Why I As A Health Insurance Broker Haven’t Bought Health Insurance

and how you - as a healthy and self-employed person - can benefit from my insider secrets and stop throwing money away for benefits you don’t need - now - without open enrollment.

This is the most unlikely of all e-books

MY STORY

No one in their right mind would express disapproval and distain for their main product.

Health insurance is the primary product I sell to others. But I don’t buy it for myself. Why?

When Obamacare (PPACA) became law on January 1, 2014, I enjoyed an instant market of uninsured people who could now finally get health insurance at a very low cost.

Many of my clients are now paying LESS than $100 per month for an amazing plan - the Silver 94 enhanced benefit plan - through either Blue Shield or Kaiser. The catch? They need to earn less than $18,000 per year to qualify for this ‘giveaway deal of the century.’ 

I personally did buy health insurance for myself back when my income was low enough to receive a subsidy (advanced tax credit) and reduce my premium to an insanely low level. 

Do you think I was sad or happy when I no longer qualified for a subsidy?

I was ecstatic! My income had soared, and no longer needed a government handout!

(I hope the same thing can be said for you, as I admire hard work that leads to success.)

But when the rate increases began to skyrocket annually, I decided to no longer keep throwing my money away, paying for specialized benefits that I didn’t want or need (such as pediatric dental/vision and maternity costs.)

So while selling to hundreds of others who NEEDED a subsidized plan — I started researching alternatives for myself.

Now, don’t get me wrong. I need some kind of a health plan that will protect my assets from huge hospital and doctor bills. We all do. After all, that is the MAIN purpose of a health plan — to limit our out of pocket exposure in the event we incur hundreds of thousands of dollars in medical expenses. And we never know WHEN we’ll need it. 

The discovery that shocked even me

MY SECRET

In my research of the new healthcare law, I noticed that there was a glaring “exemption” for certain alternative health plans called “health sharing ministry plans.” 

Some of these are restricted to evangelical Christians who are active attenders of a church. Many of these require people to sign a statement of faith and make a promise to not engage in sex outside of marriage or use any tobacco, drugs or excess alcohol. 

By only offering the plan to people practicing a “healthy lifestyle” and don’t have any chronic pre-existing conditions, the “pool” of participants is cherry-picked to include only those who are NOT already sick. This obviously allows the COST to go way down.

The ‘best of all worlds’ solution

MY FAVORITES

Among seven “health sharing” plans available, there are two that stand above the rest.

Even though they have limitations on pre-existing conditions, the PRICE is extremely lower than other options for a high level of coverage with the largest PPO networks in America. 

These two are the most LENIENT when it comes to qualifying for them. A person simply needs to affirm a basic set of lifestyle standards to qualify - not a statement of faith. 

Even if you have you been chronically ill, you can still qualify for all your medical costs being covered except for treatment of that particular disease.

Plan to have children? You can qualify for maternity benefits with the proper plan choice.

Let me give you an example. Just yesterday I quoted this plan for a couple who is retiring early from the corporate world. He’s in his 60s, she’s in her 50s. 

Their cost for a basic Bronze plan from Blue Shield PPO with three visits at $75/$105, then essentially no coverage until they spend $7,800 out of pocket within the network? 

$1792.85

Their cost for a Silver plan from Blue Shield PPO with visits at $35/$75 and $7,800 max out of pocket? 

$2293.49

Their cost for this alternative plan with unlimited visits at $35 copay (specialists/urgent care at $75) and a free preventative visit, with $2,750 max out of pocket risk in case they are hospitalized or need surgery?

** $485.00 ** Huh? One fourth the cost of a Bronze plan?!

That is not a misprint. This alternative plan saves them over $21,000 per year!

Drumroll please …

THE REVEAL

The name of one my favorite “health sharing” plans is Altrua HealthShare.

I recommend their Select Silver 2750 + Well Premium as being the most cost-effective option for most people. 

It uses both the First Health PPO network and the Multiplan PHCS (Private Health Care Systems) network with over 1,000,000 providers nationwide. Don’t take my word for it. See who is in the network in your are here:

 https://www.firsthealthlbp.com/LocateProvider/SelectNetworkType

Those using this plan are exempt from the 2.5% tax penalty - and benefits can be tailored to one's particular needs and budget. Unlike the more expensive plans, it does take into account pre-existing conditions - so I would recommend this only to people who are relatively healthy, without any chronic illness conditions. For example, this plan excludes people who've had cancer, who use tobacco, or who are currently pregnant. 

