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Innovation Brings Low 2020 Health Rate Increase & More Support

Aug. 12, 2019

Portico’s Board of Trustees approved an average baseline health contribution rate increase of 4% for 2020 for sponsoring organizations, including congregations, synods, seminaries, and the churchwide organization. This is the lowest increase in six years, thanks in part to member participation in cost-saving programs tailored to the community’s unique needs.

Next year, Portico will introduce new ways for ELCA-Primary members to save on out-of-pocket costs and strengthen their emotional well-being. In addition, ELCA-Primary members reliant on some of the most expensive specialty prescription drugs will see relief through lower copayments. The new offerings are the latest in Portico’s decade-plus effort to deliver innovative, wellness-focused benefits that both improve health and contain costs for the community.

With the continued expansion of personalized programs for ELCA-Primary members, the opportunity to earn wellness dollars in 2020 will be $200 per eligible participant.

The new year will not bring any increases to ELCA-Primary member deductibles, copayments, coinsurance, or out-of-pocket maximum amounts. For members with ELCA Medicare-Primary benefits, Medicare Advantage hospital and medical out-of-pocket cost limits will also remain unchanged. ELCA Medicare-Primary members with the Premium or Standard option will experience no change in their prescription drug cost-share amounts.

See the table below for a summary of rate changes for the 2020 ELCA-Primary and ELCA Medicare-Primary health benefits, and for disability, survivor, and retirement benefits.

Innovative Health Care Approach Continues

“As church together, we’ve all worked to embrace a more holistic approach toward how we take care of ourselves and our community,” said the Rev. Jeff Thiemann, Portico president and CEO. “By adopting better habits with the aid of innovative and personalized support, participating Portico members indicate that they are living healthier lives. Sponsoring organizations, in turn, are seeing lower contribution rate increases. This two-fold success is vital for the future of our church.”

Recognized by the Church Benefits Association for its innovative health care approach, Portico persistently researches and integrates cutting-edge services, according to Josh Smith, Portico senior director of products. At the same time, Portico leverages ELCA purchasing power and denominational partnerships in the Church Benefits Association to negotiate preferred pricing for members and sponsoring organizations.

From 2017 to 2019, Portico introduced personalized health benefits designed to tackle some of the community’s most prevalent needs: diabetes and heart disease. Member engagement has exceeded expectations and is expected to generate quantifiable results over time.

Meeting the Unique Needs of ELCA Members

In order to help all ELCA-Primary members obtain care and save money, starting in January a new primary care app will enable text-based visits with board-certified physicians for $5 or less, 24/7, 365 days a year from anywhere in the United States.

The app is designed to supplement — not replace — members’ valuable relationship with their primary care provider. It provides a more convenient and lower-cost option to obtain care, said Smith.

“This app is ground-breaking because it offers another way to receive timely care, especially for members called to smaller communities farther from health care facilities,” he said. “Members who visit the doctor several times a year could save hundreds of dollars with this new benefit, especially if it helps them avoid expensive urgent care visits.”

Additionally, next year Portico will add a new online mental health program with easy access to coaching. The service will complement the existing Employee Assistance Program and other mental health benefits, Smith said.

“Members tell us, and claims reflect, that churchworkers may be disproportionately affected by depression, anxiety, insomnia, and stress, as they often focus on caring for others before themselves,” he said. “We’re pleased to provide this innovative program at no additional cost to users.”

There are Portico members living with complex health conditions who struggle to afford the high cost of their medications. In 2020, Portico will partner with Express Scripts to offer discount programs that provide access to 150 specialty drugs for a $0 copayment (Platinum+ and Gold+ options only, due to high deductible health plan regulatory limitations) and a 30-day supply of insulin for a $25 copayment (all ELCA-Primary options).

Overall, Portico’s goal is to gain incremental year-over-year improvement in member well-being, Smith said.

“That type of improvement will lead to fewer claims over time — a win-win for all,” he said. “We believe that the clinical outcomes from our personalized programs will benefit our collective membership even more significantly than individual wellness dollars.”

Other Benefit Changes for 2020

  • ELCA Medicare-Primary Benefits: Retirees and others who continue coverage at their own expense will pay 7.5% more in monthly contribution amounts. This increase is due mostly to the Health Insurance Providers Fee, a provision of the Affordable Care Act. Yet, 2020 contribution amounts continue to reflect at least 18% savings over 2018 amounts, thanks to Portico’s 2019 change to a group Medicare Advantage plan insured by Humana.
  • ELCA Disability Plan: Sponsoring organizations will pay less for disability coverage, with the rate decreasing from 2.5% to 1.5% of defined compensation.
  • ELCA Survivor Plan: The rate will increase from 0.2% to 0.7% of defined compensation based on current market analysis. Retirees eligible for a lump-sum survivor benefit will receive a minimum of $7,500, up from $6,000, to help offset funeral costs.
  • ELCA Retirement Plan: In response to member feedback, the plan will no longer require spousal consent for retirement account withdrawals.

Summary of Contribution Rates Effective Jan. 1, 2020

For ELCA Sponsoring Organizations*

The following contribution rate changes will be effective Jan. 1, 2020. Note: Because they are applied as a percentage of a member’s defined compensation, contributions may also change when a member’s compensation changes.

ELCA Sponsoring Organizations*

  • The baseline health contribution rate for ELCA-Primary health benefits will increase by 4% for all four options (Platinum+, Gold+, Silver+, Bronze+), and for ELCA Medicare-Primary health benefits (Standard option) — Portico’s lowest rate increase in six years. Health contributions also increase annually by about 2%, on average, as plan members age.
  • The contribution rate for the ELCA Disability Benefits Plan will decrease from 2.5% to 1.5% of defined compensation.
  • The contribution rate for the ELCA Survivor Benefits Plan will increase from 0.2% to 0.7% of defined compensation.
  • There is no change to the required minimum contribution amount for the ELCA Retirement Plan.
  • ELCA retiree support continues at 0.7% of defined compensation.

Sponsoring employers can find details in their Custom Comparison Report on EmployerLink later in August.

 

For Members Continuing Coverage at Their Own Expense

Members Continuing ELCA-Primary Health Coverage

The baseline health contribution rate will increase by 4% for all benefit options (Platinum+, Gold+, Silver+, Bronze+) — Portico’s lowest rate increase in six years. Health contributions also increase annually by about 2%, on average, as plan members age.

Members Continuing ELCA Medicare-Primary Health Coverage

The contribution rate will increase by 7.5% as follows:

  • $339 to $364 per month for the Premium option
  • $299 to $321 per month for Standard
  • $224 to $241 per month for Economy

Still, 2020 contribution amounts will remain at least 18% lower than those in 2018.

The Economy option prescription drug benefit will change to be consistent with Medicare’s standard 2020 Part D benefit. Details will be provided this fall.

*Rates apply to ELCA organizations sponsoring members in the Traditional Benefits Program. Rates for other programs will be communicated separately.

Plan member rights under the plans are governed by the plan documents, which are the full, legal descriptions of the plans. If any of this information is inconsistent with the corresponding plan document, the plan document is the controlling document.