Monthly Archives

October 2017

How Christian Ministry Healthcare Sharing Programs Work and a Smart Approach to Using Them

By | Health Insurance, Health Reform

Christian Sharing MinistriesHealth care sharing ministries aren’t legally insurance companies, they don’t technically offer “coverage contracts,” instead they promise to shift monies from one member to another to “share” costs.

“Health insurance is an actuarial contract,” says James Lansberry, Samaritan’s executive vice president and also president of the Alliance of Health Care Sharing Ministries, a trade organization. “People buy policies and health insurance promises to pay out claims and makes contracts with doctors and hospitals. They are regulated by the department of insurance in whatever state they’re in.”

By contrast, Lansberry says, “health-care sharing ministries make no promises or guarantees. We are faith-based ministries that deal with what has happened rather than what might happen. Members share in each other’s bills after they have already occurred.”

After incurring a medical expense deemed eligible under the sharing organization’s guidelines, members submit these bills or “needs” to the ministry, which manages the redistribution of members’ monthly payments to the appropriate households. Samaritan simply instructs members to send their monthly share checks directly to other members in need, whereas the other two programs collect and redistribute monthly contributions.

Members are in turn responsible for paying their medical bills directly. “Hospitals and doctors treat them as self-pay patients,” Lansberry says. “We encourage them to negotiate discounts on their bills.”

In addition to members needing to negotiate their own discounts on healthcare, there are these issues:

  • Exclusion of pre-existing conditions
  • NO guarantee they will pay as promised
  • When they do pay it is not in a lump sum; it is an unreliable payment stream over an unspecified period of time
  • Medical care can be difficult to get because Christian Sharing is set up as reimbursement – so if you can’t afford to pay for care upfront many providers will not accept you as a patient

But I WANT to Join A Christian Sharing Ministry

If you want to participate in a Sharing Ministry we suggest to our clients that they back up their participation with real insurance.  Here’s how we set that up:

  • Put the family on on one of our pre-qualified Short Term Medical Plans (or smarter still – combine the Short Term Medical Plan with our Fixed Benefits-Gap-Living Benefits Program).  It is REAL Insurance, and its AFFORDABLE and we have a 12 month program available for 2018.
  • Purchase Christian Healthcare Ministries. It is Christian Sharing but at a much lower cost.

Under this structure you and your family have real insurance coverage AND SHARING — so you have best of both worlds not just the faith based promise.

To learn more call us at now at 1-800-257-1723.  We’ll be happy to design a program that fits your personal goals!

Short Term Health Insurance is an alternative to Obamacare.

By | Health Insurance

Happy to have OptionsShort term medical plans – an alternative to Obamacare – are limited to 90 days under one certificate of insurance – but Companion Life offers insureds the opportunity to apply for up to four back-to-back certificates (1 year’s coverage) at one time.  That means you do not have to qualify again for the three additional certificates – and you can cancel at any time.

How it work: If you decide to enroll in back-to-back coverage terms, a new certificate of additional coverage will follow each 90-day coverage period.  Each certificate will have an effective date that starts the day after your previous coverage expires.

Shortly before the expiration of your active coverage, you will be notified of a new coverage ID card in your online member portal which you can print and use for the following period.

The Advantage of Back-to-Back-Policies. While your deductible and any out-of-pocket responsibilities start over with each subsequent coverage certificate, any medical conditions that arise and that were covered by your initial Pivot Health plan will be covered under your subsequent new certificates, subject to plan limitations.  There are no medical questions to qualify or new waiting periods after your initial enrollment.

Changes are coming.  President Trump signed an executive order that aims to allow short-term health plans to be offered for up to one year.  Until the “Trump Fix” is effective in mid-2018, the auto-reapply, no new pre-existing conditions is the best option to keep your family protected for up to 12 continuous months.

Apply today!  Contact us at: 1-800-257-1723

Why We are Aggressive When Pre-underwriting Our Clients

By | Life Insurance

We don’t take underwriting for granted because we know you don’t like surprises and neither do we.

Based on an original article by David A. Appel

medicalrecords_101853770What’s involved in securing new life insurance? What kind of personal information do I need to provide? What’s the medical exam like? Is it invasive?  Do I really need to disclose everything – even stuff I did in college?

These are just a few of the questions clients ask their advisor when trying to obtain new life insurance. Obtaining life insurance today is one of the most invasive processes someone can go through – medically, financially and lifestyle-wise.

