PHILADELPHIA – Everyone and her cousin has an idea of how the Board of Pensions of the Presbyterian Church (U.S.A.) should structure the dues for its medical insurance plan – about what’s fair and unfair, and about what to do next.
Three possible scenarios the board is considering will be discussed in April at regional benefits consultations in Philadelphia and near Dallas. (See here for registration information for the consultations – note the March 13 registration deadline and roles of those invited to attend.)
Here’s a look at some of the numbers – including charts presented by the Board of Pensions at the meeting March 8.
Participants. About 12,100 members participate in the board’s traditional medical benefits plan – of whom about 65 percent are teaching elders and about 35 percent other employees. Including members and their dependents, about 34,000 people participate, from more than 6,600 churches and agencies.
Employers. Each month, the board bills more than 6,600 churches and other agencies for dues for members in the traditional plan. Of those employers, 76 percent (or 5,019 employers) have only one member in the plan (most likely, the church’s pastor). About a quarter (23 percent, or 1,530 employers) have two to 10 members. And 1 percent (or 79 employers) have more than 10 members belonging to the medical plan.
Minimum effective salary. The 2013 current minimum effective salary is $40,000 – the lowest amount on which dues for the health plan can be calculated, even if a pastor or employee actually earns less (which some do). Currently 15 percent of teaching elders (1,178 ministers) participate at the 2013 minimum of $40,000, as do 59 percent (2,441 employees) of other workers in the plan.
Maximum effective salary. Just 1.7 percent of teaching elders (137 ministers) participate at the 2013 maximum effective salary of $124,000 – as do 1.2 percent of other employees (52 people).
Family configuration. Here’s how it breaks down:
Member only – 16 percent.
Member plus children – 5 percent.
Member plus covered partner – 33 percent.
Member plus family (partner and children) – 46 percent.
Claims paid. Claims paid through the medical plan were split fairly evenly between members and their dependents – with 53 percent of total claims paid for members and 47 percent for their dependents.
A key factor in health care costs consists of individuals with very high medical expenses. Just 1 percent of the claimants were responsible for 30 percent of the expenses. Which individuals fell into that 1 percent varied from year to year – and membership in that group did not depend on age, gender or income.
The single largest cost paid was for more than $1 million in medical expenses, for a 21-year-old dependent.
Expense cutting alternatives. The board’s Healthcare Committee also discussed possible alternatives Presbyterians have suggested in blog posts, letters and e-mails to raising dues or asking members to pay for at least part of the medical coverage for their dependents and children. Bear in mind: the board projects a shortfall, if nothing else changes, of $14 million in 2014 and $42 million in 2015. That’s how much any alternative proposal would have to generate in order to balance the books. So far, the ideas suggested come up short.