Benefits Summary 2017 Conference Office, 324 University Ave., 3rd Floor, Syracuse, NY 13210 (315) 424-7878 Toll-free (855) 424-7878 Fax (315) 424-0975 www.unyumc.org
CLERGY BENEFITS COMPENSATION PACKAGE... 2 Minimum Base Compensation Time Off Policy Housing Exclusion Parsonage Value Considerations BENEFIT ELIGIBILITY CHART... 4 Pension Plans: MPP & CRSP... 6 CRSP at a Glance UMPIP Personal Retirement Savings... 10 UMPIP at a Glance COMPREHENSIVE PROTECTION PLAN (CPP)... 13 Long Term Disability & Death Benefits 2017 Benefit Summary VOLUNTARY TRANSITION PROGRAM Facilitating a grace-filled exit from ministry.. 16 HEALTH CARE PROGRAM... 17 Benefit Summaries Prescription Benefit Summaries & Vision Plan Summary Employee Assistance Programs Full time and Part time clergy EMPLOYEE ASSISTANCE PROGRAM for part time persons... 25 UMLIFE OPTIONS - Optional Life Insurance... 25 Optional Life Highlights FINANCIAL PLANNING SERVICES - Professional Financial Consultations... 25 Ernst & Young Services LOCAL CHURCH LAY EMPLOYEE BENEFITS PENSION & HEALTH CARE... 26 1
MINIMUM BASE COMPENSATION COMPENSATION PACKAGE A standardized minimum base compensation is established for The Upper New York Annual Conference that requires the following: A minimum base salary of $35,700 for all full time clergy persons. (Less than full time appointments shall receive a base salary pro-rated according to the appointment.) Plus a credential increment based on status as follows: Base Full connection: $39,984 Provisional: $38,556 Associate: $37,842 FT LP completed Course of Study or MDiv $37,128 FT Local Pastor: $35,700 Plus an additional amount for year of service using the following schedule(s) based on the goal of attaining 1% of minimum salary per year of FTE service up to 25 years: Full Prov. Assoc. FTLP w/mdiv/cos FTLP per year of FTE up to $311 $305 $302 $299 $290 21 years Plus an additional $500 for each additional church on the pastoral charge (over one). No pastor s salary can be decreased as a result of this policy, as long as they retain their current appointment. All churches are strongly encouraged to offer a salary increase of no less than the ten year average increase in the Consumer Price Index (2% for 2017) in order to account for increases in the costs of living. Churches are encouraged to consider further raises based on exceptional service. In addition, full time pastors are entitled to: Housing, pension, health insurance, and utilities TIME OFF POLICY All church staff are entitled to two days off per week for personal time, family time and spiritual renewal, one of which would be a Sabbath day Clergy are entitled to 4 weeks of vacation each year with 5 weeks for those with more than 20 years of service. The number of Sundays off will correspond at least one-to-one with the number of weeks of vacation. Full time clergy shall have at least 2 weeks per year of Continuing Education/Spiritual Growth leave (as per 351.1 & 351.2). Furthermore, once every quadrennial period (every four years) there should be one year where an additional month of Continuing Education/Spiritual Growth is undertaken. Full time pastors are encouraged to give a week annually to a Conference camping ministry. There will be no prescribed sick leave for clergy. Short and long term disability will be in place as needed. 2
Vacation and paid time off for part time clergy is to be individually negotiated in consultation with the SPRC, pastor and District Superintendent at the time of the initial appointment and subsequently as needed. Associate, provisional, or members in full connection may request family leave through the Board of Ordained Ministry per 354. Maternity or Paternity leave, not to exceed one fourth of a year, will be available and shall be granted to any local pastor, provisional member, associate member, or clergy member in full connection who so requests it per 356. HOUSING EXCLUSION If an exclusion from gross salary, the amount is determined by the pastor If paid as a housing allowance in addition to salary, the amount is determined during the salary package discussions Must be established prior to the first payment of the exclusion Resolution sample is available through the Conference forms website under Church/Charge Conference and Annual Forms: http://www.unyumc.org/resources/forms TREATMENT OF PARSONAGE VALUE IN COMPENSATION PACKAGES Clergyperson or Clergy Couple with separate churches, each providing a parsonage Regardless of where the clergyperson or couple lives, each clergyperson s entire compensation will include a parsonage value equal to 25% of gross salary Clergy Couple serving separate churches, living in parsonage provided by one of the churches with no parsonage offered/available from the other church Only the clergyperson serving the church which provides the parsonage will have the parsonage value (25%) added to salary 3
