Plan Member Q&A

Question

How does housing allowance fit into the eligibility calculation?

Answer

GSI uses “Salary Basis” as a defined term to establish eligibility. Salary Basis includes base salary and housing allowance. We realize that clergy have the option to deduct the value of their residence from income to calculate income tax and Canada Pension Plan contributions.  This is unrelated to the ELCIC pension and benefits plans eligibility formula. GSI’s policies do not use taxable income for eligibility.  

Manulife App

The Manulife Mobile App can help you:

  • submit your claims
  • review recent claims and payment information
  • find health care providers in your area
  • search My Drug Plan to find the lowest cost alternative
  • pharmacy saving search (find places to get your prescriptions for less)

Download the Manulife App from Google Play or Apple app store. Search Manulife and select the “Group Benefits Mobile”.

Manulife Vitality Program

Life Healthy. Earn Rewards.

Learn more about the Manulife Vitality Program

GSI supports plan members in leading healthy lives.

This is accomplished by providing a comprehensive health, dental and employee assistance plan, as well as a generous life and disability insurance program.

The new version of the ELCIC Group Benefits Plan begins January 1, 2020 and consists of 3 modules:

Blue, Green & Teal

Benefits Chart BGT with Comparison to current plan

The details of each module is included in the information for each benefit listed below.

Group benefits are important not only for the financial assistance they offer, but also for the security and peace of mind they provide for you and your family should unforeseen needs arise. It is your responsibility to understand the benefits and to put them to the best possible use.

Opening your online account is easy, just follow the steps in this brochure Connect to your benefits.

Policies of Note

Changing Modules

Changing Modules

 

After the initial module selection, plan members are able to change their module selection in certain circumstances.

Members may make a module change when there is a life event. Eligible life events are:

    • becoming a parent or when a dependent is no longer eligible as they attain age 21 or 25 if a full-time student;
    • a change in marital status
    • a change in co-ordination of benefits (i.e., your Spouse either gains or loses their employment health benefit plan).

Please note that the request for change must occur within 31 days from the event. Also, certain events will not qualify; some examples are: becoming disabled or starting a new Call at another participating employer (member needs to continue in their previous selection when benefits are reinstated).

Members may also make a module change at the annual re-enrollment on January 1st, where members can make a new selection to move to an adjacent module.

Members should also be aware that their claims history will be carried forward. This means that benefits with coverage maximums that are greater than one year such as vision care (24 months) will not reset with the redesign nor when a different module is selected at a later date.

Coordination of Benefits

Coordination of Benefits

 

Coordination of Benefits means that Manulife Financial will take into account coverage under a spousal benefits plan when determining the amount of expenses payable under the ELCIC Group Benefits Plan. This process allows for reimbursement of insured medical and dental expenses from all plans up to a total of 100% of the actual expense incurred.

The “Primary Carrier” is responsible for making the initial payment towards the eligible expense and the “Secondary Carrier” is responsible for making the payment to cover the remaining eligible expense. The Primary Carrier makes the payment for their own member first, then the any remaining balance must be submitted to the Secondary Carrier. Where both Spouses have a plan, the Primary Carrier for their Dependent Children is the Spouse with the first birthday in a calendar year. Please refer to the GSI website for information on other unique circumstances.

 

Submitting a Claim

When submitting claims where Coordination of Benefits applies, please refer to these guidelines:

  • determine which Plan is the Primary Carrier and the Secondary Carrier;
  • submit all necessary claim forms and original receipts to the Primary Carrier;
  • keep a photocopy of each receipt or ask the Primary Carrier to return the original receipts to you once your claim has been settled;
  • once the Primary Carrier has settled your claim, you will receive a statement outlining how your claim has been handled. Submit this statement along with all necessary claim forms and receipts to the Secondary Carrier for further consideration of payment, if applicable.

Plan Member Benefits

The purpose of the information below is to outline the benefits for which you are eligible as an employee of the Evangelical Lutheran Church in Canada and its affiliated organizations.

Communication Archives

Eligibility for Enrollment Policy Changes

ELCIC Group Benefits Plan – Administrative Changes for 2021

 

The GSI Board has reviewed the Benefits Plan for equity both between Rostered (R) and Non-Rostered (NR) employees and between members either under or over age 65. These changes are effective January 1, 2021.

