the benefits plan of the presbyterian church u s a n.
Download
Skip this Video
Loading SlideShow in 5 Seconds..
The Benefits plan of the presbyterian church (U.S.A.) PowerPoint Presentation
Download Presentation
The Benefits plan of the presbyterian church (U.S.A.)

play fullscreen
1 / 95

The Benefits plan of the presbyterian church (U.S.A.)

172 Views Download Presentation
Download Presentation

The Benefits plan of the presbyterian church (U.S.A.)

- - - - - - - - - - - - - - - - - - - - - - - - - - - E N D - - - - - - - - - - - - - - - - - - - - - - - - - - -
Presentation Transcript

  1. The Benefits plan of the presbyterian church (U.S.A.) Regional Representatives

  2. The Benefits Plan of the PC(USA) provides pension, healthcare and death and disability benefits to members of the Benefits Plan, their eligible dependents, and beneficiaries, where applicable.

  3. Community Nature • Key foundation of the plan • Community: plan members, churches, and other employing organizations • The whole community shares cost for the sake of all • Minimum benefits ensured for all plan members

  4. “For just as the body is one and has many members, and all the members of the body, though many, are one body, so it is with Christ. ... God has so arranged the body ... that there may be no dissension within the body, but the members may have the same care for one another. If one member suffers, all suffer together with it; if one member is honored, all rejoice together with it.” 1 Corinthians 12:12, 24-26 (NRSV)

  5. Building Blocks

  6. Effective Salary • Basis for dues and benefits • Not necessarily IRS or SECA salary amount • Includes • Cash salary • Housing or manse value • Deferred compensation • [403(b)(9); Sec. 125 plan] • Other cash payments

  7. 2013 & 2014 Median Effective Salaries *Although the figures used to calculate the pastors’ median include only teaching elders serving churches, the median applies to all teaching elders for determining benefits based on effective salary: pension credit accruals, disability benefits, and death benefits.

  8. Traditional Coverage under theBenefits Plan

  9. Core Benefits Healthcare Retirement Death Disability

  10. Healthcare

  11. Nationwide Group Plan

  12. Medical PPO Network • Network – Healthcare providers who agree to negotiated fees when treating patients in the network • Out of network – Healthcare providers in a geographic network area who do not participate in the networks offered by the Board • Non-network– A geographic area that does not have sufficient network providers within a reasonable distance of members

  13. Member Cost: Office Visit Copays • Network office visit copays • $25 for primary care/mental health • $45 for specialists • Out of network • 50% of the plan allowance • Office visit copays do not count toward annual deductibles or copayment maximums

  14. 2014 Deductible and Copayment Percentages

  15. Member Cost: Deductibles • Medical deductibles are based on effective salaries, reflecting the ability of the member to pay • Members are responsible for two deductibles* • 1.25% of effective salary for the member • 1.25% of effective salary for the rest of the family *(Network) Out of Network – 2.5%

  16. Member Cost: Network Copayment Limits • After network deductible is met, member pays 20% copayment for eligible network services • This counts toward copayment limit • After member has paid 5% of effective salary in copayments, Board pays 100% of eligible network costs

  17. Member Cost: Out-of-Network Copayment Limits • After out-of-network deductible is met, member pays 40% copayment for eligible out-of-network services • This counts toward copayment limit • After member has paid 15% of effective salary in eligible costs, Board pays 100% of eligible costs • Costs for out-of-network services that exceed plan allowance do not count toward copayment limit

  18. 2014 Healthcare Deductibles and Copayment Maximums

  19. Prescription Drug Plan

  20. Prescription Drug Plan • No annual deductible • $2,500 copayment annual limit • Maintenance medications by mail order

  21. Prescription Drugs

  22. Maintenance MedicationsMail Order • Maintenance medications are drugs taken regularly for long-term chronic conditions • Does not apply to one-time prescriptions • 90-day supply • Efficient, safe, and economical

  23. Preventive Care Benefit • Not subject to deductible • $0 office visit copay for network providers • Plan pays 100% of office visit, lab work, and tests, according to preventive schedule • Non-preventive (diagnostic) lab work or tests recommended by the provider during annual physical are covered subject to normal Medical Plan provisions

  24. Mental Health/Substance Abuse • Provided through Cigna • Treatment is reviewed by Cigna for medical necessity • Pre-certification is required for inpatient or higher-level services • Contact Cigna at 866-640-2772 or visit www.cignabehavioral.comfor network providers

