2027 RADA Open Enrollment Presentation

By MVP Health Care

1. Rochester Automobile Dealers Association 2027 Health Plan Options October 2026 ©2027 MVP Health Care
2. Your health plan is one of the most important decisions you’ll make this year. ​ We’ve got you covered. ©2027 MVP Health Care 2
3. What are my plan options? ©2027 MVP Health Care 3
4. 2027 Co-Pay and Hybrid Plan Designs EPO $25 Co-Pay $30/$1,000 Hybrid • No deductible • Flat co-pay for most services • Flat co-pay for all services • $30 primary care physician co-pay • $25 office visit co-pay • $50 specialist office visit co-pay • $50 emergency room co-pay • Deducible applies to in-patient services • $1,000/$3,000 deductible per individual/family • $100 in-patient co-pay • No coverage for out-of-network providers • PPO plan with coverage available for out of network services • 3 tier Rx coverage at $10/$30/$50 • 3 tier Rx coverage at $5/$35/$70 with $0 generics for kids *Not all plans may be offered by your employer/dealership for 2027. Please check with your HR team for specifics on your choices* . ©2027 MVP Health Care
5. 2026 HDHP Plan Designs $2,000 HDHP Plan $4,000 HDHP Plan $6,350 HDHP Plan • HSA qualified plan • HSA qualified plan • HSA qualified plan • $2,000/$4,000 deductible per individual/family • $4,000/$8,000 deductible per individual/family • $6,350/$12,700 deductible per individual/family • 20% co-insurance/cost share after deductible is met • 0% co-insurance/cost share after deductible is met • 0% co-insurance/cost share after deductible is met • $4,000/$8,000 out-of-pocket maximum • $4,000/$8,000 out-of-pocket maximum • $6,350/$12,700 out-of-pocket maximum • 3 tier Rx coverage at $5/$35/$70, subject to deductible • 3 tier Rx covered in full, subject to deductible • 3 tier Rx covered in full, subject to deductible • Many preventive services and prescriptions are covered without being subject to the deductible • Many preventive services and prescriptions are covered without being subject to the deductible • Many preventive services and prescriptions are covered without being subject to the deductible *Not all plans may be offered by your employer/dealership for 2027. Please check with your HR team for specifics on your choices* . ©2027 MVP Health Care
6. Understanding High-Deductible Health Plans You Pay You pay 100% of non-preventive medical services and prescription costs until you meet your plan’s annual deductible. You Share After your plan’s annual deductible is met, you and MVP share expenses with a co-pay and/or co-insurance. You Stop After you reach your out-of-pocket maximum, MVP pays 100% of covered services. You Save All QHDHPs can be paired with a Health Savings Account. ©2027 MVP Health Care 6
7. Is my doctor in the network? ©2027 MVP Health Care 7
8. We Have Thousands of Doctors In-Network Regional Strength and National Access MVP is widely recognized for an unmatched range of available in-network physicians and hospitals, including more than 60,000 providers and 3,400 facilities throughout New York and Vermont. Through an alliance with Cigna Healthcare®, MVP members' coverage of care extends to over 1,000,000 providers and 17,000 facilities—ensuring access nationwide*. ©2027 MVP Health Care 8
9. We’ve Made it Easy to Find Doctors Use our search tool to discover if a provider, lab, or facility is part of our network at mvphealthcare.com/findadoctor. ©2027 MVP Health Care 9
10. Are my prescriptions covered? ©2027 MVP Health Care 10
11. Find Out if Your Prescription is Covered MVP partners with CVS Caremark® for your pharmacy benefit, giving you access to many participating pharmacies and covering thousands of medications on the MVP approved drug list, the Formulary. Online tools Manage your pharmacy benefits in Gia. • Research medication costs • Order prescriptions and have them delivered • Search for money saving generic alternatives To find out if a drug will be covered by your MVP plan, visit mvphealthcare.com/prescriptions to find your Formulary or call Customer Care. ©2027 MVP Health Care 11
12. Find a Pharmacy and Drug Costs You can find this feature in the navigation menu of the Gia by MVP mobile app by selecting Pharmacy, then Drug Cost and Pharmacy Search. • Find in-network pharmacies • Search and compare drug prices at a local innetwork pharmacy for brand, generic, and specialty drugs • Drug pricing is personalized based on member plan, formulary, and deductible spending • Alerts member when drug requires a prior authorization, or is not covered by their formulary ©2027 MVP Health Care 12
13. How to Find the Formulary The list of drugs covered by your MVP health plan is called the Formulary, and the most current version can be found online. Step 1 Visit mvphealthcare.com and choose Member Resources. Step 2 Select Prescription Benefits ©2027 MVP Health Care 13
14. How to Find the Formulary Step 3 Use the dropdowns to find the Formulary for your plan type. As an RADA member you will select the Large Group plans formulary. Step 4 Click the View PDF button. ©2027 MVP Health Care 14