ELIGIBILITY FOR UNY CONFERENCE BENEFITS - 2017 CLERGY STATUS Pension-Church UMPIP Personal CPP Death & Disability Health Insurance/Dental Eligibility Cost Eligibility Cost Eligibility Cost Eligibility Cost Full Members @ Local Church Full Time CRSP 13.75%CB O Y 3% CB Y ¾ time CRSP 13.75%CB O Y 3% CB N-EAP Only ½ time UMPIP 9%CB O N N-EAP Only Less than ½ time N O N N-EAP Only Provisional Elders or Associate Members @ Local Church As determined by the Full Time CRSP 13.75%CB O participant; Y 3% CB Y ¾ time CRSP 13.75%CB O 1% of CB Y 3% CB N-EAP Only ½ time UMPIP 9%CB O strongly N N-EAP Only Less than ½ time N O encouraged; N N-EAP Only Provisional Deacons @ Local Church before- tax or after-tax; % Full Time CRSP 13.75%CB O Y 3% CB Local church of CB or $ ¾ time CRSP 13.75%CB O Y 3% CB decision amount ½ time UMPIP 9%CB O N Less than ½ time N O N Local Pastors @ Local Church Full Time CRSP 13%CB O Y 3% CB Y Part time: 3/4 time or more CRSP 13%CB O N N-EAP Only Part time: ½ time UMPIP 9% CB O N N-EAP Only Part time: less than ½ time N O N N-EAP Only Medical/Incapacity Leave Y if elig. For CPP benefit; Conf. Pays Personal, Family or Transitional Leave N N Y one year; Conf. Pays Sabbatical Leave Y Defined Benefit N Y one year; Conf. Pays Appointed to Attend School N N Y one year; Conf. Pays Extension Ministry except as Conference Staff Y = Yes N = No O = Optional CB = Compensation Base (salary + housing) $12,600 Per eligible Clergyperson N N Y if elig. For CPP benefit; Conf. Pays Y if already enrolled; participant pays actual premium (not blended rate); 12 months continuation N N N Y if already enrolled; participant pays actual premium (not blended rate); 12 months continuation 4
Benefit NON-Medicare-Eligible Active Clergy, Clergy Dependents, or Clergy on Medical Leave HEALTH & WELLNESS ELIGIBILITY CATEGORIES Medicare-Eligible Active Clergy, Clergy Dependents, or Clergy on Medical Leave AmWINS Active Clergy with Waiver of Participation in health insurance Active Clergy serving less than full time HealthFlex Medical BlueCross BlueShield First United American N/A N/A Prescriptions Optum RX ExpressScripts N/A N/A EAP United Behavioral Health ESI Employee Assistance N/A ESI Employee Assistance Vision VSP VSP N/A N/A Wellness V Pulse Walking Program V Pulse Walking Program N/A N/A Quest Diagnostics BFW N/A N/A N/A Flexible Spending Acct WageWorks (not available for those on medical Leave) N/A N/A N/A Dental MetLife MetLife MetLife N/A HealthFlex Program of Wespath Benefits and Investments: 800-851-2201 AMWINS Medicare Benefits: 888-883-3757 ESI Employee Assistance Group: 800-225-4555 MetLife Insurance Co.: 800-275-4638 5
MINISTERIAL PENSION PLAN (MPP) (for service from 1/1/82 to 12/31/2006) Accrued contributions are on account at Wespath Benefits and Investments for distribution upon retirement in the form of an annuitized benefit (65% of account) plus remaining 35% of account available via a variety of distribution options. CLERGY RETIREMENT SECURITY PROGRAM (CRSP) (effective 1/1/2007, Revised 1/1/2014) CRSP is a retirement plan administered by Wespath Benefits and Investments. It is a church plan in accordance with the Internal Revenue Code. ELIGIBILITY clergy member of conference full time, part time or student local pastor under episcopal appointment 75% or more clergy person of another denomination if not covered by another pension plan ENROLLMENT There are no salary requirements to be enrolled in CRSP eligibility is determined by Benefits Officer upon receipt of Notice of Appointment Form and enrollment form is sent from the Conference office enrollment form with participant portion completed is returned to the Conference office for processing into the Wespath and Conference invoicing system enrollment is confirmed and plan documents sent by Wespath THE PLAN There are two forms of benefit: (1) Defined Benefit (1) Defined Contribution Benefits are available upon: normal retirement at age 65 or with 40 years of service early retirement at age 62 or with 30 years of service retirement with 20 years of service (after reaching age 62) mandatory retirement at age 72 upon termination of membership, within certain guidelines 6
The distribution of the Defined Benefit is based on the annuity options available at the time of retirement and the number of years of service (after 1/1/2007) under the plan. The years of service are multiplied by 1.25% (0.0125) of the Denominational Average Compensation in effect at the time of retirement for the years of service between 1/1/2007 and 12/31/2013 to arrive at an annual benefit. For persons retiring after 1/1/2014, the multiplier changes to 1.0% of DAC for the number of years served after 1/1/2014. The monies accrued in the Defined Contribution account may be distributed in a lump sum, partial lump sum or through cash installments. Distribution can also be deferred. CONTRIBUTIONS Contributions will be determined by the Compensation Base, which is the sum of cash salary, housing exclusion and parsonage value/housing allowance. Example: Cash Salary $45,000 Housing Exclusion 3,000 Salary Subtotal $48,000 Parsonage Value (25% of salary subtotal) 12,000 Church Contribution into CRSP DIRECT BILLINGS Compensation Base $60,000 Church pays 13.75% of Compensation Base; 2 or 3% goes into the Defined Contribution Account and the remainder pre-funds the Defined Benefit annuity. The amount going into the Defined Contribution account is determined by the amount the pastor personally contributed to UMPIP. If 1% or more of compensation, 3% goes into the Defined Contribution account; if not, then 2% goes into the account. Salary information is recorded in the Conference Office when received from the District Superintendent Conference Office generates a monthly billing to the church for pension and CPP (if applicable), based on the calculated annual contribution All payments must be made on a church check to satisfy federal regulations When payment is not made, arrearage notices are sent to both the pastor and the treasurer; District Superintendent is notified and they are responsible to make contact with the church if the arrearage is not satisfied. 7
