Presentation is loading. Please wait.

Presentation is loading. Please wait.

Benefits through the stages of your life. THE BENEFITS PLAN OF THE PRESBYTERIAN CHURCH (U.S.A.) Regional Representatives.

Similar presentations


Presentation on theme: "Benefits through the stages of your life. THE BENEFITS PLAN OF THE PRESBYTERIAN CHURCH (U.S.A.) Regional Representatives."— Presentation transcript:

1 Benefits through the stages of your life. THE BENEFITS PLAN OF THE PRESBYTERIAN CHURCH (U.S.A.) Regional Representatives

2 The Benefits Plan of the PC(USA) provides pension, healthcare and death and disability benefits to members of the Benefits Plan, their eligible dependents, and beneficiaries, where applicable. 2

3 COMMUNITY NATURE Key foundation of the plan Community: plan members, churches, and other employing organizations The whole community shares cost for the sake of all Minimum benefits ensured for all plan members 3

4 For just as the body is one and has many members, and all the members of the body, though many, are one body, so it is with Christ.... God has so arranged the body... that there may be no dissension within the body, but the members may have the same care for one another. If one member suffers, all suffer together with it; if one member is honored, all rejoice together with it. 1 Corinthians 12:12, (NRSV) 4

5 BUILDING BLOCKS 5

6 EFFECTIVE SALARY 6 Basis for dues and benefits Not necessarily IRS or SECA salary amount Includes – Cash salary – Housing or manse value – Deferred compensation [403(b)(9); Sec. 125 plan] – Other cash payments

7 2013 & 2014 MEDIAN EFFECTIVE SALARIES 7 Employment Classification Median Salaries% Change in Median to 2014 Pastors*$54,000 $54, % Exempt Lay Members$40,900 $41, % Non-Exempt Lay Members$29,800 $30, % *Although the figures used to calculate the pastors median include only teaching elders serving churches, the median applies to all teaching elders for determining benefits based on effective salary: pension credit accruals, disability benefits, and death benefits.

8 Benefits through the stages of your life. TRADITIONAL COVERAGE UNDER THE BENEFITS PLAN

9 CORE BENEFITS 9 Healthcare Retirement Death Disability

10 HEALTHCARE 10

11 NATIONWIDE GROUP PLAN 11

12 MEDICAL PPO NETWORK Network – Healthcare providers who agree to negotiated fees when treating patients in the network Out of network – Healthcare providers in a geographic network area who do not participate in the networks offered by the Board Non-network – A geographic area that does not have sufficient network providers within a reasonable distance of members 12

13 MEMBER COST: OFFICE VISIT COPAYS Network office visit copays –$25 for primary care/mental health –$45 for specialists Out of network –50% of the plan allowance Office visit copays do not count toward annual deductibles or copayment maximums 13

14 2014 DEDUCTIBLE AND COPAYMENT PERCENTAGES YOUR COSTS TYPE OF COSTNetworkOut-of-Network Annual deductible Member Family 1.25% of effective salary 2.5% of effective salary Copayment (per service) 20%, up to the copayment maximum 40%, up to the copayment maximum Annual family copayment maximum 5% of effective salary15% of effective salary 14

15 MEMBER COST: DEDUCTIBLES Medical deductibles are based on effective salaries, reflecting the ability of the member to pay Members are responsible for two deductibles* –1.25% of effective salary for the member –1.25% of effective salary for the rest of the family *(Network) Out of Network – 2.5% 15

16 MEMBER COST: NETWORK COPAYMENT LIMITS After network deductible is met, member pays 20% copayment for eligible network services –This counts toward copayment limit After member has paid 5% of effective salary in copayments, Board pays 100% of eligible network costs 16

17 MEMBER COST: OUT-OF-NETWORK COPAYMENT LIMITS After out-of-network deductible is met, member pays 40% copayment for eligible out-of-network services –This counts toward copayment limit After member has paid 15% of effective salary in eligible costs, Board pays 100% of eligible costs Costs for out-of-network services that exceed plan allowance do not count toward copayment limit 17

