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BUSINESS SERVICES CORPORATION D/B/A BENEFIT CHOICES SMALL GROUP PLANS 1 of 2 - 10/30/2023 12:17 PM2024 MVP HEALTH CARE - Small Businesses ALL PLANS INCLUDE DEPENDENT CARE TO AGE 26.METAL TIER PRODUCTTIERMONTHLY RATEAggregate / EmbeddedDEDUCTIBLE (SINGLE/FAMILY)OOP MAX (SINGLE/FAMILY)OFFICE VISIT SPECIALIST VISITINPATIENT HOSPITALOUTPATIENT SURGERYURGENT CARE/ERDIAGNOSTIC RADIOLOGY LABDIABETIC SUPPLIES PRESCRIPTION DRUGSPLATINUMPLATINUM EPO 3Individual Empl/Spouse Parent/Child(ren) Family$1082.66 $2,165.32 $1,840.52 $3,085.58N/A $0/$0 $2,550/$5,100 $30 $50 $250 $100 $50/$150 $50 $30 $5/$25/$40GOLD MVP GOLD 1 EPOIndividual Empl/Spouse Parent/Child(ren) Family$957.03 $1,914.06 $1,626.95 $2,727.54Embedded $850 / $1,700 $7,000/$14,000 3 Visits @$0, then $15 No DD$50 $500 $200 $50 NoDD; $300 NoDD$50 NoDD $15 NoDD$200/$400 (name brand only); Copayment $10/$35/$70GOLD MVP GOLD 2 EPO QHDHP Individual Empl/Spouse Parent/Child(ren) Family$919.23 $1,838.46 $1,562.69 $2,619.81Agg/Emb$1,600/$3,200 Aggregate$5,000/$10,000Preventive $0; Office visit Deductible then $10 Deductible then $20Deductible then $200Deductible then $200Deductible then $20/$75Deductible then $20/$20Deductible then $10Ded. Integrated w/Medical; $10/$30/$50 (preventive drugs NoDD)GOLD MVP GOLD 3 EPOIndividual Empl/Spouse Parent/Child(ren) Family$931.20 $1,862.40 $1,583.04 $2,653.92Embedded$1,000/$2,000 - applies to all benefits except Rx$5,000/$10,000 Preventive $0; office visit $20 $40 $800 $100 $40/$300 $40/$40 $20 Deductible $0/$0; Copayment $10/$35/50% NoDDGOLD MVP GOLD 4 EPOIndividual Empl/Spouse Parent/Child(ren) Family$985.56 $1,971.12 $1,675.45 $2,808.85Embedded $0/$0 $6,750 / $13,500Preventive $0; office visit $40$60 $750 $300 $60/$500 $60/$60 $40 Deductible $0/$0; Copayment $10/$40/$60GOLD MVP GOLD 6 EPOIndividual Empl/Spouse Parent/Child(ren) Family$986.97 $1,973.94 $1,677.85 $2,812.86Embedded $350/$700 $6,550/$13,100 $30 NoDD $50 NoDDDed then $1000Ded then $300$50 NoDD / $100 NoDD$50 NoDD/ $50 NoDD $30 NoDDDeductible $0/$0; Copayment $10/$40/$60 NoDDGOLD MVP GOLD 8 EPOIndividual Empl/Spouse Parent/Child(ren) Family$905.49 $1,810.98 $1,539.33 $2,580.65Embedded $4,000/$8,000 $8,000/$16,000 $40 NoDD $60 NoDDDeductible then 20% Deductible then 20% $60 NoDD / $300 NoDD$60 NoDD/ $60 NoDD $40 NoDDDeductible, $0/$0; copayment $10/$40/$60 NoDDGOLD MVP GOLD EPO 11 DISCONTINUED 2024 - current subscribers map to Gold 1Individual Empl/Spouse Parent/Child(ren) FamilySILVER MVP SILVER 2 EPOIndividual Empl/Spouse Parent/Child(ren) Family$762.60 $1,525.20 $1,296.42 $2,173.41Embedded $4,500/$9,000 $8,400/$16,800 3 PCP Visits at $0, then $35 NoDDDeductible then $60Deductible then 30%Deductible then $300 $60 NoDD / then $350Deductible then $60 /$60 NoDD35 NoDDDed. Integrated w/Medical; then $10/$45/$90SILVER MVP SILVER 3 EPO QHDHP Individual Empl/Spouse Parent/Child(ren) Family$787.90 $1,575.80 $1,339.43 $2,245.52Aggregate $2,550/$5,100 Aggregate$6,350/$12,700Deductible then $25Deductible then $50 Deductible then $500 Deductible then $250Deductible then $50/$300Deductible then $50/$50Deductible then $25Ded. Integrated w/Medical; $15/$40/$60 (preventive drugs NoDD)SILVER MVP Silver 7 EPOIndividual Empl/Spouse Parent/Child(ren) Family$805.15 $1,610.30 $1,368.76 $2,294.68Embedded $3,100/$6,200 $8,700/$17,400 $35 NoDDDeductible then $50Deductible then $750Deductible then $250$50 NoDD / Ded then $250 Deductible then $50/$50 NoDD$35 NoDD $15/$45/$90 All NoDD

