Health Benefit Rates 2019
OPEN ENROLLMENT FOR CLERGY CONFERENCE BENEFITS CLOSES DECEMBER 1, 2018 FOR 2019.
The Conference Board of Pension and Health Benefits upon recommendation from the Health Benefits Subcommittee of the Board has approved the 2019 rate schedule for our Conference Active and Retiree Health Plans.
The board works very diligently in its responsibility to care for the clergy and their families of our conference. It also considers the impact that premiums and charges to the local churches makes. We are in a covenant together to care for each other with responsible stewardship but also appropriate and necessary benefits
The Western North Carolina Conference manages a self-funded health and dental plan. This has been our practice for a number of years even as alternatives have been and continue to be researched. We are the insurance company. Third party administrators, Healthgram and PharmAvail, assist in managing our plans. Our constituency is the conference clergy under appointment and retired as well as lay staff employees in the conference and district offices. Dependent coverage for the active plans is also a part of the mix. We pay claims as they are incurred, according to the coverage in the plans. 2017 and thus far in 2018, we are seeing a rise in claims that outpaces our premium collection, even though we collect 99.96% of our premiums. Our pool is aging and shrinking which requires additional strategies for cost constraints. We continue to encourage all of our clergy to participate in the Virgin Pulse wellness initiative.
In preparing for the 2019 rates, we studied the claim history for the past twelve months, the current stop-loss scenarios, copays and deductibles, the trending for health care costs in our state (trending between 10 and 12%), costs of certain pharmaceuticals that could be eliminated or directed to alternatives and/or generic brands and other factors. Interesting enough, we discovered that those on the Active Basic Plus Plan are submitting claims and drawing benefits at higher payouts than the Active Basic Plan. Therefore, the Health Benefits Committee recommended and the Conference Board of Pensions approved an incremental rate increase between the plans.
ACTIVE AND RETIREE RATES FOR 2019
The Conference Board of Pension and Health Benefits, on recommendation of the Health Benefits Committee, has approved the following rates for 2019 for our active and retiree plans. You will note an increase in the active health rates of 8% for the Active Basic Planand 10% for the Active Basic Plus Planfor clergy/employee coverage as well as dependent coverage. We have also modestly adjusted certain co-pays for both specialized physician and non-preferred pharmaceutical brands. Once again, we are pleased to announce that the Retiree Plan will see NO increase for 2019.
For 2019, we are offering a third plan option for the active health plan. This plan is a Health Savings Account (HSA) option that allows clergy and dependents to set aside a pre-tax amount that can be used for deductibles and co-insurance. The HSA itself must be set up with a third party institution arranged by the clergy insured and is not a part of the Annual Conference’s program. HSA plans require, by law, a high deductible health plan and we are tailoring our offering to accommodate. However, if this plan is chosen, participants must bear in mind there is no co-pay and they are responsible for the total cost of their health expenses up until the deductible. Then the conference plan begins coverage, based on co-insurance amounts and limits, after the deductible has been met. The deductible can be funded through the HSA. As a component of this third option, the conference will “seed” the HSA, upon satisfactory evidence of all requirements fulfilled with the third party, based on the following: $400 per year for individual clergy, $800 per year for clergy with spouse or children, $1,200 per year for family. Churches likewise can seed the HSA.
The following rate table has been approved as the billed rates for 2019.
|Basic Plan||$ 1,115||$ 13,375|
|Basic Plus Plan**||$ 1,115||$ 13,375|
|HSA Plan||$ 1,115||$ 13,375|
|Additional Clergy cost of Basic Plus**||$ 305**||$ 3,665**|
|For spouse (Basic Plan)||$ 785||$ 9,420|
|For spouse (Basic Plus Plan)||$ 871||$ 10,454|
|For spouse (HSA Plan)||$ 785||$ 9,420|
|For child(ren) (Basic Plan)||$ 407||$ 4,885|
|For child(ren) (Basic Plus Plan)||$ 424||$ 5,082|
|For child(ren) (HSA Plan)||$ 407||$ 4,885|
|For family (Basic Plan)||$ 1,136||$ 13,633|
|For family (Basic Plus Plan)||$ 1,290||$ 15,478|
|For family (HSA Plan)||$ 1,136||$ 13,633|
|Without Medicare (< 65)***||$ 1,145 / $ 1,420 / $1,145||$ 13,375 / $ 17,040 / $13,375|
|Medicare prior to 1/1/2003||$ 97||$ 1,164|
|Retiree > 65 after 1/1/2003|
|With less than 10 yrs of service||$ 162||$ 1,944|
|With 11 to 49 yrs of service||$ 160 - $ 99 ****||$ 1,920 - $ 1,188 ****|
*Church amount will be reduced by clergy contribution based on salary scale.
