Medical continuation

​Medical continuation coverage gives you the option to continue healthcare coverage when it would otherwise end, for example, termination of employment or retirement before age 65. Surviving spouses, former spouses, and children losing their eligibility status also may be eligible to enroll in medical continuation coverage.

Eligibility

You may be eligible to enroll in medical continuation coverage if you are

  • a member, seminary student, or an individual on transitional participation status* who is terminating from the Benefits Plan;
  • a member for whom disability status ends and termination status begins;
  • a retired member under age 65;
  • a covered child who is reaching age 26; or
  • a surviving or former spouse.

Covered spouses and children may enroll even if you do not.

Typically, medical continuation coverage for terminated members lasts up to 18 months. Children who lose their eligibility at age 26 (or later, if disabled) may elect medical continuation coverage for up to 36 months.

*Graduated seminary students whose presbyteries verify their status and ministers in Pastor’s Participation who are temporarily unemployed and actively seeking church service, enrolled for full-time church-related studies, or subject to a disciplinary process that leads to temporary leave or unemployment may first participate in transitional participation coverage and subsequently, if they do not return to church employment, be eligible for medical continuation. If they enroll in medical continuation coverage first, they will not be eligible later for transitional participation coverage.

Cost

The cost for medical continuation coverage starts on the day the coverage becomes effective. Monthly rates for 2019 for medical continuation coverage are as follows*:

​Coverage level​PPO​EPOHDHP
​Member-only​$919​$781​$721
​Member + Child(ren)​$1,425​$1,211$1,119
​Member + Spouse​$1,868​$1,588$1,466
​Member + Family​$2,544​$2,162$1,997

*Rates shown are for medical continuation coverage through Highmark. For continuation coverage through Aetna, contact the Board for costs. 

How to enroll

To continue your coverage, you must enroll within 60 days of the termination event. If you do not enroll when you are first eligible, you will not be able to enroll later. You must enroll in the same program, the PPO, EPO, OR HDHP, for medical continuation that you had while working for the Presbyterian Church (U.S.A.) or other affiliated employer.

To enroll, return to the Board the completed personal information, subscription, and authorization sections of the Medical Continuation Subscription or Waiver form, with the initial payment, within 60 days of the event that results in termination of your coverage under the Medical Plan. Your coverage begins immediately following any applicable coverage period in which coverage is provided at no cost to you.

Canceling coverage

You may cancel your medical continuation coverage by sending a written cancellation request in advance of the termination date to

The Board of Pensions of the Presbyterian Church (U.S.A.)
Attn: Plan Operations
2000 Market St.
Philadelphia, PA 19103-3298

The Board must receive your request at least one month in advance of the date you want the coverage to end. If you cancel your coverage in medical continuation, you cannot reinstate it.

Continuous coverage requirement

If you retire before age 65, medical continuation coverage may be available to bridge the gap until you become eligible for Medicare. Maintaining continuous coverage is important if you want to enroll in the Medicare Supplement Plan once you are eligible for Medicare.

You have the option of changing your coverage from medical continuation to another qualified plan, including any plan on the federal or state health insurance marketplace, and still satisfying the continuous coverage requirement for enrollment in the Medicare Supplement Plan at age 65 (keep in mind, maintaining such coverage satisfies just one of several eligibility criteria for the Medicare Supplement Plan). For information about how and why you might want to make such a change, call the Board of Pensions at 800-773-7752 (800-PRESPLAN).