Today, many churches and ministries grapple with the challenge of providing health coverage for their staff, regardless of size. Health coverage can bring peace of mind to ministry employees, but selecting the right health plan can feel daunting. Whether you’ve been tasked with choosing a church health plan for the first time or are seeking new strategies to improve existing offerings, these top five most common church health coverage questions are a helpful place to start.
Whether your church must provide health coverage depends on size, as churches are not fully exempt from the Affordable Care Act (ACA) requirements.
50 or More Full-time Employees
According to the ACA, organizations with 50 or more full-time employees are considered applicable large employers (ALEs) and are required to offer at least minimum essential coverage (MEC).
If an ALE does not offer the minimum level of coverage, it must pay a penalty if the employee who obtains coverage receives a premium tax credit or cost-sharing reduction. ACA fines can be expensive, so it is recommended that large employers provide health coverage to avoid penalties.
Fewer Than 50 Full-time Employees
However, employers with fewer than 50 full-time employees are not required to provide health coverage.
While small churches are not fined for not providing health coverage, it is best practice to do so. Health coverage can factor into employee retention and provide a financial safety net for church employees and their families, allowing them to access the necessary care.
GuideStone® Health Plans
Individuals and groups with as few as two employees can access rich health plans with built-in features typically only available to large groups. Plus, GuideStone health plans fulfill the MEC requirements for ALEs.
Churches and ministries can consider alternatives to traditional secular health plans, such as church plans.
Church Health Plan
A church health plan is established and maintained by a church, a convention or an association of churches and is potentially a lower-cost alternative to traditional insurance providers. Since church plans are composed of many churches and ministries, smaller churches may be able to obtain group rates and access to programs and features that are unavailable to them in the larger market.
Church plans are exempt from certain federal coverage requirements, so they can offer coverage that aligns with biblical views of life and family. GuideStone falls into this category and brings together Christian plan design, nationally recognized networks and plan features to serve churches and ministries with shared values.
Similar to traditional insurance plans, the cost of church health coverage depends on the type of plan chosen and employee demographics, including:
GuideStone churches and ministries undergo underwriting to determine the rate based on the above factors. Organizations typically split the health plan cost, with the employer covering a certain percentage of the monthly cost and the employees paying the rest.
Yes. Churches and ministries with only one employee can provide individual health coverage.
A church with more than one employee can work with a benefits consultant to make other arrangements, such as offering its employees an ICHRA (Individual Coverage Health Reimbursement Arrangement). This allows churches to offer money to employees seeking individual coverage with some tax advantages.
Yes. A church can reimburse its employees for health coverage through options like an ICHRA (mentioned in #2) or a QSEHRA (Qualified Small Employer Health Reimbursement Arrangement).
However, reimbursing employees incorrectly can easily lead to taxable income for the employee and/or the employer. We recommend working with a qualified professional to determine and implement the best strategy for your church or ministry.
Prioritizing benefits like church health coverage is more than fulfilling a legal obligation. It’s a genuine act demonstrating care, concern and appreciation for dedicated ministry staff. In your journey to find the right coverage strategy for your team, we suggest conducting thorough research and enlisting the assistance of proven and reputable professionals.
If you need help understanding your benefits options from GuideStone, contact us at Insurance@GuideStone.org or 1-844-INS-GUIDE (1-844-467-4843), Monday through Friday, from 7 a.m. to 6 p.m. CT.
GuideStone welcomes the opportunity to share this general information. However, this article is not intended to be relied upon as legal advice, benefits advice, medical advice, diagnosis or treatment.
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• Sep 8, 2025 