Reflections: In gratitude for all that you do

November 21, 2022

As leaders of organizations centered and rooted in faith, we draw strength from each other as we persist in our mission to bring hope and healing to people.

I began a weekly CEO Update at the start of the pandemic because I thought it was important to stay in touch and communicate through a dark and uncertain time. As one of the largest nonprofit health and human services networks that cares for one in 50 people in America, we were hit especially hard by the pandemic.

While some CEO Updates were about important advocacy issues or programs, others were more reflective. I always received feedback from member CEOs on the reflections—notes like “I really needed that today” which kept me going.

One of my board members suggested that I compile the reflections together. As I look back, it’s clear that where we thought we’d be along the way changed—often—and mostly in ways that brought more challenges and hardships to Lutheran social ministry.

What was also clear was the extraordinary leadership, creativity and perseverance that you and leaders throughout the network demonstrated—examples of true leadership to adapt to never-before-seen situations and lead your teams with grace and courage. Lutheran social ministry stood up when we were most needed and you and your teams are the Front Line Heroes that we lift up for your life-saving work.

These Reflections are dedicated to you—for your remarkable leadership and our extraordinary journey together.



Offering Choice and Affordability of Benefits is an Art and a Science

November 16, 2022

A healthy workforce is the backbone of your organization. With no end in sight to rising health care costs and insurance premiums, you need to be strategic in how you plan for the continued financial impact felt by your organization and employees at all levels. Research confirms this anticipated trend: In a recent survey of 455 U.S. employers, 71% said they expect moderate to significant increases in health care costs over the next three years.1

A comprehensive, thoughtfully prepared benefits package remains one of the greatest tools for attracting and retaining quality employees. And health insurance tops the list of necessities. Out of 1,000 adults surveyed by The Locust Group, 84% said health benefits are a big reason why they’ve stayed in their current positions.2 From an employer standpoint, we believe employees covered by great health benefits are destined to be a healthier, happier, more reliable workforce (staying more up to date on preventive care and wellness visits).

But the decision to offer health benefits is incredibly complex, and determining ideal cost-share arrangements is even more so. You have a variety of employee circumstances to consider from job categories (part-time and full-time) and salary ranges to diverse health care needs. So, how do social ministry organizations account for the impossibility of knowing the specifics health care needs of each employee? Offering a mix of health plan coverage options can help you more effectively meet the needs of most employees, and it doesn’t have to cost more.

Health Plan Options 101

As a reminder, here’s an overview of plan coverage options available and which employees might benefit most from each based on the core design tenets. Deductibles and out-of-pocket costs can vary widely across all options.

Preferred Provider Organizations (PPOs): These usually have a deductible amount along with coinsurance percentage paid by the plan. Plan values, deductible amounts, and coinsurance percentages can vary significantly. Popular among employees who want choice when it comes to which providers they can see.

High-deductible health plans (HDHP): With provider choice, an HDHP can be paired with a health savings account (HSA), which remains a popular tax-deductible vehicle for health savings with no expiration on spending balances.

Copay health plans: These plans have fixed copays based on the type of service provided and may provide a more incremental way for employees to meet their deductible rather than incurring that large expense at one time.

At Portico, we offer a range of plan options, including our two PPO style plans: Platinum+ and Gold+; two copay style plans: Select Copay and Value Copay; and two high-deductible plans: Silver+ and Bronze+.

There are multiple ways to put this puzzle together. A great way to really understand your employees and their needs is to send out a survey to find out what their specific pain points are in choosing the “right plan.” Their answers can be incorporated into next year’s annual enrollment process. Portico offers sample surveys to our existing employer clients or can execute surveys on their behalf.

Giving Employees Choices Doesn’t Have to Cost More

No matter how we slice it, one size does not fit all when it comes to health care coverage. As an employer, it may be advantageous to offer a variety of options that allow employees with varying health care situations find a coverage option that best aligns with what they are able to afford. Some employees may be facing exorbitant medical costs for themselves or a dependent, some remain most concerned about potential out-of-pocket costs, while others seek health care coverage where they can contribute to an HSA. While organizations focus on how to offer the best coverage at the lowest cost, the majority of employees are often just trying to understand deductible amounts versus monthly cost. The great news is, when you provide more choice, you don’t have to decide which option is best.

