Sharing programs may not be for everyone, but for many people who don’t have access to traditional employer-sponsored health plans — including workers in the growing gig economy — they provide a way to help share health-related costs. And the goodwill generated by a community of concerned, sharing people is a good thing, too.
Health care cost sharing is fundamentally different from health insurance. Here are some key things that you must know to understand the differences.
Traditional health insurance plans are based on contracts where an insurer becomes legally responsible for and accepts someone’s risk of loss (such as their medical bills) in exchange for their payment of premiums.
Sharing programs like Universal HealthShare are totally different. The choice to become a sharing program member is completely voluntary. And monthly contributions by sharing community members are voluntary, non-refundable gifts made to help other sharing program members meet their eligible health care expenses, and to help cover the operational and administrative costs of the not-for-profit Universal Health Fellowship organization.
Sharing contributions do not create a contract or other legally enforceable right to receive funds to pay your own health care expenses. All members take it as a matter of faith, not law, that others will voluntarily make contributions to help with medical costs. Because sharing programs don’t contractually guarantee payments, medical providers consider sharing members to be “self-pay” patients: that is, people who are considered to be individually responsible for their own medical bills.
Good news: some providers will voluntarily agree to bill their services to your ministry program for sharing. And Universal HealthShare may be able to help identify facilities and providers who have historically been friendly and cooperative towards sharing.
Sharing programs are about community cost sharing and personal choice. Because they’re not subject to the same regulations as insurance, they have more flexibility in what is (or is not) shared. As a result, sharing can be easier on your monthly budget than health insurance. This means that more people can afford to provide for their health and wellness care, and that is a wonderful thing.
Legal Notices
While sharing programs are unregulated, many state governments have published legal notices to inform their constituents about sharing organizations. Additionally, some states have adopted their own Individual Mandate laws, some of which impose a state tax penalty. It is important for each member to be familiar with their state notices and tax laws regarding sharing programs, including whether they qualify for an exemption from their state’s Individual Mandate, if any.
The state Legal Notices serve to further clarify that sharing programs are not health insurance plans. To read notices from all states that have issued them, click here
An additional notice discusses the federal and state Individual Mandates for health care programs. To read this notice, click here.
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