On this page, parish leaders and clergy will find information about health and dental insurance for employees (lay and ordained).

Staff Contact: Cathy Hobart, Diocesan Controller

(315) 474-6596 x131 | e-mail

Changes to be aware of for 2024:

  1. DENTAL: Delta Dental is replacing Cigna dental starting January 1, 2024. You must actively login and enroll in one of the new Delta Dental plans if you would like dental insurance next year. The Cigna plan you are currently enrolled in will end December 31, 2023.
  2. COVID-19: healthcare services related to the evaluation, testing, and treatment for COVID19 will be subject to member copays, deductibles, and coinsurance.
  • Home test kits
    1. Eligible individuals and their dependents who are enrolled in Anthem CDHP medical plans may receive up to four COVD over the counter home test kits per month with no coinsurance after they meet their annual network deductible. 
    2. Anthem PPO plan enrollees: Eligible individuals and their dependents who are enrolled in Anthem PPO medical plans may receive up to four COVD over the counter home test kits per month without cost-share (ie. copay, deductible, or coinsurance).
  1. TELEHEALTH: for Active Members – You can access a medical professional through telehealth platforms offered by Anthem using your computer or mobile device if your personal healthcare provider participates on this telehealth platform.. You will need high-speed internet access, a webcam or built-in camera, and audio capability. Please remember your personal healthcare provider may not participate on the vendor’s telehealth platform. For Anthem, all services received via vendor telehealth platforms are available to you with no deductible, copay, or coinsurance through December 31, 2024.
  •         Anthem Blue Cross Blue Shield – Access LiveHealthOnline.com or download the LiveHealth Online mobile app in the App Store® or Google Play™.
  1. CDHP DEDUCTIBLE INCREASES: For 2024, the Internal Revenue Service increased the minimum and maximum amounts that a high-deductible health plan (HDHP) (note that the Medical Trust refers to HDHP as CDHP) may impose as a deductible.
    • Anthem CDHP-15: Effective January 1, 2024, the Medical Trust’s Anthem CDHP-15 network deductible for self-only coverage will be $1,600 and the network deductible for family coverage will be $3,200. The out-of-network deductible for self-only coverage will be $3,200 and the out-of-network deductible for family coverage will be $6,400.
    • Anthem CDHP-20: Effective January 1, 2024, the Medical Trust’s Anthem, Cigna, and Kaiser CDHP-20 network deductible for self-only coverage will be $3,200 and the network deductible for family coverage will remain $5,450. The out-of-network deductible for self-only coverage will be $3,200 and the out-of-network deductible for family coverage will remain $6,000.

Open Enrollment

During the open enrollment period near the end of each calendar year, current clergy and lay employees may make changes to their health and dental insurance plans. In 2023, open enrollment periods are:

  • Active employees: October 11th through November 1st.
  • Retirees: Pre-65: October 25th through November 15th.
                     Post-65: October 16th through November 17th.

Get more information about Open Enrollment.

Changes for 2024:

  • The in-network deductible for Anthem BCBS HDHP-15 has increased to $1,600 single/$3,200 employee+1 or family;
  • The in-network deductible for Anthem BCBS HDHP-20 increase to single deductible only: $3,200 single/$5,450 employee+1 or family
  • DENTAL: Delta Dental is replacing Cigna dental starting January 1, 2024. ACTION REQUIRED if you have Cigna dental coverage now and want dental insurance in 2024.

Health Insurance Requirements & Eligibility

According to the Diocesan Health Care Plan Policy (2024) , all eligible clergy and lay employees must be covered by either the Standard Plan or an Alternate Plan (see plan options below) unless the cleric or lay employee elects to opt out ( Health Insurance Employee Opt-Out Form ).

Eligibility:

The following individuals are eligible for health insurance benefits:

  • Clergy who are at least half-time
  • Lay employees who are scheduled to work at least 1,500 hours a year
    • Lay employees who are scheduled to work fewer than 1,500 hours a year but who are at least half-time may be covered at the option of the diocese/ parish
  • Spouses, dependents and domestic partners of eligible clergy and lay employees

Parity between clergy and lay employees:

The plan cost paid by a diocese or parish for lay employees scheduled for at least 1,500 hours annually must equal the plan cost paid for clergy.

Enrollment

Contributions into a health savings account are not allowed once an individual turns 65. The contribution you and your employer makes into your HSA for the year you turn 65 should be pro-rated.If you will be turning 65 in 2024, you should consider choosing the Anthem BCBS BlueCard PPO 100 alternative plan. The parish can apply for a Medicare Secondary Payer Small Employer Exception(MSP SEE) for a reduced premium. Please review this information about the MSP SEE before applying.

New employees: Newly hired eligible employees must enroll in a Medical Trust plan within 30 days.