So what does a “good mix” of options look like? For some industry perspective, 80% of Portico’s current health plan clients offer three to four health plan options. One strategy to consider? Offer one of each type of coverage: low-deductible, co-pay, and high-deductible. This can adequately span a wide financial spectrum and range of health care needs. In addition, there are other strategies emerging to help manage costs in tandem with offering multiple options, such as:

  • Accounting for different income levels when structuring payroll contributions to help with costs for certain lower-income employee groups7; and
  • Changing the way organizations evaluate health insurance costs, looking at “average cost per employee.”8

Keep in Mind ACA requirements

The Affordable Care Act (ACA) states that applicable large employers (employers with 50 or more full-time employees or the equivalent) are legally required to provide “minimum essential health coverage” to employees or be subject to an assessment if any employee receives a premium tax credit for purchasing individual coverage from the marketplace. The minimum essential health coverage must:

  1. Provide “minimum value” to full-time employees and their dependents, and
  2. Be affordable based on employer shared responsibility provisions.3

Minimum value is met if it covers at least 60% of the total cost of medical services that are expected to be incurred under the plan.4 Be careful of group health plans that do not “substantially cover” inpatient hospitalization or physicians services, as it’s not clear if these plans satisfy the minimum value — not to mention, they gloss over benefits we all have come to expect as a given.5 All Portico health plan coverage options meet the ACA minimum value requirements.

As for affordability, this standard is met when employee contributions are no more than 9.12% (as adjusted) of an employee’s household income.6

For additional guidance on ACA compliance and essential coverage, organizations should consult or a tax advisor. And remember, there are mandatory ACA reporting requirements that you should be mindful of as we head into tax season.

Additional Support at the Ready

At Portico, we work closely with our health plan clients to identify the best strategies for taking care of employees while simultaneously being cost-conscious and wise about the custom coverage design. Our goal is to help clients see the whole picture and make informed decisions that stand to have positive impact overall.

We also aim to help clients by increasing employee education about their benefits. We often hear that employees may not understand different plan options, which is why clients sometimes hesitate to add more choices to the mix. Our client representatives can meet virtually or on-site during annual enrollment to answer employee questions. As a service to our clients and an incredible benefit to employees, our representatives provide direct support to eligible employees with private, in-person meetings where specific health circumstances and prescription needs can be fully discussed. The reality is, most employees don’t want to share their personal situation with employers, so this is a more comfortable approach with significant impact.

Portico’s experience evaluating different health benefit options stems from having inside experts who have encountered a wide variety of employer scenarios and are equipped to assist by:

  • Reviewing cost-share calculations;
  • Helping clients structure cost-share arrangements so they’re consistent, fair to employees, and cost-effective;
  • Providing thorough information, consultation, and general plan recommendations.

While we can’t make benefit decisions for you, we’re committed to helping organizations navigate this complicated process.

If you’d like to learn more about how Portico’s benefit programs can help you attract and retain your employees, visit or contact Ross Eichelberger, VP of Business Development at 612-752-4062 or

Learn more about Portico Benefit Services.

1Todd Shryock, Seventy-One Percent of Employers Expect Moderate to Significant Cost Increases to Health Care Benefits Over the Next Three Years, Medical Economics, Retrieved September 21, 2022, from

2Susan Rupe, Most Workers Say They are Satisfied with Their Employer’s Health Benefits, InsuranceNewsNet, Retrieved September 29, 2022, from

3Employer Shared Responsibility Provisions,, Retrieved September 30, 2022, from

4Minimum Value and Affordability,, Retrieved September 30, 2022, from

5Group Health Plans that Fail to Cover In-Patient Hospitalization Services, Notice 2014-69, Retrieved September 30, 2022, from

6Affordability and Minimum Value,, Retrieved September 30, 2022, from

7Renee Cocchi, Employers are Focused on Keeping Healthcare Benefits Costs Down for Employees, HR Morning, Retrieved October 3, 2022, from