Clergy Retirement Security Program At-a-Glance Effective January 1, 2014 The Clergy Retirement Security Program (CRSP) is a retirement program that offers: 1 security through a defined benefit (DB) component that gives you lifetime retirement income, and 2 flexibility through a defined contribution (DC) component that provides you with an account balance you can access as your retirement needs require. ELIGIBILITY The Clergy Retirement Security Program (CRSP) is an Internal Revenue Code section 403(b) retirement plan administered by Wespath Benefits and Investments (Wespath) the largest denominational pension fund in the world. It is designed to provide you with one element of your overall retirement portfolio. You are eligible to participate if you are a clergy member or local pastor under full-time Episcopal appointment to a conference, church, charge, district or conference-controlled entity or unit and you are receiving compensation. Your conference may also elect to cover clergy appointed at least half-time or at least three-quarter time. CRSP FEATURES You are automatically enrolled by your plan sponsor. You receive account statements quarterly or upon demand. Account information is accessible through the website (www.benefitsaccess.org) and the automated phone system at 1-800-851-2201. Representatives are available to answer calls at 1-800-851-2201 Monday through Friday from 8:00 a.m. to 6:00 p.m., Central time. DEFINED BENEFIT (DB) COMPONENT Provides a monthly retirement benefit that is calculated using the following formula: + 1.25% x Denominational Average Compensation (DAC) 1 at retirement x years of credited service 2 from 1/1/07 through 12/31/13 1.00% x DAC 1 at retirement x years of credited service 2 after 12/31/13 12 1 Final compensation substitutes for DAC for periods of service as a bishop. 2 Reduced for less-than-full-time appointments. You will have various DB payment options when you retire There are annual cost-of-living increase options for retirees (over) a general agency of The United Methodist Church
Clergy Retirement Security Program At-a-Glance (continued) Investment and Distribution Assistance Wespath offers services at no cost that can help you manage your DC account:* LifeStage Investment Management is an investment service that selects a mix of Wespath funds for your retirement account(s) based on your individual circumstances. EY Financial Planning Services assists you with financial planning and investment needs. DEFINED CONTRIBUTION (DC) COMPONENT Every month, the Church contributes 2% of your compensation to your DC retirement account. In addition, the Church will match your personal contributions to the United Methodist Personal Investment Plan (UMPIP) up to 1% of your plan compensation (cash salary plus housing). Your account both earnings and contributions grows tax deferred until you withdraw money. Provides convenient distribution options when you are eligible to access the money in your account including lump sum or partial distributions, or a series of regular payments. Account balance can remain in the plan until the later of participant retirement, termination or the age 70½. LifeStage Retirement Income automatically creates pensionlike monthly benefit payments from your DC account.** For more information about LifeStage Investment Management, EY Financial Planning Services and LifeStage Retirement Income, please visit www.wespath.org/retirement/ services/lifestage. * Costs for these services are included in Wespath s operating expenses that are paid for by the funds. ** Lifetime payments are not guaranteed (for example, in the event of extreme market conditions or longevity). 3412/050815
UNITED METHODIST PERSONAL INVESTMENT PLAN (UMPIP) ELIGIBILITY All appointed clergy may participate in UMPIP The salary-paying unit must be on record with Wespath as a Plan Sponsor All licensed, commissioned, or ordained pastors under appointment to a United Methodist Church at 50% and up to 74% are eligible to participate in UMPIP with the church making contributions. They will be automatically enrolled unless a waiver of participation, notarized and filed on the prescribed form is received in the Benefits Office. Participation in UMPIP is not required but strongly encouraged ENROLLMENT Eligible clergy will be provided a Contribution Agreement Form. Enrollment effective date, terms and amount of contribution should be recorded and the form signed by the pastor and treasurer or other church representative. Pastor may contribute a percentage of compensation or a flat dollar amount. Agreement must be in place prior to the withholding of contributions. One copy should be retained by the pastor, and the original should be on file with the church. Send a copy of the aforementioned Agreement Form to the Benefits Office; the information will then be submitted on-line to Wespath. Federal law now requires that withheld contributions be made promptly, so Wespath is strongly recommending that these contributions be deposited within 15 business days following the end of the month in which the contributions were withheld. Late contributions are subject to the additional payment of investment earnings by the salary-paying unit. Re-enrollment must occur when a pastor changes appointment; a new agreement form must be filed, as described above. CHURCH CONTRIBUTIONS Churches with clergy appointed at 50% to 74% will be billed by UNY Conference at 9% of clergy compensation PERSONAL CONTRIBUTIONS Made through Before-tax contributions Made through After-tax contributions Made through Roth contributions Transfers or rollovers from other 403(b) plans Billings will come from Wespath on a monthly basis and must be paid to them on a church check If participating, minimum monthly contributions are $10; maximum contributions are regulated by IRS codes Changes to the contribution amounts should be handled in the same manner as enrollments 10
