The Catholic Benefits Association
The CBA Solution to the HHS Mandate Accommodation Issue
Under Affordable Care Act regulations, almost all group health plans must provide coverage for all FDA approved contraceptive methods, abortion-inducing drugs and devices, sterilization, and related counseling (“CASC services”). HHS has exempted churches, religious institutes, and their auxiliaries from this obligation.
What is The Catholic Benefits Association (CBA)?
Led by archbishops from throughout the United States, the CBA is an Oklahoma limited cooperative association comprised of Catholic employers — both nonprofit and for-profit — committed to providing life-affirming health coverage consistent with Catholic values. The CBA owns The Catholic Insurance Company (CIC), an Oklahoma captive insurer.
What is life-affirming health care?
Life-affirming health care is comprehensive, quality health care that honors the dignity of the human person and is consistent with Catholic values. The Catholic Benefits Association (CBA) offers Catholic employers the ability to provide life-affirming health coverage to their employees.
What are the benefits of belonging to The Catholic Benefits Association (CBA)?
Some of the principal benefits of joining the CBA are:
- Access to the Catholic Insurance Company (CIC). CBA members are eligible to acquire stop-loss coverage through the CIC that CBA formed and owns. The CIC will provide competitively priced stop-loss coverage in conjunction with a national reinsurance carrier, a third-party administrator, and national and regional provider networks.
- Legal Advocacy on Behalf of Members’ First Amendment Religious Liberty Rights. The most immediate reason for joining the CBA is that it provides a cost-effective strategy for Catholic employers seeking protection from the HHS contraception, abortion-inducing drugs or devices, sterilization, or related counseling (CASC) Mandate and other similar state or federal mandates.
- Catholic Witness. The CBA/CIC program provides an opportunity for Catholic employers to witness their faith to their employees and others. It also provides a viable means for Catholic bishops and superiors of religious institutes to assist their affiliates in acquiring health coverage in keeping with Catholic values.
- Strength in Numbers. There is strength when Catholic employers come together. Such strength results in simplified access to morally compliant health coverage, bargaining power with third party contractors, cost sharing, and more.
- Education. The Affordable Care Act, related state statutes, and their respective regulations and developments in the many lawsuits create a complex and changing web of rules for Catholic employers. The CBA will keep its members up-to-date and informed about such matters.
- Advantages of Obtaining Health Coverage Through a Captive Insurer. Many employers choose to provide health coverage through captive insurers because of their inherent advantages, including greater funding and underwriting flexibility, single state regulation, tailored coverage, and retention of profits.
- Tax Advantages. The CBA and CIC follow a model designed to provide reduced costs for the same benefits package. The CIC is domiciled in Oklahoma, which gives the entity additional tax advantages.
- Ongoing Commitment to Address the Needs of Catholic Employers. The CBA and CIC know today’s problems and that there will be different problems in the years ahead. With its unique combination of Catholic leadership and members, the CBA and CIC will be ready to address the present and future challenges faced by Catholic employers.
- Charitable Support and Reduced Premiums for Catholic Ministries. The CBA and CIC are structured to produce profits over time. After meeting capitalization requirements, these profits will be used either to reduce members’ premiums, make charitable gifts to Catholic ministries, or both.
What types of Catholic employers are eligible to join The Catholic Benefits Association (CBA)?
The CBA and The Catholic Insurance Company (CIC) are structured to serve almost any Catholic employer provided it operates or enters into a self-funded plan. Present members include dioceses, parishes, religious orders, schools and colleges, nursing homes, charities, clinics and hospitals, and closely-held for-profit businesses.
What are the costs of belonging to The Catholic Benefits Association (CBA)?
The CBA’s monthly dues are 75 cents per covered employee, not to exceed $2,000 per month. Members must also pay a temporary, refundable litigation fee for the defense of CBA members against the HHS contraception, abortion-inducing drugs or devices, sterilization, and related counseling (CASC) Mandate. The litigation fee is an additional 75 cents per covered employee per month, not to exceed $2,000 per month. If the litigation is successful, that fee may be partially refundable.
The regulation implementing the Affordable Care Act mandates that employers with non-grandfathered health plans include coverage for contraceptives, abortion inducing drugs and devices, sterilization, and related counseling (CASC services). Can employers, consistent with this Catholic values, comply with this mandate?
The regulations implementing the CASC mandate provide a so-called accommodation for non-exempt ministry employers. Qualifying employers can choose this option by sending a self-certification form (EBSA Form 700) to their third party administrator (TPA) or their group insurer. Can employers, consistent with Catholic values, send the self-certification form?