8Marcus Newman, Five Health Insurance Renewal Basics to Make Open Enrollment More Successful, BenefitsPRO, Retrieved September 9, 2022, from

Lutheran Services in America Study Demonstrates Scalability of Innovative Transition Care Practices

June 24, 2021

Lutheran Services in America co-authored a study published in April by the medical journal Geriatric Nursing on the impact of our Connect-Home learning collaborative’s implementation of the innovative care transition intervention for older adults in post-acute care. Connect-Home was developed by Dr. Mark Toles at the University of North Carolina at Chapel Hill. The findings of this study demonstrate the scalability of innovative transition care practices that retrain post-acute care workers and proactively address social determinants of health to improve the quality of care for older adults.

For details, find the study in our Connect-Home resource library.


A Promise Made, A Promise Kept

March 18, 2020

Designated to advance strategic initiatives of our nationwide network, Lutheran Services in America’s “Realizing the Promise” fundraising campaign has surpassed its $500,000 goal! The campaign, scheduled to close June 30, 2020, grew ideas into dedicated action to change the lives of the one in 50 Americans our network cares for each year.

Through donors’ and member organizations’ incredible generosity throughout this campaign, our network strengthened Lutheran social ministry organizations to change the lives of 7,000 children through our Results Innovation Lab, via improvements like increased reading and graduation rates, and returning African American youth with their birth families, as well as decreased rates of teacher-student conflict; the number of times foster youth need to move to new homes; and arrest and re-arrest rates for over 700 youth of color.

Realizing the Promise also has meant making aggressive inroads in enabling seniors to live at home and in their community through our Connect-Home Learning Collaborative, committed to better preparing older adults to successfully transition home from post-acute care facilities. Importantly, the Realizing the Promise campaign also empowered us to bring together member organizations to successfully launch LSA Senior Connect, an innovative service model that connects seniors with chronic health conditions to needed resources in their communities, which already is delivering promising results in pilot stage with Genacross Lutheran Services.

This vital campaign’s success was bolstered through multi-year commitments from a wide range of people and organizations who share our commitment to the difference we can make – together – in the lives of so many people experiencing need in America. Thank you to the 39 member organizations who contributed dues above dues to support the campaign. Three leaders in particular from our network were among the first to step up and commit their support to Realizing the Promise, each of whose work ties to our key strategic areas of accelerating change, advocacy, and the power of networking:

Accelerating Change: Mark Pile, President & CEO of Diakon Lutheran Social Ministries

By working together across our network, we accomplish more than any one organization can by working on its own. As one of the first to step up and support the Realizing the Promise campaign, Diakon Lutheran Social Ministries President & CEO Mark Pile shares:

“I see my support and investment in Realizing the Promise as an opportunity to strengthen Lutheran social ministry across the U.S. The more we collectively work together – whether by sharing industry resources, lessons learned or creating new models to reach people with services who need them – the better the outcomes for the people we walk alongside. Our Lutheran tradition of service, for me, is grounded in the idea that the work we do at a local level is part of something bigger. Lutheran Services in America’s work to bring it together is not easy work, but brings great value to our organization and the people we serve here in Pennsylvania and Maryland.”

Advocacy: Linda Timmons, President and CEO of Mosaic

The voice of our faith-based network is more important now than ever. Mosaic President and CEO Linda Timmons shares her perspective:

“Strength in numbers has real meaning when it comes to amplifying our voice, our experience, and our collective expertise. Realizing the Promise has amped up Lutheran Services in America’s efforts with federal lawmakers and further honed their pulse on critical legislation affecting the one in 50 Americans we care for – lives ranging from children, youth and families to seniors, low-income individuals and people with disabilities. I’m grateful to everyone who joined Mosaic and me in supporting this campaign to advance our work as one national network, unleashing the power of our collective voice to advocate for policies affecting the one in 50 Americans we care for.”

