The Covenant Mutual Benefit Plan (COMB) Management Team recently met to review its experience thus far for 2006 and set rates for the 2007 fiscal year beginning January 1.
COMB provides health insurance, disability and life insurance for congregational employees for 10 participating area conferences within Mennonite Church USA. Mennonite Mutual Aid (MMA) representatives at the meeting reported the trend increase in the health industry for the past year is 15.5 percent. Because of COMB’s good past year and the financial strength COMB is experiencing, it will be able to offer a rate for 2007 considerably less than would otherwise have been required, and less than the industry experience. COMB has also been able to bring its reserves up to the MMA recommended level.
A summary report of a survey of COMB participants conducted through MMA also was presented at the meeting. Overall, 74.4 percent of participants reported being very satisfied or satisfied with the COMB plan and 71.9 percent reported their congregation sees COMB as an expression of mutual aid. Further, 85.9 percent said they personally see COMB as an expression of mutual aid. The COMB Management Team said it is gratifying to see the concept of mutual aid is important to participating congregations.
A decision was made one year ago to secure Highmark, an affiliate of Blue Cross/Blue Shield, to handle COMB claims through its network of Preferred Provider Organizations. The COMB Management Team reports this decision has contributed to its positive claim experience this past year, which has resulted in an ability to offer a more competitive premium rate for next year. The Management Team was further pleased to learn from the survey that 70.8 percent of respondents report this to have been a positive change in the quality of service provided and 76.6 percent reported not having noticed any difference in their health care providers as a result of this change.
The COMB plan has given participants the opportunity to offer a Health Savings Account (HSA) as an additional benefit to employees. About 87 percent of respondents reported having a HSA with 82.3 percent indicating this being a positive experience, and 79.6 percent reported their congregation contributes to the HSA. In addition, 66.4 percent said they were able to roll over money in their HSA account at the end of the year.
In addition to the above statistical report there were many comments offered by COMB participants. There were comments affirming COMB and the work of the management team. Appreciation was also expressed for the expanded preventive benefits offered through Highmark.
Major concerns expressed included: premiums and deductibles are too high and the suggestion that an option for a lower deductible be offered in the future; continued rising costs of health insurance puts a strain on congregational budgets; concern that the small COMB pool of participants may not be sustainable in the future; and questions of why pastors are not included in a larger pool that includes the Mennonite Mission Network, Executive Leadership staff and other Mennonite Church USA agencies.
The management team found the results of the survey to be helpful and encouraging. This provides important feedback that will continue to influence discussions and decisions in future meetings.
They put me at the head of the line
By Sandra Vielman
GOSHEN, Ind.“I vividly remember when they put me at the head of the line. I didn’t know why they saw me, Maria the stranger who was confined to a wheelchair, through the lens of love. I was a stranger, unknown to anyone in the congregation. And until that day, never experienced warmth in the church like what was shown to me.”
Those are the words of Maria Martinez, a woman who had lost hope until she and her husband, Jose Martinez, experienced the healing power of acceptance offered to them by Iglesia Menonita del Buen Pastor (IMBP), a Mennonite Church USA congregation in Goshen, Ind. This congregation’s acceptance and service is one example of the many ways Mennonite Church USA congregations are reaching out to those without adequate access to healthcare.
Maria and Jose’s journey is one that led them from an on-the-job injury to the turmoil of inadequate healthcare coverage. It’s a testament to the impact a congregation can have on the lives of others when it reaches out in love.
Maria and Jose migrated to the United States from Mexico in 1989 because Jose had been a migrant worker. Maria was able to obtain a Green Card and a Social Security Number within a short period of time.
In 2000, both Jose and Maria moved to Indiana and became employed at a poultry processing plant. As is the case for every employee at the plant, Maria paid into Social Security and Medicaid, and her employer provided healthcare benefits.
Two years ago, Maria was injured at work when her foot was slammed in a door. Though she saw a doctor immediately, one of her toes became infected. Because of her diabetes, the toe did not heal and became gangrenous. Her toe was amputated, and complications multiplied from then on.
During her recuperation time, her company notified her that her employment had been terminated and the insurance company refused to pay her hospital bills. They stated that her Social Security number was not valid because some one else was using the same number to work for another company. Maria was devastated and did not know where to turn for help. She had lost her job, insurance was unwilling to listen to her, her house was about to be repossessed and her husband’s wages had been garnished; reducing their sole income from $400 per week to $60 per week.
In their time of need, Maria and Jose met Lourdes Rodriguez, a member of IMBP.
“I knew Lourdes’ brother, and I told him what had happened to me,” Maria said. “He told me his sister went to church and he could ask her to visit me, so I agreed.”
Maria says Lourdes contacted his sister that day and the sister called and asked if she could visit Maria at home. Maria agreed and within five minutes the sister was there.
Lourdes invited Maria and her husband to come and visit the church, and Maria clearly recalls the details of her visit to IMBP. At the time she was confined to a wheelchair healing from her amputated toe.
“Two men carried me in” she says, smiling, amazed at their generosity. The congregation had a fellowship meal that day, and “they put ME at the head of the line,” Maria says. “I experienced the love of God in a place where I was a stranger, unknown to anyone.”
She says in a time when she was broken and had lost hope, she felt welcomed and loved.
Soon after Maria started attending church, her foot became infected, and her husband was the one taking care of her persistent infection. Maria went to the hospital for treatment of her infection, but due to Maria’s diabetes and the poor circulation in her limb, her foot became gangrenous and her leg had to be amputated below the knee.
“During this last surgery I was not afraid; I had a lot of people praying for me and that gave me peace,” she says.
Maria had done everything right, at the time of her injury she was working, paying taxes and had health insurance. Access to healthcare was an issue because her English is very limited and she rarely had a translator with her. It made understanding all that was said to her, as well as expressing herself, very difficult.
“I ask a lot of questions, it would be nice to understand doctors’ answers fully,” Maria says. “Healthcare is only fully accessible if you have money. If you do not have money to pay a translator, you go to the appointment and understand only bits of pieces of what is being said. Then, if you have a bill that you have not been able to pay, you cannot see the doctor so you go to the emergency room because they can’t refuse to see you. But then the bill comes and it is probably double what it would have cost at the doctor’s office.”
For the time being, Jose and Maria have engaged a lawyer to negotiate with the insurance company. Maria and Jose felt the need of having someone who knew the law, someone who would be able to advocate for them.
“I feel it is unfair that the insurance denied my medical claims based on something that was not true,” Maria said after she learned the reason why her insurance denied payment.
She contacted the Social Security Administration to find out whether there was another person working with her name and Social Security Number, and she received a letter stating there was only one user for that number. She was also advised to contact Work Force Development Service to find out if someone had ever filed with that number for unemployment insurance or if there was a record of that number being used by more than one person, the answer was also no.
Maria is waiting for the day when her bills are paid and the burden of debt is lifted off her shoulders. Between now and then, she’ll be relying on her newfound support system at IMBP.
“The future looks better now,” she says. “I have a church family that is very supportive, and I came to know Jesus who gives me strength. I look forward to the day when I have my prosthesis so I can walk again.”
Sandra Vielman is from Goshen, Ind., and wrote this story for Mennonite Church USA
