R7: Denominational Health Plan Resolution - passed

• Scope of Coverage - The Diocese of Ohio and all its congregations are required (except noted below) to provide medical insurance coverage for all qualified employees (those employees who work 1500 hours or more per year). This coverage must be purchased through the Denominational Health Plan designed and administered by the Trustees and Officers of the Church Pension Fund with benefits provided through The Episcopal Church Medical Trust. The diocese will determine on an annual basis the plans available for selection by qualified employees. Each organization (diocese, parish, congregational institutions, etc.) may choose to offer one or more of these plans.


• Employee Opt-Out Provision - Employees may opt out of obtaining medical insurance coverage through the Denominational Health Plan if they have medical insurance coverage through other approved sources (i.e. spouse’s employer’s plan, former employer’s plan Tri-Care, Medicare). Parishes may not opt out of coverage with the Medical Trust for its qualified employees.


• Parity Provision - At a minimum, all qualified clergy and lay employees must be provided, on an equal basis, the same percentage of the premium for a health insurance plan offered by the Diocese of Ohio through the Denominational Heath Plan. All qualified employees working for an institution must be provided equal access to the plans offered by that institution. For purposes of this resolution, the premium for a High Deductible Health Plan (HDHP) includes full (100%) funding of the plan deductible in a health savings account (H.S.A.). The specific minimum cost-sharing percentage will be determined annually by the Commission on Ministry in the resolution for clergy compensation. Any cost sharing arrangements for coverage above the minimum level must be at the same percentage for all qualified employees (parity between clergy and lay).


• Other institutions - Schools, day care facilities and other congregational and diocesan institutions, whether or not they operate under a separate tax ID for the sponsoring institution, are encouraged but not required to participate in the Denominational Health Plan on the same basis as congregations, and must contact the Episcopal Medical Trust each time medical coverage is renewed.


• Coverage for Certain Part-time Employees -  Clergy and lay employees who work 1000 hours or more, but less than 1500 hours per year, are eligible to voluntarily participate in the Denominational Health Plan and purchase insurance through The Medical Trust. Individual institutions (the diocese, parishes, and schools, day care facilities, and other diocesan institutions) may determine the cost-sharing policy applicable to the medical insurance coverage for these employees.

Submitted by

Rationale:

In 2009, the General Convention of the Episcopal Church passed Resolution A177, which established The Denominational Health Plan. The objectives behind the resolution were:

• To provide equal access to, and parity of funding for, health insurance for all full-time clergy and lay employees of dioceses and parishes of the Episcopal Church;
• To require that all domestic dioceses and parishes purchase their health insurance through the Medical Trust; and
• To mitigate cost increases in health insurance by achieving economies of scale and enhancing purchasing power.

Dioceses are charged with a four-fold task relating to the implementation of the Denominational Health Plan (DHP):

• Determine whether health insurance benefits are provided to domestic partners (same- and opposite-sex partners),
• Determine whether institutions under diocesan authority are required  vs. eligible to participate in the DHP,
• Determine annually which health insurance plans will be offered within the diocese, and
• Determine a parity policy which provides equal access to health insurance for clergy and lay employees and equal funding between clergy and lay employees.

Diocesan Council adopted a policy mandating coverage for domestic partners in 1998.  The DHP will not change this policy, i.e. domestic partners will continue to be eligible for health insurance coverage.

The health insurance administrator for the diocese, in conjunction with the Health Insurance Committee, determines which health insurance plans will be offered within the diocese.  Surveys, feedback and employee input aid these annual decision making process.  A variety of vendors, plan types, network vs. non-network access, and doctor/hospital participation impact the plan selections.

Across the Diocese of Ohio, there are a limited number of schools, day care centers, and other institutions under the authority of the diocese.   Due to the financial challenges associates with continuing to operate these organizations, the DHP Committee decided that access to health insurance was a sufficient mandate, and these organizations may independently determine their level of participation.

The Church Pension Group and the Medical Trust have devoted countless hours of research and ongoing support to dioceses to aid in the implementation of the DHP.  Other dioceses were consulted about their decision making processes and the cost-sharing policies they adopted.

Demographic data of the current Medical Trust enrollment was also reviewed.  At September 1, 2011, 91 employees and 100 dependents participate in seven different Medical Trust health insurance plans.  About 42% (38) of employees have single coverage, another 35% (32) have employee plus one (spouse/partner/child) coverage, and the remaining 23% (21) have family coverage.

For the first time in 2012, the Diocese is offering a High Deductible Health Plan (HDHP).  The insurance portion of the plan has a significantly lower premium than other traditional health insurance plans.  The deductible in the HDHP plan is $2,700 for a single employee and $5,450 for all other employees, as compared to a deductible of $200 for single and $500 for others in traditional health plans.  The premium portion is over 31% lower for all tiers in the HDHP plan vs. the lowest cost health plan offered.

The deductible amount can be deposited into a Health Savings Accounts, or H.S.A. and those funds used to pay medical costs up to the amount of the deductible.  The combination of the insurance portion and funding of the high deductible is comparable to the cost of traditional health insurance plans.  Therefore, the premium for the HDHP plan is defined to include full funding of the Health Saving Account.

The required annual resolution on the minimum standards for clergy compensation is prepared and submitted to Convention by the Commission on Ministry.  This resolution includes a provision for both compensation and health insurance funding.  Since salary and health insurance are significant parts of the total compensation package, these elements are integrated, and the recommendation for one often depends on the change in cost of the other.  Therefore, it is reasonable to determine the health insurance funding, including the cost-sharing portion thereof, of an annual basis.

The Canons of The Episcopal Church provide that each Diocese have a Commission on Ministry.  The duties of the Commission include “advising and assisting the Bishop in the determination of present and future opportunities and needs for the ministry of all baptized persons.”  The scope of their function is not limited just to ordained persons, but also to the ministry of the baptized laity.  Therefore, since the Commission on Ministry is charged with the responsibility for the resolution on clergy compensation, the health insurance parity provision is includable in that resolution.