The Synod of the Pacific
- A Synod of the Presbyterian Church USA -

Open Enrollment for 2009 Voluntary Benefits

                               Now through February 16th

Open Enrollment for the Synod's Voluntary Benefits through AFLAC and Reliance Life Insurance is being held Now through February 16th.  Any employee wishing to add or make changes to their current voluntary benefits should do so now.

The Synod's voluntary benefits are available to all employees working 20 or more hours per week for a church or related organization with the Synod of the Pacific's bounds.  The employing church or related organization must secure its medical or dental insurance through the Synod in order for its employees to purchase voluntary benefits.

JOIN OUR WEBEX TO HEAR MORE ABOUT THESE VOLUNTARY PLANS

Tuesday, January 27, 2009, 2:00 p.m. pacific time

Call (866) 469-3239, Meeting number 805 466 533, no password required

Also Join on the Web at https://heffgroup.webex.com/heffgroup/j.php?ED=103856417&UID=81696042

Enter your name and e-mail address, no password required, then click "Join Now"

To read the current Synods Benefits Service Newsletter or about the benefits being offered by AFLAC click on each link.

Applications may be faxed to the Synod Office at (707) 765-4467 or mailed to 200 Kentucky Street, Suite B, Petaluma, California  94952. All applications must be received no later than February 16th.

Should you have any questions, please call Carolyn Linzner or Ann Butterfield, Synod Benefits, at (800) 754-0669.

                                                Synod of the Pacific

Group Health Benefits Services

 

The Synod of the Pacific offers comprehensive medical, dental and vision insurance coverage along with many voluntary benefits such as a 125 Flexible Spending Account, and several AFLAC plans, to all of its lay employees who work twenty hours or more per week. There are no physical examinations and no exclusions for pre-existing conditions.

 

The Synod has several medical plans it offers: Blue Cross HMO, Blue Cross PPO, and BlueCard HSA PPO plans in California; residents outside California are offered the BlueCard PPO and BlueCard HSA PPO plan.  Each plan includes complete head to toe coverage, a prescription plan and vision benefits; all this, plus competitive pricing too.

 

Our Self Insured Dental Plan allows you to choose your own dentist.  In addition, there is a dentist Network available, if your provider is part of this network, you can enjoy less out of pocket expenses. All claims billing is done for you by your dentist’s office.

Eligibility l

  • You must be an employee of a church or affiliated organization of the Synod of the Pacific, working twenty hours or more per week.
  • Lay Employees (and their dependents) are eligible to participate in these programs after a sixty day waiting period, (from “date of hire”).
  • Ordained Clergy* may enroll immediately, coverage will begin the first day of the month following their date of hire.  However, if the date of hire is the first day of the month, coverage would begin immediately.
  • Coverage must be provided by the employing organization, as part of its standard employee benefits package.
  • Employing organizations must provide all employees with fair and equal coverage within each basic employment classification. Basic Employment Classifications are:

                      1.  Ordained Clergy*

                      2.  Non-Ordained Exempt Staff

                                    Christian Education Directors

                                    Business Managers, etc.

                      3.  Non-Exempt Staff

                                    Clerical Staff

                                    Custodians, etc.

  • Employing organizations must agree to pay at least the member portion of premiums.
  • Dependent coverage may be paid by plan members through pretax payroll deduction.

All terminations must be sent in writing to the Synod office no less than thirty days prior to employees last day. Coverage will end on the last day of the month; there are no pro-rated terminations.

 

Should you have any questions, please feel free to contact Carolyn Linzner at (800) 754-0669 or by email at carolyn@synodpacific.org.

 

* The Synod of the Pacific’s Health Benefits are available to Ordained Clergy on a voluntary basis.  Our medical plans do not compete or replace the Board of Pension’s medical plan.  

2009 Medical Plan Summaries

EFFECTIVE NOVEMBER 1, 2008

Blue Cross HMO & PPO PLANS     

Description

 

Blue Cross HMO (H17)

 

Blue Cross PPO

 

Blue Cross HSA PPO (LHSA16)

Lifetime Maximum

 

Unlimited

 

$5,000,000/member

 

$5,000,000/member

Annual Deductible

 

None

 

$250.00 – Individual

$750.00 - Family

 

$1,500 – Individual

$3,000 – Family

Annual Out of Pocket Maximum

 

$1,000 – Individual

$1,500 - Family

 

$2,000 – member/In-Network

$6,000 – member/Non PPO Provider

 

$3,000 – mem/$6,000 – Family/ In-Network

$6,000 – Mem/$12,000 – Fam/Out-of-Network

 

 

 

 

In Network

Out-Of-Network

 

In Network

Out-of-Network

Professional

 

 

 

 

 

 

  • Physician Visit

 

$20 Copay

 

$20 Copay

40%

 

10%

30%

  • Specialist

 

$20 Copay

 

$20 Copay

40%

 

10%

30%

  • Physical Therapy

 

$20 Copay

 

20%

40%

 

10%

30%

  • Home Health Care

 

$20 Copay

 

20%

40%

 

10%

30%

Hospital Services

 

 

 

 

 

 

  • Inpatient

 

$250 Copay

 

20%

40%

 

10%

30%

  • Outpatient

 

100%

 

20%

40%

 

10%

30%

  • Emergency Room

 

$100 Copay, waived if admitted

 

 $100 Deductible, waived if   admitted

 

10%

Lab & X-Ray

 

100%

 

20%

40%

 

10%

30%

Durable Medical Equipment

 

100%, $5,000 max per year

 

20%

40%

 

10%

30%

Preventive Care

 

 

 

 

 

 

  • Adult

 

