The diocese is creating the Standards and Plan Offerings for 2020 that explains lay and clergy medical and dental insurance, as well as pension benefits. Check back at the end of October for the updated information. View that information online below or download a PDF version.
You can view and download a chart that compares the plans in detail.
The diocese will offer three Medical Trust Health Insurance plans in 2020, including a new plan for relatively low-paid employees who cannot afford the cost-charing of premiums that may be required for employees:
| Name |
Employee-only coverage |
Family coverage |
| Blue Cross Consumer Directed plan with HSA funding |
$9,856 |
$21,674 |
| Blue Cross PPO 80/50 |
$9,300 |
$21,396 |
| Blue Cross PPO 90/50 |
$10,272 |
$23,638 |
The diocesan minimum standard is that the employer pays the first $8,500 in insurance costs for employee-only coverage. Employees pay the difference for the plan that they choose, unless that local congregation or other employer has established a higher benefit that is available to all qualified employees, lay and ordained. For example, the standard in the diocesan office for its employees is that the office pays $8,500 toward the cost of employee-only coverage, or $14,300 toward the cost of a family plan, provided that family coverage is under an Episcopal Church Medical Trust plan.
This diocese has an annual enrollment period in which employees already insured by the Episcopal Church Medical Trust go online and confirm the insurance coverage they wish to receive in 2020. Other employees seeking initial enrollment must contact the diocesan office during the open enrollment period.
What needs to be done?
- During the annual enrollment period this fall the employer will make available one or more of the Episcopal Church Medical Trust plans to every employee who is scheduled to work 1,500 or more hours per year in 2020 (a “qualified employee”).
- The employer will decide exactly how much the employer will pay toward the cost of health insurance, and that contribution will be the same for lay employees and members of the clergy. The exceptions are:
-
- Clergy and qualified lay employees already employed on December 31, 2012, may keep the plan already negotiated as long as they stay in their same position at their current congregation. This is a “grandfather clause” for existing clergy.
- If the employee desires to be insured by a spouse’s or partner’s employer-provided plan, the employee may choose to do so.
- If the employee is insured by a government-sponsored plan, such as Medicaid or Tricare, the employee may choose to continue to do so. However, the employer cannot pay the premiums. See later section for insurance rates available to small employers with employees who have Medicare Part A.
- If the employee wishes to remain covered under a previous employer’s group insurance plan, the employee may choose to do so (e.g., person with COBRA coverage or with retiree coverage provided by former employers).
- The qualified employee decides whether or not to have family coverage through the Episcopal Church Medical Trust. The vestry will decide how much of the added family premium will be paid by the employee (always through payroll deduction) and how much by the employer. Please remember that the same benefit is to be offered to all employees, lay or ordained, unless exempted as previously stated.
- Executive Council has approved an exemption from this health insurance requirement for school employees (i.e., someone who works exclusively with children of any age on weekdays in an educational setting), but at the same time urges you to provide this health insurance benefit.
- The employer needs to decide if it wants to offer the same dental insurance benefit to lay employees as it offers to members of the clergy.
- The employer needs to determine which lay employees are scheduled to work at least 1,000 hours in 2020 and then contribute to an approved defined benefit pension plan or an approved defined contribution pension plan. When approving the budget, the employer needs to allot an amount equal to 9% of the salary cost of eligible lay employees for lay pension contributions.
- The employer will need to decide which life and disability insurance plans it wants to pay the premiums on for its ordained and lay employees (realizing that it is already required through the diocesan compensation standards to pay for diocesan-sponsored life insurance for eligible members of the clergy). The Pension Fund pays short-term disability premiums for active clergy for whom pension assessments are paid.
The rates for 2020 for dental insurance through Delta Dental are:
| Single |
Family |
| $531.60 |
$1,294.80 |
The diocesan minimum standard is that vestries pay $531.60 for employee-only dental insurance. Although not mandated by General Convention, parity is ethically important as we provide benefits to lay and clergy employees. As guidance for the decision that your vestry will make, please note that the diocesan office pays an additional $400 for both its lay and clergy employees who desire family coverage.
