Vermont Legislature SmartTranscripts:

[Speaker 0]: We need help in

[Daisy Berbeco (Ranking Member)]: middle of the last few minutes.

[Speaker 0]: Alright, welcome back everybody. We're back. We're live. We are continuing and we're going to take a little bit of testimony on we had taken off of our wall H102 and incorporated that into this bill after we had heard testimony from Department of Financial Regulation around sharing plans. And so today we're going to hear from them. And we have with us Randy Houghton. Am I pronouncing that right?

[Randy Hultgren (Executive Director, Alliance for Health Care Sharing Ministries)]: That is correct. Can you hear me okay?

[Speaker 0]: Yes. Thank you for joining us today.

[Randy Hultgren (Executive Director, Alliance for Health Care Sharing Ministries)]: Thank you so much. I really wish I could be there in person. I am actually down in Orlando. I had a trip planned with my two year old granddaughter and our family down to Disney. So I wish I could be there, but have a couple of great people in the room. So I apologize, but I would love to be there. But good morning, Chair Black and House Health Care Committee members. My name is Randy Houghton. I'm a former US Congressman and also served in the Illinois Senate in the Illinois House, and currently have the privilege of serving as the Executive Director for the Alliance for Healthcare Sharing Ministries. The Alliance represents, let me just first say, I'm gonna give about a little under ten minutes of testimony, if that's okay. Wanna explain Healthcare Sharing Ministries a little bit. We do have two wonderful people in the room with you, Joel and Lindsay. And if you have questions, they're gonna be around today. Be happy to answer questions or talk through these healthcare sharing ministries of anything that comes up. But I do wanna just say the Alliance that I'm executive director for represents the majority of the ministries defined by the Affordable Care Act that have large nationwide memberships. There are just over a million members of healthcare sharing ministries in The United States, including about four forty two members living in more than 188 households here in Vermont. In fact, I understand that a member of your committee is a member of the healthcare sharing ministry.

[Speaker 0]: I'm sorry. Randy, would you mind giving those numbers again?

[Randy Hultgren (Executive Director, Alliance for Health Care Sharing Ministries)]: Sure. Four forty two people in Vermont are members of a healthcare sharing ministry. It's 188 households.

