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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:

Medical/Prescription Drug Plan Tools and Documents
Highmark BCBS Resources
Health Savings Account
Express Scripts Resources
98point6

Member Portal

www.highmarkbcbs.com

Highmark Member Services Team
866-472-0928

Member Portal

www.express-scripts.com

Express Scripts Member Service Team
800-987-5246

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

Comparison Chart

For more information on coverage levels, see the Summary of Benefits document below for the each of our Medical/Prescription Drug Plans.

Premium Rates Calculator

Calculators and charts provide the monthly premium rates for each of our 2021 EPC Benefit Plans

2021 Preventive Schedule

Planning your care: Know what you need and when you need it

Medical/Prescription Drug Plan Document

The 2021 Plan summary document constitutes the terms and conditions of your medical and prescription drug coverage

Platinum PPO

Summary of Benefits

Gold PPO

Summary of Benefits

Silver PPO

Summary of Benefits

Gold HDHP

Summary of Benefits

Bronze HDHP

Summary of Benefits

HIGHMARK BCBS RESOURCES

Member Portal Information

How the Member Portal helps you check claim status, view explanation of benefits, locate providers, and more

Member Portal

www.highmarkbcbs.com

Member Services Team
866-472-0928

App for Android

If you are viewing this page on a computer, scan the code with your smart device. If you are viewing this page on a device, tap the code.

App for Apple iOS

If you are viewing this page on a computer, scan the code with your smart device. If you are viewing this page on a device, tap the code.

Find an In-Network Doctor

Quickly and easily find in-network doctors participating in the BRI plan

Virtual ID Card

Works just like your plastic ID card

Personal Wellness Coach

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

Care Cost Estimator

Compare cost estimates for more than 1,600 procedures

Blue Distinction

Hospitals proven to deliver superior results for complicated, costly procedures

Blues on Call

No-cost information and support from a health coach

Baby Blueprints

Maternity education and support program

Beat Diabetes

Lower your risk of type 2 diabetes

Computer Vision Syndrome

Computer Vision Syndrome (CVS) can be caused by using a computer or mobile device for long periods of time.

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.

GETTING STARTED

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.

HSA RESOURCES

Gold HDHP

Medical/Prescription Drug Plan Summary of Benefits Coverage (SBC) Document

Bronze HDHP

Medical/Prescription Drug Plan Summary of Benefits Coverage (SBC) Document

HealthEquity Member Portal

Check your balance, review transactions, view insurance claims, invest in mutual funds, and more

HealthEquity Employer Portal Guide

A one-stop resource for easily managing your HSA program for your church. Organized by topic so you can use it as an introductory reference and an ongoing tool.

EXPRESS SCRIPTS RESOURCES

Member Portal

www.express-scripts.com

Member Services Team
800-987-5246

App for Android

If you are viewing this page on a computer, scan the code with your smart device. If you are viewing this page on a device, tap the code.

App for Apple iOS

If you are viewing this page on a computer, scan the code with your smart device. If you are viewing this page on a device, tap the code.

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

98POINT6

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

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