APEX MEC & Beazley GLI Frequently Asked Questions

Overview of the APEX MEC & Beazley GLI Solution

What are the best target industries for selling this health care solution?

Why should Employers consider the Apex MEC & Beazley GLI?

The Apex MEC & Beazley GLI solution is our most cost effective plan offering(s).  The solution is ideal for organizations who have a lower wage based employee staff. For example:

  • $8 to $20 per hour
  • Full or part-time employees
  • Seasonal, or 1099 staff, nationwide

The Apex MEC & Beazley GLI  solution should be considered by employers who want to maximize the available health care benefits package at the lowest possible price available.

Why choose the Apex Suite of MEC Products?

The Apex MEC Suite of Products are designed to expand the benefit above what is mandated by the ACA. In particular, the MEC Plus Advantage Plan offers three (3) Primary Care visits and three (3) Specialist visits; Diagnostic; Urgent Care and a six (6) tier prescription drug card program through our partner WellDyneRx. 

How does a group Limited Indemnity Policy work?

The Group Limited Indemnity policy (also referred to as a GLI policy) is designed to complement an employer’s group plan by providing fixed benefits employees can use to pay out-of-pocket costs for certain medical services. Depending on the plan options selected, covered services may include hospitalization, surgeries, physician’s office visits, diagnostic tests, prescription drugs, and ER visits for sickness or injury among others.

Each benefit option pays a fixed benefit amount for a specific number of days per year. The policy may be offered employer-funded, voluntary (employee-paid) or a combination of the two. It is available to employees and their dependents. Coverage is offered on a guaranteed issue basis with no medical underwriting needed.

General FAQ's Regarding the APEX MEC & Beazley GLI Solution

Is there an employee minimum with the Apex MEC & Beazley GLI offering?

It depends on the product or product combination that is utilized. utilizing Apec MEC products only.

If only Apex MEC products are being utilized there is a four (4) employee minimum.

When an Apex plan is used in tandem with the Beazley GLI there is a five (5) employee minimum.  The five employee minimum in this case is a Beazley Insurance Company, Inc.requirement.  No exceptions.

 Participation in all plans is completely voluntary with no underwriting.

Do the Apex plans have a Physician Network to choose from? 

Yes, the plans provide access to Preferred Health Care Services (PHCS),one of the largest physician networks in the country.  PHCS is owned by MultiPlan, Inc. and has over 900,000 physicians nationwide.  The Apex plans do not provide coverage for out-of-network services.

What other benefits are included with the Apex MEC & Beazly GLI Solution?

The Apex MEC & Beazley GLI  solution includes Teladoc.  Teladoc is a national network of U.S. board-certified physicians and pediatricians that lets you resolve your routine medical issues, on-demand 24/7, via phone or online video consultations from wherever you happen to be.  Teladoc Doctors can prescribe medical treatment for a wide range of conditions right over the phone or through a mobile app.  To learn more about the benefits of Teladoc go to https://www.teladoc.com/

Is this plan ACA (Affordable Care Act) compliant?

Yes. The Apex Suite of MEC products comply with all applicable rules and regulations Pertaining to Penalty A of the ACA.  .  See the compliance opinion letter under the "About" tab on this website.

Are Apex Group Plan Solutions fully-insured or self-insured?

The Apex Group Plan Solutions are self-insured. Apex Management Group offers, through a self-funded model, a four (4) year rate lock at a static premium level. However, Apex reserves the right to increase pricing on an annual basis no greater than 3% based on an individual client identified “loss ratio.”

Can all 4 plans be offered to an employer?

No, only 2 (two) plans can be offered per employer.

Are preventative services covered?

Yes. Covered are all mandated Preventative benefits required by the PPACA.

  • All 21 Preventative Services for Adults
  • All 28 Preventative Services for Women
  • All 31 Preventative Services for Children

A complete list is available at www.healthcare.gov/center/regulations/prevention.html

Are COBRA services included in Apex plans.

Yes, Cobra services are included with the Apex Management Group plans?

Is there a rate cap on the Apex plans and the Beazley GLI?

Apex Management Group offers, through a self-funded model, a four (4) year rate lock at a static premium level. However, Apex reserves the right to increase pricing on an annual basis no greater than 3% based on an individual client identified “loss ratio.”

The Beazley GLI Plan provides a 2 year rate guarantee.

When is payment due and what is required for eligibility?

Eligibility is determined by the payroll feed delivered to our TPA on or before the 25th of each month.  Payment is due by the 15th of the month.

One of your offerings pairs the Apex Advantage Plan with a Group Limited Indemnity Insurance (GLI) offering.  What is the benefit of GLI and why should it be considered?

Group Limited Indemnity insurance helps employees guard against the financial risks associated with paying for medical services, enabling them to fill gaps and protect their income and assets. Interest in these products continues to grow, as employers continue to introduce cost savings measures into their benefit programs, and as their employees are increasingly responsible for funding their own growing out-of-pocket expenses.

Group Limited Indemnity Insurance can greatly offset the need for an individual to deplete their savings or file for bankruptcy following a major medical event.