West Ohio Conference Health Insurance... What can we do?

In the West Ohio Conference of the United Methodist Church a pastor who is in a full time appointment is to be enrolled in the West Ohio Conference healthcare plan, paid for by the local church and provided through Medical Mutual of Ohio.  The cost to local congregation is approximately 18k (corrected) per year for a family my size, with the family also contributing a portion of the premium as a payroll deduction.  Overall the cost of this policy probably lands somewhere around 19.6k per year.

The reason for the exorbitant cost is the quantity of ‘uninsurable’  or difficult to insure members within this plan.  Given the general health of the group being insured the cost is understandable.  I am certain that within our conference the leadership has done everything within their scope of ability to negotiate with Medical Mutual of Ohio the best possible heath care package for the clergy of our conference.  I doubt that anyone would accuse them of foul play, or a lack of due diligence.  These leaders face a serious dilemma regarding making health care both available and affordable to all full time Methodist clergy in West Ohio.  This post is no way taking a stab at the praiseworthy efforts of those individuals.

The cost of this health care hinges on the more easily insurable members staying in the program.  If the young clergy, and clergy without any pre-existing conditions were to opt out of this plan, the overall cost for the rest of the aging clergy and clergy with pre-existing conditions would sky rocket.  If the ‘insurable’ clergy opt out, the churches with ‘uninsurable’ clergy would long for the days when insurance was a mere $19.6k a year.
With these realities before them, the Conference set in place a rule that if a pastor in a full time appointment decides to opt out of the West Ohio Conference’s health care plan that pastor will never, under any circumstance, be allowed to opt back into the plan.  This of course is a very real threat, and it is a threat that the Conference needed to make in order to keep costs manageable for local congregations.  (It is debatable if $20k per year is manageable).

So that is the background, but what is an insurable young clergy person to do with this?  Healthy insurable clergy placed in the middle of a rock and hard place.

Currently I get my insurance privately and the local church I serve reimburses my premiums (I am a licensed local pastor in full time appointment).  My current insurance is much more comprehensive than the Conference plan, and is over $10k per year cheaper than the conference plan.  The question is should I opt out of the WOC plan and free $10k per year of my church’s budget for ministry, or should I opt into the WOC plan to the tune of an extra $10k per year of expense to my church so that uninsurable clergy can still retain their insurance?  (Note this is all while my wife still retains maternity coverage, at some point we will no longer need that coverage which accounts for 40% of our premium.)

Whether or not to remain in is a valid question.  If, and I know it is a big ‘if’, I stay healthy and insurable, over the next 30 years I will save the local congregations I serve at least $300k.  I also will personally save money, and on top of that have better healthcare.  With those numbers before me it seems a worthy risk.  However, is it unjust to opt out knowing that it will increase the burden on churches that are served by uninsurable pastors?

Of course there is the threat of never being allowed back in the WOC plan if one opts out, but every year the WOC plan becomes less and less desirable anyway, and with the aging body of clergy it is not showing any signs of getting better.  In other words, will there ever really be a reason that I would want to re-enroll in that plan?  Moreover the nature and laws surrounding health care are in such flux right now that the odds of the current rules and healthcare laws still being in place 30 years from now are slim to none.   In light of these realities, the threat of never being allowed back in the WOC plan really is not all that threatening.  Again, the only issue at stake here is the issue of justice.  If you take that out of the equation it is a no brainer and every healthy pastor should find it to be a relatively easy decision to opt out of the WOC plan, and save their churches 10s of thousands of dollars for ministry every year.

I do not dare to call for a mass exodus from the plan, but something needs to be done to make this whole thing more equitable.  If I were to enroll in the WOC plan, my church is effectively getting stuck with an  $10k per year apportionment and the only reason they would pay that money is for the strengthening of the connection by providing all clergy with equal benefits.  The local church gains nothing by this other than piece of mind.  To call this $10k anything other than an apportionment is a mistake, because that is exactly what it is.

If we want this system to be fair, at the very least a portion (preferably the entirety) of the difference of cost between self-insurance and WOC group insurance should be deducted from the local church’s yearly conference apportionments.  (I can hear a collective cringe from conference leadership at this thought.)  Certainly that would make people at the conference offices a little bit nervous, but what else can be done?  The bottom line is that if healthy clergy take the time to look at this plan and look at the future of health care they will come to the same conclusions I am, and they will withdraw from the plan altogether.   If that occurs there is a real mess on everyone’s hands.  At least by giving churches with healthy pastors a significant break on their apportionments, the pastors could still consider it prudent to remain within the conference plan, because ultimately the local church loses nothing by staying enrolled.

