When a congregation doesn't have the budget to provide health benefits, the pastor is often left arranging coverage for the whole family. Here's how ministers and other clergy members are finding ways to spend less on health insurance this year.
Hi, I'm Sam Jaber, and I'm a licensed health insurance broker working out of Tampa. I serve clients by phone across the 36 states where I'm licensed. Whether you're leading a congregation in a small neighborhood storefront or serving a rural church a couple of hours from the nearest town, we can talk through your coverage together.
I hear the same concern from pastors all the time. Their church simply doesn't have the resources to provide medical insurance. Smaller congregations have to be careful with their budgets, and group coverage may be more than they can afford. That leaves the pastor trying to purchase insurance for the family, often with nobody available to walk them through the choices or explain the details.
I want to take some of the confusion out of choosing coverage. We can narrow things down by answering one important question first. From there, I'll explain several situations pastors commonly face so you can see which one matches your family.
Before we compare any plans, I want to know one thing: will your household income for the year you're getting coverage fall below the marketplace subsidy threshold?
The threshold is approximately four times the federal poverty level. For a household of one, that works out to a little more than $60,000 per year. The amount increases as household size grows, so a minister supporting a spouse and children can earn considerably more before crossing that threshold than someone living alone.
A minister's compensation isn't always as straightforward as a regular paycheck. You might receive a salary along with a housing allowance, and clergy have special tax rules. Your tax preparer is the person who should determine which parts of that compensation the marketplace counts toward your income. I'd recommend confirming that before applying. Once we have the correct figure, choosing between coverage options becomes much easier.
This is the situation I see with quite a few pastoral households, and it can work in your favor. If your income falls within the qualifying range, marketplace insurance will generally offer the lowest cost because premium subsidies aren't available through other coverage channels.
Your projected earnings are especially important here. When you enroll, the marketplace uses what you expect your household income to be during the upcoming year. If your estimate is lower than your actual earnings, perhaps because your congregation increases your salary or you pick up additional work, the subsidy gets reconciled when you file your taxes. You could have to return some of that assistance. Whenever your income changes, report it promptly so the marketplace can adjust your premium help accordingly.
Price isn't the only thing we'll consider. I'll also help check whether your family's regular physicians and preferred hospital participate in the plan, since paying a smaller monthly premium doesn't necessarily mean getting access to the healthcare your family relies on.
Next step: Once your tax preparer confirms the income amount, send it over to me. I'll use that figure to help you select suitable marketplace coverage.
Not every pastoral household qualifies for premium assistance. Ministers serving larger churches, or those whose spouses also earn income, may find themselves over the subsidy threshold. At that point, marketplace coverage comes at its full price, which can feel especially expensive when everyone in the family is generally healthy.
When that happens, I'll also compare coverage sold privately rather than through the marketplace. These policies use medical underwriting, meaning the application asks about each family member's health. The carrier reviews those answers when deciding whether to approve coverage and what premium to charge. Families without significant health issues can frequently find prices well below the marketplace's unsubsidized rates.
Another benefit is the nationwide reach of the PPO provider networks these policies use. Your family can access doctors in different states, which can be valuable when ministry takes you on the road, you're traveling to see relatives, or your children attend school away from home.
This type of coverage comes with considerations that don't apply to every option. An insurer might refuse an applicant because of a current or previous medical condition, or approve coverage while excluding that condition. Benefits aren't identical between policies either. Before you decide, I'll explain what the specific plan you're considering will and won't pay for.
Next step: Call me and we'll look at a nationwide PPO quote for your household alongside the marketplace's full premium, so you can compare them directly.
Perhaps you're moving away from a church position that included medical benefits, or your spouse is about to lose insurance through work. Either situation can qualify you for a special marketplace enrollment period, typically lasting 60 days, even when open enrollment isn't underway. If you've chosen COBRA temporarily, remember that canceling it voluntarily before it expires doesn't trigger another enrollment opportunity. We'll need to plan the timing around that rule.
Taking a position with another congregation may mean a different salary and a different zip code. Those changes can affect both the plans available to your family and their premiums. I'd like to review those details with you ahead of the relocation.
Next step: As soon as your new position's starting date is confirmed, give me a call. We'll arrange the timing so your replacement coverage begins when your previous plan finishes.
Depending on where you live, your marketplace might have only HMO and EPO choices, or its PPO premiums might be beyond what your family can reasonably afford. That doesn't mean you're out of alternatives. For healthy households, I can quote nationwide PPO coverage throughout the 36 states where I'm licensed. We can find out the price during a quick phone call.
We can begin without paperwork, though these details will help during our call:
I don't charge you for my assistance. When you sign up, the insurance carrier pays me directly, and your monthly premium doesn't change based on whether you enroll with my help or on your own.
Straight answers, no sales pitch.
One route is to purchase coverage through the marketplace, where your household earnings may qualify you for financial assistance with premiums. If your income exceeds that threshold and your family is healthy, I'd also compare privately offered nationwide PPO plans before deciding.
Your tax preparer should answer that because clergy compensation follows special tax rules. They can determine which portions of your earnings belong in the marketplace income calculation. Once they give you the correct number, I'll help you evaluate plans using it.
The IRS handles certain ministerial earnings differently for tax purposes than it handles wages paid to other employees. That distinction concerns taxation, though, not whether you need medical coverage. Without insurance provided by your church, you'll need to purchase your own plan just as other individuals do. Your tax preparer can clarify how your ministerial status affects your taxes.
Yes, there are options to compare. When household income is below the subsidy threshold, marketplace plans generally offer the most affordable premiums. If your household is healthy and earns above that limit, I can compare private nationwide PPO plans across the 36 states where I hold licenses.
Let me know approximately how much your household brings in, which family members need insurance, and which physicians you regularly visit. I'll explain the routes available to you, compare their costs, and give you a straightforward answer if your current coverage is already the best fit.
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