copay Deductible applies.
Urgent Care 50% coinsurance Deductible applies.
Generic Rx Coverage (Tier 1) $5 copay Deductible applies. 30 day retail/90 day mail order; preventive drugs deductible waived.
Preferred Rx Coverage (Tier 2) $30 copay Deductible applies. 30 day retail/90 day mail order.; $100 max out of pocket on 30 day supply of Insulin; preventive drugs deductible waived
Non Preferred Rx Coverage (Tier 3) 50% coinsurance Deductible applies. 30 day retail/90 day mail order; preventive drugs deductible waived.
Rx Formulary 2022 MVP Marketplace Formulary (PDF)
Rx Drug Search Pharmacy Information for New York’s Prescription Drug Program
Find a Doctor Doctor Search
Summary of Benefits and Coverage (SBC) Click here to open detailed plan benefit information
Plan Overview Click here to open the plan overview document
Plan Highlights Cigna national network, pediatric dental, savings at preferred provider facilities, 20% discount on CVS brand health-related items
Well-Being Features $600 WellBeing Rewards
Availability January 1, 2022

MVP EPO Bronze 6 HDHP NY-EPOH-SB-006 (2022)

State New York
Plan Type EPO
Exchange Off
Metal Level Bronze
Annual In-Network Deductible (Single/Family) $6,900 / $13,800
Annual Out-of-Network Deductible N/A
Annual In-Network Out-of-Pocket Limit (Single/Family) $6,900 / $13,800
Annual Out-of-Network Out-of-Pocket Limit N/A
Primary Care Visit $0 copay
Specialist Visit $0 copay
ER $0 copay Deductible applies.
Urgent Care $0 copay Deductible applies.
Generic Rx Coverage (Tier 1) $0 copay Deductible applies. 30 day retail/90 day mail order; preventive drugs deductible waived.
Preferred Rx Coverage (Tier 2) $0 copay Deductible applies. 30 day retail/90 day mail order.; $100 max out of pocket on 30 day supply of Insulin; preventive drugs deductible waived
Non Preferred Rx Coverage (Tier 3) $0 copay Deductible applies. 30 day retail/90 day mail order; preventive drugs deductible waived.
Rx Formulary 2022 MVP Marketplace Formulary (PDF)
Rx Drug Search Pharmacy Information for New York’s Prescription Drug Program
Find a Doctor Doctor Search
Summary of Benefits and Coverage (SBC) Click here to open detailed plan benefit information
Plan Overview Click here to open the plan overview document
Plan Highlights Cigna national network, pediatric dental, savings at preferred provider facilities, 20% discount on CVS brand health-related items
Well-Being Features $600 WellBeing Rewards
Availability January 1, 2022

MVP EPO Bronze 7 HDHP NY-EPOH-SB-007 (2022)

State New York
Plan Type EPO
Exchange Off
Metal Level Bronze
Annual In-Network Deductible (Single/Family) $6,200 / $12,400
Annual Out-of-Network Deductible N/A
Annual In-Network Out-of-Pocket Limit (Single/Family) $6,900 / $13,800
Annual Out-of-Network Out-of-Pocket Limit N/A
Primary Care Visit 40% coinsurance
Specialist Visit 40% coinsurance
ER 40% coinsurance Deductible applies.
Urgent Care 40% coinsurance Deductible applies.
Generic Rx Coverage (Tier 1) $10 copay Deductible applies. 30 day retail/90 day mail order; preventive drugs deductible waived.
Preferred Rx Coverage (Tier 2) $40 copay Deductible applies. 30 day retail/90 day mail order.; $100 max out of pocket on 30 day supply of Insulin; preventive drugs deductible waived
Non Preferred Rx Coverage (Tier 3) $60 copay Deductible applies. 30 day retail/90 day mail order; preventive drugs deductible waived.
Rx Formulary 2022 MVP Marketplace Formulary (PDF)
Rx Drug Search Pharmacy Information for New York’s Prescription Drug Program
Find a Doctor Doctor Search
Summary of Benefits and Coverage (SBC) Click here to open detailed plan benefit information
Plan Overview Click here to open the plan overview document
Plan Highlights Cigna national network, pediatric dental, savings at preferred provider facilities, 20% discount on CVS brand health-related items
Well-Being Features $600 WellBeing Rewards
Availability January 1, 2022

MVP HMO Bronze 10 NY-HMO-SB-010 (2022)