INVESTMENTS AND ELECTIONS BENEFITS There are seven investment funds to which you can contribute; information on each is available online at www.wespath.org. Investment elections can be made online or via an Investment Election form If the participant does not chose his/her own investment elections, Wespath will enroll the participant in LifeStage Investments, which will make investments according to the participant s age and a moderate risk portfolio Distribution options are offered to you or your beneficiary: If you reach age 59-1/2 or retire If you terminate your employment If you become disabled If you die before you retire Hardship Loans are available if you have certain major financial needs; you will pay your account back with interest. Hardship Withdrawals are available when you have exhausted other financial resources; this is a taxable distribution. 11
United Methodist Personal Investment Plan At-a-Glance The United Methodist Personal Investment Plan (UMPIP) is a retirement plan administered by Wespath Benefits and Investments (Wespath) the largest denominational pension fund in the world. UMPIP is designed to provide one piece of your overall retirement portfolio. You are immediately eligible to participate if your employer or salary-paying unit sponsors the plan. Participation for plan sponsor contributions begins once you meet the eligibility requirements established by your plan sponsor. PLAN FEATURES EY Financial Planning Services offers valuable investing and financial planning guidance. This program is available to: active participants with an account balance, surviving spouses with an account balance, and retired and terminated participants with an account balance of at least $10,000. EY Financial Planning Services are available at no cost to you.* Just call EY directly at 1-800-360-2539 Monday through Friday between 8:00 a.m. and 7:00 p.m., Central time. * Costs for these services are included in Wespath s operating expenses that are paid for by the funds. Convenient before-tax, Roth and/or after-tax contributions in a flat dollar amount or percentage of your eligible compensation, up to Internal Revenue Code limits Plan sponsor may elect to contribute matching contributions or a percentage of your eligible compensation to your account 1 Taxes are deferred on before-tax contributions and investment earnings until distribution Roth contributions are made after taxes are withheld, but Roth contributions and earnings are not taxable at distribution if qualified 2 After-tax contributions are made after taxes are withheld, but earnings on after-tax contributions are taxable at distribution Accepts eligible rollovers from most retirement plans (including Roth accounts) and traditional IRAs 3 Variety of investment fund options LifeStage Investment Management and LifeStage Retirement Income account management suite Hardship loans and withdrawals Age 59 ½ and rollover account withdrawals Distributions available upon termination of employment, retirement, disability or death Lump sum, partial lump sum or cash installment distribution options On-demand and quarterly account statements Access account information 24/7 through Benefits Access (www.benefitsaccess.org) and through our automated phone system Participant forms and other information available at www.wespath.org Representatives available to answer calls at 1-800-851-2201 Monday through Friday from 8:00 a.m. to 6:00 p.m., Central time 1 Contribution rates may vary for each plan sponsor 2 See Roth Contribution Guide 3 Roth IRAs are not accepted 3272/020816 a general agency of The United Methodist Church
ELIGIBILITY COMPREHENSIVE PROTECTION PLAN (CPP) The conditions on the chart reflect the automatic eligibility provided by the Plan Document as well as Special Arrangements approved by the UNY Conference Board of Pension & Health Benefits. FT at LC or Conf. Staff 3/4 Time 1/2 Time 1/4 Time Sabbatical or Family Leave Attend School Other Voluntary Leaves Below 60% of DAC Full Members Y Y N N Y (1 yr.) Y (1 yr.) Y (1 yr.) N Associate Members Y Y N N Y (1 yr.) Y (1 yr.) Y (1 yr.) N Provisional Members Y Y N N Y (1 yr.) Y (1 yr.) Y (1 yr.) N Local Pastors Y N N N N N N N Other Denomination Y Y N N N N N N ENROLLMENT THE PLAN Part time and student local pastors are not eligible for CPP Upon eligibility, clergy will be enrolled by the Benefits Officer provided that the pension enrollment process is complete CPP provides death and disability benefits for its participants. Disability: If granted incapacity leave and enrolled in CPP, the benefit is equal to 70% of compensation at the time of disability, less any SS benefits CPP will make contributions to your pension account while disabled There is a waiting period and a pre-existing condition clause Death Benefit: $50,000 for actives, 20% of DAC for spouses of active clergy DIRECT BILLINGS 3% of Compensation Base will be billed to churches with eligible enrolled clergy. This will be included on the monthly benefits invoice. 13