[Speaker 0]: Okay. Thank you. For

[Randy Hultgren (Executive Director, Alliance for Health Care Sharing Ministries)]: those who are curious, healthcare sharing ministries are five zero one(three) nonprofit charities that facilitate communities of like minded religious believers who come together to share each other's medical bills, pray for one another, and support each other in our health journeys. Each member agrees with the statement of shared religious belief, that the sharing guidelines of how the sharing process works, to live healthily and also as scripture commands, to treat our bodies as temples of the Holy Spirit. Our Alliance Ministries members share more than a billion dollars each year, including expensive bills like chemotherapy, heart bypasses, as well as routine procedures. My family and I have personal understanding of this since we have been Samaritan Ministry members for over twelve years. During my time in the United States Congress representing my district in the great state of Illinois, my family and I chose to opt out of the Congressional Insurance Exchange and join Samaritan Ministries International because it aligned with our religious beliefs and works so much better for us with me in DC and my family back in Illinois. We have found a sweet like minded community that in addition to choosing to share the financial burden of healthcare, praise with us and for us. I wish all of you could experience the joy and peace that comes from this type of community. I do wanna underscore that healthcare sharing ministries are not insurance. Our members make a moral, not contractual commitment to each other. Here's how it works. As a member with a medical need, I go to my doctor for care and ask for an itemized bill after the appointment. I upload the itemized bill to the ministry's portal and the ministry reviews it to confirm the charges are eligible for sharing strictly based on the ministry's publicly available guidelines. Based on the approved total, it is then assigned to our members who send their monthly commitment amounts to me. We usually receive several checks in the mail along with notes and cards of encouragement. Some ministries may gather monthly contributions for specifically assigned members and then send them as one payment directly to the healthcare providers, or in our case, we pay our healthcare providers directly after we've received these shares. But the providers and also the ministries work together to help negotiate a discount off the sticker price. Each Alliance ministry member plainly explains their processes on their individual websites, Recognizing that while such healthcare sharing memberships are not insurance, but still a reasonable choice that many religious believers make, the ACA framers chose to accept them as an alternative under the ACA mandate rule. 34 states have gone a step further to specifically clarify that these healthcare sharing ministries are not transacting the business of insurance and therefore are not subject to the insurance code. Colorado unfortunately chose in 2022 to go a different direction. It's imposing an elaborate reporting and registration scheme on healthcare sharing ministries. Two national atheist humanist groups have campaigned to introduce Colorado like bills in several other states, including Vermont. In fact, in 2025, HB 102, a mirror of the Colorado bill, was introduced in both the House and Senate, but failed to move. This year, H 102 was quietly added to section 10 of H five eighty five without debate. So the question is, why do we oppose section 10 of h five eighty five, which supporters characterize as just a reporting bill or a transparency measure? The bill actually demands that all healthcare sharing ministries turn over to the state extensive and intrusive information about those with whom we affiliate and associate, including our actual contracts and names of all vendors and partners that help us carry out our programs, our communications to current and prospective members of the ministry, our operational, statistical and and financial information, including which members needs we assist and how we staff our ministries. These requirements are akin to subjecting a church to a comprehensive inquiry and monitoring of how it spends its collection basket, how much the pastor is paid, who the HVAC vendor is, how it evangelizes, how it distributes its collection baskets for religious programs for its own members. Similar to Colorado law, section 10 of H585 also requires that state insurance commissioners to issue its own report using all of this data. And we've experienced in Colorado such reports can both be factually wrong, biased, and misleading. Here's a real life example. Colorado requires reporting of gross bills and other words, the free discount alongside with the total dollars provided to participants. Here's how it's misleading. The reported gross bill is not the actual amount the participant ultimately owes. Almost always when my family and I go in for medical needs and tell them we're cash pay, it's a significant discount off of what the insurance amount would have been. Health care sharing ministry members might submit a $10,000 bill, receive a 50% cash pay discount and end up paying $5,000 However, under Colorado's reporting structure, the health care sharing ministries must report $10,000 in billing and $5,000 shared rather than the true $5,000 paid and $5,000 shared. Colorado then reports that healthcare sharing ministries only covered 50% of the need when in reality, the full bill is paid. A 100% of what was owed was paid. Surprisingly, Section 10 also grants the department unlimited rulemaking authority, so the future cost and scope of potential burdens are unspoken and potentially endless. All this is not to say that healthcare sharing ministries should be totally unregulated or allowed to engage in misdeeds or fraud, quite the opposite. Indeed, healthcare sharing ministries are overseen by the attorney generals in every single state who have jurisdiction over all charities and nonprofits, and honestly, broader experiencing balancing constitutional religious liberty interest with consumer protection. Vermont is no exception. Religious charities in Vermont are not above the law. They remain subject to Vermont's broad consumer protection laws outlined by Title IX of Vermont statutes, which prohibit deceptive or fraudulent conduct. The Vermont Department of Justice also retains full authority to investigate and take action against any organization, religious or secular, that lies, misuse funds, or exploits the public trust. Indeed, the Division of Insurance has previously taken action against entities that have engaged in bad behavior as it should have. Vermont's existing legal framework is robust and already provides sufficient tools to hold bad actors accountable without the need to single out or impose additional burdens on faith based organizations acting in good faith. When it comes to transparency, we believe that public protection interests are best served by private accreditation entities. Two such entities have launched in recent years to evaluate ministries and provide reliable information to serve the public interest. One of them, the Healthcare Sharing Accreditation Board imposes more than 65 accreditation standards, including governance, religious identity, transparency, internal process, and much more. The three largest healthcare sharing ministries serve the vast majority of ministry members in The US along with two smaller ministries have already received accreditation by these bodies. The most frequent concern we hear from regulators is that they do not want consumers to be confused and think healthcare sharing ministries are insurance and we wholeheartedly agree since we are not insurance. However, placing us under the agency that regulates insurance itself will mislead Vermonters into believing that healthcare sharing ministries are in fact insurance, the very thing we're trying to avoid. The Alliance believes there is a better way for the public to have confidence and transparency regarding healthcare sharing ministries. Prospective and current members can review accreditation status, annual 990s, CMS certification letters, five zero one(three) determination letters, annual audits, sharing guidelines published on ministry websites. All of this is readily available to public. These tools already provide strong transparency without infringing on religious freedom. And these are tools the AG and DFR can reference in consumer bulletins if they choose to warn Vermonters that healthcare sharing ministries are not insurance. In closing, and I thank you for your time, I strongly encourage the committee to strike Section 10 of H585 due to the aforementioned reasons and because it is on desperately shaky constitutional grounds as outlined by our attorney's memo that's dated 01/31/2025, which I'll submit with my testimony. Our federal lawsuit in Colorado law is now at the tenth Circuit Court of Appeals awaiting its latest ruling. Honestly, this is not a legal challenge Vermont should have to figure out how to pay for, and the courts have been clear that it's impermissible. So again, I wanna thank you so much for your kind attention. I wanna thank you for your service. Having gone through what you've gone through in a different state, I really thank you for your willingness to serve. Thank you very, very much. Any consideration or concerns about our bills, we're grateful. We stand by ready to assist you and answer any questions. As I mentioned to Joel and Lindsay, Joel is from Samaritan Ministries. Lindsay is from Medi Share CCM. They are truly experts. I've been in this role about a month and a half, so I'm still learning, but love this. My family has loved it. And again, grateful for your attention on these issues.

