Health insurance
EPO
No-deductible health insurance with more provider options
Consider if: You anticipate many or highly specialized health care needs.
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.
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 | $916 | $614 | $302 |
| Employee + children | $1,354 | $823 | $531 |
| Employee + spouse | $1,804 | $1,015 | $789 |
| Employee + family | $2,256 | $1,203 | $1,053 |
| Coverage level | Total monthly cost* | UK pays | You pay |
|---|---|---|---|
| Employee only | $1,083 | $736 | $347 |
| Employee + children | $1,627 | $986 | $641 |
| Employee + spouse | $2,170 | $1,216 | $954 |
| Employee + family | $2,715 | $1,442 | $1,273 |
* 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.