August 10, 2020
2021 Health Rates Reflect Lowest Increase in Seven Years
Portico Benefit Services remains steadfast in its commitment to care for the well-being of those who serve in the ELCA — so they can focus on the important work of serving others. Last week, Portico’s Board of Trustees approved the average baseline health contribution rate increase of 3.5% for all members who receive ELCA health coverage through their organizations in 2021. This is the lowest increase in seven years.
Members who are continuing ELCA-Primary health benefits at their own expense will also have an average baseline health contribution rate increase of 3.5%. Members continuing ELCA Medicare-Primary coverage at their own expense will receive a 7.5% increase, including retired members. Contribution amounts for 2021 remain far lower than those prior to 2019.
Rev. Jeff Thiemann, Portico’s president and CEO, attributes Portico’s ability to keep rate increases consistently low to two factors: “First, we offer an innovative set of benefits designed specifically to help our members shape healthier lives. Second, our members have been spectacularly receptive in their utilization of the programs personalized for their needs. In doing so, they are proactively managing their wellness, which in turn is helping to contain costs for the broader ELCA community.”
Building on Years of Personalized Support and Innovation for Members
“In recent years, Portico has been working to introduce innovative programs and deliver cutting-edge services that meet the unique needs of our members. Collectively, these programs make it easier for our ELCA-Primary health benefits plan members to live healthy, resilient lives across all the dimensions of the Wholeness Wheel,” said Josh Smith, senior director of Products at Portico. “While we knew going into 2020 that adding more online wellness programs was the next step in delivering care to members on their own terms, we never could have guessed how essential it would become during the COVID-19 pandemic. By introducing these programs before the pandemic, support for our members was already in place when online care became the only option.”
Through new health benefits introduced this year, members have been able to self-direct and pursue their individual wellness journey, while saving on out-of-pocket costs. Feedback from members using 98point6 for online visits indicates that they will continue to use the text-based primary care service because of the convenience and cost-saving they have experienced. Many members have also been caring for their mental health through a new online program, Learn to Live, using cognitive behavioral therapy (CBT) to manage stress and depression so they can continue to lead in their communities through the pandemic and beyond. Being, a holistic, faith-based online learning series offers expert-led videos on a wide range of well-being skills, which align with all dimensions of the Wholeness Wheel. Courses help guide members on how to build emotional resiliency, beat burnout alongside ELCA church leaders, take steps to increase their longevity, and manage their financial well-being, among other topics. Both Being and Learn to Live are available to members at no additional cost.
The new programs added in 2020 build on the suite of personalized programs designed to improve overall member wellness. Two programs have continued to help members in need of support to prevent or manage chronic conditions, which helps them avoid serious escalation of these conditions and higher health expenses later on:
- 11,857 pounds have been lost by ELCA-Primary health plan members as of the end of 2020’s second quarter, due to participation in the Omada® program, which helps reduce the risk of developing type 2 diabetes and heart disease.
- 70% of members with diabetes participating in the Livongo® Diabetes Management program have reported improvement in their ability to manage their condition.
Summary of Changes for 2021
ELCA-Primary Health Benefits
- There will be no change to deductibles and a small increase to out-of-pocket limits. For members with Platinum+ or Gold+ coverage, there will be modest changes to prescription drug benefits.
- In response to legislation in the CARES Act, $0 copays apply for text-based primary care visits through 98point6 for all members in 2021.
- With the continuing expansion of personalized and online programs for ELCA-Primary members, there will not be an opportunity to earn wellness dollars in 2021. Any balances remaining in Personal Wellness Accounts or Health Savings Accounts (HSAs) can continue to be used in accordance with the ELCA Health Plan’s provisions.
ELCA Medicare-Primary Health Benefits
- There will be no changes in 2021 to Medicare Advantage hospital and medical benefits deductibles, copays, and out-of-pocket limit for members.
- A routine hearing benefit is being added. Starting in 2021, Humana will cover up to $50 for a routine hearing exam every two years, and up to a $3,000 maximum for all types of hearing aids up to two every three years.
- For members receiving coverage through their employer, there will be modest changes to prescription drug benefits.
- For members continuing health coverage at their own expense, prescription drug benefits for the Premium and Standard options will not change; the Economy option prescription drug benefit will change to be consistent with Medicare’s standard 2021 Part D benefit.
Details for 2021 ELCA-Primary and ELCA Medicare-Primary benefits will be available on myPortico during annual enrollment in the fall.