[Speaker 0]: We have a couple questions, but before we get to the questions, may I ask yourself personally, because you're testifying also to your own plan that you've had for, I think you said twelve years. May I ask inquire as to who your sharing plan is through? One Yes. Is your

[Randy Hultgren (Executive Director, Alliance for Health Care Sharing Ministries)]: So ours is with Suburban Ministries. Again, as a member of Congress, we were part of the Affordable Care Act as members of Congress. Since my office was in DC, I had to be part of the DC exchange. My family all lived back in Illinois. It was really, really difficult for us. And so we searched out, and ended up finding Samaritan Ministries, which is, from Peoria, Illinois, my home state. And we joined again over a decade ago and have absolutely loved it. It's been one of the sweetest things in our lives to have this ability, to be able to provide this love and care for other people and to receive that same thing when we've needed it.

[Speaker 0]: Can you say it again? Can you say the name again for Samaritan?

[Randy Hultgren (Executive Director, Alliance for Health Care Sharing Ministries)]: Samaritan Ministries. Joel is hopefully in the room there. Joel can raise his hand and he is so much smarter than I am, so is Lindsay. So they can answer questions better than I can, and they're gonna be around today if you do have other questions.

[Speaker 0]: We have a clarifying question from Leslie, and then Brian has a question. Yeah. Thank you, Randy. Just went by really fast for me. You said that there was an organization that regulates the ministries. So could you tell me who that is?

[Randy Hultgren (Executive Director, Alliance for Health Care Sharing Ministries)]: Sure. There's a couple accreditation programs. Accreditation. Yep. So, again, five of the largest ministries that are part of our alliance, have gone through this accreditation process. It's one of them is a healthcare sharing accreditation board. Lindsay and Joel can explain it even better than I can, as I'm learning a lot of this stuff. But, again, there's a lot of transparency. For us, it was very clear. We knew we were leaving insurance and joining a ministry when we did it as a family. And again, was one of the best choices we've ever made.

[Joel Noble (Samaritan Ministries International)]: Brian? So I have

[Brian Cina (Member)]: a few questions just to better understand the institution that we're talking about, the organization, the concept of a health sharing ministry. So, one is, you were talking about the scriptures command, I think you said, and so that to me, based on my personal experience, implies Christianity. Are all of the health sharing ministries Christian organizations, or are there other religions or spiritualities that that are currently operating health sharing plans?