Carriers leave no stone unturned when considering a prospect for a life insurance policy. If a doctor recommended the client have a medical procedure and that request is still open, the test must be completed. If the procedure or issue is not “closed out” and complete, the client needs a detailed explanation from the physician of why the procedure is delayed or is no longer necessary.

Clients also must understand that insurance-carrier physicians will look at their medical history differently than their primary care doctors do. My client’s doctor is making sure the client continues to live a long and healthy life, while the carrier doctor is making sure there isn’t anything in the records that could throw a curve ball into that plan.

Today, there also seems to be an abundance of unnecessary testing done in hospitals, by primary care doctors, and by concierge doctors to be “safe’.  In addition, we frequently see notes in a physician’s files that tend to be elusive, unclear or downright wrong. This is where a letter of clarification from the doctor comes into the process and must be requested. This is when we, acting as your agent, along with the client, must request the doctor to provide further explanation of why certain tests were completed, along with a description of the results.

As your agent, we also must conduct our due diligence and not take results at face value. We question the client on any information found in their records that doesn’t make sense. After 25 years in this business, I can’t even tell you the number of times incorrect bloodwork or procedures were found in our clients’ medical records.

Addressing the Issue

What’s the initial message here? Successful agents take full control of the situation. Clients don’t like surprises and neither do we. We start by having an aggressive pre-underwriting program. Before surprises pop up unexpectedly, we look for red flags in our client’s history. These red flags include medical issues as well as problems related to their motor vehicle report, in addition to any hazardous activities, use of controlled or uncontrolled substances, drugs prescribed for mental health conditions such as anxiety, or lifestyle decisions.

Without some probing or asking detailed questions, these issues tend to be placed in the “I forgot that” part of the memory bank or in the “we don’t need to disclose that now” category. Clients may think these shouldn’t make a difference on a life insurance application. But clients need to understand that everything makes a difference when it comes to applying for life insurance. Even though technology has come a long way, getting an application underwritten properly and approved is still an arduous process.

Once we start the informal tentative underwriting process or we submit a full formal application for approval, we like to make sure we present our client in the best possible light to the various insurers. We want to present the client as a human being, not just a stack of papers in a file.

In some cases, we include detailed cover letters that include a client’s background and community work, as well as a “possible underwriting issue” we recognize, such as a recent driving under the influence charge or any other pertinent information that we believe an underwriter could use to consider our client as positively as they can. The reason we bring up the “possible issue” is because we do not want the underwriter to discover it on their own. If we know an issue exists, let’s get it out on the table for discussion and be up front about it.

The amount of data you have, the clarity of that particular data, and how well it’s organized and presented can be the difference between a client getting a favorable decision from an insurer or being poorly rated, or – worst-case scenario – having their application postponed or declined.

We don’t ever want to take that chance. Our clients, their families and/or their businesses are too important to them and to us to take life insurance underwriting for granted.

That’s why we take control, take charge, and make it happen! We’re here to assist you get the coverage you want—call 800-257-1723 or write us now and let’s get started!

White House Executive Order – Now’s the time for Short Term Medical Insurance

By | Health Insurance, Health Reform
The White House
For Immediate Release

171012164525-trump-executive-order-1024x576Presidential Executive Order Promoting Healthcare Choice and Competition Across the United States

EXECUTIVE ORDER

– – – – – – –

PROMOTING HEALTHCARE CHOICE AND

COMPETITION ACROSS THE UNITED STATES

By the authority vested in me as President by the Constitution and the laws of the United States of America, it is hereby ordered as follows:

Section 1. Policy. (a) It shall be the policy of the executive branch, to the extent consistent with law, to facilitate the purchase of insurance across State lines and the development and operation of a healthcare system that provides high-quality care at affordable prices for the American people. The Patient Protection and Affordable Care Act (PPACA), however, has severely limited the choice of healthcare options available to many Americans and has produced large premium increases in many State individual markets for health insurance. The average exchange premium in the 39 States that are using www.healthcare.gov in 2017 is more than double the average overall individual market premium recorded in 2013. The PPACA has also largely failed to provide meaningful choice or competition between insurers, resulting in one-third of America’s counties having only one insurer offering coverage on their applicable government-run exchange in 2017.

(b) Among the myriad areas where current regulations limit choice and competition, my Administration will prioritize three areas for improvement in the near term: association health plans (AHPs), short-term, limited-duration insurance (STLDI), and health reimbursement arrangements (HRAs).

