Final Rule Makes Short-Term Medical Insurance Renewable for Up to 36 Months

The Trump administration has issued a final rule that will allow short-term, limited-duration insurance to be purchased in increments of up to 364 days (or 12 months).

The final rule will also allow this type of insurance to be renewable with a maximum duration of up to 36 months. However, “States remain free to adopt a definition with a shorter maximum initial contract term or shorter maximum duration (including renewals and extensions) for a policy to meet their specific market needs,” according to the final rule documentation.

These new term limits will go into effect in October according to CNBC. This comes just before the 2019 Open Enrollment Period which will run from November 1 to December 15, 2018.

This follows a proposed ruling by the Department of Health and Human Services, the Department of the Treasury and the Department of Labor published for public commentary back in February of 2018. Much in line with the Trump administration’s concerns over the rising costs of health coverage today, this final ruling is expected to increase consumer choice, competition, and affordability in the individual health insurance market.

The Centers for Medicare & Medicaid Services (CMS) projects that approximately 600,000 people will enroll in short-term limited-duration plans in 2019.

Click here to view the final rule in full courtesy of the CMS. Stay tuned for updates on how this change will affect Health Insurance Innovations (HIIQ), contracted agents, brokers and the American public at large.

Debunking short term medical insurance myths for clients

Debunk These Misconceptions About Short-Term Medical Plans

Misconceptions about short-term medical plans are common. While STM plans can provide quality benefits that meet a variety of budget needs, they fall outside of traditional healthcare coverage options, prompting your clients to have questions. The cost of healthcare continues to rise, and political scrutiny and legislative updates continue to impact the industry and your clients’ wallets. There is no better time to make sure your clients have a thorough understanding of their options so they can help to protect their health as well as the health of their loved ones and their finances.

STM plans, also called temporary health insurance, are medical plans that have a limited duration. They are designed to bridge gaps in healthcare coverage during a period of transition such as graduating from college or starting a new job. Here are 4 common misconceptions about short-term medical plans:

Misconception #1: Only a limited number of doctors accept short-term medical plans.

STM plans are accepted by many providers and facilities across the nation. If a client chooses to see an out-of-network provider, it could result in higher out-of-pocket costs. Some STM plans may provide for the services to be covered (depending on the plan) via a reimbursement, but the policyholder will pay upfront for and submit her/his own claim.

These plans often feature provider networks that ensure lower rates than providers who are outside of the network, but that doesn’t preclude your clients from choosing providers of their choice.

Just like with traditional major medical plans, clients with short-term medical coverage who choose to receive medical services outside of the featured network may incur higher out-of-pocket costs.

Help your clients know how to make the most of their benefits. This includes knowing how and where to access their member ID card, who to call with questions about benefits, who to call with questions about claims, and where to access their provider directory and pertinent details of their coverage.

Misconception #2: Only those who are young and in good health are good candidates for short-term medical coverage.  

This level of coverage may fit the needs of clients who are:

  • Transitioning between jobs
  • Waiting for employer insurance to begin
  • Graduating from college
  • Rolling off parents’ coverage
  • Waiting for Medicare coverage to become effective

You may have clients who are looking for healthcare options outside of Open Enrollment. Or you may have a client who is looking for coverage that includes preventive care for herself and her family before her new policy through her employer starts. While benefits may be limited, this level of coverage may suit such clients’ needs and help them tackle their healthcare realities. There are a variety of plans available, some of which may even be a good fit for clients who want to see providers of their choice.

Disclaimer: Short-term medical coverage is not intended to be a replacement or alternative to ACA or other major medical plans nor does it provide the minimum essential health benefits that are required and it won’t help to avoid the fee for not carrying health insurance. They can have exclusions and limitations, which may not make them a valid option for some clients.

Misconception #3: Short-term medical coverage is expensive and doesn’t provide quality coverage.

STM premiums are often lower than major medical premiums because they offer more limited and/or restricted benefits. The coverage provided by STM plans can provide a range of valuable insurance benefits for individuals and families such as:

  • Preventive care and routine doctor visits
  • Emergency care*
  • Inpatient and outpatient surgery and hospital care*

Similar to major medical, your clients can enjoy added non-insurance benefits as well such as:

  • Mobile access to board-certified doctors who can treat many common illnesses
  • Patient advocacy service that can help navigate the world of healthcare and negotiate medical bills
  • Prescription savings membership that can lower out-of-pocket costs
  • Digital fitness tool to help track your wellness journey

However, the coverage provided by short-term medical plans does not include:

  • Immediate benefits for hospital stays, surgery or anesthesia for conditions you already have
  • Benefits for prescription drugs

STM plans do not have coverage requirements, so plans vary in what is covered. Review any plan details with a client prior to purchase. Additionally, STM does not cover pre-existing conditions. Applicants are subject to underwriting approval based on answers to medical questions. Coverage is limited to a time period of no longer than three months.

