2021 MEDICAL/PRESCRIPTION DRUG PLANS
EPC Benefit Resources, Inc., offers five medical benefit plans that vary in richness from platinum to bronze levels, and include traditional and high-deductible plan options. This allows EPC churches and ministries to select plans that meet their health care commitment to their pastors and staff while working within their budget constraints. It is important to note that the EPC has established its own plans with customized coverages, so the program rates charged will never support procedures that are not ethically consistent with our values as Christians. Our traditional plans include Platinum, Gold, and Silver PPO Plans, and we offer Gold- and Bronze-level High-Deductible Health Plans (HDHP) that allow for use of Health Savings Accounts (HSAs).
All five plans utilize the broadest unrestricted national networks available through our plan administrators. These networks cover approximately 95% of all hospitals, doctors, specialists, and medical practitioners nationally and almost 100% of pharmacies. It is always to your benefit to select in-network service providers, whether it is a family doctor, specialist, hospital, lab, or an administration clinic. You can confirm that your provider is in-network simply by calling them, asking when you present your ID card, or by going to the medical or prescription program provider links provided below to see if the doctor, hospital, clinic, pharmacy, etc. is listed. If you select an out-of-network provider your benefit level will be reduced and you may see balance billing from a provider.
There is no requirement in any of our Plans to select a Primary Care Physician (PCP) to coordinate your care. Prescription drug coverage is automatically included when you enroll in a Medical Plan. All plans include wellness programs, 24/7 virtual doctor visits through telemedicine, and special assistance programs to support those with chronic or serious medical conditions, or who encounter medical emergencies. 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.
Under the prescription benefit it is likewise important that you use an in-network pharmacy whenever you are filling a doctor’s prescription order. For users of longer-term supplies (90 day) of maintenance medicines you will receive the lowest co-pays by when utilizing a pharmacy in our administrator’s “Smart 90” network or their mail order home delivery service. For high-cost, specialty medication users, participants are directed to specialty pharmacies where pharmacists and clinicians will provide advice on usage and administration procedures for the medication. For our members utilizing such costly medications, the EPC offers a special benefit that covers some—and in many cases, all—of the co-pay costs. For more information on the EPC’s Prescription Drug Plan, see Appendix 7 of the Medical/Prescription Drug Plan Document or your individual Plan’s summary of benefits.
You can use these quicklinks to navigate to the appropriate section of this page:
Medical/Prescription Drug Plan Tools and Documents
BRI Medical Benefit Resources
BRI Prescription Drug Benefit Resources
Virtual Primary Care
High-Deductible Health Plans (HDHP) and Health Savings Accounts (HSA)
Health Savings Accounts Resources
For more BRI information, see the following pages (which also are available from the Resources > Benefits menu above):
Medical Plans FAQs
Prescription Drug Benefits
Life and Disability Insurance
Other Benefit Programs
Church Administrator Resources
2021 Medical/Prescription Drug Plans
BRI’s Medical and Prescription Drug Benefit Plan administrators have convenient apps through which you can access your Plan benefits and other handy tools. To download the apps to your smart device:
• If you are viewing this page on a computer: Scan the appropriate QR Code (Android or iOS) with your device’s camera or scanning app.
• If you are viewing this page on your smart device: Tap the QR Code.
BRI’s Virtual Primary Care administrator provides app-based primary care physician visits, on-demand 24/7, from any location via text messaging using your mobile phone or smart device. Click or tap here and enter your mobile number where directed; the app download link will be sent to your phone.
MEDICAL/PRESCRIPTION DRUG PLAN TOOLS AND DOCUMENTS
BRI MEDICAL BENEFIT RESOURCES
BRI PRESCRIPTION DRUG BENEFIT RESOURCES
BRI VIRTUAL PRIMARY CARE
BRI provides Virtual Primary Care through our administrator, 98point6. This service provides primary care physician visits, on-demand 24/7, from any location via text messaging using your mobile phone or smart device. Visits with 98Point6 physicians are available to employees and dependents ages 1 and older enrolled in any of BRI’s Medical/Prescription Drug, Dental, Vision, or Life Insurance and Disability benefit plan. Each text-based visit is available at no cost to EPC plan participants.
The EPC has already confirmed Plan participants’ eligibility for 98Point6. Simply download the app on your smart device and register using the name on any of your EPC Benefit Plan insurance cards. You will have immediate access to the service if a medical question or health condition arises.
Click here for more information on 98point6.
