Church Pension Group | Health Plans

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.

Active Clergy & Lay Employee Health Plan Information - 2024
Title
What is this for?
Pages
Summary of Benefits and Coverage (SBC)
6
Summary of Benefits and Coverage (SBC)
6
Summary of Benefits and Coverage (SBC)
6
Summary of Benefits and Coverage (SBC)
6
Summary of Benefits and Coverage (SBC)
6
Summary of Benefits and Coverage (SBC)
6
Summary of Benefits and Coverage (SBC)
6
Plan Document Handbook
120
Summary of Benefits and Coverage (SBC)
6
Summary of Benefits and Coverage (SBC)
6
Summary of Benefits and Coverage (SBC)
6
Summary of Benefits and Coverage (SBC)
6
Summary of Benefits and Coverage (SBC)
6
Summary of Benefits and Coverage (SBC)
6
Summary of Benefits and Coverage (SBC)
6
Plan Document Handbook
111
Summary of Benefits and Coverage (SBC)
6
Summary of Benefits and Coverage (SBC)
6
Summary of Benefits and Coverage (SBC)
6
Plan Document Handbook
177
Seminarian Health Plan Information - 2024
Title
What is this for?
Pages
Summary of Benefits and Coverage (SBC)
6
Summary of Benefits and Coverage (SBC)
6
Summary of Benefits and Coverage (SBC)
6
Summary of Benefits and Coverage (SBC)
6
Plan Document Handbook
120
Summary of Benefits and Coverage (SBC)
6
Summary of Benefits and Coverage (SBC)
6
Summary of Benefits and Coverage (SBC)
6
Summary of Benefits and Coverage (SBC)
6
Plan Document Handbook
111
Dental Plan Information - 2024
Title
What is this for?
Pages
Information about the switch to Delta Dental as our dental vendor in 2024
2
N/A
Plan Document Handbook
60
Benefits Highlight Sheet (Summary)
2
Benefits Highlight Sheet (Summary)
2
Benefits Highlight Sheet (Summary)
2
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
2
N/A
EyeMed Insight Network benefits for The Episcopal Church Medical Trust
2
Understand common healthcare terms
6
Retired Clergy & Lay Employee Health Plan Information - 2024
Title
What is this for?
Pages
A guide to the 2024 UnitedHealthcare® Group Medicare Advantage (PPO) plan
84
Summary of benefits and coverage
12
Summary of benefits and coverage
12
Group Medicare Advantage Annual Enrollment information for retirees/post-65 former employees
5
N/A
Kaiser Annual Enrollment information for retirees
5
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
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
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
Group Medicare Advantage (GMA) members requesting reimbursement for covered medical care and supplies. Use for claims claims within, and outside of the US.
Send completed form and paperwork to the address on the the back of your member ID card.
Group Medicare Advantage (GMA) members requesting reimbursement for covered medications purchased at retail cost. Use for claims claims within, and outside of the US.
OptumRx Claims Department, P.O. Box 29046, Hot Springs, AR 71903
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
2
Denominational Health Plan (DHP) Annual Reports
Title
What is this for?
Pages
2023 Annual Report on the Denominational Health Plan
7
2022 Annual Report on the Denominational Health Plan
7
2022 Annual Report on the Denominational Health Plan
7
2021 Annual Report on the Denominational Health Plan
6
2021 Annual Report on the Denominational Health Plan
6
2020 Annual Report on the Denominational Health Plan
3
2020 Annual Report on the Denominational Health Plan
3
2020 Annual Report on the Denominational Health Plan
3
2020 Annual Report on the Denominational Health Plan
3
2019 Annual Report on the Denominational Health Plan
3
2019 Annual Report on the Denominational Health Plan
3
2018 Annual Report on the Denominational Health Plan
3
2018 Annual Report on the Denominational Health Plan
4
2017 Annual Report on the Denominational Health Plan
4
2017 Annual Report on the Denominational Health Plan
4
2016 Annual Report on the Denominational Health Plan
3
2016 Annual Report on the Denominational Health Plan (Español)
3
2015 DHP Annual Report (English)
3
2015 DHP Annual Report (Español)
4
2014 DHP Annual Report (English)
8
2014 DHP Annual Report (Español)
7
Regulatory Notices
Title
What is this for?
Pages
HIPAA Notice of Special Enrollment Rights
1
HIPAA Notice of Privacy Practices
5
Women’s Health and Cancer Rights Act Notice
1
* Our online documents are available for immediate download and viewing using Adobe's FREE Acrobat Reader.