Clergy Health Insurance Plan

The Serbian Orthodox Dioceses in the United States of America
Health and Life Insurance Plan

 

Father Milovan Katanic is the Heath Care Administrator for the SOC Central Council's Clergy Health Coverage Plans. The information provided on this page is only basic plan coverage information.

As of January 1, 2008, we are part of the Orthodox HealthPlan network!*


The Orthodox HealthPlan provides benefits for the clergy and lay employees of:

The Serbian Orthodox Church of the United States
The Greek Orthodox Archdiocese of America
The Antiochian Orthodox Christian Archdiocese
The Orthodox Church in America
The Diocese of The Armenian Church

By joining this large group we are able to secure equal or greater benefits than our previous plan, with lower, more stable premiums.


Medical and Dental Benefits are provided by Aetna, Inc. Both the Medical and Dental Plan coverages are PPOs (Preferred Provider Organizations), allowing members to use any provider of their choice, with higher reimbursement for using providers who are members of the appropriate networks.


Both the Medical Network and Dental networks are Aetna Networks. The Retiree Medical Plan benefits are provided by Monumental General for Medical coverage and Express Scripts for prescription drugs. Retiree medical coverage is only available to those age 65 and older with Medicare as their primary coverage.


*This new coverage information applies to only those members who participate in all three of our Health Care Plans (Medical, Vision and Dental.) Members who enrolled to our previous stand-alone Vision and Dental plans prior to 2008 still belong to DCSC Vision and MetLife Dental, respectively.


ENROLLMENT is open to all clergy and (at least half-time) employees of any Serbian Orthodox Church in America, within our five dioceses. Under the Church Constitution, parishes are required to provide healthcare to their priests and their dependants with the plans selected by the Central Council, or plans with equal or better coverages. A major advantage our plans is that they accept pre-existing conditions, with no waiting periods, in most cases.

Enrollment and other general administration questions should be directed to Fr. Milovan. Payment and premium questions should be directed to Central Church Council Treasurer, Jim Springborn.

PREMIUMS with the new plan are now the same for all participants and no longer based on zip code. The monthly premium for a single person is $1365.50 and $2395 for a family.


If you are interested in joining any of the Clergy Health Care Plans, please contact Fr. Milovan to provide you with and the appropriate application form(s). The more members we have in the group, the more affordable the coverage stays for all members.


In order to keep monthly premiums as low as possible, we have selected a plan that includes a deductible and coinsurance. If you are not familiar with these terms, here is a brief explanation.

  • Coinsurance refers to a sharing of costs between the member and the insurance company.

  • A deductible is a pre-determined dollar amount that is the responsibility of the member. The insurance company’s responsibility begins after the member pays their deductible. The annual member deductible is now only $300 for single coverage and only $600 for family coverage (in-network). It is important to note that most services are covered without being subject to this deductible. The deductible applies to services such as:
    • A hospital admission
    • Outpatient surgery
    • An inpatient stay at a Skilled Nursing Facility
    • Home Health Care
    • Inpatient Hospice Care


Some services are also subject to Coinsurance, meaning that the member is responsible for 10% of charges. However, the maximum out-of-pocket exposure for our members, including the deductible is $3,000 for a member with single coverage and $6,000 for someone with family coverage.


It's important to remember that in a typical year, many people will not utilize any of the services that are subject to the deductible and coinsurance. It is also important to remember that once the full deductible has been paid, there is no further obligation to pay a deductible for that benefit year. Likewise if a member incurs the out-of-pocket maximum, then the plan pays at 100% for any other services that would have been subject to the deductible or coinsurance.

NOTE: STATE REGULATIONS IN NEW YORK AND CALIFORNIA DO NOT PERMIT DEDUCTIBLES FOR IN-NETWORK SERVICES. ALSO, NEW YORK MEMBERS ARE NOT SUBJECT TO INPATIENT COINSURANCE.


Any specific coverage/benefit information should be directed to the Customer Service departments of the pertinent plan listed below.


Our current group health care provider is Aetna and be accessed online at www.aetna.com. Our Plan is the PPO plan. The Summary of Plan Benefits can also be accessed on their website once you register there or by downloading this Member Benefits pdf file.


IN-NETWORK: DOCTOR VISIT COPAYS: $25.00

In addition to web access of your coverage and medical reference materials, included in our plan are the following programs and added benefits:

24-Hour Nurse Line
Informed Health® Line
Discount Programs
Alternative Health Care Discounts
Fitness Discounts
Hearing Discounts
Oral Health Care Discounts
Vision Discounts
Pregnancy/Maternity Management Program*
Pregnancy Risk Survey
Women's Health
Breast Health Survey
Women's Health Asthma
Caring for Asthma
Diabetes
Caring for Diabetes
Heart/Vascular
Caring for Congestive Heart Failure
Caring for Coronary Artery Disease

*(Editor's note: Although this plan offers great pregnancy coverage, pregnant members are encouraged to check with their local state maternity medicaid coverage to help defray hospital stay co-pays and reduce/eliminate out-of-pocket expenses. Most states offer coverage to pay whatever the insurance does not. Family income guidelines apply.)

Dental and Vision Options:

The Clergy Health Plan also offers clergy Vision and Dental alone options. Vision is provided by the Blue Cross/Blue Shield. Dental is provided by MetLife. Please contact Fr. Milovan for rates.

Clergy Life Insurance

Clergy of the Serbian Orthodox Dioceses in the United States of America are entitled to receive Life Insurance through the Serbian National Federation (SNF) at a face value of $15,000 USD.

For an application please contact Fr. Milovan.

Download application here

SEND YOUR APPLICATIONS TO:

SERBIAN NATIONAL FEDERATION
938 Penn Avenue, Fourth Floor
Pittsburgh, PA 15222

Official website of the Serbian Orthodox Church in North, Central & South America.
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