The Detroit Conference Group Health Plan was changed by Special Conference action on February 15, 2003, to Blue Cross/Blue Shield PPO Option 4. Dental coverage is provided through Guardian Insurance, with an optional choice of vision coverage. Prescription drug coverage is provided through PharmaCare. These plans are designed to safeguard the health and well being of covered members and their families. The medical plan covers a wide range of medical expenses related to the more routine accident and illness situations, as well as the sudden unexpected medical expenses related to a major accident or illness that can generate thousands of dollars in expense in a short time frame. Your benefits booklets describe the features of these plans in full detail. Review the booklets to gain an understanding of the plans, and keep them available for ready reference in the event you require care.
Active Plan Benefits: The medical and dental care plans are designed to cover eligible active employees and their eligible dependents during their working years. The Charge- or Conference-approved salary paying unit pays the cost of coverage for the participant and family.
Retiree Plan Benefits: Blue Cross/Blue Shield Complementary Benefits Coverage to Federal Medicare (Parts A and B) is designed for medical expenses of retirees and their eligible dependents. Dental, prescription drugs and vision (optional) coverage is also available to retirees. Note: Retiree status related to eligibility, time in service, Detroit Annual Conference appointments to a local church, etc., will determine how the plan premiums are shared. Full details appear in the Retiree Plan section of this report.
Plan Administration: Beginning April 1, 2003, both the Active and Retiree plans are centrally administered by BenePro, Inc. 306 S. Washington, Suite 214, Royal Oak, MI, where enrollment and premium billings are processed. The Division of Insurance will be happy to answer your questions about the plans. Please ask any questions in writing, and send to the Board of Pensions and Insurance for reply by the Board or Treasurer’s Office. We consult with our insurance carriers as the need arises.
Who is Eligible:
Active Plan: Eligible classes include the following:
1. All full-time active employees as defined, of the Detroit Annual Conference, local churches, agencies, or institutions of the United Methodist Church are eligible. Active full-time employees age 65 through age 69, including non-working spouses 65 to 69 (regardless of the employee’s age) are also eligible until Federal Medicare becomes effective.
2. All eligible employees, as defined, of the above eligible participating groups may also become eligible as retirees. Refer to the Retiree Group Section for details and conditions relating to retired employees.
3. All surviving spouses and dependents of covered deceased employees, as defined, of the above participating groups are eligible. Premiums are paid by the Detroit Annual Conference.
4. The divorced or legally separated spouse and dependent unmarried children who are no longer eligible for the group coverage of the Blue Cross/Blue Shield participant, but subject to the following conditions:
a. Coverage of the spouse or over age child will be eligible for continuation until the earliest of the following occurs:
i. Acquisition of group health insurance from another source
ii. Remarriage of the divorced spouse
iii. Three years have elapsed following the divorce decree
b. While the Annual Conference will be billed for the premium due on the spouse over age child, the divorced spouse and dependents or overage child shall be responsible for the payment of the monthly premium billing to the Conference Treasurer’s Office. Premiums received are the remitted for payment to the insurance carriers.
c. Laid-off employees who are no longer eligible because of termination of employment (for other than gross misconduct) can continue in the group for eighteen (18) months provided they apply for continuation within 60 days of termination date and pay premiums promptly to the Conference Treasurer’s Office.
Effective Date: The date you commence work on a full time basis. Full-time is considered working at least 30 hours per week in your position.
Eligible Dependents: Dependents who are eligible are:
1. Your spouse
2. Your unmarried children under 19 years of age.
3. Your unmarried children 19 years of age but under 25 years who are registered students in regular full-time attendance at school, provided they are principally dependent upon you for support and maintenance and are not employed by one or more employers on a full-time basis of 30 or more hours per week exclusive of scheduled vacation periods.
4. Your dependent is residing in the United States of America
Note: Any changes in family status – additions, terminations, births, marriage, have an important impact on eligibility. Changes should be communicated to the benefits coordinator, Rev. Don Emmert, 1309 N Ballenger, Suite #1, Flint, MI 48504, within 30 days of the date the change occurs. Any delay in notification can mean a delay in insurance coverage by the carrier, or a delay in processing a claim, and potential loss of eligibility.
When your insurance commences: You will be insured on the date you become eligible if you have completed the required enrollment materials for the Benefits Coordinator and Blue Cross/Blue Shield in the conference treasurer’s office and provided you are not away from work due to disability on that date. If you are not actively at work due to disability, your insurance will not start until you return to active full-time work. Each or your eligible dependents will be covered on the date you become eligible for the insurance on your dependents or the date such person becomes a dependent, whichever is later, provided you have enrolled for benefits for your eligible dependents.
