the benefits plan of the presbyterian church (u.s.a.)

Benefits through the stages of your life.

THE BENEFITS PLAN OF THE PRESBYTERIAN CHURCH (U.S.A.)

Regional Representatives

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The Benefits Plan of the PC(USA) provides pension, healthcare and death and disability benefits to members of the Benefits Plan, their eligible dependents, and beneficiaries, where applicable.

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COMMUNITY NATURE• Key foundation of the plan• Community: plan members, churches, and

other employing organizations• The whole community shares cost for the

sake of all• Minimum benefits ensured for all plan

members

“For just as the body is one and has many members, and all the members of the body, though many, are one body, so it is with Christ. ...

God has so arranged the body ... that there may be no dissension within the body, but the members may have the same care for one another. If one member suffers, all suffer together with it; if one member is honored, all rejoice together with it.”

1 Corinthians 12:12, 24-26 (NRSV)

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BUILDING BLOCKS

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EFFECTIVE SALARY

• Basis for dues and benefits• Not necessarily IRS or SECA salary

amount• Includes– Cash salary– Housing or manse value – Deferred compensation

[403(b)(9); Sec. 125 plan] – Other cash payments

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2013 & 2014 MEDIAN EFFECTIVE SALARIES

Employment ClassificationMedian Salaries % Change in Median2013 2014 2013 to 2014

   Pastors* $54,000 $54,500 + 1.0% 

   Exempt Lay Members $40,900 $41,700 + 2.0%

   Non-Exempt Lay Members $29,800 $30,400 + 2.0%

*Although the figures used to calculate the pastors’ median include only teaching elders serving churches, the median applies to all teaching elders for determining benefits based on effective salary: pension credit accruals, disability benefits, and death benefits.

Benefits through the stages of your life.

TRADITIONAL COVERAGE UNDER THE BENEFITS PLAN

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CORE BENEFITS

Healthcare Retirement

Death Disability

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HEALTHCARE

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NATIONWIDE GROUP PLAN

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MEDICAL PPO NETWORK

• Network – Healthcare providers who agree to negotiated fees when treating patients in the network

• Out of network – Healthcare providers in a geographic network area who do not participate in the networks offered by the Board

• Non-network – A geographic area that does not have sufficient network providers within a reasonable distance of members

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MEMBER COST: OFFICE VISIT COPAYS

• Network office visit copays– $25 for primary care/mental health– $45 for specialists

• Out of network – 50% of the plan allowance

• Office visit copays do not count toward annual deductibles or copayment maximums

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2014 DEDUCTIBLE AND COPAYMENT PERCENTAGES

YOUR COSTS  

TYPE OF COST Network Out-of-Network  

Annual deductible• Member• Family

1.25% of effective salary1.25% of effective salary

2.5% of effective salary2.5% of effective salary

Copayment (per service) 20%, up to the copayment maximum

40%, up to the copayment maximum  

Annual family copayment maximum 5% of effective salary 15% of effective salary  

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MEMBER COST: DEDUCTIBLES

• Medical deductibles are based on effective salaries, reflecting the ability of the member to pay

• Members are responsible for two deductibles* – 1.25% of effective salary for the member– 1.25% of effective salary for the rest of the family

*(Network) Out of Network – 2.5%

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MEMBER COST: NETWORK COPAYMENT LIMITS

• After network deductible is met, member pays 20% copayment for eligible network services– This counts toward copayment limit

• After member has paid 5% of effective salary in copayments, Board pays 100% of eligible network costs

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MEMBER COST: OUT-OF-NETWORK COPAYMENT LIMITS

• After out-of-network deductible is met, member pays 40% copayment for eligible out-of-network services– This counts toward copayment limit

• After member has paid 15% of effective salary in eligible costs, Board pays 100% of eligible costs

• Costs for out-of-network services that exceed plan allowance do not count toward copayment limit

