Click Here to View the Secure STM Short Term Health Insurance Plan

Secure STM Plan Details

Just because you don’t have health insurance right now doesn’t mean you may not have health problems. Short-Term Medical (STM) insurance allows you and your family to purchase quality, affordable major medical coverage on a temporary basis. Coverage is provided for physician services, surgery, outpatient and inpatient care - View the Secure STM Brochure

Who needs this type of coverage?

Short-term medical insurance may be an affordable option for those who have recently graduated, are between jobs, newly hired or in need of an alternative to COBRA.


Who qualifies for STM?

Secure STM is available to all members of Communicating for America, Inc.* who are between the ages of 18 to 64, their spouse, and dependent children up to age 26. Each applicant must be able to qualify based on the plan’s application questions and underwriting guidelines. Child-only coverage is available for ages 2 through 18. * CA, Inc. membership requirement varies by state.


When does my coverage start?

Coverage begins as early as the day following an online application submission or the postmark date stamped on the envelope. A later effective date may be requested up to 60 days after the application date. All coverage is subject to approval and payment of the first premium.


How are benefits paid?

  1. First, the deductible selected must be paid by the insured person before plan benefits begin.
  2. Next, the Secure STM plan pays at the coinsurance level selected. The insured person is responsible for the remaining percentage of covered charges until the out-of-pocket amount has been reached. The out-of-pocket amount is specific to charges applied to coinsurance; it does not include the deductible.
  3. After the deductible and out-of-pocket maximum have been satisfied, Secure STM pays 100% of covered expenses for the remainder of the coverage period, up to a maximum benefit of $2 million.

 

Office Copay

The $50 copay applies to the physician’s consultation charge. After the copay, the plan pays 100 percent of the consultation charge balance. Other covered services performed during the office visit are subject to deductible and coinsurance. The number of office visits available is determined by the selected plan duration. Office visits above the allotted number are subject to deductible and coinsurance.


What is a family deductible?

When three covered persons in a family each satisfy their deductible, the deductible for any remaining covered family members are deemed satisfied for the remainder of the coverage period.


Do I have the option to select my doctors, hospitals, and medical providers?

Yes. A covered person has the freedom to visit any doctor and hospital. Secure STM also provides access to discounted medical services through two national preferred provider organizations (PPOs). These network providers have agreed to negotiated prices for their services and supplies. While a covered person has the flexibility to choose any health care provider, the discounts available through network providers for covered services may help lower out-of-pocket costs.


How long will STM coverage last?

Secure STM is specifically designed to fill a temporary insurance need. Coverage stops at the end of the period for which you apply. Depending on the payment option selected, coverage can continue for 30 to 364 days.


Can I continue coverage?

If the need for temporary health insurance continues, most states allow a covered person to apply for another Secure STM plan. The application is subject to eligibility, underwriting requirements and state availability of coverage. The next coverage period is not a continuation of the previous period; it is a new plan with a new deductible, coinsurance, out-of-pocket and pre-existing condition limitation.


When does coverage terminate?

Coverage ends on the earliest of the date: the premium is not paid when due; the covered person ceases to be a member of the association*; the group master policy terminates; the covered person enters full-time active duty in the armed forces; or Standard Security Life Insurance Company of New York determines fraud or misrepresentation has been made in filing a claim for benefits. A dependent’s coverage ends on the earliest of the date: the primary insured’s coverage terminates; or the dependent becomes eligible for Medicare; or the dependent ceases to be eligible.
* Applies only to states where association membership is required.


What medical expenses are covered?

Covered expenses are limited by the Usual, Reasonable and Customary Charge as well as any benefit-specific maximum. If a benefit-specific maximum does not apply to the covered charge, benefits are limited by the coverage period maximum. All benefits are subject to the selected plan deductible and coinsurance.

Covered expenses include treatment, services and supplies for:

  • Physician services for treatment and diagnosis
  • Emergency room, outpatient hospital or ambulatory surgical center charges
  • Surgeon services in the hospital or ambulatory surgical center
  • Services when a doctor administers anesthetics up to 20 percent of the primary surgeon’s covered charges w Assistant surgeon and surgeon’s assistant services up to 20 percent of the primary surgeon’s covered charges
  • Ground ambulance services up to $500 per occurrence
  • Air ambulance services up to $1,000 per occurrence
  • Organ, tissue or bone marrow transplants up to a $150,000 coverage period maximum
  • Acquired Immune Deficiency Syndrome (AIDS) up to a $10,000 coverage period maximum. This AIDS maximum of $10,000 per coverage period does not apply to policies/certificates issued to residents of AZ, CA, DC, ID, MD, ME, MO, NH, NC or ND. The maximum benefit in KS is $75,000 per coverage period.
  • Blood or blood plasma and their administration, if not replaced
  • Mammography, Pap smear and prostate antigen test (covered at specific age intervals; not subject to deductible) w X-ray exams, laboratory tests and analysis
  • Oxygen, casts, non-dental splints, crutches, non-orthodontic braces, radiation and chemotherapy services and equipment rental Inpatient covered expenses
  • Room and board, doctor visits and general nursing care up to the most common average semi-private room rate
  • Intensive care or specialized care unit up to three times the average semi-private room rate
  • Prescription drugs administered while hospital confined

Do I need to precertify ?

