Ron Bruno. AltruaHealthShare.org

Transcription

1 Ron Bruno AltruaHealthShare.org Caring for One Another Ron Bruno of Altrua HealthShare will explain the model of health sharing, an alternative to the traditional health insurance many can no longer afford. People who agree to abide by specific moral values and healthy lifestyles can share in the medical needs of fellow members. It is a growing and exciting option for people who are falling through the cracks of the insurance model. Caitlin: Well, hey, everybody! I m here with Ron Bruno, and he is the vice president of business development for Crown HealthShare Administrators. I brought him on the Work-At-Home Summit to talk about health coverage, specifically, legitimate money-saving alternatives to the traditional health insurance. When I ask people in my network what is your biggest concern of wanting to start your work-at-home business, a lot of you said that it s health insurance. You think that you have to have health insurance. You have to have a job, and you re scared to death to leave your job, even though you hate it, because you don t know how it works with health insurance. So I sought out Ron. I found him while doing my own research on health sharing. Now, I don t have health insurance myself. I have health coverage, but it s not your traditional insurance. We re going to be learning the difference between that today. I discovered in my research that there are a lot of myths floating around about health coverage. We re going to talk about those as well, so everyone watching this can be well informed about your options, what s out there, and not let the lack of knowledge about your health coverage options be the reason that you don t begin your work-at-home journey. That should not be the reason that you don t build your dreams. So, Ron, I m really honored to have you here with us today. You ve come here to talk about a very important topic, one that I just said people are very concerned about when it comes to starting their own business. Tell us what is health sharing and how you got involved in it. Maybe give us a little bit of history about what health sharing is. Ron: Fantastic. Well, thank you so much for the opportunity just to be here and really talk a little bit about something that I was introduced to several years ago by the closest of my friends that brought, actually, Altrua HealthShare from Utah to here. We re based out of Austin, Texas. For years, he s tried to get me involved in this project and now, because of what s going on, a few years ago I decided, hey, I m just going to crater and join him. My background is business development. So the idea was to actually educate the consumer on what health care sharing is. Now, health care sharing is not new, and a lot of people really kind of want to know; what s this new concept of that s out there about? Well, I like to tell everybody this country was formed on this format. And hopefully I don t offend anybody listening, but if you were around in the early 1900s, this is the way that insurance actually started. We really didn t recreate the wheel. Now, the modern day, if you will, health care sharing ministry started in the early 80s by a family that had really a horrific accident. They couldn t pay for their medical bills, so they reached out to their church and their community to help them with their medical bills and other things. So that really is how it formed, and then from that kind of grew to technically there are about 53 health

2 care sharing ministries; 48 of those around the United States have kind of like a church community. But five of us meet a recognition status. When the ACA or most people know that as Obamacare. I try to use ACA. I don t want to offend anybody came out in 2010, the health care sharing ministries really kind of lobbied for their membership not to fall within those penalties of not having typical insurance. And, so, a lot of legislation was developed, and what wound up happening was that any of us that were in operation prior to December 31st, 1999, sharing without a cease in our membership, got a recognition status meaning that all of our members are exempt from the penalties of the ACA. Anybody out there that knows those, it s getting extremely expensive, that penalty. So a lot of people that are going, I m not gonna take insurance. I m gonna pay the penalty, I think next year it s 2.5% of your income. It s going to be crazy. Caitlin: Well, I m going to stop you just for a second and just share a story that I think a lot of people will identify with. So my husband and I he had a job through which we had insurance until about January of We had decided we were going to go travel in South America for a year from 2015 to 2016 because we worked at home, and we just needed our laptops and internet. We were hitting the road, and we were able to be exempt from a penalty because of the time overseas. But it was July 2016 or June 2016; we were getting ready to come home after a year of being away. And it kind of hit us all at once that we needed to have some kind of health coverage, or we were going to have to pay this penalty. I read the entire ACA, and I was trying to figure out how I could get around this. I was strategizing and maybe I could just not pay the penalty. The only way there was it s toothless, pretty much the ACA. They can t actually do anything. There s words in it that make it so where they can t penalize you. The only thing they can do is take out of your tax returns, and I never have a tax return. I m always paying taxes; I always owe. So they could never actually take the penalty, but that s beside the point. I was looking for alternatives because I wanted some kind of coverage, and a lot of people were recommending health sharing, and that s how I realized that it was a real thing. I was looking into it and I was in the Marketplace. We all know that the Marketplace is a mess. Regardless of how you feel politically, it s kind of a mess right now. And I typed in to see what my options were, and I was expecting I d have to do this entire health questionnaire to figure out where they would place me, how they would cover me based on my health. I was relatively healthy. I had no I was very healthy actually according to standard. And the only thing they wanted to ask me it was a very short survey was how much money I made. That s when I realized, Oh, my gosh. This is kind of a tax, and they re basing the prices on how much money I make. At that time I don t remember how much I put in, but it came out to where we had to pay, for two of us, $650 a month. And it was for a Bronze Plan. The only thing that was available was some kind of Bronze Plan, $650 a month, and that got us the privilege of paying out of pocket for everything up to $13,000 a year. So we were basically paying $650 for the privilege of paying a huge deductible before the plan would cover anything. I was like, Well, maybe I ll pay the penalty. I think at that time it was 2.3, or maybe it was 2.5 at the time or was about to be. And I did the math on that and I was like, Heck no. I m not paying that. And so that s what led me to the research for how to avoid the penalty, and learning about the different alternatives from googling that.