15. How to Read the Formulary You can search the Formulary by drug name or by the name of the condition the drug is used to treat. The following symbols have special meaning: PA This drug requires prior authorization. QL This drug has a maximum quantity limit. SP This is a specialty medication, and it must be filled at a pharmacy in the specialty network, such as CVS Specialty Pharmacy. ST This drug requires Step Therapy, and you must try other drugs first to treat your condition. AGE Age Limit LD Limited Distribution OTC Over the Counter NM Not available at mail order ©2027 MVP Health Care 15
16. Prescription Delivery by Mail CVS Mail Service Pharmacy Delivers 90-Day Supplies • Get 90-day supplies of medications you take regularly directly to your door. • 90-day supplies typically cost less than 30-day supplies—and there is no cost for shipping. • CVS will send your prescriptions in secure, nondescript packaging to protect your privacy. Learn more at mvphealthcare.com/prescriptions. To get started with CVS mail order, call the CVS Caremark Customer Care at the phone number on the back of your MVP Member ID card. ©2027 MVP Health Care 16
17. CVS Caremark Cost Saver Powered by GoodRx® • Prescription drug discount solution to help lower out-of-pocket drug costs is available to fully insured MVP members • Eligible MVP members will have access to GoodRx prescription pricing to help lower costs on select generic medications at in-network pharmacies • MVP members can show their MVP Member ID card for seamless access ©2027 MVP Health Care 17
18. How do I use my benefits? ©2027 MVP Health Care 18
19. The Key to Your Coverage If you are enrolling in a new plan, you will receive your MVP Member ID card in the mail. We’ve made changes so you can find more information about your plan right on the card! • MVP Plan Type • Subscriber/Member Information • Cost-Share Information • Medical Deductible Find important contact information on the back of the card. This is a sample. Your card may look different based on your plan details. ©2027 MVP Health Care 19
20. Gia, Your Starting Point for Care Care, benefits, and support—all in one place. Everything you need, right here. • From finding doctors and other care providers to accessing virtual care, Gia helps you take your next step with confidence. Understanding your plan. • Gia helps you navigate your plan coverage and guides you through your personal health journey. Ongoing support—anytime, anywhere. • Gia is there at every moment, big or small. Download the Gia by MVP mobile app at mvphealthcare.com/gia or sign in at my.mvphealthcare.com to get started. ©2027 MVP Health Care 20
21. Treatment Cost Estimator The MVP Treatment Cost Estimator can help you prepare for treatment, a procedure, or surgery. Use this online tool to compare costs for medical treatments and services from different providers and facilities. Get started! In the Gia by MVP mobile app, slide open the bottom menu and select Estimate Treatment Costs. Or sign in to Gia at my.mvphealthcare.com. Select Get Care, then Find In-Person and Virtual Care, and lastly Estimate Treatment Costs. ©2027 MVP Health Care 21
22. Preferred Providers Save Money If your plan is not subject to a deductible, medically necessary services are covered in full at an MVP Preferred Provider. If your plan has a deductible, you can save on out-of-pocket costs until your deductible is met. Then, medically necessary services are covered in full. Preferred Provider services include: • Laboratory • Radiology • Ambulatory/Outpatient Surgery ©2027 MVP Health Care 22
23. Prior Authorization You may need prior authorization if the following is true: • You are in the midst of a treatment plan with your provider • You have a surgery or procedure scheduled for a date after your enrollment begins • You take a drug that is not on the Formulary or requires additional review as indicated on the Formulary Talk about your benefit change with your provider to ensure there is no lapse in coverage. ©2027 MVP Health Care 23
24. What else does my plan include? ©2027 MVP Health Care 24
25. NEW - $600 Well-Being Rewards Earn $600 on your path to well-being! • Earn up to $400 in MVP Well-Being Rewards • by completing various health-related activities like your online Health Assessment, a confidential survey that helps you identify potential health risks and opportunities for improvement. • Receive up to $200 in reimbursements • Sport memberships, mindfulness apps, park passes, fitness equipment, health monitoring devices, ergonomic office equipment, and much more! Stay tuned for additional details on the new Well-Being Rewards structure in the coming weeks! ©2027 MVP Health Care 25
