Sharing Guidelines

IV. Conditions of Sharing

A. Family Members Defined

A membership in REDEEM HealthShare is limited to members of the same nuclear family. Nuclear families include only husband, wife, and children, but can include grandchildren in the circumstances described below.

Children 18 and over must verify that they meet the member requirements by signing an application form.

1. Spouse

Spouse means a legally married person. It can be a person's lawfully married husband or wife. Marriage is defined as being between one biologically born man and one biologically born woman.

2. Adult Children (Age 18 and over)

Your single children from age 18 up to and including age 25 may be on your membership if they are living at home (which includes while away at school full time). A child may be considered disabled and remain on a family membership after turning 26 if the child is receiving more than 50% financial support from their parents and qualifies as a dependent on their parent's federal tax return. Contact your Member Care team before the date they turn 26 if you wish to apply for this status.

3. Newborn

A newborn, whose addition to the membership may increase the monthly share amount, will be included within the membership retroactive to the date of birth, as long as at least one parent was a member as of the baby's birth and you notify REDEEM HealthShare to add him/her to the membership no later than 30 days after the birth; otherwise, the effective membership date will be no earlier than the date of notification to REDEEM HealthShare. REDEEM HealthShare should be notified as soon as possible to add subsequent newborn children to the membership. Please be aware that there are specific Guidelines addressing sharing needs for a newborn (see Section III.G.)

4. Adoption

Adopted, unmarried children are considered members of the family the same as biological children.

5. Grandchildren

Grandchildren may be included as part of their grandparents' membership if they meet all the following criteria:

1. They live permanently with their grandparents (their residence), and
2. The grandparents have legal custody, or the grandchild is the child of a minor, and
3. They meet the eligibility Guidelines for children, and
4. They have no other agency, person, or group responsible for their medical bills.

6. Guardianships

Guardian memberships are allowed. The guardian must be 18 years old or older to manage the membership on behalf of a minor.

B. Inactivation of Membership

1. Voluntary Inactivation

Members can voluntarily inactivate their membership in good standing at any time which shall take effect at the end of any month.

2. Involuntary Inactivation

A REDEEM HealthShare membership will be inactivated if:

• The member fails to fully fund their share wallet for 60 days.
• The member fails to resolve Know Your Customer (KYC) issues within 60 days of Notice of Failure.

Notice Periods

• 30 Days' Notice: After 30 days of non-compliance, members will receive a notice informing them of their ineligibility for sharing until the issue is resolved. Membership will be suspended at this point, which means that members are not eligible to have new bills shared.
• 60 Days' Notice: After 60 days of non-compliance, the membership will be inactivated, effective from the date the member should have funded the share wallet or completed the click-to-share requirement.

C. Restart of Membership

If an existing membership is inactivated due to voluntary or involuntary inactivation, a member may apply for a new membership. All membership requirements, waiting periods, and conditions will apply as if the member had no previous membership and include the following requirements:

• Memberships that have been inactivated involuntarily must have all back-shares paid in full before a new membership can be started.
• Only eligible bills with Dates of Service (DoS) prior to the inactivation date will be shared.
• Bills for conditions incurred or discovered after inactivation will be considered pre-existing and will not be shared in the new membership until applicable pre-existing waiting periods have lapsed.

D. Changing Programs

There are specific criteria that must be met to change between programs or change AUA levels.

Qualifying Life Event Changes. Members are allowed to change their AUA level or program within 30 days of the following circumstances, with the effective date being the first day of the following month:

• Change in marital status
• Change in child/dependents
• Birth/Adoption
• Loss of spouse
• Loss of employment
• Dependent turns 26

The Program Change Request form is available in the Forms section of the Member Center.

Membership Anniversary Changes. Members are allowed to change their AUA level or program each year, effective with the first day of their anniversary month. Requests must be submitted at least 30 days in advance of the anniversary month, using a the Membership Anniversary Program Change Request form. This form is emailed to the primary member 60 days before the membership anniversary date.

