Christian Health Ministries

[Family Man]

I like the different perspectives in this thread! I'm adding two that I haven't read yet. I've had two non-clients with ACA HMO plans with legit out of network ER visits (one with a heart attack and one with a broken leg). Carriers didn't consider either one a legit ER and only paid a portion of the medical bill, leaving disgruntled ACA clients with $100k+ in bills. So, IMO, carriers have left some (many?) people with the short end of the stick, too. On the other hand, haven't had any personal contact with a disgruntled CHM member (yet).
Secondly, I've had three peers with cancer, two just died, who had been denied or delayed treatment SOLELY because the insurance carrier said it was not necessary at the doctors' requested time. Who needs "death panels" when the insurance companies can determine when and what amount of medical care is authorized? Of course, I am aware that some clients have used hundreds of thousands of dollars in treatments, but please don't sell me this arrogant foolishness that insurance carriers are angelic in paying for everything every time.

I suppose I need to clarify that I did all that one can do to appeal those medical bills not paid by the carriers. While the carriers did nothing further, the providers discounted nothing, either.

 

[Evan]

Never Trust anyone with the name "Family Man"

 

[junkman]

These are a great idea......until this what is essentally a trust has significant claims and those who can bail to whatever other plan they have access to. It may be more viable given the current world of ACA open enrollment without pre-ex. It may be one way of getting into a cleaner pool than is currently available via ACA or small group.

I know one person whose child has some significant illness with meds excluded by the plan she is on. She simply dumped him on the state plan for uninsured children and is letting the state cover it. Of course, she claims to be a devout Christian while raging against big government.

She is also one to claim that Christianity is the "peaceful religion" while espousing the belief that we should lock our boarders, throw out any illegals regardless of circumstance or cost and wage war against Islam before they come get us. Of course regardless, God will take care of her above anyone or anything. She doesn't seem to be the sharpest tack in the box but does know her insurance.

 

[sman]

I like the different perspectives in this thread! I'm adding two that I haven't read yet. I've had two non-clients with ACA HMO plans with legit out of network ER visits (one with a heart attack and one with a broken leg). Carriers didn't consider either one a legit ER and only paid a portion of the medical bill, leaving disgruntled ACA clients with $100k+ in bills. So, IMO, carriers have left some (many?) people with the short end of the stick, too. On the other hand, haven't had any personal contact with a disgruntled CHM member (yet). Secondly, I've had three peers with cancer, two just died, who had been denied or delayed treatment SOLELY because the insurance carrier said it was not necessary at the doctors' requested time. Who needs "death panels" when the insurance companies can determine when and what amount of medical care is authorized? Of course, I am aware that some clients have used hundreds of thousands of dollars in treatments, but please don't sell me this arrogant foolishness that insurance carriers are angelic in paying for everything every time. I suppose I need to clarify that I did all that one can do to appeal those medical bills not paid by the carriers. While the carriers did nothing further, the providers discounted nothing, either.

Can you show me where ANYONE has referred to carriers as "angelic"?

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These are a great idea......until this what is essentally a trust has significant claims and those who can bail to whatever other plan they have access to. It may be more viable given the current world of ACA open enrollment without pre-ex. It may be one way of getting into a cleaner pool than is currently available via ACA or small group. I know one person whose child has some significant illness with meds excluded by the plan she is on. She simply dumped him on the state plan for uninsured children and is letting the state cover it. Of course, she claims to be a devout Christian while raging against big government. She is also one to claim that Christianity is the "peaceful religion" while espousing the belief that we should lock our boarders, throw out any illegals regardless of circumstance or cost and wage war against Islam before they come get us. Of course regardless, God will take care of her above anyone or anything. She doesn't seem to be the sharpest tack in the box but does know her insurance.

Yeah those Christians are out there killing people. Very violent group. (Sarcasm intended)

 

[TNagent82]

So I feel like I'm opening a can of worms here by getting this restarted, but I'm curious to anyone who has actual experience w/ health sharing plans. I feel like there have been a lot of opinions expressed but not much substantial. I'll be honest that I don't know enough about these plans to refute what anyone is saying, but a lot of the things I've read on this post was opinion based and yes, fear mongering.

I have a client that is electing to get one of these plans (he researched on his own) which has sparked my interest in learning more about these plans and if they are a good alternative for some or not. The way I see it, in TN, the only options you have are 1) Marketplace (which we don't get paid on anymore so I'm not offering any advice anymore to clients because I don't need additional E&O exposure from something that I don't get paid, 2) Short Term Plans which have their flaws, 3) Christian Health Sharing, or 4) nothing.

My initial concerns w/ health sharing plans: 1) E&O claims and whether or not my carrier will cover (seems unlikely), 2) prescription benefit potentially not capped if client goes beyond 6 months, 3) if company becomes insolvent and withdraws and clients can't get ACA plan until open enrollment, and 4) this was brought up by someone else, but does scheduling a major surgery become an issue either in uncertainty of doctor getting paid creating an extremely high deposit requirement (is that just a fake concern?). However, using this as an example, my healthy client and family will be paying 350 vs 1500 on ACA compliant plan. The health sharing has 5k AHP but the ACA plan has 6k individual deduct w/ no copays. He doesn't qualify for subsidy. Also, largest carrier (which he is currently on) has withdrawn from 3 majors metro areas which affects him. He is affluent and understands the limitations and risks (which really the biggest risk we discussed was an extremely high prescription that goes past the 6 month window). I don't sell these (currently) so I didn't know enough to raise too many concerns.

