Last week delivered some sad news for the individual ACA market in Indiana. Both Anthem BCBS and MD Wise announced they will be exiting the ACA market in Indiana in 2018. This will leave many Hoosier clients with difficult choices to make regarding their health insurance options in 2018.
In addition to the tough choices many Hoosier clients will be forced to make, the Indiana health insurance brokers will also have some difficult new challenges. There will now be only two carriers in the market and who knows if either will be paying commissions during open enrollment. Not only that but the open enrollment window is now only 6 weeks long. For health insurance brokers focused on the individual health market this industry gets tougher by the day with all the new landmines.
As a former executive of UnitedHealthcare for 20+ years, I have been a student of this industry for a long while. For most of those years, I was highly skeptical of Healthcare Sharing Plans. They are not regulated by the Department of Insurance. They are not real insurance. They have no guarantees. They do not cover pre-existing conditions for up to 3 years. Many of them have limitations on Rx, preventive care, etc.
Two years ago, I started buying my own health insurance plan for the first time in my life. For the first year, I purchased an ACA plan with a $5,000 deductible, 80/20 coinsurance, and a narrow PPO network. I have a wife and four children so the cost was almost $1,400 per month. After a year of paying close to $20,000 per year in annual premiums, I decided there must be a better solution. I started researching all the Healthcare Sharing Plans in the market; Medi-Share, Christian Healthcare Ministries, Samaritan Ministries, Liberty HealthShare and Altrua HealthShare.
After much research, I chose to purchase a Medi-Share plan for my family. I now pay $358 for a $5,000 Annual Household Portion. A $5,000 AHP is like a $5,000 annual family deductible, then 100% for eligible sharing expenses. This program also includes a large, expansive national PPO network; Multiplan / PHCS which included 100% of all my doctors and nearby hospitals. My potential out of pocket exposure for this member sharing program is significantly less than my previous ACA plan.
There is no question that Healthcare Sharing Plans have a lot of risk. The most repeated sentence in each of the program materials is “this is not insurance and there are no guarantees”. So, what closed the deal for me? It is that the program I chose has over 300,000 members in all 50 states and they have paid every dollar they said they would pay since 1993. This is not to say that every medical bill has been paid, but according to their guidelines of what is eligible for sharing, they have fulfilled their promise for the past 24 years. My personal experience for the last year has been exceptional and their process and service for sharing my family’s medical bills has been outstanding.
Healthcare Sharing Plans are not for everyone. Most of these programs are faith-based and you must agree to the statement of faith. Most of them have strict guidelines on no sharing for pre-existing conditions for 3 years. However, there are now over 1 million Americans who are part of a Healthcare Sharing Plan in America. The numbers are growing at a staggering rate. Each time an ACA carrier decides to pull out of the market, narrow the PPO network or dramatically increase the rates I am grateful for these affordable alternative options.
Some of these Healthcare Sharing Plans are now making their programs available through health insurance brokers in Indiana and all 50 states for that matter. The great news is that they pay a generous compensation, no open enrollment period required and best of all you can offer many of your clients an affordable solution to this enormous health insurance problem they will be facing in the very near future.
If you would like more information on these Healthcare Sharing Plans please contact me.