Health Plans

You can ask for a paper copy of your Summary of Benefits and Coverage (SBC) at any time, free of charge. Check the box next to the Summary you want and then click on Mail It to Me. You can also call Client Services at (800) 480-9967 Monday - Friday 8:30AM to 8:00PM ET (excluding holidays) to request a copy.

The Medical Trust can also provide an SBC in a Spanish, Chinese, Tagalog, and Navaho. Please see our Notice of Nondiscrimination policy page or call Client Services for more information.

Active Clergy & Lay Employee Health Plan Information - 2020
Title
What is this for?
Pages
Handbook of plan details
107
Summaries of benefits
6
Summaries of benefits
6
Summaries of benefits
6
Plan handbook
1
Summaries of benefits
6
Summaries of benefits
6
Summaries of benefits
6
Handbook of plan details
106
Summaries of benefits
6
Summaries of benefits
6
Summaries of benefits
6
To help employers and employees understand health plan coverage options for active clergy or lay employees, or those returning to work after retirement
5
N/A
Information for members on Consumer Directed Health Plans (CDHP) and Health Savings Account (HSA) for 2019-2020
7
Active Clergy & Lay Employee Health Plan Information - 2019
Title
What is this for?
Pages
Handbook of plan details
76
Handbook of plan details
118
Handbook of plan details
110
Handbook of plan details
120
Information about 2019 health plans and making a plan selection
26
Summary of benefits
6
Summary of benefits
6
Summary of benefits
6
Summary of benefits
6
Summary of benefits
6
Summary of benefits
6
Information for members on Consumer Directed Health Plans (CDHP) and Health Savings Account (HSA) for 2018-2019
7
To help employers and employees understand health plan coverage options for active clergy or lay employees, or those returning to work after retirement
5
N/A
Retired Clergy Health Plan Information - 2020
Title
What is this for?
Pages
Medicare costs and Medicare Supplement plan comparisons
2
Annual Enrollment information for retirees who receive a Medicare Supplement Health Plan subsidy
8
N/A
Annual Enrollment information for retirees who do not receive a Medicare Supplement Health Plan subsidy
8
N/A
The official US Government Medicare Handbook for 2020
120
N/A
To help employers and employees understand health plan coverage options for active clergy or lay employees, or those returning to work after retirement
5
N/A
Retired Clergy Health Plan Information - 2019
Title
What is this for?
Pages
Announcing Annual Enrollment dates and medicare supplement information for retirees
8
N/A
Announcing Annual Enrollment dates and medicare supplement information for retirees not eligible for Subsidy
8
N/A
The official US Government Medicare Handbook
120
N/A
Medicare costs and Medicare Supplement plan comparisons
2
N/A
To help employers and employees understand health plan coverage options for active clergy or lay employees, or those returning to work after retirement
5
N/A
Retired Lay Employee Health Plan Information - 2020
Title
What is this for?
Pages
Medicare costs and Medicare Supplement plan comparisons
2
Annual Enrollment information for retirees who do not receive a Medicare Supplement Health Plan subsidy
8
N/A
The official US Government Medicare Handbook for 2020
120
N/A
Retired Lay Employee Health Plan Information - 2019
Title
What is this for?
Pages
Announcing Annual Enrollment dates and medicare supplement information for retirees not eligible for Subsidy
8
N/A
The official US Government Medicare Handbook
120
N/A
Medicare costs and Medicare Supplement plan comparisons
2
N/A
Dental Plan Information - 2020
Title
What is this for?
Pages
Summaries of benefits
2
Dental Plan Information - 2019
Title
What is this for?
Pages
Handbook of plan details
76
Summary of benefits
6
Seminarians Health Plan Information - 2020
Title
What is this for?
Pages
Handbook of plan details
107
Summaries of benefits
6
Summaries of benefits
6
Plan handbook
1
Summaries of benefits
6
Summaries of benefits
6
Information for members on Consumer Directed Health Plans (CDHP) and Health Savings Account (HSA) for 2019-2020
7
Seminarians Health Plan Information - 2019
Title
What is this for?
Pages
Summary of benefits
6
Summary of benefits
