Affordable Care Act (H.R.3590) Religious Exemption Program

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Presentation transcript:

Affordable Care Act (H.R.3590) Religious Exemption Program POH Christian HealthShare Include Obamacare Penalty Exemption

Altrua HealthShare : Altrua HealthShare is a fully recognized Health Care Sharing Ministry, whose members are exempt from the penalties of the Affordable Care Act. Altrua HealthShare is one of a few non-profit, recognized Health Care Sharing Ministries nationwide. POH Managing Membership Representative for Altrua HealthShare Member Recruiting Member Service

MultiPlan : Founded in 1980, almost 900,000 healthcare providers under contract, an estimated 68 million consumers accessing this network, and Multiplan is the only company that can offer access to the leading independent national primary PPO network. GAP : Non Profit Organization for Medical/Dental discount benefit (LA, ORANGE COUNTY)

900,000 doctors & Hospitals nationwide 100 Hospitals and 200 Korean doctors welcome you in Sothern California

2 Plans $17/house is cost for network using (no compensation) If your family is larger than five, add $20 more for each additional family member If husband and wife are both participating, “head-of household” is the husband. If husband and wife chose different plan, separate applications required. Plan for Dependents is same of heas-of-household

Plan Benefits Gold Plus Bronze Plus MRA* $500 per person per calendar year $5,000 per person per incident Preventive Care 3 procedures per calendar year up to $400 Not Available Doctor's office visit incident related Not Available Exams incident related Not Available Maternity $4,000 max. normal delivery $6,000 max. medically necessary C-section (only after 300 days as member) Not Available Prescription incident related Not Available Surgery included included Hospitalization included included (inpatient only) Maximum Limit $150,000/incident Amount exceed the limit Voluntary Additional Sharing among POH group membersVoluntary Additional Sharing among POH group members

Abuse of alcohol, drugs, tobacco, sexual immorality, and member who do not attend the church regularly (needs submitted in violation to the Statement of Standards and the above are not eligible for sharing) Undergoing treatment for pre-existing condition before membership Preventive care bills within 90 days after membership (sharing up to $400 per year for Gold Plus) Maintenance drugs (taken beyond a 6 month period) Dental, optometrists, vision services , chiropractic , traditional oriental medi-care (oriental medicine, acupuncture) Treatment for psychological , psychiatric , mental or emotional tests Elective cosmetic surgery/non-health related surgery Infertility testing or treatment, sterilization , tubal ligation, vasectomy or the reversal thereof Self-inflicted, non-accidental incidents and conditions Ambulance (May be submitted for medical treatment bills in the ambulance) Delay of monthly gifts Needss submitted after membership termination for any reason (except for termination due to death)

Pre-existing condition (I) If you were not hospitalized for diabetes and/or hypertension in the year prior to joining, the following limits apply: 1st Year: $15,000 ; 2nd Year: Additional $10,000; 3rd Year: Additional $25,000 ; 4th Year: Additional $100,000Pre-existing condition (II) Bills for chronic conditions such as (but not limited to) asthma, cataract, foot disorders, hernia, hemorrhoids, hysterectomy, mastectomy, kidney problem, nerve problem, tube in ears, tonsillitis, varicose veins, wart removal, back condition, prostate etc.  Following limitations apply: 1st Year: $0; 2nd Year: $15,000, 3rd Year: Additional $10,000; 4th Year: Additional $25,000, 5th Year: Additional $100,000

GAP DENTAL DISCOUNP

GAP PREVENTIVE CARE DISCOUNT BENEFIT AVERAGE PRICE (LA AREA CASH PRICE) MEMBER PRICE DOCTOR’S OFFICE VISIT VARY (UP TO $150) $45 LAB TEST ( PSA TEST INCLUDE) $100~$150 $90 (TEST ONLY) DENTAL (EXAM, X-RAY, CLEANING) $60~$200 $35 PSA TEST $100 $45 (TEST ONLY) PAP SMEAR $130 $80(TEST ONLY), $95(WITH CONSULTING) MAMMOGRAPHY $100 $60~$70 ULTRA SOUND $150~$300/SITE $70/SITE CT MRI IMMUNIZATION

Compensation Policy 1st year : $10% From 2nd year : 5% Agency : 20% override for total compensation (5 or more agents have to Active) Referral Override (Promotion until 12/31/2015) 20% for 2 years Contract period : 2 years