APEX-MEC/INTEGRITY
AWP Safety partners with Apex to offer a Limited Discount Plan. The Apex-Minimum Essential Coverage (MEC) plan provides certain essential health benefits and is not major medical coverage. Only employees of Integrity Corps are eligible to elect the Apex-MEC plan.
Apex-MEC Plan Highlights
These limited-benefit plan options are offered through Apex, utilizing Private Healthcare Systems (PHCS) network services. A PHCS is a Preferred Provider Organization (PPO) network that offers members a broader choice of hospitals, doctors, and facilities at negotiated rates with discounts on certain services from PHCS providers. When using a PHCS, keep in mind:
- This medical and prescription drug coverage meets the requirements of the Affordable Care Act (ACA) for providing essential health benefits, including preventive care, maternity and newborn care, prescription drugs, and more.
- This coverage is not considered major medical coverage and is typically more affordable than major medical insurance coverage under a traditional plan.
- You must seek care from a PHCS provider.
- Out-of-network providers are not covered.
The benefits illustrated below reflect in-network costs/allowances.
Limited Discount Plan – Minimum Essential Coverage (MEC) Plan (NOT MAJOR MEDICAL)
These limited benefit plan options are offered through Apex, utilizing PHCS Network Services. Discounts are available when services are received from PHCS providers. The benefits illustrated below reflect in-network costs/allowances. Out-of-network providers are not covered.
Benefit Features
| MEMBER PAYS | MEC Plus w/ Globe Life GLI |
|---|---|
| Preventive care as defined by the Affordable Care Act | Paid at 100% of the allowable charge. Some services include: routine screenings, preventive immunizations, well-women visits/screenings, and contraceptive methods. |
| Teladoc – Telemedicine 24/7 (Multilingual) | Free (unlimited) |
| Clever Health – Behavioral Health Services (Multilingual) | Free (unlimited) |
PHCS – PPO Network Services
| MEMBER PAYS | MEC Plus w/ Globe Life GLI |
|---|---|
| Office Visits: PCP Specialist |
$20 copay, max. 3 visits per plan year Network Discount |
| Emergency Room Visits (with Globe Life): Emergency Room for Sickness Emergency Room for Injury |
$50 per day, max. 2 days per plan year $150 per day, max. 2 days per plan year |
| Urgent Care | $50 copay, max. 3 visits per plan year |
Limited Indemnity Benefits
| MEMBER PAYS | MEC Plus w/ Globe Life GLI |
|---|---|
| Hospital Confinement | $500 per day, max. 10 days per plan year |
| Hospital Intensive Care Unit | $1,000 per day, max. 10 days per plan year |
| Hospital Admission | $200 per day, max. 1 day per plan year |
Limited Benefit Plan–Minimum Essential Coverage (MEC) Plan
Surgery/Anesthesia Benefits
| MEMBER PAYS | MEC Plus w/ Globe Life GLI |
|---|---|
| Inpatient Surgery | $500 per day, max. 1 day per plan year |
| Outpatient Major Surgery | $300 per day, max. 1 day per plan year |
| Outpatient Minor Surgery | $100 per day, max. 1 day per plan year |
| Anesthesia | $300 per day, max. 1 day per plan year |
Outpatient Benefits
| MEMBER PAYS | MEC Plus w/ Globe Life GLI |
|---|---|
| Outpatient Diagnostic Lab For lab test, ordered by a physician |
$25 per day, max. 3 days per plan year |
| Outpatient Diagnostic X-Ray For X-ray, ordered by a physician |
$75 per day, max. 1 day per plan year |
| Outpatient Major Diagnostic Testing For major diagnostic testing, ordered by a physician |
$250 per day, max. 1 day per plan year |
Prescription Benefits
| MEMBER PAYS | MEC Plus w/ Globe Life GLI |
|---|---|
| Tier 1 (Low Cost) / Tier 2 (Generics) / Tier 3 (Preferred) | $1 copay / 10% coinsurance / 20% coinsurance |
Find a Provider
With the Apex MEC plan, you have access to in-network care only. The PHCS and Multiplan networks are networks of medical doctors and facilities that health plans use in order to provide a broader choice of healthcare providers offering discounted services to their members. Multiplan does not offer insurance, does not administer benefit plans, and does not pay claims to the doctors or facilities in our network.
Find providers at multiplan.com/webcenter/portal/ProviderSearch > Click on Select Network > Choose PHCS > Select “Limited Benefit Plan” > Enter type of provider > Enter zip code and click the search icon.
Pharmacy benefits are administered by CitizensRx. Visit citizensrx.com or call 888.545.1120.
Apex-MEC Premiums
| Employee Contribution | Employee Only | Employee + Spouse | Employee + Children | Family |
|---|---|---|---|---|
| MEC Plus w/ Globe Life GLI | $66.50 | $187.50 | $173.50 | $314.50 |