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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).

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 IBAMS Account Managers will work with you to help you select the plans that are best for your group.

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)

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.

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

Annual 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. Annual enrollment usually occurs in the fall. Plan selections become effective on the first day of the following plan year.

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.

Medicare Part A and Part B provide coverage for medically necessary basic health services. Our Group Medicare Advantage plan provides additional benefits for expenses that may not be covered by Medicare.

The Group Medicare Advantage plan options are:

• GMA Premium (PPO)
• GMA Comprehensive (PPO)

All plans include several additional benefits at no additional cost to members.

Visit UnitedHealthcare's website to read detailed information about each about each plan option's coverage and benefits.

Eligibility to participate in the Group Medicare Advantage 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, who are eligible for and enrolled in Medicare Part A and B, may enroll in the Group Medicare Advantage Plan:

For specific eligibility requirements, see Eligibility.

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.

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.

Coverage begins on the first day of the month in which a retiree becomes eligible for and enrolls in Group Medicare Advantage. 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

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). Find out more about the DHP.

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.

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.)

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.

Currently, non-stipendiary clergy are not eligible to participate in the Medical Trust Plans, with a few exceptions as noted in the administrative guidelines.

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.

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

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.

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.

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

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.

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 77^th General Convention.

Examples of canons/resolutions or policies that other dioceses have developed are available upon request from your IBAMS Account Manager.

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.

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.

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.

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.

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.

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.

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.

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 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.

Declaration of the individual waiver will occur on an annual basis during annual enrollment. The employee will need to reaffirm the election to waive coverage on an annual basis.