Retiree Group
Medical/Dental Care Program
Introduction
This special section of the conference group medical and dental care plan sets for the conditions for coverage and costs. Conditions take into account length of time in local appointments and covered service in the Detroit Conference pension plan. It is very important that you understand the specific rules relating to who, when, and how you become eligible for coverage under the Retiree Plan benefits. How the cost of the program is shared is also an important factor to determine from the information that follows. You have a right to have your questions answered, as well as a responsibility to convey them in writing to the Board of Pensions and Insurance and Conference Treasurer’s office for a response. The board is ready, willing and able to assist you in understanding this important program in advance of your retirement date. We ask that you not rely on verbal response to general question raised in informational meetings or provided by representative other than the Board of Pensions and Insurance, or coming about through pre-retirement seminars not dealing exclusively with the subject.
If you have had several appointments during your career, some beyond the Local Church, or through another Annual Conference or another career path, it is important that you determine your eligibility for retiree coverage and how the cost will be shared, early on in your appointment to a local church in the Detroit Annual Conference. You will then be in a position to plan for the future.
**Post Retirement Medical/Dental Care Benefits for
Clergy**
Provides for continuing coverage in the event of death, disability, and retirement.
1. In order for coverage to continue in the event of death, disability, or retirement, the clergy person (including eligible dependents) must have been an active participant in the health insurance coverage since the most recent open enrollment period, except in the case of death or disability in which case the clergy person must have been actively participating since the most recent Annual Conference. In the event of retirement, the clergy person (including eligible dependents) must also have been an active participant in the health insurance plan for at least 30 days before the date of retirement. For January retirements only, this would require enrollment in the health insurance plan 13 months before retirement.
2. Definitions.
a. The “Health Insurance Coverage” shall mean the health insurance benefit package as approved by the Detroit Annual Conference from time to time.
b. The phrase “with pension credit from the Detroit Annual Conference” means that the Detroit Annual Conference through the apportionment system made the contributions to the General Board of Pensions and Health Benefits for retirement benefits. You are eligible depending upon age and years of service.
3. Retirement
at age 65 or with 40 years of service, subject to the following:
If the clergy person has served 20 years or more under Episcopal appointment with pension credit from the Detroit Annual Conference, then the Detroit Annual Conference will pay the full cost of the health insurance coverage for the clergy person and eligible dependents, provided that the clergy person will have served under Episcopal appointment with pension credit from the Detroit Annual Conference for five (5) years immediately preceding retirement.
If the clergy person has served less than 20 years under Episcopal appointment with pension credit from the Detroit Annual Conference, then the Detroit Annual Conference will pay a pro-rata share of the cost of the health insurance coverage for the clergy person and eligible dependents the numerator of which will be the number of years of service under Episcopal appointment with pension credit from the Detroit Annual Conference and the denominator of which will be 20; provided that the clergy person shall have served under Episcopal appointment with pension credit from the Detroit Annual Conference for the five (5) years immediately preceding retirement.
Years served under Episcopal appointment with pension credit from the West Michigan Conference shall be counted in determining the calculations under the 20-year rule and the five (5) year rule.
Both the clergy person and the clergy person’s spouse must enroll in Medicare Part B at the first date of eligibility.
Health Insurance coverage shall be provided for the clergy person, the clergy person’s spouse who was married to the clergy person at the time of retirement, and any children of the clergy person who are eligible to be covered under the health insurance coverage. The clergy person’s eligible dependents are determined as of the date of retirement.
4. Retirement
at age 62 or with 35 years of service.
If the clergy person has served 20 years or more under Episcopal appointment with pension credit from the Detroit Annual Conference, then the Detroit Annual Conference will pay the full cost of the health insurance coverage for the clergy person and eligible dependents, provided that the clergy person will have served under Episcopal appointment with pension credit from the Detroit Annual Conference for five (5) years immediately preceding retirement.
If the clergy person has served less than 20 years under Episcopal appointment with pension credit from the Detroit Annual Conference, then the Detroit Annual Conference will pay a pro-rata share of the cost of the health insurance coverage for the clergy person and eligible dependents the numerator of which will be the number of years of service under Episcopal appointment with pension credit from the Detroit Annual Conference and the denominator of which will be 20; provided that the clergy person shall have served under Episcopal appointment with pension credit from the Detroit Annual Conference for the five (5) years immediately preceding retirement.
Years served under Episcopal appointment with pension credit from the West Michigan Conference shall be counted in determining the calculations under the 20-year rule and the five (5) year rule.
Both the clergy person and the clergy person’s spouse must enroll in Medicare Part B at the first date of eligibility.
Health Insurance coverage shall be provided for the clergy person, the clergy person’s spouse who was married to the clergy person at the time of retirement, and any children of the clergy person who are eligible to be covered under the health insurance coverage. The clergy person’s eligible dependents are determined as of the date of retirement.