  25. EmployeeAssistanceProgram • Cigna • For members and household members • Confidential counseling/referral service for family, financial, alcohol, drugs, legal, life events, and stress issues • Six free counseling visits/per person/per issue; confidential counseling/referral service • Financial and legal help

  26. Health Management: ActiveHealth

  27. Pre-certification • Pre-certification is required for: • Scheduled outpatient imaging (MRI, MRA, CAT, PET, SPECT, etc.) and nuclear stress test • Bariatric surgery or any weight loss surgery • All inpatient hospitalizations including maternity • 7-10 days in advance or within 48 hours of emergency hospital admission • Call ActiveHealth®,866-794-3127

  28. Pre-certification If it is a scan, find out if you can!

  29. Emergency Care • In a life-threatening or other emergency situation, seek care immediately at the closest appropriate facility • If hospitalized from emergency room, contact must be made with ActiveHealth within 48 hours

  30. Informed Care Management • Informed Care Management • Managed by ActiveHealth • Supports those with diabetes or cardiac conditions, lower back pain, and other chronic health conditions

  31. Personal Health Record • Online confidential health record that conveniently does your health history record-keeping for you • Includes information you provide • Automatically updates when your claims from Highmark, Catamaran, and Quest Diagnostics * (if you use its labs) are processed • Start your PHR on myactivehealth.com/pcusa *not all Quest labs are in network

  32. Case Management • Case Management supports those with extended hospitalizations and complex medical conditions. It is a confidential service that can assist you with managing your medical condition by: • helping you understand the care resources available • coordinating and helping arrange medical services for you providing education and support for you and your family

  33. 24-hour Nurse Line • Toll free: 866-794-3127 • You can call the Nurse Line if you: • wonder whether you need to get medical care • need information about a medication, test, or medical procedure • want reliable information about a health condition • aren’t sure what questions you should ask your doctor • have questions about how you or your family can stay healthy

  34. 2014 Health Actions • All Members must complete: • Preventive Exam • Engage with ActiveHealth Nurse (if called) • And complete at least 2: • Health Assessment • “Know Your Numbers” lab test • Vision exam • Tobacco cessation program* • Attend CREDO (if appropriate)

  35. 2014 Health Actions • Who? • Members only in 2014 • When? • Complete Health Actions between October 1, 2013 - September 30, 2014 • How tracked? • In “Call to Health” • via Benefits Connect, or • www.MyActiveHealth.com/pcusa

  36. Call to Health

  37. Other Health Benefits • VSP - $25 annual eye exam • Find a vision provider: • 800-877-7195 • vsp.com

  38. International Travel • Before travel outside United States, call the Board at 800-773-7752 (800-PRESPLAN) or visit pensions.org • International SOS • Obtain wallet card with regional toll-free telephone numbers • BlueCard Worldwide • Advises members about safe, reliable medical providers while outside United States.

  39. Retirement Pension

  40. Retirement Pension • Defined Benefit Plan • Pension credits accrue over entire length of service • Experience apportionments may be granted by the Board of Directors • Experience apportionments permanently increase the pension credits

  41. In 2013 the Plan Paid … Retirees: $254,981,237 to 15,157 lives Survivors: $57,772,162 to 4,502 lives Total Paid: $312,753,339 to 19,659 lives Source: Benefits Plan Highlights

  42. ExperienceApportionment History: 2000-2014

  43. Actual Pension Benefits $2,681 Basic Benefit + CPI $1,990 Basic Benefit $1,000

  44. Pension Options • Joint and Survivor options available at retirement provide a larger benefit to surviving spouse • Early retirement available at 55 with reduced benefit • Post-normal retirement provides increased benefit for retirement after age 65

  45. Early Retirement • Retirement benefits may be initiated as early as age 55 • Benefit amount is determined actuarially for each year before age 65 • 55 years 50% • 58 years 59% • 60 years 65% • 63 years 84%

  46. Post-Normal Retirement • Enhanced benefit for retirement past age 65 (pension credits continue to accrue) • Additional 6.5% per year until age 70 66 6.5% 67 13% 68 19.5% 69 26% 70 32.5% 70+ 32.5% • Pro-rated to the month

  47. Death

  48. Death Benefits • Salary continuation • Lump-sum payment • Education benefit for dependent children • Survivor medical coverage for one year

  49. Death Benefit: Living Needs Benefit • Allows prepayment of part of death benefits up to • 75% of covered effective salary as lump- sum benefit, or • 100% of the present value of the salary continuation benefit, or • Both • To assist those with a terminal illness (life expectancy of 24 months or less)