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Salary Range

Deductible Copayment MaximumNetwork and Non-Network Out of Network

Network and Non-Network Out of Network

1.25% 2.50% 5% 15%$0 - $46,974 $525 $1,050 $2,100 $6,300

$46,975 - $51,954 $590 $1,175 $2,350 $7,050

$51,955 - $56,929 $650 $1,300 $2,600 $7,800

$56,930 - $61,909 $715 $1,430 $2,845 $8,535

$61,910 - $66,889 $775 $1,550 $3,095 $9,285

$66,890 - $71,864 $840 $1,675 $3,345 $10,035

$71,865 - $76,844 $900 $1,800 $3,595 $10,780

$76,845 - $81,819 $965 $1,925 $3,845 $11,535

$81,820 - $86,799 $1,025 $2,050 $4,090 $12,270

$86,800 or more $1,085 $2,170 $4,340 $13,020

2014 HEALTHCARE DEDUCTIBLES AND COPAYMENT MAXIMUMS

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PRESCRIPTION DRUG PLAN

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PRESCRIPTION DRUG PLAN• No annual deductible• $2,500 copayment annual limit• Maintenance medications by mail order

Type of Pharmacy Maximum fill Your cost per prescription

Generic Formulary Non-Formulary

Retail pharmacy Up to a 30-day

supply $1030% of cost; min $20 to max $100

50% of cost; min $50 to max $150

Mail-order service

Up to a 90-day supply $25

30% of cost; min $50 to max $300

50% of cost; min $125 to max $450

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PRESCRIPTION DRUGS

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MAINTENANCE MEDICATIONSMAIL ORDER

• Maintenance medications are drugs taken regularly for long-term chronic conditions

• Does not apply to one-time prescriptions

• 90-day supply• Efficient, safe, and economical

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PREVENTIVE CARE BENEFIT

• Not subject to deductible• $0 office visit copay for network providers

– Plan pays 100% of office visit, lab work, and tests, according to preventive schedule

– Non-preventive (diagnostic) lab work or tests recommended by the provider during annual physical are covered subject to normal Medical Plan provisions

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MENTAL HEALTH/SUBSTANCE ABUSE

• Provided through Cigna• Treatment is reviewed by Cigna for medical

necessity• Pre-certification is required for inpatient or

higher-level services• Contact Cigna at 866-640-2772 or visit

www.cignabehavioral.com for network providers

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EMPLOYEE ASSISTANCE PROGRAM

• Cigna– For members and household members– Confidential counseling/referral service

for family, financial, alcohol, drugs, legal, life events, and stress issues

– Six free counseling visits/per person/per issue; confidential counseling/referral service

– Financial and legal help

HEALTH MANAGEMENT: ACTIVEHEALTH

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PRE-CERTIFICATION

• Pre-certification is required for:– Scheduled outpatient imaging (MRI, MRA, CAT,

PET, SPECT, etc.) and nuclear stress test– Bariatric surgery or any weight loss surgery– All inpatient hospitalizations including maternity – 7-10 days in advance or within 48 hours of

emergency hospital admission• Call ActiveHealth®,866-794-3127

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PRE-CERTIFICATION

If it is a scan, find out

if you can!

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EMERGENCY CARE

• In a life-threatening or other emergency situation, seek care immediately at the closest appropriate facility

• If hospitalized from emergency room, contact must be made with ActiveHealth within 48 hours

INFORMED CARE MANAGEMENT

• Informed Care Management – Managed by ActiveHealth– Supports those with diabetes or cardiac

conditions, lower back pain, and other chronic health conditions

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PERSONAL HEALTH RECORD

• Online confidential health record that conveniently does your health history record-keeping for you

• Includes information you provide • Automatically updates when your claims from Highmark,

Catamaran, and Quest Diagnostics * (if you use its labs) are processed

• Start your PHR on myactivehealth.com/pcusa

*not all Quest labs are in network

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CASE MANAGEMENT

• Case Management supports those with extended hospitalizations and complex medical conditions. It is a confidential service that can assist you with managing your medical condition by:– helping you understand the care resources available– coordinating and helping arrange medical services for

you providing education and support for you and your family

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24-HOUR NURSE LINE

• Toll free: 866-794-3127• You can call the Nurse Line if you:

– wonder whether you need to get medical care – need information about a medication, test, or

medical procedure – want reliable information about a health condition – aren’t sure what questions you should ask your

doctor – have questions about how you or your family can

stay healthy

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• All Members must complete: Preventive Exam Engage with ActiveHealth Nurse (if called)

• And complete at least 2:1. Health Assessment2. “Know Your Numbers” lab test3. Vision exam4. Tobacco cessation program*5. Attend CREDO (if appropriate)

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2014 HEALTH ACTIONS

• Who?– Members only in 2014

• When?– Complete Health Actions between October

1, 2013 - September 30, 2014• How tracked?

