wfn.org | Some ELCA Health Plan Members Offered More Choice

[NEWS <NEWS@ELCA.ORG>]

ELCA NEWS SERVICE

May 21, 1999

SOME ELCA HEALTH PLAN MEMBERS OFFERED MORE CHOICE
99-139-SS**

   MINNEAPOLIS (ELCA) -- Trustees of the Board of Pensions of the
Evangelical Lutheran Church in America (ELCA) approved a plan to offer a
new choice of health benefits for plan members in Pennsylvania and in
the Chicago metropolitan area.
   Considered a pilot project, the plan will introduce Blue Cross and
Blue Shield Preferred Provider Organization benefits beginning Jan. 1 as
a choice for members who currently have Point-of-Service benefits
coverage through Aetna U.S. Healthcare. Trustees made this decision
during their quarterly meeting here May 6-7, after a recent survey
showed a high level of member dissatisfaction with current providers in
the selected areas compared with other parts of the country.
   "Having a choice of health benefits will come as welcome news for
plan members in the selected areas," said John G. Kapanke, president,
ELCA Board of Pensions. "If successful, we would hope to offer a choice
of health benefits to members in other areas."
   Trustees approved the expansion of PPO benefits next year to
include more than 1,500 plan members under the board's traditional
indemnity coverage in Illinois, Massachusetts, Michigan, Nebraska,
Pennsylvania, South Carolina, Texas, Virginia and Washington.  The move
is part of an ongoing effort to control the rising costs of health care
for plan members and sponsoring employers such as congregations.
   The PPO expansion rollout is projected to provide a net savings of
$2.1 million in 2000, said David Adams, the board's vice president for
research and design.  Spread over the entire ELCA health plan, these
savings should help in the board's effort to control health care costs
that are once again on the rise nationwide.
   Trustees also heard an update on the board's Year 2000 readiness
plans, including an upcoming test of critical business functions using
information copied onto separate systems with internal clocks turned
ahead to 2000.  Staff assured trustees that no change would be made in
investment strategies, which are already based on providing long-term,
risk-adjusted returns.
   The trustees discussed briefly the process of appeals by plan
members who dispute board decisions.  Currently, there is no mediation
process except turning to the court system should the board reject an
appeal, said Robert H. Rydland, the board's vice president and general
counsel.  "The ELCA owns the company, and we're merely administering the
plan," Rydland pointed out.
   "There should be something between us and the court system," said
trustee William R. Halling, Bloomfield Hills, Mich. "The issue of
arbitration is a good example of us partnering with the rest of the
church."
   The trustees received a report on conversations with each of the
ELCA's 65 synod bishops about the health plan rate structure and issues
of sharing costs.  The rate structure was designed so that congregations
of greater means helped support those of lesser means, Kapanke said, but
that has shifted.  Now congregations in lower health care cost areas are
subsidizing those in higher cost areas, regardless of their ability to
pay.  Kapanke added that bishops expressed support for sharing costs as
one interdependent church while urging the Board to address health plan
rate issues with care.
   The trustees moved to decrease the out-of-network deductible to
$360 for individuals and $720 for families, increase the out-of-network
co-insurance from 70 percent to 75 percent, and reduce the out-of-pocket
limit to $1,800 for individuals and $3,600 for families under Preferred
Provider Organization benefits effective Jan. 1.

[**Sonia C. Solomonson is managing editor of "The Lutheran" magazine.]

For information contact:
John Brooks, Director (773) 380-2958 or NEWS@ELCA.ORG
http://listserv.elca.org/archives/elcanews.html