1901 Chestnut Avenue Glenview, Illinois 60025-1604 1-800-851-2201 wespath.org 2017 Benefits Amounts for the Comprehensive Protection Plan The 2017 Denominational Average Compensation (DAC) is $68,876. The following information generally describes the benefit amounts payable under the Comprehensive Protection Plan (CPP) to eligible participants and their beneficiaries. For more information about the terms and conditions of CPP, please see the CPP Summary Plan Description (SPD) available at www.wespath.org/assets/1/7/3097.pdf. Although all efforts have been made to ensure the accuracy of this document, in the event of a discrepancy between this document and the SPD or CPP plan document, the SPD and plan document always govern. Active Participant Death Benefits payable upon the death of an eligible active CPP participant in 2017 Participant: $50,000, payable in 12 monthly installments or one lump sum Spouse of active participant: 20% of DAC in the year of death ($13,775.20 if death occurs in 2017) Surviving spouse of active participant: 15% of DAC in the year of death ($10,331.40 if death occurs in 2017) Child of active participant: 10% of DAC in the year of death ($6,887.60 if death occurs in 2017) Annual surviving spouse annuity benefit of $13,775.20, less the annuity benefit payable from the Clergy Retirement Security Program (CRSP) and other Church-related sources Annual surviving child benefit of $6,877.60, payable in 12 monthly installments 1 Annual surviving child educational benefit up to $13,775.20, payable in equal installments 2 Retired Participant Death Benefits 3 Plan Provision Death of retired participant Death of retiree s spouse Death of retiree s surviving spouse Death of retiree s child 6 Annual surviving child benefit Payable in 12 monthly installments 1 Annual surviving child educational benefit Payable in installments 2 Clergy Who Retire Before January 1, 2013 4 30% of DAC in the year of death (for 2017: $20,662.80) 20% of DAC in the year of death (for 2017: $13,775.20) 15% of DAC in the year of death (for 2017: $10,331.40) 10% of DAC in the year of death (for 2017: $6,887.60) 10% of DAC (for 2017: $6,887.60) 20% of DAC (for 2017: $13,775.20) $20,400 $15,300 $10,200 $8,160 Clergy Who Retire January 1, 2013 or Later 5 10% of DAC (for 2017: $6,887.60) 20% of DAC (for 2017: $13,775.20) 1 Ages 17 and younger. Benefits are paid through the month in which the child attains age 18. 2 Ages 18 through 24 and attending school full-time. Half of the annual benefit may be paid if the child is attending a secondary school or post-secondary school. The remaining half may be paid if the child is attending a post-secondary school. If the child enters a post-secondary institution of higher learning prior to age 18, the post-secondary educational benefit may become effective at that time. 3 To be eligible for death benefits in retirement, a clergyperson must have been covered in CPP for a requisite number of years, e.g., 10 of the last 13 years or at least 25 years in CPP, as described in the SPD. 4 Benefit available at this level for eligible retirees who retired before January 1, 2013, regardless of date of death. 5 Benefit available at this level for eligible retirees who retired on or after January 1, 2013, regardless of date of death. 6 Age 18 and younger, age 19 and older if dependent upon the participant or upon surviving spouse of the participant due to behavioral or physical condition that existed prior to age 19, or age 24 and younger and receiving surviving child benefit. (over) a general agency of The United Methodist Church 3992/090216
Disability Benefits The disability benefit equals 70% of plan compensation for the plan year in which the first payment is effective, with plan compensation capped at 200% of the DAC. The disability benefit is reduced by any disability benefits payable under the Social Security Act. 7 Participants receiving CPP disability benefits may also be eligible to receive retirement plan contributions to either CRSP or the United Methodist Personal Investment Plan (UMPIP) 8. If eligible for CRSP, CPP will contribute a nonmatching contribution of up to 2% of plan compensation (as defined by CRSP), in monthly installments, to the participant s CRSP defined contribution account. In addition, participants eligible for CRSP may be eligible for a matching contribution based on participant contributions to UMPIP, up to 1% of plan compensation. If not eligible for CRSP but eligible for UMPIP, CPP may contribute up to 3% compensation (as defined by UMPIP) to the participant s UMPIP account based on the UMPIP plan sponsor s adoption agreement elections. 7 Other reductions may apply in accordance with the terms of the SPD, as determined by Wespath Benefits and Investments (Wespath). 8 Please see the CRSP SPD (www.wespath.org/assets/1/7/3480.pdf) and UMPIP SPD (www.wespath.org/assets/1/7/3502.pdf) for additional information on eligibility as a disabled participant. SPDs are available on Wespath Benefits and Investments website under Retirement, select Plans.
