FREQUENTLY ASKED QUESTIONS
Does my organization need to become a Missio Nexus member in order to join the Missio Benefits program and if so, is there a fee?
Missio Benefits is the group health plan offered through Missio Nexus – the largest association of Great Commission organizations in North America. As such all organizations within Missio Benefits need to be members of Missio Nexus. Missio Nexus membership dues are paid/recur annually. For more information about membership fees please email firstname.lastname@example.org
Is Missio Benefits based on biblical values?
Missio Benefits is unapologetically grounded on traditional biblical values. As such we embrace a comprehensive pro-life plan design and hold to a biblical definition of marriage and gender. By joining Missio Benefits you also become part of a missional community dedicated to seeing the Gosple of Jesus Christ spread throughout the world.
Is Missio Benefits a healthcare sharing program?
No. Missio Benefits is actual insurance and is structured as a partially self-funded Association Health Plan. Creating meaningful solutions in the health & welfare space means challenging and redefining traditional market constructs. God has called Missio Benefits to combine biblical values with a traditional group insurance contract that stands up to the very best contracts the U.S. group insurance industry has to offer.
What organizations are eligible to join Missio Benefits?
Missio Benefits is available to every Christian employer in America that agrees with Missio Nexus’ Statement of Faith and is involved in the Great Commission. Through unity Missio Benefits effectively transforms the Body of Christ into one of the largest single employer groups in the world.
How does each member organization attest that they will participate in the association’s plan? Is there a contract we would have to sign? A well-defined process has been developed for organizations interested in joining the program. This process begins with our comprehensive website which houses information about every component of the program. Once you are ready to join, or have specific questions you would like our team to answer, simply click on one of the “JOIN NOW!” buttons throughout the website. This will direct you to our client management system where you can either ask for someone to contact you OR formally request entry into Missio Benefits by telling us about your organization, indicating which plans you would like to offer and other preferences your organizations has to customize the Missio Benefits platform to your specific needs. Once you complete this step our team will reach out to answer your questions OR, should your organization be approved for entry, reach out to welcome you into the Missio Benefits program and introduce you to our implementation team leaders for start the implementation process for your approved effective date.
What is Missio Nexus’ administrative responsibility?
Our selected TPA partners carry the lion’s share of administrative responsibility, but Missio Nexus does connect regularly with the plans partners in order to provide sufficient oversight of the program. Missio Nexus is also involved in promoting the program, encouraging members to submit needed information, and answering general member inquiries related to the program. Missio Nexus has also formed a seven member Benefits Committee from amongst participating organizations that ultimately is responsible for plan governance.
What is Enterprise Risk Strategies’ (ERS) role?
ERS is Missio Nexus’ consulting partner and has been working collaboratively with Missio Nexus over the past several years to get the Missio Benefits program to where it is today. They are responsible for overall plan management, vendor management, actuarial analysis, data analysis/reporting, renewal management and overall plan strategy in collaboration with Missio Nexus.
How is the plan governed?
Missio Nexus leadership has established a Health and Welfare Benefits Committee for this program. The committee is comprised seven HR/Benefit professionals and/or executive leadership from organizations actively participating in the Missio Benefits program. These individuals work together to enhance the ability of all participating organizations to procure competitive, objective and transparent employee benefits programs that exemplify quality, stewardship, integrity and unity. Committee members serve a minimum two-year term and govern the program to insure the best interest of the Missio Benefits family are always represented in the plans that Missio Benefits offers. Click HERE to see a copy of the Benefits Committee charter.
What is PlanSource’s role?
PlanSource is serving as both our benefits administration solution, benefits outsourcing/call-center partner and consolidated billing TPA. PlanSource administers premium payments, manages the Missio Benefits call center for members, and provides the technology solution that members use for enrollment and managing the plan within their organization (gathering information from employees, setting up contributions, etc.).
What is Cigna’s role?
Cigna serves as both the domestic and global Medical, Rx and Dental TPA and provides stop-loss coverage for claims that exceed our individual stop-loss threshold. Cigna also serves as the TPA on our global vision program.
What is VSP’s role?
VSP serves as the domestic vision coverage provider.
What is Unum’s role?
Unum serves as our ancillary benefits provider with products such Life, Voluntary Life, Short- & Long-Term Disability coverage and Accident coverage on both a domestic and global basis.