[Randy Hultgren (Executive Director, Alliance for Health Care Sharing Ministries)]: Yeah, Joel and Lindsay will be able to better explain it, but the one we're a part of is Tide. Honestly, heard about it from our pastor at the church that we were at. At the time, pastor's family was a part of it. We were trying to find an alternative that worked for us because the Affordable Care Act wasn't working for us. And so ours is, and there is a statement of faith that we agree to as part of this ministry. But again, it's protected, five zero one c three, religious ministry. I know there's others that, are different than Samaritan Ministries, the one that we're a part of. But again, maybe Joel or Lindsay could answer that better than I can. And they're in the room with you.

[Joel Noble (Samaritan Ministries International)]: Are they allowed

[Brian Cina (Member)]: to answer it now, or are they gonna go up? Sure. Of course. Because I have more questions related

[Joel Noble (Samaritan Ministries International)]: to this, but I'd

[Speaker 0]: like to

[Joel Noble (Samaritan Ministries International)]: hear it.

[Randy Hultgren (Executive Director, Alliance for Health Care Sharing Ministries)]: Why don't why don't I hand it over to them? I'll stay on, but they're they're so much smarter than I am. I'll be here if you've got questions, but they'll have to clean up my mess if I keep talking. But again, thank you all so much for your time and attention. But I wanted to be a little shorter so that they would be able to answer questions there. So thank you all.

[Joel Noble (Samaritan Ministries International)]: You. Thanks, Brandon. So about 90% of the million folks that are being large, Christian ministries, either Samaritan, Christian Healthcare Ministries or the Little Men of Share. There are smaller groups out there. There's a Jewish group in Ohio, it's a Muslim group, I think they're all staying in Ohio. I know the Jewish group is, I know there's a Muslim group, I'm pretty sure it's Ohio. I believe there's a non religious group called CrowdHealth that has no statement of faith like that. So, but the majority are gonna be in Christian ministries, but there's a organization probably for anybody, whether they're non deist or Jewish or Muslim.

[Brian Cina (Member)]: The next thing is I'm just trying to understand the mechanics organizationally. What I'm hearing though is that there are a variety of faiths currently taking advantage of this option. And what I'm wondering is if a faith community creating a health sharing plan, what are the criteria? Because you mentioned something five zero one(three), I can't remember what you called it, a protected, what was the word? It was a something five zero one(three), you said. To operate a health sharing plan, what are the criteria? Does someone have to form an organization registered with the government to form one of these? Or could me and a bunch of my friends who practice ancient beliefs, pagan beliefs without a church just come together and start sharing our healthcare expenses, cast these spells for each other and stuff, or do we need to form a five zero one(three)? That's what I'm getting at, it's like, does it take to actually operate, legally operate a health sharing plan?

[Joel Noble (Samaritan Ministries International)]: It would ultimately depend on the states that you want to operate in. States have different laws, and if you want to come under the definition that the federal government has. So when they exempted healthcare sharing from the ACA, personal responsibility, they put a definition in there, it's in 5,000 A, that it's either religious or ethical beliefs. So I mean, religious beliefs pretty broad and so it's ethical. So if you wanted to have ancient beliefs, then you could probably qualify. They are 501c3s, most lots of the states said they need to be nonprofit, which is a nonprofit five zero one(three). And then there's other definitions, some states say you have to meet the ACA requirement like Washington. Washington had shut down a handful of ministries because they didn't meet the definition in Washington code which they copied from the ACA. So it really depends on what states you want to operate in. And there are some of these smaller ministries don't operate in some of these states because of the way they're structured.

[Brian Cina (Member)]: And in Vermont we currently don't have any regulation?

[Joel Noble (Samaritan Ministries International)]: So the attorney general would oversee any charity in Vermont including Del Fisher High Ministries.

[Brian Cina (Member)]: Okay, so it sounds like I'll look more into it because I don't want to take too much time, but it just helps to understand, just trying to understand that there are already a variety of guardrails that you're following. It's not like people are just doing what they want. However, I have to say, part of me feels like we shouldn't be getting in the way of mutual aid, however it's conducted. If neighbors want to chip in to help each other with their healthcare expenses, why is the government going to get in the way of that? So that's just to put it out there. So I'm just trying to understand how it all works because if it just sounds like an opportunity that more Vermonters could take care take advantage of if the health care system continues to fail them, and I want people to be able to know how they can form these for their own faith beliefs. So that was sort of like the, I was trying to understand more and I'll look more to 5000A and make space for others now.

