It is the goal of the Goshen Chamber of Commerce to assist our members in achieving success in areas of their business. One of the ways we can accomplish this goal is to provide various human resource and insurance opportunities. One of the benefits we offer to our members is the ability to access excellent quality health insurance at affordable rates. We are a partner with Jannotti Insurance, which has over 30 years of experience in providing health insurance to businesses of all sizes. We are pleased to now be able to offer MVP Health Insurance in addition to our other plans.
 A new national network - including doctors and hospitals nationwide - offers seamless access to doctors, specialist and hospitals across the country everywhere you work, live and travel.
 The network includes more than 500,000 doctors and specialists in our national provider network.
MVP Preferred EPO offers the exciting features of our new Wellness Suite at no extra cost. Additional features include a Member Services Department that can be reached 7 days a week from 8:00am to 10pm. 1-888-687-6277.
An innovative Web site offers many convenient features where members can:
- Ask questions about coverage
- Compare hospitals and prescription drug costs
- Research disease and care management programs
- Use a powerful online health library, powered by Healthwise® Knowledgebase
- and much more.... Go to www.mvphealthcare.com
General costs of MVP EPO Preferred Plan:
| Sole Proprietors |
| Plan
Type |
HMO in network only |
EPO in network only |
In Network |
HSA (High Deduct.) |
| Drug Card |
|
|
| Prescription Card |
10/30/1950 |
4/30/1950 |
10/30/1950 |
|
| Prescription Maximum |
$2000 Maximum |
$2000 Maximum |
$1000 Maximum |
|
| Prescription Mail Order |
2 & 1/2 Co-payments for 90 Day Supply |
2 & 1/2 Co-payments for 90 Day Supply |
2 & 1/2 Co-payments for 90 Day Supply |
|
| Deductible Ind/Fam |
No Deductible to Apply |
Single $500 / Family $1,250.00 |
Single $500 / Family $3,000.00 |
Single ??? / Family $10,000.00 |
| Co-Insurance |
No Co-insurance Apply |
20% |
90% |
70% |
| Out-of Pocket Maximum |
No Out of Pocket Max Applies |
Single $2,000 /
Family $5,000 |
Single $4000 /
Family $8,000 |
Single $5,000 /
Family $10,000 |
| Office Co-pay |
$25.00 |
$25.00 |
Deductible & Coinsurance |
Deductible & Coinsurance |
| DXL/Lab fees |
$40.00 |
$25.00 |
Deductible & Coinsurance |
Deductible & Coinsurance |
| Specialist Co-pay |
$40.00 |
$25.00 |
Deductible & Coinsurance |
Deductible & Coinsurance |
| Lifetime Maximum |
Unlimited |
$1,000,000 Annual
Maximum Benefit |
$1,000,000 Annual Max Benefit |
$1,000,000 Annual Max Benefit |
| Hospital Benefits |
|
Hospital
In-Patient |
$500 Copay |
Deductible then 20% |
Deductible & Coinsurance |
Deductible & Coinsurance |
Hospital
Out-patient |
$100 Copay |
Deductible then 20% |
Deductible & Coinsurance |
Deductible & Coinsurance |
| Emergency Room |
$100 Copay Waived if Admitted |
Deductible then 20% - Waived if admitted |
Deductible & Coinsurance |
Coinsurance as
In-Network |
| Ambulance |
$100 Copay |
Deductible then 20% |
|
| Surgical Benefits |
|
| Surgical In-Patient |
$500 Copay |
Deductible then 20% |
Deductible & Coinsurance |
Deductible & Coinsurance |
Surgical
Out-patient |
$100 Copay |
Deductible then 20% |
Deductible & Coinsurance |
Deductible & Coinsurance |
| Mental Health |
|
Mental Nervous
In-Patient |
$500 Copay
30 day max |
$25 Copay.
30 day max |
Co-Insurance. No deductible. 30 day max |
|
| Substance Abuse In-Patient |
$500 Copay. 7 day Detox per benefit period. Max 30 Days rehab per benefit period Max |
Not covered |
Ded & Coinsurance.
7 day detox max. 30 day
rehab max
|
|
| Mental Nervous Out-Patient |
$40 Copay
20 visit max |
$25 Copay. 20 visit max |
Ded & Coins 20 visit max |
Ded & Coins 20 visit max/yr |
| Substance Abuse Out-Patient |
$25 Copay 60
visit max/yr |
$25 Copay. 60 visit max/yr |
Ded & Coins 60 visit max/yr |
Ded & Coins Not covered |
| Other |
|
| Well Care (Up to 19) |
Covered in Full |
Covered in Full |
Covered in Full |
Covered in Full |
| Routine Adult Care |
Covered in Full |
Covered in Full |
Covered in Full |
Covered in Full |
| Chiropractic Care |
$40 Copay |
$25 Copay |
Deductible & 10% Coinsurance |
|
| Home Health Care |
Covered in Full |
Covered in Full |
Deductible & 10% Coinsurance |
|
| General Costs: Subject to change. Please contact www.mvphealthcare.com for current rates |
| Single |
|
|
| EE with Spouse |
|
| EE with Children |
|
| Family |
|
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|
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