26. MVP Living Well Programs Accessible to the MVP Community Inclusive programming for diverse needs. Free or Low-Cost Participation Designed to reduce financial barriers and encourage engagement. Seasonal Offerings Programs rotate throughout the year to align with interests and health priorities. Flexible Formats Available both in-person and virtually to fit your lifestyle. Variety of Experiences Includes: Fitness opportunities Wellness education sessions One-time community events Voucher and discount-style offerings “I loved this class. It addressed issues that were relevant to me and to my family, and the input of other classmates was very helpful. The instructor was great. She made a potentially boring topic interesting by talking about her personal experiences, welcoming participation, and giving excellent suggestions. A+ !” - Fall Prevention Program Participant “[The] Wellness Offerings have definitely been an asset for me and my fitness journey. Having a constant reminder of why it's so important to be active daily is so important. It can become mundane getting the workouts/activity in. We are all so busy in our lives that we think there's no time for it BUT there's always time to do something to better yourself and your health. I also love a challenge!” -MVP Customer Visit www.mvphealthcare.com/livingwell to learn more! ©2027 MVP Health Care 26
27. Supporting Women at Every Life Stage 1 2 Young adulthood Owning your health Late teens to early 20s Physical, reproductive, and mental health support; informed choices and overall wellbeing. 3 4 Growing your family Navigating midlife Aging well Early 20s to early 40s Pregnancy through early childhood Early 40s to early 60s Early 60s to 80s+ Healthy lifestyle support, reminders, routine care, and proactive prevention. Little Footprints brings together maternity and early family support, including breast feeding, doula support, and more. Preventive care plus specialized menopause and hormonal transition support. Support to maintain health, manage chronic conditions, reduce fall risk, and protect quality of life. Doula Support Elektra Health $1,500 reimbursement per contract, per year Menopause and hormonal transition Reimbursement for support received from trained and certified doulas. ©2027 MVP Health Care Virtual platform offering one-on-one care, support, and education for women experiencing perimenopause and menopause 27
28. Meal Delivery MVP wants to make sure your employees get the nutrition they need. When recovering from an inpatient hospital stay, members can receive two weeks of home delivered meals – at no cost! • MVP Case Managers are available to review menu options and help place orders • Meals are designed to support the nutritional needs of different health conditions and lifestyles • The member receives 14 refrigerated meals, delivered to their home ©2027 MVP Health Care 28
29. Care Management With MVP, care keeps going. MVP Care Management connects members with a dedicated team of nurses, social workers, and other health care professionals who help them navigate their own health. Care managers support members who are managing a chronic condition, recovering from a hospital stay, or adjusting to a new diagnosis—helping them understand their care, connect to resources, and stay on track with their health and well-being. Better outcomes Informed guidance Support over time Better performance Helps members navigate care, overcome barriers, and connect to the support they need. Helps members understand what's happening, what's next, and the choices available to them. Provides ongoing support across changing health needs, not just during isolated events. Identifies high-risk populations and intervenes early, improving outcomes while reducing avoidable costs. Care Management is a consistent source of guidance that helps members navigate their health, understand their options, and access the support they need over time. ©2027 MVP Health Care 29
30. State Programs ©2027 MVP Health Care 30
31. Child Health Plus Offers free or low-cost coverage for children under 19 who do not qualify for Medicaid, do not have other health insurance, and are not covered by a public employee health plan like the New York State Health Insurance Program (NYSHIP). Great coverage with no co-pays for: • Regular checkups, shots, and sick visits • Dental and vision care • Prescription and over-the-counter drugs if ordered by a licensed provider • Emergency care • Hospital visits, x-rays, and diagnostic testing • Specialty care, including behavioral health, allergists, and speech/occupational therapy* *Some limits apply ©2027 MVP Health Care 31
32. Essential Plan Offers an affordable health plan with no deductible and a $0 monthly premium. This plan also includes up to $225 in Well-Being Reimbursement*. Use it for fitness classes, back-friendly chairs, and more! Plan Highlights: • Doula services reimbursement • Affordable vision coverage • Low or no co-pays for prescriptions • Doctor visits, online or in person • Maternity care • Personalized inpatient and outpatient care • Emergency room services • Mental health and substance support *Per contract, per calendar year ©2027 MVP Health Care 32
33. Thank you Contact: Kimberley Monroe RADA Account Manager ©2027 MVP Health Care 33