Dramatic changes are happening in the Short-Term Medical market! Now and up to August 31st, 2024, you can establish up to a 3-year policy via Allstate Health Solutions. As of September 1st, 2024, STM (Short-Term Medical) will be relegated to only 3-month policies, and only renewable upon re-application and you must be in good health. So, it will no longer be a viable alternative to the ACA (Affordable Care Act (i.e. ObamaCare)). This is thanks to the Biden Administration trying to force everyone into the ACA, even those that it does not make sense for. Such as young individuals earning $50K or more are generally not great candidates for subsidies (often times zero subsidies!), and therefore forced to purchase a policy via HC.gov at substantially higher rates than traditional STM rates that were about half the cost of full retail pricing of ObamaCare. Not to get political, but here are the facts; Obama shortened STM to 3 months on his way out, and Trump extended it back to 3 years, and now once again Biden is shortening it back to only 3 months. You can decide for yourself. I personally utterly disagree with this move by the Biden Administration, and the fact is this change has reduced the number of choices each individual has in deciding what plan is best for their personal situation. Approximately 20 plus percentage of my clients chose a STM policy because it simply made sense for them.Â
All that being said, we simply have to work within the confines and the choices that are ahead of us. As an independent agent, I will continue to explore alternative options to best serve my clients. I believe very strongly that any policy that I offer must be regarded as a “true major medical” coverage and be compatible with the ACA-Essential Health Benefits and not leave anyone vulnerable to any excessive out-of-pocket expense that could be financially crippling.
I have already begun to explore a viable option that I am getting more familiar with and becoming more comfortable with. So far, the plan itself seems excellent, the plans offered are very rich in benefits, Nationwide Networks with a varying degree of deductibles just like the Bronze, Silver & Gold plans that are offered via the ACA. These plans will be ACA Compliant with all the EHB-Essential Health Benefits that are guaranteed via the ACA. I do believe there will be health Q’s but will also cover Pre-Ex Conditions from day one of coverage! So far, mostly good news, well, here comes the not so good news. These plans do not seem to be very well priced for the “under 45” age group. But for those over 45 the pricing gets competitive, and for those over 55, the pricing gets really competitive. Yes, everyone’s situation will be different. It remains my job to continue to explore and offer to you all your options, and give you back the “choice” you deserve!
This is a transition that will be challenging, and I will do all I can to make things as smooth as possible. Also, anyone currently on a STM plan with me via Allstate should be in good shape until their expiration (all contracts will continue to be honored and grandfathered in). Many of my clients currently have 2- and 3-year contracts with Allstate and should be covered for the next few years. My concern is moving forward, for those that have not yet called.
Let’s end on a happy note, at least 85 plus percent of those that need individual health coverage do indeed qualify for subsidies via the ACA. So, for the most part, this will / should only affect a small number of clients. But its’s my job to keep you informed in “What the Health?” is going on in this quite dynamic industry and I will continue to do my best to do so!
Happy Health,
Kevin F Gourgues