Plan Benefits and Coverage Details:

ApexBold (HMO) H9828-001Available in Cabarrus, Gaston, Iredell, Mecklenburg, Polk, Wilkes, Stanly, Stokes and Yadkin counties (North Carolina).

• Summary of Benefits
• Evidence of Coverage
• Enrollment Form

ApexEnrich (HMO) H9828-002Available in Cabarrus, Gaston, Iredell, Mecklenburg, Polk, Wilkes, Stanly, Stokes and Yadkin counties (North Carolina).

• Summary of Benefits
• Evidence of Coverage
• Enrollment Form

ApexBold (HMO) H9828-003Available in Alleghany, Alexander, Anson, Ashe, Buncombe, Burke, Catawba, Cleveland, Davidson, Davie, Forsyth, Guillford, Henderson, Lincoln, Madison, Montgomery, Randolph, Richmond, Rowan, Scotland, Surry and Union counties (North Carolina). And Chesterfield, Marlboro and York counties (South Carolina).

• Summary of Benefits
• Evidence of Coverage
• Enrollment Form

General Plan Forms and Information:

• Appointment of Representative Form
• Authorization for PHI Disclosure Form
• Pre-Enrollment Checklist
• Scope of Appointment

ApexBold (HMO) H9828-001 Available in Cabarrus, Gaston, Iredell, Mecklenburg, Polk, Wilkes, Stanly, Stokes and Yadkin counties (North Carolina).

• Summary of Benefits
• Evidence of Coverage

ApexEnrich (HMO) H9828-002 Available in Cabarrus, Gaston, Iredell, Mecklenburg, Polk, Wilkes, Stanly, Stokes and Yadkin counties (North Carolina).

• Summary of Benefits
• Evidence of Coverage

ApexBold (HMO) H9828-003 Available in Alleghany, Alexander, Anson, Ashe, Buncombe, Catawba, Cleveland, Davidson, Davie, Forsyth, Guillford, Henderson, Lincoln, Madison, Montgomery, Randolph, Richmond, Rowan, Scotland, Surry and Union counties (North Carolina). And Chesterfield, Marlboro and York counties (South Carolina).

• Summary of Benefits
• Evidence of Coverage

General Plan Forms and Information

• Appointment of Representative Form
• Authorization of PHI Disclosure Form
• Enrollment Form
• Scope of Appointment