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

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 2018, open enrollment periods are:

  • Active employees: October15th through November 2nd.
  • Retirees: October 15th through December 7th.

Get more information about Open Enrollment.

Health Insurance Requirements & Eligibility

According to the Diocesan Health Care Plan Policy (2019), 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.

Eligible active clergy and lay employees age 65 and older:

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

Available plan: Anthem BCBS BlueCard MSP PPO 100 (age 65+ with prior authorization) (2019)

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 for an annual eye examination, prescription eyeglasses or contact lenses and other vision benefits
  • Hearing Discount Plan for discounted costs on hearing exams
  • Employee Assistance Program providing mental health information, resources, and referrals
  • Health Advocate to help employers and employees navigate the healthcare and insurance systems
  • Travel Medical Protection to provide emergency medical and travel assistance services while traveling outside the U.S. and other services when traveling at least 100 miles from the member’s primary residence

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. 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:

  • $692 per month = 100% of the Single premium, PLUS
  • $1,400 per year = 100% of the Single deductible, PLUS
  • $934.50 per month = 75% x ($1,938-$692) = 75% of the difference between the Family premium ($1,938) and the Single premium ($692), PLUS
  • $1,050 per year = 75% x ($2,800-$1,400) = 75% of the difference between the Family annual deductible ($2,800) and the Single annual deductible ($1,400).

So the total monthly premium cost to the parish will be $1,626.50 ($692 + $934.50) and the total annual deductible cost to the parish will be $2,450 ($1,400 + $1,050).

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:

  • $311.50 per month = 25% x ($1,938-$692) = 25% of the difference between the Family premium ($1,938) and the Single premium ($692), PLUS
  • $350 per year = 25% x ($2,800-$1,400) = 25% of the difference between the Family annual deductible ($2,800) and the Single annual deductible ($1,400).
  • Any additional costs such as coinsurance, co-pays, and annual out-of-pocket maximums. See  Standard Plan (2019): 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: (800) 480-9967
Monday–Friday, 8:30 a.m.–8:00 p.m. EST

Anthem Blue Cross Blue Shield
anthem.com
Phone: (844) 812-9207
Monday–Friday, 9:00 a.m.–8:00 p.m. EST

Cigna (Dental)
mycigna.com
Phone: (800) 244-6224
24 hours a day, 7 days a week

Express Scripts Prescription Drug Benefits
express-scripts.com 
Phone: (800) 841-3361
24 hours a day, 7 days a week (except Thanksgiving and Christmas)

Cigna Behavioral Health & Employee Assistance Plan
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

Affordable Care Act/ Health Insurance Marketplace:

Under the Affordable Care Act, clergy and lay employees may also choose to waive denominational health insurance benefits and purchase coverage on the health insurance marketplace.

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