FAQs

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Apex is legalled incorporated in MA therefore, the BCBS of MA HMO plan is only available in our region. We looked at comparable low-cost plans across the U.S. for all employee to access (the plans are referred to as an EPO) and it was costlier than the current plans with less value. For this reason, we added the 3rd plan which offers an HSA for an alternative choice for all teammates outside of the New England area.

If you are a higher income earner and you are looking to reduce taxable income, the HSA is a great option. Using funds from an HSA can offer a triple tax benefit.
HSA contributions are deducted from taxable income, so your investment is with pre-tax dollars
HSA funds are tax-deferred, meaning the money may only be taxed upon withdrawal in retirement
HSA withdrawals will not incur taxes if the money is used for qualifying medical expenses. If you are a lower income earner, the HSA can still be a great option.
The HSA's premium offers the least amount of money taken from your paycheck, you will still receive a contribution towards your premium from Apex, and you are still protecting your health.
This option is likely best suited for individuals who do not frequent the doctor's office due to this PPO being a high-deductible health plan (HDHP).

**Health Reimbursement Arrangement (HRA) - You will be automatically enrolled on the HRA if you select the HMO Blue NE $4000 or PPO $4000**
The HRA plan is administered by Health Equity
Claims processed by BCBS (medical insurance carrier) are recieved directly from providers or pharmacies
BCBS processes the claims and sends Health Equity the details on your member out of pocket responsibility
Health Equity automatically processes the claim based on the HRA funding and sends you a reimbursement check; you can select Pay to Provider if you haven't paid the invoice yet
**Health Savings Account (HSA) - You are eligible to contribute to an HSA if you enroll on the PPO HSA Saver $4000 plan ONLY**
The HSA is administered by Health Equity
You can contribute to an HSA on a pre-tax basis up to the IRS limits for an individual and family based on what tier you are enrolled (Employee only, EE+SP, EE+CH or Family)
On top of your own contributions, Apex will contribute on your behalf:
$800 if you are on an individual plan
$1,600 if you are on a family plan (a family plan is 2 or more covered members)
**Flexible Spending Account (FSA) - You are eligible to elect an FSA if you enroll on the HMO Blue NE $4000 or PPO $4000 - You cannot elect an FSA if you enroll on the PPO HSA Saver plan.**
The FSA is administered by Health Equity
You can contribute on a pre-tax basis up to the IRS limits
As FSA allows you to set aside money to pay for qualified medical and pharmacy expenses
You can also use FSA dollars to pay for a wide variety of other eligible expenses under IRS code section 213(d)
Visit the FSAStore.com for a list of eligible expenses
**Limited Purpose Flexible Spending Account (LPFSA) - You are eligible to elect the LPFSA if you enroll on the PPO HSA Saver $4000 plan**
The LPFSA is administered by Health Equity
A LPFSA allow you to set aside money on a pre-tax basis to use for eligible dental and vision expenses
This account is designed to be used in conjunction with a Health Savings Account and will help save more on taxes while managing healthcare costs
For more information visit Health Equity LPFSA page

If you already have an HSA card then yes, you will receive a second card for your LPFSA account. If you are new to both, you will receive one card that can be used for either account. The card has SMART technology that can determine what the card is being used for and pull from the proper account. You can check your balance on your HealthEquity webpage at any time. Health Equity Member Account

You cannot adjust your contribution after Open Enrollment. You may adjust them any time during Open Enrollment.

HSA contributions made by you and Apex will continue to build as you contribute and stay in your plan unless you use them.

Defer to full list of higher-cost sharing hospitals here. If it's not outlined as a lower cost-sharing hospital, assume that the satellite companies will be considered high-cost.
⚠️ **Broken reference.** The word "**here**" is styled as a link but **carries no hyperlink target in the source document**. The website build must supply the BCBS higher-cost-sharing hospital list URL, or the answer is unusable.

Health Equity is managing all 5 spending accounts
Flexible Spending Account (FSA)
Dependent Care Spending Account (DCFSA)
Limited Purpose Spending Account (LPFSA)
Health Reimbursement Account (HRA)
Health Savings Account (HSA)

You can only enroll in benefits outside of open enrollment if you have a qualifying life event. Examples of qualifying life events include having a new baby, the death of a spouse or child, loss of coverage, getting divorced, marriage, moving to a new location, or gaining U.S. citizenship. If you need coverage and fall under the criteria to meet a qualifying life event, you must let People Team know within 30 days of change.

Yes, this is the time to make those changes unless you have a qualifying life event where a dependent gains other coverage.

You will need to complete the Retaining Coverage for a Disabled Child Form and return to jeff@apexbenefitsonline.com for upload to Blue Cross Blue Shield in the year your dependent turns 26 or at Open Enrollment if they are already 26. Blue Cross Blue Shield will be the primary benefit plan and will coordinate with your states' plan (if any) for coverage. Usually, the State plan will not pay for services already covered in full. Some states requier the dependent to be on a group sponsored plan and will either provide additionla coverage for copays/deductibles or premium assistance.
⚠️ **The form link points to a PRIVATE People Team SharePoint library** and includes a session token in the URL. **Employees will not be able to open it from a public website.** The form must be re-hosted, or the answer changed to "request the form from jeff@apexbenefitsonline.com."
*Typos preserved: "some states **requier**", "**additionla** coverage".*

Unfortunately, realizing you need benefits will not qualify as a life event.

No. The FSA is a front-loaded debit card, so it can't be changed once an amount has been chosen and added to the card during open enrollment.

No, you cannot purchase regular sunglasses. If you have a prescription you can purchase prescription sunglasses up to the benefit amount. You will need to make sure that you have your annual vision exam and that the provider takes BlueCross Insurance. If you still want regular sunglasses check out the Blue365 deals for discounts on popular brands.
⚠️ **Replace the Bing redirect with the direct link `https://www.blue365deals.com/BCBSMA/`.** Bing tracking URLs expire and look untrustworthy.

PillarRx is used for specialty medications. If you are prescribed an eligible prescription, PillarRX will reach out to you. You can get your prescriptions through CVS but, through PillarRx they will be at a much lower cost.
*PillarRx is not available under the PPO Saver HSA plan.

AHealthyMe will connect to almost all smart devices-it pairs with the app. Apple Watch is among those.

Yes, it is and the cost for the actual Peloton bike would be covered. You and your covered family members can be reimbursed up to $150.00 for virtual/online membership, subscription, program, or class that provides cardiovascular and strength-training using a digital platform; or for home fitness equipment. You can request this reimbursement each calendar year.

Initial Clinical Assessments from Licensed care advocate, available 24/7. After the assessment, the mental health professional will direct the member to the appropriate form of care.
Short-term Counseling: Sessions will help employees address acute issues and are available virtually. They may also use this time to direct employees to additional resources, like substance abuse support groups, or give long-term counseling referrals if needed
Child and elder care referral: Provide resources and support that can help meet the variety of needs that arise when caring for a child or aging loved one.
Legal Consultation: Free 30-minute legal consult (either over the phone or face-to-face) to obtain advice and resources for various legal issues. If the employee would like to continue working with that lawyer, they can do so at an additional cost.
Financial Consultation: Unlimited free telephonic consultations with a financial specialist to help manage budgets, address debt, and more. If something more specialized is needed, the financial specialist will make a referral.
ID theft support: Identity recovery professionals can provide telephonic consultations and help create an action plan if an employee experiences identity theft.
Convenience Referrals: Specialists provide referrals for home improvement, pet care, car repair, travel, cleaning services and more!