Managed Health Plan Employee Benefits
The Additional Benefits Employees Receive
$0 Copay for Primary Care / Specialists / Urgent Care Visits
- The Plan pays 100% of the employees’ office visit charges (in the PHCS network) with a $0 copay. (Employee Only)
Unlimited Prescription Coverage
- Wholesale pricing for over 2,900 prescription medications. (Employee plus Family)
Unlimited Telemedicine and Mental Health $0 Copay
- No copay or cost 24/7/365. (Employee plus Family)
100% Preventative Care $0 Copay (MEC)
- Minimum Essential Coverage pays 100% of services required by the Patient Protection and Affordable Care Act through PHCS network. (Employee Only)
ManagedHealthPERX
- Provides discounts for dental, vision, hearing, labs, imaging, chiropractic services, diabetic supplies and additional prescription discounts. (Employee plus Family)
ManagedHealthPERX
Dental > Save 20-40%
- Cleanings, X-rays, crowns, root canals and fillings, orthodontics, periodontics
- Humana Dental - over 160,000 dental locations
Chiropractic Care > Save 30-50%
- X-rays, diagnostic services and treatments at thousands of chiropractors nationwide
Hearing Aids
- Retail Hearing Care by Amplifon
Vision > Save 10-60%
- Glasses, contacts, laser surgery and exams
- Save at LensCrafters, Pearle Vision, Visionworks, JCPenny, Target and more
Lab Testing
- Direct access to major clinical laboratories nationwide on typical lab work
RX Discounts
- Most prescriptions included at 60,000 retail locations
Diagnostic Imaging > Save 10%
- MRI & CT scans nationwide
- Discounts available on ultrasound, x-rays and more
Diabetic Supplies > Save 10-50%
- Diabetic testing supplies and a free glucose monitor with the first order
ACA Minimal Essential Coverage
Employer Mandate
The Affordable Care Act (ACA, AKA Obamacare) was signed into law by President Barack Obama on March 23, 2010. The ACA's major provisions went into force in 2014 and the Employer Mandate fully went into effect in 2016.
The Employer Mandate requires employers with 50 or more full-time employees to offer Minimum Essential Coverage (MEC) health insurance or pay penalties. Under the ACA, an employee is considered full-time when they work 30 (not 40 hours) per week.
The Managed Health Plan qualifies as a MEC plan and satisfies the Minimum Essential Coverage requirement. It is the perfect solution for employers who are currently or will be subjected to penalties.
Enrollment
Additional Information
Implementation of the plan can happen at any time, not just during the employer’s annual enrollment period, requiring minimal effort from HR.
Employees are automatically enrolled in the plan as long as there is a positive monetary impact for the employee. It would be considered a negative impact if enrollment in the plan resulted in a reduction of net pay for the employee. In those instances (extremely rare), the employee would have to opt in.
A census is done that illustrates the impact for each individual employee and for the employer.
