On this page, lay and ordained employees will find information about health and dental insurance. If you are an employer looking for information please go to this page.
Health Insurance Enrollment & Eligibility
Eligibility:
Denominational Health Plan eligibilty: Employee normally scheduled to work 1,000 or more compensated hours per plan year*
- Diocesan Health Care Plan Policy (2027) (revised 9.9.26), 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.
- 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
Enrollment periods for eligible employees:
- Enroll within 30 days of hire/eligibility for 1st of subsequent month start date
- Within 30 days of a significant life event
- During Annual Enrollment period for subsequent year.
Annual Enrollment: Annual enrollment for 2027 is:
October 14 – November 6th for Active and pre-65 retirees
October 21 – November 20th for post-65 retirees
Staff Contact: Cathy Hobart, Diocesan Controller
Plan Options & Overviews
Available Plans:
Health Insurance Plans (all include EAP Plan):
Anthem BCBS CDHP 15* – Standard Plan
Anthem BCBS CDHP 20*
Anthem BCBS PPO 80
Anthem BCBS Medicare Secondary Payer PPO 80 – Standard Plan age 65+
*Important Note: Contributions into a Health Savings Account (HSA) 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 prorated. One of the CDHP plans may not fit your needs. If you will be turning 65 in 2027, you may consider choosing the Anthem BCBS PPO plan. This plan may be converted to an Anthem BCBS MSP PPO plan by your parish and would be considered the Standard Plan for active employees age 65+
Standalone Employee Assistance Program (EAP) Plan:
- May be offered to Employees who are Eligible Individuals for health plan coverage but who have opted out
- EAP is automatically included with enrollment in one of the health plans
Dental Insurance Plans:
Delta Dental Basic
Delta Dental Comprehensive
Delta Dental Premium
Health Insurance Plans
Health Insurance Overview
- Premium and deductible amounts show are for the Employee Cost for Full-Time employees hired after December 31, 2015.*
- *Part-time employees: Please check your costs for premium and deductible with your employer.
- Monthly Premium and Annual deductible amounts contributed by parish are prorated for less than full time making employee costs higher than listed.
- The employee cost for those working 1000-1499 hours is 100% unless otherwise determined by your parish employer.
Standard Plan: Anthem BCBS CDHP 15 – Employee Cost Full-Time employees* hired after December 31, 2015
| Coverage Level | Employee’s Monthly Premium | Annual Deductible Cost – Employee | Out of Pocket Maximum (in-Network) | Copays/Coinsurance (in-Network) | Prescriptions |
|---|---|---|---|---|---|
| Single | $0 | $550 | $3,900 | 15% | 15%-50% |
| Emp + 1 | $247.25 | $2,750 | $7,800 | 15% | 15%-50% |
| Family | $556.25 | $2,750 | $7,800 | 15% | 15%-50% |
| Coverage Level | Employee’s Monthly Premium | Annual Deductible Cost – Employee | Out of Pocket Maximum (in-Network) | Copays/Coinsurance (in-Network) | Prescriptions |
|---|---|---|---|---|---|
| Single | $0 | $900 | $5,000 | 20% | 15%-50% |
| Emp + 1 | $0 | $5,409 | $10,000 | 20% | 15%-50% |
| Family | $15.75 | $7,200 | $10,000 | 20% | 15%-50% |
| Coverage Level | Employee’s Monthly Premium | Annual Deductible Cost – Employee | Out of Pocket Maximum (in-Network) | Copays/Coinsurance (in-Network) | Prescriptions |
|---|---|---|---|---|---|
| Single | $0 | $918 | $5,000 | varies – see plan | $10 – $500 |
| Emp + 1 | $269.75 | $3,000 | $10,000 | varies – see plan | $10 – $500 |
| Family | $667.75 | $3,000 | $10,000 | varies – see plan | $10 – $500 |
Full-Time employees* hired after December 31, 2015
| Coverage Level | Employee’s Monthly Premium | Annual Deductible Cost – Employee | Out of Pocket Maximum (in-Network) | Copays/Coinsurance (in-Network) | Prescriptions |
|---|---|---|---|---|---|
| Single | $0 | $375 | $5,000 | varies – see plan | $10 – $500 |
| Emp + 1 | $211.75 | $1,875 | $10,000 | varies – see plan | $10 – $500 |
| Family | $476.50 | $1,875 | $10,000 | varies – see plan | $10 – $500 |
Employee Assistance Program (EAP)
Standalone Employee Assistance Program (EAP) Plan Overview
Available to eligible employees who have opted out of coverage under one of the health insurance plans.
| Coverage Level | Employee’s Monthly Premium |
|---|---|
| Single | $0 |
| Emp + 1 | $0 |
| Family | $0 |
Dental Plans
Dental Insurance Overview
All plans cover:
-
- diagnostic and preventive care
- three dental cleanings a year (four under certain conditions)
- basic and major restorative services (subject to applicable coinsurance, deductibles, limitations, and exclusions)
The Comprehensive and Premium Plans both offer orthodontice coverage. The Premium Plan provides a higher in-network lifetime benefit. Using the Delta Dental PPO network offers the highest and maximum benefit. Using an out-of-network dentist may result in higher out-of-pocket expenses.