6
Information for members on Consumer Directed Health Plans (CDHP) and Health Savings Account (HSA) for 2018-2019
7
Additional Benefits
Title
What is this for?
Pages
Get 24/7 help with behavioral health, family, and personal issues
2
N/A
For clergy to get 24/7 help with behavioral health, family, and personal issues
2
N/A
Emergency assistance available when traveling
6
A personal health advocate service to help you with healthcare and insurance issues
6
N/A
EyeMed Insight Network benefits for the Episcopal Church Medical Trust
2
Understand common healthcare terms
4
Claims
Title
What is this for?
Contact Information
To submit a claim for medical expenses, or behavioral health expenses
Anthem Blue Cross and Blue Shield PO Box 105187 Atlanta, GA 30348
To submit a claim for international medical expenses
To submit a claim for medical expenses
Mail form with itemized bills to Cigna address on your ID Card
To submit a claim for medical expenses
Kaiser Permanente Insurance Company (KPIC) Self-Funded Claims Administrator P.O. BOX 30547 Salt Lake City, UT 84130-0547 Phone: (866) 213-3062
To submit a claim for dental services
For mailing address, call Customer Service at number listed on your ID Card
Colleague Group Reimbursement Claim Form
The Episcopal Church Medical Trust 19 East 34th Street, New York, NY, 10016; or fax to (212) 251-8891
To submit a claim for prescription drugs
Express Scripts, Inc. P.O. Box 66583 St. Louis, MO 63166-6583 ATTN: NGC STD ACCTS
To request reimbursement for covered medications purchased at retail cost
Send completed form with pharmacy receipt(s) to: OptumRx Claims Department P.O. Box 29044 Hot Springs, AR 71903
Prescription Claim Form for Medicare Part D
Express Scripts ATTN: Medicare Part D P.O. Box 14718 Lexington, KY 40512-4718 FAX: (608) 741-5483
To submit a claim for behavioral health expenses
Cigna Behavioral Health, Inc. Attn: Claims Service Dept. P.O. Box 188022 Chattanooga, TN 37422 Or follow mailing instructions on your ID Card
Out of Network Vision Services Claim Form
EyeMed Vision Care Attn: OON Claims P.O. Box 8504 Mason, OH 45040-7111
Hearing Benefit Claim Form (UHC)
MAIL the Claim Form and the proof of payment attachments to: UnitedHealthcare, Atlanta Service Center, PO Box 740827, Atlanta, GA 30374
Submitting international travel claims for Retirees participating in Medicare Supplement plans only
Episcopal Church Medical Trust Travel Protection Benefit Coordinator PO Box 2745 New York, NY 10163
Medicare Secondary Payer (SEE) Forms
Title
What is this for?
Contact Information
Eligibility for the Episcopal Health Plan for Qualified Small Employer Exception Members (the SEE Plan)
The Episcopal Church Medical Trust 19 East 34th Street, New York, NY, 10016 or fax to (212) 251-8891
Medicare Secondary Payer (SEE) Publications
Title
What is this for?
Pages
Medicare Secondary Payer - Small Employer Exception
5
Letter sent to members explaining Medicare Secondary Payer See program
1
Denominational Health Plan
Title
What is this for?
Pages
2019 Annual Report on the Denominational Health Plan
3
N/A
2019 Annual Report on the Denominational Health Plan
4
N/A
2018 Annual Report on the Denominational Health Plan
4
N/A
2018 Annual Report on the Denominational Health Plan
4
N/A
2017 Annual Report on the Denominational Health Plan
4
N/A
2017 Annual Report on the Denominational Health Plan
4
N/A
2016 Annual Report on the Denominational Health Plan
1
N/A
2016 Annual Report on the Denominational Health Plan (Español)
1
N/A
2015 DHP Annual Report (English)
3
N/A
2015 DHP Annual Report (Español)
4
N/A
2014 DHP Annual Report (English)
8
N/A
2014 DHP Annual Report (Español)
7
N/A
Regulatory Notices
Title
What is this for?
Pages
HIPAA Notice of Special Enrollment Rights
1
HIPAA Notice of Privacy Practices
4
Notice of Nondiscrimination
2
Women’s Health and Cancer Rights Act Notice
1
Health News
Title
What is this for?
Pages
Exploring strength in community
1
Inspiration to meet your goals
1
Fall colors: The changing seasons of life. Preparing for the times ahead.
1
Summer wellness: what to do when the heat is on!
1
Planting the Seeds for Your Tomorrow
1
Being SMART about the New Year
1
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