Left Navigation


Common Questions

Top Questions

How do I enroll an employee in a health plan?

We are standing by to help you enroll your employees. Please call us at (855) 215-5990 Monday through Friday, 8:30AM – 8:00PM ET (excluding holidays).

What is the Denominational Health Plan?

A Church-wide program of healthcare benefit plans authorized by General Convention and administered by The Church Pension Fund (CPF), with benefits provided through The Episcopal Church Medical Trust (the Medical Trust).

Active Clergy & Lay Employees

How many health insurance plans should my organization offer?

You may offer any of The Episcopal Church Medical Trust plans that are available in your geographic area. Which plans, and how many, is completely up to you. Our Regional Relationship Specialists will work with you to help you select the plans that are best for your group.

Which additional benefits are included with the health plans, and which are optional to provide to employees?

The following benefits are included with all the Medical Trust active health plans:

  • Pharmacy (Standard, Premium, or Consumer-Directed Health Plan benefits)
  • Vision care
  • Behavioral Health/Substance Use Disorder
  • Employee Assistance Program
  • Health Advocate

The following benefits may be offered by employers:

  • Dental

The following benefits may be offered by employers as a stand-alone benefit to qualified members:

  • Employee Assistance Program (EAP)

Why should my organization offer dental benefits?

In addition to the many health benefits of proper dental care, offering dental benefits can result in better employee retention, productivity and morale. According to the American Dental Association, dental disease and discomfort is an often overlooked reason for missed work days and poor employee performance.

How soon must an eligible employee enroll in a health plan?

Employees must enroll within 30 days of their date of hire or eligibility date.

What is open enrollment and when does it take place?

Open enrollment is a designated period each year when members may enroll in, or make changes to, healthcare coverage for themselves and/or their dependents. Members are able to add or remove dependents at this time. Open enrollment usually occurs in the fall. Plan selections become effective on the first day of the following plan year.

How does the Employee Assistance Program differ from standard mental health benefits?

Behavioral health and substance use disorder benefits are available with all the Medical Trust plans and cover both outpatient services, such as counseling sessions, and inpatient services. The Employee Assistance Program (EAP) is an additional layer of coverage available to help members with work/life balance issues. The plan covers unlimited telephone consultations and up to 10 in-person visits with a Cigna counselor per issue. Licensed clinicians can provide resources and referrals on issues such as coping with stress, child and senior care, legal/financial matters, substance use disorder, and emotional and physical health. For more information, visit myCigna.com online or call (866) 395-7794.

Retired Clergy and Lay Employees

Why do retirees need a Medicare Supplement Health Plan?

Medicare Part A and Part B provide coverage for medically necessary basic health services. The three Medicare Supplement Health Plans offered by the Episcopal Church Medical Trust provide additional benefits for expenses that may not be covered by Medicare, as well as vision and hearing benefits. 

Which additional benefits are included with the Medicare Supplement Health Plans, and which are optional?

All Medicare Supplement Health Plans have a prescription drug benefit. Only people with Medicare Part D may opt out of the prescription drug benefit.

The following benefits are included with all Medicare Supplement Health Plans:

  • Vision
  • Hearing
  • SilverSneakers
  • Employee Assistance Program
  • Health Advocate
  • UnitedHealthcare Global Travel Assistance

Retirees may choose to enroll in dental plans at an additional cost.

What are the differences among the three Medicare Supplement Health Plans?

Comprehensive Plan
Plus Plan
Premium Plan
2019 Monthly Cost Per Person:
With prescription drug benefit
Without prescription drug benefit
$205 $240 $295
2020 Monthly Cost Per Person:
With prescription drug benefit
Without prescription drug benefit
$210 $245 $295

Out of Pocket Costs 2019 & 2020


Annual out-of-pocket maximum per benefit period
Inpatient hospital copayment
No cost
No cost
Medicare Part B physician copayment
Routine physical exam
No cost up to $200
No cost up to $200 
No cost up to $200


For details, download the 2020 Medicare Supplement Handbook.

Who is eligible for a Medicare Supplement Health Plan?

Eligibility to participate in the Medicare Supplement Health Plan is determined by the plan and validated by the group administrator. Eligibility for Medicaid or the receipt of Medicaid benefits will not be taken into account in determining eligibility.

Eligible individuals and eligible dependents described below, who are eligible for and enrolled in Medicare Part A and B, may enroll in a Medicare Supplement Health Plan:

  • For specific eligibility requirements, see Eligibility

How soon after retiring must a clergy member or employee enroll in a Medicare Supplement Health Plan?

