D034 Revise Denominational Health Plan Mandate
Resolved, the House of Bishops concurring,
That this church revise the principles underlying participation and provision of benefits under the Denominational Health Plan as previously adopted in 2009-A177 as follows:
For all domestic dioceses, parishes, missions and other ecclesiastical organizations or bodies subject to the authority of this church, for clergy and lay employees who are scheduled to work a minimum of 1,500 hours annually, in accordance with the following principles:
- The Denominational Health Plan shall be designed and administered by the Trustees and officers of the Church Pension Fund, following best industry practices for comparable plans
- The Denominational Health Plan shall provide that each diocese has the right to make decisions as to plan design options offered by the plan administrator, minimum cost-sharing guidelines for parity between clergy and lay employees, domestic partner benefits in accordance with General Convention Resolution 1997-C024 and the participation of schools, day care facilities and other diocesan institutions (that is, other than the diocese itself and its parishes and missions) in the Denominational Health Plan;
- The Denominational Health Plan shall provide equal access to health care benefits for eligible clergy and eligible lay employees;
- The Denominational Health Plan shall provide benefits through the Episcopal Church Medical Trust, which shall be the sole plan sponsor for such benefits and continue to be operated on a financially sound basis;
- No domestic diocese, parish, mission, or other ecclesiastical organization or body subject to the authority of this church shall be required to participate in the Denominational Health Plan if, in the judgment of the Bishop or Ecclesiastical Authority exercising oversight:
a. The premiums of the Denominational Health Plan exceed by 25% the cost of obtaining comparable coverage on either private or public insurance markets for any entity subject to the Denominational Health Plan, or if
b. A sole plan provider is offered through the Medical Trust to any entity subject to the Denominational Health Plan, or if
c. The choice of providers covered within Medical Trust plans in a given location is insufficient to meet the needs of plan participants without excess travel.
- In the event a Bishop or Ecclesiastical Authority exercising oversight grants permission for a diocese, parish, mission, or other ecclesiastical organization to obtain coverage outside of the Denominational Health Plan, they shall provide to the Medical Trust:
a. A Summary of Benefits Provided under External Coverage, and
b.A Summary of Premiums Assessed under External Coverage, and
c. An assessment of why, in the opinion of the Bishop or Ecclesiastical Authority, such External Coverage is in the best interest of the diocese, parish, mission or other ecclesiastical organization.
- The Denominational Health Plan shall have a church-wide advisory committee, as previously established in Resolution 2009-A177. The advisory committee shall consist of twelve members representative of the whole church. Four of the members shall be appointed by the Trustees of the Church Pension Fund, four of the members shall be appointed by the Presiding Bishop, and four of the members shall be appointed by the President of the House of Deputies. The church-wide advisory committee shall receive from the Episcopal Church Medical Trust an annual report about the status of the Denominational Health Plan, and a complete copy of all data sets held by the Medical Trust used to create said report; such data shall be appropriately anonymized to withhold personally identifying information and be suitable for review by a third-party actuary should such analysis be desired. The Annual Report and the anonymized data sets supporting the same shall be published in full each year to the whole church.
- For purposes of this resolution, the term “domestic” shall mean ecclesiastical organizations and bodies located in the United States, including the Dioceses of Puerto Rico and Virgin Islands;
- The Church Pension Fund shall continue to work with the Dioceses of Colombia, Convocation of American Churches in Europe, Dominican Republic, Ecuador Central, Ecuador Litoral, Haiti, Honduras, Micronesia, Cuba, Taiwan and Venezuela to make recommendations with respect to the provision and funding of healthcare benefits of such dioceses under the Denominational Health Plan.
Over a decade after the General Convention created the Denominational Health Plan, the lived experience of dioceses and parishes across a wide swath of the church indicates a disparity in premiums and coverage for plan participants. While in many dioceses the plan is working as designed, in others, premiums are not keeping pace with the private market. In some cases, seeking coverage outside of the medical trust has enabled more local provision of care or produced significant cost savings, even among older plan participants. In many contexts, such costs can mark the difference between full and part time clergy and lay employment, often placing parishes and diocese in no-win situations as they seek to grow their ministries.
In order for the Denominational Health Plan to meet the needs of the church, new competitive pressures need to be introduced to keep it cost-competitive with the private markets. Under this resolution, if DHP premiums exceed the cost of the private market by over 25%, the Bishop or Ecclesiastical Authority may exempt a participating entity from participation; likewise, the Episcopal Church Medical Trust would be provided with information about external coverage received to enable it to remain competitive.
To better represent the whole church, the Advisory Committee on the DHP, previously constituted under General Convention 2009-A177, is revised to consist of a more of the church: 4 members appointed by the Presiding Bishop, 4 members appointed by the President of the House of Deputies, and 4 members appointed by Trustees of the Church Pension Fund. The committee is now tasked with publishing an annual report to the whole church and the distribution of anonymized actuarial data for continued external evaluation of the DHP’s effectiveness.