Clergy Wellness Commission Report
Introduction
The Rev. L. Ray Chandler – Chair, Memphis Conf. Clergy Wellness Commission
Malesus UMC: 731.427.9195,
As always we cannot begin this annual report without a profound sense of gratitude to all of those who are involved in the success of our health care program. In the conference office we have James Finger and Sheila Owens who work so faithfully in handling all the minute details of our plan. Along with the financial data, James keeps us informed with the variety of conference United Methodist health plans throughout the country. Whenever you have a question about our coverage Sheila is always there with an answer. She has saved you and our plan thousands upon thousands of dollars steering our participants in the direction that is not only best for you but also best for our plan. With Jim Horobetz as our consultant we are kept up to date with all the many facets of our health care program. We could not experience the success we have on a yearly basis if it was not for Jim. Cigna has been such a blessing to us and we continue to give God thanks and praise for all the many benefits we have on so many fronts. Then we have the gracious support of Methodist Healthcare who gives us hospital discounts that are absolutely phenomenal. I cannot imagine our world without those discounts. When it comes to wellness programs we are so thankful for the work of Virgin Health Miles, Methodist Healthcare, The Center of Excellence for Health and Wellness, The Church Health Center, the Living on the Front Porch Ministry, our EAP opportunities, and The Clergy Coaching Network. Finally, we have a wonderful commission with folks who are dedicated in keeping the plan not only viable but also thriving. It takes a complete team to manage, plan, and implement such a big task and we have an excellent team.
Once again we had another great year with claims well below our anticipated/projected figure. This means that our plan is working at every level. The commission once again took a risk in raising the stop-loss minimum rate for big claims to save us a good deal of money. We feel confident that we will not be affected by raising the rate. Therefore with money left over from unpaid claims, the savings from the stop-loss, and a healthy reserve we were able to come up with a plan that requires no increase with premiums or our apportionment figure without taking away any benefits. This celebration is remarkable.
We know the Affordable Healthcare Act is a question on everyone’s mind. We want to know how it is going to play out with our plan. Jim, James, and Sheila are working overtime to keep up with all the changing information. Our projected costs include the rates we have to pay into the Health Care Act but once again with our savings we do not feel the brunt of those costs. Matter of fact in order to be comply with the legislation and not to jeopardize our Medicare D attestation abilities by eroding the value of the plan, and to provide a consistent RX maximum out of pocket limit (includes deductibles and coinsurance) for Actives and retirees, without increasing the current retirees out of pocket maximum, and lastly, to not be a risk for ACA non-compliance we have amended the CIGNA contracts, effective 1/1/2014 as follows:
A. Active plans (OAPOS): Change the current medical out of pocket maximum from $4,500 single/9,000 family to $3,350 single/6,700 family
· Change the current RX out of pocket maximum from $4,500 individual/9,000 family to $3,000 individual/6,000 family
· Change the OOP for out of network settings to 2 x in network, which is allowed by ACA.
This combination provides us the ACA maximum in network, out of pocket of 6,350 single and 12,700 family which meets the ACA requirements.
B. For Retiree plans: Leave the current medical OOP as is at $1,500
Change the current RX OOP from 3,500 to 3,000 individual. (providing a consistent RX OOP for actives and retirees, and also reducing the RX for retirees, providing them an improved benefit. The bottom line is actually better benefits.
We want to thank all of our participants in begin diligent about their health and the success of our plan. Your diligence makes our health care coverage a blessing to all of us. As always we are here to serve God and you in the times when you need help the most. There is nothing more fragile than our health. Never hesitate to call one of us when you have a question or a need.
2015 Budget Consideration
We request the premiums beginning January 1, 2015, be as follows.
Group Insurance Medical Plan Premiums
ACTIVE Annual 80% 20% Quarterly
Member $7,130.76 $5,704.61 $1,426.15 $1,782.69
Member + Child $11,765.76 $9,412.61 $2,353.15 $2,941.44
Member + Spouse $14,293.36 $11,434.69 $2,858.66 $3,573.34
Family $17,152.04 $13,721.63 $3,430.41 $4,288.01
RETIRED Annual Conf: 80% 20% Qtr.