I honestly see some risks and limitations w/ both health sharing and short term, but there is such a huge premium difference for my clients that don't qualify for a subsidy that people are out looking for alternatives and consider the risks to be calculated ones. Maybe I'm completely blind, but I feel like there is a huge segment of population that doesn't qualify for subsidy and are healthy where these types of plans make sense. I also have never been big on the indemnity plans, but with the high deducts that people are having to take, I see them making a lot more sense.

I guess that was a long winded way of asking: 1) do you really know enough about these plans to advise against them and 2) are most of you selling ACA plans still or selling alternative plans like short term or health sharing? I sell mostly P&C so I would just prefer to get out of the individual health market anyways, but I keep seeing a large segment of people that are looking for alternatives.

 

[somarco]

Things I don't like and why I would never participate in or offer one to clients.

1 - No financial guarantees.
2 - No direct regulatory oversight
3 - No true appeal process for denied claims
4 - Some plans don't cover p-x or have caps
5 - Some plans have annual overall caps
6 - Repricing discounts are arbitrary or non-existent without leverage
7 - May not be considered creditable coverage for transitioning to Medicare
8 - Some plans have non-existent drug coverage, only a discount

There are probably other concerns but these are the ones that jump out.

 

[Cenla Agent]

Things I don't like and why I would never participate in or offer one to clients.

1 - No financial guarantees.
2 - No direct regulatory oversight
3 - No true appeal process for denied claims
4 - Some plans don't cover p-x or have caps
5 - Some plans have annual overall caps
6 - Repricing discounts are arbitrary or non-existent without leverage
7 - May not be considered creditable coverage for transitioning to Medicare
8 - Some plans have non-existent drug coverage, only a discount

There are probably other concerns but these are the ones that jump out.

Glancing at it quickly, I think these are quite valid. I've noted some of them myself, maybe even in this thread if it is the one I'm thinking of. (As far as I know, none of them cover p-x or else they definitely exclude many p-x.)

The biggest thing that people need to know is that ultimately there is no promise (or guarantee) to pay. My understanding is that this is why it isn't considered insurance, although usually there is a state or two at any given time that isn't allowing it to be sold.

It seems to me that the people who get these tend to fall into two categories:

1 - Those who have a political and/or moral objection to Obamacare
2 - Those who wouldn't get Obamacare regardless due to cost

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So I feel like I'm opening a can of worms here by getting this restarted, but I'm curious to anyone who has actual experience w/ health sharing plans. I feel like there have been a lot of opinions expressed but not much substantial. I'll be honest that I don't know enough about these plans to refute what anyone is saying, but a lot of the things I've read on this post was opinion based and yes, fear mongering.

There is indeed some fear mongering, (and a little "hate," to use a word that is overused today) along with some very good advice and information. But with regard to the "fear mongering" keep in mind that the original purpose of health insurance was to cover catastrophic situations, and that is precisely where the biggest exposure under these plans is.

If you're looking for advocates of these plans, this forum is the wrong place to look, for obvious reasons. Google is your friend. I recall seeing a number of blogs and other sites in which people related their experiences (good and bad) with these ministries.

I think these plans are probably fine for many people IF people understand what they are. Some do, some don't. The kind of people who don't understand what they are tend to be the kind of people who don't understand what anything is. Some of them are the kind of people who would buy the NASE insurance several years ago and couldn't be persuaded otherwise. Huge mistakes can be made by going with the wrong ACA plan as well, especially now that companies have started offering plans with extremely narrow HMO networks.

I have a client that is electing to get one of these plans (he researched on his own) which has sparked my interest in learning more about these plans and if they are a good alternative for some or not. The way I see it, in TN, the only options you have are 1) Marketplace (which we don't get paid on anymore so I'm not offering any advice anymore to clients because I don't need additional E&O exposure from something that I don't get paid, 2) Short Term Plans which have their flaws, 3) Christian Health Sharing, or 4) nothing.

My initial concerns w/ health sharing plans: 1) E&O claims and whether or not my carrier will cover (seems unlikely), 2) prescription benefit potentially not capped if client goes beyond 6 months, 3) if company becomes insolvent and withdraws and clients can't get ACA plan until open enrollment, and 4) this was brought up by someone else, but does scheduling a major surgery become an issue either in uncertainty of doctor getting paid creating an extremely high deposit requirement (is that just a fake concern?). However, using this as an example, my healthy client and family will be paying 350 vs 1500 on ACA compliant plan. The health sharing has 5k AHP but the ACA plan has 6k individual deduct w/ no copays. He doesn't qualify for subsidy. Also, largest carrier (which he is currently on) has withdrawn from 3 majors metro areas which affects him. He is affluent and understands the limitations and risks (which really the biggest risk we discussed was an extremely high prescription that goes past the 6 month window). I don't sell these (currently) so I didn't know enough to raise too many concerns.