The self-certification form has the legal effect of amending the employer’s health care plan to include CASC services and appointing the TPA or group insurer to provide those services at no cost to the insured persons under the employer’s plan. An employer acts contrary to Catholic values if it cooperates with the self-certification procedure unless it has exhausted all other alternatives that do not bring about a greater wrong. One viable alternative for many Catholic employers is to avoid the CASC mandate by joining the Catholic Benefits Association.
On August 22, 2014, the government issued an interim final rule that “augments the accommodation” described above. Under this rule, the employer sends a notice along with contact information for its TPA or group insurer directly to the government. Has the CBA Ethics Committee determined whether a Catholic employer can participate in the augmented accommodation procedure?
On September 12, 2014, the CBA Ethics Committee adopted this resolution: that the use of contraceptives, abortion-inducing drugs and devices, sterilization, and counseling in support of such options (“CASC services”) is contrary to Catholic values. A Catholic employer, therefore, cannot, consistent with Catholic values, comply with the government’s CASC mandate, with the “accommodation” provided to “eligible employers,” or with the “augmented accommodation”--unless such an employer has exhausted all alternatives that do not effect a greater evil and unless such an employer has taken reasonable steps to avoid giving scandal.
What is The Catholic Insurance Company (CIC)? How does it provide health coverage to members of The Catholic Benefits Association (CBA)?
The CIC is an Oklahoma association captive, stop-loss insurance company. When it is advantageous to do so in certain states, the CIC may function as a reinsurer, and its reinsurer will function as the stop-loss provider. The CIC has contracted with a national third-party administrator to provide morally compliant, full-service claims administration and health provider networks to insured CBA members.
What are the advantages of utilizing the health coverage available through The Catholic Insurance Company (CIC)?
In a word - simplicity. The Catholic Benefits Association (CBA) team offers members a streamlined, simplified means of staying afloat in the constantly changing swirl of health care regulations. Through a single monthly payment to the CIC’s third-party administrator, members will have access to:
- Benefits analysis
- Full-service claims administration
- Provider networks
- Stop-loss insurance
Because CIC is owned by the CBA and is nonprofit, its profits, after providing for capitalization needs, will be applied exclusively for either reducing premiums or making charitable contributions to Catholic ministries.
Does joining The Catholic Benefits Association (CBA) exempt my organization and affiliated employers from having to comply with the HHS contraception, abortion-inducing drugs or devices, sterilization, and related counseling (CASC) Mandate?
Some employers — primarily dioceses, parishes, religious institutes and their unincorporated apostolates — are already exempt. Most other Catholic ministries and for-profit Catholic employers are not. Through the CBA’s advocacy, the U.S. District Court for the Western District of Oklahoma issued a preliminary injunction on June 4, 2014 from that made its members at that time—both non-exempt ministry employers and closely held Catholic business employers— exempt from the CASC Mandate even though they do not submit the so-called self-certification form. The CBA thereafter commenced legal action, based on this precedent, to ensure that employers that become CBA members after that date will receive the same exemption.
Can I belong to The Catholic Benefits Association (CBA) without becoming an insurance member?
What is the advantage of joining The Catholic Benefits Association (CBA) if the employer does not utilize The Catholic Insurance Company’s (CIC) stop-loss coverage?
The CBA will represent and advocate on behalf of all its members’ First Amendment religious liberty rights. Through its education efforts, the CBA will help all members through the maze of increasingly complicated laws and regulations. Should an employer’s present insurance arrangements later prove to be unsatisfactory in terms of cost, service, or moral compliance, members can immediately look to the CIC for a ready alternative.
Is there a minimum number of employees required to participate in The Catholic Benefits Association (CBA) and The Catholic Insurance Company’s (CIC) health coverage?
No. While economic considerations can make self-funded plans for smaller employers challenging, the CIC captive manager will work with individual employers to help them put the most cost-effective health care plan in place.
Who are the network providers?
Aetna, Cigna and potentially others, depending on region.
What if neither of those networks is strong in my area?
Provide us with more details on what is important in your area, and the network you are currently accessing. The third-party administrator will work to access your preferred network or develop a comparable network alternative.
Will my current plan change?
While there will be a template for the health care plan, there will be choices for deductibles, employee/employer cost sharing (within the requirements of the Affordable Care Act), and specific and aggregate attachment points. Additionally, there is room for some customization.
Will my employees be able to keep their doctors?
In most cases, yes. The national provider networks are very comprehensive. Additionally, CIC’s third-party administrator is committed to negotiating with out-of-network providers, especially for larger employers, to ensure that they have the service providers best for their employees.