Retiree $4,243.80 $3,395.04 $848.76 $212.19
Retiree + Spouse $8,487.60 $6,790.09 $1,697.52 $424.38
Retiree + Spouse < 65 $11,374.56 $9,099.66 $2,274.91 $568.73
SURVIVING SPOUSE Annual Conf: 80% 20% Qtr.
Surviving Spouse $4,243.80 $3,395.04 $848.76 $212.19
Surviving Spouse + Child $8,878.80 $7,103.04 $1,775.76 $443.94
Surviving Spouse + Family $13,513.80 $10,811.04 $2,702.76 $675.69
ENROLLED IN MEDICARE PART D Quarterly % Reduction Qtr.
Retiree $212.19 25% $159.14
Retiree + Spouse $424.38 25% $318.29
Surviving Spouse > 65 $212.19 25% $159.14
· Once enrolled in the Medicare Part D plan you will not be eligible for re-entry into our plan.
Please contact the Treasurer’s office immediately for eligibility and enrollment information if your status or appointment changes. Dependent upon the eligibility rules you may be eligible to enroll in the conference sponsored medical plan within the first “thirty-one (31) days” of a “new appointment effective date”; the medical plan does not have an “Open Enrollment Period.” You must contact the Treasurer’s office to request an enrollment form. The enrollment form must be completed in full and returned within the first thirty-one days of eligibility.
Our Mandatory Generic Drug Policy became effective January 1, 2007. For both active and retired the co-pay is 50% with a $100 family deductible.
Our basic life insurance will provide a benefit of $40,000 for active members, subject to standard age reductions. The benefit reduces to $26,000 at age 70 and to $20,000 at age 75. It will also provide $1000 for an active spouse or retired member. Additional benefits will be provided according to the policy. Also, life insurance benefits for eligible participants on disability/incapacity leave will be administered in accordance with the carrier’s plan provisions.
We encourage the participants in our group insurance program to take advantage of the Vision benefits, Lifestyle Management and Disease Management Programs that are available to them as participants in the medical plan. Preventative care and disease management are important factors in improving health among clergy and their families.
Lifestyle change programs include a health coach to assist in meeting personal goals around stress management, weight management, and quitting tobacco use. This telephonic program is easy to use and offers both motivation and accountability. Active participants on the conference health plan can access this program by calling 1-866-417-7848.
With the disease management programs, a participant on the conference insurance plan can speak with a nurse to help in managing conditions such as asthma, back pain, diabetes, cardiac, depression, COPD, and weight. Typically, a Cigna nurse reaches out to active members who have a chronic disease.
In-Network Vision Benefits Include:
• One vision and eye health evaluation including but not limited to eye health examination, dilation, refraction, and prescription for glasses;
• One pair of prescription plastic or glass lenses, all ranges of prescriptions (powers and prisms)
Polycarbonate lenses for children under 18 years of age
Oversize lenses
Rose #1 and #2 solid tints
20% savings non-covered lens options
Progressive lenses covered up to bifocal lens amount with 20% savings on the difference;
• One frame of choice covered up to retail plan allowance of $130, plus a 20% savings on amount that exceeds frame allowance;
• One pair of contact lenses or a single purchase of a supply of contact lenses in lieu of lenses and frame benefit, (may not receive contact lenses and frames in same benefit year). Allowance applied towards cost of supplemental contact lens professional services (including the fitting and evaluation) and contact lens materials
• Coverage for Therapeutic contact lenses will be provided when visual acuity cannot be corrected to 20/70 in the better eye with eyeglasses and the fitting of the contact lenses would obtain this level of visual acuity; and in certain cases of anisometropia, keratoconus, or aphakis; as determined and documented by your Vision Provider. Contact lenses fitted for other therapeutic purposes or the narrowing of visual fields due to high minus or plus correction will be covered in accordance with the Elective contact lens benefit in compliance with the Schedule of Benefits.
In hopes of improving health for all clergy in the Memphis Conference the Clergy Wellness Commission continues to sponsor the Virgin HealthMiles walking program on behalf of both active and retired clergy and their spouses who participate or have participated in a conference sponsored pension plan. You can enroll in the walking program by visiting www.virginhealthmiles.com/memphis.
