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Healthy Today,
Healthy Tomorrow
Walking Together Through Health Care Reform
Health Care Reform Will
Change How Americans
Get Health Coverage
• In 2014, more Americans will be covered. The Patient Protection and
Affordable Care Act mandates everyone to have health coverage
or pay a penalty, and it prevents insurers from excluding individuals
due to pre-existing conditions.
• Some employers will rethink whether to offer health coverage.
As a result, exchanges may replace employers as the source
of coverage for some individuals.
• Lower-income households may get federal subsidies to help pay for
health coverage. For those who qualify, federal subsidies will reduce
the cost of coverage purchased on a health insurance exchange.
Count on Portico to See You Through
For 25 years, the ELCA Health Benefits Plan has been there for plan
members and their families. In changing times, Portico’s ministry
continues.
Health care reform is bringing new choices to the marketplace, which
could result in some members purchasing coverage on the exchanges.
Retaining membership enables our health plan to continue to deliver
the benefits that support our shared ministry.
The ELCA Philosophy of Benefits is being revised to help ELCA employers
offer benefits in a changing marketplace. Portico, in turn, is designing new
2014 health plan options that continue to support church needs.
Use this booklet to help you and your organization prepare for
health benefit-related change coming this fall.
Portico is Designing New
Health Plan Options
Four Types of Plans
Exchanges are expected to offer plans grouped into four “metallic” levels
(bronze, silver, gold, and platinum) based on the percentage of health care
costs paid by the plan and the member.
n
Exchange Plans Grouped by Type
n = Health care costs paid by individuals
= Health care costs paid by plan
10%
40%
60%
Bronze
30%
70%
Silver
20%
80%
gold
90%
platinum
Portico Today — Our current ELCA-Primary health coverage is most
similar to the gold plans; on average, ELCA plan members pay 20% of
health care costs through deductibles, coinsurance, and copayments.
Portico in 2014 — We intend to offer plan options that compare to
the four metallic levels, with additional benefits like dental and wellness
incentives not expected in the exchange plans.
Price Variation by Age
Portico Today — Our current ELCA-Primary health contribution
rates are based on geographic region and salary, but not on age.
Portico in 2014 — To offer competitive pricing relative to the
exchanges, we intend 2014 ELCA-Primary health contribution rates
to also be based on plan member age.
This Fall, Every ELCA Employer and Hea
Employer
Selection Period:
Employers choose a
Portico
announces
plan details
their employees on
EmployerLink
{
2014 health
health plan option for
augustseptemberoctober
2013
ELCA Philosophy
State/Federal
of Benefits
exchanges
revisions are
expected to
finalized
open
alth Plan Member Has a Choice To Make
Enrollment Period:
Members confirm
employer’s choice
or buy up to another
january
plan option on
1
myPortico
New plan
{
Plan Member
november
year starts
december january
2014
NOW — Connect and Plan
Choose how you want to stay connected:
4 Register on EmployerLink or myPortico
PorticoBenefits.org
Registered users will hear first when we announce 2014 plan details in August.
4 Follow Live Well ELCA on Facebook
facebook.com/livewellelca
Track health care reform developments and ask questions.
4 Subscribe to Healthy Leaders e-newsletter
PorticoBenefits.org/subscribe
Get monthly updates and email notification when 2014 plan details are announced.
Employers:
4 Mark your calendar
Put health plan options on your organization’s September calendar so you’re ready
to take action.
August — evaluate your options
Employers:
4 Review 2014 ELCA health plan details and pricing
Watch for information mid-August following the ELCA Church Council meeting.
4 Use Portico’s decision-making tools
We’ll provide resources to help you make a well-informed decision.
4Involve your employees
Discuss with your employees.
Plan members:
4 Review 2014 ELCA health plan details and pricing
Watch for information mid-August following the ELCA Church Council meeting.
fall — Make your choice
Employers:
4 Choose a health plan option
In early fall, use EmployerLink to select a plan option. Inform your employees of
your choice.
Plan members:
4 Confirm or buy up
In late fall, use myPortico to confirm your employer’s choice or buy up to another
plan option.
