An employee is eligible to enroll in benefits if the employee is normally scheduled to work 1,000 or more compensated hours per plan year, regardless of whether they are an exempt or non-exempt employee.
Annual Enrollment Overview
Active Employee Enrollment Period October 27 – November 17, 2021
Annual Enrollment is the time of year when employees can enroll in a healthcare plan and/or make changes to their healthcare coverage for the upcoming year. All eligible employees currently enrolled in a medical or dental plan should receive an Annual Enrollment package mailed from Church Pension Group to their address.
All eligible employees NOT currently enrolled in either a medical or a dental plan will not receive an Annual Enrollment package from Church Pension Group. If you wish to enroll in a medical and/or dental plan with coverage beginning January 1, 2022, please follow the instructions stated on this page.
If you do not actively re-enroll in a health plan by the deadlines above, and your current plan is still available for 2021, you will automatically be re-enrolled in the same plan with the same coverage tier.
How to Enroll/Makes Changes
How to Enroll/Make Changes to Existing Enrollment
Option 1 – Online:
For step by step instruction on how to complete a new enrollment online, or to make changes to an existing enrollment online, click here.
Option 2 – Paper Forms:
If you wish to have our office enroll you in a medical and/or dental plan with coverage beginning January 1, 2022, or make changes to an existing enrollment effective January 1, 2022, download the related forms listed below and return them no later than Tuesday, November 15, 2021 via email, fax, or mail as noted below:
Mail: Episcopal Diocese of Northern California
350 University Avenue, Suite 280
Sacramento, CA 95825
2022 Benefit Updates
2022 Benefit Updates
COVID-19 Provisions The Medical Trust will continue to waive all copays, deductibles, and coinsurance for its members for healthcare services relating to the evaluation and testing for COVID-19 through at least December 31, 2022. In addition, the Medical Trust also will waive all copays, deductibles, and in-network coinsurance for its active members for healthcare services relating to the treatment of COVID-19 through at least December 31, 2022.
Telehealth platforms for Active Members You can continue to access a medical professional through telehealth platforms offered by Anthem, Cigna, or Kaiser using your computer or mobile device. You will need high-speed internet access, a webcam or built-in camera, and audio capability. Please remember that your personal healthcare provider may not participate on the vendor’s telehealth platform. In response to the COVID-19 pandemic, effective March 1, 2020, all services received via vendor telehealth platforms are available to you with no deductible, copay, or coinsurance through December 31, 2022.
Anthem Blue Cross Blue Shield – Access LiveHealthOnline.com or download the LiveHealth Online mobile app in the App Store® or Google Play™.
Cigna – Access MDLiveforCigna.com on your computer, or download the MDLIVE mobile app by searching in the App Store or Google Play.
Kaiser Permanente – Access Kaiser’s telehealth platform services by calling the number on the back of your member ID card.
Virtual Visits A virtual visit is an appointment with your personal healthcare provider carried out through an electronic medium of your provider’s choice (e.g., Zoom, Skype, telephonic) but that is not offered through your health plan carrier’s telehealth platform (e.g., Anthem LiveHealth Online, Cigna MDLive). The Medical Trust will continue to allow claims for virtual visits with network and out-of network providers that do not use a telehealth platform offered by Anthem or Cigna. Prior to March 1, 2020, virtual visits with your personal healthcare provider were generally excluded from health plan coverage. The virtual visit benefit exclusion will be removed from the Medical Trust’s Anthem and Cigna health plans effective January 1, 2022.
Virtual visits are covered at standard levels of benefits and member cost shares.
Note: Kaiser’s healthcare model requires its members to use the Kaiser telehealth platform for telehealth services.
Cigna Dental Modernization To ensure that members have high-quality, comprehensive dental benefits, the Medical Trust has reviewed and modernized its dental plan offering with Cigna.
Effective January 1, 2022, the Medical Trust’s Cigna Dental plans will include coverage for Exparel, a long-lasting, non-opioid pain management medication for patients having oral surgery. Unlike systemic medications, Exparel works directly at the surgical site to numb nerves that cause pain; it is not a narcotic, and it is not addictive.
In addition, the Medical Trust is reclassifying osseous surgery, currently considered a Major Restorative Service, as a Basic Restorative Service for all its Cigna Dental plan offerings. This means that the Medical Trust’s Cigna Dental plans will reimburse these services at a higher rate starting in 2022.
Cigna EAP The Cigna Employee Assistance Program (EAP) now includes access to Talkspace® virtual behavioral health!
Connect with a licensed therapist or psychiatrist online, by video or by text using Talkspace, available for Cigna EAP members, ages 13 and up
Visit mycigna.com to access Talkspace virtual behavioral health
For an overview of all benefits available to eligible employees, click here.
