(We offered to write this article for the Living Lutheran, but they did not respond to our offer.)
In our work we review long-term disability claims from around the country. Recently we looked at the Evangelical Lutheran Church of America (ELCA) Long Term Disability Plan. The plan is offered by Portico Benefit Services. As we understand it, Lutheran Pastors in the ELCA are offered only this disability plan in their benefits package.
Lutheran pastors and their congregations would do well to go onto the open market and purchase a long-term disability insurance policy that offers better protection than this Portico policy and which offers meaningful access to the courts if benefits are not properly paid. At very least Lutheran pastors should know that this Portico policy is, at best, a C+ policy.
The long term disability plan is offered as part of a broader package of employee benefits. The disability plan is funded by the ELCA (which likely explains why it is such a narrow, benefit "light", plan).
Here are the limitations of the policy:
- If your claim is denied, and you exhaust your appeals, your only court remedy is to file suit in Minnesota. That's right, even if you live and work in Alaska, Hawaii, Florida, Texas, etc., you must travel to Hennepin County Minnesota, and file your case in the Minnesota Fourth Judicial District Court if promised benefits are not delivered. Every other policy we've ever reviewed allows you to file suit in your own state.
- Most disability policies provide protection for at least 24 months if you cannot work in your "own occupation." This policy limits coverage to 12 months. After 12 months you are only eligible for benefits if you can't work at "any occupation" and make 70% of what you were making as a pastor. Most every group policy has this "own occupation/any occupation" definition, but most protect you for at least 24 months in your "own occupation."
- If you are disabled and you then receive social security disability benefits, your ELCA benefits will be reduced. This is true for almost every group policy but is almost never true in an individual policy.
- If your disability was caused by a third party (auto accident, for example) you must repay Portico. Only about 15% of group disability policies have this type of "subrogation" provision.
- You only have 60 days to appeal a denial of benefits. Most group policies allow 180 days. This is important because, generally speaking, an appeal should make all legal and medical arguments available and should incorporate prior case law decisions about your injury or illness. (Note: long term disability appeals should not generally be handled without experienced counsel.)
Any business (or religious body) is free to offer (or not offer) whatever benefits it wants. Most ELCA pastors we have spoken to are shocked to learn the details of this Portico policy.
Our advice to ELCA pastors and Congregations: protect yourself with at least a supplemental policy but, if you can afford it, buy an individual long-term disability policy on the open market.