Automotive Parts & Service Association of Illinois

Group Medical Expense Reimbursement Plan

What it is:

In order to help with the rising cost of health care, the APSA of Illinois Insurance Trust Committee established the “APSA of Illinois Group Medical Expense Reimbursement Plan” (AGMERP) for the benefit of members and their employees.  This program was designed to provide reimbursements to qualified participants for eligible medical expenses not paid by their health insurance provider.

How it works:

In order to be eligible, a member must:

  • Be a regular or affiliate member in good standing of APSA of Illinois.
  • Participate in a health program written through an APSA of Illinois endorsed agent.
  • Submit a completed application form.

The Plan will reimburse participants for certain expenses which are covered but not paid by any insurance policy. Eligible expenses are limited to the following medical expenses (excluding dental and vision expenses):

  • deductibles,
  • co-pays,
  • co-insurance, and
  • co-pays for prescription cards.

Employees of Regular members of APSA of Illinois are eligible for annual reimbursements up to $300 if they have family coverage or $150 if they have single coverage.

Employees of Affiliate members of APSA of Illinois are eligible for annual reimbursements up to $200 if they have family coverage or $100 if they have single coverage.

For more information on membership, click here. (link back to membership page)

Due to the design of this program, funds will ultimately diminish, which makes this a limited time membership benefit.

For more details contact us at 217-786-2850 or email us at insurance@apsail.com.

If you are already a plan participant, visit our “frequently asked questions”, or contact:  Administrative Services, Inc. at agmerp@asi-tpa.com or at (217) 498-8450.

The information provided above is intended to summarize certain plan provisions in as accurate a manner as possible.  However, in the event of any inconsistency between this information and the plan documents, the language of the plan documents will govern.

PDF iconView list of Health Insurance Agents.

Frequently Asked Questions

How do I participate in the APSA of Illinois Group Medical Expense Reimbursement Program?

Your company must be a Regular or Affiliate member in good standing of APSA of Illinois, and participate in a Health Insurance Program written through an APSA of Illinois Endorsed Agent.  Completion and acceptance of a one-page application is required.

What is considered an eligible expense for reimbursement under the program?

Eligible expenses are limited to the following medical expenses (excluding dental and vision expenses unless covered by the basic health plan):

  1. Deductibles
  2. co-pays
  3. co-insurance,
  4. co-pays for prescription cards.

Expenses listed as “Not Covered” by the health insurance plan are also not eligible for reimbursement through AGMERP.

How and where do I submit a claim?

Your employer should be able to provide you with a claim form for completion, if not contact Administrative Services, Inc. at 217-498-8450. When filing a claim, you must submit a completed claim form along with your insurance company’s Explanation of Benefits and itemized statements from your service provider (Prescription co-pays do not normally require an Explanation of Benefits). Be sure that both you and your employer sign the claim form, and that your employer completes the “Health Coverage Box”.  Claims should be submitted to agmerp@asi-tpa.com, by fax to 217-498-8481 or by mail to:

APSA of Illinois /Administrative Services, Inc.
PO Box 590
Rochester, IL   62563

I sent in a claim two weeks ago and have yet to receive a check. How long does processing take, and whom should I call to check on my claim status?

Claims that are received by the 25th of each month are processed at the beginning of the next calendar month, and are typically received by participating member companies by the 20th of that month. To check on your claim status contact Administrative Services, Inc. at agmerp@asi-tpa.com or at (217) 498-8450.

When should I file my claim?

Claims must be filed no later than 60 days after the close of the calendar year in which the expense is incurred. In other words, if you have a doctor appointment in January 2009, you have until February 28, 2010 to file the claim

How do I know what I’ve already claimed? How can I find out how much benefit I have left??

It is always good to keep a copy of any claims you submit. Use these copies for reference when checking on your claim status or appealing denials. You can also use them to make sure an expense is not submitted twice and to track how much benefit you have received. Also, each check comes with a stub that shows your maximum benefit, the amount you have claimed and the amount you have received.

The information provided above is intended to summarize certain plan provisions in as accurate a manner as possible.  However, in the event of any inconsistency between this information and the plan documents, the language of the plan documents will govern.