With Portico, You’ll Have
a Partner That Supports
Your Ministry
Employers
Not everything’s changing. ELCA health plan options for 2014 will
continue to provide you with a good return on your investment and a
simple benefits solution.
Invest Your Benefit Dollars Where They Work Hardest
As a non-profit, member-focused ministry, Portico operates more efficiently
than most insurers,1 holding the rise in ELCA health plan rates to 15% over
the past five years — compared to 35% for the average U.S. employer.2
Administer Benefits with Confidence
The ELCA benefits program makes it easy to provide comprehensive
health coverage. You get one bill, benefit support for your employees,
discounted group pricing, and no sales commissions. By offering the
same benefits as other ELCA employers, you’ll have fewer variables to
discuss during the call process.
1The ELCA health plan is 14% more efficient than the average large U.S. employer, according to
the 2012 Towers Watson Health Care 360 Performance Study of nearly 700 U.S. employers.
2According to figures from the Kaiser/HRET Survey of Employer-Sponsored Health Benefits,
2009 – 2011, and the National Business Group on Health, 2012-2013.
Plan Members
All ELCA health plan options for 2014 will include features you’ve
come to know and value that may not be available through plans on
the exchanges.
Use Your Benefits to Live Well
Count on the same preventive benefits, wellness incentives, nationally
recognized administrators, and broad provider networks to support your
physical, emotional, and financial well-being.
Carry Your Benefits with You Throughout Your Ministry
A lifetime of service happens in more than one place. ELCA benefits travel
with you through changes of call and employment, enabling you to keep
your progress toward deductibles and familiar coverage during times of
transition.
Beyond basic benefits
This year’s ELCA-Primary health coverage includes a variety of
benefits chosen to support your physical and emotional well-being.
4 Medical & Mental Health
4 Prescription Drugs
4 Dental
4 ELCA NurseLineSM
4 Fitness Center Discount
4 Personal Wellness Account
4 Mayo Clinic EmbodyHealth
4 Employee Assistance Program
4 Vision Discount Program
4 Hearing Discount Program
4 Health Care Advocacy Team
Glossary
• ELCA Philosophy of Benefits — A document describing the ELCA’s
perspective on benefits intended to help employers, rostered leaders,
and lay employees make benefit decisions in alignment with this
church’s values.
• Exchange — A marketplace where individuals can buy health insurance.
Each state will have one. In states that choose not to provide one, the
federal government will manage one on the state’s behalf. A partnership
exchange is operated by the state and federal government jointly.
• Federal subsidy — Government funding that helps qualifying
individuals pay for health insurance purchased on an exchange if their
employer doesn’t offer a minimum value, affordable plan. Minimum
value plans cover at least 60% of an individual’s health care expenses.
Affordable means an individual spends less than 9.5% of his or her
income on premiums for single coverage.
• Metallic plans — Refers to the bronze, silver, gold, and platinum
categories of exchange plans.
• Patient Protection and Affordable Care Act (PPACA) — Official name
of the health care reform legislation that became law in March 2010.
Not an ELCA Health Plan Member or Employer?
Help your congregation know what’s coming. Pass this brochure along to
the folks who will make health coverage decisions this fall — such as your
pastor, congregation council president, or treasurer.
Portico Benefit Services:
Helping You Live Well — For Life
Now in its 25th year as an ELCA ministry, Portico offers health, flexible
spending, retirement, disability, and survivor plans to enhance the
well-being of rostered leaders and lay employees throughout their lives.
We serve more than 7,000 congregations and organizations, and more
than 50,000 people across the ELCA — including pastors, associates in
ministry, diaconical ministers, deaconesses, lay employees, retirees, and
their family members.
We strive to empower our members to become healthy — physically,
financially, and emotionally, because we believe that by living well as
whole people of God, we can better enhance the lives of others —
making Christ known for the sake of the world.
[email protected]
PorticoBenefits.org
800.352.2876
Printed with soybean inks on recycled paper containing 50% post-consumer fiber.
80-410 (3/2013)