HealthFlex - 2020

2020 NYAC HealthFlex Exchange Insurance Information

The Conference Board of Pension & Health Benefits has expanded the HealthFlex insurance plan options available to you and your family.   In 2019, we began to offer six insurance plan options in the three categories described below: 

Wespath HealthFlex Exchange Insurance Options

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.

H1500, H2000, H3000 Plans

  • These plans combine the medical and pharmacy deductible for all family members. 
  • 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 also elect a limited use Medical Flexible Spending Account.

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.

All Six Plans Include:

  • Preventative and wellness services are covered at 100%, with no deductible required
  • The same network providers and the same prescription drug formularies (BCBS, UBH, OptumRx)
  • An annual family deductible which must be met before the insurance pays
  • Vision Exam Core plan through VSP
  • Wellness programs, such as VirginPulse, Health Coaching, Employee Assistance Program, MDLive tele-medicine, Weight Watchers and others

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

 

IMPORTANT NOTE:   You must determine which plan is best for your family, not based solely on the monthly premium, but also upon your estimated out-of-pocket costs.  Lower cost plans will have higher out-of-pocket costs for provider services.  It important for you to recognize and plan for higher costs if you choose a lower premium plan; i.e. higher annual deductibles, higher co-insurance costs, etc.   Check the Benefit Coverage for the plan you are considering. You should consider pre-tax contributions to a medical FSA or HSA to help cover your higher out-of-pocket costs.

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 2020, the Uniform Rate will be $18,240 annually ($1,520 monthly) for each church.

 

The monthly amount that each pastor and conference employee pays is 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 2020 Uniform Rate.

You 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. 

 

2020 NYAC HealthFlex Monthly Premium Credit

 

Single

Member + 1

Family

$750

$1,531

$2,150

 

 

2020 HealthFlex Exchange Monthly Premiums

 

 

Plan

Single

Member + 1

Family

Includes

B1000 

$931

$1,769

$2,420

FSA

C2000

$884

$1,680

$2,299

HRA / FSA

H1500

$861

$1,636

$2,239

HSA / FSA

H2000

$788

$1,498

$2,050

HSA / FSA

C3000

$750

$1,426

$1,951

HRA / FSA

H3000

$687

$1,305

$1,786

HSA / FSA

 

Here are examples that might help:

Pastor and spouse are allocated a Premium Credit of $1,531 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 B1000 plan, they will be billed $238 per month by the conference.

                If they choose the H1500 plan, they will be billed $105 per month by the conference.

If they choose the C3000 plan, the “extra” funds of $105 will be deposited monthly into an HRA for their non-reimbursable medical expenses.  

OR they could use the “extra” funds to buy the dental PPO plan at the cost of $92 per month AND not get a bill from the conference at all! And still have funds deposited into an HRA monthly.

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.

 

Premium Rates for Voluntary Dental and Vision Plans

 

2020 Dental Monthly Premiums

 

 

  Plan

 

Single

Member + 1

Family

Dental Passive PPO 2000

$57

$114

$160

Dental PPO

$47

$92

$130

Dental HMO

$14

$26

$45

 

 

 

 

 

 

2020  Vision Monthly Premiums

 

 

 

 

 

  Plan

 

Single

Member + 1

Family

Vision Exam Core

included in all plans  at no charge

Vision Full Service

$5.96

$9.60

$15.16

Vision Premier

$14.38

$23.32

$37.02