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Do You Have Questions about Healthcare, Insurance and ACA?

 

UPDATE: The United Methodist General Board of Pensions and Health Benefits has released a resource designed to help clergy and laity better understand the Affordable Care Act. Click here or the Affordable Care Act and You graphic below to access this resource.
 
Join the club. We are all in the same boat as there are many more questions than there are answers. In an attempt to help you navigate the choppy and unknown waters on which we all sail as it relates to the future of healthcare, we are providing a note about what your Conference Board of Pension (CBOP) is doing, has done and will continue to do on behalf of the clergy, their families, the covered lay staff and the churches of the CTC. There is also a Q&A that might unpack for you some of the anticipated questions.
 
Rev. Frank Briggs, chair of our Conference Board of Pension, shared this with us at the 2013 CTC Annual Conference in June at Arborlawn UMC in Fort Worth,
 
“I want you to hear loudly and clearly that each member of your CBOP are either pastors or lay members of local churches….we are all in this together and we partner with you and for you by trying to provide our clergy and covered lay staff the finest benefits possible while at the same time watching the cost to the local church. In other words don’t ever forget that what affects you affects every one of us as well and that we too have to live with the consequences of the decisions that we must make. Those decisions are not taken lightly nor made easily. We discuss and research items for many months, we use the General Board plus outside independent health care experts to get as much information from as many sources as possible before any recommendation is presented.
 
This year more than any other, we have been involved in research, and questions regarding the cost of the benefits that our local churches provide for our various staff members. The Affordable Care Act (ACA) demands that the current face of the health care industry is radically changing…and will continue for the next few years. We will be exposed in the insurance business and each of us will need to become “consumers”…in essence to be responsible for many of our own health insurance questions, such as rates, coverage, companies etc. We plan on offering informational seminars and workshops next year to begin to educate us all to the known and raise questions that each of us might need to know about the known and unknown future.”
 
What became apparent from all our research is that there were too many unknowns about the ACA to recommend that we scrap the health insurance plan that we have in order to blindly jump into unknown health care exchanges in 2014. (In fact, even as I write this we are still awaiting decisions that will affect the health plans that can be offered to participants in the non-profit sector.) We do know some of our families might benefit from entering the exchanges and some of our families might be harmed. We took the cautious approach in our recommendation to the annual conference.
 
As Frank indicated, your Conference Board of Pension will continue to study the impact of this law on our clergy and their families. In fact, one of the pieces of data we requested from our clergy at AC was the number of dependents and household income (MAGI) number from their tax return as those play deciding roles in who qualifies for what benefits. We will evaluate the information we gather and make our recommendation to the annual conference in June 2014 for approval and implementation on Jan. 1, 2015.
 
Included in the Q&A below is some very basic information and a link to the General Board of Pension and Health Benefits (GBOPHB) web site that is continually updated with the latest information available. The GBOPHB web site will be your best source as they are actively involved in working on our behalf with the makers and interpreters of the law and because they provide the basics of our HealthFlex conference health plan.
 
Let me end by saying that the members of your CBOP request your prayers as we continue to work on your behalf. If you have specific questions, we would be glad to try to provide answers for you. You can call the conference service center at 817-877-5222 or toll free 800-460-8622 or use the experts at the GBOPHB and email at the address provided below.  
Q & A
Q. What are some of the newest particulars regarding the ACA that impact the CTC clergy, their families and/or churches?
 
