Eligibility
All employees working at least twenty hours per week at Covenant churches, ministries, regional conferences, camps, and conference centers are eligible to enroll in Covenant Benefits. Covenant-ordained ministers whose non-Covenant employer is paying into the Covenant Pension Fund on their behalf, and/or are approved by the Ordered Ministry to serve in a non-Covenant setting are also eligible for coverage.
Retirees and part-time employees (working 20 to 29 hours per week) are not eligible for life and long-term disability benefits. These individuals may only enroll in our health insurance package.
You may choose to waive health insurance and enroll only in life and long-term disability benefits if you are receiving health benefits through another employer (either a spouse’s or parent’s employer or a secondary employer of your own) or a government-subsidized plan (such as veterans’ benefits, Medicaid, etc.). If you are enrolled in life and long-term disability benefits, you are eligible to enroll in health insurance at any time in the year. You may not waive health insurance and elect other benefits if you are enrolled in an individual policy, or another policy offered by your Covenant employer.
If you waive health insurance, you may choose to elect dental and vision coverage for yourself and your family.
MINIMUM PARTICIPATION
Employers who wish to enroll staff in Covenant Benefits must meet minimum participation requirements to be eligible—at least 75% of benefits eligible employees must be enrolled (does not apply to ministers serving outside the Covenant). This policy helps the Covenant to provide high-quality benefits at a reasonable premium rate to all Covenant churches and ministries.
Enrollment
You may only change your health plan selection at the following times:
- You may select the health plan you prefer for the next year during open enrollment each year. If you do not select your health plan, you will be automatically re-enrolled in a health plan most similar to the one in which you are currently enrolled.
- You may change your health plan selection if you transfer employment to another church or ministry or if your family size changes due to birth, marriage, divorce, or death. Note: Your deductible may start over if you cancel the health plan you are enrolled in and choose a different one mid-year.
New employees are eligible for benefits on their date of hire. Exceptions to open enrollment apply if your current health insurance contract expires mid-year or if your employer is newly invited into the Covenant denomination.
TRANSFERRING FROM ONE COVENANT EMPLOYER TO ANOTHER
To complete the transfer of benefits from one Covenant employer to another, contact us to receive a link to a secure online form.
Your former employer will be responsible for your health insurance coverage until the end of the month in which your employment was terminated. Reimbursements and/or invoices will be sent automatically after your transfer of benefits has been processed.
TERMINATING EMPLOYMENT
If your employment is terminated or your hours per week are decreased below the eligibility requirements, you are eligible for benefits through the end of the month in which the change occurred, and reimbursement will be sent to your employer automatically for unused premiums after your termination of benefits has been processed. If terminating health insurance, you will automatically be offered a continuation of coverage by mail. You may continue your health insurance policy at your own expense for up to 18 months.
TERMINATING INSURANCE FOR OTHER REASONS
If you choose to terminate your insurance plan to elect another insurance plan other than another employee plan provided by a different employer, you may not continue life and long-term disability benefits and you may not re-enroll until the next open enrollment period. This waiting period is immediately canceled if you transfer employment to another Covenant institution.
SEVERANCE PACKAGES
If your employer chooses to offer you a severance package when terminating employment, please note that you are only eligible for health benefits (including medical, dental, vision, and prescription insurance). You are not eligible for life and long-term disability benefits after your employment has been terminated.
After your severance package agreement has expired, you will be offered continuation of coverage, which allows you to remain enrolled in health insurance at your own expense for up to 18 months.
RETIRING
Retiring ministers in the Covenant Pension Fund are eligible to enroll at the time of their own retirement, their spouse’s retirement, or the date they begin withdrawing from the Covenant Pension Fund.
If you plan to retire soon, please contact us for a Retiree/Medicare Supplemental Insurance application and packet. You and your eligible dependents can continue receiving health benefits into retirement. After the age of 65, this plan is a supplementary plan to Medicare and includes vision, dental, and Medicare Part D prescription coverage.
Payments and Updates
PAYMENTS
Since Covenant Benefits is a group health plan, payment must be made from your employer (church or Covenant organization). We cannot accept personal checks, except from retirees.
Covenant Benefits bills monthly. Employers must pay by automatic ACH withdrawal, which occurs on the 10th day of the month in which the premium applies.
Please immediately notify Covenant Benefits of any financial issues that may disrupt full, timely payments.
SALARY UPDATES
An accurate salary is necessary to calculate accurate long-term disability premiums. Please update salary information any time your salary changes by requesting a secure online form.
Dependents
Please update dependent information on the online portal as soon as any changes in your dependents’ eligibility occur. Newborns are not automatically added to your policy when they are born. Notice of a change must be received within 60 days.
DEPENDENT ADDITIONS (NEWBORNS, ADOPTIONS, AND MARRIAGES)
Newborn children are eligible as dependents the day they are born. Adopted children are eligible as dependents the day members receive legal custody over them. Newly married spouses of members are eligible on the day of marriage.
Legal documentation for newly added dependents may be required. If notice of dependent eligibility is not received within 60 days, your dependent will be ineligible to elect benefits until our next open enrollment period with benefits beginning on January 1.
DEPENDENTS THROUGH AGE 25 ARE ELIGIBLE
All children are eligible for benefits until they turn age 26. Covenant Benefits will send a letter to your home a few months in advance to remind you that your child will be removed from your policy and that continuation of coverage is available. Your child may purchase continuation of coverage for up to 36 months after their 26th birthday if elected within 60 days of cancellation.
DISABLED DEPENDENTS
If you have a disabled child age 26 or older who is your legal dependent, please request a Disabled Dependent Certification form from Covenant Benefits to qualify for continuous coverage on your family health insurance plan.
Filing Claims
FILING CLAIMS IN THE UNITED STATES
If you visit a doctor outside the network or before your enrollment has been processed, you may need to pay the full amount due, then file your own claim to receive reimbursement for the portion covered by your benefits. To file a claim:
- Complete the appropriate claim form found on our forms and downloads page.
- Make a copy of the completed form and send it, along with any additional information available (e.g., copies of bills or receipts, doctor’s notes), to the address listed on the claim form. For medical claims, we recommend calling Highmark Blue Cross Blue Shield to acquire a case manager and faxing it to that individual.
- Allow four weeks for processing. If no response is received, contact the appropriate insurance company to find out the status of the claim.
- If you are unable to resolve the claim with the insurance company yourself, Covenant Benefits will act as your liaison to ensure that eligible claims are paid in a timely manner.
- Life and long-term disability claims: Claims should be filed within 90 days, if possible. Contact Covenant Benefits for instructions.
- Medical, prescription, dental, or vision claims: Claims must be filed within 12 months of the date of service.
FILING CLAIMS OUTSIDE OF THE UNITED STATES
When overseas, in-network doctors are very scarce. When receiving medical attention or filling prescriptions, you will most likely be required to pay the balance upfront and request reimbursement for the covered portion by filing a claim after the date of service. Send claims as soon as possible after the date of service to avoid delays and complications in the approval/reimbursement process. When filing a claim, the following information must be provided:
- The appropriate completed claim form can be found on our forms & downloads page.
- Details of what happened on the date of service (not necessary for Express Scripts prescription claims)
- Your bill or a letter from the doctor explaining the appointment with a detailed description of the amount owed
- An English translation of your bill and/or letter from your doctor
- The exchange rate to US dollars
All claims should be processed and approved within six weeks of receipt. If you are global personnel working through Serve Globally, reimbursement checks are sent to Serve Globally and deposited to your personal account (unless alternate arrangements have been made).