Delta Dental Basic
| Coverage Level | Employee’s Monthly Premium | DD PPO Dentists – Max Benefit/member | DD Premier Dentists – Max Benefit/member | Non-Delta Dental Dentists – Max Benefit/member |
|---|---|---|---|---|
| Single | $39 | $2,000 | $1,500 | $1,000 |
| Emp + 1 | $70 | $2,000 | $1,500 | $1,000 |
| Family | $109 | $2,000 | $1,500 | $1,000 |
No Orthodontics
Delta Dental Comprehensive
| Coverage Level | Employee’s Monthly Premium | DD PPO Dentists – Max Benefit/member | DD Premier Dentists – Max Benefit/member | Non-Delta Dental Dentists – Max Benefit/member |
|---|---|---|---|---|
| Single | $62 | $2,000 | $1,500 | $1,000 |
| Emp + 1 | $112 | $2,000 | $1,500 | $1,000 |
| Family | $174 | $2,000 | $1,500 | $1,000 |
| DD PPO Dentists – Max Benefit/member | DD Premier Dentists – Max Benefit/member | Non-Delta Dental Dentists – Max Benefit/member | ||
|---|---|---|---|---|
| 50% / $1,500 lifetime | 50% / $1,500 lifetime | 40% / $1,000 lifetime |
Delta Dental Premium
| Coverage Level | Employee’s Monthly Premium | DD PPO Dentists – Max Benefit/member | DD Premier Dentists – Max Benefit/member | Non-Delta Dental Dentists – Max Benefit/member |
|---|---|---|---|---|
| Single | $83 | $3,000 | $2,500 | $2,000 |
| Emp + 1 | $149 | $3,000 | $2,500 | $2,000 |
| Family | $232 | $3,000 | $2,500 | $2,000 |
| DD PPO Dentists – Max Benefit/member | DD Premier Dentists – Max Benefit/member | Non-Delta Dental Dentists – Max Benefit/member | ||
|---|---|---|---|---|
| $0 deductible / $2,000 lifetime | $0 deductible / $2,000 lifetime | $50 deductible / $1,500 lifetime |
All health insurance plans include, at no additional cost to the employers or employees:
- Quantum Care Coordination – As a single point of contact, Quantum Health simplifies the healthcare experience for members enrolled in a medical plan that uses the Anthem networks. To get help with enrollment, call (866) 871-0629.
- Vision Benefits – Vision benefits via EyeMed’s Insight Network include coverage for an annual eye exam and cost savings on prescription glasses and contact lenses. For a full list of benefits, see the EyeMed Insight Network flyer, call 866-723-0513, or visit EyeMed.
- Hearing Benefits – Hearing exams and an allowance of up to $3,000 every three years for the purchase of hearing aid devices.
- Employee Assistance Program –A free and confidential 24-hour service that connects employees, dependents, and household members with counselors, attorneys, financial consultants, etc. Learn more about the EAP.
- United Healthcare Global Assistance – Available to members traveling at least 100 miles from their primary residence, in the US and abroad. To learn more, call 800-527-0218, visit UnitedHealthcare Global Assistance, or download the UnitedHealthcare Global Assistance brochure.
- Hinge Health – Online exercise therapy for back and joint pain. See how Hinge Health can help.
Learn more about the Cigna Employee Assistance Program (EAP) with this online course.
Group Medicare Advantage plans:
GMA Premium (PPO)
GMA Comprehensive (PPO)
Detail on each plan, plan costs, and post-retirement health subsidy information for 2027 can be found on CPG’s website.
UnitedHealthcare’s dedicated call center:
866-519-5401, TTY 711
Monday to Friday
8:00 AM to 8:00 PM local time
Sign in or register on the UHC website to access your claims, prescriptions, out of pocket maximum, explanation of benefits, and other tools to help you manage your Medicare benefits online.
Seeing Out-of-Network Providers
With the UnitedHealthcare Group Medicare Advantage (PPO) plan, members can see any Medicare provider (in-network or out-of-network) at the same cost share, as long as the provider accepts the plan and has not opted out of or been excluded from Medicare.
Review this flyer for tips on using out-of-network providers and what to do if they have questions.
Visit the UnitedHealthcare website to find:
- UnitedHealthcare Virtual Education Center
- Plan Coverage and Benefits
- Prescription plan information (Optum RX)
- UnitedHealthcare Renew Active
- Group Medicare Advantage FAQs
To enroll in the GMA plan you must be enrolled in Medicare Parts A and B and satisfy other eligibility requirements.
CPG Client Services helps former employees aged 65 and older determine whether they are eligible during the retirement process, or when they reach age 65 and become eligible for and enroll in Medicare.
Enrollment generally takes place:
- Every year in the fall, coinciding with Medicare’s Open Enrollment Period
- When individuals experience a significant life event, like a change in marital status or enrollment in Medicare
If you have questions, call us at 800-480-9967, Monday to Friday, 8:30 AM to 8:00 PM ET, or email [email protected].
Step-by-Step Enrollment Guide
How to Enroll:
- Review the plan options available in our diocese
- Compare the plans to determine which is the best fit for your needs.
- Download the Medical/Dental Enrollment Form
- If enrolling, return the completed form to your employer.
Significant Life Events
Include: change in marital status, establishment or termination of a Domestic Partnership, change in number of eligible dependents (ie marriage, birth, adoption, death), change in dependent status, change in employment status affecting plan eligibility, judgment, decree, or order, change in employment or insurance status of spouse.
Notify employer of life event change within 60 days following the event or up to 90 days in advance.
Important phone numbers and contact information
- For eligibility and enrollment support, or general questions, contact CPG Client Services call center at (800) 480-9967, Monday to Friday, 8:30 AM to 8:00 PM ET.
- Visit CPG’s website for vendor contact information for questions about specific coverage details