As far as I know, no one "sells" these, do they? As long as he knows it isn't insurance, he may be fine so long as he understands the risk he is taking.

Due to the model, these ministries (at least the ones I've looked at) wouldn't go "insolvent" in quite the way that an insurance company would. Ultimately there is no promise to pay, which is why it isn't considered insurance. My understanding is that the members are asked to kick in extra if someone has cancer, etc. Obviously that has its limitations and I can't help but think that it will go upside down at a certain point. But if it is a choice between this and no coverage at all, who is to say it is wrong? Certainly not me, especially with the skyrocketing premiums that figure only to get worse if Trump gets rid of the individual mandate but keeps the GI requirement.

The high deposit requirement for surgery definitely is not a fake concern. I think you can see this even with high deductible insurance plans. They can generally expect to pay up front for all visits, etc. as a cash customer.

If you don't want E&O exposure and don't want anyone saying you gave them advice, simply refer them to Samaritan or whoever if they have questions. Many of the questions you have here can probably be answered by going to the websites of the various ministries. If it is vague, (and all of them are to a certain degree) that's a cause for concern to be sure.

I honestly see some risks and limitations w/ both health sharing and short term, but there is such a huge premium difference for my clients that don't qualify for a subsidy that people are out looking for alternatives and consider the risks to be calculated ones. Maybe I'm completely blind, but I feel like there is a huge segment of population that doesn't qualify for subsidy and are healthy where these types of plans make sense. I also have never been big on the indemnity plans, but with the high deducts that people are having to take, I see them making a lot more sense.

I agree that there is a segment of the population that wouldn't be wrong to give these options serious consideration. Some of the options are more worthwhile than others.

I guess that was a long winded way of asking: 1) do you really know enough about these plans to advise against them and 2) are most of you selling ACA plans still or selling alternative plans like short term or health sharing? I sell mostly P&C so I would just prefer to get out of the individual health market anyways, but I keep seeing a large segment of people that are looking for alternatives.

Unless it is one of the indemnity or short term plans, there isn't money to be made in the market regardless. I haven't sold any of it this year and don't plan to.

EDIT: OK I do see the link now about selling Altrua and earning commissions. I do think that stinks. I recently had someone contact me on LinkedIn about selling an Obamacare alternative. He's not a guy I'd trust and I wouldn't be surprised if this is what he is pushing.

The only ones that I've ever glanced at in passing have been Samaritan Ministries and CHM.

 

[somarco]

As far as I know, none of them cover p-x or else they definitely exclude many p-x

Could be mistaken, but I believe one (or more) of the plans have a "rider" that provides limited p-x coverage.

isn't considered insurance

Correct.

No oversight by the DOI. Some of the plans that have failed were taken to task by the AG.

Bruce Hawthorn ran afoul of the law when he was affiliated with Christian Brotherhood.

Christian Group Criticized As Unsound Insurance Plan - NYTimes.com

Lawsuit: Health Plan Accused | Christianity Today

After the Scandals - Newsletter - ChristianityTodayLibrary.com

Ohio Jury Finds Nonprofit Founder and Family Liable for $14 Million in Damages | News | PND

 

[kgmom219]

S
I guess that was a long winded way of asking: 1) do you really know enough about these plans to advise against them and 2) are most of you selling ACA plans still or selling alternative plans like short term or health sharing? I sell mostly P&C so I would just prefer to get out of the individual health market anyways, but I keep seeing a large segment of people that are looking for alternatives.

1. Yes. I've read the fine print and its crap
2. I sell ACA,convert as many to group as possible for 2017 and STM
3. Under no circumstance will I sell this atrocity
4. Call your favorite cancer center, tell them you have Good Samaritan and ask how the coverage works
5. No one gets judge me on Earth. And these plans judge their membership.
6. I've seen claims letters for $100K claims, where they paid $25K and suggested the member ask for charity relief or file bankruptcy
7. If you get lung cancer, are they going to pay the claim? Smoking falls outside the "Christian living" requirements. 10-15% of lung cancer patients never smoked. How do they handle that?

Want me to keep going? These Christian Share Ministries are an abomination to the faith. They are not going to take care of you. Or your children. And I will not be responsible for selling these plans, knowing that if you have a catastrophic diagnosis you are going to be without adequate coverage.

(Although, I am still considering doing a Snake Ministry plan. Take everyone's money for 6 months. You can get the plan if you don't get bit by the snake. I'm going to collect the premiums, stall on any claims, then take off to some place without extradition. There's no government oversight on this, so who is going catch me before I land in Venezuela?)

 

[tonyisme]

It sad many of the people that buy these still think it's some kind of insurance even though they're told it's not insurance. (Maybe they are told...maybe not) And some of these healthy people left the insurance risk pools that would have helped hold down premium rates.

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Yeah last year I went to lunch with about three other men who go to my parish ..three of them had the Christian Healthshare plan and I was the only one that had insurance... seems like when one person buys it they go and tell their friends and pretty soon you know what happens