Understanding Your Health Benefits at AmeriPharma

Understanding Your Health Benefits at AmeriPharma

We offer a range of health, dental, and vision benefits designed to support employees across different states. This article outlines eligibility, enrollment timelines, where to find plan information, and the benefit options available to you.


Eligibility for Health Benefits

Full-Time Employees

Full-time employees become eligible for health benefits on the 1st day of the month following their initial hire date.

For example:
If your start date is March 15, your benefits eligibility date would be April 1.

Part-Time Employees Who Are Becoming Full-Time Employees

Eligibility is determined based on a three-month average of hours worked and requires a review request from the employee.

  • Once an employee averages 30 hours per week over a three-month period, they become eligible for health benefits.

  • Once an employee averages 36 hours per week over a three-month period, they become eligible for dental, vision, and PTO benefits.

To initiate the eligibility review, the employee must submit a request. Hours are then evaluated based on the three-month measurement period to determine qualification.


How to Access Your Benefits Information

You can review and manage your health benefits through Paychex by selecting “My Benefits.”

If you do not see the “My Benefits” tab in Paychex, scroll down and click “Submit a ticket” and HR will reach out to you as soon as possible.


Enrollment Deadlines and Important Timing

General Enrollment Deadlines

  • Benefit elections must be completed before your eligibility

  • Any enrollments or changes requested after your eligibility date must wait until open enrollment, unless you experience a qualifying life event

  • Open enrollment takes place in June

  • Health benefit premiums are deducted bi-weekly from your paycheck

Qualifying Life Event (QLE)

Benefit elections generally cannot be changed outside of your initial eligibility window or annual open enrollment.

However, changes may be permitted if you experience a qualifying life event, such as marriage, divorce, birth or adoption of a child, or loss of other coverage. In these cases, changes must be submitted within the required timeframe following the qualifying event. Please click here for a list of QLE's.

Also, you can find this helpful video on QLE's below!


In order to make changes to your current benefits enrollment, you’ll work directly with our benefits administrator through Paychex Flex & Flock. To request changes, you must submit a qualifying life event (QLE).

To submit a qualifying life event request, follow these steps:
  1. Log in to your Paychex Flex account.
  2. Click on “My Benefits” in the left menu bar.
  3. Click “View Complete Enrollment” in the top right of your Benefits page.
  4. Click the green “Life Event” button to submit a life event.
  5. Fill out the prompted fields and upload any supporting documentation recommended.
  6. Select “Save & Proceed” to submit your life event request.
Once completed, your request will be evaluated by our benefits administrator. If your submission does qualify, you will be granted special enrollment outside of the annual open enrollment period. Please note that there is typically a limited window (usually 60 days from the qualifying life event date) to re-enroll and make changes to your benefits.

If your request is declined, this means the event does not qualify for special enrollment. In this case, you will not be able to make changes to your benefits until the company-wide open enrollment period

Non-Qualifying Life Event

Employees who do not make benefit elections within their initial eligibility window may still request enrollment after their eligibility date, even if no qualifying life event has occurred.

Please note the following conditions apply:

  • Coverage will be effective retroactive to the employee’s original eligibility date

  • Payroll deductions will be backdated to reflect premiums owed since that eligibility date

  • Backdated deductions may be taken from one or more future paychecks to account for missed premiums

Because late enrollment can result in significant payroll adjustments, employees are strongly encouraged to complete benefit elections on time or contact HR with any questions prior to their eligibility date.


Benefits Plan Documents

Employees can review detailed plan information by accessing the appropriate benefits brochure, linked here.

These brochures include coverage details, costs, and plan comparisons.


Available Benefit Plans

California Employees

Employees in California have access to:

Medical Plans

  • Select HMO

  • Traditional HMO

  • Classic PPO

Dental and Vision Options

  • DHMO Dental Plan

  • Guardian Dental PPO Plans:

    • Low $1,000 annual maximum option

    • High $2,000 annual maximum option

  • One voluntary vision plan

Employees in Other States

Employees outside of California have access to:

  • Anthem Medical Plan:

    • Classic PPO with $1,500 deductible

  • One voluntary vision PPO plan

  • One dental plan


Need Help?

If you have questions about eligibility, enrollment, or accessing your benefits platforms, scroll down and click “Submit a ticket” and HR will reach out to you as soon as possible.


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