Switching Fee and Resetting AUA

• Switching Fee. Changing your program or AUA level requires a switching fee of $100. You can choose the first day of any future month for your switch to occur and the $100 switching fee will be included in your Total Share Amount Due within one to two months after the switch is effective.
• Resetting AUA. Changing your program or AUA level will reset the AUA for the year.
• Adding or Removing Members Eligibility. You can add or remove members from your membership at any time.
• Share Amount Adjustment. If the addition or removal of a member impacts your share amount, the change will be reflected in your next Share Notice.

Switching Between Programs and AUAs

When switching from REDEEM Essential to REDEEM Enhanced OR when switching from a higher AUA to a lower AUA, the 12-month waiting period for the conditions and treatments listed in Sharing Limits (Section III.C.) resets.

E. Member Privacy

Members may share deeply personal prayer requests and detailed health information with one another to allow for support, fellowship, and prayer. While it is expected this information may be shared with family and prayer partners, be sensitive; do not post names or details on social media, blogs, or websites without permission, or in any other way misuse the information.

F. Guidelines Govern

These Sharing Guidelines explain the program requirements and govern the sharing of medical bills. The Guidelines in effect at the time of service govern the program, not the Guidelines in effect when a member joins REDEEM HealthShare or changes to the Guidelines that occurred after the time of service. The Guidelines are available online at redeemhealthshare.org/guidelines and in your Member Center.

G. Changes to the Guidelines

Changes to the Guidelines can be made at any time by REDEEM HealthShare as approved by the Samaritan Ministries Board of Directors. Members will be notified of the changes, and a history of changes will be available in the Member Center online for two years from the date of the change.

H. Balancing Needs and Shares/Proration

In any particular month, the funding of Shares across REDEEM HealthShare Ministry may or may not meet the eligible bills submitted for sharing. In that event, a pro-rata sharing of eligible medical bills may be initiated whereby REDEEM HealthShare shares a percentage of eligible bills within that month and holds back the balance of those bills to be shared in a subsequent month. If the funding of Shares is not adequate to meet the eligible bills submitted for sharing over a 60-day period, then the suggested monthly share amount may be increased in sufficient proportion to satisfy the eligible bills. This action may be taken temporarily or on an ongoing basis. If an eligible bill is not funded by member sharing in that bill within 90 days of entering the normal sharing queue, then that bill is removed from the normal sharing queue and will be handled through the Member Assistance Fund, if possible. Any money currently in the bill account will be sent to the provider as a partial payment.

The balancing of expenses and shares calculations may be done by sharing across two or more Samaritan Ministries programs or by keeping them separate, as allowed by the Samaritan Ministries Board of Directors.

I. Other Responsible Parties

If a member has insurance or is eligible/qualified for any insurance benefits or other health or welfare benefits, such as an employment related health or welfare plan, worker's compensation insurance, homeowner's insurance, or fraternal benefits, the member is expected to take all reasonable steps to qualify for such payments and to exhaust benefits available under those resources before submitting a request for sharing. Additionally, any time another individual or entity is or may be responsible for some or all of a medical bill intended to be submitted to REDEEM HealthShare to be shared, whether through litigation, insurance, or otherwise, the member must take all steps necessary to make sure such other individuals or entities pay the amounts applicable to their respective responsibilities before submitting the bill for sharing. Should any member receive a settlement or reimbursement applicable to medical bills already shared, the member must send those funds back to REDEEM HealthShare or to another member in need as directed. Seeking assistance from government aid programs is never required by Samaritan Ministries International or REDEEM HealthShare Ministry and is contrary to our understanding of God's desire for His people. REDEEM SeniorSaver requires participation in Medicare Part A and Part B.

J. Other Sources of Payment

A member who has the right to a reimbursement from an HRA, FSA, or HSA for a shareable medical expense is not required to pay the bill with those funds, although he should consider whether this resource should be used to lessen the burden that the community will bear. If HRA, FSA, or HSA money is used to pay the expense, then that bill may still be submitted to be shared. Please note: there may be income tax consequences from using reimbursements from an HRA, FSA or HSA to pay for an expense for which you also received share amounts. Please consult your tax advisor.

