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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. However, employers are not required to cover the cost of these benefits unless the employee is scheduled to work 1,500 or more compensated hours per plan year.
Rate Increase for PPO 100/90/EPO Plans
General Convention Resolution 2024-A101 urged the Church Pension Group to make plans self-sufficient and self-funding at each benefit level to the extent possible and appropriate. To align with this directive, the Anthem and Cigna PPO100/90 and Kaiser EPO High plans will see higher rate increases than plans with less generous benefits. The PPO 80/70 plans can expect an average increase of 4%, whereas the PPO 100/90 plans can expect an increase between 11%-14% as compared to 2024’s rates. Due to this, we highly encourage members enrolled in the richer plans to review all plan summaries to ensure you are utilizing the higher cost plans, and if not, we recommend considering selecting a lower cost plan to fit your needs for 2025. Click here to see plan rates.
2025 Deductible Increases for Anthem and Cigna CDHP-15
Anthem and Cigna CDHP-15
Effective January 1, 2025, deductibles for Medical Trust plans utilizing the Anthem and Cigna CDHP-15 networks will increase from $1,600 to $1,650 for self-only coverage and from $3,200 to $3,300 for family coverage. The out-of-network deductibles will increase from $3,200 to $3,300 for self-only coverage and $6,400 to $6,600 for family coverage.
2025 Deductible Increases for Kaiser CDHP-20
Effective January 1, 2025, deductibles for Medical Trust plans utilizing the Kaiser CDHP-20 networks will increase from $3,200 to $3,300 for self-only coverage and $5,450 to $6,600 for family coverage. The out-of network deductibles will increase from $3,200 to $3,300 for self-only coverage and $6,000 to $6,600 for family coverage.
Healthcare Navigation Vendor – Quantum Health (NEW - Replacing Health Advocate)
Quantum will guide members whose plans use the Anthem and Cigna networks as they navigate the complexities of today’s healthcare system, help them understand the different care options available to them, and show them how to make the most of their benefits. Due to the robust nature of Quantum’s services, those of Health Advocate will no longer be available. Instead, Quantum will provide those services.
During Annual Enrollment this fall, Quantum will be available to help both members whose plans use the Anthem and Cigna networks and individuals eligible for those plans to review existing benefits, understand plan options, and choose the right plans for themselves and their families. Members covered by Kaiser Permanente and by the Hawaii Medical Service Association have comprehensive services as part of their plans and will not use the services of Quantum. Neither will members enrolled only in a dental plan (through Delta Dental), a disability policy (through Aflac), and/or the standalone EAP.
Click here to learn more.
Personal Precision Oncology Management (NEW)
Through Quantum Health, the Medical Trust will provide members and their treating oncologists with support from renowned oncologists who specialize in rare, complex cancers and work on breakthrough treatments. Their support will include case reviews and clinical collaboration with the treating physicians. Click here to learn more.
Teladoc Health Services (NEW - Replacing LiveHealth and MDLive)
Teladoc Health Services will replace LiveHealth Online and MDLIVE for Anthem and Cigna members, respectively. A fully integrated virtual care platform, Teladoc offers primary, mental health, acute, chronic, specialty, and complex care services, all seamlessly accessed via Quantum. Through real-time intervention, Quantum will be able to increase telemedicine utilization when it is the most appropriate and efficient way to access care. Click here to learn more.
Magellan Healthcare (NEW)
The utilization and cost of behavioral health services have increased since the pandemic. To ensure that members in need receive the best possible care of this type, we are introducing Magellan Healthcare. It provides a holistic approach to behavioral healthcare
management by collaborating with members to help them successfully address their mental health needs. Accessed via Quantum, Magellan’s services include crisis intervention, outreach to individuals while in treatment, continuing care plans, education, support, and resources. Click here to learn more.
EncircleRx (NEW)
In 2023, GLP-1 agonists (drugs that lower blood sugar levels and promote weight loss) accounted for 9.3% of the Medical Trust’s prescription drug costs. This was a 295% increase over 2022 in our costs for GLP-1 agonists used as weight-loss medications. During the same period, our peers in the Church Benefits Association’s coalition with Express Scripts experienced a 193% increase in the cost of these drugs when used for losing weight.
To manage these costs and ensure these medications are used appropriately, the Medical Trust is introducing the EncircleRx program from Express Scripts, which:
Click here to learn more.