$20 Copay

 

$20 Copay

40%

 

No Copay

30%

  • Children

 

$20 Copay

 

$20 Copay

40%

 

No Copay

30%

Maternity

 

 

 

 

 

 

  • Office Visits

 

$20 Copay

 

$20 Copay

40%

 

10%

30%

  • Hospitalization

 

$250 per admission

 

20%

40%

 

10%

30%

Mental Health

 

 

 

 

 

 

  • Inpatient

 

Non severe not covered

 

20%

40%

 

10%

30%

  • Outpatient

 

$35 Copay, max 20 visits per year

 

20%

40%

 

10%

30%

Chemical Dependency

 

 

 

 

 

 

  • Inpatient

 

Non severe not covered

 

20%

40%

 

10%

30%

  • Outpatient

 

$35 Copay, nax 20 visits per year

 

20%

40%

 

10%

30%

Chiropractic Benefit

 

PCP referred

 

20%

40%

 

10%

30%

Vision Benefit

 

Covered thru VSP Plan

 

Covered thru VSP Plan

 

Covered thru VSP Plan

Prescription Drug

 

 

 

 

 

 

  • Generic

 

$10 Copay

 

$10 Copay

50%

 

10%

30%

  • Brand

 

$20 Copay

 

$20 Copay

50%

 

10%

30%

  • Non-Formulary

 

$40 Copay

 

$40 Copay

50%

 

10%

30%

  • Days Supply

 

30 days

 

30 days

 

30 days

This information is meant to be a summary of benefits only. Please refer to the plan document for detailed information. If there is a conflict between this information and the plan document, the plan document will prevail.

2009 Delta Dental and Vision Benefits Summaries

 EFFECTIVE November 1, 2008

Dental Benefits

In Network

Out of Network
 

Vision Benefits

In Network
Out of Network

Calendar Year Deductible

  Per Person

  Family Unit

$50

$50

$150

$150

 

Copayment

  Exam

  Materials

$10.00

$25.00

Annual Benefit Maximum

  Per Covered Person

$1,500

$1,500

  Eye Exams
$100%
$46.00 Max

Preventive Service (deductible waived)

 Emergency Palliative Treatment

 Oral Examination - every 6 months

  X-rays - four bitewings every 12 months,

  full mouth series every 5 years

  Teeth Cleaning - every 6 months

  Fluoride Treatment for Children

  Space Maintainers for Children

  Topical Sealants (up to age 16)

100%
100%
 

Lenses

  Frequency: Every 12 months

     Single Vision

     Bifocal

     Trifocal

     Lenticular

Note: Percentages and dollar amounts are after copayment.

 

100%

100%

100%

100%

 

$47.00 max

$66.00 max

$85.00 max

$125.00 max

Basic Service

  Laboratory Test

  Diagnostic Consultation - one per year

  Fillings: Amalgam, Silicate, Acrylic

  Crowns: Stainless Steel

  Repairs of dentures, bridgework, crowns

  Endodontic Services/Root canal

  Periodontal Services

  Oral Surgery - Uncomplicated extractns

  General Anesthesia - Surgical

  procedures only

  Injectable Antiobiotics

90%
80%
 

Contact Lenses

  Fequency: Every 12 Months

  Medically Necessary

  Elective (maximum)

 

*Copay does not apply

(If you choose contact lenses,

you will not be eligible to receive lenses for 12 onths and frames for 24 months following the date contacts were obtained.)

 

100%

$120.00

 

 

$210.00 max

$120.00 max

Major Services

  Bridges Installation fixed or removable

  Dentures - Full or Partial

  Crowns: Acrylic Metal, Porcelain

  Inlays

  Onlays

  Posts

60%
50%
 

Frames

  Frequency: Every 24 Months

$120.00

 

Orthodontics (Under age 19)

  $1,500 Lifetime Maximum

  Deductible does not apply

50%

50%

       
2009 Medical and Dental Monthly Insurance Rates
EFFECTIVE November 1, 2008
DENTAL INSURANCE OPTIONAL VISION INSURANCE
       
Delta Dental Insurance     Vision Service Plan (VSP)  
  Employee $52.00       Employee $18.00
  EE + Dependent $100.00       EE + Dependent $35.00
  Family $160.00       Family $55.00

 

MEDICAL INSURANCE (Includes Vision Benefit)
       
California Plans     Outside California Plans  
      
Blue Cross HMO    
  Employee $571.14  
  EE + Spouse $1,250.56  
  EE + Child(ren) $1,022.85  
  Family $1,758.50  
     
Blue Cross PPO     BlueCard PPO  
  Employee $626.97       Employee $696.97
  EE + Spouse $1,367.35       EE + Spouse $1,521.40
  EE + Child(ren) $1,119.33       EE + Child(ren) $1,245.36
  Family $1,921.06       Family $2,138.08
     
BlueCard Lumenos HAS PPO (High Deductible )     BlueCard Lumenos HAS PPO (High Deductible )
  Employee $504.79       Employee $591.10
  EE + Spouse $1,098.59       EE + Spouse $1,288.43
  EE + Child(ren) $899.44       EE + Child(ren) $1,054.75
  Family $1,542.33     Family $1,809.83
     
Kaiser Permanente HMO     Kaiser Northwest HMO (limited to parts of OR & WA)
  Employee $530.15       Employee $447.50
  EE + Spouse $1,150.29       EE + Spouse $883.77
  EE + Child(ren) $943.08       EE + Child(ren) N/A
  Family $1,619.60       Family $1,319.77
     
       
Note: The Synod's general participation guidelines state that the employer will pay the employee cost for HMO coverage.
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