3 But inside the ACA, it says that it s only religious organizations. Now, not everyone who s watching is religiously affiliated, so what I wanted to talk to you about specifically was that there s a myth floating around that it s all religiously affiliated. That the only people who can participate in the HealthShare and become exempt from the ACA penalty for not having health insurance officially are people who are religiously affiliated. But that s not true, is it? Ron: Well, it s not, and thanks for bringing that up because now, of the five of us, three of them are religious affiliated. You have to be of a Christian background, and you have to proveup that religious affiliation to be a member. Which is great, and they re good at what they do. But what we chose to do is open it up to those of like-minds, healthy moral ways of living our life. So we re not tied to a religious affiliation. We have what we call a Statement of Standards. It is six different statements of standards on how to live life. Now, with that said, it s still not for everyone, because there are some folks that look at the Statement of Standards and say, Mm, no. I m not going to live by that lifestyle. But what ours has enabled people to do is people of multiple walks of faith we have people that are of Christian background and Jewish background and Mormon background and Muslim background, and those people have started to flock to us because of that. We don t require our members to provide us verification of their religious affiliations. It s just not something that we want to do. Now, we re strong people of faith, but what we like to tell everybody is just not going to cram my faith down anybody else s throat. Because of that, we really feel like we wanted to be able to open up. So that really has opened it up to a larger population around the country. Caitlin: Yeah, for sure. And, so, health sharing one thing that people caution me on is that it s not really health insurance. But what I was finding out in my research, especially when I found out I d only qualify for this really expensive plan, is that these insurance companies and I used to proofread transcripts. I would proofread a lot of insurance cases where the insurance companies were just refusing to cover, refusing to cover. In my mind there was just as much risk that these people were saying, Well, you have to have real insurance, you know? Don t get scammed. They re saying that health sharing was a scam because it s not real insurance. But it s not about insurance or not insurance; it s about coverage. What I was finding is that the same risk that they were saying was inherent in not having insurance was also inherent in insurance because the insurance companies make the rules. They decide whether or not they ll pay, and it costs money to challenge that. There are lawsuits involved, and you have to get a lawyer to say, Hey, this is my coverage, and there are depositions and all this stuff. So even working with the official medical health coverage of insurance in the Marketplace or whatever, even following the rules of the ACA I mean, we re all following rules but following the official ACA, buying the coverage that the government wants you to buy or getting penalized, there s still risk inherent in that. So what are the differences between health sharing and health insurance? We ll start there. Ron: Absolutely. Yeah. We re considered as health sharing. Now, we operate, again, differently than the other health care sharing ministries. We talk about that here not just by the Statement of Standards, but the difference being is that members of health care sharing ministries are considered to be self-pay. Now, there s a massive self-pay movement in this country. The