Again, I don’t presume to have all the answers on this, and I know that my solution of reduced apportionments doesn’t solve the whole issue, BUT it might keep our young healthy clergy from making the obvious decision to opt out.  The bottom line is that no matter how you cut it, whether you reduce apportionments, or whether pastors start opting out, the churches that are served by uninsurable pastors are going to get short end of the stick.  On the flipside, for the last so many years the churches have been served by insurable pastors are the ones who got the short end.

I am very interested in thoughts of other West Ohio friends surrounding this.  Charge conferences are only 4 or 5 short months away, and at that point we are going to have to nail our colors to the wall one way or another.  Do I stick the church with a $10k bill and commit to the good of uninsurable pastors, or do I self-insure and commit to the good of the community of Delta?

I know this post was outside of the scope of what we normally do here at The Tenth Letter…, and I apologize for taking the time of non-West Ohio Conference pastors and parishioners who may have trudged through this, but this is my only real public venue to air this, so this is where the post had to land.

Update: June 20, 2012
The total cost for insuring my family through the WOC plan is $19.6k with $1.5k being the clergy's responsibility.  The church is responsible for about $18k.  (I corrected those numbers up top since the original posting)

It is important to note that the conference has included an HSA contribution within the scope of this plan which is an important upside to the plan. (Again I still maintain they are doing their best with what they have to work with), but the plan has a deductible much higher than the personal plans healthy clergy can obtain.

Finally, I want to express appreciation for the Conference Treasurer for directly contacting me in response to this blog.


babl_darryl said...


Here are some initial thoughts from one who is "uninsurable". You have identified the key issue in providing health care for our Annual Conference and the nation. It is all about the pool.

In the short run, you will save your congregation money, but you will be forcing other congregations to spend more on health care. Over all, I estimate that the cost to the other churches would be more than the savings to the congregations who have a temporary savings. So, your actions while saving your family and one congregation money in the short term, would require other local churches (not the annual conference) to spend more on health insurance.

Second, when a new pastor is appointed to your congregation, they will likely get an "uninsurable" pastor - so their costs will now be greater. Most likely, they will have a pastor who stays in the plan and whatever savings they had, will be lost as they have to pay for more expensive coverage.

If you are moved, you will likely go to a church that has been served by an "uninsurable" pastor. So while you have been saving your family money, this congregation has been paying more in health coverage. When you take leadership, they will not be as fruitful as they could have been over that period because additional resources had to paid for more expense health insurance rather than ministry. Heck, they may have a smaller salary package and low and behold, your family will lose money.

Finally, you are not going to be young and healthy for ever, you will age and diminish. You will likely acquire a disability. At some point, you will be "uninsurable" or you may have a child who is uninsurable and then the equation will be entirely different. You will be looking for an insurance pool that will include you. At that point, you will be costing congregations more to insure . . . It will be more expensive for your family . . .

I think those are the key points that you haven't considered in your analysis.

I think it is ultimately a question of responsibility. Are we responsible to balance what is right for our family and for the community as a whole? It seems the Biblical answer from Gen 4 on - is yes. Being responsible means balancing individual interests with the interests of the community.

Jay D. Miklovic said...

Thanks for your comment babl_daryl. The points you have made were all taken into consideration in the writing of the post, they really were.

The question is whether or not our primary obligation is to the connection, or to the local congregations we serve. There should not be a dichotomy there, but there is, and that is what this post is pointing out. As you said, congregations that are served by the 'uninsurable' are going to be less fruitful because of the increased cost to their healthcare. On the other hand the local congregations that are currently served by people who could get insurance cheaper are forced to be less fruitful than they could be.

Where do you think Wesely would have fallen on this? Would he have wanted his circuit riders and the circuits they rode to be investing their resources in this manner, or would have he taken an approach that was more concerned with putting resources into work in the community as opposed to maintaining the benefits of his riders? It is a legit question, and I think we know the answer to it. (Granted it is obvious that he lived in a different world than we do, but the principles still fit.)

I do not want to throw the uninsurable under the bus, I really don't. At the same time I don't want to throw my church under the bus to pay for the uninsurable, especially in the light of the ever changing reality of health insurance.

There must be a better way to keep the insurable in the program than to threaten them with life time rejection from it. I still contend that if you made the difference up in apportionments you could keep everyone in the program. Yes the uninsurable would still cost their church more, but it would stop the ever increasing gap between the cost of WOC health insurance vs private health insurance.

Finally, I have talked to a lot of people about this. The current threats don't seem to be stopping young insurable clergy from thinking along the same lines that I am. The threat needs to be revisited because it is not going to work.

As far as the biblical answer from Gen 4 onward... I think I am more apt to serve the stranger among us with the resources saved in health insurance and health care expenses. I have 10k a year freed up for the widows and orphans... or I can work instead to simply save money and hoard benefits for those already in the church. You can spin that one both ways.

I understand your plight... and that is why I prefer coming up with an answer that will actually work... the current proposed answer will not (whether it should or shouldn't is beside the point, the fact is that it won't.)