Christian Health Ministries

[Family Man]

I've referred some folks to these plans (to enroll on their own) as long as they understand that such plans are NOT health insurance and that I cannot sell these plans. These ministries fit a need despite their shortcomings (avg health insurance premium is up 200-250 per member per month among my few existing major med clients). After explaining these particular points, I offer that they couple a ministry plan with a short term plan if eligible. Despite the above insurance forum opinions, I've recently and personally met three different people who said the ministries paid claims--as they said they would pay--for "covered/eligible/whatever" items. Bottom line: I always offer eligible individuals (those who intend to enroll into a sharing ministry) a short term MM policy.

 

[Cenla Agent]

6. I've seen claims letters for $100K claims, where they paid $25K and suggested the member ask for charity relief or file bankruptcy.

I'd love to see a copy of one of those letters advising bankruptcy if anyone has an example. Whatever happened to "Owe no man anything?" Charity? Huh. And all along I thought charity existed because the church "isn't doing its job." Christians not paying their bills? What kind of testimony is that? Well, I guess we can be like Trump and "take advantage of the laws of this country."

The fact of the matter is, medical costs, etc. have gotten beyond the point to where most religious organizations can meet them. And I'm referring to the denominationally owned hospitals of the past and not these kinds of ministries. Think of all of the Baptist, Presbyterian, Methodist and similar hospitals of the past. Most of those are corporately owned now, other than the Catholic systems, I guess.

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I'll add that I've heard credible reports of 100k claims being paid with these sharing ministries, at least eventually. But the point is that unlike insurance, there there is no guarantee of payment, whether timely or not.

 

[TNagent82]

Thanks for all the responses. Quick question for ACA alternatives (again, I'm in TN so agents can't really sell ACA Compliant plans anymore since no carrier is paying a commission and honestly, it wasn't worth the small commission last year): I still have a lot of clients that don't qualify for subsidies that are looking for alternatives. I know some short term plans might work but there are obviously some concerns going that route as well. One client brought up Farm Bureau health plans and I'm having an issue figuring out their plans. They have several plans that are listed as not ACA compliant on the website and just looking at the summaries online, these plans: 1) don't say they are short term, 2) have maternity coverage, 3) offer 100% preventative coverage, 4) have an unlimited lifetime max, etc. I was under the understanding that short term and indemnity (and medishare) were the only options for an alternative to ACA and some of these coverage options aren't supposed to be available for non-compliant plans. Am I missing something?

 

[Cenla Agent]

Thanks for all the responses. Quick question for ACA alternatives (again, I'm in TN so agents can't really sell ACA Compliant plans anymore since no carrier is paying a commission and honestly, it wasn't worth the small commission last year): I still have a lot of clients that don't qualify for subsidies that are looking for alternatives. I know some short term plans might work but there are obviously some concerns going that route as well. One client brought up Farm Bureau health plans and I'm having an issue figuring out their plans. They have several plans that are listed as not ACA compliant on the website and just looking at the summaries online, these plans: 1) don't say they are short term, 2) have maternity coverage, 3) offer 100% preventative coverage, 4) have an unlimited lifetime max, etc. I was under the understanding that short term and indemnity (and medishare) were the only options for an alternative to ACA and some of these coverage options aren't supposed to be available for non-compliant plans. Am I missing something?

I don't know, but I'm not familiar with the TN market. Maybe they got some kind of waiver? The website says that their plans use United's network. In other states their agents will sell health but it will be Blue Cross or Humana or whatever. Whatever their ACA compliant plan is, apparently it is off-exchange only.

I am familiar with a plan in a different state that offers coverage for 364 days (with an option to renew upon answering a handful of health questions) but they have a lifetime max. It basically works like the traditional major medical otherwise. But I didn't see anything about limited term here.