– In “Call to Health”• via Benefits Connect, or• www.MyActiveHealth.com/pcusa

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2014 HEALTH ACTIONS

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CALL TO HEALTH

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OTHER HEALTH BENEFITS

• VSP - $25 annual eye exam– Find a vision provider:

• 800-877-7195– vsp.com

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INTERNATIONAL TRAVEL

• Before travel outside United States, call the Board at 800-773-7752 (800-PRESPLAN) or visit pensions.org

• International SOS

– Obtain wallet card with regional toll-free telephone numbers

• BlueCard Worldwide

– Advises members about safe, reliable medical providers while outside United States.

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RETIREMENT PENSION

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RETIREMENT PENSION

• Experience apportionments may be granted by the Board of Directors

• Experience apportionments permanently increase the pension credits

• Defined Benefit Plan

• Pension credits accrue over entire length of service

Retirees: $254,981,237 to 15,157 livesSurvivors: $57,772,162 to 4,502 livesTotal Paid: $312,753,339 to 19,659 lives

Source: Benefits Plan Highlights

IN 2013 THE PLAN PAID …

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EXPERIENCE APPORTIONMENT HISTORY: 2000-2014

2000 2001 2002 2003 2004 2005 2006 2007 2008 2009 2010 2011 2012 2013 20140%

1%

2%

3%

4%

5%

3.0%

0.0% 0.0%

2.0%

3.0%

3.6%3.7% 3.7%

3.8%

0.0% 0.0% 0.0% 0.0%

1.0%

4.6%

Apportionment %

19881989199019911992199319941995199619971998199920002001200220032004200520062007200820092010201120122013

0

500

1000

1500

2000

2500

3000

Monthly Benefit Comparison 1988-2013

Actual Pension Benefits$2,681

Basic Benefit + CPI$1,990

Basic Benefit$1,000

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PENSION OPTIONS

• Early retirement available at 55 with reduced benefit

• Post-normal retirement provides increased benefit for retirement after age 65

• Joint and Survivor options available at retirement provide a larger benefit to surviving spouse

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EARLY RETIREMENT

• Retirement benefits may be initiated as early as age 55

• Benefit amount is determined actuarially for each year before age 65– 55 years 50%– 58 years 59%– 60 years 65%– 63 years 84%

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POST-NORMAL RETIREMENT

• Enhanced benefit for retirement past age 65 (pension credits continue to accrue)

• Additional 6.5% per year until age 7066 6.5%67 13%68 19.5%69 26%70 32.5%70+ 32.5%

• Pro-rated to the month

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DEATH

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DEATH BENEFITS

• Salary continuation

• Survivor medical coverage for one year

• Education benefit for dependent children

• Lump-sum payment

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DEATH BENEFIT: LIVING NEEDS BENEFIT

• Allows prepayment of part of death benefits up to– 75% of covered effective salary as

lump- sum benefit, or– 100% of the present value of the salary

continuation benefit, or– Both

• To assist those with a terminal illness (life expectancy of 24 months or less)

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DISABILITY

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DISABILITY BENEFIT

• All disability cases are actively managed and provide

– Partial income replacement– Medical coverage– Continued pension accrual (Traditional

coverage only)– Death benefit

DISABILITY BENEFIT — INCOME

• Begins after 90 consecutive days away from work

• 60% of effective salary or churchwide median salary for employment classification (whichever is greater)

• Initial benefit cannot exceed 100% of member’s salary

• Covered salary is capped at $90,000

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DISABILITY MEDICAL CASE MANAGERS

• All disability cases are actively managed by Liberty Mutual

• Benefits offset and coordinated with other payments (Social Security, workers’ compensation, military benefits, etc.)