Reference New Provision Previous Plan Provision
Health + Dental All employees meeting eligibility will be required to enroll in a health + dental module. Employees meeting eligibility with spouses also having a work benefits plan were allowed to waive their health + dental coverage.
all benefits

NR vs R

All employees will be required to meet and maintain minimum earnings of 25% of YMPE* (no hours test) Non-Rostered employees also had to meet an hours test of 20 hours per week to qualify for benefits
Travel All active plan members will have the travel benefit (included in each module) Member aged 65+ did not have the travel benefit

*YMPE – Years’ Maximum Pensionable Earnings (as defined by Canada Revenue Agency)

Letter to Plan Members - June 25, 2020

Letter to plan Members June 25, 2020

 

The ELCIC Group Services Inc. Board of Directors (“the Board”) would like to thank everyone who took time to participate in the health redesign survey and attend the consultations. Your engagement in the process and your thoughtful comments speak to the importance placed on being a part of the ELCIC Group Benefits Plan (“Benefits Plan”) design review.

Redesign Survey and Consultation 

The strongest message that came from the health redesign survey and the consultations was the great appreciation for the Benefits Plan. Over 90% of participants indicated that the Benefits Plan was a very important part of the compensation package. This importance was underscored by the number of plan members who make claims on a regular basis and also the frequency and thoroughness with which plan members read the newsletters and benefits information available on the website.

A variety of suggestions were made regarding possible improvements to the health plan; all were studied by the Board when considering changes to the redesign. Recurring messages included: (1) addition of a health care spending account or other flexible options, and (2) need for travel insurance for working plan members age 65 and up. The aspect of the redesign that was most criticized was the need to meet an earnings threshold in order to require employers to pay premiums for enhanced benefits.

The survey comments and consultation conversations indicate that there may not be a consistent understanding of what is meant by the reference to ‘sustainable’ and the concern that sustainability might be at risk. The Board has determined that sustainability, in the ELCIC’s context, means managing costs to keep the Benefits Plan affordable for the congregations, which are currently paying 100% of the premium. Based on industry trends and developments and our own Plan’s usage, the Board recognizes that premium rates could rise to a level where many congregations would have to forgo having a paid pastor, due to the associated costs of offering a Benefits Plan. This concern is of vital importance going forward, especially in light of the opening comments around the value of the plan.

The Survey Results Report is available for those interested in more details.

 

New Modular Design

The Board considered the survey results and comments, together with the discussions held at the consultations, and determined that changes could be made to the redesign in consideration of this feedback. These changes (i.e., a new modular design) will maintain the goal of adding flexibility, while mitigating the risk to the plan’s sustainability. The Board hopes the redesign will address concerns expressed on the initial redesign proposal.

The new design will offer three modules for selection: Blue, Green and Teal. A summary of coverages in each module is outlined in this chart, which will be implemented on January 1, 2021.

Survey Results Report

Survey Results Report

 

ELCIC Group Services Inc. (“GSI”), in its role as Benefits Plan sponsor for the ELCIC Group Benefits Plan (“Benefits Plan”) regularly monitors each of its components. As part of this process, the Board of Directors (“the Board) regularly receives and reviews statistical reports detailing how members are using the Benefits Plan, as well as financial information in terms of how the Benefits Plan is running. Adjustments are regularly made to the Benefits Plan contract and design, based on this process.

Background
Approximately every five years, the Board undertakes a detailed look at the Benefits Plan, which might include comparison to the external market, a more in-depth review of utilization information, and consideration of how the Benefits Plan fits into ELCIC’s organizational and compensation philosophies.

The journey into examining the health and dental components of the Benefits Plan began in early 2015, with an educational presentation on the pharmacy landscape. This presentation provided the Board with insight into this rapidly changing and growing industry, which accounts for the majority of claims paid by the Benefits Plan. The Board then looked more closely at ELCIC’s claims trends and the related premium rate increases over the past decade.

Based on this research, and with the assistance of benefits consultants, the Board began to explore options to update the Benefits Plan’s health and dental components, in order to incorporate features that could provide greater flexibility, while also addressing fiscal responsibility. Ensuring that the Benefits Plan will be sustainable into the future was identified as an important guiding principle to this process.

To this end, the Board put forward its ideas for updating the Benefits Plan in October 2018. Some Benefits Plan members and congregations provided feedback to these suggestions, and because members indicated that they consider the Benefits plan to be a key component of their compensation, the Board felt that it was important provide a greater opportunity for feedback. To achieve this, GSI sent out a survey and held a series of consultations.

Survey
On December 16, 2019, Benefits Plan members (299 Rostered and 121 Non-Rostered) were sent a survey with benefits-related questions, as well as a brief section to collect basic demographic information. In the end, 34% of Rostered and 22% of Non-Rostered Benefits Plan members completed the survey.

At the same time, 347 employers subscribing to the Benefits Plan were sent a survey with benefits- related questions and a brief demographic section. 28% of employers completed the survey.

We sincerely thank all survey participants for their time and thoughtful comments. In the next section, we are pleased to provide an overview of what we heard from Benefits Plan Members and employers.

You may download the full Survey Results Report here.