2020 MEDICAL/PRESCRIPTION DRUG PLANS

EPC Benefit Resources, Inc., provides medical insurance coverage through Highmark Blue Cross Blue Shield. EPC Medical Plan participants have access to more than 96 percent of hospitals and 95 percent of doctors and specialists contracted through the Blue Card Preferred Provider Organization (PPO).

A Preferred Provider Organization, or PPO, offers two levels of benefits. You receive the highest level of benefits if you are provided services from a provider in the PPO network, often called In-Network. If you receive services from a provider who is not in the PPO network, often called Out-of-Network, this will be at a reduced benefit. There is no requirement to select a Primary Care Physician (PCP) to coordinate your care, but please be aware of the reduced benefit when using an Out-of-Network provider. Please refer to the appropriate Summary of Benefits document for your Plan or the Medical/Prescription Drug Plan Document for more information on coverage levels.

When you enroll in the Medical Plan, you will be enrolled in the Prescription Drug Plan, which is administered by Express Scripts.

To receive the highest level of benefits, prescription drugs must be obtained from a Pharmacy in their national pharmacy network or directly via the Express Scripts Mail Service or Specialty Pharmacy.  Prescriptions dispensed for acute care (short-term) medications and initial fills of maintenance (long-term) medications may be obtained through an in-network pharmacy for up to a 30-day supply. Short-term drugs include antibiotics and other medications that you take for short periods of time. Long-term drugs, also called maintenance medications, are those you take on an ongoing basis, such as drugs that treat high blood pressure, cholesterol or chronic diseases. Maintenance medications are only available under the Smart90 program.

For those using Specialty Medications that require focused care and monitoring to maximize effectiveness of treatment, BRI has contracted with Accredo, an Express Scripts specialty pharmacy with more than 25 years of experience in the field. Accredo provides comprehensive local clinical services and 24/7 personalized support and education to patients navigating complex health issues through pharmaceutical therapy.

For more information on the BRI Prescription Drug Plan see Appendix 8 of the Medical/Prescription Drug Plan Document. You can use these quicklinks to navigate to the appropriate section of this page:

Medical/Prescription Drug Plan Tools and Documents
Highmark BCBS Resources
Express Scripts Resources
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