Final Ruling: 90 Day Limit for STM

I will save a lot more in 2018 if I go uninsured. (Stm in 2017)

Looking that way unless something is fixed.

I can make up to $225,000 in 2017 and be exempt from penalty in az, at $1530/Mo premium for low cost bronze. Duh, wat shuld I do?
 
Seriously buying st in 90 day increments is ridiculously risky.
The government is really screwing with people over 400% FPL leaving them with NO affordable options.
Very very sad.
 
Limiting STM to 90 days stops insureds making it to the next open enrolment.
That will magically allow the insured to affored an $1800 monthly premium . This will cause the insureds who were buying STM to buy ACA compliant plans.

Sorry I'm not seeing that happen. The flip side is STM should now be extremely and I mean extremely cheap in comparison to an ACA policy. 90 days does allow for an insured to create an SEP.

People will choose to go without or they will go the 90 days and risk it.

What's to stop someone buying a STM and then get diagnoset with cancer from renting a trailer the next county over and "moving" creating a SEP and hopping on a ACA plan. Desperate people will do desperate things when they are forced to.
 
Had a client do this when local medical center wouldn't agree to put on lung transplant list. "moved" to another state and sep allowed heim to leave his MA plan and go to regular medicare and now at Cleveland Clinic waiting on transplant.
 
I just spoke to UHC. The requirement limiting the contract term to 90 days likely won't become effective until 4/1. UHC is currently writing for 360 days. They are using the same network as their broadest national network which is used for groups.

I have to dig out the contract details but am thinking drop my BC direct policy. Enroll somewhere through the exchange. Ride the ACA grace period for 5 days then start the STM. Writing 2 STMs is a possibility that comes to mind. The 1st could be for whatever the shortest period is and run to day 6 of 2017. The 2nd would run to the end of the year when theoretically an ACA compliant plan would be available.

The main issue with this plan is at the end of the day, there are holes in coverage. I note that there is no pre-ex coverage. RX is limited (working from memory ~$3,000). The deductible is per cause, per term and could be expensive.

The other options are already expensive and are more expensive when sick.

My UHC STM Premium is ~$3,300 for what amounts to a $10,000 X number members OOP vs $20,000 in premium for a $6,400 OOP x2 family. I may add a supp acc rider for $5k to cover me if I fall off my bike.

Does anyone have a link to accurately calculating the family penalty? I'm going to try finding a sample cert.
 
Last edited:
I just spoke to UHC. The requirement limiting the contract term to 90 days likely won't become effective until 4/1. UHC is currently writing for 360 days. They are using the same network as their broadest national network which is used for groups.

I have to dig out the contract details but am thinking drop my BC direct policy. Enroll somewhere through the exchange. Ride the ACA grace period for 5 days then start the STM. Writing 2 STMs is a possibility that comes to mind. The 1st could be for whatever the shortest period is and run to day 6 of 2017. The 2nd would run to the end of the year when theoretically an ACA compliant plan would be available.

The main issue with this plan is at the end of the day, there are holes in coverage. I note that there is no pre-ex coverage. RX is limited (working from memory ~$3,000). The deductible is per cause, per term and could be expensive.

The other options are already expensive and are more expensive when sick.

My UHC STM Premium is ~$3,300 for what amounts to a $10,000 X number members OOP vs $20,000 in premium for a $6,400 OOP x2 family. I may add a supp acc rider for $5k to cover me if I fall off my bike.

Does anyone have a link to accurately calculating the family penalty? I'm going to try finding a sample cert.

I would think if you make enough to be worrying about a family penalty then you probably make more than $200,000 a year and should just buy the ACA compliant plan.
 
I would think if you make enough to be worrying about a family penalty then you probably make more than $200,000 a year and should just buy the ACA compliant plan.

Thanks for stating your opinion. However, there are friends and clients who have slightly different situations and those that make $200,000 aren't thrilled about sucking down a $20,000 premium for a plan that they will only see claims paid of $300 under the wellness benefit - especially since premiums will likely go up next year.

The issue of knowing exactly how the penalty works is still there. It's easy to know concepts and approximations but knowing the specifics or not is what makes an agent's information worth something. Never buy or sell insurance without understanding the situation.
 
Thanks for stating your opinion. However, there are friends and clients who have slightly different situations and those that make $200,000 aren't thrilled about sucking down a $20,000 premium for a plan that they will only see claims paid of $300 under the wellness benefit - especially since premiums will likely go up next year.

The issue of knowing exactly how the penalty works is still there. It's easy to know concepts and approximations but knowing the specifics or not is what makes an agent's information worth something. Never buy or sell insurance without understanding the situation.

I apologize I didn't mean to offend you, my point was only the premiums are so high for ACA plans allows about 85,% of the population to. Be exempt from the penalty, look up 8.05% ACA affordability exemption
 
I apologize I didn't mean to offend you, my point was only the premiums are so high for ACA plans allows about 85,% of the population to. Be exempt from the penalty, look up 8.05% ACA affordability exemption

That is useful. Thank you. Numbers for 1 scenario: Pay $20,000 for HDHP with $6400 OOP vs ~$3,500 for crappy benefits of STM.

The next question becomes "are there any other STM besides UHC with less holes in coverage".
 
Back
Top