The Power of Networking: Ted Goins, President & CEO of Lutheran Services Carolinas

Lutheran Services Carolinas President & CEO Ted Goins is a natural networker. He often brings ideas to Lutheran Services in America he thinks can benefit other members like a partnership with the University of North Carolina at Chapel Hill, which led to the launch of our Connect-Home program involving additional members. Ted shares:

“I invested in the Realizing the Promise campaign because I see the power of collaborating with my fellow Lutheran social ministry organizations, and the ability of Lutheran Services in America to bring us together and create national partnerships that take us further than any of us can go on our own. I’m inspired to be part of something bigger than any one person or organization, and all that is possible as we journey together.”

Families First Coronavirus Response Act Signed Into Law

March 20, 2020

On March 18, President Trump signed into law the Families First Coronavirus Response Act, legislation which aims to provide economic relief for individuals, businesses, and organizations impacted by COVID-19, including Lutheran Services in America member organizations. Among its other provisions, the law provides increased federal support for Medicaid spending during the pandemic in the form of a 6.2% emergency Federal Medical Assistance Percentage (FMAP) increase to states. The FMAP is the federal portion of the total Medicaid expenditure for each state.

The law also institutes a temporary paid sick leave mandate, along with an expansion of family and medical leave provisions. Employers with fewer than 500 employees, including nonprofits, will be required to provide employees who are themselves sick or quarantining two weeks of fully paid sick leave, and 10 additional weeks of leave at two-thirds pay. Employees caring for others who are sick or children whose childcare services are closed must be paid at two-thirds of their regular pay for up to 12 weeks. Employers will be fully reimbursed for providing this leave via a refundable tax credit allowed against the employer portion of payroll taxes—thus benefitting nonprofits. Any paid leave costs that exceed the amount of payroll taxes owed will be refundable to the employer at the end of each quarter. Finally, the law suspends SNAP work requirements and provides free testing for COVID-19, $2 billion in unemployment assistance and $1 billion in food aid.

Another relief bill is currently being written in Congress, which is expected to include additional specific support for the nonprofit sector and individuals and families.

Today’s Frontline Hero: Allegheny Lutheran Social Ministries (ALSM) in Altoona, PA

March 24, 2020

Allegheny Lutheran Social Ministries (ALSM) in Altoona, PA is coming up with creative ways to keep their community connected to their important work. Their dedicated team has asked community members to make homemade masks out of fabric and, according to President and CEO Pat Savage, ALSM has received an outpouring of generosity! People from far and wide have donated masks to all three of ALSM’s campuses, helping protect the healthcare workers and those they serve. Individuals from the Altoona Community Theatre even switched their efforts from making costumes to making masks.

In addition to the masks, ALSM residents are receiving letters and artwork from children who are home from school. This demonstration of love and support from ALSM’s community is lifting spirits and connecting people, despite physical social distancing. To keep residents in contact with their loved ones, staff members at the Lutheran Homes are coordinating FaceTime and Skype calls. One of the residents was overjoyed to hear her son’s voice and to be able to tell him, “I love you!”

We are proud to recognize Allegheny Lutheran Social Ministries’ excellent work, as well as their generous community!

Today’s Frontline Hero: St. John’s United in Billings, MT

March 25, 2020

One of our members of Lutheran Services in America’s Great Plains Senior Services Collaborative, St. John’s United in Montana, has gone the extra mile in their communities to promote and create employment opportunities to help community members affected by COVID-19-related economic impact. David Trost, the organization’s President & CEO, posted this ad of solidarity in the Billings Gazette, and partnered with Montana Health Network to provide FREE at-home CNA training to help reduce the barrier to entry for workforce. Great teamwork from David, Taylor, Sarah, and the entire St John’s United team!

Today’s Front Line Hero: Lutheran SeniorLife in Mars, PA

March 26, 2020

Today’s Front Line Hero is Lutheran SeniorLife in Mars, PA, who put out a request for homemade masks from their community members. Lutheran SeniorLife is committed to protecting their staff and their residents, and is drawing on their community’s resources to fill gaps during the global shortage of personal protective equipment. Their slogan, “Make it fashionable, make it fun – as long as it’s cotton, you’ll help a ton!” inspires creativity and encourages the community to have fun with this valuable donation. Their website even includes video tutorials for making masks. We are proud to recognize Lutheran SeniorLife for their great work with senior adults and throughout their community!

