Securing Health Insurance for Church Staff While Avoiding Costly Mistakes

Your church size determines your health insurance strategy. Smaller-sized churches need simple solutions and trusted advisors. Medium-sized churches require collaborative decisions without endless debate. While larger churches typically need a formal health insurance process with clear documentation.

Get this wrong, and you'll either overspend by thousands or leave families with inadequate coverage. Get it right, and you'll protect your people while stewarding your church's resources wisely.

Here's how to navigate health insurance for church staff based on your situation.

How Church Size Shapes Your Decision Process

Church size is about more than just the number of people on staff. It determines both your decision-making process and available expertise. 

Health Insurance for Church Staff Decision Workflow

If you're a pastor at a small church, you're probably wearing many hats — including the benefits manager. On any given day, you could be balancing staff needs against tight budgets.

If you’re a pastor at a larger church, you have more voices with expertise to draw from to reduce stress.

However, your primary focus remains the same: selecting a benefit provider with multiple plan options, while evaluating total costs alongside the benefits and out-of-pocket expenses your staff will face. The challenge is that it’s a balancing act.

Here are a few tips based on church size. 

Small Churches (1–3 people on insurance)

Embrace the “pastor as the benefits manager” reality. You might be making insurance decisions without formal training while balancing staff needs against the church budget. This dual pressure is real and challenging.

Use a streamlined decision framework. Small churches benefit from simple approaches. Start by finding a trusted advisor — maybe another pastor, a denominational contact, or an insurance partner who understands ministry.

Ask basic questions: What can we afford? What do our families actually need? Remember, every dollar per person matters more when you're covering just a few people.

Medium Churches (4–6 people on insurance)

Build your benefits team. Include your treasurer, maybe a deacon who handles finances, and definitely the staff who will use the benefits. Balance pastoral authority with collaborative input. Your goal is buy-in without endless debate.

Use simple consensus methods to create a simple process. Present two or three options, not 10. Give people time to review with their families, and then let them make the decision. Clear communication prevents confusion and hurt feelings later.

Large Churches (7+ people on the same insurance plan)

Create a Formal Committee. Larger churches will be able to draw on stakeholders and expertise from within the congregation. You'll find that forming a benefits committee with clear roles and timelines is particularly helpful.

Include representation from deacons (especially those handling finances), affected staff, and church leadership. Plan for longer decision-making processes. The more people who are a part of this process means the more time needed.

Follow documentation and approval processes. Create presentations for your church council that show how you evaluated options and arrived at your decision. This keeps everyone in the loop.

Understanding the Health Insurance for Church Staff Cost/Risk Analysis

After selecting a provider, you have two options: Choose one plan for everyone, or let staff pick from multiple plans. One plan is simple to administer, while multiple options let staff tailor coverage to their needs, but require you to understand all plans.

Most providers offer three general plan types:

  1. Premium Plans offer lower deductibles but higher monthly costs. Best for predictable expenses when staff regularly use medical services.
  2. High-Deductible Health Plans (HDHPs) have lower premiums but higher deductibles. Staff can contribute to Health Savings Accounts (HSAs) for tax advantages. Popular with younger, healthier groups.
  3. Fixed Copay Plans eliminate deductibles with set amounts for each service — $35 for doctor visits, $200 for MRIs. Most predictable costs, but may limit network options.

Matching Your Insurance Strategy to Church Size

Small churches will find it easier to focus on each person. It’s often simpler to pick the provider and plan together. This provides financial protection for your small staff while being easier to administer.

Medium and large churches should take a portfolio approach. It makes sense that with a larger staff, there will be a wider range of needs. 

One solution is to offer a set amount, paid out monthly, that staff can put towards their medical care. This allows them to pick a more costly plan and pay the difference while still getting the services they need. And it allows others to choose less costly plans because they feel their risk of needing medical services is low.

When You’re Ready to Make the Decision

Reformed Benefits Association (RBA) understands churches face tight budgets and unique ministry challenges. RBA offers multiple plan options tailored for different church sizes and individual needs, with personal consultation that considers your specific situation.

The right health insurance choice depends on your church's size, budget, and staff needs. Start by asking key questions: What's our total budget? What are our staff's biggest health concerns? 

Avoid choosing based only on the lowest premium. Consider monthly costs, deductibles, and network coverage in your area. Remember, there's no perfect plan—just the right fit for your church family. 

RBA's ministry-focused approach helps both church leadership make smart administrative decisions and staff understand their personal options.

Ready to compare your options? Download RBA's Health Plan Comparison Guide for a detailed analysis of plans designed specifically for churches like yours.



The information contained in this blog is for educational purposes only. Please seek professional advice before acting on the information you have read above.