All the Medical Trust plans provide care through a network of doctors, dentists, hospitals, pharmacies, laboratories, and other providers. However, the different types of plans offer a range of options regarding the availability and cost of care in and out of network. The plan descriptions below can help you understand the features for each plan type. We offer the following types of medical plans:1
Members enrolled in a Kaiser EPO Plan agree to use only the plan’s network of professionals and facilities, and they are responsible for ensuring that the services and care they receive are covered by the plan. Kaiser EPOs do not cover the cost of services received from out-of-network providers, except in emergency situations.
As the Kaiser plans are built on a managed-care platform, members are required to select a Primary Care Physician (PCP), and, depending on your service area, may need a referral to see a specialist.
PPO (Preferred Provider Organization)
PPO members can receive services from any provider — inside or outside of the plan’s network — without coordinating their care through a primary care physician. However, the plan pays greater benefits for care received from a network provider or facility. PPO members are responsible for ensuring that the services and care they receive are covered by the plan. They are often responsible for submitting their own claims for out-of-network care.
CDHP/HSA (Consumer-Directed Health Plan /Health Savings Account)
A CDHP/HSA member’s coverage consists of two parts:
A traditional health plan that promotes preventive care and protects members against catastrophic healthcare expenses (Consumer-Directed Health Plan) and
A tax-advantaged savings/reimbursement account (Health Savings Account) that allows members to take control of their day-to-day healthcare costs.2
With the exception of certain types of preventive care, the benefits from a Consumer-Directed Health Plan begin after the member meets the annual deductible.3 Contributions to a Health Savings Account help members build savings for current and future medical expenses that fall within the deductible of the health plan. A list of qualified medical expenses that may be paid with funds held in the HSAs can be found at the IRS website.
How the CDHP works
The Consumer-Directed Health Plan works much like a PPO. Members can receive services from any provider, and they do not have to coordinate their care through a PCP. While the CDHP covers services in and out-of-network (like the PPO), the CDHP provides very strong financial incentives for members to use network providers.4 Under these plans, certain preventive care services are not subject to the deductible and require no cost share if provided by network providers.
How the HSA works
The Health Savings Account is funded by the employee and/or employer, with a “tax-favored” status. Members can open an HSA only if they are enrolled in a qualified High Deductible Health Plan. When they incur medical expenses, they can choose to pay with either HSA funds or out-of-pocket. If HSA funds are not used, the balance continues to grow with tax-free earnings and is available for future medical expenses.
Funds deposited in an HSA belong to the member until they are spent. Unused dollars may earn interest tax-free, with certain restrictions. If members change employers or retire, they can take their HSA with them. Withdrawals from an HSA are tax-free, as long as they are used to pay for qualified medical expenses. Distributions from an HSA that are not used for qualified medical expenses will be assessed a penalty of 20 percent. For tax reporting, it is important for members to retain records of these expenses.
Medicare Secondary Payer (MSP) Small Employer Exception (SEE) Plan
The Medical Trust provides the option for eligible employers to apply for the Medicare Secondary Payer (MSP) Small Employer Exception (SEE). If an employer applies for and is approved for the plan, eligible employees and their spouses can choose to participate in the SEE Plan.
In most cases, Medicare is the secondary payer of healthcare claims for active employees covered under Medicare Part A, and the Medical Trust plan is the first, or primary, payer. Medicare allows for an exception to the secondary payer rule for small employers called the Small Employer Exception (SEE). Participation in SEE is voluntary for eligible employers and their employees. It is anticipated that out-of-pocket costs will be lower for plan participants and that employers will save significantly in the cost of health benefits.
These plans are noted with MSP in the plan name.
Qualifying for SEE
In order to be eligible to participate, employees and/or spouses must be:
65 years or older
Enrolled in Medicare Part A
Enrolled in a Medical Trust SEE plan
Work for an employer with fewer than 20 employees (The exception must be applied for and approved before the SEE Plan can be implemented.)
What costs are covered?
Under the exception, Medicare will become the primary payer of claims covered under Medicare Part A. These include hospitalization expenses, including inpatient care in hospitals, skilled nursing facilities, hospices and home healthcare settings. The Medical Trust plan will be the secondary payer. For other coverage, such as doctor visits, outpatient procedures and prescription drug coverage, the Medical Trust plan will be the primary payer. However, if an employee or eligible spouse elects to enroll in Medicare Part B coverage, Medicare will become the primary payer of Part B claims and the Medical Trust plan will be the secondary payer.
1Every group does not offer every plan. Please check with your group administrator for the plans available to you. 2In general, members and/or their spouses are not eligible for the CDHP/HSA option if they have any other health coverage that would apply to services covered by the CDHP/HSA, such as coverage through a spouse’s employer. Participation in a flexible spending account (FSA) may also limit a member’s ability to obtain coverage under the CDHP/HSA option. 3The CDHP deductible is a combination of medical and pharmacy deductible requirements. Therefore, to begin receiving benefits from the CDHP medical and prescription drug plans, members must meet one combined deductible. 4 The Kaiser CDHP-20/HSA is built on a managed care platform, and therefore requires the selection of a Primary Care Physician, requires a referral to see a specialist, and does not have out-of-network benefits.
