Know Your Medical Plan

Apex is a Self Funded Group

Apex has a self-funded group health plan where Apex assumes the financial risk associated with providing health care benefits to you. Rather than paying fixed premiums to an insurance company, Apex pays for medical claims out of pocket as they are incurred.


Managing Joe’s Type 2 Diabetes
Joe is going to the physician, receiving diagnostic blood tests, needing prescription drugs, and using a Glucose monitor.
The total cost of all these services is $7,250
Copayments (office visits, Rx
drugs and blood test)
Coinsurance $200$5,790
Limits and Exclusions $60n/a
What Joe would pay$1,460What Apex would pay$5,790

Joe would still have $7,250 to pay before he reaches his maximum out of pocket responsibility for the year.