Enrollment and termination for Delta Dental insurance is through the diocesan office, NOT online during the Medical Trust’s annual enrollment period.
The Church Life Insurance Corporation makes available life and disability insurance for active members of the clergy and lay employees who work at least 1000 hours per year. All newly hired members of the clergy and lay employees need to contact the diocesan office immediately upon employment in order to enroll for the appropriate coverage because enrollment is guaranteed only during the first 30 days after hire date. The following chart details the insurance coverage that is available.
|
Benefit
|
Clergy
|
Lay Employees
|
|
Church Pension Fund-sponsored Life Insurance (based on salary, with a cap of $150,000 for clergy, $50,000 for lay)
|
Automatically enrolled as long as the employer pays assessments to the clergy defined benefit pension plan.
|
Automatically enrolled as long as the employer pays assessments to the lay employee defined benefit pension plan ONLY.
|
|
Diocesan-sponsored $40,000 Life Insurance with an accidental death and dismemberment rider
|
The employer must pay the premium for this policy. The cost is currently $302.40 per year. The employee must sign up through the diocesan office.
|
If choosing to offer this policy, the employer must pay the premium (currently $302.40 per year). The employee must sign up through the diocesan office.
|
| Optional Supplemental Life Insurance(The employee pays the additional premium.) |
Additional life insurance that provides coverage above CPF and diocesan-sponsored insurance.
|
Additional life insurance that provides coverage above CPF and diocesan-sponsored insurance.
|
|
Supplemental Spouse Life Insurance
|
Available only if the employee signs up for at least $10,000 supplemental life insurance.
|
Available only if the employee signs up for at least $10,000 supplemental life insurance.
|
|
Income Replacement Insurance
(Short-Term Disability)
|
Provides 66.67% income replacement for loss of income due to disability for 26 weeks following covered accident or illness. Automatically enrolled as long as the employer pays assessments to the clergy defined benefit pension plan.
|
Provides 66.67% income replacement for loss of income due to disability for 26 weeks following covered accident or illness. The employer must pay the premium for this optional coverage. The cost is 0.456% of compensation.
|
|
Long-Term Disability
|
Provides 40% income replacement for approved disability that lasts more than 26 weeks. The employer must pay the premium for this optional coverage. The cost is 0.092% of compensation.
|
Provides 40% income replacement for approved disability that lasts more than 26 weeks. The employer must pay the premium for this optional coverage. The cost is 0.092% of compensation.
|
In early 2020, there will be a one-time open enrollment period for short- and long-term disability insurance for existing employees. New employees must sign up within 30 days after their hire date.
More information on life and disability insurance is available at www.cpg.org.
The federal government provides a Medicare Secondary Payer Exemption for small employers. Under certain circumstances it allows Medicare Part A coverage to be primary, with employer-provided coverage to become secondary for hospital stays, resulting in lower Medical Trust premiums for employees who are on these specific plans. The two plans offered have benefits identical to the benefits of our standard plans.
The requirements of such plans are very specific: 1) The employee or the employee’s spouse must be enrolled in Medicare Part A; and 2) the employer (that is, the local congregation) must never have more than 19 employees during a calendar year. For information on whether or not you meet these eligibility requirements, contact Mary Jane Hodges at mjhodges@episcopalarkansas.org.
2020 Medicare Secondary Payer Exception Rates
|
Employee only |
Family |
BCBS PPO 80
(age 65+) |
$7,536 |
$17,328 |
BCBS PPO 90
(age 65+) |
$8,304 |
$19,104 |
The diocesan standard for employees covered under this program is that the employer pays the first $8,200 in insurance costs for coverage for an employee only or family coverage. If the employer offers a higher benefit to its employees using the standard health insurance policies, it must offer the same benefit to employees who choose this Medicare Secondary Payer Exemption option.
Please note that an employer is not legally allowed to encourage an employee to choose full Medicare coverage over employer-provided insurance.
