The Administrator Journey: Unpacking Key Topics and Tasks Presenters: Lauri Begley Associate Account Specialist (IBAMS) Jeff Hamilton Account Specialist (IBAMS) October 15, 2020 CPG Administrator Webinar Series
The Administrator Journey Today’s Agenda Benefits Management Medical Trust Eligibility Employee Enrollment and Changes Health Plan Options for Active Employees Age 65+ Cigna Employee Assistance Program (EAP) Health Advocate Additional Vendor Programs and Services COVID-19 2
Benefits Management • The IBAMS Team • How We Work Together • Expectations • Administrator Resources 3
The IBAMS Team Relationship Management* and Business Development • Regionally based • Consultative and personalized • Special care for issue resolution Administrator Resources and Professional Development • Administrators ’ Resource Center • Webinars, newsletters, job aids, resources, and conferences • New administrator onboarding Implementation and Operations • Managing “ behind the scenes ” • New group enrollments for all products *Account management is provided to dioceses, parishes with 10+ enrolled employees, and institutions or schools which provide benefits through CPG. Visit cpg.org/ibams to learn who is your account manager. Other resources provided are for all administrators. 4
The IBAMS Team: Who We Serve Domestic and International dioceses • Bishops • Bishop staff and leadership • Benefit administrators Domestic benefit administrators • Parishes • Parochial and non-parochial schools • Independent institutions – Camp and Conference Centers, Social Service Agencies, etc. 5
How We Work Together Administrator roles vary, but there are common responsibilities • Understanding and adhering to CPG policies and procedures • Educating employees about CPG benefits • Complying with federal/state laws and regulations • Making timely contribution payments 6
How We Work Together We are here to help you and your employees by… • Providing education, information, and resources • Assisting with system and process issue resolution • Collaborating to address your benefit needs 7
How We Work Together Supporting you with educational programs. Enrollment and In-person, conferences, Financial and physical benefit education web-based, customized wellness education for our members 8
Benefits Management — Expectations Administrator roles vary, but there are common responsibilities • Confirming eligibility for benefits • Timing • Training newly enrolled staff • MyCPG Accounts • Notifying CPG of employee changes • ER (administrator) • MyCPG Accounts (member) • Calling CPG Client Services Call Center • Processing your monthly invoices 9
Benefits Management — Administrator Resources CPG Webinars News & Updates What to Do When 10
Benefits Management — Administrator Resources Administrators’ CPG Client Services Administrative Administrator Services Policy Manual Resource Center Call (855) 215-5990 cpg.org/ARC Monday through Friday 8:30AM to 8:00PM ET Email admin-assist@cpg.org 11
New CPG Call Center Authentication Process June One (1) One-time 2020 passcode is One-time sent to client’s passcode mobile device authentication or land line, process and read back rolled out by the client This approach is used by many financial institutions. 12
Future Online Authentication Process Multi-Factor Authentication Step 1 Step 2 Step 3 Enter password Confirm identity Access granted 13
Medical Trust Eligibility • Active Employees • Active Employee Dependents • Pre-65 Retirees • Seminarians 14
Medical Trust Eligibility: Active Employees Eligible Not Eligible x Exempt employee Non-exempt employee scheduled to work and be compensated for fewer Non-exempt employee scheduled to than 1,000 hours per year work 1,000 or more compensated hours annually* x Contracted employees who receive a Form 1099 (and not a Form W-2) A postulant, novice, or professed member of Episcopal Religious Temporary or seasonal employee x Orders who has been accepted or Volunteer x received by the Religious Order Employee whose working papers have x expired and can no longer legally work *Employees are eligible for coverage at 1,000 hours, but if employer is subject to the DHP, they are required to participate at 1,500 hours. 15
Medical Trust Eligibility: Active Employee Dependents Eligible Spouse Domestic Partner, if Domestic Partner benefits are elected by the Participating Group Eligible Children to the end of the calendar year in which they turn 30* Disabled Child, regardless of age, if physically or mentally disabled and incapable of self-support (provided the disability began before the age of 25) *Fully insured plans may not cover children up to age 30; as the eligibility rules of the regional or local plans vary and will apply, please confirm prior to enrollment. 16