What is HCMS’s role?
HCMS provides and manages our integrated data warehouse from which our advanced analytic tools are derived. They also develop the predictive risk index scores that we use to provide targeted resources to our high-risk members through their clinical team.
What is the role of insurance brokers or consultants?
Members may choose to retain the services of a healthcare broker or consultant. These organizations can serve as “boots on the ground” for direct communication or as a liaison between member and program. Much of what brokers typically do will be handled through the Missio Benefits platform. There are no commissions, rather compensation is structured as a consulting fee of $7 PEPM based on employees enrolled in one of our healthcare programs.
Missio Benefits is not responsible for any misrepresentations of our plans, services, structure and/or administrative process tied to a third-party organization you may choose to work with. Additionally, it is your organizations responsibility to insure that any broker or consultant you choose to work with maintains appropriate life and health insurance licensing as well as appropriate E&O coverage.
Is there a minimum participation requirement to join the Missio Benefits program?
While Missio Benefits accepts all groups – regardless of size – we do have participation requirements that must be followed. Groups of 1 or 2 employees must have 100% healthcare participation amongst benefit eligible employees. Groups of 3+ employees must have at least 50% healthcare participation amongst benefit eligible employees after valid waivers.
What happens to my deposit if I leave the program?
The deposit requirement is non-refundable and used towards paying run-out claims should a group leave the program after 24 months of coverage. Click HERE for a copy of the deposit form. Should a group leave within the first 24 months, the group is liable for their terminal liability (claim run-out) exposure.
Does our organization have to offer both the domestic and global healthcare programs to our employees or can we just participate in one?
Participating organizations have the choice to offer our program to both domestic and global staff OR only global staff. We do not allow an organization to only offer our program to their domestic staff.
Can our organization offer other benefit programs alongside the Missio Benefits program?
Participating organizations are not able to offer alternative (competing) benefit programs alongside the Missio Benefits program. That said, we do allow a life and disability exception for organizations that offer retiree life benefits given our program does not provide retiree coverage. As such, if you currently offer retiree life benefits we will allow your organization to “opt-out” of Missio’s life and disability program. Organizations that choose to opt-out and provide an external life and disability program will be responsible for administering these programs on their own as they will not be reflected in the Missio Benefits administration system.
Will Missio Benefits allow deductible carryover from our current healthcare program?
No, we do not administer/allow deductible carryover into the Missio Benefits program.
What is the renewal date of Missio Benefits?
The renewal date is July 1
Are deductibles based on a policy plan year (July 1) or calendar year (January 1)?
Deductibles are based on a policy plan year, July 1 -June 30
When do deductibles and out-of-pocket maximums reset?
July 1, corresponding with the plan renewal.
What are the fixed costs within the medical plans?
Fixed costs include: Third-Party Administrator (TPA) fees, centralized billing, benefit administration, marketing fund, data warehouse/analytics, stop-loss coverage, travel risk management and consulting fees.
Is there COBRA takeover?
No. There is no Cobra takeover with the Missio Benefits program. This means any current Cobra participants you currently have cannot roll into Missio Benefits.
Is there COBRA continuation coverage through Missio Benefits?
Yes – any actively enrolled members covered only on the domestic medical, domestic dental, or domestic vision plan effective July 1, 2019 and beyond are able to continue coverage. There is no COBRA coverage through the global plans.
Are there any pre-existing condition limitations in the Medical/Rx program?
No. There are no pre-existing condition limitations in the Missio Benefits Medical/Rx program.
Are there any annual benefit limitations in the Medical/Rx program?
No. The Missio Benefits Medical/Rx program has an unlimited annual benefit maximum.
No. Following the biblical model of marriage the employee and spouse must be legally married and of the opposite sex.
How do we handle the transition of our current HSA or FSA accounts and account values to Missio Benefits?
The plan for transition of current HSA and FSA accounts and values is coordinated during the implementation process. The process will depend on what can be supported by your current HSA/FSA administrator.
HSAs – Employees typically have to complete an HSA transfer form that they send to their prior HSA custodian, initiating a transfer for their HSA funds to their Missio Benefits HSA. The transfer form they need to complete depends on who your current HSA administrator is and we will discuss that during the implementation process. If a group is large enough (over 100 to 200 employees) there may be an option to perform a bulk transfer of accounts and that process can be discussed during implementation if it is an option.
