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Glossary

A B C D E F G H I J K L M N O P Q R S T U V W X Y Z
 
Board of Managers — A group appointed by the Board of Directors of the Synod to administer the Concordia Plans and programs. The Board of Managers is composed of seven laypersons, two parish pastors, one teacher, and the Chief Financial Officer of the Synod.
 

Brand-name drug — A drug known by its brand name rather than its chemical name.
Child — Your natural child, adopted child, stepchild, or foster child.
 
Chiropractic care — Treatment by the manual manipulation of the spine and related body structures to correct misalignment of the spine and related body structures, X-rays to diagnose and determine treatment progress, and the following adjunctive therapy modalities—hot or cold packs, mechanical traction, electrical stimulation, paraffin packs, diathermy, manual traction, and ultrasound.
 
Close relative — A member, and spouse, child, brother, sister, or parent of member or member’s spouse.
 
Coinsurance — The percentage you must pay for covered medical services after any deductibles have been satisfied. If you are participating in Option HD-1 and you have dependents enrolled, the family coinsurance maximum must be satisfied before any member of the family has benefits paid at 100%. The family coinsurance maximum may be satisfied by one member of the family or by two or more members of the family.
 
Coinsurance Maximum — The maximum share that you have to pay toward covered medical expenses (excluding copays and deductibles.)
 

Compensation — The basic wage or salary paid to a worker by his/her Employer for personal services rendered plus:

  • 25% of the basic wage if housing is furnished by the Employer
  • Any cash utility allowance
  • Any cash housing allowance

Other cash allowances are not included; neither are bonuses, car allowances, nor any other form of remuneration. Benefits are based on the compensation used to determine contributions. Changes in compensation are made only on January 1, unless the salary change is due to transfer to another Employer or the result of a change in duties or the number of hours worked. In order to comply with federal law, annual compensation for which contributions and benefits are based for CRP purposes is limited to $200,000 in 2003. This amount is subject to change each year, as directed by the government. For purposes of determining a death benefit for a disabled member, compensation in effect at the time the disability began will be increased by 3%, compounded annually, for each full year of disability.
 
Compensation Credit — At the end of each year, each Supplemental Retirement Account (SRA) account for enrolled workers, including those who are totally disabled under the provisions of the Concordia Disability and Survivor Plan (CDSP), receives a compensation credit. The compensation credit is determined by multiplying the worker’s annual compensation for that year by 1.5%.
 

Concordia Plans — The benefit programs adopted and maintained by the Synod for the benefit of the workers of The Lutheran Church–Missouri Synod and certain affiliated Employers. The three plans are:

  • the Concordia Health Plan (CHP), which provides health care benefits.
  • the Concordia Disability and Survivor Plan (CDSP), which provides disability-income benefits and pre-retirement death benefits.
  • the Concordia Retirement Plan (CRP), which provides pension benefits and post-retirement death benefits.
 
Copay — The dollar amount you pay for doctor visits, prescriptions, and emergency room care.
 
Creditable Service — The total amount of time you work for an Employer as a member of the CRP (assuming that all required contributions are made during that time), expressed in years and twelfths of years. If you had earned Creditable Service under the definition(s) of one or more of the prior plans, that will also be counted as Creditable Service under the CRP.
 
Custodial care — Care that provides a level of routine maintenance for the purpose of meeting personal needs. Custodial care includes help in walking, getting into or out of bed, bathing, dressing, eating, and other functions of daily living.
 

Customary charge — The most common charge for a medical or dental service or item in a geographic area.
Deductible — The portion of covered expenses you must pay before the CHP pays benefits. If you are participating in Option HD-1 and you have dependents enrolled, the entire family deductible must be satisfied before any benefits are paid by the Plan for any enrolled member. The family deductible can be satisfied only by the member and his/her enrolled dependents.
 