**Clergy who opt for Basic Plus pay the difference between two Active Plans ($3,665 in additionto their clergy contribution per salary scale).
***Under age 65 Clergy choose one of the Active Plans; they do not qualify for Retiree Plan
**** This range is on a sliding scale with years of service, from 99% to 61% of the premium.
For retirees, this premium is based on the number of years of service in Western North Carolina Conference. A retiree prior to 1/1/2003 is billed 60% of the total premium. This is based on the action of the 2002 Annual Conference, incorporating a sliding scale rate for health benefits in conjunction with the years of service.
Please also bear in mind that since 2010 as approved by the 2009 Annual Conference, the clergy do contribute a percentage of the health benefit rate to the plan, thereby reducing the cost of health benefits to the local church. With the addition of plan options in 2015, pastors also contribute the differentialin cost (premium) if they choose the Basic Plus Plan. (Pastor’s Contribution to Health Benefits document can be found on the Conference administrative website, benefits page.
IF YOU DON’T NEED TO MAKE ANY CHANGES BETWEEN PLANS OR ADD/DELETE DEPENDENTS, DO NOTHING! BUT IF YOU DESIRE A PLAN CHANGE OR ADD/DELETE DEPENDENT COVERAGE, NEW ENROLLMENT FORM REQUIRED!!!!!
FLEXIBLE SPENDING ACCOUNTS & HEALTH SAVINGS ACCOUNT
As introduced in 2016, the Conference will again be sponsoring a Flexible Spending Account Plan for each of our clergy persons eligible forand participating in either the Basic Plan or the Basic Plus Plan of our active health plans in 2019. YOU CANNOT PARTICIPATE IN BOTH HSA AND FSA arrangements. Therefore there is no FSA option with the HSA Plan.
In order to offer this benefit for the whole conference, we have received compliance directives from the general counsel at Healthgram, who administers our insurance and FSA plans, that in order to offer the Conference FSA Plan, it must be the ONLY FSAplan for those covered by our Health Benefits to participate. This is because the health insurance plans are a part of the WNCC’s Section 125 Cafeteria Plan and thus the only avenue to offer a valid FSA arrangement.
Our plan, as managed by Healthgram, fully complies with the Internal Revenue Code Section 125. Furthermore, the conference pays the fees for administrating this plan—something we DO NOT pass along to the churches and agencies. Finally, the plan goes along with the clergyperson regardless of appointment changes.
For lines 2b, 2c, 2d and 2e of the Clergy Compensation forms, only those who are participating in Conference benefit options (dependent health coverage, life insurance, medical and dependent flexible spending accounts) will be allowed to complete and submit the appropriate amounts on those lines. This is due to these items falling under the Conference’s Section 125 Plan.
If you have any questions regarding the above or other benefits related items, please contact Dale Bryant, the Conference Benefits Administrator or myself as your Conference Treasurer either via phone or email. As with last year, look for an instructional video to be posted on the Conference Web-Site highlighting our benefit plans.
NEW 2019 ENROLLMENT FORM REQUIRED EVEN IF YOU ARE ENROLLED IN 2018.
ALL FORMS DUE TO TREASURY SERVICES
BY DECEMBER 1, 2018
BY DECEMBER 1, 2018
Resources for Vital Congregations
GBHEM Leadership Resources
A Disciple’s Path; A Guide for United Methodist
RESOURCES TO CONNECT WITH THE COMMUNITY: