Medical Plan
The Medical Plan offers employers the choice of three coverage options (PPO, EPO, and HDHP) — all of which deliver outstanding value to you and your employees and include high-value features that promote wholeness and well-being.
Three additional Medical Plan options — a new PPO, EPO, and HDHP — will be available effective Jan. 1, 2027, for a total of six options. Read more about these options:
Quantum Health provides personalized support to members
Care navigation is available to members enrolled in the PPO, EPO, and HDHP as part of their medical benefits. When these employees have a question about medical benefits, Quantum Health's Care Coordinators are just a call, click, or tap away.
Flexibility, affordability, and choice
The Medical Plan offers flexibility and affordability to employers with the choice of three coverage options:
- preferred provider organization (PPO)
- exclusive provider organization (EPO)
- high deductible health plan (HDHP)
Each option delivers high-quality coverage and outstanding value, with features not readily found on the commercial market.
The Board of Pensions partners with Highmark Blue Cross Blue Shield for network and claims administration. Employees enrolled in the Medical Plan have access to the Blue Cross Blue Shield national network of physicians, hospitals, and other healthcare providers.
Commitment to wholeness and well-being
All three medical options include unique features that deliver outstanding value in promoting wholeness and well-being, such as:
- generous preventive care benefits
- enhanced benefits for select preventive prescription drugs
- fully integrated, comprehensive mental well-being benefits, including an Employee Assistance Plan
- care navigation for personalized support navigating today's complicated healthcare system
- telemedicine services through Teladoc Health
- a diabetes management program through Teladoc Health
- Call to Health well-being program
Read more about these features.
Return on value and pricing stability
As a nonprofit organization, the Board of Pensions is able to pass along greater value per dollar to our participating employers than can be found commercially. Backed by strong operating reserves, we have demonstrated significant year-over-year pricing stability for employers. Additionally, our high-cost claims fund insulates employers from risk.
The Board of Pensions is a leader in the Church Benefits Association and contracts for all medical coverage as part of the association's purchasing coalition, which includes dozens of other denominations. Having such power in numbers — nearly 200,000 faith communities — results in the ability to negotiate lower administrative costs and highly favorable contract terms. We pass along any savings we receive to our employers.
Community nature
As a reflection of the community nature that underlies the Benefits Plan of the Presbyterian Church (U.S.A.), the Medical Plan is designed to promote shared responsibility for healthcare costs — gains and losses are shared across the total population of employers participating in the Medical Plan in the form of standard rates, adjusted for age and regional cost factors. In the PPO option, deductibles and medical coinsurance out-of-pocket maximums are income-sensitive, so members with the greatest resources help support those with the least.
A culture and tradition of service
Our in-house customer service team is staffed by highly trained representatives who provide caring, thoughtful guidance to employers and plan members. Read more about the administrative resources and personalized service support we provide.
Cost
Employers may offer either the PPO, the EPO, or the HDHP; any two options; or all three.
Employees elect coverage in levels:
- Member-only
- Member + Spouse
- Member + Child(ren)
- Member + Family
As the employer, you must contribute at least 50% of the cost of Member-only coverage in the lowest-cost option offered — regardless of which option or coverage level the employee elects.
Employees may be required to pay:
- the balance of the cost for Member-only coverage, and/or
- up to 100% of the incremental cost of coverage for their eligible family members
Medical coverage costs are based on claims experience adjusted for regional and demographic factors.
Questions about the Medical Plan?
Employers who currently offer benefits through the Board of Pensions can call 800-PRESPLAN (800-773-7752) (TTY: 711) to speak with an Employer Services representative. They can answer questions about benefits and offer support on administering benefits through Benefits Connect.
PC(USA) employers and congregations are encouraged to reach out to their Church Consultant to help determine which dues package is right for their situation, understand available benefits for staff and how to structure them, and guide faithful benefits decision-making.
Interested in offering benefits for the first time?
PC(USA)-affiliated employers who do not currently offer benefits through the Board can contact our sales consultants. They can help build a benefits experience for organizations so their employees can thrive.
About Highmark Blue Cross Blue Shield
Highmark Blue Cross Blue Shield is a national, diversified healthcare partner that serves members across the United States. The company is among the largest health insurers in the United States.