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.

Enrollment takes place:

• When a new group joins the Medical Trust
• Every year during Annual Enrollment
• When you have a significant life event, such as a change in marital status or the birth of a child

For additional information about who is eligible to enroll, significant life events and eligibility for changes to coverage, consult your employer or participating group, or review the applicable plan document handbook.

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.

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