STM who Has Continuation of Benefits?

Discussion in 'Health Care Reform Forum' started by junkman, Aug 7, 2017.

  1. junkman
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    junkman Well-Known Member

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    STM can only be written for 3 months under current law. Rumor (from carrier reps) has it that this "may be" extended.

    Under old (perhaps ancient) rules, benefits for a given illness would continue past the contract end date for example if the insured were in the hospital.

    UHC at least has no continuation of benefits meaning when contract ends 10/31 and the person is in the hospital, charges from 11/1 and later are not eligible expenses under the contract.

    You can take an app 60 days before the effective date and the policy would be issued. You could still run into a pre-ex problem. Suppose you write 1 contract effective 1/1 with a 3 month term. The person can pass underwriting on 2/1 so you write for a 4/1 effective date the date that the old contract ends. The contract would be issued effective 4/1 however, any new illness or accident incurred prior to 4/1 would not be covered.

    Note that some illnesses are an automatic decline ie cancer etc.

    Is there a carrier that would cover someone that's in the hosp at the end of the contract term until they get out of the hosp?
     
  2. somarco
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    somarco Well-Known Member

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    I never wrote much STM. Considered it more akin to gambling than real insurance.

    That being said, I don't recall EVER seeing continuation of benefits in an STM. Group insurance, yes. Most (all?) traditional major med had continuation.

    If STM had continuation the premiums would be considerably higher.
     
  3. AllenChicago
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    AllenChicago Well-Known Member

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    Yes. See gacquote.com. called ez-stm.
     
  4. somarco
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    somarco Well-Known Member

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    AC, the language in the brochure is not a true continuation of benefits. It appears the plan will waive px for covered conditions that occurred during a prior STM policy.

    Maybe you have seen something different that I missed. The referenced language has a fair amount of wiggle room.
     
  5. junkman
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    junkman Well-Known Member

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    STM has many holes. Waiver of pre-ex that occurred in prior period is better than nothing.

    Pre-ACA we'd write STM when there were no other options. Now, price is a driver especially for the unsubsidized in good health.
     
  6. mschlange
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    mschlange Well-Known Member

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    I have one that can cover 360 days with an online enrollment process. Add an MEC and you also avoid the penalty. PM me if your interested
     
  7. CHUMPS FROM OXFORD
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    CHUMPS FROM OXFORD Well-Known Member

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    Why not post details publicly?
     
  8. taterpeeler
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    taterpeeler Well-Known Member

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    according to Obama a 360 day policy is illegal....has anyone of your clients had the "MEC" for over a year where the plan passed muster with the Internal Revenue Service?

    Are you using "Talking Point" provided by USA for healthcare?
     
  9. kgmom219
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    kgmom219 Well-Known Member

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    I'm going with illegal, unethical or immoral.

    One of those ;)
     
  10. Yagents
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    Yagents Well-Known Member

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    He's referencing the 4 X 3 STM products out there. Four - 3 month policies back to back with no new medical questions on subsequent apps, but it does have a new deductible each 3 mo period.

    Then packaging it probably with some $40 MEC plan from somebody.

    They best reverse the SM 12 mo prohibition, or the carriers will just find some way around it, building a less than optimal product at the clients' expense.
     
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