FSAs – The prior FSA administrator will either continue to pay out claims for the plan year they were administering or employee balances can be loaded into the Missio Benefits system. If balances are loaded into the Missio Benefits system there will be a required “blackout period” (typically a week) where employees cannot use their prior FSA administrator’s card or submit claims. This ensures accurate balances are loaded into the Missio Benefits system.
What am I going to be responsible to administer on HSA or FSA accounts we use in the Missio Benefits program?
You are responsible for the following:
- Joining the Missio Benefits program will streamline many of the HSA/FSA tasks you’ve had to manage in the past including:
- Managing enrollment/elections in multiple systems.
- Managing EDI/file feeds.
- Some of the key areas you will still be responsible to administer include:
- Ensure employee election amounts are correct in the PlanSource system.
- Ensure employees are enrolled/terminated timely in the PlanSource system.
- HSA contributions will automatically be pulled from a bank account you provide.
- FSA claim and debit card aggregate amounts will automatically be pulled from a bank account you provide (typically done daily. Weekly and monthly options available if you provide a pre-fund amount that is between 5% to 10% of your annual elections).
- Have a high level understanding of how employees access their online account and what tools/resources are available.
- Have a high level understanding of why FSA debit card transactions sometimes require employees to submit receipts.
- Understand how employees enrolling in an HSA go through the Consumer Identification Process (CIP) and that if they are asked to provide information (Driver’s License, Birth Certificate, Social Security Card, etc.) that they need to do that before their HSA can be opened and HSA contributions loaded into it.
How are pharmacy rebates handed within this program?
We have done everything possible to minimize fixed cost, thereby reducing the premiums employees have to pay. As such, an incentivized pharmacy credit has been included in the Cigna Medical/Rx TPA quote which has significantly reduced annual TPA cost (in leu of Missio Nexus receiving quarterly pharmacy rebates down the road). Once pharmacy consumption data has been collected for a period of time the Benefits Committee will discuss potential changes to this structure based on what is in the best interest of Missio Nexus and its member organizations.
Do run-out claims have stop-loss protection for members that leave the program?
Missio Nexus and its members will continue to have stop-loss protection for all claims incurred while insured under the program. An organization that chooses to leave the program within the first 24 months of their effective date may be responsible for run-out claims up to applicable stop-loss thresholds.
Is the deductible embedded into the out-of-pocket maximum in the HSA Plans?
Yes, the deductible is embedded into the out-of-pocket maximum in the HSA Plans.
Does the deductible apply before the coinsurance for inpatient/outpatient hospital and prescriptions?
Yes, the deductible would apply before the coinsurance for Inpatient/Outpatient hospital for all plans and for the HSA on prescriptions. However, the deductible would not apply for prescription on the PPO plan.
How long are dependents eligible for coverage in the Missio Benefits program?
Dependents are covered up to age 26, mirroring ACA guidelines.
How are the claims up to stop-loss attachment point administered and who will receive and review these reports?
All claims below the specific stop-loss thresholds will be paid from the Missio Nexus benefits account. Missio Nexus has access to daily claims reporting as well as access to an integrated data warehouse we have built for Missio Nexus called “Online Business Intelligence” or OBI for short. OBI will consolidate all data flowing through the Missio Nexus Medical/RX program and allows us to look at a nearly infinite number of variables tied to the programs aggregate data for the purposes of reporting and broader plan stewardship.
What are the medical plans and corresponding rates?
Click here for current plans & rates.
Is the Group Risk Health Assessment processed yearly or is this a one-time evaluation?
This is a one-time evaluation that will not be repeated in subsequent years.
Our organization does not have a July 1st renewal date so how do we join the program given our renewal date doesn’t align with Missio Benefits?
Organizations can request entry into Missio Benefits any month they like. If you don’t currently have a July 1 renewal date the transition to a July 1st plan year is very simple. If you would like to join Missio Benefits on July 1st just confirm that your current policy has a 30-day cancelation provision (most fully-insured contracts do) and then provide notice of the transition at least 30 days in advance. If you would like to join Missio Benefits based on your current renewal date, simply request entry into Missio Benefits and if approved you will join “off-cycle” with a short plan year leading up to the July 1st renewal date.