Questions, answered.
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Employers
What size employer is EPC built for?
Employers Preferred Choice (EPC) is built for employers with 5+ employees in Arizona, Texas, Illinois and Florida.
Do we have to change our TPA or stop-loss carrier?
Not necessarily. EPC works with your third-party administrator, stop-loss carrier and pharmacy benefit manager. Some groups keep their current stop-loss carrier.
How do you estimate savings?
We model your census, 12 to 24 months of paid claims and current plan designs across conservative, expected and strong scenarios. The figures on this site are illustrative; your analysis uses your data.
How long does implementation take?
Typically 60 to 90 days from contract to go-live.
What do you charge?
Three numbers: a stop-loss premium, your claims allocation and one flat per-employee-per-month admin fee, disclosed line by line. No percentage of savings, no overrides, no spread.
We're fully insured today. Can we still look at EPC?
Yes. EPC is self-funded, and your analysis compares it with what you pay now, including what a bad year could cost with stop-loss in place.
What happens in a bad claims year?
Stop-loss caps it. Your analysis shows the worst-case range next to the expected case, so your CFO sees the ceiling before signing.
Will our people lose their doctors?
Tier 2, the Unity Network, gives broad access, and Tier 3 is out of network. A navigator helps members find Tier 1 doctors. Final benefits are set by the plan document and SBC.
What does it cost members?
Tier 1 is $0: no deductible, copay or coinsurance at Northwestern Medicine and direct contracts. The HSA design applies its deductible first. Tier 2 follows the plan design you choose.
Which states do you cover?
Illinois is live. Arizona, Texas and Florida are in development.
What do you need for an analysis?
It depends on how you're funded today. Fully insured: census, benefit summaries, rates and renewal, and 18 months of claims if available. Self-funded: census, SPD, current vendors and fixed costs, and 24 months of monthly paid claims. Files go to a secure upload, never this site.
Is the analysis a firm quote?
No. It's an illustrative estimate built from your data. Firm pricing follows underwriting.
How do you protect our data?
This website collects business contact details only. Census and claims go to a secure upload covered by a business associate agreement.
Can we keep our broker?
Yes. EPC works with brokers and consultants, and your broker can run the quote with you.
Brokers
Can I quote before I'm appointed?
Yes. Quotes can start today. Firm quotes and enrollments wait for your appointment, and compensation starts once you're appointed.
How long does appointment take?
Start in about two minutes with your NPN and license states. We email a secure link for your W-9, broker agreement and E&O, and target appointment within a set number of business days of a complete packet.
How is compensation paid?
Flat, disclosed, on the case, in writing to your client. No volume overrides or placement bonuses, and we never compete with you for the relationship.
What size groups fit?
Employers with 5+ employees in Illinois today, with Arizona, Texas and Florida coming.
My agency is already on file. Do I start over?
No. Start your appointment with your NPN and tell us your agency is on file. We check against our appointed list so there are no duplicates.
Do you work with general agencies?
Yes. Tell us whether you're a writing agent, an agency principal or a general agency when you start your appointment.
What do I need to get appointed?
Your NPN and license states to start. Your W-9, broker agreement and E&O certificate are handled through a secure link we email you, not on this website.
What do you need to quote my client?
Start with the RFP checklist. Fully insured groups: census, benefit summaries, rates and renewal, and 18 months of claims if available. Self-funded groups: census, SPD, current vendors and fixed costs, and 24 months of monthly paid claims. Send what you have; we'd rather start than wait.
Will my client's incumbent stop-loss carrier be affected?
EPC works with your client's TPA, stop-loss carrier and PBM. We'll walk through the setup on your first group.
Is the analysis a firm quote?
No. It's illustrative, built from your client's data. Firm quotes follow underwriting and your appointment.
How do I show my client the savings?
Each analysis shows the expected case and a worst-year ceiling, with fixed fees on one page your client's CFO can check.
What support do I get once appointed?
A welcome email with your broker portal login, your compensation schedule and the census template, plus the EPC broker kit.
Members
How do I find a doctor?
Browse Tier 1 in Find a doctor on the Members page, search the Unity Network for Tier 2, or ask a navigator to find one for you.
What do the tiers mean for me?
Tier 1 is $0. Tier 2 is the Unity Network, with your plan's deductible and copays. Tier 3 is out of network at a higher cost. Your plan document and SBC set your exact costs.
What if I have an emergency?
Go to any emergency room. Emergencies are covered anywhere.
How do I reach a navigator?
Call or text the navigator number on your ID card, or send a message from the Members page.
Is a procedure covered?
Request a call under Is it covered on the Members page. A navigator will talk it through by phone, so nothing medical goes through this website.
I lost my ID card. What now?
Ask a navigator and we'll mail a new one.
Providers
How do I join the network?
Apply on the Providers page with your practice name, specialty and group NPI. Our network team will reply by email.
How do I check a patient's eligibility?
Request a call back on the Providers page. Don't enter patient details on this website.