After his family's $2.5 billion sale of Meridian Health, Jon Cotton is already back in the health care game.

Specific business and philanthropic plans are uncertain for the four other members of the Medicaid health plan's founding family. But Meridian's charismatic 40-year-old corporate president and one of the three sons of David and Shery Cotton, who founded Meridian in 1997, has already launched ApexHealth, a Grosse Pointe Farms-based Medicare Advantage managed care company. In addition, he says the family is working to structure a family foundation to handle their charitable giving.

Sean, Jon's twin brother, and Michael, 38, are taking time off and have not yet made firm business plans. Shery Cotton and David Cotton, who was chief of obstetrics and gynecology at Detroit Medical Center before founding the Medicaid HMO company under the original name of Health Plan of Michigan, have retired but plan to stay involved in charitable activities in Southeast Michigan, Jon Cotton said.

Jon Cotton was was one of Crain's top 10 Newsmakers of the Year for 2015 for helping to guide Meridian's Medicaid health plans in Michigan and Illinois to become the largest in each state.

"People said 'My God, you are not taking a vacation?' " before starting up Apex, said Jon Cotton, pausing a second as any good stand-up would do to deliver the punchline: "I did. It was the Labor Day weekend."

Cotton, a high-energy individual who along with Michael has a black belt in Taekwondo, noted he has worked at Meridian for nearly half his life.

"It's all I know," he deadpanned. "We do what competitors aren't doing. We are high-touch, member-friendly. I have huge satisfaction in what we do."

Some of that Meridian "we" is coming with Cotton.

He hired three former Meridian employees to help with his startup. Ray Pitera will be chief development officer and senior vice president, similar titles to those he held at Meridian. Danielle Devine is vice president of operations. And longtime administrative assistant Sara Terrio will be there, too.

"My wife said I needed to hire Sara or not come home," he said.

For now, Apex is in temporary digs at a former rug shop in a 900-square-foot office with one bathroom at 92 Kercheval Ave. But that will be only for about five months until renovations are completed next door at 96 Kercheval.

"My dad saw the location and cried. He said it was perfect. It was so much like his first office" in 1997, said Cotton, adding that he furnished the office with old Meridian furniture handpicked by current staff before the movers arrived.

With that staff of three, Cotton says he has more responsibilities than before. "I empty the trash can now."

The other change is his new drive time.

"I now have a 45-second commute" from his home in Grosse Pointe Farms, he said. "I am at work at 8:15 every morning, right after I drop my kids off at school."

The office amenities are of little importance yet, because it will take some time before Apex gets individual state approvals for Medicare Advantage plans in North Carolina, South Carolina, Virginia and Tennessee.

"We were looking at those states prior to the sale, so it was a natural to go there," he said. "We have done our homework. We have relationships there."

After that, Apex will need Medicare licenses from the federal Centers for Medicare and Medicaid Services, mostly likely next February, but won't start signing up members until January 2020. The family has a five-year noncompete in Michigan, Illinois, Indiana and Ohio, Cotton said.

Cotton said he is projecting modest first-year membership of 5,000 to 8,000 and a workforce of about 40 at the Grosse Pointe Farms office. He said more than a dozen more employees will be needed in the four states to work with providers.

"My dad was groundbreaking in that. Provider network development was a big thing, working with doctors, talking about quality of health care," Cotton said. "We plan to bring the same approach Dad started at Meridian."