This plan offers greater flexibility of health care providers similar to the PPO plan. However, there are no deductibles or co-insurance. This excellent coverage is achieved in exchange for a higher monthly premium.
Health insurance EPO No-deductible health insurance with more provider options
Employee health insurance
Service coverage and costs
All employee health insurance plans provide one annual preventive care visit with your primary care provider at $0 co-pay within specified networks.
For other common visits, this is what you’ll pay with EPO.
$15
UK HEALTHCARE PRIMARY CARE CO-PAY
$25
ANTHEM PRIMARY CARE CO-PAY
$40
UK HEALTHCARE SPECIALIST CO-PAY
$50
ANTHEM SPECIALIST CO-PAY
Coverage highlights
| EPO health plan | Maximums | UK HealthCare | Anthem |
|---|---|---|---|
| Lifetime Maximum Benefit | Unlimited | Unlimited | |
| Out-of-Pocket Amount | Annual deductible | $0/member; $0/family | $0/member; $0/family |
| Medical out-of-pocket maximum | $4,000/member; $8,000/family | $4,000/member; $8,000/family | |
| Prescription out-of-pocket maximum | $5,000/member; $10,000/family | $5,000/member; $10,000/family |
Employee monthly rates
| Coverage level | Total monthly cost* | UK pays | You pay |
|---|---|---|---|
| Employee only | $836 | $577 | $259 |
| Employee + children | $1,254 | $774 | $480 |
| Employee + spouse | $1,671 | $954 | $717 |
| Employee + family | $2,089 | $1,131 | $958 |
| Coverage level | Total monthly cost* | UK pays | You pay |
|---|---|---|---|
| Employee only | $916 | $614 | $302 |
| Employee + children | $1,354 | $823 | $531 |
| Employee + spouse | $1,804 | $1,015 | $789 |
| Employee + family | $2,256 | $1,203 | $1,053 |
* Regular part-time and temporary employees (less than 0.75 FTE or work less than an average of 30 hours per week in a 12-month measurement period), who are not eligible for the UK credit toward the costs of coverage, pay this rate.
Coverage for common services
| EPO health plan | Service | UK HealthCare | Anthem |
|---|---|---|---|
| Preventive Care (Coverage under preventive care category depends on age, symptoms and diagnosis) | Routine immunizations (through age 18) | $0 | $0 |
| Routine mammogram and Pap smears | $0 | $0 | |
| Routine child care (through age 18) | $0 | $0 | |
| Routine adult physical exam (19 years and above) | $0 | $0 | |
| Physician Services | Primary care office visits (excludes certain diagnostic lab tests and X-ray) | $15 co-pay per visit | $25 co-pay per visit |
| Specialist office visits (excludes certain diagnostic lab tests and X-ray) | $40 co-pay per visit | $50 co-pay per visit | |
| Lab tests and X-rays | Same as office visit co-pay | Same as office visit co-pay | |
| Allergy injections | $10 co-pay per visit | $10 co-pay per visit | |
| Inpatient services | $0 | $0 | |
| Outpatient surgery and diagnostic tests | $0 | $0 | |
| Physician visits to emergency room | $0 | $0 | |
| Hospital Services | Inpatient care (semi-private room and board, nursing care, ICU) | $300 co-pay per admission (limited to two co-pays per plan year) | $500 co-pay per admission (limited to two co-pays per plan year) |
| Outpatient surgery | $100 co-pay per procedure | $150 co-pay per procedure | |
| Outpatient diagnostic testing (high costs - MRI, MRA, CT, PET scans) | $75 co-pay per test | $100 co-pay per test | |
| Outpatient nonsurgical care | $0 | $0 | |
| Outpatient tests, lab and X-ray | $0 | $0 | |
| Ancillary services | $0 | $0 | |
| Organ transplant | $0 | $0 | |
| Emergent Medical Services | Emergency room | $100 co-pay plus 20% co-insurance (waived if admitted) | $100 co-pay plus 20% co-insurance (waived if admitted) |
| Urgent treatment center | N/A | $50 co-pay per primary care visit | |
| Ambulance services | $100 co-pay | $100 co-pay | |
| Other Medical Services | Skilled nursing facility (up to 100 days/plan year) | $0 | $0 |
| Home health care (up to 100 visits/plan year) and hospice services | $0 | $0 | |
| Hospice services | $0 | $0 | |
| Durable medical equipment | 20% co-insurance up to $500 member cost per year | 20% co-insurance up to $500 member cost per year | |
| Chiropractic care*, physical, speech, music, hydrotherapy, occupational and acupuncture therapy (limited to 45 visits per plan year, combined) *Maximum 20 visits for chiropractic care | $20 co-pay/visit | $30 co-pay/visit | |
| Mental Health and Substance Abuse | Inpatient | $300 co-pay per admission | $500 co-pay per admission |
| Outpatient | $40 co-pay per visit | $50 co-pay per visit |
PROVIDER NETWORK UK HealthCare and Anthem
EPO plan members have access to any UK HealthCare provider or in-network Anthem providers.
Eligibility and enrollment
Welcome to UK! You can sign up for benefits depending on your FTE. Enroll in your benefits quickly in myUK.
If you experience a major life change outside of open enrollment you can also make changes to your insurance. This is known as a qualifying event. You'll need to fill out and submit a form within 30 days.
Our Benefits Open Enrollment happens every year so you can make changes. Changes can be made in myUK, or with paper forms.
Please use the Retiree Benefits Enrollment form and return to Scovell Hall.
How to change your benefits
Signing up as a new employee or making changes during Benefits Open Enrollment can be done in myUK, or with paper forms.
Making changes at other times of the year due to a qualifying event are completed using our Benefits Enrollment Form.
Paper forms can be emailed, faxed or brought to Scovell Hall.