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DISABILITY . . . WAYS YOU CAN BE HELPFUL

• Inquire about disability coverage early so can be fully informed

• Report disabilities early to Board of Pensions (within the first 90 days)

STRETCH BREAK

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OPTIONAL BENEFITS

• Optional dental

• Supplemental disability• Long-Term Care Insurance• Retirement Savings Plan 403(b)(9)

• Supplemental death

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OPTIONAL DENTAL

• Group dental program through Aetna• Plan provisions vary depending on where you live• Limited enrollment periods

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SUPPLEMENTAL DEATH

• Varying coverage levels available for

– Member– Spouse– Dependent children

• Dues are greater for tobacco users

• Medical underwriting

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SUPPLEMENTAL DISABILITY

• Available for those earning $100,000 or more annually• Increases basis for salary protection

• Member or church/employing organization may purchase the coverage

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LONG-TERM CARE

• Underwritten by CNA• Age-based rates• Four tiers of coverage• Open to members and family members

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RETIREMENT SAVINGS PLAN 403(b)(9)

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RETIREMENT SAVINGS PLANADVANTAGES

• Tax-deferred savings• Tax-deferred earnings

•Contributions through payroll deduction

• Numerous investment options• Easy account access

•Withdrawals are designated housing allowance for clergy

• Low annual fee - $15

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RETIREMENT SAVINGS PLAN

• Any employee of an eligible employing organization may participate

• Fidelity Investments is record keeper

• Contributions may be made by employee, employer, or both

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2014 CONTRIBUTION LIMITS

• Employee– $17,500 annually or 100% of annual cash

salary, whichever is lower. Participants over 50 may increase by $5,500

• Employer/Employee– Combined contribution equal to 100% of

annual cash salary or $52,000• Tax credits for lower annual income

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THE PARTICULARS

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TRADITIONAL PROGRAM MEDICAL DUES FOR 2014 & 2015

2014 2015

Coverage Tier Member + Family Member –only Member + Family

Dues Percentage(percentage of member’s effective salary*)

23% 23% 24.5%

Medical Participation Basis(also known as the dues minimum)

$42,000 $44,000

Sample Total Dues(calculated on the dues minimum)

$805/mo$9,660/yr

$843/mo$10,120/yr

$898/mo$10,780/yr

Sample Allowable Dues-share Amount(up to 1.5% for Member + Family coverage)**

$0 $0 $0 - $55/mo$0 - $660/yr

(at minimum dues basis of $44,000)

* Subject to the medical participation minimum and maximum and based on the standard full-time equivalent (FTE) calculation for medical dues

** Sample calculated on the dues minimum; subject to presbytery rules

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DUES FOR 2014 & 2015

2014 2015

Pension dues 11% 11%

Death and Disability dues 1% 1%

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ENROLLMENT PRINCIPLES

• Installed teaching elders are mandated into the plan

• Lay employment classifications• Equal coverage for employment

classification

• Non-installed teaching elders and lay employees may be covered through Traditional coverage under the Benefits Plan or the Affiliated Benefits Program

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CALCULATING DUES• Healthcare• Pension/Death and

disability

• Minimums and maximums

• Calculator available on pensions.org in Available Resources section and at bottom of page

Benefits through the stages of your life.

AFFILIATED BENEFITS PROGRAM

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A FLEXIBLE APPROACH

• Designed to provide an option for Presbyterian employing organizations to extend benefits coverage to employees who work at least 20 hours per week who are not enrolled in Traditional coverage

• Cost-sharing provision

• Medical, disability, and death benefit options

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COVERAGE CAN INCLUDE

• Medical benefits• Death and disability coverage• Optional coverages

– Optional dental– Supplemental death– 403(b)(9) Retirement Savings Plan– Long-Term Care Insurance– Supplemental disability

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FLEXIBLE PRICING

• Employees may be required to pay a portion of the Medical Plan cost

• Employer must pay at least 50% of member only cost

• Employees covered through other sources (a covered partner’s employer, for example) may decline coverage

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AFFILIATED BENEFITS PROGRAM

2014 Active Medical DuesCoverage Level Monthly Annually

Member Only $624.00 $7,488.00

Member & Child(ren) Only 926.00 11,112.00

Member & Covered Partner 1,281.00 15,372.00

Member & Family 1,668.00 20,016.00

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AFFILIATED BENEFITS PROGRAM

Death and Disability 2014Dues are 3.5% of whichever is greater: the enrolled member’s total annual effective salary or the minimum participation basis subject to maximum established by federal law. The minimum participation basis is 25% of the median.

Monthly Annual

Minimum Basis: $13,625 $39.74 $476.88

Maximum Basis: 255,000 743.75 8,925.00

Benefits through the stages of your life.