18 Salary Range DeductibleCopayment Maximum Network and Non-NetworkOut of Network Network and Non-NetworkOut of Network 1.25%2.50%5%15% $0 - $46,974$525$1,050$2,100$6,300 $46,975 - $51,954$590$1,175$2,350$7,050 $51,955 - $56,929$650$1,300$2,600$7,800 $56,930 - $61,909$715$1,430$2,845$8,535 $61,910 - $66,889$775$1,550$3,095$9,285 $66,890 - $71,864$840$1,675$3,345$10,035 $71,865 - $76,844$900$1,800$3,595$10,780 $76,845 - $81,819$965$1,925$3,845$11,535 $81,820 - $86,799$1,025$2,050$4,090$12,270 $86,800 or more$1,085$2,170$4,340$13, HEALTHCARE DEDUCTIBLES AND COPAYMENT MAXIMUMS

19 PRESCRIPTION DRUG PLAN 19

20 PRESCRIPTION DRUG PLAN No annual deductible $2,500 copayment annual limit Maintenance medications by mail order 20 Type of Pharmacy Maximum fillYour cost per prescription GenericFormularyNon-Formulary Retail pharmacy Up to a 30-day supply $10 30% of cost; min $20 to max $100 50% of cost; min $50 to max $150 Mail-order service Up to a 90-day supply $25 30% of cost; min $50 to max $300 50% of cost; min $125 to max $450

21 21 PRESCRIPTION DRUGS

22 MAINTENANCE MEDICATIONS MAIL ORDER Maintenance medications are drugs taken regularly for long-term chronic conditions Does not apply to one-time prescriptions 90-day supply Efficient, safe, and economical 22

23 PREVENTIVE CARE BENEFIT Not subject to deductible $0 office visit copay for network providers –Plan pays 100% of office visit, lab work, and tests, according to preventive schedule –Non-preventive (diagnostic) lab work or tests recommended by the provider during annual physical are covered subject to normal Medical Plan provisions 23

24 MENTAL HEALTH/SUBSTANCE ABUSE Provided through Cigna Treatment is reviewed by Cigna for medical necessity Pre-certification is required for inpatient or higher-level services Contact Cigna at or visit for network providers 24

25 EMPLOYEE ASSISTANCE PROGRAM Cigna –For members and household members –Confidential counseling/referral service for family, financial, alcohol, drugs, legal, life events, and stress issues –Six free counseling visits/per person/per issue; confidential counseling/referral service –Financial and legal help 25

26 HEALTH MANAGEMENT: ACTIVEHEALTH 26

27 PRE-CERTIFICATION Pre-certification is required for: –Scheduled outpatient imaging (MRI, MRA, CAT, PET, SPECT, etc.) and nuclear stress test –Bariatric surgery or any weight loss surgery –All inpatient hospitalizations including maternity –7-10 days in advance or within 48 hours of emergency hospital admission Call ActiveHealth ®,

28 PRE-CERTIFICATION 28 If it is a scan, find out if you can!

29 EMERGENCY CARE In a life-threatening or other emergency situation, seek care immediately at the closest appropriate facility If hospitalized from emergency room, contact must be made with ActiveHealth within 48 hours 29

30 INFORMED CARE MANAGEMENT Informed Care Management –Managed by ActiveHealth –Supports those with diabetes or cardiac conditions, lower back pain, and other chronic health conditions 30

31 PERSONAL HEALTH RECORD Online confidential health record that conveniently does your health history record-keeping for you Includes information you provide Automatically updates when your claims from Highmark, Catamaran, and Quest Diagnostics * (if you use its labs) are processed Start your PHR on myactivehealth.com/pcusa *not all Quest labs are in network 31

32 CASE MANAGEMENT Case Management supports those with extended hospitalizations and complex medical conditions. It is a confidential service that can assist you with managing your medical condition by: –helping you understand the care resources available –coordinating and helping arrange medical services for you providing education and support for you and your family 32