Eligible employees must enroll within 30 days of the date on which they retire and receive confirmation of enrollment in Medicare Part A and Part B. If they do not join within 30 days after retirement or confirmation of enrollment in Medicare Part A and Part B, they may do so during the open enrollment period each year.

When can retirees change their enrollment selections?

Enrollment selections may be changed during the annual open enrollment period, as well as within 30 days of a significant life event such as a marriage.

When is open enrollment for retirees?

The open enrollment period for retirees coincides with Medicare’s open enrollment and is usually in the fall.

When does coverage begin and end?

Coverage begins on the first day of the month in which a retiree becomes eligible for and enrolls in a Medicare Supplement Health Plan. Coverage ends on the earliest of:

  • The last day of the month in which the retiree ceases to be a retired employee
  • The last day of the month in which the retiree ceases to be eligible
  • The last day of the month in which coverage payments cease
  • The date the plan ends


The Denominational Health Plan (DHP)

What is the Denominational Health Plan (DHP)?

A Church-wide program of healthcare benefit plans authorized by General Convention and administered by The Church Pension Fund (CPF), with benefits provided through The Episcopal Church Medical Trust (the Medical Trust).

What does Resolution A177 require of employers?

Employers are required to provide all eligible clergy and lay employees with equal access to and parity of funding for healthcare benefits, to be provided through the Medical Trust. Under the terms of this resolution, an eligible employee is someone who is scheduled for at least 1,500 hours of compensated work annually for any domestic diocese, parish, mission, or other ecclesiastical organization or body subject to the authority of the Church.

What is the deadline for complying?

Full implementation of the DHP was to be completed no later than January 1, 2013.  The period for achieving parity in cost-sharing was extended to December 31, 2015 by Resolution B026 in 2012.While the majority of dioceses have DHP policies in place, the IBAMS Account Managers continue to consult with those dioceses that continue in the implementation process.

What are the advantages of the DHP?

  • Provide healthcare cost-containment for our Church by leveraging its aggregated size for large-scale purchasing of employee healthcare benefits.
  • Provide dioceses and groups with control, choice, and flexibility.
  • Balance financial constraints with the cost of delivering employee healthcare benefits.
  • Provide equal access to healthcare benefits for all eligible employees through parity of plans and funding for the eligible clergy and lay employees of groups required to participate.
  • Provide the assurance of future healthcare benefits for clergy and lay employees.
  • Provide financial stability for employees through protection from catastrophic healthcare expenses and position employers to better absorb claim fluctuations and volatility.
  • Decrease the healthcare benefit administrative burden for most employers.
  • Provide comprehensive and integrated care management programs and processes for delivery of improved health outcomes.
  • Proactively encourage the Church’s clergy and lay employees to embrace healthy lifestyles, wellness strategies, and preventive healthcare.
  • Provide excellent customer service.
  • Provide individualized service, support, and education to dioceses through the assignment of a Regional Relationship Specialist from the Medical Trust’s Client Relations department for each province.

Is the DHP competitive in the Marketplace?

As of April 2016, average Medical Trust rates were approximately 4% below the average health insurance exchange rate, and we expect the DHP’s position to improve for 2017. The Medical Trust estimates that over 90% of the groups participating in the DHP will be in a more competitive position than their local exchanges in 2017.

The Medical Trust was able to deliver a single-digit average rate increase of 5.5% for the 2017 plan year, a favorable result as compared to exchange rate increases that averaged 24%. The ongoing process of monitoring local market developments enables the Medical Trust to make necessary adjustments in future renewals to address market competitiveness issues that may continue or arise due to volatility in the exchanges.

Does the DHP require parish schools, camps and conference centers, social service agencies, and other Episcopal institutions to participate?

No. The decision as to whether or not to require the participation of other Episcopal institutions under diocesan authority will be left to each individual diocese. However, organizations that are not required to participate by the diocese can choose to do so voluntarily.

Does participation in the Medical Trust under the DHP require a group to comply with the requirements of the Lay Employee Pension System (Resolution A138) too?

The Lay Employees’ Pension System and the Denominational Health Plan are two separate canonical requirements. Although they are independent of each other, all dioceses, parishes, and missions are required to comply with each.

How has national healthcare reform affected the DHP?

The Patient Protection and Affordable Care Act (PPACA) and the regulations issued under it will have significant short term and long term impacts on the health plans of the Episcopal Church. The Medical Trust remains informed on the impact to employer-sponsored health coverage, and is compliant with changing requirements as well as adapting our health plans in ways that seek to minimize disruption to our employers and our members.