4 advantage of being self-pay is that generally, with providers, there s already a typically lower negotiated cost prior to that. So someone who says I m going to be self-pay is generally going to get a much lower rate than what somebody would be if they walk in with their insurance. Why? That provider s going to bill that insurance carrier the highest price that he can because he knows that insurance carrier is going to come back and go back and forth with him. With health care sharing ministries, what happens is the member now, I m going to use Altrua, for instance. The way that we operate is that we operate with a true member-to-member sharing escrow account. So our member, he s going to walk into the provider. We have our own provider network, and we also use a large nationwide network as well. They walk into their provider. They show their membership card, looks eerily like an insurance card. On the front, tells the provider everything about the customer. On the back it tells that provider how to submit the claim we call it a need directly to our adjudication system. It goes through the process just like it would with an insurance carrier, and we re going to pay that provider directly from the member-to-member sharing escrow account. We don t want our member paying up front. We don t want our member negotiating. Now, the other health care sharing ministries, that s they do a share letter/share box format where the member s really kind of responsible to pay or negotiate up front. Our background is medical negotiations, and if you as a member pay $1 to that medical bill as a self-pay patient, you ve accepted that bill as is. The negotiation is completely out the window. And so it s not insurance. They re self-pay. The way Altrua works is that we operate as the negotiator. We do all of the work. We negotiate all the claims. We pay all the claims for the membership. So it s really more like people are used to with that typical insurance product. But you re right. It s not an insurance product. And I love what you were talking about about people always go, Well, are they going to pay their claims? I tell everybody, Read the fine print on your insurance policy. Caitlin: They might. They might not. Ron: Yeah. And so, for us, what we say is that not all eligible needs will be shared in if they re direct violation of those Statement of Standards, or they re in violation of those member guidelines. We don t do policies; we do member guidelines. So a lot of the difference is just in the terminology, and it really kind of operates very eerily like that insurance model. Caitlin: Yeah. What I ended up doing is I m with Medi-Share. And I filled out a survey; it was a long survey. It took about 20 minutes, all about my health, and I actually qualified for a discount. Some organizations will do a discount 20% depending on whether you meet healthy standards. So my husband and I have the highest deductible and they use a different term; it s household amount or something of $10,000. Ron: We call it the MRA, Member Responsibility Amount.

5 Caitlin: Yeah, yeah. That s exactly what it is. It s not your deductible, but it functions just like it. We re paying $111 per month for $10,000 deductible, and we qualify for discounts. What s really been cool is I don t pay anything. I hand them my card, and I go to one of the network, which is the same network that many insurance providers already work with. So it s not like I m limited to this small amount of doctors. And I go in. I give them my card. I don t pay anything and then I don t know. I think I went to the doctor in January, and I just got a bill that I saw had been negotiated down. You can see how much they were charging, but then I was paying a whole lot less than that. I think it ended up being like $350 for the doctor appointment, but because I wasn t paying the $650 a month and then paying out of pocket because the insurance plans that I had qualified for, they wouldn t even cover a doctor visit at all. So I was paying $650, and then I would have to pay the $350. Like I d be paying the monthly $650 plus you get the negotiated price down. But I m saving so much more money just paying it self-pay but qualifying for those discounts because I m part of the network. So it was just so much better. I m saving so much more money for exactly the same care. The process is really good because people are your go-between, and they re the ones who do all the work, and you re just saving so much money and everybody kind of wins. So how does it work with pre-existing conditions? That was one of my subscriber s concerns is pre-existing conditions, and the insurance will cover that up to a certain point, or it s a lot more expensive or something like that. So how does it work with insurance versus how it works with health sharing? Ron: Absolutely. And the good thing that also I wanted to real briefly say that this is not an exemption status. Our members are exempt. We here at Altrua have developed a product that rivals health coverage out there with the insurance carriers. That s the idea behind what it is that we do. We put together a multiple benefit packages for individuals and families and people that are looking for different health coverage products. That s the one thing I certainly want to stress is that we re not here just to play the exemption game. We re here to be a true health coverage. So what we re trying to do and help me out with your question again because I got myself off track. You re looking for? Caitlin: We re looking for the Ron: Oh, the limit! I m sorry. Pre-existing, yeah, here we go. We call them limitations. In the insurance world, it s known as a rider or a waiting period. Now, again, over the last seven years, our minds have gotten completely warped because of the ACA, and everything has to be covered. That s why we are in the mess that we are in with health coverage. But what we did is we kind of went back again going back old-school. So somebody with a pre-existing condition and the way we do it, it s other than cancers we call it a 24/24. So if somebody has, say, high blood pressure, and that s been diagnosed or treated 24 months prior to application, then what happens is we tie a 24-month limitation to that pre-existing condition, for hospitalization. So if you get put in the hospital for anything related to that pre-existing condition in the first 24 months, it s not shared in by the membership. Again, that s what old insurance used to do with a rider or waiting period, so they re not going to pay for that specific pre-existing until that rider or waiting period expires. Now, that same person with high blood pressure that I ve got to go to the office. I ve got to go to a doctor and have it checked once or twice a year well, we have