Select Silver 2750 covers catastrophic costs with only a $2750 deductible for hospital and surgical costs -- which is much less than a standard plan's $7,800 out of pocket risk. It is important to understand there are some limitations with this plan when compared to major medical coverage. For example, this health-sharing plan provides up to a $1,000,000 benefit that can be expanded to $3,000,000 at an additional cost.

Could this be the answer you’ve been looking for?

This is the type of strategy that I’ve chosen to use for my own health plan.

According to PPACA, it is “not insurance” — but it meets my need at a much lower cost.

    Here is the chart showing the summary of benefits for the doctor visit and testing portion of this health plan:

It costs $229 for one person,

$349 for a married couple,

$349 for a parent and children,

$449 for a family of any size.

    Here is the chart showing the summary of monthly cost for the hospital and surgery portion of this is health plan with only a $2,750 deductible:

• Age 0-39
• Age 40-49
• Age 50-59
• Age 60-64

 Add together the cost of USA Well Premium + Altrua. Will this option work for you?

A SECOND GREAT OPTION

ZION HEALTH is a more recent alternative that costs even LESS than Altrua. It doesn't provide the $35 doctor visit copays - but it has NO UPPER LIMIT on what it will cover.

Instead of a $2750 out of pocket for hospital/surgery, you can choose one of three levels: $1,000, $2,500 or $5,000. The amount you choose is per incident, up to a cap of three separate incident within 12 months; so if you choose $1,000, and had five separate incidents, your max out of pocket for the year would be $3,000. If you had a reoccurrence of the same condition within 12 months, only the first IUA would apply. They will cover those who use tobacco with a $50 surcharge per household. Overall, their monthly cost is much lower than most. (See pdf on pricing based on the decade of age of the oldest family member.)

Everyone is accepted. No one is declined due to prior medical conditions or religious beliefs. Like other plans, it utilizes the large nationwide PHCS/Multiplan network (https://zionhealth.org/phcs) for your no-cost annual wellness visit (including mammogram, immunizations, colonoscopy) following one year of membership. Unlike other plans, they will pay for any doctor or hospital, regardless of being out of network, after they call the provider to negotiate to lower the bill. Zion even covers medical costs when on a vacation or serving a mission outside the USA.

Zion issues an ID card that you give to the provider, who bills Zion directly (i.e. it’s directly paid to the provider, not a reimbursement to you). Zion pays claims very quickly, within 5-7 days. They'll even cover maternity cost as long as the pregnancy begins 60+ days after signing up. They don't cover alcohol/drug treatment, mental health treatment, or insulin. They don't cover pre-existing conditions in the first 12 months, defined as any condition that was treated within the past 24 months. However, in year 2, pre-X is covered up to $25K; in year 3, up to $50K; in year 4, up to $125K. 

Zion includes unlimited Teladoc consultations 24/7 at no cost. Unlike other plans, there are no caps on how much they'll cover (i.e. no $250K or $1M limits like other health-share plans have). If a new cancer is diagnosed soon after enrolling, they cover it (without a 12 month waiting period like others). They will cover acupuncture IF the treatment is a referral from a M.D. They'll cover up to 40 chiropractic or physical therapy visits IF it is linked to a treated medical incident (but not for health maintenance purposes). 

One downside of Zion is that it does not protect you from California's 2.5% tax penalty. However, you can still be protected by adding a MEC (minimum essential coverage) plan from a sister company, Planstin.com, in order to be ACA compliant and be exempt from that tax. It provides for no limits on pre-existing conditions and all the preventative services mandated by the Affordable Care Act. ($75 for one; $150 for a family.) If you wanted to add this MEC plan benefit AND avoid that tax, click on  https://planstin.com/base-health/ 

THE DECISION

After studying the options above, and doing your research, have you come to the conclusion that Altrua or Zion is a good health plan option that can work for you?

CALL ME and I will be happy to provide you with an accurate quote for your particular family, and then will help you enroll. Altrua can begin the first of any month so long as the applications are submitted by the 25th of the previous month. Zion can begin no ANY day of the month. There is a one-time $125 application fee for Altrua, or a one-time $50 application fee for Zion.

Please CALL/TEXT me at 805-870-5080 or EMAIL [email protected] with your questions. I look forward to helping you save thousands of dollars this year — starting next month!

— Dale Johnsen, JohnsenInsuranceSolutions.com 805-870-5080

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