On this page, parish leaders and clergy will find information about health and dental insurance for their employees (lay and ordained).
Health Insurance Enrollment & Eligibility
Eligibility:
Employee normally scheduled to work 1,000 or more compensated hours per plan year*
Diocesan policy coverage required unless the employee opts out:
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- Clergy who are at least half-time
- Lay employees who are scheduled to work at least 1,500 hours a year
- Spouses, dependents and domestic partners of eligible clergy and lay employees
- Optional: 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
Option to Opt Out:
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.
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 periods for eligible employees:
- Enroll within 30 days of hire/eligibility effective 1st of month following hire,
- Within 30 days of a significant life event,
- During the Annual Enrollment period for subsequent year ( if no significant life event).
Staff Contact: Cathy Hobart, Diocesan Controller
Step-by-Step Enrollment Guide
How to Enroll an employee:
- Determine the employee is eligible for coverage.
- Download the Medical/Dental Enrollment Form
- Determine cost sharing for employee.
- Give the form along with this website address for available coverage options, and cost sharing information (if not full-time).
- If they choose to enroll in a plan, return the completed form for processing to either:
- your parish institution administrator for MAP* (if any)
- Cathy Hobart at the diocesan office.
*Contact Cathy Hobart for more information on parish institution administrator.
If an eligible employee opts out:
If the employee decides they do not want coverage through your plan, have them complete this opt-out form and return it to you.
This form should be kept in the employee’s personnel file at the church. It does not need to be sent to the diocesan office.
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+
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
- 100% of the cost must be paid by employer
- To provide this to your employees, it must be provided to all eligible employees who have opted out. You cannot choose to cover some but not all of those eligible.
Dental Insurance
Employees may choose from three available dental plans at their own cost :
Delta Dental Basic
Delta Dental Comprehensive
Delta Dental Premium
Health Insurance Plans
Health Insurance Overview
Standard Plan – Anthem BCBS CDHP-15
Full-time employees
- Costs to Employer – Full-Time Employees hired before January 1, 2016
Standard Plan – 100% of premium and 75% of individual deductible for any coverage tier - Costs to Employer – Full – Time Employees hired after December 31, 2015
Premium: 100% of the premium for Single coverage plus 75% of the premium differential for Employee +1 or Family, Plus
Deductibles: 75% of the deductible for Individual coverage for any coverage tier (single, employee +1, or family)
Part-time employees (1500+ hours annually/50%+ time for clergy):
The diocese/parish would pay the same as for Full-Time Employees prorated at a percentage equal to the percentage of time in Letter of Agreement (clergy) or time scheduled (lay).
Alternate Plans:
The employee would pay any cost (premium and deductible) above the Standard Plan parish contribution. Any cost savings would remain with the parish not be passed onto the employee.
Billing for Premiums:
Billing for premiums is monthly from The Episcopal Church Medical Trust and is electronically delivered and paid. **If you do not already have representatives designated as the benefit bill payer or institution administrator, you will need to name one. Contact Cathy Hobart at the diocesan office for assistance with enrolling them in the role.
The parish will be billed for the full monthly premium. Any cost sharing from the employee is paid to the parish.
Health Savings Accounts (HSA) for deductible contributions:
- can be used by employees enrolled in one of the two CDHP plans (15 or 20). They cannot be used for employees enrolled in the PPO 80 or MSP PPO 80 plans.
- are opened by the individual, not the parish. Any funds put in by the parish remain with the employee at year end.
- Accounts are automatically opened through HealthEquity when an indivdiual enrolls in one of the CDHP health insurance plans. The employee may use this account, use their exisiting HSA account, or open an account at a banking institution of their choice.
- Once an employee turns age 65, contributions can no longer be made into their HSA account. In the year they turn 65, if they are enrolled in a CDHP plan, the amount contributed would be prorated for the year.
- Timing of funding the parish portion of the HSA contribution for the year should be based on parish cash flow and agreement with employee. Preference would be to fund in full at the beginning of the year, but semi-monthly, quarterly, and monthly are options.
- If your employee is using HealthEquity, they will receive funding information to pass onto the employer. Payment may be electronically or by paper check, determined by HealthEquity.
Health Reimbursement Accounts (HRA) for deductible contributions for PPO80 or MSP PPO 80:
The parish/Diocese could establish a Health Reimbursement Account (HRA) to fund a portion of the deductible for active employees pre-65.
The parish/Diocese should establish a Health Reimbursement Account (HRA) to cover the deductible (at a minimum) for those active clergy/lay employees enrolled in Medicare Secondary Payer.
Any unspent funds in these accounts revert to the parish at year end.