A. On February 1, 2013, the Internal Revenue Service (IRS) adopted a final rule under the Patient Protection and Affordable Care Act (PPACA or ACA) about the affordability of employer health coverage offered to families of employees. The rule denies federal financial assistance in the form of premium tax credits (PTCs) to many family members of employees who cannot afford the family coverage offered by their employers.  Under the ACA rules, as long as the employer-offered coverage costs the employee less than 9.5% of MAGI for self-only coverage, then no matter what the employer charges to cover the employee’s dependents, those dependents offered coverage will be precluded from seeking government-subsidized coverage on the Exchanges.  In determining whether an employer’s health plan is “affordable” for “related individuals” (i.e., spouses and children of a covered employee) for purposes of determining eligibility for the PTC, the IRS will look at the cost of coverage only for an individual employee—not for the family. Even if employer health coverage is unaffordable to an employee’s family at the family-coverage level, family members will not be eligible for PTCs to purchase coverage through the ACA’s health insurance exchanges (Exchanges) as long as the employee-only cost of the offered employer coverage is less than 9.5% of household income. In cases where family coverage is prohibitively expensive and the employee declines employer-provided coverage of his or her dependent children or spouse, PTCs would still not be available to help the family purchase insurance for children or the spouse through an Exchange.
 
Q. I can’t get my mind around all of that…Can you unpack it for me?
A. Yes. As a clergy in one of the eligible and mandated categories you have individual health care coverage which is paid for totally by your church.
 
Q. So, I have health care coverage, of which the church furnishes to me as a benefit, at no cost…What about my spouse and/or dependent children? Do they have to be covered by this conference plan?
 
A. No. Other members of your family are free to choose what is best for them, individually and as a family. If your spouse works outside the home, their employer should be consulted first. But your spouse and children may choose to be covered by your spouse’s employer’s insurance plan, the conference plan or an independent insurance provider…including an exchange. 
 
Q. So, you are telling me that my spouse and/or dependent children can be covered by other sources like the exchange but I can’t? Why?
 
A. Yes. For years, our conference has mandated certain categories of clergy into the health insurance plan. If you are in one of those mandated categories your church must fund the cost of your insurance through the conference plan.
 
Q. I have heard that before but in light of the ACA why don’t we, the annual conference, change that?
 
A. The annual conference might. The whole face of health care is changing but the recommendation for 2014 because there were so many unknowns, particularly the impact on our participants and churches, the CBOP felt the best course of action would be for us to remain in the program we know and the annual conference passed that recommendation.
 
Q. Premium tax credits are mentioned above…am I eligible?
 
A. No. According to the rules of the ACA, Premium Tax Credits are available to those who meet certain qualifying conditions. Since the plan for you, the “employee”, is provided totally by your church it is obviously affordable so you nor your family are eligible for PTC’s.
 
Q. But dependent members of my family are free to seek coverage through an exchange we just aren’t able to qualify for tax credits?
 
A. Yes.
 
Q. I don’t agree with any of this. Why has the conference done this to me?
 
A. Your CBOP follows the law and rules enacted by the ACA legislation. Decisions for 2014 had to be made well ahead of all the known ramifications of the legislation and we chose to recommend to the annual conference we stay status quo for 2014.
 
Q. What will we do for 2015?
 
A. We don’t know. The annual conference will act upon the recommendation of the CBOP in June, 2014. The CBOP will continue to gather information to help us come up with a recommendation for health care benefits for our clergy and their families and covered lay employees, while watching the costs for our churches. If you have suggestions contact Randy Wild for inclusion on the next CBOP agenda.
 
Q. Where can I go to get more information on the ACA and its impact on me or my local church?
 
A. The General Board of Pension and Health Benefits (GBOPHB) has a plethora of information with regard to healthcare reform on their website www.gbophb.org/health_welfare/healthcarereform/index.asp
 
Q. What if I have a specific or additional question(s)?
 
A. You may certainly call the Conference Service Center or there are ACA experts at GBOP that can help you.  You may email your questions to healthcarereform@gbophb.org
 
 
We intend this document to answer some basic questions regarding the new ACA and how it might affect you. It is not meant as an exhaustive discourse and has been checked as best we can for the accuracy of the answers to the questions. However do not rely on this document solely to make your decisions regarding your healthcare needs. It is not intended to give specific individual, legal or benefits advice but merely to point out the need for you to get all the information to order make an informed decision.