LCMS Convention Workbook St. Louis, Missouri — 1998, Page 94

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94 SYNODICAL REPORTS

* Changed the invoice billing cycle to monthly instead of quar-
terly.

¢ Provided option to extend health coverage for up to six months
for children who are no longer eligible dependents.

* Implemented a Vision Plan in July of 1997 to help with cost of
routine eye exams, eye glasses, and contact lenses.

* Introduced new hearing program to help Concordia Health Plan
members with cost of exam and hearing aids.

* Changed Concordia Health Plan benefits on 1/1/98 to conform
with various new laws, adjust to new forms of treatment and
technology, and deal with increasing medical and dental costs.
As aresult, the following changes were made:

Dental

* Increase annual benefit maximum to $1500 from $1000

* Increase lifetime orthodontic maximum to $1500 from $1000
* Pay preventive at 100 percent instead of 80 percent

* Increase reasonable and customary reimbursement from $5th
to 90th percentile

Medical-Indemnity
¢ Increase individual annual preventive benefit to $100 from $75

¢ Reimburse preventive care at 100 percent instead of 50 per-
cent »

Eliminate family annual maximum preventive benefit

¢ Increase annual deductible from $250/$500 to $300/$600 (last
increased in 1989)

* Increase reasonable and customary reimbursement from 85th
to 90th percentile

¢ Set annual benefit limit on chiropractic of $750

Medical-Managed Care

* Increase doctor visit copays to $15 from $10

* Set annual benefit limit on chiropractic of $750, no Primary
Care Physician referral needed

Prescription Drugs

¢ Increase mail-order brand-name copay to $20 from $12 for 90-
day supply

* Increase mail-order generic copay to $7 from $5 for 90-day
supply

* Change definition of short-term to 30 days or less

Mental Health and Substance Abuse
¢ Raise lifetime maximum reimbursement to $1,000,000 from
$100,000

* Establish a 60-day lifetime limit on inpatient treatment for sub-
stance abuse, and a 60-day annual limit on inpatient treatment
for mental health

Medicare

* On Part B expenses, pay 100 percent instead of 80 percent of
Medicare-approved charges not paid by Medicare

« No payment for charges above the Medicare-approved amount

Continued to send each member the quarterly newsletter “Bet-
ter Health,” which provides ongoing helpful information about
maintaining physical, mental, emotional, attitudinal, and spiri-
tual health. :

¢ Expanded communication efforts to assure that members and
employer representatives are well informed about their bene-
fits. This included appointing a director of communications
and establishing a communications division.

* Implemented a new computer system for processing member-
ship, billing, and claim payment transactions, which included a

new imaging system for internal filing and routing of all docu-
ments.

¢ Streamlined how we do our work and revamped the organiza-
tional structure to eliminate layers of management so that staff
can operate more efficiently.

Since all specific changes in the Worker Benefit Plans are.com-
municated to all participating members and employers, and all the
financial activities are distributed annually, only a brief summary
about each program is presented here.

Concordia Health Plan

The Concordia Health Plan is a comprehensive major medical
and dental plan.

Approximately 11,000 members participate in the managed-
care medical program. Prudential is the main administrator of this
program, covering 48 locations nationwide. Other network admin-
istrators include CIGNA, Blue Cross and Blue Shield of Min-
nesota, Humana, and SelectCare. In a managed care program, ben-
efits at a higher level are provided if network providers are used. If
the member opts to use nonnetwork providers, lower benefits (and
a deductible) are applicable.

Members of the Concordia Health Plan who are in areas where
managed care has not been implemented continue to participate in
the traditional indemnity plan. After satisfying a required calendar-
year deductible, the plan pays a major portion of the medical costs
incurred by the members and their enrolled dependents.

The managed mental health and substance abuse benefits are
administered by Value Behavioral Health, utilizing their network
of providers.

The prescription drug benefits are administered by Caremark
Prescription Services. Members purchase short-term medications
at their local pharmacy and are encouraged to use the Caremark
mail-order service for purchase of long-term medications.

The dental benefits of the Concordia Health Plan are adminis-
tered by the Worker Benefit Plans department.

Retirees and surviving spouses age 65 and older can purchase
Medicare supplemental coverage through the Concordia Health
Plan.

Coverage is currently provided for 21,975 members and their
29,600 dependents, a total of 51,575 individuals. Of the 21,975
members, 80 percent are full-time workers participating through
5.760 congregations, schools, and agencies, and the remaining
members are retired, disabled, or on leave of absence.

The number of enrolled members has increased over the past
three years by approximately 13.6 percent.

The benefits paid by the plan for the past three years are shown
below:

1997 1996 1995

Benefits Paid $68, 130,000 $69,620,000 $60,260,000

Concordia Retirement Pian

The purpose of the Concordia Retirement Plan is to provide a
pension benefit upon retirement at age 65. However, there are pro-
visions for a benefit to begin as early as age 55. Members become
vested and earn a right to a benefit after five years of participation
in the plan. Death benefits (lump-sum and/or monthly survivor in-
come) are available to an enrolled spouse upon death of a retired
member or a vested member (whether active or terminated). Also,
the plan provides a lump-sum benefit upon the death of an enrolled
dependent of a retired member.

There are 26,780 members enrolled through 5,950 congrega-
tions, schools and agencies of the Synod.

During the last three years, benefits provided by the Plans were -
as follows:

Benefits Paid 1997 1996 1995
Retirement Income $38,000,000 $32,300,000 $28,500,000
Death Benefits $ 5,100,000 $ 4,300,000 3,800,000

The number of individuals currently receiving benefits is 8,700.