  1. review the plan options available in our diocese
  2. visit the Church Pension Group website to explore these plans in-depth
  3. download the Medical/Dental Enrollment Form
  4. return the completed form via email to Cathy Hobart

Current employees: Current eligible employees may enroll in a Medical Trust plan or change their plan during the annual Open Enrollment period.

All eligible employees may opt out of coverage: Under the terms of the Denominational Health Plan, clergy and lay employees who have medical benefits through an approved source may waive medical coverage under the Denominational Health Plan and maintain their medical benefits through the approved source. Examples of approved sources include coverage through a spouse or partner’s medical benefits.

Have the employee complete an Health Insurance Employee Opt-Out Form and keep the form in that individual’s personnel folder at the church.

Health Care Plan Options in the Diocese of Central New York

The diocese offers a Standard Plan and two Alternate Plans:

Important note: Contributions into a health savings account are not allowed once an individual turns 65. If you will be turning 65 in 2024, you should consider choosing the Anthem BCBS BlueCard PPO 100 alternative plan. The parish can apply for a Medicare Secondary Payer plan for a reduced premium.

Compare plans:

Plan costs: 

Eligible active clergy and lay employees age 65 and older:

Under the Age Discrimination in Employment Act1, an employer who offers Medical Trust health plans to active employees under age 65 and their spouses must offer the same health plans to its employees age 65 and over and their spouses—regardless of Medicare eligibility—provided that they meet the Medical Trust plans’ eligibility rules. In other words, employers cannot discriminate against an employee or spouse age 65+ in the provision of health benefits.

Employees age 65+ who are actively working and meet one of the eligibility criteria, 1)an employee normally scheduled to work 1,000 or more compensated hours per calendar year or 2) a member of a religious order, must be offered health coverage through a Medical trust Episcopal Health Plan by their employer.

Per Medicare regulations, if you have employees age 65+ who are eligible for active health coverage, you may not provide any incentive to influence their choice of coverage. For example, you may not reimburse these employees for the cost of • the Medicare Part B premium, • a Medicare supplement plan, or • a Medicare Advantage Plan. In addition, the Church Pension Fund Post-Retirement Health Subsidy cannot be offered to employees eligible for active health coverage.

The Medical Trust provides the option for eligible employers to apply for the Medicare Secondary Payer (MSP) Small Employer Exception (SEE). If an employer applies for and is approved for the plan, eligible employees and their spouses can choose to participate in the SEE Plan.

To take advantage of MSP SEE for employees age 65 or older:

Please see this offering from Church Pension Group on understanding health plan options for employees Age 65+ .

For more information, please contact Cathy Hobart at the diocesan office.

Available plan:  Alternate Plan 2 (2024): Anthem BCBS BlueCard PPO 100 (age 65+ with prior authorization) (2024)

No contribution may be made into the Health Savings Account of an individual age 65 or older. 

Value-Added Benefits

All plans include, at no additional cost to the employers or employees:

  • Vision Benefits include an annual eye exam with no copay in-network, eyeglasses, and contact lens benefits. A copay may be required for certain services.
  • Hearing Benefits include hearing exams and a benefit allowance for hearing aid devices
  • Employee Assistance Program is a free, confidential, 24-hour service that connects you with counselors to help you with immediate health needs and with assistance for therapy referrals, tips for balancing your personal and professional life, legal consultations, financial services, and much more.
  • Health Advocate is a confidential service that can reduce some of the stress and confusion of navigating the healthcare system by helping you understand your diagnoses, secure second opinions, manage health benefit claims, and more. It is included as part of your health plan.
  • Travel Assistance UnitedHealthcare Global Assistance provides travel services for Medical Trust plan members traveling at least 100 miles from their primary residence, either in the US or abroad.

Learn more about these value-added benefits on the Church Pension Group website.

Optional Dental Plans:

Employees may choose from three available dental plans at their own cost. Delta Dental will be the dental provider starting in 2024. For those currently enrolled in a Cigna Dental plan:

Details are available on the Church Pension Group website.

Health Insurance Costs to the Employer (Parish or Diocese)

Full-Time Employees hired before January 1, 2016

The diocese/parish shall pay for the Standard Plan:

  • 100% of the Single, Employee+1, or Family premium, PLUS
  • 100% of the Single, Employee+1, or Family annual deductible. If possible, the employer should fully fund the annual deductible amount to the employee’s Health Savings Account in January.

Full-Time Employees hired after December 31, 2015

The diocese/parish shall pay for the Standard Plan:

  • 100% of the Single premium, PLUS
  • 100% of the Single deductible, PLUS
  • 75% of the difference between the Employee+1 or Family premium and the Single premium, PLUS
  • 75% of the difference between the Employee+1 or Family annual deductible and the Single annual deductible.

If possible, the employer should fully fund the employer’s portion of the annual deductible amount to the employee’s Health Savings Account in January.

