SALA 1Complete - for groups of 3 or more
SALA is proud to offer the new 1Complete program for groups of three or more. Built on the success of original SALA Healthcare Program that put together Apex preventive care and Sedera medical cost sharing for an innovative and cost effective alternative for members.
The SALA 1Complete Solution is a fully integrated multi benefit healthcare solution for employees and their families (3 Employee Minimum Participation). The solution is a multi-provider health care strategy that supplies specific benefits from best-in-class providers on a single integrated platform. The solution provides::
- A single health care strategy providing multiple healthcare benefits.
- Restoring the relationship between a patient and physician.
- Removing the bureaucracy that exists in current plans with physicians, health care systems and insurance carriers.
- Initiate healthcare options that provide transparency on the cost of care.
- Allow members to choose any doctor, any hospital, anywhere.
- Improve the member experience.
- Lower Plan Level Costs, 50 to 60% lower in most cases.
- Lower Individual Out-of-Pocket Costs.
- One Consumer App for All Services
Learn about the SALA Healthcare Program Components:
The Apex Management Group provides the preventative and routine care component of the SALA Healthcare Program. Participants will be enrolled into the Apex Advantage MEC Plan, which complies with ACA mandated preventive services with 100% coverage for all 21 preventative services for adults, 26 services for women, and 27 services for children. (Click here to learn more about the ACA requirement)
The Apex plan is not an insurance product, but a self‐funded plan sponsored by the Small Association Leadership Alliance (SALA). It qualifies as a Minimum Essential Coverage (MEC) plan for preventative care coverage. A MEC plan must cover 100% of the Centers for Medicare & Medicaid (CMS) listed preventative and wellness benefits. The Apex plans are designed to meet your day-to-day healthcare needs.
The Apex Advantage provides 100% coverage for preventive care, copayments for small and medium cost medical expenses, and prescription coverage.
- This plan includes: 100% coverage for preventive care services
- Small co-pays for Specialists, Urgent Care, Lab, Imaging and Prescription Drugs.
- Prescription drug coverage managed by CitizensRx
PHCS Network Participation:
Before you enroll it is important to make sure your physician participates in the PHCS Network. There are slightly different networks depending on if you're in Apex HDHP Basic MEC or Apex Advantage. Use the PHCS Search Instructions to find in-network physicians and facilities. (Please note, preventive services performed at hospitals are not covered.)
To learn more about the Apex options, we recommend reviewing the following:
Individuals who use primary care are more likely to be engaged in their health, attend routine checkups, identify health issues earlier and more effectively, and better manage chronic conditions.
National studies have shown that 96% of issues for which patients traditionally turn to an urgent care facility for a primary care office visit can be diagnosed and treated from beginning to end virtually. MeMD provides remarkable and streamlined primary care. Members get the primary care services they need virtually, helping them avoid costly in-person visits.
- Unlimited Use per family
- $0 Copay
- No Deductible
- Call, Text, Video
- Rx order to your local pharmacy
- Use any time 24/7/365
- To learn more about MeMD, we recommend reviewing the following: About MeMD
The Sedera medical cost sharing model boldly challenges the insurance status quo. Through an innovative layering of healthcare services, we enable individuals and family's access to high quality healthcare that is affordable, flexible and effective.
In addition to sharing medical expenses, Sedera provides access to valuable Counseling, Medical Bill Negotiation, Telemedicine, Expert Second Opinion, and Personal Member Advisor services to all members.
All members enrolling in the SALA 1Complete Solution will be enrolled in the Sedera $1500 IUA membership. The IUA is the specified financial amount (in dollars) that members are required to bear on their own
prior to any amount that may be eligible for sharing.
To learn more about Sedera we recommend reviewing the following:
WARNING: SEDERA, INC. IS NOT AN INSURANCE COMPANY AND THE SEDERA MEDICAL COST SHARING MEMBERSHIP IS NOT ISSUED OR OFFERED BY AN INSURANCE COMPANY. WHILE EVERY EFFORT IS MADE TO MEET MEMBER'S MEDICAL NEEDS, SEDERA, INC. AND THE SEDERA MEDICAL COST SHARING COMMUNITY DO NOT GUARANTEE PAYMENT OF ANY MEDICAL EXPENSE.
Rx Valet is a complete one-stop-shop solution to paying less for high-cost prescription medications! We provide consumers a comprehensive solution, to make prescription medications available at lower prices to everyone, everywhere! Your enrollment includes five cutting-edge savings tools in one all-inclusive benefit.
- Retail pharmacy discounts that saves up to 80% off the retail rates
- Mail order for a convenient, cost effective way to save. Over 500 formulations priced at $13.95 for a 90-day supply
- International option for up to 70% savings on Brand Drugs with free shipping and auto-refill
- Prescription Assistance Plan (PAP) for those who need assistance with expensive drugs
- Plus: Patient Advocacy, Diabetic Supplies, and even Pet Medications
- To learn more about RXValet, we recommend reviewing the following: About Rx Valet
The direct.fit Dental plan utilizes the Careington Network, one of the largest national dental networks. This gives you the flexibility to find a preferred dentist at an affordable price, in your area. Provides 100% coverage of Preventive service….(check those in-network, out-of-network numbers on the slide!)
The direct.fit Vision Reimbursement Plan is designed to improve access and affordability to vision services for you and you family. No copay and $200 annual reimbursement for vision services rendered at Costco, Sam’s Club, Walmart or America’s Best Contacts and Eyeglasses.
To learn more about our Vision & Dental offer, we recommend reviewing the following: direct.fit Vision and Dental.
NOTE: The SALA 1Complete Healthcare Solution is currently unavailable in VT, WA, NY, ND, and IL
The SALA Healthcare Program and 1Complete are membership affinity programs. Products are offered and serviced by Apex Management Group, Pinnancle Peak Administrators, and Sedera for the Small Association Leadership Alliance (SALA). The Small Association Leadership Alliance is not a licensed insurance entity and does not sell insurance. Medical cost sharing is not subject to the regulatory requirements or consumer protections of your particular State’s Insurance Code or Statutes.