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View Poll Results: Will you offer Health Ministry Plans in 2018?
Yes, because it's a great solution 3 13.04%
Yes, but reluctantly 0 0%
No, because it's not major medical 5 21.74%
No, for a host of other reasons 10 43.48%
Undecided as of now 5 21.74%
Voters: 23. You may not vote on this poll

Reply to Will You Offer Health Ministry Plans in 2018?     
Old 08-23-2017, 04:46 PM   #31
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kgmom219 on Will You Offer Health Ministry Plans in 2018?
 
Join Date: Apr 2013
Posts:4,873
State: kgmom219 is an Insurance Agent from Texas
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Will You Offer Health Ministry Plans in 2018? Re: Will You Offer Health Ministry Plans in 2018?
Originally Posted by Yagents View Post
Anyone read these guidelines and exclusions yet?
What are your top 5 pain points?

https://altruahealthshare.org/resources/guidelines/
1. There are no primary providers in Dallas TX.

Search Type: Provider Location: dallas, TX Type of Doctor: Family Practice / General Practice / Internal Medicine

No results were returned.

2. 24 months of pre-ex

Isn't 2 enough???

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Good things don't come to those who wait. They come to those who work their butts off and never give up.
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Old 08-23-2017, 05:36 PM   #32
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STIBROKER on Will You Offer Health Ministry Plans in 2018?
 
Join Date: Sep 2006
Posts:9,854
State: STIBROKER is an Insurance Agent from Texas
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Will You Offer Health Ministry Plans in 2018? Re: Will You Offer Health Ministry Plans in 2018?
As a non-insurance membership Altrua HealthShare or the
membership is not liable for any part of an individual’s medical need.

MEDICALLY NECESSARY
A service, procedure, or medication necessary to restore or maintain physical function that is provided in the most cost-effective setting consistent with the member’s condition. The fact that a provider
may prescribe, administer, or recommend services or care does not make it
medically necessary. This applies even if it is not listed as a membership limitationor an
ineligible need in the Membership Guidelines.

Ineligible Needs
Any need that requires pre-authorization is considered ineligible within the first 90 days from the effective date

Inpatient hospital stays exceeding 60 days per medical need.

Lifestyles or activities engaged in after the application date
that are in conflict with the Statement of Standards

Any illness, injury, or condition for which there is a
membership limitation. The member will be notified of membership limitations
when applying for membership


https://altruahealthshare.org/pdfs/a...nes_2017-2.pdf




Last edited by STIBROKER; 08-23-2017 at 05:53 PM.
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Old 08-24-2017, 09:25 PM   #33
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Join Date: Mar 2012
Posts:573
State: junkman is an Insurance Agent from Tennessee
Will You Offer Health Ministry Plans in 2018? Re: Will You Offer Health Ministry Plans in 2018?
Bummer. If you're married, can't get any stray. If you're not married, can't get any stray. Many in the church could not live up to that.

UHC said that STM may be able to be sold for 12 months. They are currently only 3 months. Here's hoping the Repubs at least can get that done.

What's a person to do? Pay $28,000 in premium for the cheapest plan or ????
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Old 08-25-2017, 05:58 AM   #34
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somarco on Will You Offer Health Ministry Plans in 2018?
 
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Posts:26,422
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Will You Offer Health Ministry Plans in 2018? Re: Will You Offer Health Ministry Plans in 2018?
Arguing for or against the nuances of a CSM may be fun on this forum but in real life it could be less enjoyable.

I do a very good job of educating my clients on the downside of enrolling in insured plans. Yet when claims roll in many of them forget what we discussed. Almost no one bothers to read their policy when it arrives, much less attempt to understand it.

If you visit consumer sites you will find numerous complaints about how the insurance carrier screwed them over by denying their claim. If you press them for details you will almost always find the following.

- they had no idea what was covered because they did not read their policy until AFTER the claim (if then)

- they almost never cross-check EOB's against medical bills, even when they get dunning letters

- they ASSUME once they pay their copay that is the extent of their liability

- they almost never understand what happens when they use a non-par provider and complain that failure of the carrier to pay the full amount is unfair

- more often than not they view their insurance card as medical credit card with an unlimited line of credit and expect it to pay everything

So why would you think they will read and understand the limitations of a CSM plan?

The health insurance market (including CSM and ancillary plans) is a snake pit right now. Enter at your own risk.



------------------------------------
The doctor is in. Five cents please.
Georgia Medicare Plans
GA Medicare Supplement Rates
(404) 252-5859
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Old 09-14-2017, 04:40 PM   #35
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Will You Offer Health Ministry Plans in 2018? Re: Will You Offer Health Ministry Plans in 2018?
Originally Posted by bluemarlin08 View Post
E and o won't cover a claim against you.
That says it all. We would be essentially sharing in the client's risk, too.

Somarco mentioned clients not reading policies. They have what I call the "motel theory" of assumptions about insurance, it covers almost everything, right?
When we think of a motel room, we make certain assumptions about the basic features: 1. TV with remote 2. toiletries in the bathroom, also bathroom for you, not shared with other guests. 3. clean linens (well, some are aware this could be an issue) 4. coffee maker with supplies to make coffee. 5. ice machine down the hall, bucket with plastic bag liner in your room. 6. hoping for breakfast buffet and free parking, sometimes disappointed. 7. fridge & microwave, disappointed if not there.

Insureds think insurance covers sickness and accidents, maybe a deductible, these days they usually expect copays, some sharing, but a maximum out of pocket. Essentially the structure of group and individual coverage for several decades. In rare instances some bumped up against lifetime limits pre ACA, and there are still stories searchable online, heart wrenching ones about coverage denied to sick kids, etc.

I have 3 clients who have had claims over $1 mil, and those are the ones I know about. All had unlimited coverage after the Max out of pocket.

I could not sleep if I was selling products that could be misinterpreted, give a false sense of security & I would not be covered for lawsuits/judgments under E&O.

So, no, not selling faith based plans. People need to read up on market values and costs. Your house isn't worth what it was worth at a market peak, and lower cost health plans will cover less.
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Last edited by yorkriver1; 09-14-2017 at 04:45 PM.
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