High Insurance Costs Prompt Consumers To Consider Alternatives

Dec. 10--As health insurance costs climb, some consumers are turning to alternative products for coverage that can impose strict Christian-based moral expectations and are unregulated in many states including Missouri and Illinois.

The alternative coverage may also lack some of the hallmark protections included in the Affordable Care Act, such as the requirement to cover individuals with pre-existing conditions.

But with the alternative coverage, known as health care sharing ministries, consumers are exempt from paying a federal tax penalty for not having insurance. Consumers also can enroll in these plans any time during the year, not just during open enrollment like traditional insurance.

For many consumers, health care sharing ministries have become the only affordable option for coverage.

After five years of being uninsured, hairstylist Melissa Peirick signed up for coverage with Christian Healthcare Ministries. She couldn't afford traditional health insurance, and coverage wasn't offered through her Chesterfield salon.

With Christian Healthcare Ministries, she's paying about $130 per month for coverage.

St. Louis area health insurance brokers say there are many consumers who, like Peirick, are choosing these low-cost options.

Health care sharing ministries, in many ways, resemble traditional health plans. They require members to pay a monthly share similar to a premium and they have similar deductible-type payments. But consumers need to read the finer details to be aware of limitations, insurance brokers and health policy experts said.

"I think it's a reasonable choice; I'm concerned people are enrolling without understanding what is and what is not covered," said Joe Bottani, a broker with St. Louis-based Arch Brokerage Inc. He said he doesn't promote these types of plans.

Some limitations include payment for care related to a pre-existing condition only after a period of time and financial caps on paid claims.

And with these products come Christian-based moral expectations, a significant deviation from a traditional health plan.

For example, if an unmarried woman were to get pregnant, the related health care services would not be covered, said Corey Durbin, president of Shared Health Alliance of St. Louis.

Or if a drunken driver caused an accident and was injured, the driver's health care needs would not be covered.

"For the people that are paying for their own health care, for most of them the cost has gotten so out of whack a non-mainstream or a counterculture health care option becomes very viable," Durbin said.

For Peirick, Ohio-based Christian Healthcare Ministries asked what church she attended and the name of her priest.

In online documents, Christian Healthcare Ministries explains that its organization is not health insurance.

Health insurance is a contract between a company and the consumer in which the insurance company is required to pay the consumer's health expenses, according to its online guidelines.

But no such contract exists with organizations such as Christian Healthcare Ministries. Instead, the group pools funds among Christians to help one another in times of need, according to their online guidelines.

Christian Healthcare Ministries has a lifetime limit of $125,000 per diagnosis, according to its online guidelines.

Durbin has his family enrolled in a similar plan. He also started his own company -- after a career in the employee benefits industry -- to help consumers fill the gaps with other insurance options the health care sharing ministries won't cover, such as prescription drug coverage and preventative screenings.

He says the savings are significant.

"My deductible went from $9,000 to $1,500," Durbin said.

Bill Hill, local insurance broker with Visor Benefits, said the demand for health care sharing ministries has "exploded." He has consulted for about 20 individuals this year, some with families, who will enroll Jan. 1 when their current coverage expires.

His clients can't afford their current plans and are seeking alternative options.

However, many of these products are unregulated.

Many states, including Illinois and Missouri, don't consider these products health insurance, which means they are not regulated by state insurance departments.

These products are not required to have financial reserve requirements, unlike insurance companies, so there's no guarantee they will pay claims, said Sabrina Corlette, research professor and lawyer at Center on Health Insurance Reforms at Georgetown University's Health Policy Institute.

"Before they (insurance companies) can be in the market, they have to prove to the state that they have enough cash or capital to pay claims even if it's a really bad year like if you got a flu epidemic or Zika," Corlette said.

"What I would say is 'buyer beware,'" Corlette said.

Samantha Liss --314-340-8017

@samanthann on Twitter

sliss@post-dispatch.com

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