[Daisy Berbeco (Ranking Member)]: Daisy? Thank you for joining us. This is really interesting to learn more about the structure of these and how they can help Vermonters and how they are helping Vermonters. I'm curious how they're structured to protect risks for folks. So this is clearly a business. It's not a bunch of friends, in my opinion, supporting each other. It's a nonprofit. That's business. They are, in my understanding, look a lot like and act a lot like health insurance. And in some situations, I'm sure you're aware, they have been portrayed as health insurance in other states, and there has been a lot of fraud around that. So how in Vermont are these sharing ministries protecting Vermonters from false advertising, from purchasing what they think is insurance and then being met with sticker shop when they get medical bills that aren't covered by the sharing ministry. Lindsay with MediShare. So just follow-up process. Whenever someone's interested in calling, we have anybody who can see our guidelines are available online, so those are member voted. So it is the community, the membership who is deciding on what they'll share.

[Lindsay (Medi-Share/Christian Care Ministry representative)]: It's not us as the administrator, kind of the ones that connect people with those needs. So our members have set those guidelines and publicly available. We're always there encouraging them, talking and sharing that we're not insuring. This is what community looks like. This is how your monthly shares are going out every month to help somebody in need. And so we really work through that with them, how we are not insuring. But that's not regulated. That's just you as your ministry having the faith and the will to understand your moral responsibility to each So other to do we're trusting each ministry in Vermont is going to do that for its members.

[Joel Noble (Samaritan Ministries International)]: Yeah, so a member that, a prospective member, if they're researching health care, if they want to join a health care sharing ministry, I think Randy laid out there's a number of things that they can look for. Are they accredited? And so in that case they know that they have gone through third party independent accreditation. The one that Samaritan's Gone Through Administration has gone through has more than 65 different criteria that they're looking at and this is folks that have experiments doing this. Many of these folks came from a group called the ZFA which was started years ago to protect against like televangelists, needle fraud, things like that, things like that and starting in the same type of thing, they can look for the nine ninety which every nonprofit has to file if they're a nonprofit of the churches and it shows what the folks are being paid, where the money's going and how much is coming in, how much is going out. And I would do that for any charity waiting for I give them money. They can get the IRS determination letter to make sure that they're a five zero one(three). The ACA requires any of the ministries that need that definition have to provide an audit on request so you can get our audit from us and look at an audit which is done by an independent audit firm. And so there's tons of tools for folks that research healthcare sharing. And if they don't find those things, then it's probably not a group that I would recommend going for, it's not best practices. And so it's those type of things that they can look for if they do some research.

[Daisy Berbeco (Ranking Member)]: Do you think that we do enough to educate Vermonters on the research that they need to do in order to protect themselves when joining a ministry? Maybe not.

[Joel Noble (Samaritan Ministries International)]: I mean, I know a lot of states and Department of Insurance puts out bulletins that says these are not insurance and if Vermont, EFR put out a bulletin like that, we would welcome it. We'd welcome as many people as possible saying this is not insurance and I would encourage them to put the trust and that we're providing and say, ask them if they're accredited, ask them for the 99, ask them for their audits. You're looking at a health care sharing ministry, ask them these questions, and that would probably help a lot.

[Francis “Topper” McFaun (Vice Chair)]: Thank you. Leslie?

[Speaker 0]: And then Lori. I'm wondering if you could give some examples of what the costs would be to be part of this for an individual and a family?