The Medical Trust healthcare plans conform to many of the new healthcare reform requirements:

  • Plan members are provided with 100% coverage for most preventive services recommended by the U.S. Preventive Services Task Force (USPSTF).
  • Eligible members are not excluded from coverage on the basis of their individual health conditions.
  • Pre-existing condition limitations are not imposed.
  • Contribution rates are not determined on the basis of individual health history.
  • Coverage is not canceled on the basis of individual health status.
  • The Medical Trust expanded health coverage to eligible adult children and stepchildren through age 30, regardless of student status, marital status, or tax-dependent status.
  • The Medical Trust health plans have no annual or lifetime maximums.
  • The Medical Trust absorbed an accumulated $3.03 million in required ACA fees rather than passing these fees about to participating dioceses and institutions.
  • The Medical Trust is compliant with IRS reporting (1094-B and 1095-B) to individuals and the IRS for the individual mandate.

There are ongoing provisions that may impact the Medical Trust health plans in the future. We are working with other denominations through the Church Alliance to determine how our healthcare plans may be affected in the future. We will keep you up to date as more information becomes available.

The future of the ACA is uncertain following the 2016 election results. President Donald J. Trump and congressional leadership have indicated repealing and replacing the law is a top priority. The ACA also faces instability in the state exchanges due to high premium increases and lower participation than expected. While it is too early to tell what will ultimately happen, the ACA is likely to undergo significant changes over the next few years. The Medical Trust will continue to monitor these developments and how the DHP is impacted.

What was the spirit behind the Resolution?

Both this resolution and Resolution A138 (Lay Employee Pension System) speak to social justice issues around adequate benefits for the Church’s lay employees. While cost concerns around these initiatives are real, so is the need of lay employees to have adequate pension and healthcare benefits. The support and dedication of lay employees make many ministries possible, and providing them with adequate benefits is not only necessary, it’s the right thing to do.

Historically, there has been some inequity between lay and clergy benefit cost to the employee. Resolution A177 requires that each diocese establish a cost-sharing policy, and that it be the same for clergy and lay employees who are scheduled for at least 1,500 hours of compensated work per year.

Eligibility (DHP)

Which employees are required to participate in the Medical Trust’s health plans?

Clergy and lay employees required to participate in the Medical Trust’s health plans are those who are scheduled to work at least 1,500 compensated hours per year for any domestic diocese, parish, mission, or for any other ecclesiastical organization or body subject to the authority of the Church (and whose diocese has determined it must participate.)

Can part-time employees participate in the Medical Trust plans under the DHP?

The Medical Trust’s eligibility rules relating to part-time employees currently remain the same as before the formation of the DHP. This means that clergy and lay employees of any Episcopal institution who are regularly scheduled to work between 1,000 and 1,499 hours per year are eligible to participate voluntarily.

How are hourly lay employees who are hired to work fewer than 1,500 hours per year, but who actually work and are compensated for 1,500 hours or more per year, treated regarding participation?

The requirement to participate and the eligibility to participate voluntarily in the Medical Trust Plans are governed by actual compensated hours. In this case, the employees would be required to participate because the actual hours worked total or exceed 1,500 per year.

What about clergy who receive a salary with no established hourly schedule?

Clergy generally know if they are full-time (more than 1,500 hours annually) or part-time (less than 1,500 hours annually) employees. Full-time clergy employed by groups required to participate in the DHP are required to participate in the Medical Trust health plans. Salaried clergy employed by groups not required to participate in the DHP and who are considered full-time are eligible to participate voluntarily. Part-time salaried clergy employed by other Episcopal entities may participate voluntarily if their employers offer health-care benefits through the Medical Trust.

Are non-stipendiary clergy eligible to participate in the Medical Trust?

Currently, non-stipendiary clergy are not eligible to participate in the Medical Trust Plans, with a few exceptions as noted in the administrative guidelines. The Medical Trust is evaluating the eligibility of non-stipendiary employees as part of a strategic project initiated in 2010. Because The Episcopal Church Clergy and Employees’ Benefit Trust (“ECCEBT”), the trust through which The Medical Trust plans are funded, is a Voluntary Employee’s Beneficiary Association (VEBA ), we must evaluate eligibility of non-employees carefully.

Are non-parochial clergy eligible to participate in the Medical Trust Plans?

Non-parochial clergy employed by Episcopal institutions that offer healthcare benefits through the Medical Trust are eligible to participate if they are regularly scheduled to work at least 1,000 hours per year. Non-parochial clergy (working more than 1,500 compensated hours annually) employed by diocesan institutions may be eligible or required to participate at the option of the diocese.

Are domestic partners of clergy or lay employees eligible for benefits under the DHP?