33 24-HOUR NURSE LINE 33 Toll free: You can call the Nurse Line if you: –wonder whether you need to get medical care –need information about a medication, test, or medical procedure –want reliable information about a health condition –arent sure what questions you should ask your doctor –have questions about how you or your family can stay healthy

34 34

35 All Members must complete: Preventive Exam Engage with ActiveHealth Nurse (if called) And complete at least 2: 1.Health Assessment 2.Know Your Numbers lab test 3.Vision exam 4.Tobacco cessation program* 5.Attend CREDO (if appropriate) HEALTH ACTIONS

36 Who? –Members only in 2014 When? –Complete Health Actions between October 1, September 30, 2014 How tracked? –In Call to Health via Benefits Connect, or HEALTH ACTIONS

37 CALL TO HEALTH 37

38 OTHER HEALTH BENEFITS VSP - $25 annual eye exam –Find a vision provider: –vsp.com 38

39 INTERNATIONAL TRAVEL Before travel outside United States, call the Board at (800- PRESPLAN) or visit pensions.org International SOS –Obtain wallet card with regional toll-free telephone numbers BlueCard Worldwide –Advises members about safe, reliable medical providers while outside United States. 39

40 RETIREMENT PENSION 40

41 RETIREMENT PENSION 41 Experience apportionments may be granted by the Board of Directors Experience apportionments permanently increase the pension credits Defined Benefit Plan Pension credits accrue over entire length of service

42 Retirees:$254,981,237 to 15,157 lives Survivors: $57,772,162 to 4,502 lives Total Paid: $312,753,339 to 19,659 lives Source: Benefits Plan Highlights IN 2013 THE PLAN PAID … 42

43 EXPERIENCE APPORTIONMENT HISTORY:

44 Actual Pension Benefits $2,681 Basic Benefit + CPI $1,990 Basic Benefit $1,000 44

45 PENSION OPTIONS 45 Early retirement available at 55 with reduced benefit Post-normal retirement provides increased benefit for retirement after age 65 Joint and Survivor options available at retirement provide a larger benefit to surviving spouse

46 EARLY RETIREMENT Retirement benefits may be initiated as early as age 55 Benefit amount is determined actuarially for each year before age 65 –55 years50% –58 years59% –60 years65% –63 years84% 46

47 POST-NORMAL RETIREMENT Enhanced benefit for retirement past age 65 (pension credits continue to accrue) Additional 6.5% per year until age % 6713% % 6926% % % Pro-rated to the month 47

48 DEATH 48

49 DEATH BENEFITS Salary continuation 49 Survivor medical coverage for one year Education benefit for dependent children Lump-sum payment

50 DEATH BENEFIT: LIVING NEEDS BENEFIT Allows prepayment of part of death benefits up to –75% of covered effective salary as lump- sum benefit, or –100% of the present value of the salary continuation benefit, or –Both 50 To assist those with a terminal illness (life expectancy of 24 months or less)

51 DISABILITY 51

52 DISABILITY BENEFIT All disability cases are actively managed and provide 52 – Partial income replacement – Medical coverage – Continued pension accrual (Traditional coverage only) – Death benefit

53 DISABILITY BENEFIT INCOME Begins after 90 consecutive days away from work 60% of effective salary or churchwide median salary for employment classification (whichever is greater) Initial benefit cannot exceed 100% of members salary Covered salary is capped at $90,000 51

54 DISABILITY MEDICAL CASE MANAGERS All disability cases are actively managed by Liberty Mutual 54 Benefits offset and coordinated with other payments (Social Security, workers compensation, military benefits, etc.)

