Apex Group Plan Solution
The Apex Basic and Advantage Plan Solution is a very affordable Healthcare option with open enrollment year round (4 Employee Minimum Participation).

Apex Basic Plan and Advantage Plan Solution

The solution offers Small Co-pays, No Deductibles, Prescription Lab Services, and Drug Coverage. The plans also have the added benefit of advanced information solutions that provide participants:

  • Instant access to expert medical advice and opinion via text message
  • The ability to search locally for the best price on prescriptions
  • Search for medical procedures and prices in your local area
  • Reminders about plan updates and changes, and tips for accessing cost effective health care
  • All these services are available at a cost effective price, and a four (4) year "rate lock"

State Availability: Apex products are not available in MA, ND.

Target Hourly Rate

Apex Management Group Medical Benefits

Basic Plan Advantage Plan
Preventive Benefits – Covers all mandated Preventive benefits required by PPACA. PPO Network Services: PHCS
Note: This list will be updated from time to time and a current list of covered preventive services is available by visiting: www.Healthcare.gov
PPO Network Services: PHCS
21 Preventive Services for Adults 100% Coverage for Mandated Preventive Care Services
28 Preventive Services for Women
31 Preventive Services for Children
Telemedicine, Primary Care, Specialists and Urgent Care
Telemedicine - HealthWallet $0 Copay, unlimited use for all family members
Primary Care Office Visit $0 Copay
(Max 1 visit per calendar year)
$20 Copay
(Max 3 visits per calendar year)
Specialists Office Visit Not Covered $50 Copay
(Max 3 visits per calendar year)
Urgent Care Not Covered $50 Copay
(Max 3 visits per calendar year)
Diagnostic Lab, Imaging and Hospital, Surgical Benefits
Diagnostic X-Ray, Lab Not Covered $50 Copay by Date of Service
(Max 5 services per calendar year)
*MRI/CT Scan
*Only Base Charges covered for MRI or CT Scan. Enhanced Imaging or 3-D imaging services, not covered.
Not Covered $200 Copay
(Max 1 CT Scan or MRI per Calendar Year)
PPO Network Services: PHCS
Hospital Confinement Not Covered Not Covered
Outpatient Surgery Not Covered Not Covered
Anesthesia Not Covered Not Covered
PPO Network Services: PHCS
PPO Network Services: PHCS Not Covered Not Covered

 

Prescription Drug Benefit Options (choose one)



Citizens Rx provides formulary management services designed to offer access and cost efficiency to their members. Formulary management services offer a variety of tiered arrangements with the most cost-effective prescription drugs in preferred categories.

Learn More


Rx Valet provides multiple ways to purchase medications. Five cutting-edge savings tools, providing multiple ways to save in one, all-inclusive benefit.

Learn More

 

Contribution Schedule (Rates)

Four Year Rate Lock: Increase in years 2 through 4 cannot exceed 3% on an accumulative basis

Basic Plan Advantage Plan
EE Only $98.40 $143.00
EE Plus Child(ren) $127.80 $216.40
EE Plus Spouse $127.80 $233.50
EE Plus Family $137.80 $313.75

Above Rates include fee for Pinnacle Connect Ben Admin System: $12.50 PMPM. COBRA Administration Services, fully integrated with Pinnacle Connect: Add $2.00 PMPM.
Disclaimer: Apex Management Group Suite of Healthcare Solutions are not insurance products, but self-funded plans. Please see plan documents and SPD for full details