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The Diocesan Benefits Administrator's Office maintains the group insurance plans offered by the Diocese of New York through the Episcopal Church Medical Trust to clergy and lay employees of our congregations and related institutions. Details of these plans are provided in the following pages.
An individual must work at least 20 hours per week for a congregation or covered institution to be eligible for any of the insurance coverage offered through the diocesan group.
There are very important deadlines with respect to this coverage. Employees must enroll in the coverage they want within 30 days of the date of employment.
If an employee misses this deadline, enrollment in a managed care plan for medical insurance will have to wait until the next annual open enrollment period. The Medical Trust will effect enrollment in other kinds of insurance only on approval of health statements.
Effective date of coverage
Your coverage will be effective on the first day of the first full month of your employment. If your hire date is July 1 (or the first working day in July), your coverage will be effective July 1. If your hire date is July 10, your coverage will be effective on August 1. The effective date of coverage is not up to the employer or the employee; it is based without exception on the employee's date of hire.
Same-sex partner coverage
The diocesan group plans include coverage for the same-sex partners of eligible employees. There are affidavits and supporting documentation that must be submitted to the Controller's office if you would like this coverage. Please contact us for further information.
Mental Health and Behavioral Coverage If you are enrolled in the following medical plans: AETNA, United Healthcare and Empire BC/BS your Mental Behavioral Health Coverage is managed by CIGNA. If you are enrolled in MVP you are entitled to 20 visits and this is not managed by CIGNA, it is directly covered under MVP.
Should you have any problems with your Mental Behavioral Health Coverage, please call Libby Miller, AVP, at the Medical Trust's confidential toll-free number: 800-441-7118.
Prescription Drug Benefits 2012
If you are enrolled in any medical plan, you have prescription drug benefits. The annual individual retail deductible is $50/person/year at Retail, none by Mail Order. Copayments are $10 Generic/$35 Formulary Brand Name /$60 Non-Formulary Brand Name and Barnd Non-Sedating Antihistamines for retail prescriptions and $25/$90/$150 for mail order prescriptions. There is mandatory mail-order for maintenance medications.
Vision Benefits 2012
All enrolled members in AETNA, United Healthcare, Empire BC BS are eligible to participate in the Vision benefits plan, offered through EyeMed. Participants are allowed 1 visit per 1 year period, with a $130 limit on the price of frames/contact lenses. See the plan summary for more details.
Members enrolled in MVP receive Vision Care through the MVP Plan.
Significant life changes
If you experience a significant life change during the year (e.g., marriage, divorce, birth or adoption of a child, loss of spousal coverage), you may make changes outside of the open enrollment period as long as (1) you file the necessary paperwork within 30 days of the event, and (2) there is no break in coverage.
The Lay Compensation Guidelines mandate that congregations at least provide access to the insurance for their eligible lay employees.
Medical insurance options
CSP Clergy Medical and Dental Benefits and Premiums
Short-term disability insurance
Long-term disability insurance
Group term life insurance