UPDATE: Coronavirus Aid, Relief and Economic Security Act Signed into Law

March 26, 2020

Over 600 Lutheran Services in America member representatives reach out to Congress.

UPDATE: On March 27, 2020, President Trump  signed this bill into law.

On March 25, 2020, the U.S. Senate voted unanimously to approve the Coronavirus Aid, Relief and Economic Security Act (H.R. 748), a $2.2 trillion package meant to address the coronavirus pandemic and its impact on the economy. This is the third and by far the largest to date in what is expected to be a series of additional such relief measures. A vote in the House of Representatives is expected on Friday (3/27) to finalize this legislation.

Particularly important for Lutheran Services in America members, the package makes available forgivable loans for small business with less than 500 employees per location that can be used to cover payroll support, such as employee salaries, paid sick or medical leave, insurance premiums, and mortgage, rent, and utility payments. The package also creates a low-interest loan program that can be used for larger nonprofits who employee between 500 and 10,000 employees. (Additional key details to come shortly.)

Over 600 Lutheran Services in America member representatives sent nearly 1,150 messages to their Senators and Representatives, at all hours of the day and night, calling for nonprofit organizations to be included in this relief package. This priority outreach from so many people in our network made an enormous difference, and we heartily thank everyone for their vital efforts and action during this critical time!

While this legislation is an important step forward, we emphasize that much work remains to help ensure that health and human service agencies working on the frontlines of this crisis have access to the equipment, supplies, and funding they need to help carry out their work helping so many people each day. Lutheran Services in America will continue to work closely with our federal partners in the coming days and months to help ensure the needs of our members and the people they serve are front and center.

We issued a statement shortly after the Senate vote, in which we emphasized these loans are a “crucial part of this third Congressional relief package, given how many nonprofits like our 300 health and human services organizations are on the frontlines fighting COVID-19.” You can read the full statement here.

Today’s Front Line Hero: Graceworks Lutheran Services

March 27, 2020

Today’s Front Line Hero is Graceworks Lutheran Services, (with 63 locations in Ohio, Indiana and Kentucky), who is going above and beyond to meet the holistic needs of residents and employees.

Graceworks is focused not only on keeping residents and employees safe amid the COVID-19 pandemic, but on making sure residents don’t feel isolated during this time. For example, staff at Bethany Village (Centerville, Ohio) are creating original programming on the senior living community’s internal television station for residents in independent and assisted living settings as well as long-term care, including exercise classes, mini concerts by talented staff, and frequent spiritual segments. Resident council meetings and regular updates also are being broadcast, all helping to lift the spirits of residents and keep them engaged, helping earn Bethany Village recognition from local media for their efforts to connect residents and family members during times when visitors aren’t allowed in licensed areas. Staff help residents utilize iPads and smartphones to connect with their loved ones, as well.

Staff at Graceworks Housing Services, providing affordable housing for income-qualified seniors or those with disabilities, is connecting residents with donors from the community who want to help in this time of need. At Messiah Community in Urbana, Ohio, a local restaurant owner delivered a shopping cart full of items to a resident who had no means of shopping for herself. The owner indicated he would be back as needed to make sure she has supplies so she can stay home during the pandemic.

And at Graceworks Enhanced Living, which provides homes for persons living with intellectual disabilities, staff is supporting one another by displaying ways to practice safe hygiene during the crisis. They also are encouraging residents to practice social distancing while still enjoying the warming weather.

The organization’s Human Resources staff are focused on making sure employees practice self-care as well. Graceworks has adopted a motto of SHINE, for Supporting the Holistic and Individual Needs of Employees. Regular messages are being sent to employees thanking them for their valuable and selfless service, for doing the right things to keep everyone safe, and providing information on ways to focus on all areas of holistic health.

Lutheran Services in America is proud of the holistic care our member organizations like Graceworks are providing. We’re glad to recognize them for their valuable efforts today!