Example:

A full-time parish employee hired after December 31, 2015 chooses Family coverage under the Standard Plan. The parish will pay:

    • $942 per month = 100% of the Single premium, PLUS
    • $1,600 per year = 100% of the Single deductible, PLUS
    • $1,272.00 per month = 75% x ($2,638 – $942) = 75% of the difference between the Family premium ($2,638) and the Single premium ($942), PLUS
    • $1,200 per year = 75% x ($3,200-$1,600) = 75% of the difference between the Family annual deductible ($3,200) and the Single annual deductible ($1,600).

So the total monthly premium cost to the parish will be $2,214.00 ($942 + $1,272.00) and the total annual deductible cost to the parish will be $2,800 ($1,600 + $1,200).

Part-Time Employees

The diocese/parish would pay as above except at a percentage equal to the percentage of time in Letter of Agreement (clergy) or time scheduled (lay).

Alternate Plans

An employee who chooses an Alternate Plan shall be responsible for any additional costs.

The diocese/parish may pay a larger percentage of the Alternate Plan costs as long as parity is maintained between clergy and those lay employees who are scheduled to work at least 1,500 hours per year.

Health Insurance Costs to the Employee (Lay or Clergy)

Full-Time Employees hired before January 1, 2016

The employer plays 100% of the premium and deductible for the Standard Plan (for Single, Employee+1 or Family coverage). If possible, the employer should fully fund the annual deductible amount to the employee’s Health Savings Account in January.

All employees who select an Alternate Plan are also responsible for any additional plan costs above the Standard Plan (premium, deductible). All employees are also responsible for costs such as  coinsurance, co-pays, and annual out-of-pocket maximums. See plan options above for detail of these costs.

Full-Time Employees hired after December 31, 2015

Full-Time employees hired after December 31, 2015 shall pay for the Standard Plan:

  • 25% of the difference between the Employee+1 or Family premium and the Single premium, PLUS
  • 25% of the difference between the Employee+1 or Family annual deductible and the Single annual deductible.

All employees who select an Alternate Plan are also responsible for any additional plan costs above the Standard Plan (premium, deductible). All employees are also responsible for costs such as  coinsurance, co-pays, and annual out-of-pocket maximums. See plan options above for detail of these costs.

If possible, the employer should fully fund the employer’s portion of the annual deductible amount to the employee’s Health Savings Account in January.

Example:

A full-time parish employee hired after December 31, 2015 chooses Family coverage under the Standard Plan. The employee will pay:

    • $424.00 per month = 25% x ($2,638-$942) = 25% of the difference between the Family premium ($2,638) and the Single premium ($942), PLUS
    • $400 per year = 25% x ($3,200-$1,600) = 25% of the difference between the Family annual deductible ($3,200) and the Single annual deductible ($1,600).
    • Any additional costs such as coinsurance, co-pays, and annual out-of-pocket maximums. See Standard Plan (2024): Anthem BCBS Consumer-Directed Health Plan-15/Health Savings Account for detail of these costs.

Important Phone Numbers and Websites:

Church Pension Group/ Church Medical Trust
cpg.org
Phone: (855) 215-5990
Monday–Friday, 8:30 a.m.–8:00 p.m. EST (excluding holidays)

Anthem Blue Cross Blue Shield (Medical and Behavioral Health)
anthem.com
Phone: (844) 812-9207
Monday–Friday, 9:00 a.m.–8:00 p.m. EST
Anthem Anywhere mobile app available for download (Android, iOS)

Delta (Dental)
deltadental.com
Phone:
Delta Dental Mobile App available for download (Android, iOS)

Express Scripts Prescription Drug Benefits
express-scripts.com 
Phone: (800) 841-3361
24 hours a day, 7 days a week (except Thanksgiving and Christmas)
Express Scripts mobile app available for Download (Android, Blackberry, iOS, Windows Phone)

Cigna Employee Assistance Plan (EAP)
mycigna.com
Phone: (866) 395-7794 (members)
(800) 926-2273 (for pre-membership information)
24 hours a day, 7 days a week

EyeMed Vision Care
eyemedvisioncare.com
Phone: (866) 723-0513 (members)
(866) 723-0596 (pre-enrollment)
Monday–Saturday, 8:00 a.m.–11:00 p.m. EST
Sunday 11:00 a.m.–8:00 p.m. EST

Health Advocate
healthadvocate.com
Phone: (866) 695-8622
24 hours a day, 7 days a week; business hours are 8:00 a.m.–9:00 p.m. EST

Health Equity (HSA services for some members in denominational health plans)
healthequity.com
Phone: (866) 346-5800
24 hours a day, 7 days a week

HealthEquity mobile app available for download (Android, iOS)



UnitedHealthcare (retirees)
http://www.uhcretiree.com/ecmt
Phone: (866) 519-5401, TTY 711
Monday – Friday, 8:00 a.m.-8:00 p.m. local time

Health4Me mobile app available for download (Android, iOS)



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