HealthEquity offers HRA accounts. For parishes that process payroll with ADP, there is a significant discount available for the account. Please contact Cathy Hobart for more information if you process with ADP and would like to open an HRA account.
STANDARD PLAN: Anthem BCBS CDHP 15 Cost– Full-Time employees* hired after December 31, 2015
| Coverage Level | Employer’s Monthly Premium | Employer’s Annual Deductible Cost | Employee’s Monthly Premium | Employee’s Annual Deductible Cost | Plan Total Monthly Premium | Plan Total Annual Deductible Cost |
|---|---|---|---|---|---|---|
| Single | $1,236 | $1,650 | $0 | $550 | $1,236 | $2,200 |
| Emp + 1 | $1,977.75 | $1,650 | $247.25 | $2,750 | $2,225 | $4,400 |
| Family | $2,904.75 | $1,650 | $556.25 | $2,750 | $3,461 | $4,400 |
| Coverage Level | Employer’s Monthly Premium | Employer’s Annual Deductible | Employee’s Monthly Premium | Employee’s Annual Deductible Cost | Plan Total Monthly Premium | Plan Total Annual Deductible Cost |
|---|---|---|---|---|---|---|
| Single | $1,092 | $2,700 | $0 | $900 | $1,092 | $3,600 |
| Emp + 1 | $1,966 | $1,791 | $0 | $5,409 | $1,966 | $7,200 |
| Family | $3,042.25 | $0 | $15.75 | $7,200 | $3,058 | $7,200 |
| Coverage Level | Employer’s Monthly Premium | Employer’s Annual Deductible Cost | Employee’s Monthly Premium | Employee’s Annual Deductible Cost | Plan Total Monthly Premium | Plan Total Annual Deductible Cost |
|---|---|---|---|---|---|---|
| Single | $1,325 | $582 | $0 | $918 | $1,325 | $1,500 |
| Emp + 1 | $2,115.25 | $0 | $269.75 | $3,000 | $2,385 | $3,000 |
| Family | $3,042.25 | $0 | $667.75 | $3,000 | $3,710 | $3,000 |
| Coverage Level | Employer’s Monthly Premium | Employer’s Annual Deductible Cost | Employee’s Monthly Premium | Employee’s Annual Deductible Cost | Plan Total Monthly Premium | Plan Total Annual Deductible Cost |
|---|---|---|---|---|---|---|
| Single | $1,059 | $1,125 | $0 | $375 | $1,059 | $1,500 |
| Emp + 1 | $1,694.25 | $1,125 | $211.75 | $1,875 | $1,906 | $3,000 |
| Family | $2,488.50 | $1,125 | $476.50 | $1,875 | $2,965 | $3,000 |
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.
This cost cannot be paid by employee.
| Coverage Level | Employer’s Monthly Premium |
|---|---|
| Single | $4 |
| Emp + 1 | $4 |
| Family | $4 |
Dental Plans
Dental Insurance Overview
Dental Insurance-
Optional to Employee at their cost, not required to be provided by Employer.
Delta Dental Basic Cost
| Coverage Level | Employee’s Monthly Premium |
|---|---|
| Single | $39 |
| Emp + 1 | $70 |
| Family | $109 |
| Coverage Level | Employee’s Monthly Premium |
|---|---|
| Single | $62 |
| Emp + 1 | $112 |
| Family | $174 |
Delta Dental Premium Cost
| Coverage Level | Employee’s Monthly Premium |
|---|---|
| Single | $83 |
| Emp + 1 | $149 |
| Family | $232 |
| 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 |
- Employees age 65+
- Age Discrimination in Employment Act employers cannot discriminate against an employee or spouse age 65+ in the provision of health benefits.
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- 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.
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- Employees aged 65+ who are actively working and meet one of the eligibility criteria, must be offered health coverage through a Medical trust Episcopal Health Plan by their employer.
- Medicare Secondary Payer (MSP) Small Employer Exception (SEE).
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- Employer must apply for the exception which gives access to reduced premium
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- Please review this Information about the MSP SEE before applying.
- If the parish qualifies,
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- Have the employee enroll in the offered Anthem BCBS BlueCard PPO plan during annual enrollment. Premiums will be retroactively adjusted to the MSP rates when the parish application for MSP SEE is approved.
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- complete the application Medicare Secondary Payer Small Employer Exception (MSP SEE).
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- Make a copy of employee Medicare card.
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- The parish/Diocese should establish a Health Reimbursement Account (HRA) to cover the deductible (at a minimum) for those active clergy/lay employees enrolled in Medicare Secondary Payer.
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- MSP plan is the standard plan for active employees age 65+
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
Employee should notify you 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
- HealthEquity for HRA account information:Vladimir Margovskiy, Regional Sales Manager, M: 608.669.6885, [email protected]