6 an office visit plan that allows that person to go have their high blood pressure checked. And through the discount prescription plan, they can go get their high blood pressure medicine. So we understand that healthy people have things that have happened to them, and we re going to tie that pre-existing to it. Obviously, the biggest is being that cancer side of it. We don t share in cancers and we call it sharing it s pay claims, in cancers, in the first 12 months. Well, you ve always got to mitigate the risk of the group. It keeps people from getting on the plan, getting something done and then jumping off. That s what happened in the insurance world. Well, that s why we re where we re at paying these high prices for our insurance today. So there are things we do just to mitigate the risk. Now, it doesn t mean that somebody s diagnosed with cancer in the first six months, we just kind of kick them to the curb and go, You know what? Call us in six months. We ll take care of you. No. We take them through the process. We re always negotiating for our membership. It just means the membership dollars don t share until the 12-month has been exceeded. So we look at that. Now, what I tell people and I worked with about 5,500 licensed, trained, and certified insurance agents around the country that have gone through my training and certification program to offer this up as part of their portfolio. What I tell people is, go back to your agent, and talk to them about a critical illness plan or a cancer plan for the first 12 months. Generally, those are going to range anywhere from $50 to $100. Well, my contributions, or you know those as premiums, are about a third of what you ll find on Marketplace today. If I m going to save you that, then just fill that gap with what insurance agents call ancillary products. So there are ways to fill the gaps to get yourself an even greater coverage than just trying to go on Marketplace and just finding what the government can get you. This is a way to protect your whole family with multiple products, and you re still paying a considerably lower price point than what you re going to find on the Marketplace. Caitlin: Yeah. So what I m hearing is that it is even with somebody who has health concerns and has gone to the doctors a lot or is on prescriptions there s still a lot of benefits to working with health sharing because you re able to negotiate lower prices. You have discount prescription cards. And I mean, especially even for cancer, 12 months is not a long time to wait especially if there s other options in the interim that can cover you. It sounds like that if you could what I ve noticed in working with a health sharing company, organization, ministry, is that everybody s really helpful. I never have to wait on the phone. Everybody knows their stuff, and it s not somebody who s getting paid $10 an hour. And it s not that I m knocking people s pay. Everybody s got to start somewhere or whatever. But they know their stuff, and they re willing to help you. So if I called in and I was like, Hey, I have high blood pressure. What do I do? I m self-employed. I m starting a home business, and I need health care coverage. What are my options? I know that I would get the answers to those questions, and they would have my best interests in mind, is what I m saying. Instead of how they re just doing their job, going through the motions, following the script or whatever. It s actually people helping people, which is what has drawn me to it so much over the years. Ron: Absolutely. That s the idea behind it. Like I said, it s not anything different than a GoFundMe. It s those of us reaching out to one another to insure. And look, again, we re not

7 being forced to have to pay for health issues that are created by somebody s negative way of affecting their body with excessive alcohol consumption or illicit drugs or whatever the case may be. We re about those healthy like-minded people. We should want to help others. We shouldn t be mandated or told we have to. That s the idea behind it, and that s the mentality of those of us in the health care sharing industry, and that is truly working and helping one another. For those that are out there that are self-employed, one of the things that we re doing for 2018 none of the health care sharing ministries share in occupational coverage. If you have a medical need that arises while earning a profit, generally, it s not shared in. What we decided to do is, I launched a program in 2018 that we are actually now sharing in what we call occupational sharing where, if there is something that occurs while a self-employed person is earning a profit, we re going to share in that up to a specific cap. So I m with you. Those are some things that we re really kind of looking at. We re looking at developing group products that are for those sharing in that like-minded so that we can assist the employer. Because employers are getting left out in the cold as well, and we want to be able to bring as many into the option available to them that s out there. Caitlin: Yeah. I love that. I want to talk real quick about we ve talked about somebody who s self-employed. I want to shift gears a little bit on talk about family. So if there s one person in the household that s working at home, or if there s a power couple like my husband and I are both working at home and we don t have kids yet, but say we had a few kids down the road. Is health care sharing still a good option, or is it safer to go with insurance? Ron: Well, no. Absolutely. We have a lot of families that get on our plan. We have two plan types, a Standard, and an Advantage. And that Standard is a very low, what we call, MRA. People know that as a deductible. Let s say our highest plan is our Gold Standard Plan. So for $480 a month, a 35-year-old family of five can have maternity coverage, can have six office visits per member, not per family, per year Caitlin: Oh, my goodness. Ron: the discounted plan. A lot of people just go, There s no way. How can you do that? Well, it s simple. One, what were premiums prior to the ACA, I tell everybody? And the second being, we still underwrite. So, again, that s one of the things that s been pulled out of the insurance world because of the ACA, is underwrite. We still do the underwriting. We talked about those limitations. But yeah, that family so it would be that plan s like $500 a year is the first MRA or deductible per member. And, then, what we do is we call a second MRA or second deductible. It s kind of like reinsurance. That s 25% of the next $10,000. So maximum out-of-pocket for an individual or a family would be $3,000 per member per year. They ve now reached their deductible or MRA; the membership s going to share 100% up to a million dollars. Caitlin: Wow.

