Eligibility and Enrollment

The Medical Trust determines the plan’s eligibility criteria.

Employers or participating groups determine whether active employees are eligible for employer contributions toward coverage, confirm that employees meet the eligibility criteria, and maintain documentation related to member enrollment and elections.

To enroll, eligible individuals and their eligible dependents must be part of a group that participates in the Episcopal Health Plan.

The Medical Trust also provides retiree health benefits through a UnitedHealthcare® Group Medicare Advantage (GMA) plan, subject to enrollment in Medicare Part A and Part B, and other eligibility requirements.

For information about who is eligible to enroll in the Medical Trust’s health plans, please review the plan document handbook for the applicable plan or the Medical Trust’s Administrative Policy Manual.

Enrollment takes place:

• When a new group joins the Medical Trust and its employees go online to select a health plan
• Every year in the fall, to give individuals the opportunity to review and make changes so as to meet their healthcare and financial needs for the coming year
• When individuals experience a significant life event, like a change in marital status or the birth of a child, and they notify their group/diocesan administrator or The Episcopal Church Medical Trust of their election change within 30 days of the event. 

Retirees Under Age 65

Those who qualify under the Medical Trust's eligibility rules* and whose former employer participates in the Episcopal Health Plan, can continue their existing health coverage at their own expense until they turn 65 and are eligible for Medicare.

Employees Age 65 and Older

Employers that offer Medical Trust health plans to active employees under age 65 and their spouses must offer the same health plans to its employees age 65 and over and their spouses—regardless of Medicare eligibility—provided that they meet the Medical Trust plans’ eligibility rules.

Individuals should check with their employer and see the Understanding Health Plan Options for Employees Age 65+ bulletin for more information.

*Review the applicable plan document handbook and check with your group or diocesan administrator for eligibility requirements. Please note that employers may not offer all plans.

The Episcopal Church Medical Trust Disclaimer

HIPAA Privacy Notice