As a pastor, finding a faith-based health insurance provider for yourself and your church staff should be easy. Over 60% of Americans identify as “Christian” — surely there are insurance organizations that cater to you.
In reality, actual faith-based insurance companies aren’t easy to find. Search “Christian Health Insurance” on Google and you will find a multitude of options. However, these companies will help you cover the costs of medical procedures but do not meet the legal requirements to be called insurance companies. “Christian health sharing” companies, “Medishare,” and others fall into this category.
In this blog, we’ll help you distinguish the differences between these “insurance-like” companies and traditional insurance that you can access through faith-based plan sponsors. We will also be taking a look at the pros and cons of each of these options.
What’s the difference between “insurance-like” health-sharing companies and traditional insurance offered through faith-based plan sponsors?
When you think of health insurance, you’re probably thinking of “plans that help cover medical costs.” However, for a sponsor to legally advertise their offerings as insurance, they need to follow strict federal and state regulations.
So, how do you know if you’re looking at an “insurance-like” company? The easiest way is to look for certain words.
Christian Healthcare Ministry, Christian Healthcare, Christian Healthcare Sharing Plans, and Christian Medishare plans won’t call themselves insurance companies — because legally, they aren’t.
So, how do these companies work?
Christian healthcare sharing companies
Healthcare sharing programs work by sharing the costs of medical procedures amongst a large group of people. This forces each plan to have a set list of procedures with a set amount of costs they will cover. They will typically have a provider network that you must use to receive payouts.
How it works
The first thing you may notice is that not anyone can join a Christian healthcare sharing program. Your acceptance will depend on the information in your application. They may ask for both demographic details, along with your medical history. You may also have to include a statement of faith.
From there, you will make monthly payments. And when you need medical help, the plan will reimburse you a set amount for certain procedures. It’s at this point you will need to understand exactly what is, and isn’t, covered in your benefits.
What is included in these plans?
The short answer — it depends.
They provide help with medical costs for procedures and illnesses. But this coverage is not the same for each company. You will find a variation in the amounts of cost sharing and which medical situations are covered.
Sharing programs will likely have a cap on payouts to prevent expensive procedures from draining the plan’s resources. You may find your coverage capped by personal limits on each new illness or procedure.
Some plans also include a maximum lifetime payout. This limits the amount of coverage for specific issues. They can even include a cap on the total lifetime payout within the plan.
The most generous and flexible plans are the ones with the largest number of clients. More money in the pool creates the ability to have higher caps and more benefits.
Why do people like sharing plans?
These plans are fairly common, particularly within a faith-based framework. Here are a few of the top benefits they offer.
1. They are typically less expensive than traditional insurance. There is a reason for this (see item #1 in the “What challenges do people face with Christian Health Plans?” section to learn why). But for someone shopping purely on cost, these are some of the most competitive options.
2. Healthcare sharing plans reflect the faith of their participants. Typically, a statement of faith must be signed by everyone. That means everyone else has a shared set of values and beliefs.
3. Healthcare sharing incorporates modern tools. Options like remotely connecting with doctors (Telemedicine) or mental help treatment are more widely available than in the past. Utilizing these tools and services makes them feel more like traditional insurance.
What challenges do people face with Christian Healthcare Sharing Plans?
Cost, coverage, and a faith community may be appealing traits. But there are some important limitations to take into account as well.
1. They are not health insurance companies. While this helps keep costs down, it comes with a price. They are exempt from most state and federal regulations. This will leave you with less legal recourse should you need to seek it. Some hospitals no longer work with them because they are not legally required to cover medical expenses or keep a substantial monetary reserve on hand.
Sharing plans also are not eligible for reimbursement through a Health Reimbursement Arrangement (HRA).
2. Christian healthcare sharing companies have more restrictions. Out-of-pocket spending thresholds can be large. You will have to spend more of your own money on treatment before the program will help with medical costs. They also tend to have a much longer list of pre-existing conditions and treatments that they will not cover.
3. They don’t meet the requirements for minimum essential coverage. This is not a stumbling block for churches with less than 50 full-time staff, but it does have an impact on individuals. People who lose their sharing plan do not qualify for special enrollment in a traditional plan. They will have to wait for the yearly open enrollment time. During this time, they won’t have health insurance.