Funds raised by crowdfunding for shareable medical expenses must be reported and will be applied to reduce the shareable amount.

If a member simultaneously participates in another health care sharing ministry, he may not seek shares/payments from multiple ministries in excess of his shareable bills, for to do so is to obtain assistance beyond his burden.

K. Sharing Appeal

A member can appeal bill-sharing eligibility decisions with which they disagree if he or she believes:

1. the medical records were misread, or
2. the Guidelines were misapplied, or
3. one or more of the member's providers incorrectly recorded their medical history.

After a review by REDEEM HealthShare, if the member still disagrees with the decision, the member has 90 days to request a review by a member Appeal Panel composed of seven to thirteen REDEEM members. As part of this process, the member may submit a written position statement to the Panel. A teleconference will be held wherein the Panel can ask questions of both the member and REDEEM HealthShare. A simple majority vote will carry the decision to share or not, and the Panel's decision will be binding and non-appealable.

Membership requirement issues related to your payment of shares or your integrity (with respect to the submission and payment of medical bills) may be appealed to the Institute for Christian Conciliation as explained below. All other questions regarding whether you meet membership requirements may be appealed to the Samaritan Ministries Board of Directors who make the final, non-appealable decision.

Any other issue shall be settled in accordance with the Rules of Procedure for Christian Conciliation™ of the Institute for Christian Conciliation. (Complete text of the Rules is available at ICCpeace.com or by contacting ICC Peace at info@iccpeace.com.) However, if both REDEEM HealthShare Ministry and you agree, the dispute may be submitted to a randomly selected panel of members instead. In all events, you will have available the same relief as a court could grant. REDEEM HealthShare will pay all the arbitrator's fees and costs unless the arbitration determines there was no reasonable basis for your complaint, in which case you will be responsible for the fees and costs.

You understand that these methods shall be the sole remedy for any civil controversy or claim arising out of your relationship with REDEEM HealthShare and expressly waive your right to file a lawsuit in any civil court against REDEEM HealthShare Ministry, its employees, members, associate members, and directors, for such disputes, except to enforce an arbitration decision obtained under conditions specified herein. This also includes any determinations as to whether the matter in dispute comes within this arbitration agreement or can be required to be arbitrated. If an arbitration decision has been made and anyone is failing to follow that decision, the decision may be entered only in the Circuit Court of Peoria County, Illinois, or any jurisdiction where the member resides.

Resolving disputes within the Body of Christ is always the command of Scripture and in the interest of all our members (MATT 18:15-20; 1 COR 6). Therefore, even if REDEEM HealthShare or a member participates to some extent in a court proceeding regarding a matter in dispute, this participation will not be forfeiting the ability to later demand that the dispute be resolved by these arbitration procedures.

For all civil matters of procedure and substance regarding any dispute or claim that comes within these mediation/arbitration requirements, the laws of the State of Texas, and if applicable of the United States, shall govern.

L. Misuse of Trust and Accountability

Members commit to act with integrity. Members presenting a falsified need, using deceptive practices, or participating in another member's misuse of trust will be dropped from membership.

Members submitting bills further commit to working with REDEEM HealthShare staff and designated third-parties to determine if the bills are shareable, to seek fair and reasonable prices from providers, and to document amounts paid to providers.

When an issue of misuse of trust by a member arises (whether inactive or currently a member), the administrative office may seek the assistance of the member's Christian church and provide it with the necessary information to address the issue and hold the member accountable. The member may request resolution of the question through the mediation and arbitration provisions of the Guidelines.

M. Sponsorship

There may be circumstances where applicants or current members may not be able to pay the entire Share amount. In certain cases, we may be able to offer temporary reductions in the Share amount to assist a member experiencing financial difficulty. Because we are committed to the central role of the family and the local Christian church in all of life, including health care, application for help through Sponsorship will require that these other avenues of assistance be explored first, so they have the first opportunity to receive the blessing of giving. For more information about how to apply for Sponsorship, please contact us.