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The Benefits plan of the presbyterian church (U.S.A.)

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Presentation on theme: "The Benefits plan of the presbyterian church (U.S.A.)"— Presentation transcript:

1 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.

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

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)

5 Building Blocks

6 Effective Salary 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
Employment Classification Median Salaries % Change in Median 2013 2014 2013 to 2014    Pastors* $54,000 $54,500 + 1.0%     Exempt Lay Members $40,900 $41,700 + 2.0%    Non-Exempt Lay Members $29,800 $30,400 *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 Traditional Coverage under the Benefits Plan

9 Core Benefits Healthcare Retirement Death Disability

10 Healthcare

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

14 2014 Deductible and Copayment Percentages
Your Costs Type of Cost Network Out-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 salary 15% of effective salary

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%

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

18 2014 Healthcare Deductibles and Copayment Maximums
Salary Range Deductible Copayment Maximum Network and Non-Network Out 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 $13,020

19 Prescription Drug Plan

20 Prescription Drug Plan
No annual deductible $2,500 copayment annual limit Maintenance medications by mail order Type of Pharmacy Maximum fill Your cost per prescription Generic Formulary Non-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 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

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

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

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

26 Health Management: ActiveHealth

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®, 27

28 If it is a scan, find out if you can!
Pre-certification 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

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

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 *not all Quest labs are in network

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

33 24-hour Nurse Line Toll free: 866-794-3127
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 aren’t sure what questions you should ask your doctor have questions about how you or your family can stay healthy


35 2014 Health Actions All Members must complete:
Preventive Exam Engage with ActiveHealth Nurse (if called) And complete at least 2: Health Assessment “Know Your Numbers” lab test Vision exam Tobacco cessation program* Attend CREDO (if appropriate)

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

37 Call to Health

38 Other Health Benefits VSP - $25 annual eye exam
Find a vision provider: 38

39 International Travel Before travel outside United States, call the Board at (800-PRESPLAN) or visit 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

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

42 Source: Benefits Plan Highlights
In 2013 the Plan Paid … 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

43 Experience Apportionment History: 2000-2014

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

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

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 years 50% 58 years 59% 60 years 65% 63 years 84%

47 Post-Normal Retirement
Enhanced benefit for retirement past age 65 (pension credits continue to accrue) Additional 6.5% per year until age 70 66 6.5% 67 13% % 69 26% % % Pro-rated to the month

48 Death

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

50 Death Benefit: Living Needs Benefit
To assist those with a terminal illness (life expectancy of 24 months or less) 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

51 Disability

52 Disability Benefit All disability cases are actively managed and provide 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 member’s salary Covered salary is capped at $90,000 53

54 Disability Medical case managers
All disability cases are actively managed by Liberty Mutual 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 Report disabilities early to Board of Pensions (within the first 90 days)

56 Stretch Break

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

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

59 Supplemental Death Varying coverage levels available for Member Spouse
Dependent children Dues are greater for tobacco users Medical underwriting

60 Supplemental Disability
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

62 Retirement Savings Plan 403(b)(9)

63 Retirement Savings Plan Advantages
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 Contributions may be made by employee, employer, or both Fidelity Investments is record keeper

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

66 The Particulars

67 Traditional Program Medical Dues for 2014 & 2015
Coverage Tier Member + Family Member –only Dues Percentage (percentage of member’s effective salary*) 23% 24.5% Medical Participation Basis (also known as the dues minimum) $42,000 $44,000 Sample Total Dues (calculated on the dues minimum) $805/mo $9,660/yr $843/mo $10,120/yr $898/mo $10,780/yr Sample Allowable Dues-share Amount (up to 1.5% for Member + Family coverage)** $0 $0 - $55/mo $0 - $660/yr (at minimum dues basis of $44,000) * Subject to the medical participation minimum and maximum and based on the standard full-time equivalent (FTE) calculation for medical dues ** Sample calculated on the dues minimum; subject to presbytery rules

68 Dues for 2014 & 2015 2014 2015 Pension dues 11%
Death and Disability dues 1%

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

70 Calculating Dues Healthcare Pension/Death and disability
Minimums and maximums Calculator available on in Available Resources section and at bottom of page

71 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

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

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 partner’s employer, for example) may decline coverage

75 Affiliated benefits program
2014 Active Medical Dues Coverage Level Monthly Annually Member Only $624.00 $7,488.00 Member & Child(ren) Only 926.00 11,112.00 Member & Covered Partner 1,281.00 15,372.00 Member & Family 1,668.00 20,016.00

76 Affiliated benefits program
Death and Disability 2014 Dues are 3.5% of whichever is greater: the enrolled member’s 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. Monthly Annual Minimum Basis: $13,625 $39.74 $476.88 Maximum Basis: 255,000 743.75 8,925.00

77 Other Programs

78 The Assistance Program

79 The Assistance Program
Church workers: Shared, Emergency Assistance, Adoption Assistance, and Transition-to-College Grants Retired church workers: Income and Housing Supplements Pastor’s vocational leadership needs: Seminary Debt Assistance, CREDO, Sabbath Sabbatical Support

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

81 Assistance Program Funding
Funds Types of Grants Shared Grants Emergency Assistance Grants Income Supplements Housing Supplements Christmas Joy Offering Adoption Assistance Grants Transition-to-College Assistance Grants Seminary Debt Assistance Grants Sabbath Sabbatical Support Grants Presbyterian CREDO Gifts, Bequests & Endowments (Investment Earnings) 81

82 Seminary Students 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 Level Monthly Annual Member Only $458 $5,496 Member & Covered Partner 702 8,424 Member & Child(ren) Only Member & Family 804 9,660

84 Medicare Supplement 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

86 Post-Retirement Service
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 Dues basis – 12%
Vacancy dues support Medicare Supplement fund

88 Resources

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

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

91 Contacts: 800-773-7752 (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 –

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

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)

95 95

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