Page 3 - FL_STM_Connect PLus
P. 3
An STM policy may be right for you if you:
• Have missed the open enrollment period and aren’t eligible for special enrollment under the
Affordable Care Act (ACA)
• Are waiting for your ACA coverage to start
• Are waiting for health insurance benefits to begin at a new job
• Are looking for coverage to bridge you to Medicare
• Are needing an alternative to COBRA
• Are under age 65
STM policies are not ACA plans
STM policies do not meet ACA standards. The ACA is a Federal law that requires all major medical
plans to provide specific benefits and requires that most Americans have health plans that qualify
as Minimum Essential Coverage (MEC). These rules do not apply to STM policies. Short-term
medical insurance is a limited duration medical expense policy and is non-renewable. The amount
of benefits provided depends on the plan selected and the premium will vary with the amount of
benefits selected. STM is not a replacement for the comprehensive health insurance required under
the ACA.
Keep the following in mind as you plan for your needs and explore your options:
• STM plans do not meet the Minimum Essential Coverage requirements under the ACA
and may result in a tax penalty. STM plans are designed to provide temporary healthcare
insurance during unexpected coverage gaps.
• The ACA-compliant medical plans are guaranteed issue, meaning you cannot be denied
coverage based on your health history. STM plans are underwritten, which means you must
answer a series of medical questions when applying for coverage. Based on your answers,
you may be declined for coverage.
• Unlike the ACA plans, which are required to cover the 10 Essential Health Benefits (EHB),
STM plans cover some EHBs but not necessarily all. Policies will vary in what they cover, so
you should check your policies details carefully.
STM policies provide flexible temporary coverage. It’s also important
that you understand what you’re buying so you can make a fully informed
choice for you and your family.
Pre-existing condition limitation
Unlike most STM plans, Connect Plus provides a benefit for eligible pre-existing conditions. The
plan provides not to exceed a maximum of $25,000 for eligible medical expenses for a pre-existing
condition, per person, per policy. After the $25,000 maximum has been reached, expenses due
to pre-existing conditions are not covered. Refer to page five for the definition of a pre-existing
condition.
Pre-existing condition definition
A pre-existing condition is any medical condition or sickness for which medical advice, care,
diagnosis, treatment, consultation or medication was recommended or received from a doctor within
five years* immediately preceding the covered person’s effective date of coverage; or symptoms
within the five years* immediately prior to the coverage that would cause a reasonable person to seek
diagnosis, care or treatment. This period of time may vary by state.
*Six months in ID, KY, MI, ND, NH, NM, OH, WA, WY; 12 months in CA, CO, CT, IN, LA, MD, ME,
MS, NC, NV, SD, VA; 24 months in FL, IL, UT; and 36 months in MT.
Payment options to suit your situation
These plans offer a single or monthly premium payment using credit card or automatic bank
withdrawal. For policy durations of 91 to 180 days, you may prepay the premium for your entire
coverage duration through a single payment option. For durations of 91 days to 6 months, premium
payments are made on a monthly basis. Not all states allow for durations greater than 90 days.
3 Brochure Connect Plus 1018
• Have missed the open enrollment period and aren’t eligible for special enrollment under the
Affordable Care Act (ACA)
• Are waiting for your ACA coverage to start
• Are waiting for health insurance benefits to begin at a new job
• Are looking for coverage to bridge you to Medicare
• Are needing an alternative to COBRA
• Are under age 65
STM policies are not ACA plans
STM policies do not meet ACA standards. The ACA is a Federal law that requires all major medical
plans to provide specific benefits and requires that most Americans have health plans that qualify
as Minimum Essential Coverage (MEC). These rules do not apply to STM policies. Short-term
medical insurance is a limited duration medical expense policy and is non-renewable. The amount
of benefits provided depends on the plan selected and the premium will vary with the amount of
benefits selected. STM is not a replacement for the comprehensive health insurance required under
the ACA.
Keep the following in mind as you plan for your needs and explore your options:
• STM plans do not meet the Minimum Essential Coverage requirements under the ACA
and may result in a tax penalty. STM plans are designed to provide temporary healthcare
insurance during unexpected coverage gaps.
• The ACA-compliant medical plans are guaranteed issue, meaning you cannot be denied
coverage based on your health history. STM plans are underwritten, which means you must
answer a series of medical questions when applying for coverage. Based on your answers,
you may be declined for coverage.
• Unlike the ACA plans, which are required to cover the 10 Essential Health Benefits (EHB),
STM plans cover some EHBs but not necessarily all. Policies will vary in what they cover, so
you should check your policies details carefully.
STM policies provide flexible temporary coverage. It’s also important
that you understand what you’re buying so you can make a fully informed
choice for you and your family.
Pre-existing condition limitation
Unlike most STM plans, Connect Plus provides a benefit for eligible pre-existing conditions. The
plan provides not to exceed a maximum of $25,000 for eligible medical expenses for a pre-existing
condition, per person, per policy. After the $25,000 maximum has been reached, expenses due
to pre-existing conditions are not covered. Refer to page five for the definition of a pre-existing
condition.
Pre-existing condition definition
A pre-existing condition is any medical condition or sickness for which medical advice, care,
diagnosis, treatment, consultation or medication was recommended or received from a doctor within
five years* immediately preceding the covered person’s effective date of coverage; or symptoms
within the five years* immediately prior to the coverage that would cause a reasonable person to seek
diagnosis, care or treatment. This period of time may vary by state.
*Six months in ID, KY, MI, ND, NH, NM, OH, WA, WY; 12 months in CA, CO, CT, IN, LA, MD, ME,
MS, NC, NV, SD, VA; 24 months in FL, IL, UT; and 36 months in MT.
Payment options to suit your situation
These plans offer a single or monthly premium payment using credit card or automatic bank
withdrawal. For policy durations of 91 to 180 days, you may prepay the premium for your entire
coverage duration through a single payment option. For durations of 91 days to 6 months, premium
payments are made on a monthly basis. Not all states allow for durations greater than 90 days.
3 Brochure Connect Plus 1018
