1. Short Term Plans - In Washington state, these plans are heavily restricted. We are talking 90 day non renewable. They can exclude pre-existing conditions and can exclude treatments and overages. As I write this I am aware of 1 company offering a plan that has made it through the Office of the Insurance Commissioner's standards. With the amount of coverage excluded, we feel that a customer is best served by purchasing a full health-plan for a short period of time. We have had new customers come to us over the years because they made a mistake and purchased a short-term plan and discovered it did not cover what they needed covering.
2. Association Health Plans (AHP)- AHPs are a type of Health insurance the employers and professional trade associations offer to their employees or members. As they were described small groups of similar companies could band together and buy healthcare across state lines. They can consider someone's health condition when setting premiums. They can not cover self employeed with no employees. Please make sure that they are licensed to do business in Washington State. There is concern from experts that they will become vehicles for fraud and produce market instability. There is a history of AHP plans leaving policy holders with unpaid bills. As brokers, we have had more than one approach us to offer their product that we turned away for not being licensed in Washington state.
3. Health Reimbursment Arrangements - An employer and not the employees own these. When an employee leaves then they lose benefits. HRAs can be used to pay for qualified medical expenses and the rules are going to change substantially in 2020. Starting in January 2020, HRAs will change considerably. The government will allow employers to offer their employees a new type of HRA called an individual coverage HRA in lieu of group health insurance. Employees can use these HRAs to buy their own comprehensive individual health insurance with pretax dollars either on or off the Affordable Care Act's health market place. These plans can vary from employer to employer so they still require deep understanding on the plan's function.
4. Healthcare Sharing Ministry - These are faith based co-ops where members agree to pay other member's bills. These often have limited faith clauses, can exclude pre existing conditions and are not insurance. This year the Office of the Insurance Commissioner ordered Aliera which operates Trinity Healthshare to halt operations in Washington State because of deceptive practices. Yes, some of these plans even pay brokers commissions but are not effectively regulated.
A recent article titled by Bob Herman, "Ads for 'Trumpcare,' which doesn't exist, are everywhere." is fairly accurate. I have had friends hit me with copies of emails and websites for these things since the American Health Care Act (AHCA) was unveiled to the public and crashed in the Senate. So the administration has been reshapping healthcare using rules and most noteably the work around with the 2017 GOP Tax Bill which brought the individual mandate penalties to zero. Once that was done a bunch of GOP Attorney Generals sued to invalidate the ACA. The Federal position has been to rip away healthcare.
Some states have initiated to improve healthcare and coverage. There have been states that have done 1332 Reinsurance Wavers that have lowered consumer cost considerably. We are looking at 5 states and Washington DC returning to taxing the individual mandate. The majority of improvement will have to be done on the state level for the next couple of years so be patient.
With Trumpcare there is serious buyer beware. In Washington state, use the Enrollment Centers. You can walk in during regular hours through out the year and get service. They had to meet additional background checks and contracting. The brokers there do not charge fees and can answer questions about the shifting markets. By contract the Enrollment Centers do not offer Trumpcare products first and in our case might have to refer you to a company that does engage with those produts.