Template #2 – Letter to Employees (Members and Non-Participating Employees)

Date

Dear <Name>:

This letter contains important information about your health benefits for 2016. Please read it carefully and contact me with any questions.

Our online Open Enrollment for your 2016 health benefits will run from October 21 – November 6

Medical Plans

We are offering the following medical plans to our employees through The Episcopal Church Medical Trust (Medical Trust):

Note: For each of the following Medical and Dental plan tables, please populate the table version that reflects the tier basis offered by your group, and delete the others.

Plan Name / Plan Code / 2016
Single / Plus Spouse / Plus Child / Family
Anthem BCBS EPO80 / MSEZ / 725 / 1,305 / 1,305 / 2,030
Anthem BCBS EPO90 / MSE0 / 786 / 1,415 / 1,415 / 2,201
Anthem BCBS High Deductible Health / MHDE / 561 / 1,010 / 1,010 / 1,571
Anthem PPO 75/50 / MSPV / 682 / 1,228 / 1,228 / 1,910
Anthem PPO 80/60 / MSPZ / 760 / 1,368 / 1,368 / 2,128
Anthem PPO 90/70 / MSP0 / 836 / 1,505 / 1,505 / 2,341
Anthem BCBS High Deductible Plan 15 (NEW) / MHDG / 635 / 1,143 / 1,143 / 1,778
Anthem BCBS High Deductible Plan 40 (NEW) / MHBR / 507 / 913 / 913 / 1,420
Anthem BCBS PPO 70 SLV (NEW) / MPSI / 638 / 1,148 / 1,148 / 1,786
EAP / MEAP / 5 / 5 / 5 / 5
Kaiser Permanente EPO 80 Plan / MKL0 / 696 / 1,253 / 1,253 / 1,949
Kaiser Permanente High Option EPO Plan / MKH0 / 868 / 1,562 / 1,562 / 2,430
Kaiser Permanente Mid Option EPO Plan / MKM0 / 844 / 1,519 / 1,519 / 2,363
Aetna Choice POS II (Open Access) / MUC2 / OPTION NOT OFFERED IN 2016
Aetna Select EPO / MUE0 / OPTION NOT OFFERED IN 2016
UnitedHealthcare Choice 80 / MMUF / OPTION NOT OFFERED IN 2016
MEDICARE SUPPLEMENT
Plan Name / Plan Code / 2016
Single / Plus Spouse / Plus Child / Family
Anthem BCBS MS EPO80 / MSG7 / 594 / 1,069 / 1,069 / 1,663
Anthem BCBS MS EPO90 / MSG6 / 644 / 1,159 / 1,159 / 1,803
AnthemHigh Opt MS PPO / MSG1 / 704 / 1,267 / 1,267 / 1,971
Anthem PPO MS 75/50 / MSG5 / 559 / 1,006 / 1,006 / 1,565
Anthem PPO MS 80/60 / MSG3 / 608 / 1,094 / 1,094 / 1,702
Anthem PPO MS 90/70 / MSG2 / 668 / 1,202 / 1,202 / 1,870
Anthem BCBS MS PPO 70 SLV (NEW) / MSG8 / 523 / 941 / 941 / 1,464
Anthem BCBS MS EPO100 / MSG4 / OPTION NOT OFFERED IN 2016
**Any plan marked MS requires Medicare Small Employer Secondary Payee Exception eligible enrollment

Dental Plans

We are offering the following Cigna dental plans through the Medical Trust:

Plan Name / Plan Code / 2016
Single / Plus Spouse / Plus Child / Family
Preventive Dental / DDPV / 32 / 58 / 58 / 90
Basic Dent-50/150 / DD50 / 59 / 106 / 106 / 165
Dent&Ortho-25/75 / DD25 / 77 / 139 / 139 / 216

Plan Documents

2016 Summaries of Benefits and Coverage and 2015 Plan Handbooks have more information about the available plans and may be found on the Church Pension Group website at . You can use the “Mail It To Me” option to receive a free paper copy of the Summaries of Benefits and Coverage. (Plan Handbooks will be updated on the website in January 2016.)

Insert red text for the group to choose accordingly for their situation:

No Changes to Current Plan Selections

Please note that we have not made any changes to our current plan options for the coming year. However, we strongly encourage you to go online during Open Enrollment and check your information (name, address, dependents, etc.) to ensure accuracy, or to make changes if necessary.

OR

Please note that for 2016, our plan offering with the Medical Trust has been changed:

Plans Going Away

Please note that the <NAME> plan will no longer be offered in 2016. If you are currently in this plan, it is imperative that you select another plan if you want to continue medical/dental coverage for the 2016 plan year.

New Plans Offered

Please note that we are offering new plans from the Medical Trust for the 2016 plan year – <INSERT NAME(S)>. Additional information about the plan designs, including Summaries of Benefits and Coverage is available for your review on as well as on the Open Enrollment page.

Current Members

You will receive a letter from the Medical Trust approximately one week before Open Enrollment begins. This letter will have information regarding when and how to access the Open Enrollment website. Even if you do not want to make changes to your health plan, it is important for you to log in to the Open Enrollment website to check that your personal information is correct for yourself and your dependents. You can submit any corrections through the online system and/or by notifying me.

IMPORTANT NOTE: For 2016, you will use the same user name and password you created to access
your benefits information on MyCPG Accounts to access the enrollment web page. If you have not already created an account on MyCPG Accounts, please do sobefore Open Enrollment begins. (Note: You will need your Client ID number to create an account.) For assistance, contact the Client Services Team at (800) 480-9967, Monday to Friday, 8:30AM – 8:00PM ET (excluding holidays). Or, email .

Begin reviewing your options now if you are considering a plan change or considering enrolling in a Medical Trust Plan. Research your optionsprior to the Open Enrollment period to allow yourself time to make your decision. This is also the time of year when you may add eligible dependents to your plan or remove eligible dependents from your plan without the need to demonstrate a qualifying event.

Not a Member and Want to Enroll?

If you are not currently participating in a Medical Trust plan and would like to enroll, please review the plan options in this letter, and go online to select Active Clergy or Lay, then Health to explore the plans and benefits. You will not receive a letter from the Medical Trust, so please contact me to request an enrollment form and a free copy of the Summaries of Benefits and Coverage or to ask any questions.

Note: You may want to add information on your organization’s funding policy for members and dependents.

Employee Assistance Program (EAP) with Cigna Behavioral Health

In addition to the health plans, your employer also offers a stand-alone EAP plan for qualified employees who have spousal or other qualified coverage that is not through the Medical Trust. (The EAP is already included as part of each medical plan offering.) This outstanding program covers your entire household,
and is paid for by your employer.

If you have any questions, please don’t hesitate to contact me.

Sincerely,

Group Administrator Name

Phone / Email