VOLUNTARY TRANSITION PROGRAM This program was developed to provide transitional benefits to facilitate a grace-filled exit from ministry. ELIGIBILITY Clergy in full connection for a minimum of five years, enrolled in CPP, and in good standing Clergy person must surrender credentials THE PLAN Severance benefit of two weeks of participant s plan compensation for each full year of continuous service up to a maximum of six months pay Continuation coverage for health insurance, clergyperson pays same personal contribution as when active for the transition period then full premium for the remaining portion of the 18 month continuation period Moving expenses based on retiree moving policy 90 days of outplacement services CONTACT The Benefits Officer for procedural information. Must be approved by the Bishop, District Superintendent, and BOM Conference Relations Division. 16
HEALTH CARE PROGRAM The conference-sponsored health care program is insured by Blue Cross Blue Shield of Illinois in partnership with Wespath Benefits and Investments through a program called HealthFlex. Administrative policies are determined by the Conference Board of Pension and Health Benefits, in compliance with policies set by Wespath. Clergy over age 65, even if active, will be moved to the Medicare supplemental plan insured through United First American, and administered by AmWINS. ELIGIBILITY Clergy under full time episcopal appointment to a local church; churches pay blended rate of $12,600 in 2017 for each eligible clergyperson. Persons must be enrolled for five years immediately preceding retirement in order to have coverage in retirement; or at first eligibility when enrolled less than five years prior to retirement date. ENROLLMENT IMPORTANT! BENEFITS Upon receipt of Notice of Appointment Form, the Benefits Officer determines eligibility and will forward enrollment information, OR Requests for enrollment can be made by the Pastor to the Conference Office Enrollment must occur when first eligible, or during the month of November for a January 1 effective date, or when there is a change in status Enrollment form must be completed by the participant and returned to the Conference Office within 25 days of eligibility Participants can choose between a PPO plan or a high deductible consumerdriven plan (CDHP); if no indication is made, the PPO plan is the default plan Benefit schedules differ for the under age 65 and over age 65 programs, as well as the PPO and CDHP plans A Summary of Benefits is provided with the enrollment packet and is on the Benefits Office webpage; comprehensive information is available on the HealthFlex/WebMD website BCBS (under 65) ID card also acts as a prescription card with a three-tier copayment made at the pharmacy United First American (over 65) issues two (2) ID cards, one for medical expenses and one for prescriptions; participants must also have Medicare Parts A and B BCBS Pharmacy Plan has a mandatory mail order (90 day prescription) program for maintenance drugs and strongly encourages the use of generics United First American Pharmacy Plan offers mail order discounts for 90 day prescriptions but it is not mandatory 17
DIRECT BILLINGS Monthly premium of $1,050 per eligible clergy person billed to church or churches based on their sharing percentage Invoices are mailed by the conference office to churches monthly Individuals pay (by payroll deduction) when enrolled; amounts vary by coverage selected; see chart below RATES CHARGED TO LOCAL CHURCHES Any Family Size Participating Premium Annual $12,600 Participating Premium Monthly $1,050 Pastor s Annual Personal Contribution PPO B1000 Plan CDHP Plan First United American (over 65 plan) MetLife Dental Option 2 Buy Up Plan Any Family Size No Personal Contribution No Personal Contribution No Personal Contribution; responsible for Part B premium $13.60/mo - Single $27.04/mo - Participant & Spouse $29.59/mo - Participant & Child $43.49/mo - Family RETIREE PREMIUM TO LOCAL CHURCHES In 2017 the Upper New York Conference will continue to support part of the cost of providing health insurance to its retired clergy through use of reserve funds and participant contributions The remaining financial support for the cost of retiree health care is billed to all of the local churches in the conference using a proportional method 18
UNDER AGE 65 -- BCBS PPO PLAN B1000/P2 OPTION Benefits payable after $1,000 deductible per person/ $2,000 per family when Health Quotient completed; otherwise $1,250 per person / $2,500 per family Plan Feature Participating Provider Benefits Only Out of Pocket Limit $5,500 individual/$11,000 family Primary Care Physician Office Visits $30 co-payment per visit, then plan pays 100% Primary care physicians: internists, general practitioners, family practitioners, obstetricians, gynecologists and pediatricians. Therapies: Covered therapies are physical therapy, $30 co-payment per visit, then plan pays 100% occupational therapy and speech therapy. Specialist Office Visits $50 co-payment per visit, then plan pays 100% Allergy injections only, plan pays 100% Preventive Care Well Child Benefits (Under age 16) Well Adult Benefits (16 and Over) - Office visit Mammograms, pap smears, prostate exam, blood work and colorectal screening for cancer. Outpatient Diagnostic Services and Treatment Physician office Hospital, independent lab and x-ray facility Outpatient Services/Ambulatory Surgery Includes surgery in the physician s office. Inpatient Hospital Care Emergency Care In participating or non-participating physician s office Hospital emergency room Urgent care, facility or outpatient facility Ambulance (medical emergency) Maternity Care/Physician Charges Alternative Therapies: licensed chiropractors, massage therapists, acupuncture and naprapaths. Combined 35 visit limit per