Dental Insurance Premiums
The following are the current premiums; we will not have the 2015 rates until later this year.
Dental Plan Annual Quarterly Monthly
DD1: Member $404.40 $101.10 $33.70
DD2: Member + One $752.36 $188.10 $62.70
DD3: Family $1352.86 $338.22 $112.74
•The dental plan coverage is offered only to members that are enrolled in the medical plan. The minimum period of enrollment is one year from the original date of enrollment. You must contact the Treasurer’s office to request an enrollment form. The enrollment form must be completed in full and returned within the first thirty-one days of eligibility.
• You are eligible to enroll in the dental program within the first “thirty-one (31) days” of a “new appointment or during the Open Enrollment” period held annually in December with a January 1st effective date. The effective date is always the first (1st) of a month and the cancellation date is always the last day of the month. The enrollment form must be completed and returned to the treasurer’s office by December 25.
• If you enrolled during an open enrollment period you are eligible to opt out December 1st following the year of enrollment otherwise it is one year from the original enrollment date. The written cancellation request must be submitted to the Treasurer’s office within thirty (30) days of cancellation.
• As the primary participant, you can elect the following types of coverage:
1. Single (DD1: member only)
2. Couple (DD2: member & spouse)
3. Family (DD3: member, spouse, & dependent children)
• Open Enrollment: December 1st officially starts the Delta Dental open enrollment period. Your completed enrollment form must be received in the Treasurer’s office no later than December 25th in order for you to be enrolled in the dental plan with a January 1st effective date.
The participant is responsible for submitting the premiums in full by the end of the quarter to prevent cancellation.
REMINDER: NOTHING IS AUTOMATIC; each participant is responsible for reporting in writing, any change in status immediately to the Conference Treasurer’s office. Changes affecting coverage that should be reported include, but are not limited to, births, deaths, marriages, divorces, and children who cease to qualify as participants. You can contact the Treasurer’s Office by phone at 731.664.5540 or fax at 731.660.2085.
The apportionment for 2015 is requested to be $1,628,699. Our fully detailed budget is included in the CFA report.
General Description
The following constitutes the provisions of the Group Insurance program of the Memphis Annual Conference of The United Methodist Church for July 1, 2014, through
December 31, 2015.
1. That the Plan Booklet, revised July 1, 2014, to include changes and amendments to any previous plan, will be policy unless amended by the Annual Conference.
2. That authority be given the Clergy Wellness Commission, as listed in the Annual Conference Journal, to administer and amend the plan as deemed necessary between sessions of the Annual Conference.
3. That a Third Party Administrator be retained as the administrator of the group health benefits program for the period July 1, 2014, through December 31, 2015.
4. That the life insurance program be continued with Unum as the carrier for the Memphis Annual Conference basic group life insurance program for the period July 1, 2014, through December 31, 2015. Policy coverage will be $40,000 per active member. The coverage becomes $1,000 at retirement. Life insurance benefits for eligible participants on disability/incapacity leave will be administered in accordance with the carrier’s plan provisions.
5. That the voluntary dental insurance program continues with Delta Dental Plans of TN.
6. That a second surgical opinion will remain voluntary.
7. That the budget for the Memphis Annual Conference Group Insurance Program, including health and life insurance, be approved in the amount of $3,995,938.
8. That the Council on Finance and Administration provide an apportionment of $1,628,699 to pay 80% of the premiums for eligible retired clergy and their spouses, surviving spouses, dependent children of deceased active clergy, district superintendents, the CMT director, campus ministers, and conference staff; to pay 100% of the premiums for disabled clergy and conference staff; and to pay for other Clergy Wellness Commission program expenses. This apportionment is for the calendar year of 2015, subject to the Council on Finance and Administration providing for necessary adjustments at the policy’s anniversary date, and is to be a priority item.
9. As of July 1, 2005, future certified candidates attending seminary not appointed to local churches on a full-time basis will provide their own insurance.
10. That the total amount billed to active members appointed to local churches, to retirees and their spouses, and staff, based on current enrollment be $1,985,767.