Everyone who is currently covered will be automatically covered without regard to pre-existing conditions. All employees will be required to complete an online health risk assessment. The information is not used to deny coverage but to determine an aggregate.

The goal was to offer a plan that promotes healthy leaders through comprehensive benefits that are comparable to those received by plan members through the Presbyterian Board of Pensions, extend those benefits to all full-time church employees and do so at a reasonable cost.

The 2012/13 Employee Benefits Program unveiled by the Evangelical Covenant Order of Presbyterians (ECO) promises to deliver on all those levels – and as soon as April 1, 2012. The presenters informed a standing-room only crowd at the benefits breakout that “We determined that we needed to have the goal of ECO to have our group be healthier and have ourselves care as much about ourselves as we care about ministry and others.”

Although attempts were made to negotiate a way for those realigning their denominational affiliation from the Presbyterian Church (USA) to the ECO to have continuing coverage through the Board of Pensions, attendees were informed, “It was not possible to stay with the BOP and it was not possible to stay with Blue Cross & Blue Shield.”

The speaker continued, “We wanted to end up with comparable plans and comparable coverage. We’ve been able to develop a system that does not increase the cost for those whose costs are currently underwritten.”

That gap, cleverly called GAP (grant assistance program), is covered by a $20/month fee for each member in the new plan. More like a flat tax on everyone instead of the graduated tax used in the BOP formula where those who make more pay more, the ECO plan flattens the entire fee structure — no more figuring percentages. The rate sheet is simple and clearly defined.

The biggest difference is that, whereas under the current PCUSA/BOP plan churches are only required to enroll and pay for installed clergy, the ECO plan requires churches to offer benefits to all full-time employees.

With no special benefits to pastors, the same benefits are provided equitably to all. And although that may increase the cost that churches are paying, it is “more just, more equitable and the right thing to do.” It is also estimated that the move will lower the average age of plan members from the BOP’s 56 to about 45. “That makes a huge difference in our premium costs,” the presenter said.

Three plans are offered through Cigna Healthcare. The basic Core Plan (EPO) is the required level of participation. Two other plans are offered at higher rates for additional benefits. All rates are per employee, per month and the effective dates for these rates is April 1, 2012 – March 31, 2013 according to the handout distributed at the breakout session.

Medical rates (Cigna Healthcare)

Plan name

Core Plan (EPO)

Buy-Up #1 (PPO)

Buy-UP #2 (PPO)

Employee only

$562.03

$701.34

$598.06

Employee & spouse

$1,180.26

$1,472.80

$1,255.93

Employee & children

$1,067.86

$1,332.54

$1,136.31

Employee & family

$1,686.09

$2,104.01

1,794.18

The medical plan includes mental-health coverage, through Cigna Behavioral Health, which is also the current provider of those services to BOP plan members. Life, accidental death and dismemberment and disability coverage is required for pastors and is comparable to BOP benefits. Those rates are pennies per month. Dental coverage must be offered but there are opt-out provisions and a vision plan is also offered through EyeMed.

Like the BOP plan, the ECO plans are self-insured, but there are some distinguishing features:

• – Only non-elective (defined as medically necessary to save the life of the mother) abortions will be covered.
• – No consideration is being given to coverage for the same-sex partners.
• – It includes a $200 co-pay for emergency-room care (current BOP requires participants reach a deductible then pay 20 percent).
• – Walgreens is in the network.

• Buy-up options are available for pharmacy benefits, including specialty drugs which benefits those with chronic conditions that require specialty drugs often not covered in drug plans. Every church must participate at 100 percent in the Core plan. Some may choose to “buy up” an increased benefit plan for a higher premium that would cover specialty drugs and other benefits.
• A Life Assistance Program, also known as EAP, offers trained professionals to work with participants as they search for solutions to personal and workplace issues.
• CIGNA Will preparation is included. [Editor’s note: the original URL (link) referenced is no longer valid, so the link has been removed.]
• CIGNA Secure Travel, a 24/7 international concierge service which covers participants any time they are more than 100 miles from home, is included for all plan members.

Provider information

• Cigna Healthcare will be the insurance partner, providing medical, dental, life and AD&D, and disability plans. The national network of providers is called Access Plus.
• Cigna behavioral health provides all mental health care coverage (same as BOP).
• EyeMed will be the provider for vision coverage.

Eligibility

Everyone who is currently covered will be automatically covered without regard to pre-existing conditions. All employees will be required to complete an online health risk assessment. The information is not used to deny coverage but to determine an aggregate.

The Grant Assistance Program (GAP)

The Grant Assistance Program is available to the church to provide benefits for the pastors and church staff currently enrolled on the BOP medical plan prior to the transition date of joining the ECO. The GAP offers assistance for qualified participants based on the availability of funds. GAP will be funded through a $20/month, per plan participant fee which appears on the rate sheet as the “Small Church Support Fee.”

Churches will apply for GAP funds but it appears that distribution of such funds would only be possible after a sufficient number of churches enroll, pay their full premiums and the needs for GAP are evaluated. “Pastoral premium assistance” is designed to help pay premiums for lower income pastors and “healthcare hardship assistance” is designed to help pay catastrophic claims.

The transition process

Professional enrollment counselors are available and there will be open enrollment through 2014 via an online enrollment tool called benefitsCONNECT.

Churches transitioning to ECO would identify the date for joining the ECO, complete the Employee Heath and Welfare Questionnaire and call the Benefit Services Group to make the transition. There will be no lapse in coverage and coverage can begin as soon as April 1, 2012.

The sample 60-day transition timeline shared at the meeting included:

1. turn in Church questionnaire form: Jan. 20, 2012;
2. complete church group set-up package: Jan. 30, 2012;
3. receive church group set up package: Feb. 15, 2012;
4. employee open enrollment period: Feb. 27-March 9, 2012;
5. employee benefit plan effective date: April 1, 2012;

Question & Answer

During the question-and-answer portion of the presentation, attendees were told that the ECO plan “can offer benefits to the church staff of union churches, but pastors would remain under the BOP plan.” It was noted by attendees that it will provide no relief of conscience for union churches from the proposed extension of benefits through the BOP plan to same-sex partners. The presenter responded, “If you’re in the PCUSA, you’re in the BOP plan. Union churches would be in the PCUSA.”

Judy Mackey is the CEO/President of Benefits Services Group, Inc. Other presenters included Tina Neuendorf and Erin Kautzner. BSG is the dedicated service provider for the plan. They can be contacted toll free at 866-417-9931 or via email at [email protected], [email protected] and [email protected].

Carmen Fowler LaBerge is president of the Presbyterian Lay Committee and executive editor of its publications. This article first appeared on The Layman website and is used with permission
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