Medical continuation

How it works

If your medical coverage through the Board of Pensions is ending, enrolling in medical continuation coverage enables you to keep the same coverage you have now — PPO,* EPO, or HDHP — but on a self-paid basis and for a limited time.

You may be eligible to enroll in medical continuation coverage if you are

• a member who is terminating employment or whose hours are reduced resulting in a loss of eligibility for coverage;
• a seminary student or an individual on transitional participation status who is terminating from the Benefits Plan;
• a disabled member whose disability status is ending;
• a member who is retiring before age 65;
• a covered child who is reaching age 26; or
• a surviving or former spouse.

*If enrolled in medical continuation coverage under the PPO, your deductible(s) and medical out-of-pocket maximum are based on the salary range of $58,270 to $63,024.

Early retirement

If you are under age 65 and retire on or after January 1, 2024, you may enroll in medical continuation coverage and maintain this coverage until age 65, if you wish. Once you are eligible for Medicare and are enrolled in Medicare Parts A and B, you will be eligible to enroll in the Humana Group Medicare Advantage PPO plan.

You may have other options, including any plan on the federal Health Insurance Marketplace or a state’s health insurance exchange, for healthcare coverage before you become eligible for Medicare. Your state may offer assistance through the State Health Insurance Program (SHIP) to help you find Medigap plans or other Medicare Advantage plans. You may also contact Via Benefits for assistance with finding other healthcare coverage.

Duration of coverage

How long you may continue coverage depends on why your current medical coverage is ending, as shown on the Medical continuation eligibility and duration chart. Typically, medical continuation coverage for terminated members lasts up to 18 months. Children who lose their eligibility at age 26 (or later, if disabled) may elect medical continuation coverage for up to 36 months.

If you are a pastor or graduated seminary student on transitional participation status, you may continue medical benefits for an additional 18 months after you reach your maximum eligibility for transitional participation coverage by enrolling in medical continuation coverage. If you enroll in medical continuation coverage first, you will not be eligible for transitional participation coverage.

Cost

The cost for medical continuation coverage starts on the day the coverage becomes effective. Monthly rates for medical continuation coverage are as follows:

2024 Monthly Costs

2025 Monthly Costs

How to enroll

You must enroll for medical continuation coverage within 60 days of the event that caused your coverage to end. If you do not enroll when you are first eligible, you will not be able to enroll later. You must enroll in the same option (PPO, EPO, or HDHP) and coverage level (Member-only, Member + Spouse, Member + Child(ren), or Member + Family) for medical continuation coverage that you had while working for the Presbyterian Church (U.S.A.) or an affiliated employer.

To enroll, return the completed personal information, subscription, and authorization sections of the Medical Continuation Enrollment or Waiver form to the Board, with the initial payment, within 60 days of the event that resulted in termination of your coverage under the Medical Plan. Your continuation coverage begins immediately following any applicable coverage period in which coverage is provided at no cost to you.

Your covered spouse and children may enroll in medical continuation coverage, even if you do not.

Canceling coverage

You may cancel your medical continuation coverage by emailing a cancellation request in advance of the termination date to memberservices@pensions.org. The Board must receive your request at least one month in advance of the date you want the coverage to end.

Important: If you cancel your medical continuation coverage, you cannot reinstate it.