Brethren Benefit Trust board approves Health Savings Accounts.

Beginning Jan. 1, 2006, the Brethren Medical Plan will feature a new way for members to manage healthcare expenses through Health Savings Accounts (HSAs). Originally approved in concept by the Brethren Benefit Trust (BBT) Board in Nov. 2003, the move to offer HSA plan designs in 2006 is another step to stabilize the plan in the wake of escalating medical costs, an aging employee group, and a declining membership base.

HSAs are a pre-tax way to set aside money for medical, dental, and vision care expenses not paid by an insurance plan or flexible spending account. Unused funds in an account carry over from year to year and are not forfeited. The HSA belongs to the employee, so when employment terminates, the employee keeps the account. HSAs must be used in conjunction with high-deductible health plans. These plans must have a deductible of at least $1,000 for an individual or $2,000 for a family; deductibles may not exceed $5,000 per individual, $10,000 per family. The HSAs will be used in conjunction with the existing PPO networks in the Brethren Medical Plan. An indemnity option will be available for those without access to PPO networks.

On April 22, the board approved two HSA plan designs, an option with a $3,000 individual/$6,000 family deductible, and an option with a $4,000 individual/$8,000 family deductible. These were crafted in late March and recommended to the board by the Brethren Medical Plan's Interim Advisory Panel of representatives from the Pastoral Compensation and Benefits Advisory Committee, the Ministers' Association, the Council of District Executives, the Annual Conference agencies, and BBT.

The board is recommending a minimum annual employer contribution of $500 for employees with individual healthcare coverage, $1,000 for employees with family coverage. The maximum contribution to HSAs allowed in 2005 is the lesser of the deductible or $2,650 per individual or $5,250 per family. Employees 55 and older will be able to contribute an additional $700 in 2006. The board also approved a $300 benefit for preventive care.

The board's approval of the HSA plan came four days after 16 BBT board members and staff representatives met with 35 denominational leaders to discuss the future of the Brethren Medical Plan. Following the board's April 16-17 meetings in Elgin, Ill., where a decision regarding HSAs was temporarily tabled, the BBT contingent met for seven hours on April 18 in Richmond, Ind., with most of the district executives, four of five executives of Annual Conference agencies, Conference moderator and moderator-elect, and representatives of the Pastoral Compensation and Benefits Advisory Committee.

The meeting came at the invitation of the district executives in response to a decision made by the BBT board that districts with less than 75 percent of eligible congregations committed to participating in the Brethren Medical Plan by Jan. 1, 2007, will no longer be able to participate unless they subsequently meet the participation requirement. The return to the 75 percent requirement, which was in place 50 years ago when congregations and districts first joined the plan, was approved in an attempt to increase the spread of risk and bring claims in line with premiums. In 2003 and 2004 the plan suffered $1.4 million in losses; in 2005 the plan is being subsidized by BBT and Mennonite Mutual Aid.

The April 18 meeting discussed the future viability of the Brethren Medical Plan, BBT's plan to implement HSAs in 2006, the struggle congregations have in balancing their support for the plan with the pressures of stewardship and saving by purchasing their own health insurance, a proposed system to allow some pastors and church staff to have group health insurance while others will not, a concern for those who will be uninsurable without the plan, what the participation requirement will do to the future calling of pastors across the denomination, and the process by which the board adopted the 75 percent participation requirement.

As the meeting drew to a close, many voices did give general support for one plan of action--that a Brethren Medical Plan resolution be taken to the 2005 Annual Conference for discussion and to receive denominational direction regarding the future of the plan, reported BBT.

Following the April 18 meeting, the board reconvened April 22 via conference call to address the items it had tabled. It then approved the new HSA plan designs, the recommended minimum contribution by employers to employees' HSAs, and the preventive care benefit. In a related move, the board during its April 16 meeting approved dropping prescription drugs from its Medicare Supplement Plan effective Jan. 1, 2006. This decision was made because Medicare will offer a prescription drug plan, which means those who do not want to be part of a prescription drug plan should see premium savings within the Church of the Brethren Medicare Supplement Plan.

Because of the complexity of HSAs and the possibility that high deductibles could lead church staff initially to believe that their out-of-pocket costs will be greater than they have been, BBT staff have trained district-appointed Brethren Medical Plan advocates and equipped them with resources and information about HSAs. Some advocates are scheduling district meetings with BBT staff in an attempt to further clarify the benefits of moving to HSAs.

Source: 5/11/2005 Newsline
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