calendar year Hearing Benefit Hearing aids Every 24 months Plan pays 100% Plan pays 100% Plan pays 100% $30 co-payment if PCP, then plan pays 100% $50 co-payment if specialist, then plan pays 100% $30 co-payment if PCP, then plan pays 100% $50 co-payment if specialist, then plan pays 100% $200 co-payment, then plan pays 100% $100 co-payment, then plan pays 100% $30 co-payment for first visit to confirm pregnancy, then plan pays 100% for prenatal care, except ultrasounds which are after deductible $30 co-payment for chiropractor 50% coinsurance for naprapathy, acupuncture and massage therapy 50% up to $500 per ear $50 co-payment, then plan pays 100% Exam This summary highlights some of the features of this benefit plan. The controlling terms and conditions of the benefit plan are contained in the plan documents, policies and the HealthFlex Benefit Booklet (collectively, the Documents ) maintained by Wespath Benefits and Investments. If there are any conflicts between the information in this summary and the terms of the Documents, the terms of the Documents shall control. 19
UNDER AGE 65 PHARMACY PLAN FOR PPO PLAN Plan Feature Annual Deductible Annual Out-of-Pocket Maximum Retail Pharmacy Generic Preferred brand name 1 Participating Pharmacy Benefits Only None $5,500 per person up to $11,000 per family Participating pharmacy retail co-payment: 30-day maximum supply $15 co-pay, then plan pays 100% 25%; min. $25 up to max. $65 Non-preferred brand name 1 30%; min. $50 up to max. $120 Mail Service Mail service co-payment: 90-day maximum supply Generic $35 co-pay then plan pays 100% Preferred brand name 1 25%; min. $60 up to max. $150 Non-preferred brand name 1 30%; min. $95 up to max. $260 1 Patient is required to pay the generic co-payment plus the difference in cost between the generic and brand name drug, when the brand name is chosen and a generic is available. UNDER AGE 65 BCBS CDHP PLAN C2000/P2 OPTION Benefits payable after $2,000 deductible per person/ $4,000 per family when Health Quotient completed; otherwise $2,250 per person / $4,500 per family Plan Feature Built in Health Reimbursement Account (HRA) Out of Pocket Limit Primary Care Physician Office Visits Primary care physicians: internists, general practitioners, family practitioners, obstetricians, gynecologists and pediatricians. Therapies: Covered therapies are physical therapy, occupational therapy and speech therapy. Specialist Office Visits Preventive Care Well Child Benefits (Under age 16) Well Adult Benefits (16 and Over) - Office visit Mammograms, pap smears, prostate exam, blood work and colorectal screening for cancer. Outpatient Diagnostic Services and Treatment Physician office Hospital, independent lab and x-ray facility Outpatient Services/Ambulatory Surgery Includes surgery in the physician s office. Inpatient Hospital Care Emergency Care In participating or non-participating physician s office Hospital emergency room Urgent care, facility or outpatient facility Ambulance (medical emergency) Participating Provider Benefits Only $1,000 individual/$2,000 family $6,000 individual/$12,000 family Plan pays 100% Plan pays 100% Plan pays 100% 20
Maternity Care/Physician Charges Initial Visit All subsequent physician charges for prenatal/post natal visits and delivery Ultrasounds and subsequent eligible physician charges Alternative Therapies: licensed chiropractors, massage therapists, acupuncture and naprapaths. Combined 35 visit limit Hearing Benefit Hearing aids Every 24 months Exam Plan pays 100% for prenatal care for chiropractor 50% coinsurance for naprapathy, acupuncture and massage therapy 50% up to $500 per ear $50 co-payment, then plan pays 100% UNDER AGE 65 PHARMACY PLAN FOR CDHP C2000/P2 PLAN Plan Feature Annual Deductible Annual Out-of-Pocket Maximum Retail Pharmacy Generic Preferred brand name 1 Participating Pharmacy Benefits Only None $6,000 per person up to $12,000 per family Participating pharmacy retail co-payment: 30-day maximum supply $15 co-pay, then plan pays 100% 25%; min. $25 up to max. $65 Non-preferred brand name 1 30%; min. $50 up to max. $120 Mail Service Mail service co-payment: 90-day maximum supply Generic $35 co-pay then plan pays 100% Preferred brand name 1 25%; min. $60 up to max. $150 Non-preferred brand name 1 30%; min. $95 up to max. $260 1 Patient is required to pay the generic co-payment plus the difference in cost between the generic and brand name drug, when the brand name is chosen and a generic is available. UNDER AGE 65 ALL HEALTHFLEX PLANS -- MENTAL HEALTH PROVISIONS & EMPLOYEE ASSISTANCE PROGRAM MUST CALL 1-800-788-5614 for pre-auth. Managed Mental Health Network Non-Network* Employee Assistance Eight visits at 100% coverage Program (EAP) with pre-certification N/A Outpatient PPO: $30 co-payment CDHP: Inpatient Mental Health or Chemical Dependency: $200 co-payment then 40% coinsurance Penalties Apply for Non-Notification Additional services available through United Behavioral Health, for which there is no limit, include: Legal Assistance Financial Services Adult/Elder Support Services Child/Parenting Support Services Life Learning Support Services Chronic Condition Support Services 21
