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2019 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 Summary of Benefits or the EPC Medical 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.

Prescriptions dispensed for acute care (short-term) medications and initial fills of maintenance (long-term) medications may be obtained through any retail 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.

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. It is highly recommended that you take a moment and go to the ESI website at www.expressscripts.com and register; be sure to have your member ID number handy. Once registered and logged-in, you can locate a pharmacy, identify formulary and non-formulary medications to find the lowest co-pay priced medication, and even print an ID card for a family member.

If you have questions or don’t have internet access, call Express Scripts Customer Service at 800-987-5246. One of the prescription benefits specialists will be happy to assist you. For enrollment related questions, contact the EPC Administration Office at 877-578-8707. For pharmacy plan questions or support, contact Express Scripts Customer Service at 800-987- 5246.

For more information, see the Medical/Prescription Drug Plan Document below.

Premium Rates Calculator

Calculators and charts provide monthly premium rates for 2019 EPC Benefit Plans

Medical/Prescription Drug Plan Document

The 2019 Plan summary document constitutes the terms and conditions of your medical and pharmacy coverage

Medicare Supplement Plans

A Medicare Supplement benefit is designed to “supplement” coverages provided by “original” Medicare

BCBS Global Core Plan

Also known as the Gold Ex-Pat Plan, the BCBS Global Core Plan is designed for our World Outreach global workers serving overseas

Platinum

Medical Plan Summary of Benefits Coverage (SBC) Document

Gold

Medical Plan Summary of Benefits Coverage (SBC) Document

Gold HDHP

Medical Plan Summary of Benefits Coverage (SBC) Document

Silver

Medical Plan Summary of Benefits Coverage (SBC) Document

Bronze HDHP

Medical Plan Summary of Benefits Coverage (SBC) Document

Prescription Drug Plan Smart90 Fact Sheet

Smart90 provides 90-day refills of maintenance medication prescriptions via Walgreens or Express Scripts home delivery

Prescription Drug Mail Order Form

Information and instructions for our Express Scripts prescription drug home delivery program

Prescription Drug Reimbursement Form

Use this form to submit receipts for prescription drugs you have purchased at full price from a retail pharmacy

HIGHMARK RESOURCES

Highmark BCBS

Highmark Blue Cross Blue Shield’s website

Highmark Baby Blueprints

Maternity education and support program

Highmark Beat Diabetes

Lower your risk of type 2 diabetes

Highmark Blue Distinction

Hospitals proven to deliver superior results for complicated, costly procedures

Highmark Blues on Call

No-cost information and support from a health coach

Highmark Care Cost Estimator

Compare cost estimates for more than 1,600 procedures

Highmark Member Portal

Check claim status, view your explanation of benefits, locate providers, and more

Highmark Personal Wellness Coach

Connecting you to resources available through your health plan, employer, and community

Highmark Virtual ID Card

Works just like your plastic ID card

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 benefits@epc.org or 407-930-4492 (voice and fax).

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5850 T.G. Lee Blvd., Suite 510
Orlando, FL 32822
407-930-4239
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info@epc.org

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