The MVP Plan Advantage: Low Participation & TPA Integration

Many employers and brokers face significant challenges when implementing traditional health plans. Two major hurdles often stand in the way: high participation requirements and complex administration. Minimum Value Plans (MVP) offer a solution to these issues, providing a more accessible and streamlined approach to employee health coverage.

Breaking the Participation Barrier

One of the most significant advantages of MVP plans is their low participation requirements. Unlike traditional health plans that often demand high employee enrollment, MVPs have much more flexible thresholds. For instance, some MVP providers, like Evolved Benefits, require as few as five enrolled employees to implement a plan.

This low participation requirement is beneficial for several reasons:

1. Accessibility for Small Businesses: Smaller companies can now offer health benefits without the typical enrollment challenges.

2. Flexibility for Diverse Workforces: Businesses with a mix of full-time and part-time employees can more easily provide coverage options.

3. Competitive Edge for Brokers: Insurance brokers can use MVP plans to offer solutions where traditional plans fall short, potentially winning new clients.

The Advantage of Integrated Third-Party Administration (TPA)

Another key feature of many MVP plans is the integration of the health plan provider and the Third-Party Administrator (TPA) into a single entity. This integration offers several benefits:

1. Reduced Administrative Complexity: With the plan provider and TPA under one roof, there's less bureaucracy and fewer points of potential miscommunication.

2. Streamlined Claims Processing: Claims can be processed more efficiently without the need for external coordination.

3. Enhanced Customer Service: Employees often have access to dedicated account managers and customer service representatives who are intimately familiar with their specific plan.

Practical Benefits

The combination of low participation requirements and integrated TPA can lead to significant practical benefits:

• Cost Savings: Lower administrative overhead can translate to more affordable plans for employers and employees.

• Improved Access to Care: With easier-to-understand plans and dedicated support, employees are more likely to use their benefits effectively.

• Flexibility: MVP plans can often be offered alongside traditional plans, giving employees more options to choose from.

Considerations for Brokers and Employers

If you're a broker or an employer considering MVP plans, keep these points in mind:

1. Research State-Specific Requirements: Rules vary by state, so it's crucial to understand local regulations.

2. Compare with Existing Plans: Most carriers allow MVP plans to be offered alongside their traditional plans, but always verify this possibility.

3. Focus on Employee Needs: Consider how employees will actually use the plan. Sometimes, a higher-premium MVP plan might result in lower out-of-pocket costs throughout the year.

Next Steps

MVP plans offer a way to provide valuable health coverage to employees who might otherwise go uninsured. Their low participation requirements and integrated administration make them an attractive option for businesses of all sizes, particularly those struggling with traditional plan participation.

For brokers, MVPs present an opportunity to differentiate your services and provide innovative solutions to clients. For employers, these plans can help you offer competitive benefits while managing costs.

To learn more about how MVP plans can benefit your clients or your business, contact us. With our expertise in this area, we can provide detailed information and help tailor a solution to your specific needs.

As health coverage becomes increasingly important for American workers, MVP plans are proving to be a valuable tool in bridging the coverage gap for many employees.