4. They make their own rules. Healthcare sharing plans decide what they will cover, how much they cover, and when they will stop covering. For example, many of them don’t cover preventative care. Lifetime payout limits, which can leave you on the hook for 100% of your medical costs, differ between programs. This can make them hard to compare with each other as there are no standards.
Faith-based plan sponsors provide access to traditional health insurance.
However, faith-based sponsors can offer your church all the benefits of traditional health insurance. These organizations understand your church needs, align with your mission, and yet still provide access to the same insurance plans you would find on the Health Insurance Marketplace or individual companies. These are called “plan sponsors” or “benefit partners.”
They bring together smaller groups of people and add them together into a larger pool. Insurance companies can then base pricing and plan options on the number of participants in the whole group. This lowers costs and increases coverage. Many insurance plans of this type will draw from well-known insurance providers that offer benefits, procedures, and coverage similar to corporations in the secular environment.
Access based on the plan you choose
Faith-based health insurance plan sponsors that offer traditional plans that cover a wide range of procedures, illnesses, medications, and preventative treatments. The amount of coverage you receive is based on the type of plan you purchase. More expensive plans may have lower copays or cover more situations.
These traditional plans give you an extensive range of protection. An arrangement with a solutions partner opens doors. It allows you access to benefit plans that are cost-prohibitive if based on the number of employees at your church.
Why working with a faith-based plan sponsor is a great option.
When you find the right faith-based plan sponsor you get the best of both worlds. First, your plan sponsor will share your beliefs. Second, they open the door to accessing real insurance. You will find 4 benefits that go beyond what you get in your insurance plan.
1. They are backed by stringent regulations. There are more consumer protections in place with a traditional insurance plan. They create less risk for their customers and are required by law to cover a wide range of situations.
2. There is more emphasis on prevention and recovery. Insurance companies want you to be healthy. That’s why they encourage people to prevent illness and injury in the first place. They also encourage therapies for recovery because they get people healthy quicker.
3. Traditional companies have a large network of medical professionals and facilities. Large insurance companies can negotiate fees and access to medical treatments across the country. That’s the power of having deep financial resources. This makes it easier for you to stay in-network. There will be specialists, and hospitals all across the country for you to work with.
4. A Christian plan sponsor brings the faithful together. Churches are communities that work together to support and strengthen the congregation and each other. Working with a Christian plan sponsor is another way to increase unity within your denomination. Your plan sponsor will already have a deep understanding of your needs. The wider faith community will provide prayer and support.
Traditional health insurance has tradeoffs.
There are always tradeoffs between options, and choosing a traditional health insurance plan has them as well. Typically, there are three.
1. The plans sometimes cost more. By law, traditional health insurance covers a vast range of medical conditions and issues. Regulations also require that they have enough resources on hand to meet their obligations for payouts.
The good news is that there are plan sponsors who provide access to traditional insurance at competitive rates. This allows you to find comprehensive coverage you can afford and gives you peace of mind.
2. Open enrollment dates may limit when you can join. Traditional insurance companies have a set period when new clients can join or change coverage each year. This is known as “open enrollment.” While there are exceptions made for new hires and major life events, in general, there are restrictions in place that keep people from joining whenever they wish.
3. Your best access is within a larger group. Some traditional insurance plans will let individuals join. But in cases like this, you may find expensive monthly fees and not a lot of great benefits. If you can access them through a larger group from a plan sponsor, the fees become more affordable and benefits are comprehensive.
The best choice? Work with a Christian faith-based health insurance plan sponsor.
When you’re looking for health coverage, you have to balance cost, benefits, and how comprehensive the coverage is. When you need to use your health coverage, you want something that works and lets you focus on getting better.
Reformed Benefits Association is a non-profit created to offer healthcare, dental, and life insurance to Christian ministries. As a plan sponsor, our number one goal is to provide access to traditional health insurance by bringing together staff from churches in the Christian Reformed and Reformed denominations.
If you’re looking for a health insurance option that is easy to use and comprehensive, send us an email. You’ll get a personal advisor who will help you through every step of the insurance process to help you find the right health insurance. It’s our mission to make church health insurance easy, so you can focus on your ministry.
The information contained in this blog is for educational purposes only. Please seek professional advice before acting on the information you have read above.