STM Solution?

Full Throttle

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Midwest
This could really go in the individual health forum as well. I get a call from someone who is on a group plan at work and has to make an open enrollment decision on whether to include his daughter this year (currently has no coverage).

The group premium is steep for his budget with a very high deductible. The daughter is ineligible for any dependent only plans in my area except for short term medical. Assurant has a contract for up to 6 months which would take her to January when the exchanges kick in.

If I understand correctly, the daughter would be eligible for the exchange even if dad is on a group plan? But, there wouldn't be a subsidy even if the income was under 400% FPL since he is eligible for the group plan at work? I am correct on this?
 
in most cases you are correct... no subsidy for you

yea....it is going to get real up in here...
Not Qualified For Obamacare's Subsidies? Just Lie -- Govt. To Use 'Honor System' Without Verifying Your Eligibility - Forbes

I, and several others at the time, said “wait a minute.” According to the law, you aren’t eligible for Obamacare’s subsidies if your employer has offered you what the government considers “affordable” coverage. But if employers are no longer going to report whether or not they’ve offered “affordable” coverage, how can the government verify whether or not workers are eligible for subsidies?
 
the STM option is getting a lot of attention as a 'long term' solution for people above the subsidy line-they would have to pay the penalty but the premiums are much lower.

This is a very good solution for healthy higher income people who just want to make sure their assets are protected in the event of a catastrophic illness-it's a pretty good deal for the agent as well.
 
the STM option is getting a lot of attention as a 'long term' solution for people above the subsidy line-they would have to pay the penalty but the premiums are much lower.

This is a very good solution for healthy higher income people who just want to make sure their assets are protected in the event of a catastrophic illness-it's a pretty good deal for the agent as well.

DEFINITELY...so long as their STM expiration date coincides with the annual open-enrollment period, or the plan is in effect during an OEP. Too bad there aren't customizable STM's that can be set for more than a 12 month duration. Those could be sold today and run all the way to December 2014.
 
DEFINITELY...so long as their STM expiration date coincides with the annual open-enrollment period, or the plan is in effect during an OEP. Too bad there aren't customizable STM's that can be set for more than a 12 month duration. Those could be sold today and run all the way to December 2014.


OK...but what about prex with STM......that has always been a issue with this product....
 
OK...but what about prex with STM......that has always been a issue with this product....

I joined the thread in mid-discussion, but isn't the original poster assuming there there is no existing or previously existing medical conditions? You DO NOT want to write an STM if there is a medical condition now, or in the recent past. As you say STI, too many potential landmines. One "blew up" on me a few years ago.

For that matter, even the limited benefit indemnity plans will avoid paying a claim, or cancel the policy outright, if a Pre-existing condition requires medical treatment in the first year...unless you disclosed it on the application. Had one of those "blow up" on me too...just this year.
-ac
 
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OK...but what about prex with STM......that has always been a issue with this product....

Pre-ex not covered with STM, that's why it needs to be used the right way and only offered to people without any pre-ex that might run up a big medical bill before they could get on an exchange plan.
 
only offered to people without any pre-ex that might run up a big medical bill before they could get on an exchange plan.


yea....over 19 years have found everyone has some sort of prex....then you get sued for writing it and not putting them in the exchange.....
 
Because STM is not underwritten, insurers often use non-related medical issues that aren't even asked about on the application to deny claims.

Example: "Do you have, or have you had hypertension in the past ____ years, is not a question on the TEMP application. But if you have a heart attack, stroke, or any other vascular related medical incident, the STM company will pull your medical records, find out you have/had hypertension, and deny the claim. :nah:

Government regulation has its place in health insurance, because the cost for medical care is staggeringly high. Unfortunately, STM's and Indemnity Plans are (almot) totally un-regulated in their present form. This is a major reason why the premiums are relatively low and commissions very high.
-ac
 
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