wfn.org | ELCA Board of Pensions Considers Health Plan Member Cost-Sharing

[NEWS@ELCA.ORG]

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 news@elca.org
http://www.elca.org/news