Member Services: (800) 244-6224
24 hours a day/7 days a week Cigna website
All plans cover preventive care and three checkups a year at no cost to members when network providers are used. Cigna offers a choice of providers in their dental network of dentists, endodontists, pediatric dentists, periodontists, orthodontists, and other dental providers. Please note: Preventive procedures are not subject to the annual out-of-pocket limit.
Most of our health plans include a comprehensive prescription drug benefit through Express Scripts. If you are enrolled in a Kaiser health plan, your pharmacy benefits will be provided by Kaiser. Visit the Kaiser website for details about your pharmacy benefits.
Express Scripts offers retail pharmacy benefits, as well as via Home Delivery Pharmacy ongoing, refillable prescriptions. To save on your prescriptions
Request generic drugs whenever possible. Your doctor can advise you whether a generic medication is appropriate.
Use home delivery pharmacy for prescriptions you need on an ongoing basis.
Express Scripts’ national network of participating retail pharmacies offers discounts when you present your Express Scripts ID card.
You can order up to 90 days of medication at one time, usually at a significant cost savings, through Express Scripts’ home delivery service. You will receive automatic refills and reminders when your prescription is expiring. Home delivery is required for maintenance medications after the third fill at a retail pharmacy.
Visit Express Scripts’ website to price a medication, download the formulary, or find a participating retail pharmacy. You may also call Express Scripts Member Services at (800) 841-3361
Cigna (Medical, Behavioral, & Dental) myCigna.com Phone: (800) 244-6224
24 hours a day, 7 days a week
Kaiser Permanente kp.org Northern California: (800) 663-1771
TTY: (877) 870-0283
Monday – Friday, 7:00AM – 9:00PM ET
Express Scripts Prescription Drug Benefits express-scripts.com Phone: (800) 841-3361
24 hours a day, 7 days a week (except Thanksgiving and Christmas)
EyeMed Vision Care eyemedvisioncare.com Phone: (866) 723-0513 (members)
(866) 723-0596 (pre-enrollment)
Monday – Saturday, 8:00AM – 11:00PM ET
Sunday 11:00AM – 8:00PM ET
Cigna EAP myCigna.com Phone: (866) 395-7794 (Members)
(800) 926-2273 (for pre-membership information)
24 hours a day, seven days a week
Health Advocate HealthAdvocate.com Phone: (866) 695-8622
24 hours a day, seven days a week
Business hours are 8:00AM – 9:00PM ET
UnitedHealthcare Global Assistance United Healthcare Global Assistance Phone: (800) 527-0218 (from U.S., Canada, Puerto Rico, Virgin Islands and Bermuda)
(410) 453-6300 (from all other locations, call collect)
24 hours a day, seven days a week
Health Equity (HSA services for some members in CDHP plans) healthequity.com Phone: (877) 713-7712
24 hours a day, 7 days a week
Q: What is Annual Enrollment?
A: Annual Enrollment for 2022 Medical Trust active health benefits begins in October 2021. This is your opportunity to review and make changes to your Medical Trust benefits and to add or drop coverage for eligible dependents for the upcoming plan year. Be sure to take the time to review your options.You cannot make changes until the next Annual Enrollment period, unless you have a qualified significant life event (as defined in the Plan Document Handbook), such as the birth of a child, marriage, or divorce. Even if you do not plan to make any changes to your health benefits, it’s a good idea to log in to your account and review your personal and dependent information and make any necessary updates.
Q: Who is eligible to enroll?
A: An employee is eligible to enroll in an Episcopal Health Plan (EHP) regardless of whether you are an exempt or non-exempt employee, if you are normally scheduled to work 1,000 or more compensated hours per plan year.
Q: What is the deadline to enroll?
A: The enrollment period for active employees to enroll or make changes is from October 27, 2021 – November 17, 2021
Q: If I want to keep the same medical and/or dental plans for 2022, do I need to do anything?
A: If you would like to keep the same medical and/or dental plans for 2022 and you are not adding or removing any dependents, you do not have to do anything. You will automatically be re-enrolled into your current plans for 2022. However, CPG highly recommends you log into your CPG account at www.annualenrollment.cpg.org to confirm the accuracy of your personal and dependent information.
Q: How do I enroll online?
A: Go to www.annualenrollment.cpg.org and use your MyCPG Account username and password to login, or create one using your Client ID number (included in your individual Annual Enrollment brochure). You can also download step-by-step instructions for enrolling online by clicking here.
Q: Are any of the 2021 plans not being offered in 2022?
A: No. All of the same plans that were available in 2021 will be available in 2022.
Q: Where can I find more information on other employee benefits?
A: For an overview of all benefits available to eligible employees, click here.
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