OTHER PROGRAMS

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THE ASSISTANCE PROGRAM

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THE ASSISTANCE PROGRAM

• Church workers: Shared, Emergency Assistance, Adoption Assistance, and Transition-to-College Grants

• Retired church workers: Income and Housing Supplements

• Pastor’s vocational leadership needs: Seminary Debt Assistance, CREDO, Sabbath Sabbatical Support

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THE ASSISTANCE PROGRAM

• Christmas Joy Offering• Bequests• Endowments• Individual gifts

The Assistance Program is funded through:

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ASSISTANCE PROGRAM FUNDING

5. Adoption Assistance Grants6. Transition-to-College Assistance

Grants7. Seminary Debt Assistance

Grants8. Sabbath Sabbatical Support

Grants9. Presbyterian CREDO

Gifts, Bequests &Endowments(Investment Earnings)

Christmas Joy Offering1. Shared Grants2. Emergency Assistance Grants3. Income Supplements4. Housing Supplements

Types of GrantsFunds

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SEMINARY STUDENTS

• May participate for medical coverage only

• Must be inquirer or candidate and enrolled as a full-time student

• Enrollment period is in fall except for life-change events

• Coverage may continue after graduation

2014 SEMINARY STUDENT MEDICAL DUES

Coverage Level Monthly AnnualMember Only $458 $5,496

Member & Covered Partner 702 8,424

Member & Child(ren) Only 702 8,424

Member & Family 804 9,660

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MEDICARE SUPPLEMENT

• Medicare Supplement available to members and covered partner at $218 per person per month in 2014

• “Choosing Healthcare Coverage at Retirement” – great resource for options

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AT TERMINATION OR RETIREMENT

If plan participant for at least one year, member receives 30 days of free medical coverage, then:• Transitional participation (24 months)

– While actively seeking a call within Presbyterian Church (USA), $805/month per family

• Medical Continuation Program (18 months, unless meets Rule of 70)– $733/person, $1,466/family

• Medicare Supplement – $218/person, $436/couple

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POST-RETIREMENT SERVICE

• Retired members may be employed in post-retirement service

• Church pays post-retirement dues on honorably retired ministers of 12% for 20 hours/week or more

• Post-retirement service dues provide a direct subsidy to Medicare Supplement fund

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VACANCY DUES

• Applicable for 12 months

• Vacancy dues support Medicare Supplement fund

• Dues basis – 12%

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RESOURCES

pensions.org

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BOARD UNIVERSITY

• Learn how to make the most of your finances, benefits and retirement– Seminars

• Getting in Shape Fiscally, A Financial Planning Seminar

• Growing Into Tomorrow … Today, A Pre-Retirement Planning Seminar

• Post-Retirement Seminar• Render Unto Caesar, A Clergy Tax and Terms of Call

Seminar

pensions.org/seminars

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BOARD UNIVERSITY

• Learn at your convenience– E-Learning

• Getting Ready: The Change in Medical Dues• Tax Advantage Plans• Call to Health• Tax Tips• Housing Allowance• Personal Finance Series• And more

pensions.org/BoardUniversity

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CONTACTS: 800-773-7752 (800-PRESPLAN)

• Member Services team– Available Monday-Friday

• 8:30 a.m. – 5:00 p.m. ET, (closed between noon and 1:00 p.m.)

• Member Advocate • Regional Representative• Education Specialists• All staff and benefits areas• Website – pensions.org

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REGIONAL REPRESENTATIVES CAN:

• Help members understand and maximize their benefits

• Help enroll new pastors and church employees in the Benefits Plan

• Help presbyteries assist church workers with financial needs with Board programs

• Assist members obtain Assistance grants• Maintain contact with retirees• Keep presbyteries informed of Board programs

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IMPORTANT PHONE NUMBERS

• Board of Pensions 800-773-7752• Cigna Behavioral Health 866-640-2772• ActiveHealth 24-Hour Nurse Line 866-794-3127• Highmark Blue Cross/Blue Shield 888-835-2959• Fidelity Investments 800-343-0860• Liberty Mutual – Disability 800-838-5290• CNA – Long-Term Care 800-528-4582• Aetna – Dental (call the Board) 800-773-7752• VSP 800-877-7194

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IMPORTANT FORMS

• Benefits Plan Membership Application (enr-001)

• Affiliated Benefits Program Membership Application (enr-002)

• Service Change (enr-110)• Change of Salary (enr-111)• Change of Address (enr-106)• Service Termination (enr-301)• Medical Continuation Subscription or

Waiver (med-100)

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