BUSINESS SERVICES CORPORATION D/B/A BENEFIT CHOICES SMALL GROUP PLANS 2 of 2 - 10/30/2023 12:17 PM2024 MVP HEALTH CARE - Small Businesses ALL PLANS INCLUDE DEPENDENT CARE TO AGE 26.METAL TIER PRODUCTTIERMONTHLY RATEAggregate / EmbeddedDEDUCTIBLE (SINGLE/FAMILY)OOP MAX (SINGLE/FAMILY)OFFICE VISIT SPECIALIST VISITINPATIENT HOSPITALOUTPATIENT SURGERYURGENT CARE/ERDIAGNOSTIC RADIOLOGY LABDIABETIC SUPPLIES PRESCRIPTION DRUGSBRONZEMVP BRONZE 2 EPO EMBEDDEDIndividual Empl/Spouse Parent/Child(ren) Family$650.28 $1,300.56 $1,105.48 $1,853.30Embedded $6,150/$12,300 $8,900/$17,8003 visits at $0, Deductible then $35 Deductible then $60Deductible then 30%Deductible then $300Deductible then $60/$350Deductible then $60/ Deductible then $60Deductible then $35Ded. Integrated with Medical; Copayment $10/$40/$60BRONZEMVP BRONZE 3 EPO QHDHP EMBEDDED DISCONTINUED 2024-current subscribers map to Bronze 7Individual Empl/Spouse Parent/Child(ren) FamilyDeductible then $30Ded. Integrated w/Medical; $10/$40/$60 (preventive drugs NoDD)BRONZEMVP BRONZE 6 EPO QHDHP EMBEDDEDIndividual Empl/Spouse Parent/Child(ren) Family$701.16 $1,402.32 $1,191.97 $1,998.31Embedded $7,100/$14,200 $7,100/$14,200Deductible, then 0%Deductible, then 0%Deductible, then 0%Deductible, then 0%Deductible then 0%$0*/$0* 0%Ded. Integrated w/Medical; $0/$0/$0(preventive drugs NoDD)BRONZEMVP BRONZE 7 EPO QHDHP EMBEDDEDIndividual Empl/Spouse Parent/Child(ren) Family$670.61 $1,341.22 $1,140.04 $1,911.31Embedded $6,350/$14,200 $7,100/$14,200Deductible, then 40%Deductible, then 40%Deductible, then 40%Deductible, then 40%Deductible, then 40%$40*/$40* 40%Ded. Integrated w/Medical; $10/$40/$60 (preventive drugs NoDD)* Member amount after deductible is met. NOTE: In case of a discrepancy in the display of these plan details and rates, The carrier's actual plan details and rates prevail.AGGREGATE: For any policy with two or more members, the deductible must be met by any one or any combination of members before the plan makes payments.EMBEDDED: Each member must meet their individual deductible before plan makes payments. The individual deductible also applies to family deductible level. Once family deductible is met, plan begins payment of services for all contract members.MVP'S Wellbeing Rewards Program - Earn up to $600 per contract, per calendar year for making healthy choices: up to $200 for completing activities, $200 with Connected! Tracking, and up to $200 in reimbursements.VIRTUAL CARE SERVICES: GIA virtual care services are $0 on all plans except qualified high-deductible plans in 2022. The IRA requires members enrolled in QHDHPs to pay for virtual care services until their plan deductible is met.PEDIATRIC DENTAL COVERAGE TO AGE 19 is included with all MVP NEW York Small Group plans. Preventative services subject to $25 co-pay (deductible applies to QHDHP), routine services subject to 20% co-insurance, and major services, including medically necessary orthodontia, are subject to a 50% co-insurance.TELEMEDICINE BENEFIT - access care anywhere, anytime on your computer, tablet or smartphone with 24/7 online doctor visits. Board-certified doctors and therapists.