Disabled — Eligible to receive a disability benefit under the CDSP.
Eligible charges—Charges for services and supplies that are:
  • Billed to the CHP member or to a covered dependent.
  • Ordered by a physician.
  • Medically or psychologically necessary.
  • Not specifically limited or excluded under the rules of the CHP.
  • Not above the allowed amount or customary amount.
  • Incurred while the member is covered under the CHP.
 
Employer — For the purposes of the Concordia Plan Services, these are the Synod itself, its controlled organizations, and any member congregation or eligible affiliated agency which has adopted the CRP and the CDSP, and/or the CHP. The controlled organizations include the districts of the Synod, the seminaries and colleges operated by the Synod, Concordia Publishing House, Lutheran Church—Missouri Synod Foundation, Lutheran Church Extension Fund–Missouri Synod, and Concordia Historical Institute.
 

Extended care or Skilled nursing facility — An institution providing skilled nursing and rehabilitation services under the supervision of a physician, registered nurse or medical staff. This does not include an institution that is used mainly as a place of rest for the aged.
Final Average Monthly Compensation (FAMC) — For a worker who has at least five years (60 calendar months) of Creditable Service, FAMC will be 1/60 of the total compensation on which contributions are based during the highest-paid 60 consecutive calendar months out of the final 240 months worked (assuming, of course, that the worker is a member of the CRP and contributions are made on his/her behalf during that time). For a worker with less than five years of Creditable Service, FAMC will be the average of Compensation during the worker’s entire period of membership.
 

Formulary — A list of prescription medications chosen by Express Scripts for their ability to be clinically and cost effective.

Generic drug — A drug known by its chemical name rather than by a brand name.
Home health care — Nursing care and medical services approved by a physician and administered in the patient’s home that replaces hospitalization.
 

Hospice — A facility, agency, or service that is certified by Medicare or is licensed, accredited, or approved by the proper regulatory authority and:

  • Jointly with the attending physician establishes a program of hospice care services
  • Arranges, coordinates, and/or provides hospice care services for terminally ill persons (life expectancy of six months or less as certified by the attending physician)
  • Maintains records of hospice care services provided and bills for such services on a consolidated basis.
 

Hospital — A medical institution with permanent and full-time care for bed patients, physicians in regular attendance, 24 hour-a-day care by registered nurses on duty or on call, mainly engaged in giving care for injuries or illnesses, have surgical facilities, and be operated lawfully in its location. This definition does not include rest, nursing or convalescent homes, homes for the aged, or places operated mainly for the treatment of the chronically ill.
Illness — A medically determinable disorder of the body, or a mental disorder of any kind, as certified by a physician. Pregnancy is considered an “illness” for the purpose of the CHP.
 
Integration Level — A number used in determining your benefits to reflect the fact that Social Security provides a higher benefit as a percentage of pay for employees at lower pay levels. This number is based on federal requirements for combining benefits from Social Security and a pension plan. Because the maximum salary subject to Social Security tax changes each year, the Integration Level also changes each year.
 

Interest Credit — At the end of each year, each SRA account receives an interest credit. The interest credit is determined by multiplying the account balance by the 5-year U.S. Treasury rate from September of the prior calendar.

Life-threatening emergency — An accidental injury or emergency medical condition that is life-threatening or may cause serious injury to bodily functions and requires you or a family member to seek immediate medical care. Heart attacks, loss of consciousness or respiration and other similarly acute conditions are considered emergencies.
Medically or psychologically necessary — Services or supplies that:
  • Are adequate and essential for the evaluation and/or treatment of a disease, condition or illness as defined by standard diagnostic nomenclatures.
  • Can reasonably be expected to improve a person’s condition or level of functioning.
  • Are, in the case of mental health and substance abuse care, in keeping with national standards of mental health professional practice as defined by standard clinical references, valid empirical experience for efficacy of psychotherapy(ies), and national professional standards referred to in any applicable provider agreement and its exhibits in effect at that time.
  • Are provided at the most cost-effective level of care.
 