Each diocese will decide individually whether or not to offer healthcare benefits to same-sex domestic partners, opposite-sex domestic partners, or both.

How are seminarians treated under the DHP?

The DHP does not address seminarian healthcare benefits coverage. Seminaries traditionally obtain their student coverage outside of diocesan medical plans. Many Episcopal seminaries use the Medical Trust’s seminarian program.

How will former employees currently enrolled in a benefit continuation program be treated under the DHP?

Although the Medical Trust plans are exempt from the Employee Retirement Income Security Act of 1974, as amended (ERISA), we do offer an Extension of Benefits (EOB) program that will cover existing employees receiving COBRA benefits through the end date that is currently in place at the time they transition to the Medical Trust Plans. Once an employer participates with the Medical Trust, the EOB program will be available to departing employees. Those employees who left employment in 2010 or before are eligible for a maximum period of 18 months from their employment termination date. Beginning January 1, 2011, employees who leave employment will be able to extend their benefits for a maximum of 36 months from their employment termination date.

Plans, Products & Vendors

Will most employees have access to the same plan and provider network as they do currently?

While the plans available from the Medical Trust may not be exactly the same as those currently offered by a particular group, the Medical Trust’s variety of plans should meet the needs of most employees. A copy of our current plan offerings is available upon request.

What is the prescription drug benefit under the DHP?

The Medical Trust currently offers three prescription drug plan options through Express Scripts. These designs work well for our groups and there are no plans to change them. As with the medical plan design, each group will choose which level of prescription drug benefit to offer its eligible employees.

For those groups that choose a regional Kaiser network plan, the prescription drug benefit is managed through Kaiser rather than Express Scripts.

Is dental coverage required under the DHP?

No. Only medical benefits are required under the DHP. The Medical Trust does offer three dental plans using the Cigna dental network.

Can the Medical Trust provide a disruption report for any networks that are different from the ones we currently use?

We can provide you with a detailed provider access report for employee zip codes. Depending on the quality of the data available from the prior healthcare benefit provider, we may be able to provide actual provider disruption reports.


What does “parity” refer to?

The DHP requires that each diocese establish, on a diocesan-wide basis, the minimum required employer cost-sharing policy for healthcare benefits. That means that a diocese can require employers to cover all or a portion of the contribution (premium) for employees and their families. “Parity” refers to the requirement that the diocesan policy regarding employer cost-sharing must be the same for all eligible clergy and lay employees scheduled to work at least 1,500 compensated hours per year. In other words, all clergy and lay employees who are scheduled to work at least 1,500 compensated hours per year must receive the same minimum level of funding — such as a percentage of the premium cost, a flat dollar amount, or a coverage level (i.e., single, family, etc.) — for healthcare benefits.

When is the deadline for complying with the parity requirement?

January 1, 2013 was the deadline for full implementation of the DHP.  The deadline for parity was extended to December 31, 2015 by Resolution B026 passed at the 77th General Convention.

Does the Medical Trust have examples of canons, policies, rules, or guidelines other dioceses have created to govern the cost-sharing parity requirement?

Examples of canons/resolutions or policies that other dioceses have developed are available upon request from your Regional Relationship Specialist.

Do the parity rules apply only to clergy and lay employees hired after implementation of the DHP within the diocese? Can the diocese grandfather current employees using its current cost-sharing policies?

No. By December 31, 2015, all clergy and lay employees who are scheduled to work at least 1,500 compensated hours per year must be treated equally with regard to cost-sharing of the medical plan premiums, no matter when they were hired.

Can the diocese set a policy that treats full-time and part-time employees differently?

Yes. The DHP requires that all clergy and lay employees who are scheduled to work at least 1,500 compensated hours per year be treated equally with regard to the cost-share of medical plan premiums. Employers are free to provide a different cost-share to their part-time employees.


What role does the diocese have in the implementation process?

The diocese is the primary partner in implementing the DHP within that diocese. The diocese must establish canons, policies, rules, or guidelines to determine:

  • Whether institutions under its authority (schools, day care facilities, social service agencies, etc.) are required to participate
  • Whether the diocese wishes to provide healthcare benefits to domestic partners
  • A cost-sharing policy that is the same for clergy and eligible lay employees
  • Which Medical Trust plans will be offered in that diocese. The diocese makes this decision annually.

How does the diocese determine what other institutions it may require to participate with the diocese in the Medical Trust plans?

The rules governing the ECCEBT’s status as a VEBA require that only eligible employees of Episcopal institutions be allowed to participate in the Medical Trust’s plans. The Medical Trust has developed a document, “Questions to Consider When Determining if an Organization is Subject to the Authority of the Church,” to assist dioceses in determining which of its diocesan institutions are considered Episcopal institutions, according to these stipulations.

