The New York Times published a story on health care sharing ministries online on January 2 that mentioned Samaritan Ministries International and featured SMI member Mark Collie of North Carolina. Mark’s son, Blake, suffered a brain bleed in September 2019. Although the Collies started a Need with Samaritan, hospital staff suggested the Collies apply for Medicaid, which paid all of Blake’s bill.
Mark said in a phone call Thursday morning that he and his family consider Samaritan Ministries to be “phenomenal.”
“Every situation where we had to post a Need, it’s always been clear what’s going to be shared and what’s not,” Mark said. “We know what we’re in. It’s not insurance. It’s a ministry. We were fully aware of what we were getting into when we started with Samaritan and we’re more than satisfied.
“One of the stories I told this reporter is I’ve had conversations with a variety of your colleagues and each time they prayed for us and showed compassion and care, praying with me at the end of each phone call. Long story short, we have been blessed to have been a part of Samaritan Ministries.”
Mark also says that “Blake is doing well, and we are thankful every day that he is with us.”
New York Times reporter Reed Abelson interviewed Mark last fall about the family’s experience with paying Blake’s bills. She then sent questions to Samaritan Ministries about health care sharing. We sent written answers by Anthony Hopp, our Vice President of External Relations, to Abelson through our PR firm, Hamilton Strategies, on October 31 and then answers to follow-up questions on November 14.
We do not believe that the Times’s January 2 story used our answers in proper context and did not use the information we provided them to provide clear information to its readers.
Below we provide our complete answers to Abelson’s questions.
Our October 31, 2019, answers
Questions from reporter Reed Abelson are in bold italics.
I'm looking into the growth in membership in these ministries and some of the concerns being raised about their marketing,
Because of the time we spend educating potential members that health care sharing is not insurance, Samaritan Ministries’ growth has been and continues to be relatively modest. It’s difficult to grow when you’re telling people there is no coverage, no guarantee of payment, and to just trust God through His people. But that’s what we’ve been telling members and prospective members since 1994, and that’s what we’ll keep telling them. We also have never, nor will we ever, use insurance agents or brokers to sell Samaritan because we don’t want people to confuse us with insurance. We’d rather take the time to talk with potential members to explain how we’re different and ensure they have all their questions and concerns answered. All this attention to education and onboarding means we grow slower, but that’s a sacrifice we’re willing to make so that our members are served and informed.
….the limits of the coverage (note: because we are not insurance*, we do not have coverage of any sort. Rather, we have eligible or shareable medical needs).
57% of Samaritan members have chosen to participate in Save to Share where members share medical needs over $250,000. Historically, this has included medical needs in excess of $1,000,000. Members who choose not to participate in Save to Share may have medical needs up to $250,000 shared (per incident or illness/injury – there is no annual or lifetime maximum).
….and the oversight.
Health Care Sharing Ministries (HCSMs) are not insurance companies; they are ministries. As such, they are not subject to state insurance laws. HCSMs operate on a completely voluntary basis, and are regulated as charities in their home states under each state’s charity laws and each state’s attorney general, and as 501(c)(3) charities by the Internal Revenue Service. Samaritan Ministries has been doing a yearly independent audit for 15 years and files a federal form 990 annually. As a member-driven organization, oversight is provided by a nine member Board, and, with the exception of the president, none of the directors serving on the Board are compensated. Six of the board members are members themselves elected by the members. Additionally, the entire Samaritan Ministries membership (82,000+ households) determine through a vote whether the monthly share should be increased (historically, members have voted to increase the monthly share approximately every two years). Finally, on the rare occasion that a member has a dispute over what the guidelines say (whether a medical need should or should not be shared), a randomly selected panel of 13 members adjudicates the appeal and the panel’s decision is binding on the staff and on the member. We’re not aware of many insurance companies that offer that kind of consumer protection. In 25 years of sharing, this arbitration process has only been used 4 times because our members are overwhelmingly happy (member retention of nearly 90% and member satisfaction of well over 90%).
I've talked to one individual who is very happy with the ministry but has catastrophic medical costs that far exceed the limit of $250,000 set by the plan, and I'm interested in how Samaritan views this kind of situation…
See response above regarding “limits…”. If the individual with the catastrophic medical need was/is participating in Save to Share, the amount over $250,000 would’ve been/will be shared as well.
…and how it differs from other sharing ministries.
Samaritan members share directly with one another, person to person, household to household, because we believe a medical need involves more than just a financial transaction; there are spiritual and emotional needs as well. Through our direct connection with one another, members are able to enact an economy of grace, kindness, and compassion by praying for each other and sending cards and notes of encouragement to one another. As a result, Samaritan members don’t do health care alone; they do it together in the context of a loving community. Also, as stated above we are a member-driven organization (member-elected board, members vote on share increases, member panel, etc.). Finally, we are committed to honoring God through clear communication (to avoid consumer confusion) and complete transparency.
Note from Samaritan Ministries: *not insurance: Insurance is a contract whereby one party agrees to be legally responsible for and accept another party’s risk of loss in exchange for a payment (premium). Health care sharing is Christians agreeing to assist one another with medical expenses through voluntary giving. HCSMs are not licensed or registered by any insurance board or department because they are not practicing the business of insurance. Neither the ministry nor the participants assume financial liability for another other participant’s risk.
Our November 14 answers (reporter's questions in bold):
1) How many people are enrolled in Samaritan for health care sharing and how much in medical expenses in 2018 was shared?
As of 11/13/2019, there were 82,802 Samaritan households comprising 271,011 people. In 2018, members shared over $325,000,000.
2) There's discussion of state regulation where ministries would be required to register and give general information about enrollment, how much they are collecting and how much goes to medical expenses . . . Is that something you would favor?
Samaritan Ministries values transparency; it’s one of our core values. We desire to carry out our mission in the light, for all to see, walking in a manner worthy of the Lord. We would not at all find it unreasonable to give general information about enrollment or how much our members share directly with one another. We have voluntarily shared this information numerous times in the past with state agencies that have asked for it and we share these numbers monthly with our members. Also, our revenues and expenses are indicated in our publicly available annual audit and 990.
3) Any thoughts on how to protect people who may not understand the ministries are not insurance or don't understand what wouldn't be eligible for sharing, i.e. a pre-existing condition?
We believe that health care sharing organizations should be very clear, in all of their communication, that they are not insurance. At Samaritan, we go out of our way and make every effort to educate our prospective members and existing members on the various elements involved in health care sharing, including the fact that we are not insurance. For this reason, we do not and will not use health insurance agents to market health care sharing. One of the reasons our members have a great experience and remain members (historical annual retention rates of nearly 90%) is that they are not confused on who we are, what we do, and how health care sharing works. Regarding “understanding what wouldn’t be eligible for sharing”; our members are given access to and are required to read our ministry guidelines (available online or as a hard copy), which list out in detail what medical needs are eligible for sharing and which ones are not. Before joining, members sign off that they have read and understand the guidelines.