American Medical Plan

Employee must submit a completed health enrollment form or declination form no later than 30 days after employee’s start date.


Health Insurance Information

Benefits

Medical Monthly Pricing

MEC PLUS MEC Enhanced Limited Day MVP (minimum rates)
Employee $99.00 $219.00 $298.00 $349.00
Employee + Spouse $163.00 $436.00 $656.00 $638.00
Employee + Child(ren) $144.00 $409.00 $537.00 $629.00
Family $209.00 $599.00 $895.00 $979.00

Medical Weekly Pricing

MEC PLUS MEC Enhanced Limited Day
Employee $24.75 $54.75 $74.50
Employee + Spouse $40.75 $109.00 $164.00
Employee + Child(ren) $36.00 $102.25 $134.25
Family $52.25 $149.75 $223.75

Group Insurance Plans FAQ:
Important Information

  1. How do I know if I am eligible to join your group health plan?

    All full-time employees (averaging 30 or more hours/week) are eligible to join.

  2. What do you need from me?

    ALL full-time employees must submit a completed enrollment form or declination form through the myTime employee portal.

  3. When will my health coverage start if I started employment before 12/31/18?

    Coverage will be effective 1/1/19.

  4. When will my health coverage start if I started employment on or after 1/1/19?

    Your coverage will be effective on the first of the month following a waiting period of 60 days after your start date.

  5. When will my dental coverage start if I started employment before 12/31/18?

    Coverage will be effective 1/1/19.

  6. When will my dental coverage start if I started employment on or after 1/1/19?

    Your coverage will be effective on the first of the month following a waiting period of 30 days after your start date.

  7. How will my health premium be deducted from my payroll if I started employment before 12/31/18?

    We will deduct your premium on a pre-tax basis through weekly payroll deductions on the first four payrolls of each month. Deductions will start one month prior to your effective date since the plan requires that all monthly premiums be paid in advance. Your weekly deductions will begin the first payroll period of December provided we receive your enrollment form before 12/1/18. If we received your enrollment form in December 2018, payroll deductions will be adjusted for the month of December to cover the monthly premium. Should you work less than 4 weeks in any month, your weekly premium may be adjusted in order to cover your full month’s premium. Overpaid premiums will be reimbursed should your assignment end.

  8. How will my health premium be deducted from my payroll if I started employment on or after 1/1/19?

    We will deduct your premium on a pre-tax basis through weekly payroll deductions on the first four payrolls of each month. Should you work less than 4 weeks in any month, your weekly premium may be adjusted in order to cover your full month’s premium. Overpaid premiums will be reimbursed should your assignment end.

  9. What if I start Part-Time and my hours change to Full-Time?

    If your part-time status changes to an average of 30 hours per week or more at any time during your employment, and you are interested in our group insurance plan, you may join by applying within 30 days of your change in status. Your effective date will be the first day of the following month. If you miss this deadline you may still join the plan during our open enrollment period at the end of the year.

  10. Can I cancel my health coverage?

    Once enrolled, you cannot cancel your coverage unless you experience a qualifying event such as recently acquiring other coverage and changes in your family size (marriage, divorce, or birth of a child). You must provide proof of the life-changing event within 30 days of that event.

  11. Can I add a dependent to my health plan?

    If you gain a new dependent through birth, adoption, or marriage, you may enroll the new dependent at that time. You must provide proof of the life changing event within 30 days of that event.

  12. Can I enroll in health coverage at a later date if I experience a life-changing event?

    Yes, you may enroll if you have a qualifying event such as marriage, divorce, or the birth of a child provided you enroll within 30 days of the qualifying event. If you are covered under another plan but that coverage is lost, you can enroll in our group health plan within 30 days of losing the other coverage.

  13. What happens if my employment ends?

    If your employment ends, your insurance will be discontinued at the end of the month. You may elect to continue your coverage through COBRA.

  14. Where do I find provider information?

    To locate a specific provider within the PHCS Multiplan Network visit www.multiplan.com.

  15. How do I check if my prescriptions are covered?

    Refer to the Drug Formulary for a list of prescriptions covered through the OptumRX network.

  16. What are my plan options and what do they cover?

    Refer to the Benefit Handbook for information.

    Brief Description of the Health plans:

    MEC PLUS** – Offers basic benefits that include three annual primary care office visits, one annual urgent care visit, and prescription coverage. There is no hospitalization or outpatient facility coverage.

    MEC ENHANCED** – includes the minimum essential coverage of the MEC plan with additional benefits including prescription coverage, primary care, specialist visits, diagnostic X-Ray and lab, imaging (CT/Pet Scan and MRI), emergency room, and urgent care.

    LIMITED DAY MEDICAL PLAN** – Benefits include daily in-hospital benefits, hospital services, ambulance, surgery, anesthesia, maternity, home health care, mental health, substance abuse, prescription coverage, primary care, specialist visits, diagnostic x-ray and lab, imaging (CT/Pet Scan and MRI), emergency room, and urgent care. There are day limit caps on certain services.

    MVP** – High Deductible and high premium health plan. Requires completion of a health questionnaire and a $7,150 deductible must be met before any services are covered.

  17. What is the cost for Delta Dental?

    Employee = $39.39/month. Employee + 1 Dependent = $77.92/month. Employee + 2 or more Dependents = $120.75/month. There is a $1,000 calendar year maximum and $50 calendar year deductible per person. Refer to the Delta Dental Information packet for more information. Coverage is effective on the first of the month following a 30 day waiting period after your start date. Deductions start on the first pay period after coverage is effective.

  18. Can I select Delta Dental or Indemnity without selecting a MEC health plan?

    Yes.

  19. What is the cost for each of these plans?

    Refer to the Pricing Comparison Table.

  20. Who do I contact if I have any questions?

    If you have any questions, please contact our insurance team at 562-284-5333 or email customerservice@americanmedicalplan.com.