Are you Self-Employed, or 1099?
This exciting program offers rates much less than ACA qualified plan and allows access to see any doctor. You can enroll into this plan at anytime of the year.
NCBA Apex-PALIC Health Choice Select
The 3 key Components of the Apex-PALIC Health Choice Select solution pairs the Apex Advantage Plan with Indemnity Benefit Plans from Philadelphia American Life Insurance Company – (“PALIC”).
Component 1
Apex Advantage Plan
The Apex Advantage Plan Component satisfies the Minimum Essential Coverage requirement of the PPACA, and is designed to be utilized for preventative and day-to-day medical needs.
Component 2
PALIC Health Choice Select
The PALIC Health Choice Select component is for more serious and unforeseen healthcare needs.
Component 3 (Optional)
PALIC Optional Riders and Policies
PALIC Supplemental Benefits provide added protection for life’s unexpected expenses. Options include the highly recommended Critical Illness Policy and more. By pairing Apex and PALIC products, employers and employees can benefit from significant health care cost reductions and savings. The PALIC Component of this health care solution provides generous defined benefit payments for treatment for various sickness, injury, and professional services provided. All 3 Component choices are efficiently enrolled and administered on one convenient platform.
At the employer level these plans are available to employer groups starting at low as 4 (four) employees with Full Underwriting. Guaranteed Issue plans start with employer groups as small as 10-15 employees with a minimum of 8 participating employees participating in the plan. PALIC can supply the Employer Sponsored Enrollment Guide for further information regarding enrollment and underwriting guidelines.
At the employee level, the Apex and PALIC Health Saver Plus Select solution requires a minimum purchase of Components 1 and 2.
Component 1
Apex Advantage Plan Benefits Include:
- ACA Compliance for employers of 50 or more
- Four (4) Year “Rate Lock”
- No waiting periods
- Small Co-pays
- Coverage for Primary Care, Specialist, Urgent Care, Lab, Imaging, and Prescription Drugs
Component 2
PALIC Health Choice Select Plan Benefits Include:
- $5,000,000 Lifetime Coverage
- Three Benefit Options to choose from to fit budgets
- 1st Day (Only) Hospital Benefits Reduction (Cost Savings Option)
- Three Annual Maximum Benefit Amounts to Choose From
- Covers Inpatient and Outpatient Services
- No Deductibles for Outpatient Services
- 20 Doctors Office Visits/year – 6 can be for Chiropractic
- Covers Brand Name and Generic Prescriptions
- Freedom of Choice – Any Doctor, Any Hospital, Nationwide
- National PPO Network Available for Additional Cost Savings
- Teladoc – Free Unlimited Doctor Consultations via phone or video chat
- Karis 360 – Health Concierge Service and Bill Negotiator
- Guaranteed Renewable to Age 65
- Enhanced 24 Hour Accident Benefit with Disability Income Rider
- Critical Illness Benefit up to $50,000
Component 3
PALIC Optional Riders and Policies – Available Options Include:
- Enhanced Outpatient Benefit Rider
- Outpatient Emergency / Urgent Care Rider
- Family Term Life Insurance Rider
- Catastrophic Accident Policy
- Critical Illness Insurance Rider/Policy
- 24 Hour Accident Expense Insurance Policy
- 24 Hour Indemnity Accident Policy
Component 1:Apex Advantage Plan
The Apex Advantage Plan: for Day-to-Day Health Care Issues
Component 2: PALIC Health Choice Select
PALIC Health Choice Select – Policy Options
Hospital Indemnity Benefits – Facility Fees
Professional Services
This is a limited-benefit fixed-indemnity plan and not a major medical insurance plan. Fixed-indemnity benefits are provided for hospital confinement, specified medical, surgical and outpatient events. These benefits are paid in specific amounts and do not provide expense reimbursement for charges based on your health care provider’s bill. Fixed-indemnity insurance plans do not meet the Minimum Essential Coverage requirements under the Affordable Care Act and you may need to pay a tax penalty depending upon your income level and the cost of plans available.
Outpatient Benefits
Component 3: PALIC Optional Riders & Policies
PALIC Optional Riders & Policies
OUTPATIENT EMERGENCY/URGENT CARE RIDER: Pays an additional benefit for treatment in an emergency room or urgent care facility. Also pays an accidental death benefit if death occurs due to accidental bodily injury.
CRITICAL ILLNESS RIDER: Select from $10,000 to $50,000 to help cover out-of-pocket medical expenses and other cost associated with a covered medical illness. Critical Illness insurance is designed to ease the financial pressure by providing a lump sum cash benefit paid directly to you upon diagnosis of a covered illness. Maximum amount of Critical Illness Insurance available is $50,000 for any one person.
24 HOUR ACCIDENT EXPENSE INSURANCE POLICY: Accident Expense insurance provides you with up to $4,000 for accidental injury; up to $100,000 for an accidental death and up to $10,000 for ground or air ambulance. The accident plan also has an optional accident disability benefit and pays in addition to other insurance you may have and is guaranteed renewable to age 80.
24 HOUR INDEMNITY ACCIDENT POLICY (CA ONLY): Indemnity Accident Insurance pays a fixed benefit amount of up to $2,000 for an accidental injury. Also covers air and ground ambulance. A daily hospital confinement benefit if an injured is hospitalized for an accidental injury and a dismemberment benefit.
FAMILY TERM LIFE INSURANCE RIDER: Protect your family with inexpensive term life insurance coverage that pays a death benefit depending on age of up to $50,000 for the principle insured, $10,000 for the spouse and $3,000 on each child.
Note: Riders and Policy availability can vary by State. Check with a licensed PALIC representative for State availability and specific policy and/or rider details.
Value-added Benefits
Taking charge of your healthcare spending has never been easier! As our policyholder, many resources and value added benefits are available for you to use with your Select Plan at no additional charge.
TELADOC
The quality of care you need, in the convenience of your home! Feeling a bit under the weather? If you are feeling unwell, you can receive convenient, quality care from a large network of health professionals 24 hours a day, 365 days a year, by web, phone or mobile app. www.teladoc.com
PHCS NETWORK
An additional opportunity to save healthcare dollars! You will have access to doctors, hospitals, labs, imaging centers and home healthcare centers at discounted rates through MultiPlan’s PHCS Limited Benefit Network at no additional charge.
KARIS 360
Patient advocacy before, during and after a healthcare event! Members gain a resource and concierge-style service to help them navigate through the chaos and confusion often associated with the healthcare marketplace. This includes services such as finding providers and healthcare facilities, scheduling appointments, pricing for non-emergency surgeries, and a personal advocate to help lower the patient’s portion of medical bills to something more manageable. www.thekarisgroup.com
SCRIPTSAVE WELLRX
ScriptSave allows you to locate the lowest discounted price for your medication! At no extra cost you have access to use the prescription savings card, or app, to receive instant savings on both brand name and generic prescription medication. ScriptSave WellRX is accepted at over 62,000 pharmacies! Philadelphia American’s group number is 2242. www.scriptsave.com
SAVE BY TAKING AVANTAGE OF THE PPO NETWORK DISCOUNTS
While you are free to use any Doctor or Hospital you choose without Penalty. You have the option of accessing the MultiPlan / PHCS Limited Benefit Network to take advantage of great savings at no additional costs. You will have access to Doctors, Hospitals, Labs, Imaging Centers and Home Healthcare Centers. To find providers in your area go to www.neweralife.com and select Provider Search.
