ELCA NEWS SERVICE March 23, 2004 ELCA Board of Pensions Considers Health Plan Member Cost-Sharing 04-046-SS* MINNEAPOLIS (ELCA) -- A health plan that strengthens preventive benefits and emphasizes health and wellness was approved "in concept" by the trustees of the Board of Pensions of the Evangelical Lutheran Church in America (ELCA) Feb. 27-29 when they met here. The trustees discussed the 2005 health plan design at length before approving the concept, expressing concern for the way deductibles and out-of-pocket expenses would affect both low-income and high-income members. In his written report to the trustees, Bradley J. Joern, Board health actuary, emphasized the denomination's philosophy of benefits: a plan that provides adequate benefits for members and that is affordable for congregations and other employers. Joern reminded trustees of the Board's move toward cost-sharing for medical services of 20 percent by plan members and 80 percent by the plan. Currently the plan reimburses about 84 percent of medical expenses, with members paying 16 percent through deductibles, co-payments and co-insurance. The move to 80/20 "could be accomplished by simply increasing member deductibles, reducing the co-insurance percentage paid by the plan, and/or increasing member out-of- pocket limits," Joern reported. "Unfortunately, we believe that such a one-dimensional approach to increasing the member share of medical services will violate the principle of financial protection for the lowest paid members." To avoid that burden for low-income members, Board staff proposed a plan whereby high-income plan members would bear higher out-of-pocket costs than low-income members. However, trustees noted that relating deductibles and out-of-pocket expenses to compensation moved the ELCA to a new concept -- cost- sharing at a member level in addition to employer cost-sharing. Saying there are too many questions, trustee Jon B. Christianson, Arden Hills, Minn., said it's "premature to adopt the cost-sharing now." The Rev. Lowell G. Almen, ELCA secretary and advisor to the trustees, said the proposed plan needed changes, even if it meant holding up roll-out of the plan. Board staff will rework the proposal, and discussion among trustees and staff will continue, said David Adams, vice president of research and design. The trustees' recommendation approving the plan "in concept" said in part that "specific plan design parameters (e.g., deductibles, reimbursement percentages and out-of-pocket limits) are still being tested and staff needs to establish contribution rates for 2005 and begin communicating the new plan prior to bringing plan amendments to the August Board of Trustees meeting for approval." An amendment which was approved asked that the recommendation be transmitted to the ELCA Church Council for its November meeting. In other business, the trustees: + Discussed the Board's ongoing health-and-wellness initiatives for the health-care plan. They heard that more than 6,700 individuals registered on the http://www.elcaforwellness.org/ Web site and, of that number, nearly 4,500 completed the Health Risk Assessment. Trustees heard about possible incentives for plan members who sign and follow through on a wellness covenant. + Heard a challenge for the future from John G. Kapanke, president of the Board of Pensions. "This is the 55th meeting of the board," Kapanke said. "The next five years will be as significant, if not more so, than the previous 55 meetings. We need a new vision statement -- one that makes us stretch. This one is inward-focused and doesn't forecast the future." Kapanke added that the board would keep the values it now embraces: integrity, excellence, respect, stewardship and collaboration. The Board's vision statement is: "We are the first place to contact when you need a caring and responsive partner to meet your health care and retirement needs. Information at our fingertips enables us to assist members with knowledgeable, supportive service. We are advocates to ensure that the ELCA benefits programs meet the needs of the entire church." The trustees' next meeting is to be here Aug. 4-6. -- -- -- The ELCA Board of Pensions has its home page at http://www.elcabop.org/ on the Web. * Sonia C. Solomonson is managing editor for The Lutheran, the magazine of the ELCA. For information contact: John Brooks, Director (773) 380-2958 or [log in to unmask] http://www.elca.org/news