*Typically not covered for pre-existing conditions

Misconception #4: Short-term medical plans can help those enrolled avoid the Affordable Care Act’s tax penalty.

While STM coverage can be an affordable and quality option for your clients who are looking to help bridge the gap in their health coverage, it does not qualify as minimum essential coverage under the Affordable Care Act. That means that they are likely to face tax penalties. Your clients who are without minimum essential coverage for less than 3 months within a year and those who belong to certain groups are exempt from the penalty.

Because STM plans don’t have to adhere to ACA regulations, your clients have a range of plan options to choose from, including some with lower monthly rates than major medical plans. Current legislative reform attempts are expected to make room for more STM plan options.

 

Are you ready to expand your client offerings with short-term medical options?

Learn more today by:

Calling 877.376.5831 and selecting option 3

Emailing salessupport@hiiquote.com

Click here to like us on Facebook, here to follow us on Twitter, and here to see our videos on YouTube to join the conversation about industry issues and concerns!

 

 

Here’s How to Help Your Clients Improve Their Health and Get Fit

Here’s How to Help Your Clients Improve Their Health and Get Fit

For every month – especially National Physical Fitness and Sports Month in May – it’s important to talk to your clients about the benefits of physical activity. They bring you their health concerns in the hopes of finding coverage that meets their needs, a perfect opportunity to go over benefit options that complement their goals to improve their overall health by increasing their fitness.

Consider these recommendations from the World Health Organization1
  • 150 minutes: the time that adults 18-64 years old should engage in moderate physical activity throughout the week
  • 2 days a week: the time that adults 18-64 years old should engage in muscle-strengthening activities to see additional health benefits
  • 1 in 4: the number of adults globally who are not active enough
Consider these recommendations from the Centers for Disease Control and Prevention2:
  • 60 minutes: adults who live with chronic health conditions can benefit from aerobic activity for this amount of time
  • 120-150 minutes: adults who engage in aerobic activity for this amount of time each day are likely to lower their risk of type 2 diabetes and metabolic syndrome
  • 7 hours a week: adults who are physically active for this amount of time each week have a 40% lower risk of dying early that those who are active for less than 30 minutes a week
If your clients are ready to begin their physical activity journey, talk to them about this fitness recommendation from the American Heart Association3:
  • 3 periods
  • 10 minutes each
  • 30 minutes a day
  • 5 days a week

With these goals, your clients can easily introduce physical activity into their day-to-day lives, allowing them to3:

  • Improve physical wellness
  • Improve mental wellness
  • Prolong optimal health

Celebrate National Physical Fitness and Sports Month by talking to your clients about short-term medical and limited medical coverage options that includes benefits that support their overall health and fitness goals such as:

  • Wellness care
  • Preventive care
  • Routine doctor visits
  • Access to digital fitness tools
  • 24/7/365 access to board-certified doctors
  • Patient advocacy service

It’s important to keep in mind that neither short-term nor limited-benefits medical coverage are intended to be a replacement or alternative to ACA or other major medical plans. These types of coverage do not provide the minimum essential health benefits that are required and will not help to avoid the fee for not carrying health insurance.

Learn more by:

Health Insurance Innovations, Inc. is a leading developer and administrator of affordable, web-based individual health insurance plans and ancillary products. We help consumers address their health insurance needs by offering access to a number of products offered by various insurance carriers.

For agent use only – not for use with the general public

1Source: World Health Organization. “10 facts on physical activity.”

2Source: Centers for Disease Control and Prevention. “Physical Activity and Health.”

3Source: American Heart Association. “Physical activity improves quality of life.”

 

 

 

Infographic: The Future of Short-Term Medical Coverage Sales

There has been an upward trend in the sales of short-term medical coverage, and it remains popular going forward in 2017.

Are you ready to see your sales surge with short-term medical products?

Click the title above to learn more.

the-future-stms_infographic_final

health insurance innovations - 9

New Year, New Coverage: Short-Term Medical in 2017

As you and your clients gear up for all that 2017 has to bring, help them stay on track and face medical concerns with short-term medical coverage.

