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MEDICAL/PHARMACY PLAN

The EPC Medical Plan is a self-funded program that offers medical and pharmaceutical coverage to EPC ministers and eligible employees. The EPC provides these plans, not simply because medical coverage is wise, but because as Presbyterians we believe we have a mutual obligation toward one another.

The plan benefits and oversight belong entirely to the EPC. At the same time, the EPC uses two third-party administrators (TPA) to administer all aspects of the Medical and Pharmaceutical Plan and process claims according to the plan provisions.

Use these quick links to go to the appropriate section:

For information about other BRI plans, see the following pages (which are also available from the Resources > Benefits menu above):

About Benefits
Life, AD&D, and Disability Plans
Retirement Plan
Additional Benefits
Documents, Forms, and Notices
Church Administrator Resources

MEDICAL PLANS

Our TPA for Medical claims is Highmark Blue Cross Blue Shield. Through Highmark, EPC participants gain access to the Blue Card Preferred Provider Organization (PPO).

For our World Outreach global workers serving overseas, we encourage you to become familiar with the Blue Cross Blue Shield Global Core website at www.bcbsglobalcore.com.

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.

For immediate medical plan help, participants should call Highmark Customer Service at (866) 472-0928. This number also is on the back of your Medical Insurance Card. Highmark Customer Service should have the information necessary to answer your questions.

Need a new ID card for your Highmark BCBS Insurance? Highmark now offers a virtual ID card, for easy access from any computer or mobile device, and it works just like your plastic ID card. Click here for instructions on how to access your virtual ID card.

PHARMACY BENEFITS

Express Scripts is our provider to support your pharmaceutical needs. Pharmacists are available 24/7 to assist you, and prescriptions can be ordered for home delivery or through your local pharmacy.

New for 2018: We are changing the delivery method of maintenance drugs this year with the Express Scripts Smart90 program. This allows for maintenance drugs to be delivered via mail order or at your local Walgreens. Click here for more information about the Smart90 program.

Click here for instructions for Express Scripts home delivery
Click here for the mail order form (or you can use your local pharmacy)
Click here for the Express Scripts prescription drug reimbursement form

Visit www.express-scripts.com to locate a pharmacy, price a medication, or identify medications preferred by the EPC Plan.

To have the best access to your benefits, enroll at www.express-scripts.com/activate. Activation is easy! Be sure you have your new member ID number handy. New ID cards also can be printed once you have activated your account online. 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.

Click here for an FAQ sheet that answers many common questions about the Express Scripts program.

MEDICAL PREMIUM RATES

The monthly premium rates for the 2018 medical insurance, including dental, vision, and life/AD&D/LTD for each of the EPC plans (Platinum, Gold, Gold HSA, and Silver) for Employee, Employee + Spouse, Employee + Child(ren), and Employee + Family can be found at www.epc.org/healthrate2018.

MAKING CHANGES TO YOUR COVERAGE

This brief (less than 2 minutes) video outlines the three situations in which you can change your insurance coverage.
Making Changes to Your Benefits Video

MEDICAL/PHARMACY PLAN DOCUMENTS

MEDICAL PLAN SUMMARY

The Medical Plan summary constitutes the terms and conditions of your medical and pharmacy coverage. Click here to download the 2018 Plan summary document in pdf format.

SUMMARY OF BENEFITS AND COVERAGE (SBC) DOCUMENTS

Click on the appropriate Plan option below to download the SBC in pdf format.

2018 Platinum
2018 Gold
2018 Gold HDHP (also known as HSA)
2018 Silver

Click here for information from the United States Department of Labor about SBC compliance regulations.

PREVENTIVE SCHEDULE

Click here to download the most recent EPC Medical Plan Preventive Schedule in pdf format.

GOLD HSA (HEALTH SAVINGS ACCOUNT) OPTION

Click here for information about the Gold HSA Plan, our high-deductible health plan/health savings account (HDHP/HSA) option.

Click here for a handy quickstart guide to starting an HSA.

NOTICE OF PRIVACY PRACTICE

Click here to download the most recent Notice of Privacy Practice in pdf format.

PRESCRIPTION PLAN MAIL ORDER INFORMATION

Click here for information about our Prescription Plan mail order service.

CREDITABLE COVERAGE LETTER

Click here to download the Creditable Coverage Letter regarding prescription drug coverage and Medicare.

MEDICAL/PHARMACY PLAN FORMS

BENEFITS ENROLLMENT/CHANGE FORM

Click here to download the EPC Benefits Enrollment/Change Form to enroll new participants into the Medical, Life, Long-Term Disability, Dental, and Vision plans. For insurance(s), the date of eligibility depends on whether the employee is currently insured:

For a new hire transferring from another Plan, coverage will commence the day following termination of coverage from their previous plan.
For a new hire not transferring from another plan, EPC insurance benefits will begin on the first day of the month following the date of hire.
If you are a new employee to the EPC, contact your church administrator to learn what EPC benefits are offered from the options available.

BENEFITS PREMIUM PAYMENT COUPON

Click here to download the payment coupon for Medical, Life Insurance, and Long-Term Disability insurance premiums.

BENEFITS TERMINATION REPORT

Click here to download the termination report, necessary to remove a participant from the EPC Benefits Plans.

HSA AGREEMENT—EXCEPTION DOCUMENT (OPT-OUT)

Click here to download the HSA Agreement—Exception document to opt out of the HSA Plan. Complete and return by email at epc@cdsadmin.com or fax to 412-224-4465.

QUALIFYING LIFE EVENT/FAMILY CHANGES

A Qualified Life Event is a change in your family status or employment that affects your benefits eligibility. Examples include marriage; birth or adoption; divorce or separation; a dependent child aging out of benefits at age 26; gain or loss of a spouse’s health coverage; or a spouse’s employer offering benefits with a different Open Enrollment period.

If you experience a Qualified Life Event, you must notify the EPC Benefits Administration Office and request benefit changes within 30 days of the event. Click here to download the EPC Benefits Enrollment/Change Form.

ADDRESS AND/OR CONTACT INFORMATION UPDATE FORM

Click here to download the form required to make any changes to your address or other contact information that we have on file.

CHURCH BENEFITS ELECTION FORM

Church administrators: Click here to download the form required to select those benefits you will offer to your staff. The EPC Administration Office must have this completed form on file for employees of your church to enroll in the EPC Benefit Plans.

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).

Office of the General Assembly
5850 T.G. Lee Blvd., Suite 510
Orlando, FL 32822
407-930-4239
407-930-4247 (fax)
info@epc.org

OGA Staff Contacts