2021 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 more BRI information, see the following pages (which also are available from the Resources > Benefits menu above):
2021 Medical/Prescription Drug Plans
2021 Dental Plans
2021 Vision Plan
2021 Life/AD&D/LTD Insurance
Other 2021 Benefit Plans
2021 Wellness Program
Medicare Enrollment Planning
Church Administrator Resources
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
HEALTH SAVINGS ACCOUNT
Your 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 Plan. By selecting an HSA-qualified plan, you are eligible to contribute tax-free money into a health savings account (HSA). Your HSA funds can then be used tax-free to pay for qualified medical expenses. In addition, your HSA contributions earn tax-free interest and carry over from year-to-year, even if you change jobs or retire.
Your HSA contributions earn tax-free interest and carry over from year-to-year, even if you change jobs or retire. Just like the funds you contribute, interest earned on your HSA balance is not taxed.
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.
WHY SHOULD YOU CONSIDER AN HDHP PLAN?
If you enroll in the Gold HDHP Plan and meet certain criteria, 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.
• Both plans must comply with the IRS annual limits.
• Use your HDHP funds to pay for your deductible and other out-of-pocket costs under the medical plan.
• Tax advantages.
• 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 aren’t penalized for non-qualified medical expenses (though normal income tax still applies). You may also continue to withdraw money for qualified health expenses tax-free.
IS THE GOLD HDHP PLAN RIGHT FOR YOU?
If you want a tax advantaged account to save for current and future health expenses and want to take a more active role in your health care decisions, the Gold HDHP plan might be right for you. Because of the tax advantages, the IRS has rules you must follow to be eligible for a HSA. If you are considering the Gold HDHP plan, be sure to familiarize yourself with the regulations. The IRS does not permit you to contribute to a HSA if:
• You have other first-dollar health coverage, such as coverage through your spouse (including a regular Health Flexible Spending Account plan).
• You are enrolled in Medicare.
• You were claimed as a dependent on someone else’s tax return.
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.
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 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.
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).