State New York
Plan Type HMO
Exchange Off
Metal Level Bronze
Annual In-Network Deductible (Single/Family) $8,300 / $16,600
Annual Out-of-Network Deductible N/A
Annual In-Network Out-of-Pocket Limit (Single/Family) $8,300 / $16,600
Annual Out-of-Network Out-of-Pocket Limit N/A
Primary Care Visit $0 copay
Specialist Visit $0 copay
ER $0 copay Deductible applies.
Urgent Care $0 copay Deductible applies.
Generic Rx Coverage (Tier 1) $0 copay Deductible applies. 30 day retail/90 day mail order.
Preferred Rx Coverage (Tier 2) $0 copay Deductible applies. 30 day retail/90 day mail order. $100 max out of pocket on 30 day supply of Insulin
Non Preferred Rx Coverage (Tier 3) $0 copay Deductible applies. 30 day retail/90 day mail order.
Rx Formulary 2022 MVP Marketplace Formulary (PDF)
Rx Drug Search Pharmacy Information for New York’s Prescription Drug Program
Find a Doctor Doctor Search
Summary of Benefits and Coverage (SBC) Click here to open detailed plan benefit information
Plan Overview Click here to open the plan overview document
Plan Highlights Pediatric dental, savings at preferred provider facilities, 20% discount on CVS brand health-related items
Well-Being Features $600 WellBeing Rewards
Availability January 1, 2022

MVP HMO Bronze 2 NY-HMO-SB-002 (2022)

State New York
Plan Type HMO
Exchange Off
Metal Level Bronze
Annual In-Network Deductible (Single/Family) $6,000 / $12,000
Annual Out-of-Network Deductible N/A
Annual In-Network Out-of-Pocket Limit (Single/Family) $8,400 / $16,800
Annual Out-of-Network Out-of-Pocket Limit N/A
Primary Care Visit $35 copay ($0 copay first 3 visits)
Specialist Visit $60 copay
ER $350 copay Deductible applies.
Urgent Care $60 copay Deductible applies.
Generic Rx Coverage (Tier 1) $10 copay Deductible applies. 30 day retail/90 day mail order.
Preferred Rx Coverage (Tier 2) $40 copay Deductible applies. 30 day retail/90 day mail order. $100 max out of pocket on 30 day supply of Insulin
Non Preferred Rx Coverage (Tier 3) $60 copay Deductible applies. 30 day retail/90 day mail order.
Rx Formulary 2022 MVP Marketplace Formulary (PDF)
Rx Drug Search Pharmacy Information for New York’s Prescription Drug Program
Find a Doctor Doctor Search
Summary of Benefits and Coverage (SBC) Click here to open detailed plan benefit information
Plan Overview Click here to open the plan overview document
Plan Highlights Pediatric dental, savings at preferred provider facilities, 20% discount on CVS brand health-related items
Well-Being Features $600 WellBeing Rewards
Availability January 1, 2022

MVP HMO Bronze 9 HDHP NY-HMOH-SB-009 (2022)

State New York
Plan Type HMO
Exchange Off
Metal Level Bronze
Annual In-Network Deductible (Single/Family) $6,100 / $12,200
Annual Out-of-Network Deductible N/A
Annual In-Network Out-of-Pocket Limit (Single/Family) $6,900 / $13,800
Annual Out-of-Network Out-of-Pocket Limit N/A
Primary Care Visit 50% coinsurance
Specialist Visit 50% coinsurance
ER 50% coinsurance Deductible applies.
Urgent Care 50% coinsurance Deductible applies.
Generic Rx Coverage (Tier 1) $10 copay Deductible applies. 30 day retail/90 day mail order; preventive drugs deductible waived.
Preferred Rx Coverage (Tier 2) $35 copay Deductible applies. 30 day retail/90 day mail order.; $100 max out of pocket on 30 day supply of Insulin; preventive drugs deductible waived
Non Preferred Rx Coverage (Tier 3) $70 copay Deductible applies. 30 day retail/90 day mail order; preventive drugs deductible waived.
Rx Formulary 2022 MVP Marketplace Formulary (PDF)
Rx Drug Search Pharmacy Information for New York’s Prescription Drug Program
Find a Doctor Doctor Search
Summary of Benefits and Coverage (SBC) Click here to open detailed plan benefit information
Plan Overview Click here to open the plan overview document
Plan Highlights Pediatric dental, savings at preferred provider facilities, 20% discount on CVS brand health-related items
Well-Being Features $600 WellBeing Rewards
Availability January 1, 2022