Essential Forms for Employer Health Insurance Plans
Find commonly used MVP Health Care forms for employers, including large and small group plan documents, creditable coverage templates, and Medicare Advantage resources for New York and Vermont.
Common Forms for Employers
Find common forms, tools, and resources for large group and small group plans across New York State and Vermont.
General Employer Tools and Resources
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Plan Selection Forms
2026
- NY Vision Plan Selection Form
- VT Small Group Plans Selection Form
- VT Vision Plan Selection Form
- NY Individual Health Plan Selection Form
2025
Spending Account Forms
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- Employer Large Group Size Attestation
- Employer Large Group Size Attestation (Fillable)
- Grandfathered Plan Status Certification
- Grandfathered Plan Status Certification (Fillable)
- Independent Contractor Attestation
- Independent Contractor Attestation (Fillable)
- Large Group HMO Attestation
- Large Group HMO Attestation (Fillable)
- MVP Core Analytics
New York and Vermont Forms
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- Affidavit of Group Sponsored Coverage for Common Law Employees
- Affidavit of Group Sponsored Coverage for Common Law Employees (Fillable)
- Attestation for Eligibility For Small Group Products
- Attestation for Eligibility For Small Group Products (Fillable)
- Grandfathered Plan Status Certification
- Grandfathered Plan Status Certification (Fillable)
- Independent Contractor Attestation
- Independent Contractor Attestation (Fillable)
New York Small Group
- Enrollment/Change Form—New York Small Group HMO
- Enrollment/Change Form—New York Small Group HMO—Spanish
- Enrollment/Change Form—New York Small Group EPO/PPO
- Enrollment/Change Form—New York Small Group EPO/PPO—Spanish
- New York Small Group Application HMO (Fillable)
- New York Small Group Application EPO/PPO (Fillable)
Healthy New York
- Enrollment/Change Form—Healthy New York
- Enrollment/Change Form—Healthy New York—Spanish
- Healthy New York Small Group Application
- Healthy New York Small Group Application (Fillable)
- Healthy New York Small Group Recertification Form
- Healthy New York Small Group Recertification Form (Fillable)
Vermont Small Group
Creditable Coverage Forms
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2026
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Tools and Resources for Medicare Plans
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