Sharing Guidelines

2. Health Care Sharing Programs

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

2.1. How Health Care Sharing Works

Health care sharing is a voluntary arrangement that unites you and other families in the REDEEM HealthShare 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 a shared faith and Biblical principles, the community comes together to bear each other’s burdens and demonstrate the love of Christ in practical ways.

There is no transfer of risk from you to REDEEM HealthShare or from you to other members, and there is no contract of indemnity between REDEEM HealthShare and you or between you and other members.

REDEEM HealthShare Ministry is not an insurance company. The terminology and processes might be different or unfamiliar to you. You do not pay “premiums” and REDEEM HealthShare does not collect money to “cover” medical expenses. You receive a Share Notice each month that informs you who you will share with and the reason for the medical Need. You submit voluntary monthly Shares to assist other members with their eligible medical bills, which is separate from the amount sent to REDEEM HealthShare to support the administration and program services of the ministry. You are always responsible for your medical bills and expenses.

2.2. Overview: The REDEEM® HealthShare Sharing Process

You will select a sharing program that aligns with your desired level of medical bill sharing and your budget. Each month, you will deposit your Total Amount Due into your Share Wallet. The Share Wallet is a specific member-owned (not REDEEM HealthShare-owned) bank account opened by the primary member during the application process with our third-party Financial Institution, America’s Christian Credit Union. Medical providers or you submit medical bills to the ministry. REDEEM HealthShare matches and publishes eligible medical bills to the membership prior to sharing in accordance with the Sharing Guidelines. REDEEM HealthShare implements a member-to-member approach to sharing which means that you share funds directly with another member. Through a process called Publishing, once you are matched to share, you will receive a notification about 1) who will receive your funds, and 2) the amount you send from your Share Wallet to help pay for another member’s eligible medical bill. The amount shared to each receiving member transfers to a Virtual Bill Account for the payment of the eligible medical bill. Once completed, the funds transfer directly to the medical provider or to the member, where applicable.

You will find complete details on the sharing, publishing, and payment process in the REDEEM® Sharing Platform, see section 6. REDEEM® HealthShare Sharing Platform.

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

2.3. Important Membership Terminology

REDEEM HealthShare uses defined terms and vocabulary. See section 8. Glossary of Terms section for the full list.

Unshareable Amount. All eligible medical bills are subject to the selected Unshareable Amount, which is the dollar amount you pay toward your eligible medical bills before REDEEM HealthShare publishes your eligible medical bills for sharing with other members.

Note: Ineligible bills do not contribute towards your Unshareable Amount. Some REDEEM HealthShare programs have Co-Share amounts and other limits described herein.

Annual Unshareable Amount (AUA). The AUA is the dollar amount your household membership must pay toward all your household’s eligible medical bills during a 12-month period before REDEEM HealthShare publishes those eligible medical bills for sharing with other members. The AUA 12-month period begins on your Effective Date. The AUA resets 1) on your Membership Anniversary Date, 2) if you switch between programs, or 3) if you move from a higher to a lower Unshareable Amount. If you switch between programs or change your Unshareable Amount levels, then the AUA resets on the anniversary of the Effective Date.

Co-Share Amounts and Limits (REDEEM® Essential only). In REDEEM Essential only, once the membership household meets the Unshareable Amount, REDEEM HealthShare shares 80% of eligible medical bills. You pay the remaining 20% (the Co-Share amount) toward your eligible medical bills, up to the annual Co-Share limit. The AUA Co-Share limit is $5,000 per household per year. The AUA Co-Share limit will reset on the Membership Anniversary Date. The Co-Share limit will reset on the Effective Date of any change to your Unshareable Amount.

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

Samaritan Ministries Legacy Member. A member who transfers participation from a current Samaritan® Classic or Samaritan® Basic program without membership interruption to REDEEM HealthShare.

2.4. REDEEM® Essential

REDEEM Essential offers a sharing solution at a low monthly cost and allows you to select the level of sharing participation to determine the monthly share amount and Unshareable Amount. See section 3.1 REDEEM Essential Sharing of Expenses for details.

2.5. REDEEM® Enhanced

REDEEM Enhanced is our most comprehensive sharing program and allows you to select the level of sharing participation to determine the monthly share amount and Unshareable Amount. See section 3.2 REDEEM Enhanced Sharing of Expenses for details.

2.6. REDEEM® SeniorSaver

REDEEM SeniorSaver is a program for you if you are 65 years of age or older. See section 3.3 REDEEM SeniorSaver Sharing of Expenses for details.

2.7. REDEEM® Groups

REDEEM Groups is an option if you are affiliated with a group, such as employers, associations, or other multi-household groups, to fund and manage REDEEM memberships. All REDEEM HealthShare programs are available to groups, including REDEEM Essential, REDEEM Enhanced, and REDEEM SeniorSaver. The FlexShare add-on is also available to REDEEM HealthShare Groups. See section 3.4 REDEEM Groups Sharing of Expenses for details.

2.8. FlexShare® Add-On

The FlexShare® add-on is an optional sharing service that permits sharing of additional items, such as vision, dental, and supplements. See section 4 FlexShare® Add-On for details.

2.9. Annual Sharing Caps and Lifetime Limits

2.10. Liability

As a member of REDEEM HealthShare Ministry, you share one another’s Needs. REDEEM HealthShare facilitates this member-to-member sharing by directing your shares and support to those who have eligible Needs.

REDEEM HealthShare is not insurance. REDEEM HealthShare is a division of Samaritan Ministries International, a certified health care sharing ministry under the Patient Protection and Affordable Care Act. REDEEM HealthShare facilitates the sharing of Needs among its members, directly from one member to another, in accordance with these Guidelines and at the discretion of REDEEM HealthShare.

You pay your providers from share contributions you receive from other REDEEM community members. Medical bill funding does not come from REDEEM HealthShare itself and REDEEM HealthShare is not liable for the payment of medical bills. Members have no legal obligation to contribute toward your (or another member’s) medical bills. It is a sharing community.

REDEEM HealthShare programs are not insurance. You 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. However, by participating in REDEEM HealthShare you are exempt from the “Affordable Care Act” federal individual 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.

2.11. Pilot Programs

REDEEM HealthShare might offer Pilot Programs to test the feasibility of new processes and programs. If the ministry offers a Pilot Program, it is voluntary and only by invitation.

REDEEM HealthShare may end a Pilot Program in its sole discretion.