The Florida Conference has plans to be an early adopter of the insurance marketplaces under the new health care legislation, commonly called Obamacare.
Starting in January 2014, the conference no longer will provide health insurance for lay employees at its local churches and extension ministries, such as campus ministries.
The decision by a conference task force will compel many lay local church employees to use the insurance exchange. Pastors began notifying their lay employees of the change in April.
The conference will continue to provide coverage to its full-time employees, including laity. Churches with 50 or more full-time employees will need to provide insurance for their lay workers starting in 2015.
Florida is among 27 states relying on the marketplace which the U.S. Centers for Medicare and Medicaid Services will set up. Nationwide, insurance marketplaces are scheduled to be open for enrollment starting in October.
Beginning next year, all individuals will be required to have health insurance or face a federal tax penalty.
Concerns about change
The conference's change, not surprisingly, worries some lay workers.
Among them is Pam Petersen, the office manager at the Gator Wesley Foundation, the United Methodist campus ministry at the University of Florida. She has worked with the ministry for 18 years.
"The bigger concern for me is that all of the anticipated benefits based on the Affordable Care Act are completely unknowns at this point," she said. "We don't know if there will be a savings. We don't know how the exchanges are going to work. ...The lack of information is what is alarming to me."
She added that she is also concerned that the decision was made without the approval of the full annual conference session that met June 13-15.
Because the task force's decision does not affect clergy, it does not require the annual conference session's vote, said Wendy McCoy, the Florida Conference's director of human resources and benefits.
The Book of Discipline, the denomination's law book, leaves it up to conferences whether to provide health benefits for lay workers who are not employees of the conference.
The new insurance marketplaces
United Methodist conferences across the United States are determining how they will use the online insurance marketplaces. The options on the marketplaces are just starting to become public.
The U.S. health care law commonly called Obamacare requires all 50 states and the District of Columbia to have health insurance marketplaces where people without insurance through their employer or some other program like Medicare can buy coverage from an array of private plans. The federal government will establish the marketplace in states that do not set up their own.
Because these new marketplaces can pool large groups of people, the expectation is that the insurance options will be more affordable than what individuals or small businesses now can buy.
The federal government also will provide subsidies for individuals and families in the insurance marketplaces whose household income is between 100 percent and 400 percent of the federal poverty line. That translates to annual income between $11,500 and $46,000 for an individual or between $23,500 and $94,000 for a family of four.
She said the conference's self-funded insurance plan exists primarily to serve clergy. The Florida Conference now provides insurance for 1,100 employees, not including spouses or children. But McCoy does not know how many of the individuals covered are laity.
She said the conference only offered its program to church lay employees because the pool of people at most local churches was not big enough for churches to pay for insurance on their own. And, most lay people unlikely could afford insurance otherwise, she said.
"A pre-existing condition was the biggest impediment" to getting insurance for many lay workers, she said. However, with changes under the Affordable Care Act, that no longer will be the case.
McCoy added that many lay workers make less than $46,000 a year and thus likely will qualify for subsidized health insurance on the insurance marketplace. "So the same rationale for why we started (the lay worker) program no longer exists," she said.
She said that sending lay workers onto the insurance exchange likely will save the conference some money. But she stressed that was not the main reason for the decision.
"The main driver is certainly not saving money at the conference level," she said. "We just think it is the right thing for the churches to do and especially for the employees to have the benefits of the insurance exchanges and the subsidies."
She also noted that even on the voluntary insurance plan the conference now uses, local churches must meet strict underwriting rules that are beyond the capacity of some congregations. For example, the plan requires 75 percent of employees at a local charge or extension ministry to sign on for any to participate. So, if only one of three local church employees is interested in joining, no one can join.
McCoy said the conference's plan for lay employees also might be too expensive for some. It is $661 a month for a single person with a $750 deductible.
Robert Jackson, choir director at First United Methodist Church in Gainesville, said that amount may sound like a lot but is far better than what employees could get on their own in the insurance market now. Like Petersen, Jackson worries it is too soon to tell whether the insurance marketplaces will serve employees' needs.
"Wouldn't it have been better to wait and see before deciding to toss us out with the bathwater?" he asked.
McCoy acknowledged that no one knows whether lay church employees on the exchanges still will be able to get roughly the same coverage for the same or lower costs because the federal exchange isn't set up.
While uncertainty exists, McCoy is confident that lay workers will have a better array of options on the insurance marketplace.
Hopes for the future
Jackson, for his part, is in the preliminary stages of seeing whether Florida local church and extension ministries lay employees can join together to buy health insurance independent of the conference.
His congregation has three full-time employees that the insurance change affects.
"If insurance companies aren't willing to insure small groups from individual churches, I asked our church administrator about the possibility of calling area local churches and asking how many lay people does this (change) affect," Jackson said. "If we could group all these people together and get a larger group, maybe an insurance company will pick us up that way. Our church administrator thought it was a great idea."
For now, he said, his church staff-parish committee is also waiting for more information from the conference.
"Everything points to them not knowing anything until October when enrollment begins," he said. "We've got an insurance agent who is looking into some things for us, but we've been instructed as employees to do the research on our own and be ready to move on our own if we have to."
McCoy said she is optimistic that people will find more options suited to their needs, especially the lay employees who have not been able to get coverage under the conference's plan.
She plans workshops later this summer to help churches determine whether they need to set up their own plan or use the exchanges for lay employees.
"Today, the plan I am able to make available to local churches is the equivalent of a very nice Mercedes-Benz," she said. "Most people would like to purchase a Toyota Camry. I can't offer that type of plan. The exchange can offer several plan choices with a range of costs. It's supposed to meet people where they are and what they can afford."
*Hahn is a multimedia news reporter for United Methodist News Service.
News media contact: Heather Hahn, Nashville, Tenn., (615) 742-5470 or firstname.lastname@example.org.