5. Retirement under the Twenty-Year Rule under
Episcopal Appointment
A clergy person (less than age 65), the clergy person’s spouse who was married to the clergy person at the time of his/her retirement, and any children of the clergy person who are actively participating in the health insurance coverage at the time of retirement under the Twenty-Year Rule shall be eligible to continue the coverage but the clergy must pay the premium in full. Failure to remit the premium in a timely fashion will result in the coverage being cancelled.
At age 65, the clergy person will be eligible for the benefits as provided for and subject to the conditions set forth in paragraph three (3) above provided that the clergy person will have served under Episcopal appointment with pension credit from the Detroit Annual Conference for five (5) years immediately preceding retirement.
Years served under Episcopal appointment with pension credit from the West Michigan Conference shall be counted in determining the calculations under the 20-year rule and the five (5) year rule.
Both the clergy person and the clergy person’s spouse must enroll in Medicare Part B at the first date of eligibility.
6. Clergy placed on Conference Disability Leave.
If the clergy person was actively participating in the health insurance coverage at the time of being placed on disability leave, the conference will provide and pay for health insurance coverage for the clergy person and the clergy person’s eligible dependents at the time of being placed on disability leave.
If the clergy person remains on disability leave until retirement, then the clergy person shall be eligible for the health insurance coverage as provided in paragraph three (3) above and the years on disability leave shall be counted in determining the application of the 5-year and 20-year rules.
Both the clergy person and the clergy person’s spouse must enroll in Medicare Part B at the first date of eligibility.
7. Death of a clergy person serving under Episcopal Appointment
with pension credit from the Detroit Annual Conference.
If the deceased clergy person was participating in the health insurance coverage at the time of death, the Detroit Annual Conference will provide and pay for health insurance coverage for the eligible dependents of the clergy person.
The surviving spouse must enroll in Medicare Part B at the first date of eligibility.
a. In the case when a clergy person marries or remarries after retirement or being placed on disability leave, the surviving spouse will be covered under the health insurance coverage at his/her own cost and may continue to be covered until his/her death. Failure to remit the premium due in a timely manner will result in the coverage being cancelled.
b. The event of remarriage of a surviving spouse who was covered by the health insurance coverage, shall in no way change the covered status of such a person. However, the surviving spouse’s new spouse shall not be entitled to coverage by the health insurance coverage unless such person is so eligible by virtue of his/her own status.
In the event any of the above provisions need to be interpreted, the Division of Insurance is authorized to make any needed interpretation which will be considered final unless appealed to the Board of Pensions and Insurance, which will have the final authority to decide any issue. In the event of any dispute or disagreement by a participant, the Division of Insurance is authorized to negotiate and settle the matter subject to the terms and conditions of the underwriter of the coverage and review by the Board of Pensions and Insurance.
In the event any person is required to pay part of the premiums for health insurance coverage, the Detroit Annual Conference Treasurer shall promptly bill such person for the appropriate dollar amount.
Schedule
of Life Insurance Benefits
(Underwritten
by the Canada Life Assurance Company)
Each member who becomes insured
under the policy prior to his/her 65th birthday and whose age, on the
15th of September coincident with or next following birthday, is:
Amount of *Member’s
Attained Age
Insurance Contributions
Under 45 $ 50,000
45 45,000
46 40,000 $18 quarterly
47 35,000 goes to “paid-up”
48 30,000 portion of the
49 - 62 25,000 individual’s
63 18,000 policy
64 16,000
65 14,000
66 12,000
67 10,000
68 8,000
69 6,000
Each member who becomes insured under this policy on or after his/her 65th birthday and whose age, on the September 15th coincident with or next following his/her birthday is:
Amount of *Members
Attained Age Insurance Contributions
Under 65 $ 16,000
65 14,000
66 12,000 $.90 quarterly
67 10,000 to term portion
68 8,000 of policy
69 6,000
Life Insurance for dependents
Spouse $4,000
Each Child (over 2 wks of age) 2,000
Under 2 Weeks 0
Note: A member’s life insurance terminates on the September 15th coincident with or next following his/her 70th birthday. Members who have joined the plan prior to the 65th birthday will contribute $18 quarterly for the paid-up portion of insurance. Members who have joined after their 65th birthday will contribute $.90 quarterly to the term portion of insurance.
* As an addition to the contribution in the schedule, each member will pay $1 monthly which is applied to the cost of the term portion of insurance.
It is important to enroll promptly; after 90 days from date of eligibility, the prospective enrollee is required to submit evidence of insurability satisfactory to the underwriter before they can become insured. Contact the conference treasurer’s office if you have any question relating to contributions or enrollment procedures.
Respectfully submitted on behalf of the
Board of Pensions and Insurance by
William Burnett, President
Rev. Marshall G. Dunlap, Pension Officer
320 W. 7th Street, Royal Oak, MI 48067
(248) 541-4100
Rev. Don Emmert, Pension Administrator
800-334-0544, Ext 353