HIGH-DEDUCTIBLE PLANS AND HEALTH SAVING ACCOUNTS
IS A HIGH-DEDUCTIBLE HEALTH PLAN RIGHT FOR YOU?
If you enroll in the Gold HDHP or Bronze HDHP and are not yet Medicare eligible, you are eligible for a Health Savings Account (HSA). An HSA is a special, tax-advantaged savings account that allows you to pay for your qualified health expenses.
• Under the EPC Gold HDHP plan, the church contributes $1,000 for individuals and $2,000 for families annually to the HSA.
• Under the EPC Bronze HDHP plan, the church contribution amount is up to the employer’s discretion.
• In both cases you may make additional contributions to your HSA through payroll withholdings within certain IRS annual limits.
• You do not pay taxes on amounts withheld from your pay or on interest earned in your account.
• Use your HSA funds to pay for your deductible and other out-of-pocket costs under the medical plan.
• Your money rolls over year after year, so you build savings.
• It’s portable—the money stays with you even if you change jobs or retire.
• At age 65, you can use your funds for any expense. You may continue to withdraw money for qualified health expenses tax-free. You aren’t penalized if used for non-qualified medical expenses, but you will need to pay normal income tax.
You should carefully evaluate the coverages provided by a HDHP before enrolling, because there is always a large up-front deductible before the plan starts paying benefits. Thus the name: “High Deductible Health Plan.” If you are generally healthy—and stay healthy—there is an opportunity to build up a substantial income-tax-free savings in your HSA that can be used in the future to cover out-of-pocket medical and other health related costs. Being enrolled in an HDHP and having more of your own personal money at stake, you will want to take a more active role in your healthcare decisions because there is a wide range of fees charged for the same procedures and services depending on the doctor and facility chosen. If you have a chronic condition or expect to be incurring regular medical expenses, it is likely in your best interests to enroll in a traditional plan if you have not yet built up an HSA balance.
HEALTH SAVINGS ACCOUNTS
A Health Savings Account (HSA) is a tax-advantaged medical savings plan that is an integral part of the EPC’s federally qualified, High Deductible Health Plans (HDHP). By selecting an HSA-qualified HDHP plan, you are eligible to contribute tax-free money into a health savings account (HSA). Your HSA funds can then be used to pay for qualified medical expenses. The money in the account is yours, and the balance earns tax-free interest and carries over from year-to-year, even if you change jobs or retire. The EPC does not charge a fee to our HSA account holders for your account administration.
You can use a tax-free health account for a wide variety of expenses:
• Deductibles, copays, and coinsurance.
• Medically necessary expenses not covered by your health plan.
• Prescription drugs.
• Over-the-counter (OTC) drugs prescribed by your doctor.
• Some drugstore items, such as diabetic supplies and first aid.
• Dental and vision care services.
• Certain types of medical equipment.
• Other eligible expenses as designated by the IRS.
For more information on HSA federal regulations, visit www.irs.gov/publications/p502.
GETTING STARTED WITH A HEALTH SAVINGS ACCOUNT
If you are new to HSAs, follow these steps to optimize your account and put you on the pathway to building health savings.
Step 1: Log on
Sign in to the member portal by visiting www.my.healthequity.com If it is your first time logging in, select ‘Create user name and password’ and follow the step-by-step process to verify your account. Once you are logged in, complete the following:
• Add a beneficiary to ensure your HSA benefits your loved ones in the event of your death.
• Elect to receive eStatements to avoid a monthly statement fee.
• Navigate the portal and familiarize yourself with its features and capabilities. For a comprehensive portal guide, visit www.healthequity.com/learn/hsa/member-guide/member-portal.
Step 2: Activate your debit card
Once your HSA is opened, you will receive a member welcome kit including a HealthEquity Visa® Health Account Card. Activation instructions are included in the envelope. You can also speak to one of our account mentors to activate your card and receive additional insight into your account. For more information, go to Healthequity.com, login to your member portal and explore the various member resources, or call 866-346-5800.
HEALTH SAVINGS ACCOUNTS RESOURCES
Information provided in this web site does not constitute legally binding advice. EPC benefits are subject to the provisions of the Medical Plan and Retirement Plan documents available on this web site or in print from EPC Benefit Resources, Inc. (BRI), 5850 T.G. Lee Blvd., Suite 510, Orlando FL 32822. For more information, contact BRI at email@example.com or 407-930-4492 (voice and fax).