Essential Information - what to know and who to call

Essential Information - what to know and who to call

Thank you for enrolling in the SALA Healthcare Program provided through your membership organization.  As a reminder, the program is not insurance but a self-funded Association Sponsored plan from eBenefits and Medical Cost Sharing through Sedera.

Below are a few helpful reminders on how the program works!

  • eBenefits Summit and Essential:
    • You will receive your eBenefits card in the mail the first week of the month your coverage starts.  If you haven’t received your card within two weeks or need a new card, please email hpsupport@smallassociations.org.
    • The third-party administrator (TPA) for eBenefits is ARM.  For any questions on claims and related, you can contact them at 800-392-1770.
    • To use your eBenefits plan, you must see a doctor or facility that is in the network.  Directions on the network can be found here.
    • In most cases, routine preventative care performed at hospitals will be denied coverage.  
    • eBenefits focuses on your preventive care with some ongoing care and a prescription option.  eBenefits does not provide coverage for anything outside of this.  Please see the plan documents emailed to you after you enrolled.   
    • Please note, if you have enrolled in just an eBenefits plan and did NOT add Sedera or have comparable coverage in another insurance product, you are at financial risk.  In the case of significant medical needs such as unexpected illness, accidents, or hospitalization you are fully responsible for all related costs.
  • Sedera:
    • You will receive a separate welcome email form Sedera.
    • As a reminder, you do not receive a card with Sedera.  Sedera is Medical Cost Sharing and all members are cash pay patients.  Please review the Sedera video here.  
    • To view details on Sedera, medical cost sharing, pre-existing condition restrictions and similar, please view the videos available here.
    • Please review the complete Sedera guidelines found here.
    • Sedera is medical cost sharing for the larger, more significant medical needs.  You must have Sedera to share the larger medical needs.  eBenefits does not provide any coverage as noted above.
    • 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.
    • Phone:  855.973.3372
  • RCI (Dental):
    • You will receive your RCI card in the mail the first week of the month your coverage starts.
    • Their web site is https://www.regionalcare.com/
    • Need to speak to someone?  Please call:  (800) 795-7772 - Main Number/Customer Service
    • To find participating Dentists, please call 800-513-7177 #7 or www.Aetna.com/Dental.
  • Please email hpsupport@smallassociations.org if you need help with your account information including:
    • Address, phone, or email changes.
    • Adding or removing dependents.
    • Changing bank information.
    • Annual changes such as IUA level changes.
    • Or questions about changing age bands in Sedera.
  • Important Dates:
    • To add/remove dependents, change bank accounts, or cancel your program, all requests must be received by the 15th of the month to be processed before the 1st of the following month. 

 



    • Related Articles

    • General Information for SALA Healthcare Program

      Interested in learning about the SALA Healthcare Program? The best place to start is by viewing our overview video: https://youtu.be/ymOv5xDyymg The first component of the healthcare program is preventive care through eBenefits. While it is an ...
    • Where should claims for eBenefits plans be submitted?

      Plan Name: SALA Summit or Essential Plan Employee ID or Subscriber ID: This is your Employee ID listed on your card Group: 10503 Claims Mailing Address: ALTRISK PO BOX 21873 EAGAN MN 55121 Claims Phone Number: 800-392-1770 If needed: EDI 63240
    • How to find a provider for eBenefits Summit and Essential Plans

      If you are enrolled in the eBenefits Summit product: Visit: https://www.multiplan.com/webcenter/portal/ProviderSearch Click on "Select Network" Select "PHCS" Select "Practitioner and Ancillary" Check "Remember my network" You can now use the search ...
    • What to do in the case of an urgent medical event

      If you know you are facing an urgent medical event, immediately seek the appropriate care. In the past, emergency rooms were the main place people knew to access urgent care. Now, in almost any town across the country, there are urgent care ...
    • 2022 Changes to Apex Products

      On April 1, 2022 there will be some significant changes to the Apex Advantage and Apex Basic MEC products including the addition of a virtual primary care benefit and a robust mobile app that brings all the program components together in a convenient ...