Insurance Information
Insurance Information
Table of Contents
IMPORTANT BENEFIT INFORMATION
TO: All Clergy and Employees in the Diocese of Pueblo
FROM: Theresa Farley, Director of Human Resources
DATE: June 23, 2004
SUBJECT: Insurance Coverage for 2004-2005
Eligible Employees: 30 hours or more per week
We have now received the final agreements for our diocesan insurance plans. The health insurance will remain with Rocky Mountain Health Care Options. There will be a few changes to the plan design and coverage. I have provided a copy of the new plan summary sheet so that you can review the coverage. The co-pay amounts are slightly lower and the new co-pays for prescriptions will be $12/$35/$50.
The deductible structure has changed also. The individual deductible will be $500. Preventive care, routine office visits, etc. are not subject to this deductible. You may visit RMHP.org to view a list of providers for your area. I understand that RMHCO will issue new cards to subscribers. If you have not received your cards by the end of July, please let me know.
Dental coverage will now be with MetLife Dental. The new plan is an Indemnity, meaning you may choose any dentist that you want; however, if you go to a dentist who is on the MetLife network, your out-of-pocket expenses can be significantly less than if you go out-of-network. The deductible amounts are the same. I have enclosed a plan summary sheet so that you can review the coverage. Please note that orthodontia will be available for children (up to age 19), and the $1,000 maximum does not apply to the annual maximum benefit amount.
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Health coverage anticipated a 12% increase in premiums, but we were able to keep the actual increase to just 4% for lay and just under 10% for clergy.
· Vision coverage will remain with VSP. The premium rates did not increase.
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Dental will transfer to MetLife Dental. Rates presented are an increase of approximately 3.5 % (8% increase was anticipated), however we are continuing to negotiate a further decrease in the premium amounts for dental and life.
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Life insurance will remain with MetLife. The current rates will continue.
We will be doing a census enrollment for the new dental plan. This means that if you are currently covered under the diocesan dental plan, your coverage will automatically be transferred (at your current level of employee, employee + 1, or employee + 2 or more). You do not need to complete an application form. If you do not currently have the dental insurance, but would like to enroll, you will need to complete an application (provided in this packet).
The new rates are:
RMHCO Health VSP VISION MetLife DENTAL MET LIFE
Lay Clergy
EE $369.40 $374.94 $6.61 $24.30 $3.70
EE + 1 $757.27 $768.63 $10.58 $48.36
EE + Children $701.86 $712.39 $10.80 $84.60
FAM $1052.79 $1068.58 $17.41 $84.60
I have attached a new rate sheet to help you calculate employer and employee premium costs for coverage.
THIS INFORMATION IS ALSO AVAILABLE ON THE DIOCESAN WEBSITE: dioceseofpueblo.com
Please remember that open enrollment is during July for our group. If any eligible employees would like to make changes to their coverage, or add dependents, they may do so at this time for a July 1 effective date.
I have enclosed enrollment and change forms for all insurances. You may use these forms to alert our office of any changes to your coverage that you would like to make.
Bishop Tafoya has reviewed the clergy plan and has again authorized the parishes to provide up to $2,000 per year of support to the clergy to assist with meeting deductible and coinsurance amounts. This directive for the parishes is considered by the Bishop on an annual basis. This assistance will be done on a reimbursement basis, with the clergy providing documentation to the parish of fees paid. The deductible and coinsurances which would qualify for this reimbursement are for health and dental-related costs, including prescription costs. The $2,000 is not to be issued as a stipend before services have been received, and is the maximum amount the parish should pay for the benefit year.
If you have any questions about the insurance, or the new rates, you may contact me at 719-544-9861 ext. 171; Judy, Human Resources Secretary at ext. 172; Christine Medina at RMHCO, 719-253-3904; or Stephanie Allen at MetLife dental at 800-275-4638. Thank you.
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EMPLOYEE AND CLERGY PLANS HAVE BEEN SEPARATED |
Prescription coverage: 12/35/50 |
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Diocese/Parish pays full single premium for health |
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Diocese/Parish pays 60% of EE+Spouse, EE+children, & family premium; employee pays 40% |
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Diocese/Parish pays full single premium for vision |
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Employee pays remainder of employee & spouse, or family premium for vision |
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Diocese/Parish pays full single premium for dental |
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Employee pays remainder of employee + 1, or family premium for dental |
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Rocky Mountain Health Plans |
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EMPLOYEE PLAN PPO |
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CLERGY PLAN PPO |
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Total |
Employer |
Employee |
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Total |
Employer |
Employee |
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Premium |
Pay |
Pay |
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Premium |
Pay |
Pay |
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Employee |
369.40 |
369.40 |
0 |
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Employee |
374.94 |
374.94 |
0.00 |
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Employee + Spouse |
757.27 |
454.36 |
302.91 |
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Employee + Spouse |
768.63 |
461.18 |
307.45 |
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Employee + Child/ren |
701.86 |
421.12 |
280.74 |
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Employee + Child/ren |
712.39 |
427.43 |
284.96 |
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Employee + Family |
1052.79 |
631.67 |
421.12 |
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Employee + Family |
1068.58 |
641.15 |
427.43 |
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VSP thru RMHP |
Total |
Employer |
Employee |
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METLIFE INSURANCE |
Employer |
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Vision |
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Pay |
Pay |
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Life |
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Pay |
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Single |
6.61 |
6.61 |
0 |
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Employee |
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3.70 |
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Employee + Spouse |
10.58 |
6.61 |
3.97 |
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Employee + Child/ren |
10.80 |
6.61 |
4.19 |
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METLIFE DENTAL |
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Family |
17.41 |
6.61 |
10.80 |
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Dental |
Total |
Employer |
Employee |
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Pay |
Pay |
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Single |
24.30 |
24.30 |
0.00 |
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Employee + one |
48.36 |
24.30 |
24.06 |
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Family (EE +2 or more) |
84.60 |
24.30 |
60.30 |
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TOTALS |
Lay |
Lay |
Clergy |
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Clergy |
ANNUAL |
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Employer |
Employee |
Employer |
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Employee |
Lay |
Lay |
Clergy |
Clergy |
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H+V+D+L |
H+D+V |
H+D+V+L |
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H+D+V |
Employer |
Employee |
Employer |
Employee |
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Single |
404.01 |
0.00 |
409.55 |
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0.00 |
4848.12 |
0 |
4914.60 |
0 |
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Employee + Spouse |
488.97 |
330.94 |
495.79 |
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335.48 |
5867.66 |
3971.26 |
5949.46 |
4025.78 |
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Employee + Child/ren |
455.73 |
345.23 |
462.04 |
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356.06 |
5468.71 |
4142.81 |
5544.53 |
4272.672 |