This level of coverage may fit the needs of your clients who are:

  • Transitioning between jobs
  • Waiting for employer insurance to begin
  • Graduating from college
  • Rolling off parents’ coverage
  • Waiting for Medicare coverage to become effective

If you have clients who miss the open enrollment period for major medical coverage, they may reach out to you to discuss other options that can help bridge the gap in their coverage such as short-term medical.

Considering changing short-term medical legislation, it’s important to remember the following dates so that your clients enroll in the coverage they deserve:

Before April 1, 2017

Your clients can enroll in short-term medical plans with coverage up to December 31, 2017 with the option to reapply.

After April 1, 2017

Your clients can enroll in short-term medical plans with coverage up to June 30, 2017 with the option to reapply.

So what are some of the features that short-term medical plans provide?

  • Your clients can choose short-term medical coverage at any time in the year. There is no special enrollment period.
  • Many plans include preventive care for individuals as well as for families.
  • Some plans offer lower rates that than major medical coverage.
  • Your clients can often see providers of their choice. If a provider does not file a claim for your client in office, your clients can submit their own claims for reimbursement.
Disclaimer: STM coverage is not intended to be a replacement or alternative to ACA or other major medical plans nor does it provide the minimum essential health benefits that are required and it won’t help to avoid the fee for not carrying health insurance.

Learn more about short-term medical coverage by:

Health Insurance Innovations, Inc. is a leading developer and administrator of affordable, web-based individual health insurance plans and ancillary products. We help consumers address their health insurance needs by offering access to a number of products offered by various insurance carriers.

For agent use only – not for use with the public

Infographic How Are Short-Term Medical Plans & ACA Plans Different

Infographic: How Are Short-Term Medical Plans & ACA Plans Different?

The world of healthcare coverage can feel convoluted and confusing, making it tricky for your clients to navigate. As costs of medical care continue to rise and challenges to healthcare legislation continue to spark headlines, it’s crucial that your clients understand the differences in coverage available.

stm-vs-aca_infographic

short term medical myths

Dispel These 3 Myths About Short-Term Medical Coverage to Grow Your Sales

Myths and misconceptions about healthcare coverage – specifically short-term medical (STM) plans – are common.

But with the cost of healthcare continuing to increase, the need for your clients to have a thorough understanding of their options so they can help to protect their health and finances is more pressing than ever.

Let’s take a look at 3 common myths about STM plans so you can help your clients make informed decisions:

Myth #1: STM plans are only accepted by a limited number of doctors.

STM plans are widely accepted by providers and facilities across the nation. If a client chooses to see an out-of-network provider, the services may still be covered (depending on the plan), but she/he will pay upfront for and submit her/his own claim to be reimbursed.

These plans often feature provider networks that ensure lower rates than providers who are outside of the network, but that doesn’t preclude your clients from choosing providers of their choice.

Just like with traditional major medical plans, clients with STM coverage who choose to receive medical services outside of the featured network may incur higher out-of-pocket costs. Many STMs even offer your clients the ability to see any provider they wish.

Myth #2: STM plans can help those enrolled avoid the Affordable Care Act’s tax penalty.

While STM coverage can be an affordable and quality option for your clients who are looking to help bridge the gap in their health coverage, it does not qualify as minimum essential coverage under the Affordable Care Act. That means that they are likely to face tax penalties. Your clients who are without minimum essential coverage for less than 3 months within a year and those who belong to certain groups such as non-citizens are exempt from the penalty.

This year, the penalty for the uninsured and underinsured will be the greater of $695 or 2.5% of adjusted annual income.

Myth #3: STM coverage is expensive and doesn’t provide quality coverage.

STM premiums are often lower than major medical premiums. The coverage provided by short-term plans typically includes a wide range of valuable insurance benefits for individuals and families such as:

  • Preventive care and routine doctor visits
  • Emergency care
  • Inpatient and outpatient surgery and hospital care

Your clients can enjoy added non-insurance benefits as well such as:

  • Mobile access to board-certified doctors who can treat many common illnesses
  • Patient advocacy service that can help navigate the world of healthcare and negotiate medical bills
  • Prescription savings membership that can lower out-of-pocket costs by up to 75% on medicines for you, your family, and even your pet
  • Digital fitness tool to help track your wellness journey

However, the coverage provided by short-term plans does not include:

  • Immediate benefits for hospital stays, surgery or anesthesia for conditions you already have
  • Benefits for prescription drugs
Learn about adding STM plans in your portfolio today by: