Portico Announces 2017 Rates, Cost-Saving Way to Deliver Health Benefits

Aug. 07, 2016

At its Aug. 4 – 5 meeting in Minneapolis, Portico Benefit Services’ board of trustees voted to approve Portico’s recommended 2017 contribution rates as well as innovative changes designed to limit the growth of health care cost increases.

As the next step in the ELCA wellness reformation, Portico is introducing a new way to deliver health benefits. Starting in 2017, ELCA-Primary plan members will have access to care coordinators who can help them use their health benefits with an eye to both quality and cost.

Thanks to the anticipated savings from this approach, a renegotiated prescription drug contract, and the decision to build the 1% discount into this year’s rate, Portico was able to recommend the lowest ELCA-Primary baseline health contribution rate increase in four years. This preserves current ELCA-Primary deductibles, out-of-pocket levels, and wellness dollars for 2017.

2017: Lowest ELCA-Primary health contribution increase in 4 years.

A New Approach to Providing Health Care

In 2017, all ELCA-Primary plan members (Bronze+, Silver+, Gold+, Platinum+) will have one place to call for help managing their medical and pharmacy needs. One phone number connects them to Portico Care Coordinators by Quantum Health, a team of nurses and benefit specialists representing the next evolution in benefit support. In addition to answering questions and resolving claim issues, they can offer real-time guidance, help members manage their medical conditions, and identify highly-rated, cost-effective health care providers.

“Whether you use health care once a year or once a week, Care Coordinators can help make it an easier experience,” says Cathy Broady, Portico’s Health Services Manager. “Let’s say you only see a doctor for your annual check-up, but one day you injure your back working in the garden. With one call to the Care Coordinators, you can talk with a nurse about treatment options and find a provider in the network. If you need medical imaging, Care Coordinators can help you find the best quality and lowest cost facility, and even schedule the appointment for you.”

This service is especially valuable for plan members with complex health care needs like heart disease, cancer, and musculoskeletal conditions who typically face an overwhelming maze of providers, treatment options, and bills. “Anyone living with a serious health condition knows how isolating it can be,” says Broady, who’s served ELCA health plan members for more than 15 years. “I think our members will take great comfort in having someone by their side to point them in the right direction and be a strong advocate on their behalf.” Because a person requiring complex care can easily incur upwards of $75,000 a year in claims, Portico expects care coordinator assistance to help drive down costs while providing better support for members who need care.

New Health Care Administrator, Same Network

To support this new approach to delivering benefits, Portico is transferring the medical and mental health claims administrator role to Blue Cross and Blue Shield of Minnesota’s wholly-owned third-party administrator, BlueLink TPA. BlueLink will process claims and continue to offer the same Blue Cross preferred provider (PPO) network — no need to change doctors. BlueLink will also provide the Employee Assistance Program and fitness center discount offered today.

Portico is committed to finding ways to keep the cost of health care coverage affordable for ELCA congregations. Medical and prescription drug costs continue to rise across the country, with the average U.S. employer’s health plan costs climbing 100% since 2007. While the ELCA faces the additional challenges of an older membership, Portico President, the Rev. Jeff Thiemann, credits wellness and administrative efficiency for helping hold ELCA rates to a compound 64% increase over the same 10-year period.*

2017 Contribution Changes
Sponsoring Employers
Estimate 2017 costs using the Custom Comparison Report and spreadsheet available on EmployerLink.
  • Health care contributions will increase by 5% across all four options (Platinum+, Gold+, Silver+, and Bronze+) and for sponsored members receiving ELCA Medicare-Primary health benefits.
    Note: Contributions also increase by about 2% each year as plan members age. They also increase if a member’s defined compensation increases.
  • The 1% discount for employers tied to health assessment participation has been built directly into the contribution rate. Because 100% of eligible employers successfully earned the health contribution discount in 2015 and 2016, we believe health assessment participation has become an established annual wellness step.
  • Disability plan contributions will decrease from 3.5% to 3.0% of defined compensation.
  • Rates for basic group life insurance, retiree support, and minimum required retirement contributions will remain the same.
Members Continuing ELCA-Primary Coverage
  • ELCA-Primary health contribution rates will increase by 5%.
  • They will also increase by about 2% each year as plan members age.
Members Continuing ELCA Medicare-Primary Coverage
  • ELCA Medicare-Primary health contribution rates will increase by 7.5%, driven primarily by prescription drug costs. Monthly contributions will increase from $385 to $414 per month for the Premium option, $340 to $365 per month for Standard, and $326 to $350 per month for Economy.
  • Members who choose the Standard option will have a new $50,000 lifetime maximum on coverage received outside the United States beginning Jan. 1, 2017.
  • All other ELCA Medicare-Primary health benefits, deductibles, out-of-pocket costs, and prescription drug co-payments will remain the same.

*During the 10-year period from 2007 — 2016, ELCA health contribution rates grew by a compound increase of 63.8% compared to a national average of 99.6%. National average is based on large employers’ health care trend before plan and contribution changes as reported in the 2016 Willis Towers Watson Emerging Trends in Health Care Survey.

About Portico Benefit Services
Portico Benefit Services provides health, retirement, disability, and survivor benefits and related services for approximately 50,000 active and retired ELCA pastors, rostered laypersons, lay employees, and their families.