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EPC MEDICARE SUPPLEMENT PLANS

A Medicare Supplement benefit is designed to “supplement” coverages provided by “original” Medicare. That means if you are enrolled in original Medicare A & B coverages, Medicare pays your eligible claims first as your “primary payor,” then the Medicare Supplement coverage pays an additional portion of remaining costs as the secondary payor.

IMPORTANT NOTE: If you are age 65 or over and elect to decline the EPC Medicare Supplement Plan, you will be ineligible for coverage under the EPC Medical Plan in the future.

Employees of Smaller Churches (<20 Employees)
Employees of Larger Church (20+ Employees)
Requirements for Employers

MEDICARE SUPPLEMENT PLAN SUMMARIES

Medicare Silver Supplement Plan

This chart outlines how the EPC Medicare Silver Supplement Plan pays for specific services after medical claims are processed through Medicare as the primary payor and prescription drug claims are processed through EPC BRI as the primary payor.

Individual Monthly Premium: $364.35

Medicare Gold Supplement Plan

This chart outlines how the EPC Medicare Gold Supplement Plan pays for specific services after medical claims are processed through Medicare as the primary payor and prescription drug claims are processed through EPC BRI as the primary payor.

Individual Monthly Premium: $408.77

Medicare Platinum Supplement Plan

This chart outlines how the EPC Medicare Platinum Supplement Plan pays for specific services after medical claims are processed through Medicare as the primary payor and prescription drug claims are processed through EPC BRI as the primary payor.

Individual Monthly Premium: $560.55

EMPLOYEES OF SMALLER CHURCHES (<20 EMPLOYEES)

If you are an employee of an EPC church that has less than 20 employees, then you and your Church Administrator should evaluate and determine which Medicare coverage is best for you. Because the costs and benefit levels provided by Medicare Supplement providers and Medicare Advantage providers vary widely throughout the country, you and your church should look carefully at the options available under original Medicare A, B, and D coupled with the EPC Medicare Supplement coverage, and compare that to the costs of other available “Medigap” Medicare Supplement Policies.

You also should look at the costs and coverages (including network doctors and covered medications) of various Medicare Advantage Plans in your area and find the package that provides the best coverages for you. Because these other Medicare supplements and Advantage programs receive federal subsidies, in some situations they may be more economical than the EPC Medicare Supplement Plans.

Please note that if you elect the EPC Medicare Plan (or another Medicare Supplement Plan), your dependents under age 65 are eligible to continue to be covered under their current EPC Medical Plan. You will need to complete a Medicare Supplement Enrollment Form to select dependent only coverage. If your dependent has reached age 65 and he or she also qualifies for Medicare Supplement coverage, you will need to complete a Medicare Supplement Enrollment Form to select Medicare Supplement coverage for you and your spouse.

PLAN REQUIREMENTS

Step 1:
Evaluate and determine which Medicare Supplement coverage you will enroll in (Silver, Gold, or Platinum) and verify with your church administrator or authorized church representative.

Step 2:
Your church administrator will complete the Small Employer Exemption Form and send to the BRI Admin Office. This form confirms the small employer exemption status of the church. In addition, CMS uses this form to authorize Medicare as your primary coverage.

Step 3:
Complete the Medicare Supplement Enrollment Form for the appropriate level of coverage (Silver, Gold, or Platinum), sign, and return to the BRI Admin Office at epc@cdsadmin.com or fax to 412-224-4465.

Step 4:
When you receive your Medicare card, send a copy to the EPC Admin Office at epc@cdsadmin.com or fax to 412-224-4465. You will not be fully enrolled until the EPC Admin Office receives both the completed Medicare Supplement Enrollment Form and a copy of your Medicare card.

EMPLOYEES OF LARGER CHURCHES (20+ EMPLOYEES)

Medicare Coordination of Benefit Rules require Large Employers that provide medical benefits to continue providing the Primary coverage to Medicare eligible full-time employees. Your church’s Benefit Administrator can tell you if your church is obligated to provide benefits to Medicare eligible employees or covered spouses aged 65 or older. If that is your situation, your church-provided benefit will continue and be your primary coverage if you remain a full-time employee (at least 30 hours per week). There will be no change to your current EPC Medical and Prescription Drug Plan coverage.

Even if you are employed by a large employer, you should still enroll in Medicare A when you become eligible for Medicare because Medicare may pay benefits for you as a secondary payor to the extent that the employer provided benefits are less than otherwise would be provided by Medicare.

PLAN REQUIREMENTS

Your Church Administrator will complete the Large Employer Certification Form (LEE) and email to the BRI Admin Office at epc@cdsadmin.com or fax to 412-224-4465. This form confirms the Large Employer status of your Church so that your church-provided benefit will continue and be your primary coverage if you remain a full-time employee (at least 30 hours per week). To be fully compliant, this form must be submitted prior to the participant turning 65 years of age.

REQUIREMENT FOR EMPLOYERS

The Church Administrator needs to complete the appropriate certification form and send to the BRI Admin Office at epc@cdsadmin.com or fax to 412-224-4465. This form must be submitted prior to the employee turning 65 years of age to be fully compliant.

 

Small Employer Certification Form

This form confirms the Small Employer status of the church.

Large Employer Certification Form

This form confirms the Large Employer status of the church.

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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