New York Small Group Silver 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 Silver 1 NY-EPO-SS-001 (2022)

State New York
Plan Type EPO
Exchange Off
Metal Level Silver
Annual In-Network Deductible (Single/Family) $2,100 / $4,200
Annual Out-of-Network Deductible N/A
Annual In-Network Out-of-Pocket Limit (Single/Family) $7,800 / $15,600
Annual Out-of-Network Out-of-Pocket Limit N/A
Primary Care Visit $30 copay
Specialist Visit $50 copay
ER $350 copay Deductible applies.
Urgent Care $50 copay Deductible waived.
Generic Rx Coverage (Tier 1) $15 copay Deductible waived. 30 day retail/90 day mail order.
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
Non Preferred Rx Coverage (Tier 3) $70 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 Silver 2 NY-EPO-SS-002 (2022)

State New York
Plan Type EPO
Exchange Off
Metal Level Silver
Annual In-Network Deductible (Single/Family) $4,500 / $9,000
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 waived.
Generic Rx Coverage (Tier 1) $10 copay Deductible applies. 30 day retail/90 day mail order.
Preferred Rx Coverage (Tier 2) $45 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) $90 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 Silver 3 HDHP NY-EPOH-SS-003 (2022)

State New York
Plan Type EPO
Exchange Off
Metal Level Silver
Annual In-Network Deductible (Single/Family) $2,200 / $4,400
Annual Out-of-Network Deductible N/A
Annual In-Network Out-of-Pocket Limit (Single/Family) $5,200 / $10,400
Annual Out-of-Network Out-of-Pocket Limit N/A
Primary Care Visit $25 copay
Specialist Visit $50 copay
ER $300 copay Deductible applies.
Urgent Care $50 copay Deductible applies.
Generic Rx Coverage (Tier 1) $15 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 Silver 4 with HRA NY-EPO-SS-004 (2022)

State New York
Plan Type EPO
Exchange Off
Metal Level Silver
Annual In-Network Deductible (Single/Family) $2,500 / $5,000
Annual Out-of-Network Deductible N/A
Annual In-Network Out-of-Pocket Limit (Single/Family) $6,350 / $12,700
Annual Out-of-Network Out-of-Pocket Limit N/A
Primary Care Visit $20 copay
Specialist Visit $50 copay
ER $300 copay Deductible applies.
Urgent Care $50 copay Deductible applies.
Generic Rx Coverage (Tier 1) $10 copay Deductible waived. 30 day retail/90 day mail order.
Preferred Rx Coverage (Tier 2) $35 copay Deductible waived. 30 day retail/90 day mail order.; $100 max out of pocket on 30 day supply of Insulin
Non Preferred Rx Coverage (Tier 3) 50% coinsurance Deductible waived. 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 Silver 7 NY-EPO-SS-007 (2022)

State New York
Plan Type EPO
Exchange Off
Metal Level Silver
Annual In-Network Deductible (Single/Family) $3,100 / $6,200
Annual Out-of-Network Deductible N/A
Annual In-Network Out-of-Pocket Limit (Single/Family) $8,000 / $16,000
Annual Out-of-Network Out-of-Pocket Limit N/A
Primary Care Visit $30 copay
Specialist Visit $40 copay
ER $200 copay Deductible applies.
Urgent Care $40 copay Deductible waived.
Generic Rx Coverage (Tier 1) $15 copay Deductible waived. 30 day retail/90 day mail order.
Preferred Rx Coverage (Tier 2) $45 copay Deductible waived. 30 day retail/90 day mail order.; $100 max out of pocket on 30 day supply of Insulin
Non Preferred Rx Coverage (Tier 3) $90 copay Deductible waived. 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 Silver 8 HDHP NY-EPOH-SS-008 (2022)

State New York
Plan Type EPO
Exchange Off
Metal Level Silver
Annual In-Network Deductible (Single/Family) $3,900 / $7,800
Annual Out-of-Network Deductible N/A
Annual In-Network Out-of-Pocket Limit (Single/Family) $6,000 / $12,000
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) $15 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 Silver 12 NY-HMO-SS-012 (2022)

State New York
Plan Type HMO
Exchange Off
Metal Level Silver
Annual In-Network Deductible (Single/Family) $1,700 / $3,400
Annual Out-of-Network Deductible N/A
Annual In-Network Out-of-Pocket Limit (Single/Family) $7,900 / $15,800
Annual Out-of-Network Out-of-Pocket Limit N/A
Primary Care Visit $30 copay
Specialist Visit $50 copay
ER $250 copay Deductible applies.
Urgent Care $50 copay Deductible applies.
Generic Rx Coverage (Tier 1) $10 copay Deductible waived. 30 day retail/90 day mail order.
Preferred Rx Coverage (Tier 2) $35 copay Deductible waived. 30 day retail/90 day mail order. $100 max out of pocket on 30 day supply of Insulin
Non Preferred Rx Coverage (Tier 3) $90 copay Deductible waived. 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 Silver 13 NY-HMO-SS-013 (2022)

State New York
Plan Type HMO
Exchange Off
Metal Level Silver
Annual In-Network Deductible (Single/Family) $2,850 / $5,700
Annual Out-of-Network Deductible N/A
Annual In-Network Out-of-Pocket Limit (Single/Family) $8,700 / $17,400
Annual Out-of-Network Out-of-Pocket Limit N/A
Primary Care Visit $35 copay ($0 copay to age 26)
Specialist Visit $50 copay
ER $250 copay Deductible applies.
Urgent Care $50 copay Deductible waived.
Generic Rx Coverage (Tier 1) $15 copay Deductible waived. $0 copay to age 26; 30 day retail/90 day mail order.
Preferred Rx Coverage (Tier 2) $45 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) $90 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 Silver 3 HDHP NY-HMOH-SS-003 (2022)

State New York
Plan Type HMO
Exchange Off
Metal Level Silver
Annual In-Network Deductible (Single/Family) $2,200 / $4,400
Annual Out-of-Network Deductible N/A
Annual In-Network Out-of-Pocket Limit (Single/Family) $5,200 / $10,400
Annual Out-of-Network Out-of-Pocket Limit N/A
Primary Care Visit $25 copay
Specialist Visit $50 copay
ER $300 copay Deductible applies.
Urgent Care $50 copay Deductible applies.
Generic Rx Coverage (Tier 1) $15 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 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