8 Ron: And so it is very affordable for the families. That s the idea. We want to be able to target families. It s not just for individuals. It is for the family model. Caitlin: Yeah. I kind of use my own experience in 2016 when I was looking in the Marketplace, and $650 for two people that were in their early 30s I hadn t even hit 30 yet, and my husband was in his early 30s. We had no health issues, no kids, and it was $650 a month. But, again, it was based on how much money we made, and they just wanted to know our net income for our household. You put in that amount, and they just have their little algorithm or whatever that says, okay, well, this is how much you can afford. Because they use the people who are making more money to offset, and I understand why they re doing that, but at that point it becomes more like a tax and it s not equal. We all have the same needs as humans. Just because somebody makes a little more money or a lot more money or a lot less money, we all have the same needs as humans in terms of needing health coverage. Ron: Absolutely. You ll never get a question on our application how much money you make. It doesn t happen. And these our contribution or premiums that everybody knows is they re the same across state lines. So it makes no difference what state you re in. It s the same price point. And the product, as with your group that you re talking about, you can use that across state lines because we do have a national network as well. We ve got a lot of large providers. Cancer Centers of America have now contracted with us; they don t contract with anybody. So we re seeing a lot of providers coming to us because they re starting to see it as a true alternative for the consumer. Caitlin: Yeah. It s been two years since I ve had it or a year-and-a-half at this point, and I ve been very happy with it. Even included in my plan is, I can talk to a nurse 24/7 live for free. So if I have a health care concern, maybe if I had a kid that I m watching or my dog well, maybe not my dog, but I love my dog because he s like a kid. But if some poison control thing happened where I accidentally got something in my eye, and then I ve just got to talk, or maybe there s something that is growing on my arm just some, any random thing that I could be potentially concerned about. I don t need to necessarily make a doctor appointment. I can talk to this health care professional live on chat or on Skype or whatever, and just show them or just let them know that I m concerned. Then they can give me advice based on whether I need to actually go to the doctor or not. So it saves me a lot of time, too. I ve just really been impressed with the entire process, and I m certainly glad that I started doing research. I m glad that you re able to come on today, and just clear the air because there s been a lot of misconceptions and myths about health care coverage and the word insurance itself. It s all coverage, and it s just words at this point. If you re going to get better coverage with health sharing than you would with regular insurance, and it s more reliable than regular insurance, then go with what works and what serves your family. And stop beating words around because it s just words at this point. Ron: Absolutely. And I m a member, too. I m not just a VP here. I m a member Caitlin: You re not a sales guy.

9 Ron: and it works really well for me. Caitlin: Yeah. I ve definitely been happy with it. Well, I really appreciate this has been some awesome information that you ve shared on health coverage, and it s a huge topic. It s not just insurance anymore. There are other options not having the option of health insurance through an employer. You just talked about how employers are starting to gravitate towards health sharing for their organizations as well. Now we know that not having and it s available to pretty much anybody. It s not just a certain religious affiliation anymore, and so there are options. There s no reason why somebody who s sitting there at home watching the Work-At-Home Summit right now thinking, oh, you know, I don t have any options because you re probably paying more even with your employer s help for your insurance than you would if you were paying for your coverage through a health share all on your own. Of course, then there are the discounts and perks that come with it as well. It s just important to have people know they can still have quality health coverage without paying a ton of money for it. I m certainly benefitting from it. So if you re interested in learning more about health care sharing or think that it s a great fit for you and you want to know more, I m going to include links below the video for you to get more information on Altrua HealthShare, and to get in touch with Ron as well links below the video. Thanks so much for joining us, Ron. You ve been a wealth of knowledge and information. Ron: Awesome. Well, thank you, Caitlin. I appreciate it. And anytime, holler back at me.