Should the UCC have a health care insurance program? If so, who should be responsible for it? Who should pay for it? Who should be eligible to participate in it? How should it be designed?
Such questions dominated the discussion from June 18-20 as 25 persons gathered at the UCC's Church House in Cleveland for what was billed as a "Health Care Conversation." (See list of participants below.)
The UCC's current health care plan for clergy and employees is a fee-for-service plan with an optional PPO (preferred provider organization). It has been administered by the Pension Boards since 1983, as Pension Boards executive vice president Joan Brannick explained in a brief historical review. It has been self-insured since 1987, she said, and has 6,400 members, including about 2,500 retirees. The average age of a member, excluding retirees, is 49, about the same as in other major denominations.
The UCC plan paid out $29 million last year in claims, she said, all of which were covered by premiums. Administrative costs are covered by earnings on reserves.
Even so, participation by UCC clergy and employees is low, as various Conference Ministers testified. The Rev. Stephen Gray, Indiana-Kentucky Conference Minister, said he was "astonished" to learn from the Pension Boards data that little better than 50 percent of I-K local church pastors belong. The Rev. John Deckenback, Central Atlantic Conference Minister, said that only 32 percent of those churches belong. He cited one New Jersey church with 51 employees, only two of whom are in the UCC's health care plan.
Cost an issue
Marie Dufresne of the Hay Group, compensation and benefits consultants, led the discussion. When she asked why participation was so low, three answers emerged: the cost of the program, the availability of spouses' programs and eligibility limitations.
Elinor Christiansen, a physician who works actively for a national, single payer health care plan, found that her church in Colorado could get similar coverage for its pastor for 50 percent of what it pays now. But her pastor asked her not to go that route, since he has a child with disabilities who would be ineligible for the UCC plan if he tries to reenter it when he moves to a different church.
The eligibility question kept coming up during the three-day meeting, especially the current 90- day open enrollment period at the beginning of a pastor's employment. "The 90-day requirement is dysfunctional," Deckenback declared. Most participants agreed, leaning toward "a significant open enrollment period" with maximum flexibility.
Many present pointed out the difference between the UCC's public advocacy on health care and its practice in its own program. "If we saw another organization treating its employees the way we treat ours," said Hugh K. Penny, "we'd be outside picketing them." Penny, who has been a local church treasurer, administers health care benefits for Shaw's Supermarkets in New England.
Cost vs. value
Participants agreed that offering health care to all clergy and employees should be part of the mission of the church and that the plan's portability when clergy accept new calls is one example of that covenant.
"We have to remember that health care is not simply a commodity," said the Rev. Steven Johnson, UCC Minister for Higher and Theological Education. "It's also about relationships."
"Right now all people care about is price," said Michael Downs of the UCC Insurance Board. He added that the Insurance Board has worked to change the perception of insurance from being a commodity to being part of the mission of the church.
The group also discussed the current plan's marketing and distribution efforts. Downs offered that the UCCIB already has agents in place who visit churches regularly and don't sell non-UCC programs to UCC churches. "If there's a product in place that's good for the church and ready to be sold, I'll turn our agents loose to sell it," he said. "They're church folk visiting church folk, already talking about mission, already talking about covenant."
Whose plan is it?
"Who has to feel responsible for this plan in order to drive it?" Dufresne asked. "People see it now as the Pension Boards' plan."
"We've got to say it's the UCC's plan," said Dale Bishop, Executive Minister of Wider Church Ministries. "We need to own it and say it's ours."
"In the past we've all said, 'Pension Boards, what have you done for us lately?'" said the Rev. John H. Thomas, UCC General Minister and President. "Now we're saying, it's all of us who have to address the health care problem."
"It's important now to build broad ownership," added Thomas, at whose prodding this "conversation" took place. "The health care arena broadly creates problems, but it also offers new opportunities, especially for a closer alliance among the Pension Boards, the Council of Conference Ministers and the Covenanted Ministries."
The ideal plan
This group had no decision-making authority. Nevertheless, participants did agree on what an ideal plan would look like. It would make available health care coverage for all UCC clergy, employees, retirees and their dependants; it would be affordable, accessible and portable; and it would be considered part of the mission of the church.
They also felt that this goal could be achieved because of many "new realities" in the UCC, among them:
An emerging sense of responsibility for the plan from the Council of Conference Ministers;
A sense from the Pension Boards that it still needs broad input;
The new national structure;
New kinds of partnerships;
A willingness to move forward without preconceptions.
Among the next steps is a survey of local churches as to whether they offer a health care plan; if so, whose? and if not the UCC's, why not? The UCC's research department is currently preparing this survey for the Pension Boards.
A planning committee from this group will meet in Cleveland on Oct. 31-Nov. 1 to proceed on ideas generated at this meeting.
"Why not rethink this?" asked the Rev. David Ruhe of Plymouth Congregational UCC in Des Moines, Iowa, as the meeting ended. "Why not let God recreate us in all kinds of new ways?"
Participants in the Health Care Conversation
The Rev. Curtis S. Ackley, Council on Human Services Ministry (CHHSM)
The Rev. Jean M. Alexander, Maine Conference Minister
Donald A. Barnes, The Pension Boards
The Rev. Martha Ann Baumer, Eden Theological Seminary, Pension Boards Trustee
Dale Bishop, Wider Church Ministries
Joan F. Brannick, The Pension Boards
Gwen Bullock-Smith, Chesapeake Association Church and Ministry Committee, Baltimore
The Rev. Stephen W. Camp, Local Church Ministries
The Rev. Frank Chong, Pacific Islander and Asian-American Ministries (PAAM), Waikiki Health Center, Honolulu
Dr. Elinor Christiansen, Physicians for a National Health Program, Englewood, Colo.
The Rev. Arthur L. Cribbs Jr., Christian Fellowship Community Congregational UCC, San Diego
The Rev. John R. Deckenback, Central Atlantic Conference Minister
Michael A. Downs, UCC Insurance Advisory Board, Gaithersburg, Md.
The Rev. Rachel F. Dunn, Grace UCC, Spring Mills, Pa.
The Rev. Stephen Gray, Indiana-Kentucky Conference Minister
Timothy Hackett, United Church Homes, Marion, Ohio
Bernice Powell Jackson, Justice and Witness Ministries
The Rev. Steven D. Johnson, UCC Minister for Higher and Theological Education
The Rev. Scott Libbey, Retired Conference Minister and national executive, Des Moines, Iowa
The Rev. Russell M. Mitman, Pennsylvania Southeast Conference Minister
Richard N. Ogle, Local Church Ministries
Hugh K. Penney, Benefits Administrator, Shaw Supermarkets, Lynnfield, Mass.
The Rev. David R. Ruhe, Plymouth Congregational UCC, Des Moines, Iowa
The Rev. John H. Thomas, UCC General Minister and President
The Rev. Kenneth L. Ulmer, Connecticut Conference, Associate Conference Minister