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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.

EPO Plan Booklet PDF
Summary of coverage and benefits PDF

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 $3,000/member; $6,000/family $3,000/member; $6,000/family
  Prescription out-of-pocket maximum $4,900/member; $9,800/family $4,900/member; $9,800/family

Employee monthly rates

2021-2022 EPO
Coverage level Total monthly cost* UK pays You pay
Employee only $812 $564 $248
Employee + children $1,218 $752 $466
Employee + spouse $1,624 $927 $697
Employee + family $2,030 $1,098 $932
2022-2023 EPO
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

* 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 (waved if admitted) $100 co-pay (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

Your first 30 days

Welcome to UK! You can sign up for benefits depending on your FTE. Enroll in your benefits quickly in myUK.

Qualifying events

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.

Benefits Open Enrollment

Our Benefits Open Enrollment happens every year so you can make changes. Changes can be made in myUK, or with paper forms.

Retirees

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.

Step-by-step tutorial

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.