True “Relief of Conscience” – Can it be
accomplished?
by
Laureen Bodnar
Preparations
for the 218th General Assembly (to be held in San Jose, CA, June
21-28, 2008) are underway at PPL. Through the overture process
we continue to search for a method to accomplish true “Relief of Conscience
(ROC)” for congregations who don’t want their dues paid to the Board of
Pensions (BOP) Medical and Benefit Plan to pay for abortions.
Upon approval by
a Presbytery, Relief of Conscience is granted to congregations that do not want
to pay for abortions and/or related expenses with their dues contributed to the
BOP Medical Benefits Plan. These
dues are required by the Book of Order ‘Terms of the Call’ (G-14.0534).
Under the ROC
program a percentage of dues from ROC churches (equal to the percentage of all
health coverages spent on abortion coverage during the previous year) is
diverted to an Adoption Assistance Grant program. Created in 1998, in response
to a recommendation from the 204th General Assembly, the “Relief of Conscience”
program was implemented without an accountability process in place. The BOP does not provide any annual
report to the General Assembly, The Presbyteries, or the ROC churches for the
handling of the divided “dues streams”
collected from ROC and Non-ROC churches. There is no reporting of how
many dollars were paid for abortions each year or the total amount contributed
to the Adoption Assistance Grant Fund.
For seven years
(according to Andy Brown at the BOP), the BOP has worked to strengthen
their data base in order to properly handle the ROC program and streamline its
efforts but it is still a work in progress.[1]
How
does ROC work?
Can we be sure
that the dues from ROC churches are not funding abortions? The truth is we cannot. It’s not rocket science to arrive at that
conclusion by looking at the program design.
The explanation
of the ROC dues separation on page 42, paragraph three under “Relief of
Conscience” of the BOP Benefits Administrative Handbook reads:
“…the Relief of Conscience
process separates the incoming dues stream between employing organizations [2] that have not sought relief and those certified by their
presbyteries of jurisdiction to be Relief of Conscience employing
organizations. Medical claims for
abortion procedures are paid from the Non-Relief of Conscience dues
stream. A dollar amount equal to the
cost of abortion claims from the prior year is set aside from the Relief of
Conscience dues stream and helps fund the Adoption Assistance Grant
Program. Then, the dues streams are
merged and all other medical claims and costs are paid from the merged dues
streams.”
How
are dues tracked?
So how does the BOP system track the dollar
amount separated into the two streams of money? We wouldn’t know because they
provide no report to General Assembly with the details nor is it found on the BOP website. When I spoke with Andy Brown from the BOP, who was very helpful and
promptly answered my questions, he advised that it has taken the BOP seven years to get their data
base to where it is today and they are still working to perfect it. He did say they do know which churches (507
total and several self-paying individuals) are ROC so I assume that means they
are able to track the ROC/Non-ROC dues
separately.
On page 42 of
the BOP Administrative handbook, it
also states in paragraph 6 that;
“The full protection of the
Medical Plan is available to all Plan members whether or not the church of
service is a Relief of Conscience church.”
That statement
speaks very clearly to me because of my 18 years of Claims and Benefits
Administration experience. It is a
“cover all” statement because they are not able to guarantee that ROC monies
will not be used for abortions. This
statement negates their assurance in the first paragraph on page 42:
“Through the Relief of
Conscience process, the Board makes sure dues contributed by employing
organizations that object to any medical coverage for abortion related expenses
will never be used to reimburse such expenses.”
How can the BOP assure ROC churches this if
“full protection” of benefits is available to “all plan members”?
Guaranteeing
ROC
It
comes down to this. There is only one Blue Cross Blue Shield plan for pastors,
some lay people, and their families. The
only way to have true ROC is if the BOP requests two separate
Highmark[3] plans; one for the ROC churches
and one for the non-ROC churches. The BOP would then have the authority
to flag or restrict all abortion-
related CPT-4 procedure codes and ICD-9
diagnosis codes from being processed under the ROC group number. Since the BOP does not currently flag any
abortion codes through Highmark, according to Andy Brown, all abortion claims
are paid, regardless of the ROC status.
Another way to prevent ROC abortion claims from being paid would
be for the BOP to request the ability to review all abortion claims before
Highmark processes them. The claims
received by Highmark would be referred back to the BOP for review to determine if
it’s a covered abortion based on the ROC or Non-ROC status of the church paying
dues for that individual. Some plans will request this type of a review for
surgery bills in excess of a certain dollar amount or if they want to examine
the medical necessity of the service or procedure. It’s not common but it is
done.
The surest guarantee of ROC would be for the BOP to eliminate coverage for
abortion from the Medical and Benefits plan and require Non-ROC churches to
purchase a special benefit rider through Highmark if they want to provide
abortion coverage for their pastor and/or family. A rider is a policy exception that would be
given to a particular group within a medical plan so that a particular benefit
could be covered. This would be the
fairest and most accurate way to obtain
true ROC.
All abortions are covered.
As it is now, based on the plan guidelines, if you are a female in
an ROC church and want to get an abortion for any reason, its cost will be
covered. But, dues from the Non-ROC churches will have to pay for it. This is
not true ROC. If I am in a ROC church and my pastor’s daughter can get an
abortion on demand, my conscience is not relieved because indirectly, I am
paying for it. If that same daughter were to pay out-of-pocket for her
abortion, then it is only her own conscience that is at risk.
I was also
told by Andy Brown that the BOP
does not request a report from Highmark regarding the dollar amount paid for
abortion-related expenses[4] . How then
does the BOP know
what dollar amount should be placed into the Adoption Assistance Grant Fund if
there is no claims report from Highmark? On the BOP website
under “Financial Assistance” it states, “In addition to other Funding, the
Adoption Assistance program is supported by funds captured to the Relief of
Conscience program.” Even if it is being
done properly, it does not prevent dollars being spent on abortions, it just
guarantees that an equal dollar amount will be placed in the Adoption
Assistance Grant Fund.
Simple Solutions
There is one simple solution to guarantee
the proper ROC process. Overture the
General Assembly to:
• Instruct the BOP to provide accurate, annual
reports to GA, the Presbytery granting ROC, and the ROC churches themselves and
to include in those reports 1) details of the ROC plan, 2) number of
participating churches, 3) total dollars paid for abortion-related expenses,
and 4) dollars placed into the Adoption Assistance Grant Fund.
• Direct the BOP to identify the two streams of
dues by assigning separate Fund numbers to ROC and Non-ROC churches.
• Direct the BOP to request a Highmark group
number for each of these two entities. Flag all abortion-related services and
diagnosis codes and restrict any payment using ROC funds.
• Direct the BOP to request an annual report
from Highmark for dollars spent on abortions.
• Direct the BOP to reconcile that dollar amount
with the dollars placed in the Adoption Assistance Fund
• Instruct the BOP and each Presbytery to post on
their websites the details on how to obtain ROC, what it is, and how it works.
• Have the BOP and each Presbytery clearly publicize the details on how pastors
and their families can obtain grants for adoption-related expenses.
The Board of Pensions website is http://www.pensions.org. Through the overture process, the PC (USA)
can assure true Relief of Conscience to the congregations that believe that
abortion takes a Human life which ought to be protected.
For a sample overture on this issue, visit www.ppl.org. The
direct link is 
http://www.ppl.org/indexov08.htm.
Laureen Bodnar is the Associate Director of PPL
and an elder at Northminster
Presbyterian Church, Pittsburgh, PA.
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