55 DISABILITY... WAYS YOU CAN BE HELPFUL Inquire about disability coverage early so can be fully informed 55 Report disabilities early to Board of Pensions (within the first 90 days)

56 STRETCH BREAK

57 OPTIONAL BENEFITS 57 Optional dental Supplemental disability Long-Term Care Insurance Retirement Savings Plan 403(b)(9) Supplemental death

58 OPTIONAL DENTAL Group dental program through Aetna 58 Plan provisions vary depending on where you live Limited enrollment periods

59 SUPPLEMENTAL DEATH 59 Varying coverage levels available for – Member – Spouse – Dependent children Dues are greater for tobacco users Medical underwriting

60 SUPPLEMENTAL DISABILITY 60 Available for those earning $100,000 or more annually Increases basis for salary protection Member or church/employing organization may purchase the coverage

61 LONG-TERM CARE Underwritten by CNA Age-based rates Four tiers of coverage Open to members and family members 61

62 RETIREMENT SAVINGS PLAN 403(b)(9) 62

63 RETIREMENT SAVINGS PLAN ADVANTAGES 63 Tax-deferred savings Tax-deferred earnings Contributions through payroll deduction Numerous investment options Easy account access Withdrawals are designated housing allowance for clergy Low annual fee - $15

64 RETIREMENT SAVINGS PLAN Any employee of an eligible employing organization may participate 64 Fidelity Investments is record keeper Contributions may be made by employee, employer, or both

65 2014 CONTRIBUTION LIMITS Employee –$17,500 annually or 100% of annual cash salary, whichever is lower. Participants over 50 may increase by $5, Employer/Employee –Combined contribution equal to 100% of annual cash salary or $52,000 Tax credits for lower annual income

66 THE PARTICULARS 66

67 TRADITIONAL PROGRAM MEDICAL DUES FOR 2014 &

68 DUES FOR 2014 &

69 ENROLLMENT PRINCIPLES Installed teaching elders are mandated into the plan 69 Lay employment classifications Equal coverage for employment classification Non-installed teaching elders and lay employees may be covered through Traditional coverage under the Benefits Plan or the Affiliated Benefits Program

70 CALCULATING DUES 70 Healthcare Pension/Death and disability Minimums and maximums Calculator available on pensions.org in Available Resources section and at bottom of page

71 Benefits through the stages of your life. AFFILIATED BENEFITS PROGRAM

72 A FLEXIBLE APPROACH Designed to provide an option for Presbyterian employing organizations to extend benefits coverage to employees who work at least 20 hours per week who are not enrolled in Traditional coverage Cost-sharing provision Medical, disability, and death benefit options 72

73 COVERAGE CAN INCLUDE Medical benefits Death and disability coverage Optional coverages –Optional dental –Supplemental death –403(b)(9) Retirement Savings Plan –Long-Term Care Insurance –Supplemental disability 73

74 FLEXIBLE PRICING Employees may be required to pay a portion of the Medical Plan cost Employer must pay at least 50% of member only cost Employees covered through other sources (a covered partners employer, for example) may decline coverage 74

75 AFFILIATED BENEFITS PROGRAM 2014 Active Medical Dues Coverage LevelMonthlyAnnually Member Only$624.00$7, Member & Child(ren) Only , Member & Covered Partner 1, , Member & Family1, ,

76 AFFILIATED BENEFITS PROGRAM Death and Disability 2014 Dues are 3.5% of whichever is greater: the enrolled members total annual effective salary or the minimum participation basis subject to maximum established by federal law. The minimum participation basis is 25% of the median. MonthlyAnnual Minimum Basis: $13,625$39.74$ Maximum Basis: 255, ,

77 Benefits through the stages of your life. OTHER PROGRAMS

78 THE ASSISTANCE PROGRAM 78

79 THE ASSISTANCE PROGRAM Church workers: Shared, Emergency Assistance, Adoption Assistance, and Transition-to-College Grants Retired church workers: Income and Housing Supplements Pastors vocational leadership needs: Seminary Debt Assistance, CREDO, Sabbath Sabbatical Support 79

80 THE ASSISTANCE PROGRAM 80 Christmas Joy Offering Bequests Endowments Individual gifts The Assistance Program is funded through:

81 81 ASSISTANCE PROGRAM FUNDING 5.Adoption Assistance Grants 6.Transition-to-College Assistance Grants 7.Seminary Debt Assistance Grants 8.Sabbath Sabbatical Support Grants 9.Presbyterian CREDO Gifts, Bequests & Endowments (Investment Earnings) Christmas Joy Offering 1.Shared Grants 2.Emergency Assistance Grants 3.Income Supplements 4.Housing Supplements Types of Grants Funds

82 SEMINARY STUDENTS 82 May participate for medical coverage only Must be inquirer or candidate and enrolled as a full-time student Enrollment period is in fall except for life-change events Coverage may continue after graduation

83 2014 SEMINARY STUDENT MEDICAL DUES Coverage LevelMonthlyAnnual Member Only$458$5,496 Member & Covered Partner7028,424 Member & Child(ren) Only7028,424 Member & Family8049,660 83

84 MEDICARE SUPPLEMENT 84 Medicare Supplement available to members and covered partner at $218 per person per month in 2014 Choosing Healthcare Coverage at Retirement – great resource for options

85 AT TERMINATION OR RETIREMENT If plan participant for at least one year, member receives 30 days of free medical coverage, then: Transitional participation (24 months) –While actively seeking a call within Presbyterian Church (USA), $805/month per family Medical Continuation Program (18 months, unless meets Rule of 70) – $733/person, $1,466/family Medicare Supplement –$218/person, $436/couple 85

86 POST-RETIREMENT SERVICE 86 Retired members may be employed in post-retirement service Church pays post-retirement dues on honorably retired ministers of 12% for 20 hours/week or more Post-retirement service dues provide a direct subsidy to Medicare Supplement fund

87 VACANCY DUES Applicable for 12 months 87 Vacancy dues support Medicare Supplement fund Dues basis – 12%

88 RESOURCES 88 pensions.org

89 BOARD UNIVERSITY Learn how to make the most of your finances, benefits and retirement –Seminars Getting in Shape Fiscally, A Financial Planning Seminar Growing Into Tomorrow … Today, A Pre-Retirement Planning Seminar Post-Retirement Seminar Render Unto Caesar, A Clergy Tax and Terms of Call Seminar pensions.org/seminars 89

90 BOARD UNIVERSITY Learn at your convenience –E-Learning Getting Ready: The Change in Medical Dues Tax Advantage Plans Call to Health Tax Tips Housing Allowance Personal Finance Series And more pensions.org/BoardUniversity 90

91 CONTACTS: (800-PRESPLAN) Member Services team –Available Monday-Friday 8:30 a.m. – 5:00 p.m. ET, (closed between noon and 1:00 p.m.) Member Advocate Regional Representative Education Specialists All staff and benefits areas Website – pensions.org 91

92 REGIONAL REPRESENTATIVES CAN: Help members understand and maximize their benefits Help enroll new pastors and church employees in the Benefits Plan Help presbyteries assist church workers with financial needs with Board programs Assist members obtain Assistance grants Maintain contact with retirees Keep presbyteries informed of Board programs 92

93 IMPORTANT PHONE NUMBERS Board of Pensions Cigna Behavioral Health ActiveHealth 24-Hour Nurse Line Highmark Blue Cross/Blue Shield Fidelity Investments Liberty Mutual – Disability CNA – Long-Term Care Aetna – Dental (call the Board) VSP

94 IMPORTANT FORMS Benefits Plan Membership Application (enr-001) Affiliated Benefits Program Membership Application (enr-002) Service Change (enr-110) Change of Salary (enr-111) Change of Address (enr-106) Service Termination (enr-301) Medical Continuation Subscription or Waiver (med-100) 94

95 95


Download ppt "Benefits through the stages of your life. THE BENEFITS PLAN OF THE PRESBYTERIAN CHURCH (U.S.A.) Regional Representatives."

Similar presentations


Ads by Google