HealthFlex - 2019

The Conference Board of Pension & Health Benefits is expanding the HealthFlex insurance plan options available to you and your family.   We have previously offered two insurance plans; starting in 2019, we will offer six insurance plan options in the three categories described below: 

Wespath HealthFlex Exchange Insurance Options

B1000 Plan

  • Medical and behavioral health office visits, urgent care and ER have a fixed co-payment, and the plan pays 100% of the remaining cost
  • Certain provider services require that a deductible be met first, before the plan pays a fixed percentage (co-insurance).
  • There is no pharmacy deductible – there are fixed co-pays for generic meds and co-insurance for brand medications. 
  • Members may elect a Medical Flexible Spending Account to assist with out-of-pocket expenses.

H1500, H2000, H3000 Plans

  • These plans combine the medical and pharmacy deductible. 
  • Medical and behavioral health services (office visits, inpatient & outpatient) as well as all medication/pharmacy services require that you meet the full annual deductible for all covered members before the plan pays a fixed percentage (co-insurance.) 
  • Plan includes a Health Savings Account and the member may elect a limited use Medical Flexible Spending Account.

C2000, C3000 Plans

  • These plans have separate deductibles for individual and families which must be met initially for medical and behavioral health services (office visits, inpatient & outpatient) before the plan pays a fixed percentage (co-insurance.) 
  • There is no pharmacy deductible; there is a fixed co-payment for generics and percentage co-insurance for brand medications.
  • Plan includes a conference sponsored Health Reimbursement Account and members can elect a Medical Flexible Spending Account, as well.

All Six Plains Include:

  • Preventative and wellness services are covered at 100%, with no deductible required.
  • The same network providers and the same prescription drug formularies.
  • All plans include a deductible which must be met before the insurance pays.
  • All plans include the Core Vision Exam plan through VSP
  • Wellness programs, such as VirginPulse, Health Coaching, Employee Assistance Program, MDLIve tele-medicine, Weight Watchers and others

 

HealthFlex members will be able to choose a version of one of the above plans, as well choose from three Dental Insurance plans and enhanced Vision plans.

For the first time, you will see actual insurance premiums charged by Wespath.  You will have complete access to the coverage included in each insurance option and will be able to calculate the costs of the plan appropriate for your family’s medical and financial needs.  The benefit levels differ by plan type and cost, however all plans cover medical, behavioral health, pharmaceutical and wellness plans and all plans have annual deductibles.

The Conference Board of Pension and Health Benefits is responsible for determining the health insurance uniform rate, which is debated and approved at annual conference. This is calculated by determining the total annual cost for active pastors in full-time or three‐quarter-time appointments as well as conference staff, divided by the number of clergy under full-time and three‐quarter appointment and conference staff.  The Uniform Rate is not an insurance premium. Every church pays the same base uniform rate, regardless of their pastor’s family size and church location.

 

In 2019, the Uniform Rate will be $17,208 annually ($1,434 monthly) for each church.

 

The monthly amount that each pastor and conference employee will pay will be determined by the plan they choose from among the six options. The conference will provide a monthly Premium Credit, based upon your coverage:  single, member + one, or family.   The Premium Credit, i.e. spending dollars, are used to “buy” a plan for you and your family from the six plans offered.  The Premium Credit amount is derived from the 2019 Uniform Rate.

You will apply the Premium Credit to the actual cost of the plan you choose. If you choose a plan that costs less than the Premium Credit funding provided, the excess funds will be placed in an HRA or HSA for your use.  If you choose a plan that exceeds the Premium Credit funds provided, the conference will bill the excess cost to you. In each tier, (i.e. single, member + one, family) you will find that there are plans which cost less than the Premium Credit and plans which cost more. 

2019 NYAC HealthFlex Premium Credit

Single

Member + 1

Family

$637

$1,456

$1,870

 

2019 HealthFlex Exchange Monthly Premiums

Plan

Single

Member + 1

Family

Includes

P1000 

$800

$1,656

$2,094

FSA

C2000

$762

$1,581

$1,995

HRA / FSA

H1500

$755

$1,560

$1,972

HSA / FSA

H2000

$691

$1,433

$1,812

HSA / FSA

C3000

$658

$1,363

$1,721

HRA / FSA

H3000

$602

$1,247

$1,576

HSA / FSA

 

Here’s an example that might help:

Pastor and spouse are allotted a Premium Credit of $1,456 per month.  Reviewing the plan options above, shows that there are three Member + 1 plans which cost more than their Premium Credit and three that cost less.  

If they choose the P1000 plan, they will be billed by the conference $200 per month.

If they choose the H1500 plan, they will be billed by the conference $104 per month.

If they choose the C3000 plan, the “extra” funds of $93 will be deposited monthly into an HRA for their non-reimbursable medical expenses.  

OR they could use the “extra” funds to buy a dental plan at the cost of $93 per month AND not get a bill from the conference at all!

(Pastors currently pay $120 per month for the PPO plan and $60 for the HDHP plan.)

Think of the Premium Credit as a store gift card.  While shopping, you check the prices to see what your gift card will purchase. Depending on the items you choose to buy, you might end up paying at the cash register. But if you are a savvy shopper, you could end up with money left on the gift card for future use.

This is a major shift in how medical insurance has been provided. Wespath provides several Decision Support Tools on HealthFlex WebMD to help you choose the best plan for you and your family.

Visit www.wespath.org  choose HealthFlex WebMD and log-in to your account or register.

 

For additional information, please review the following materials:

HealthFlex Exchange Plan Comparison

Health Account Comparison

Dental Plan Comparison

Vision Plan Comparison