Medical Trust Eligibility: Pre-65 Retirees Pre-65 Retiree Dependents Retired from a Participating Group, Spouse and; Domestic Partner, if Domestic Partner Covered, or eligible to be covered, benefits elected by the Participating and; Group At least 55 years of age, or if younger, Eligible Children to the end of the eligible for a disability benefit under a calendar year in which they turn 30 CPF pension plan, and; Disabled Child, regardless of age, Has at least 5 years of continuous if physically or mentally disabled and service (Lay) or credited service incapable of self-support (provided the (Clergy) disability began before the age of 25) 17
Medical Trust Eligibility: Seminarians Eligible Not Eligible x Seminarian who is a full-time Seminarian who is a not a full-time student enrolled at a participating student enrolled at a participating seminary of the Association of seminary of the Association of Episcopal Seminaries Episcopal Seminaries x Employees of the Seminary are not eligible for Seminarian Plans but may be eligible as active employees 18
Employee Enrollments and Changes 19
Employee Enrollments and Changes Use the “What to Do When” checklists on the Administrators’ Resource Center (ARC) for instructions on how to: cpg.org/administrators/resources/arc/what-to-do-when/ • Add a new cleric or lay employee Administrators • Report a termination, retirement, or death • Record Compensation Changes • Report a life event 20
Health Plan Options for Active Employees Age 65+ 21
Active Employees Age 65+ Under the Age Discrimination in Employment Act… An employer who offers Medical Trust health plans to active employees under age 65 and their spouses, must offer the same health plans to its employees age 65 and over and their spouses. Regardless of Medicare eligibility — provided they meet the eligibility rules. 22
Active Employees Age 65+ Medicare beneficiaries can decline employer coverage. • Retain Medicare as primary coverage • Can also purchase secondary coverage BUT not from employer group plan • Employer can not provide financial incentive to take Medicare as primary 23
Medicare Secondary Payer Small Employer Exception Plans Less expensive than the corresponding standard plan, because they coordinate with Medicare Offered to certain employees and employers • Employers with fewer than 20 employees in the current and preceding year (Small Employer) • Employees of Small Employer and/or their spouses who are eligible for and enrolled in Medicare Part A (or Parts A and B) 24
Medicare Secondary Payer (MSP) Rules What are the MSP rules? MSP rules Employer group MSP rules determine when health plans usually provide an Medicare is not pay primary for exception for responsible for Medicare-eligible small employers paying first members according (or primary) to MSP rules* *Comparable to private insurance “coordination of benefits” 25
What is the Small Employer Exception (SEE)? Medical Trust offers MSP SEE Plans through Anthem and Cigna. Participating groups must elect to offer the plans during annual renewal Individual employers (parish, Medical Trust will institution, etc.) pay secondary must meet SEE criteria to Medicare becomes enroll eligible the primary payer employees and their eligible dependents. 26
MSP SEE Eligibility An employee and their eligible dependents are eligible if they meet each of the following conditions. • Employee meets standard Medical Trust eligibility criteria • Employer offers MSP SEE plan to employees • Employee and/or eligible dependent is 65 or over • Employee is working for an employer who has fewer than 20 full- and/or part-time employees in the current and preceding years • Employee and/or eligible dependent is enrolled in Medicare Part A or Parts A and B (enrollment must be on the basis of age only) 27
MSP SEE Eligibility (cont’d.) How does the family plan work if not everyone is age 65+? Any member of the family under age 65 who meets standard eligibility requirements for coverage under an active employment-based plan will be enrolled in the MSP SEE plan along with the 65+ member who qualified; however, their benefits will not be coordinated with Medicare. 28 28
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