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:
For information about other BRI plans, see the following pages (which also are available from the Resources > Benefits menu above):
Highmark and Express Scripts 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.
98point6 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
HIGHMARK BCBS RESOURCES
EXPRESS SCRIPTS RESOURCES
98point6 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 PPO plan participants, and for all other eligible participants there is only a $5 co-pay.
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.
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 firstname.lastname@example.org or 407-930-4492 (voice and fax).