UNDER AGE 65 ALL HEALTHFLEX PLANS ADDITIONAL BENEFITS MEDICAL REIMBURSEMENT ACCOUNT (Flexible Spending) WEIGHT WATCHERS DISCOUNT OF 50% OFF MULTI-WEEK PROGRAM FEES VIRGIN PULSE WALKING PROGRAM WITH CASH INCENTIVES OVER AGE 65 MEDICARE SUPPLEMENTAL PLAN MUST ALSO BE ENROLLED IN MEDICARE PARTS A & B (Participant pays premium) MEDICARE (PART A) - HOSPITAL SERVICES - PER BENEFIT PERIOD Services Medicare Pays Plan Pays You Pay Hospitalization*: semi-private room and board, general nursing and miscellaneous services and supplies: First 60 days All but Part A Part A Deductible $0 Deductible 61st through 90th day All but daily copay Daily Copay $0 91st through 150th day: While using 60 lifetime reserve days: All but Daily Copay Daily Copay $0 Additional 365 days: $0 100% of Medicare- Eligible Expenses Skilled Nursing Facility care*: semi-private room and board, skilled nursing and rehabilitative services and other services and supplies. First 20 days All approved amounts $0 $0 21st through 100th day All but Daily Copay Daily Copay $0 Blood: When furnished by a hospital or skilled nursing facility during a covered stay. First 3 pints $0 100% $0 Additional amounts 100% $0 $0 Hospice Care: Pain relief, symptom management and support services for terminally ill. Available as long as your doctor certifies that you are terminally ill and you elect to receive these services. 100% for hospice care all but $5 for prescription drugs 95% for inpatient respite care $5 for prescription drugs 5% for inpatient respite care MEDICARE (PART B) - MEDICAL SERVICES - PER CALENDAR YEAR Services Medicare Pays Plan Pays You Pay Medical Expenses: In or Out of the Hospital and Outpatient Hospital Treatment, such as Physician's services, inpatient and outpatient medical and surgical services and supplies, physical and speech therapy, diagnostic tests, durable medical equipment: $0 $0 First Medicare-approved amounts $0 $0 Part B Deductible Remainder of Medicare-approved amounts Generally 80% Generally 20% Up to $20 copay for some doctor s office visits and up to $50 copay for ER visits that don t end in an admission Part B Excess Charges (above Medicare-approved amts.) Clinical Laboratory services, blood tests, urinalysis and more $0 $0 All costs 100% $0 $0 22
Blood: First 3 pints $0 100% $0 Additional amounts $0 $0 Part B Deductible Remainder of Medicare-approved amounts Generally 80% Generally 20% $0 MEDICARE PARTS A & B Services Medicare Pays Plan Pays You Pay Home Health care: Medicare approved services: Medically necessary skilled care services and medical supplies durable medical equipment: 100% $0 $0 First $166 of Medicare approved amounts** $0 $0 Part B Deductible remainder of Medicare approved amounts Generally 80% Generally 20% $0 Foreign Travel emergency***: OTHER BENEFITS - NOT COVERED BY MEDICARE Deductible - First $250 each calendar year $0 $0 $250** Medically necessary emergency care services beginning during the first 60 days of each trip outside the US. $0 80% to a lifetime maximum of $50,000 20% and amounts over the $50,000 lifetime maximum. OVER AGE 65 PRESCRIPTION BENEFIT PLAN Drug Types Plan Pays Amount You Pay 90 Day Mail Order Tier 1 Generics Tier 2 Preferred Brand Tier 3 Non-preferred brand & Specialty All but $10 $10 $10 All but $20 $20 $20 All but $35 $35 $35 This plan offers full coverage through the coverage gap (or doughnut hole ). You are simply required to pay the above co-pay amounts only for each prescription. Once you pay a total of $4,950 in prescription costs during the calendar year, the plan then pays 95% of remaining prescription costs. This plan is a creditable coverage Medicare Part D Prescription Drug Plan. OVER AGE 65 ADDITIONAL BENEFITS ESI EMPLOYEE ASSISTANCE PROGRAM FOR OVER AGE 65 APPOINTED TO A CHURCH HEARING AID REIMBURSEMENT SAME AS HEALTHFLEX PLAN VIRGIN PULSE WALKING PROGRAM WITH CASH INCENTIVES 23
ALL HEALTH PLAN PARTICIPANTS VISION BENEFITS PROVIDED BY VSP Network Plan Feature Annual Exam Prescription Glasses Contacts Participating VSP Provider Benefit $20 copayment $20 copayment $150 allowance; one set annually 24
EMPLOYEE ASSISTANCE PROGRAM (FOR PART TIME CLERGY/SUPPLY AT LOCAL CHURCHES) The Conference utilizes ESI Employee Assistance Group to provide EAP services to persons serving less than full time in local churches, including lay supply, AND clergy over age 65. Services include: Three counseling sessions with licensed counselors, free of charge, per issue per year Counseling and information on child and/or elder care Legal and financial resources UM LIFE OPTIONS The Optional Life Insurance Plan provides eligible participants (Clergy on CPP) with the opportunity to purchase life insurance for themselves, their spouse and dependent children. This insurance would be in addition to life insurance coverage the participant receives through CPP. Participant can select coverage from a number of death benefit options Portable when a participant retires, is terminated, or becomes ineligible Accelerated death benefit in the event of a terminal illness Billed direct to participant by Unum Insurance FINANCIAL PLANNING SERVICES Free, professional financial planning services are offered to participants of the Wespath Benefits and Investments retirement plans by Ernst & Young (800-360-2539). Unlimited access to a financial planner Planners educated in Wespath retirement plans Objective advice on educational expenses, retirement planning, debt management, home ownership, taxes, estate planning No products are sold by Ernst & Young planners 25
PENSION UNY CONFERENCE BENEFITS INFORMATION - 2017 LOCAL CHURCH LAY EMPLOYEE BENEFITS 2012 Book of Discipline, Para. 258.2g(12) states that the PPRC shall recommend 100% vested pension benefits of at least 3% of compensation for lay employees who work at least 1040 hours per year UMPIP is available to local churches for this purpose Local churches can utilize other options Churches can contact Wespath directly, or contact the Benefits Office for assistance HEALTH CARE Lay employees working 30 hours per week or more may enroll in HealthFlex Local Church must sponsor but it can require anywhere from 0 to 100% of premium be paid by the employee Premiums are based on the actual premium charged to the Conference by HealthFlex, not the blended rate charged for clergy Plan benefits are the same as the active clergy plan Church representative can contact the Benefits Office for information and to obtain a Sub-Adoption Agreement 26