(i) Large employers often are able to obtain better terms on health insurance for their employees than small employers because of their larger pools of insurable individuals across which they can spread risk and administrative costs. Expanding access to AHPs can help small businesses overcome this competitive disadvantage by allowing them to group together to self-insure or purchase large group health insurance. Expanding access to AHPs will also allow more small businesses to avoid many of the PPACA’s costly requirements. Expanding access to AHPs would provide more affordable health insurance options to many Americans, including hourly wage earners, farmers, and the employees of small businesses and entrepreneurs that fuel economic growth.

(ii) STLDI is exempt from the onerous and expensive insurance mandates and regulations included in title I of the PPACA. This can make it an appealing and affordable alternative to government-run exchanges for many people without coverage available to them through their workplaces. The previous administration took steps to restrict access to this market by reducing the allowable coverage period from less than 12 months to less than 3 months and by preventing any extensions selected by the policyholder beyond 3 months of total coverage.

(iii) HRAs are tax-advantaged, account-based arrangements that employers can establish for employees to give employees more flexibility and choices regarding their healthcare. Expanding the flexibility and use of HRAs would provide many Americans, including employees who work at small businesses, with more options for financing their healthcare.

(c) My Administration will also continue to focus on promoting competition in healthcare markets and limiting excessive consolidation throughout the healthcare system. To the extent consistent with law, government rules and guidelines affecting the United States healthcare system should:

(i) expand the availability of and access to alternatives to expensive, mandate-laden PPACA insurance, including AHPs, STLDI, and HRAs;

(ii) re-inject competition into healthcare markets by lowering barriers to entry, limiting excessive consolidation, and preventing abuses of market power; and

(iii) improve access to and the quality of information that Americans need to make informed healthcare decisions, including data about healthcare prices and outcomes, while minimizing reporting burdens on affected plans, providers, or payers.

Sec. 2. Expanded Access to Association Health Plans. Within 60 days of the date of this order, the Secretary of Labor shall consider proposing regulations or revising guidance, consistent with law, to expand access to health coverage by allowing more employers to form AHPs. To the extent permitted by law and supported by sound policy, the Secretary should consider expanding the conditions that satisfy the commonality‑of-interest requirements under current Department of Labor advisory opinions interpreting the definition of an “employer” under section 3(5) of the Employee Retirement Income Security Act of 1974. The Secretary of Labor should also consider ways to promote AHP formation on the basis of common geography or industry.

Sec. 3. Expanded Availability of Short-Term, Limited‑Duration Insurance. Within 60 days of the date of this order, the Secretaries of the Treasury, Labor, and Health and Human Services shall consider proposing regulations or revising guidance, consistent with law, to expand the availability of STLDI. To the extent permitted by law and supported by sound policy, the Secretaries should consider allowing such insurance to cover longer periods and be renewed by the consumer.

Sec. 4. Expanded Availability and Permitted Use of Health Reimbursement Arrangements. Within 120 days of the date of this order, the Secretaries of the Treasury, Labor, and Health and Human Services shall consider proposing regulations or revising guidance, to the extent permitted by law and supported by sound policy, to increase the usability of HRAs, to expand employers’ ability to offer HRAs to their employees, and to allow HRAs to be used in conjunction with nongroup coverage.

Sec. 5. Public Comment. The Secretaries shall consider and evaluate public comments on any regulations proposed under sections 2 through 4 of this order.

Sec. 6. Reports. Within 180 days of the date of this order, and every 2 years thereafter, the Secretary of Health and Human Services, in consultation with the Secretaries of the Treasury and Labor and the Federal Trade Commission, shall provide a report to the President that:

(a) details the extent to which existing State and Federal laws, regulations, guidance, requirements, and policies fail to conform to the policies set forth in section 1 of this order; and

(b) identifies actions that States or the Federal Government could take in furtherance of the policies set forth in section 1 of this order.

Sec. 7. General Provisions. (a) Nothing in this order shall be construed to impair or otherwise affect:

(i) the authority granted by law to an executive department or agency, or the head thereof; or

(ii) the functions of the Director of the Office of Management and Budget relating to budgetary, administrative, or legislative proposals.

(b) This order shall be implemented consistent with applicable law and subject to the availability of appropriations.

(c) This order is not intended to, and does not, create any right or benefit, substantive or procedural, enforceable at law or in equity by any party against the United States, its departments, agencies, or entities, its officers, employees, or agents, or any other person.

DONALD J. TRUMP

THE WHITE HOUSE,

October 12, 2017.