Group Plans Available To Individuals and Families

These three sets of plans are provided through Associations. They are administered by third party administrators and are written on a group chassis to individuals and families who qualify. Applicants must successfully answer health questions to qualify for enrollment, but there are no pre-existing condition limitations in these plans. They are regulated by ERISA and are available in all states except Washington, but the plans can be utilized in all states.

Applicants must become members of the Association for the plan they choose to become eligible to join. Currently they must apply and make the first month’s payment by the 25th of the preceding month to be eligible for enrollment the first of the following month for the Med Performance, MedAccess and MedMax plans (see the following sections for more information about these plans).

However, we highly recommend that enrollment and premium payment occur no later than the 20th of the month. Applicants must certify that if they enroll in or make payment for coverage between the 21st and 25th of the month for a coverage effective date of the first day of the following month (or if they are applying for a plan that will be paid via list bill from their employer) activation of this status in the third party administrator and prescription claims systems may be delayed by up to 10 business days.

These plans renew automatically, so as long as a plan is available it is not necessary to renew yearly as is generally required for Affordable Care Act plans. These plans are not available for residents of Washington state.

Members must enroll for one of these plans before age 65 but they may retain their plan past 65 unless they are enrolling in Medicare. Please contact us at 786-970-0740 for information about group plans that can be purchased AFTER age 65 by those who are not eligible for Medicare.)

Med Performance Major Medical PPO Plans

Click here to learn more about the four different Med Performance plans (3500 Classic, 5000 Classic, 5000 HSA, and 7350 Value). Premiums are age-banded based on the age of the primary enrollee (for spouses this can be the younger spouse). There are four age bands (18-29; 30-39; 40-49; 50-59; and 60-64) and four premium tiers [single; couple; subscriber and child(ren); and family; note: the subscriber is mentioned as the employee because these plans are offered on a group chassis]. There is a $75 application fee to join one of the plans.

The premium on an age-banded plan adjusts the first of the month following the month in which the primary member reaches the minimum age of the next age band. (For example, a person with a birthday of 8/3/1967 enrolls in Med Performance as of 6/1/2026, which puts that person in the age 50-59 age band. This person will be charged the premium for the age 60-64 age band as of 9/1/2027. Note: a person who changes age bands after the third month of his or her year of enrollment will not be charged the premium for the next age band until January 1 of the following year.)

These are PPO plans that utilize Cigna’s largest PPO Network. Non- and lowly subsidized individuals who qualify will find they’ll save significantly by purchasing one of these plans instead of a subsidized ACA plan with similar benefits and networks. Click the Info tab under the name listing each of the four plans to see the plan brochure (the brochure includes information on premiums), the Schedule of Benefits, and the plan’s list of covered medications. Click here for instructions to look up in-network providers (the network is the same for all four plans).

All applicants must be able to answer all these questions NO in order to be eligible to join one of these plans, but if a person can successfully answer the health questions there are no pre-existing condition limitations.

These are very comprehensive and competively priced plans. These plans meet requirements for plans that qualify as ACA plans in states e.g., California that impose penalties for not enrolling in health insurance.

MedAccess and MedMax Plans

MedAccess offers a choice of two plans (MVP Basic and MVP Pro), and both plans utilize the First Health Network (which is owned by Aetna). These are EPO plans that don’t require referrals but also don’t provide out-of-network coverage. Monthly premiums are age-banded (18-45 and 46-64) and vary by family size and whether the enrollee chooses the Basic or Pro version.

Applicants must answer NO to just one health question in order to qualify. There is a one-year waiting period to be eligible for maternity benefits offered by the MVP Pro version of the plan; otherwise, there are no pre-existing condition limitations for any covered benefits for those who successfully answer the applicable health questions. Because there is just one health question that must be answered NO to qualify, individuals who may not be eligible for other group plans on an individual chassis may qualify to enroll in this plan, but it is important to insure that prospective participants understand the coverage offered by this plan to make sure the plan meets their requirements.

The five MedMax plans are all the same except each has a different deductible ranging from $250 to $1500. These plans use the same First Health network that is used for the MedAccess plans. Premiums are banded into four different age bands: 18-29; 30-44; 45-54; and 55-64 and also vary by family size.

Applicants must answer all of these health questions NO in order to be eligible to enroll. Once enrolled, there are no pre-existing condition limitations for any covered benefits.

Please contact us at 786-970-0740 (Cell) for more information, pricing, and/or enrollment in any of these plans or any other group health plans that we may be able to offer to individuals or families.