 

[junkman]

Thanks for all the responses. Quick question for ACA alternatives (again, I'm in TN so agents can't really sell ACA Compliant plans anymore since no carrier is paying a commission and honestly, it wasn't worth the small commission last year): I still have a lot of clients that don't qualify for subsidies that are looking for alternatives. I know some short term plans might work but there are obviously some concerns going that route as well. One client brought up Farm Bureau health plans and I'm having an issue figuring out their plans. They have several plans that are listed as not ACA compliant on the website and just looking at the summaries online, these plans: 1) don't say they are short term, 2) have maternity coverage, 3) offer 100% preventative coverage, 4) have an unlimited lifetime max, etc. I was under the understanding that short term and indemnity (and medishare) were the only options for an alternative to ACA and some of these coverage options aren't supposed to be available for non-compliant plans. Am I missing something?

I "think" I'm going with UHC's STM over the $20,000 ACA plans. I haven't made the final decision but am looking at the specifics now.
see my post for final questions.

I'm only considering OOP liability, shortcomings/limitations and premiums. Copays copays and coinsurance are not important to me. The deductible is not included in the OOP which means that a $5,000 deductible with $5,000 OOP is really a $10,000 OOP. I may buy down to a $5,000 deductible by adding supp acc since I bike ride and am more likely to have an accident than anything. The per cause deductible is an option that I'm not comfortable with because it pushes the liability too high.

My current thoughts are to buy the cheapest ACA plan available. I'll put my son and wife on one contract. If it makes financial sense, I'll pay her January premium and fully fund a family HSA. I won't pay my premium unless I'm in the hospital.

I'll enroll her and my son under a UHC STM effective 01/23/2016 and have coverage through 2016. I'll be under another STM.

My thinking is that if one of us gets sick in Jan, I'll keep the ACA plan for the duration but I don't want to pay the premium for the entire family. I'll ride the grace period in Dec 2016 and again in Jan. Total savings are upwards of $15,000.

You'll have to do your own calculations and it is not cost effective to do all of this for anyone else if you want to consider all of the options. ACA carriers are Cigna, Humana or BCBST and Farm bureau. FB is using UHC's commercial network as is the Golden Rule STM.

Feel free to weigh in on this other thread.

http://www.insurance-forums.net/for...e-forum/correct-aca-uhc-grule-stm-t85737.html

 

[bluemarlin08]

Why not do a NG 30 day plan for January then the GR for the balance of the year?
That is what many folks are doing and adding a $45 per month per person bronze CHM plan for those with high incomes subject to penalty.

 

[junkman]

Why not do a NG 30 day plan for January then the GR for the balance of the year?
That is what many folks are doing and adding a $45 per month per person bronze CHM plan for those with high incomes subject to penalty.

My main reason is that a STM will be unavailable to anyone that has a serious illness. We can currently live with the pre-ex that we have. UHC's STM can only be written for 360 days and not a full year. What happens if one of us gets sick in the 1st 5 days and has no ACA coverage? How do you spell **** out of luck?

I don't believe in buying the high commission look-like-insurance plans that many are touting. They have so many holes as to be worth the paper they are written on only if you are the one selling and not the one buying.

I still haven't found a premium grace period for paying the 1st month's premium.

Basic law of insurance: Premium - commission - overhead is available to pay claims. The higher the commission, the less claims the carrier is planning on paying.

 

[bluemarlin08]

What happens if one of us gets sick in the 1st 5 days and has no ACA coverage? How do you spell **** out of luck?

If you had a 30 day plan for January, and had a big claim, you can go to an aca plan effective Feb 1, the issue would be if you had a claim within the 15th and end of month and couldn't immediately get on an ACA plan. Risk everywhere.

 

[junkman]

If you had a 30 day plan for January, and had a big claim, you can go to an aca plan effective Feb 1, the issue would be if you had a claim within the 15th and end of month and couldn't immediately get on an ACA plan. Risk everywhere.

That may work because the STM has to extend to the end of an illness so you'd be covered until for example out of the hosp (at least used to - I have to confirm under current rules). Write 1 STM for the 1st month. Have another ready to go beginning 2/1. Have an ACA plan ready 2/1 but only pay the premium if necessary. Stay in the house the few hrs where there you're uncovered and hope you don't have a heart attack. Alternatively, go on vacation because most illnesses happen at home. (JK about the last statistic because while true, it has nothing to do with probability.)

So far, UHC has the best STM by far that I've seen.

 

[bluemarlin08]

Compare their rates with National General. Different ages, huge premium difference.