The exclusive provider organization (EPO) offers comprehensive coverage for care from network providers only, at a lower monthly cost than the PPO. The EPO does not cover out-of-network care.
Key features of the EPO include the following.
Employers may choose to offer the EPO to ministers of the Word and Sacrament and employees who are regularly scheduled to work at least 20 hours a week. There is no work-hour requirement for ministers in self-employed validated service to participate in the EPO.
The EPO is not available to those in Pastor's Participation.
For medical coverage under menu options, employers may offer either the PPO, the EPO, or the HDHP, any two options, or all three. The employer must contribute at least 50 percent of the cost of Member-only coverage in the lowest-cost option offered — regardless of which option or coverage level the employee elects.
Employees enrolled in menu options may be required to pay
Employees enrolled in the EPO have access to the Blue Cross Blue Shield (BCBS) network of physicians, hospitals, and other healthcare providers. The EPO requires use of network physicians and hospitals to access
The EPO also provides resources to improve well-being.
Services provided by out-of-network providers are not covered.
For those enrolled in the Medical Plan, the preventive care benefit covers 100 percent of the plan allowance for eligible preventive screenings and immunizations with a network provider and is not subject to a deductible.
Prescription drug benefits are automatically included with all medical options. Benefits are administered by OptumRx, which offers a national network of participating pharmacies, including a mail-order pharmacy, and maintains a formulary of preferred prescription medications.