Minimum Participation Requirements

Minimum participation levels protect the long-term financial stability of the Concordia Health Plan for all LCMS employers. Minimum participation levels help maintain a balance of healthy and less healthy, younger and older workers by requiring that employers enroll all – or nearly all – of their workers who are eligible for health coverage (except “eligible opt-outs” – see below).

Employers wanting to participate in the Concordia Health Plan must meet the following minimum participation requirements:

• Employers who have adopted the Concordia Health Plan (CHP) cannot offer another health plan alongside the CHP (i.e., no “dual choice”).
• If an employer has 1-5 workers, all workers must be enrolled in the CHP (except “eligible opt-outs” – see below).
• If an employer has 6 or more workers, at least 75% of them must be enrolled in the CHP (except “eligible opt-outs” – see below).
• Eligible Opt-outs” are workers who are not enrolled in the Concordia Health Plan because they already have health coverage under:
  • A spouse’s health plan
  • A parent’s health plan
  • A former employer’s group medical plan
  • A Medicare supplement plan
  • A state medical assistance program for low-income persons
  • The military

OR, a worker is considered an “eligible opt-out” if he/she does not meet the minimum hours-worked requirement (20, 25, or 30 hours per week, as selected by their employer) to be eligible for the Concordia Health Plan.