Can groups required to participate choose to purchase healthcare benefits elsewhere, especially if they can get them at a lower cost?

No, but the Medical Trust will work with all employers to find plans that are economically viable for their specific situations and populations. It is important that all required groups participate with the Medical Trust to ensure optimal leverage in negotiating services from our contracted vendors.


Who is going to monitor compliance with the DHP?

Participation in a Medical Trust plan is required by the canon enacted by the General Convention of The Episcopal Church and is enforced in the same manner that any canon is enforced. It is the individual diocese’s responsibility to ensure compliance with Resolution A177, as it is with all canons. The Medical Trust will not enforce compliance.

What should the diocese communicate about DHP implementation to its constituents?

The Medical Trust has developed specific communication tools for the diocese to use for effective communications. We will work with each diocese to create a communication plan regarding the implementation of the DHP.

Who handles the annual enrollment communications under the DHP; the diocese or the Medical Trust?

Before the annual enrollment period begins, the diocese should communicate specific information to its parishes and other participating institutions regarding its plan selections, associated rates, and plan design changes so that employees can make informed decisions about their specific healthcare options. During annual enrollment, the Medical Trust communicates directly with employees to provide information about how to review their plan selection choices, the resources and references available to them, and how to access the MLPS system and manage their enrollment.

(Most of the actual annual enrollment verifications and changes are done directly by the employees, using our user-friendly web-based MLPS system)


Can an employee opt out of the DHP, and if so, under what circumstances?

Under the terms of the DHP, clergy and lay employees who have medical benefits through approved sources will be allowed to waive medical coverage under the DHP (“opt out”) and choose to maintain their medical benefits through the approved source. Examples of approved sources include coverage through a spouse’s or partner’s employment, medical benefits through a government-sponsored program such as Medicaid or TRICARE, or coverage from a previous employer. The list of approved sources is subject to change based on the federal healthcare reform law.

An employee may elect to waive coverage at the initial point of employment, during annual annual enrollment, or at the time of any significant life event. The employee will need to reaffirm the election to waive coverage on an annual basis, as determined by the Medical Trust.

Will there be some type of form or waiver that employees are required to sign if they opt out? For those who do, will this be required annually?

Declaration of the individual waiver will occur on an annual basis during annual enrollment beginning with the enrollment for 2012. The employee will need to reaffirm the election to waive coverage on an annual basis. Each year, administrators will make sure all employee decisions to opt-out are captured properly. This data can be updated throughout the year as members join or leave the plans.

What about employees in rural areas? What will the DHP do for them in terms of cost and access?

Access to providers in rural areas is a global challenge and one we continue to work to address with our national carriers BCBS, Cigna, Kaiser and UHC. These carrier networks provide 98% of members with access to a participating provider where lower out-of-pocket costs for both the member and the plan exist. In addition, we offer plans with non-network benefits that allow members to seek care from any licensed provider. We recognize that, for rural members, this often results in either extensive travel to find a participating provider or the higher costs associated with having to utilize non-network care. This is why we have engaged our plan partners in the process of seeking solutions, since they are better able to influence and engage local healthcare providers on our behalf. Geographic cost of healthcare is a factor in the pricing of groups; as overall cost efficiencies are realized, rural groups will benefit.

How does an existing Letter of Agreement (LOA) with a cleric or lay employee affect a diocese’s compliance with Resolution A177’s parity requirement?

The issue is complicated. There are several factors that may influence the relationship between an existing letter of agreement and the DHP. It is important to have your diocesan chancellor review existing LOAs to determine whether revisions to the LOAs are required and, if so, to determine the appropriate process for amending them.


How are pre-65 retirees covered under the DHP?

The DHP does not change the Medical Trust’s current practice of providing coverage for eligible employees who retire before they are eligible for Medicare. If an employee has worked for the Church (a diocese, a congregation, or other institution under the authority of the Church) and has accrued at least five years of credited service immediately prior to retirement, that employee is eligible to enroll in any of the active medical plans offered by the diocese from which the employee retires.

Will there be any change in the Medicare Supplement coverage as a result of the DHP?

No, the post-65 Medicare supplement coverage will not change because the DHP addresses only active clergy and lay employees, not retirees.


Health benefits are offered through plans maintained by Church Pension Group Services Corporation (doing business as The Episcopal Church Medical Trust), 19 East 34th Street, New York, NY 10016.

The Episcopal Church Medical Trust Disclaimer