Sharing Guidelines

II. Health Care Sharing Programs

REDEEM HealthShare is a nonprofit health care sharing ministry that facilitates direct member-to-member sharing of eligible medical expenses.

A. How Health Care Sharing Works

Health care sharing is a voluntary arrangement that unites individuals and families in the REDEEM community through acts of mutual support and love, reflecting the early Christian church's commitment to caring for one another (Acts 2:44-45). Guided by our shared faith and Biblical principles, we come together to bear each other's burdens and demonstrate the love of Christ in practical ways.

There is no transfer of risk from a member to REDEEM HealthShare or from a member to other members, and there is not a contract of indemnity between REDEEM HealthShare and any member or between the members themselves.

REDEEM HealthShare Ministry is not an insurance company and some of the terminology and processes may be different than you are used to or be unfamiliar. REDEEM members do not pay "premiums" and money is not collected by REDEEM HealthShare to "cover" medical expenses. Members receive Share Notifications each month which inform the members who they'll be sharing with and what the need was for. Members submit voluntary Monthly Shares to assist other members with their eligible medical expenses and support the administration and program services of the Ministry. Members are always responsible for their medical bills and expenses.

Overview: The REDEEM™ Sharing Process

Members select a sharing program that aligns with their desired level of medical expense sharing and financial considerations. Members deposit monthly their Total Share amounts into a specific member-owned (not-REDEEM-owned), bank account—called a Share Account—opened by the primary member during the application process with our third-party fiduciary, America's Christian Credit Union. Medical bills will be submitted to REDEEM HealthShare directly by medical providers or by the member. Medical bills that are eligible for sharing per the Guidelines are matched, allocated, and published to the membership prior to sharing. REDEEM HealthShare implements a member-to-member approach to sharing which means that members share funds directly with one another, rather than drawing funds from a common pool. Members who are matched to share will be notified through a process called Publishing as to the amount that is due to be withdrawn from their Share Account for the payment of another member's assigned bill. They will be notified as to who will be receiving their funds. The amount shared to each receiving member is transferred to a Virtual Bill Account for the payment of the bill. Once completed, the funds are directly transferred to the medical provider as payment for the bill or to the member where applicable.

Complete details on how the sharing, publishing, and payment process work can be found in REDEEM™ Sharing Platform (see Section V).

All eligible medical bills are subject to an Annual Unshareable Amount (AUA), which is the dollar amount a household membership must pay direct to providers toward their own eligible medical bills during a twelve (12) month period before their eligible medical bills can be published and shared by REDEEM HealthShare. Some REDEEM programs have Co-Share amounts and other limits described herein.

REDEEM HealthShare offers three sharing programs which offer different sharing levels and health care sharing support and an optional add-on program providing additional flexible sharing options.

B. Important Membership Terminology

REDEEM HealthShare is defined using certain terms, vocabulary and definitions. A complete list may be found in the Glossary of Terms.

Annual Unshareable Amount (AUA). The Annual Unshareable Amount (AUA) is the dollar amount a household membership must pay direct to providers toward their own eligible medical bills during a 12-month period before their eligible medical bills can be published and shared by the membership. All eligible medical bills are subject to the AUA unless otherwise specified. The AUA 12-month period begins on your membership date. The AUA resets on the anniversary of your membership date or upon switching between programs or AUA levels after which it resets on the Effective Date Anniversary.

Membership Date. Your membership date is the date that your membership in a REDEEM HealthShare program started. All medical bills with a date of service after this date will be determined for eligibility under these Guidelines.

Co-Share Amounts and Limits (REDEEM Essential only). In REDEEM Essential only, once the AUA is met, REDEEM HealthShare shares 80% of eligible medical bills. The remaining 20% (the Co-Share amount) is paid directly by the member up to the annual Co-Share limit. There is a $5,000 Co-Share limit per household membership per year. The Co-Share limit will reset on the anniversary of the membership date or on the effective date of any AUA reset occurring during the membership year.

Samaritan Ministries Legacy Member. A member who migrates without membership interruption from Samaritan™ Classic or Samaritan™ Basic in good standing to REDEEM HealthShare membership. These members have transferred their participation from a current Samaritan Classic or Samaritan Basic program.