Medicare — Title XVIII of the United States Social Security Act.
 
Medicare-approved amounts — Eligible expenses that Medicare will cover.
 
Member — Any worker enrolled in the CRP and whose membership has not subsequently terminated.
 

Mental health care — The diagnosis and treatment of mental illness, psychoneurotic disorders, or personality or behavioral disorders.
Network-area Employer — A participating LCMS Employer whose zip code is within the boundaries of a PPO network, as defined by the CHP.
 
Network Manager — An organization, as selected by the Board of Managers, that selects, contracts with and oversees the activities of network providers, and processes claims for network and non-network services and supplies submitted by or on behalf of network-eligible members.
 

Network Physician — A physician who is a member of a health care network to which the worker belongs.

Out-of-pocket Maximums — The total amount a worker must pay out of his/her pocket. The total amount is derived by adding together the corresponding coinsurance maximum and deductible.
Physician (or doctor) — A licensed physician, surgeon, osteopath, chiropractor, dentist, or podiatrist, practicing within the scope of the profession for which such person is licensed. For purposes of the CDSP, a physician cannot be the spouse, parent, child or sibling of the disabled member. The physician's specialty or experience must be appropriate for treating the disabling condition.
 

Plan (or “the CHP”) — The Concordia Health Plan as in effect January 1, 2003.
  (or “the CRP”) — The Concordia Retirement Plan as in effect June 1, 2002.
  (or “the CDSP”) — The Concordia Disability and Survivor Plan as in effect July 1, 2001.
 
Pre-existing condition limitation–Concordia Health Plan (CHP) — A pre-existing condition for CHP purposes is a medical condition where medical advice, diagnosis, care, or treatment was recommended or received within the 6-month period immediately prior to the worker’s CHP enrollment date. A pre-existing condition limitation is applicable to workers and/or dependents enrolled during an Annual Open Enrollment period.
 
Pre-existing condition limitation–Concordia Disability and Survivor Plan (CDSP) — A pre-existing condition for CDSP purposes is a medical condition where the worker received medical treatment, consultation, care, or services, or had symptoms that would cause a person to seek diagnosis, care, or treatment within the 3-month period immediately prior to the worker’s CDSP enrollment. A pre-existing condition limitation is applicable to workers and/or dependents enrolled on or after January 1, 2005.
 
Prescription drugs—Medicines and legend drugs prescribed by a physician and dispensed by a licensed pharmacist, including syringes needed for administration of a drug (e.g., insulin).
 

Primary Retirement Benefit (PRB) — The primary pension benefit from the CRP, which is a defined benefit calculated by using the normal retirement benefit formula and normally paid at age 65, or as early as age 55.

Retirement Income Benefit — The amount of your monthly pension from the CRP at your normal retirement date. The benefit formula uses your Final Average Monthly Compensation, Creditable Service, and the Integration Level in effect at the time the benefit is determined.
Spouse — A spouse is a person of the opposite sex to whom a member is legally married.
 
State-Mandated Benefits — Benefits paid because of disability or death under the provisions of any Workers Compensation Act, Occupational Disease Act, or Compulsory Disability Benefit law.
 
Substance abuse care — The diagnosis and treatment of alcoholism, drug abuse or chemical dependence.
 

Supplemental Retirement Account (SRA) — A cash balance addition to the Concordia Retirement Plan (CRP) which provides for either a monthly benefit or a lump sum payment, normally at age 65, or earlier for workers who are vested at termination.
 

Synod — The Lutheran Church—Missouri Synod.

Worker — For Concordia Plan Services purposes, a worker is a person who is regularly employed by a participating LCMS Employer and receives a salary for the duties of his or her position. A person employed on a temporary, special, or part-time basis, or who is on active duty in a military force of any country, is not eligible for enrollment.
 
©Copyright 2007 Concordia Plan Services of The Lutheran Church—Missouri Synod. All rights reserved.
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