A covered person must notify the professional review organization 10 days prior to a nonemergency hospital admission or surgery and 48 hours, or as soon as reasonably possible, following an emergency admission to the hospital. Failure to precertify will result in a benefit reduction of 50 percent. Precertification is not a guarantee of benefits.


What is the Usual, Reasonable and Customary Charge?

The Usual, Reasonable and Customary Charge for medical services or supplies is the lesser of: a) the amount usually charged by the provider for the service or supply given; or b) the average charged for the service or supply in the locality in which it is received. With respect to treatment of medical services, usual, reasonable and customary means treatment which is reasonable in relationship to the service or supply given and the severity of the condition. In reaching a determination as to what amount should be considered as usual, reasonable and customary, we may use and subscribe to a standard industry reference source that collects data and makes it available to its member companies.


What are my payment options?

Choose from two convenient payment options.

  • Monthly payments: Payments may be made for up to 6 months by check, money order, credit card or automatic bank withdrawal. If the need for insurance ends before the coverage period ends, simply sent written notification. Subsequent monthly deductions will occur based upon the effective date of coverage. If coverage effective date is the 1st - 14th, premium will be deducted on the 1st of the month. If coverage effective date is the 15th - 31st, premium will be deducted on the 15th of the month.
  • Single payment: Ideal if the exact number of days coverage is needed is known since this option has a reduced rate. Pay for just the coverage needed through one, single payment. Single payment can be made for a minimum of 30 days to a maximum of 180 days by check, money order or credit card or automatic bank withdrawal.

What services are not covered?

The following is a partial list of services or charges not covered by Secure STM*:

  • Any services that are not medically necessary, as defined in the policy
  • Eye exams, eyeglasses, hearing aids
  • Dental or orthodontic services and any treatment for jaw joint problems
  • Outpatient prescription or legend drugs and medications
  • Conditions resulting from an act of war
  • Pregnancy or childbirth, except for complications of pregnancy; newborn treatment prior to discharge from the hospital, unless the charges are medically necessary to treat premature birth, congenital injury or sickness, or sickness or injury sustained during or after the birth; any infertility or sterilization treatments
  • Spinal manipulation or adjustment
  • Services or supplies provided by your immediate family- Medical care received outside of the United States, Canada or its possessions- Charges eligible for payment by Medicare and any expenses paid or payable under workers’ compensation- Cosmetic surgery, treatment for acne, hair loss or varicose veins
  • Physical exams and other services not needed for medical treatment, except as specifically covered
  • Experimental or investigational services
  • Learning disabilities, attention deficit disorder, hyperactivity or autism
  • Mental illness or nervous disorders, suicide or attempted suicide
  • Alcohol or drug dependency and disorders
  • Obesity treatment or weight reduction, including all forms of surgery
  • Sleep disorders
  • Participation in school or organized competitive sports or any high-risk sport, including riding an all-terrain vehicle, snowmobile or go-cart

 

*Limitations and exclusions may vary by state. Please see the Policy/Certificate of Insurance for detailed information about these and other plan limitations and exclusions.


Is there a pre-existing condition limitation?

Secure STM will not provide benefits for any loss caused by or resulting from a pre-existing condition. 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.


Is there a free-look period?

If not completely satisfied with this coverage, and a claim has not been filed, the Certificate of Insurance may be returned within 10 days and premium will be refunded. Enrollment and administrative fees are not refundable.


Who is the Association?

Communicating for America, Inc.* (CA) provides many discounts to its members. Your enrollment as a member of CA is completed upon receipt of the association dues. Your membership information will be mailed shortly thereafter. Secure STM is available to residents of: ID, IN, KS, LA, ME, MD, MN, MT, ND, NH, NV and SD on an individual basis and not through CA. Therefore, membership is not required in these states. In all other states the membership is included in the rates.

* CA is not affiliated with Standard Security Life Insurance Company of New York, nor is it part of the insurance coverage. CA is a 501(c)(5) nonprofit association headquartered in Fergus Falls, Minn., with an office in D.C., providing members valued benefits and savings since 1972.


Who is the Insurance Company?

Secure STM is insured by Standard Security Life Insurance Company of New York (Standard Security Life), a member of The IHC Group. Standard Security Life is rated A- (Excellent) for financial strength by A.M. Best Company, Inc., a widely recognized rating agency that rates insurance companies on their relative financial strength and ability to meet their obligations to their insured. Standard Security Life has chosen IHC Health Solutions, also a member of The IHC Group, to provide service for your Secure STM plan.


This website provides a brief description of the benefits, exclusions and other provisions of the group policy Form SSL-STMP-1104 and individual policy SSL-ISTM-1104.
For complete listing, see the Policy/Certificate of Insurance. Benefits may vary by state. STM is not available in all states. Association membership may be required in some jurisdictions.

For more information on the short term health insurance plans, Visit www.ConsumerBenefits.net