India Synod at its XVIIth session held at Tambaram in 1980. Deputy Moderator During the XXth session of the Church of South India Synod held at Trivandrum in 1986, Premasagar was elected as the deputy moderator. Moderator During the XIst session of the Church of South India Synod held during 13–18 January 1988 in Madurai, he was elected as the moderator of the Church of South India. Bishopric Later, in 1983 he was elected as the bishop-in-Medak, Asia's largest Anglican bishopric. It was at this time that indigenous methods were devised and put into practice for raising funds from the local congregations for supporting church programmes which was met with widespread success. He was instrumental in bringing rapid development of the church – congregation-wise as well as in its social action. As for the educational institutions in the Diocese of Medak, schools were made to adapt to modern trends to face the changing pattern. St. George's Grammar School, Wesley College and other educational institutions were modernised during Premasagar's tenure. In 1983, Elizabeth II of the United Kingdom came to Hyderabad. On 20 November 1983, the Queen celebrated her 36th wedding anniversary in the Holy Trinity Church in Bolarum, Secunderabad. The church service was officiated by Bishop Premasagar and his ministerial colleagues Rev. B. Prabhakar Rao and Rev. B. P. Sugandhar, the present bishop-in-Medak and the moderator of the CSI. Lambeth Conference The bishops of the Church of South India are invited to the decennial Lambeth Conference held at the Lambeth Palace, the seat of the archbishop of Canterbury in London. Rev. Premasagar attended the eleventh and twelfth conferences in 1978 and 1988 respectively. Other endeavours Bible Society of India Premasagar was a translator for the Bible Society of India (BSI) in its Telugu Bible Common Language Translation Programme since the 1970s. He headed the Translations Committee of the Bible Society of India Andhra Pradesh Auxiliary until the 1990s and then was followed by Rev. G. Babu Rao, his colleague while at ACTC. Premasagar was also the president of the Bible Society of India headquartered in Bangalore from 1988 to 1994 and continued to be a member of the India Bible Society Trust Association for a long period. Retirement After retirement from the bishopric, Rev. Ryder Devapriyam, Bishop in Nandyal and a former colleague of Rev. Premasagar while at ACTC, succeeded him as the moderator while Rev. B. P. Sugandhar, presbyter-in-charge