Care navigation is available to members enrolled in the PPO, EPO, and HDHP as part of their medical benefits. When these employees have a question about medical or prescription drug benefits, Quantum Health's Care Coordinators are just a call, click, or tap away.
The Medical Plan offers flexibility and affordability to employers with the choice of three coverage options:
Each option delivers high-quality coverage and outstanding value, with features not readily found on the commercial market.
The Board of Pensions partners with Highmark for network and claims administration. Employees enrolled in the Medical Plan have access to the Blue Cross Blue Shield network of physicians, hospitals, and other healthcare providers.
All three medical coverage options include unique features that deliver outstanding value in promoting wholeness and well-being, such as
As a nonprofit organization, the Board of Pensions is able to pass along greater value per dollar to our participating employers than can be found commercially. Backed by strong operating reserves, we have demonstrated significant year-over-year pricing stability for employers. Additionally, our high-cost claims fund insulates employers from risk.
The Board of Pensions is a leader in the Church Benefits Association and contracts for all medical coverage as part of the association's purchasing coalition, which includes dozens of other denominations. Having such power in numbers — nearly 200,000 faith communities — results in the ability to negotiate lower administrative costs and highly favorable contract terms. We pass along any savings we receive to our employers.
As a reflection of the community nature that underlies our Benefits Plan, the Medical Plan is designed to promote shared responsibility for healthcare costs — gains and losses are shared across the total population of employers participating in the Medical Plan in the form of standard rates, adjusted for age and regional cost factors. In the PPO coverage option, deductibles are income-sensitive, so members with higher salaries pay more to help support those who earn less.
Our in-house customer service team is staffed by highly trained representatives who provide caring, thoughtful guidance to employers and plan members. Read more about the administrative resources and personalized service support we provide.
Employers may offer either the PPO, the EPO, or the HDHP; any two options; or all three.
Employees elect coverage in levels:
As the employer, you must contribute at least 50 percent of the cost of Member-only coverage in the lowest-cost option offered — regardless of which option or coverage level the employee elects.
Employees may be required to pay
Medical coverage costs are based on claims experience adjusted for regional and demographic factors.
If you currently offer benefits through the Benefits Plan of the Presbyterian Church (U.S.A.), you may elect this benefit when you update your Employer Agreement on Benefits Connect for the following year. Employer Agreements are usually available for updating July through October.
If you do not currently offer benefits through the Benefits Plan and would like to learn more about its features and how the Board of Pensions serves employers, call our Employer Services team at 800-773-7752 (800-PRESPLAN) (TTY: 711) to discuss how we can best meet your and your employees' needs.
Highmark Blue Cross Blue Shield is a national, diversified healthcare partner that serves members across the United States. Highmark, and its affiliates, operate health insurance plans that serve more than 21 million members. The company is among the top 10 largest health insurers in the United States.