C. REDEEM™ Essential

REDEEM Essential offers a reliable solution at a low monthly cost and allows the household membership to select the level of sharing participation to determine their monthly share amount and AUA. Members mutually share eligible medical expenses, subject to the AUA, a Co-Share amount, and subject to $1 million per household membership maximum per year.

D. REDEEM™ Enhanced

REDEEM Enhanced is our most comprehensive sharing program and allows the household membership to select the level of sharing participation to determine the monthly share amount and AUA. Members share eligible medical expenses as well as certain preventative screenings, wellness visits, and prescription costs subject to the AUA as documented herein. REDEEM Enhanced has a $2 million per household membership maximum per year and is not subject to a Co-Share.

E. REDEEM™ SeniorSaver

REDEEM SeniorSaver is a program for members 65 years of age and older. It is designed to work with Medicare Parts A and B (and if applicable, Medicare Advantage plans) with sharing secondary to those Medicare plans. Medicare Parts A and B will cover 80% of the costs of bills incurred for services that Medicare covers; the REDEEM community shares the remaining portion of eligible bills, with some exceptions. Members are not required to join REDEEM SeniorSaver when they turn 65; they can participate in REDEEM Essential or REDEEM Enhanced for as long as they like. REDEEM SeniorSaver has a $500 AUA.

Additional REDEEM SeniorSaver Requirements

1. REDEEM SeniorSaver requires participation in Medicare Part A and Part B and is considered secondary to Medicare Part A, Part B, and, if applicable, Medicare Advantage plans.
2. Members wishing to have prescriptions shared must also have Medicare Part D.
3. Members may only participate as an individual. Those wishing to have a "couple" or "family" membership will need to participate in REDEEM Essential or REDEEM Enhanced.
4. All other membership requirements in Conditions of Sharing (Section IV) and Foundational Overview (Section I) apply.

F. FlexShare™

FlexShare is an optional add-on program, permitting the submission of additional items for sharing, such as vision, dental, and supplements. The program provides a per household membership annual allowance for eligible expenses of $1,000 for REDEEM Essential, $1,500 for REDEEM Enhanced, and $1,000 for REDEEM SeniorSaver. There is no Co-Share or AUA for FlexShare.

A household membership may submit bills in the FlexShare program after six months of participation. The annual allowance amount resets on the membership anniversary date or on the effective date, and any unused balance does not carry over to the next year.

FlexShare expenses must comply with the Statement of Faith and Lifestyle Requirements, and bills or receipts must be submitted through the Member Center bill submission portal as a FlexShare expense. This feature is intended to offer additional support within the stipulated FlexShare annual limit and under the specified terms and conditions and is subject to the list of items not eligible for sharing.

See the Appendix for examples of expenses that are eligible for FlexShare.

G. Annual Sharing Caps and Lifetime Limits

H. Liability

Members of REDEEM HealthShare Ministry share one another's medical expenses. REDEEM HealthShare facilitates this member-to-member sharing by directing members' shares to those who have eligible expenses. REDEEM HealthShare is not insurance. A division of Samaritan Ministries International, REDEEM HealthShare is a health care sharing ministry, as outlined in the Patient Protection and Affordable Care Act and facilitates the sharing of medical bills and expenses among members, one with another, according to these Guidelines, at REDEEM HealthShare's reasonable discretion.

REDEEM HealthShare is not liable for the payment of a member's medical bill. If sharing occurs, the shared medical bills are paid by the member that incurred the bill from other member's share contributions only, not from funds of REDEEM HealthShare itself. Members have no legal obligation to contribute toward another member's medical bill, but send assistance as part of a volunteer community.

REDEEM HealthShare's programs are not insurance. However, REDEEM HealthShare may be used to avoid the "Affordable Care Act" federal mandate that became effective January 1, 2014, requiring "applicable individuals" to maintain "minimum essential [insurance] coverage" and to be exempt from similar mandates in California, New Jersey, Rhode Island, Massachusetts, and the District of Columbia.

These are the only exceptions. Otherwise, members must not certify that REDEEM HealthShare is insurance to avoid purchasing insurance required by law, rule, or regulation, such as worker's compensation insurance, or extended auto coverage in some states, such as Michigan.