[Randy Hultgren (Executive Director, Alliance for Health Care Sharing Ministries)]: I can jump in on this, and maybe both of you can clear up. So I'll just tell you personally. So my wife and I have four kids, each of grown, so but we still are a family plan. So we we pay about $700 a month, to be part of Samaritan Ministries. And, again, we get a list of a family each month that we send our share to. Different ministries handle it different ways. Some ministries get the checks and send it, on behalf of the patient, and Lindsay can explain that a little bit better. But for us, it is it's sobering. So when I go into the doctor, I'll ask the doc doctor how much something costs. Oftentimes the doctor doesn't know how much something costs. They'll have to call the insurance company to find out how much something costs, and then they'll come back and say, well, if you were insurance, it'd be this. But since you're not, it's 50% off of that or 40% off. It's almost always a discount, because they don't have to go through one of these huge companies. And again, our providers, doctors have been so happy. They get paid so much more quickly than they would've otherwise. And again, for us, it's about $725 a month for us, a family of my wife and I and our kids to have been part of this. But clear, if there's things I've said wrong, I just wanted to kind of give it from my personal experience. Joel, Lindsay.

[Speaker 0]: So if I could continue. Yeah. Of course. So let me make sure I understand. So you pay in $700 a month to the system.

[Randy Hultgren (Executive Director, Alliance for Health Care Sharing Ministries)]: No. I I pay it to a person, so I don't pay it into the system. I get a name of a a family. You know, last month, it was a family up in Minnesota, that had a health, issue. So we write a check to that family. Okay. We write write a note to that family. Honestly, we say a prayer for that family. And there's you know, so if it's a a $7,000 bill, there'd be probably 10 of us, that are notified to send our check directly to this person. We send it directly to them. They put those checks in their account and write a check to their doctor, and it's done. It happens very quickly, very smoothly, and we've never missed, for us, either, receiving or giving shares. Sorry. Go ahead.

[Speaker 0]: No. I'm sorry. So this is really an innocent question, honestly. There there if you're let's say there are 10 families that are sending them you know, their share, and that's cool. But there's nothing that necessarily that that individual will pay off their medical bill, right? There isn't that dynamic necessarily.

[Randy Hultgren (Executive Director, Alliance for Health Care Sharing Ministries)]: Right. And I can, again, Joel and Lindsay can explain it better, but no, but there literally is hundreds of thousands of families that we're together with. So if somehow one and it's happened where they they tell us very specifically, you know, keep track. These are the 10 people you should get checks from. Keep track of who you get checks from. If you don't get from somebody, let us know, and we'll substitute somebody else in their place. That's the way Samaritan has worked for us. We've never had that problem because everybody has sent their check, and we've been able to pay the doctor and hospital or whatever the other issue is extremely quickly and kind of from what we hear from them much more quickly than they would have if it was insurance. So we've never missed, but if someone didn't, there's again literally hundreds of thousands of other families that are in place. And as I mentioned in my testimony, we haven't needed it, I'm grateful for, but, you know, very expensive cancer treatments, very expensive bypass. All the the bills have been completely paid. And, so, again, I think this is something as people become more familiar with it, I think doctors and hospitals and other groups, are gonna love it. So I'm saying too much. But, Joel or Lindsay, anything else on that?

[Speaker 0]: I'll add this so that when you reply No, I'm sorry. So let's say there's a bypass, big expense. The person presents the hospital as self pay, or how does that work?

[Randy Hultgren (Executive Director, Alliance for Health Care Sharing Ministries)]: We do. And so we say we're cash pay. And again, there's never been a time where we haven't gotten a discount. It's it's amazing.

[Joel Noble (Samaritan Ministries International)]: And I'm interested

[Speaker 0]: in those discounts because what's the impact on the hospital budget?

[Randy Hultgren (Executive Director, Alliance for Health Care Sharing Ministries)]: It's it's they get the same amount, because, you know, again, it with these companies, insurance companies, they're huge companies and they negotiate, things. So they have a price, but they also have a real price that gets paid out. And, Joel and Lindsay can explain it better than I can. But, because it goes much more quickly, because they know it's gonna be, you know, this full amount that they give us, we've always fully paid any bill that we've received. Joel, Lindsay, anything I said incorrectly?

[Joel Noble (Samaritan Ministries International)]: No. I would say providers certainly are not losing money by giving us discounts. My family going back seven generations was at Caterpillar, Earthmoving, larger more than 100 companies. So I've seen what insurance pays for different banks and I know what I've been billed for very similar things. And it's often 2000% higher as a cash paying patient. And so getting a 50% discount on a bill that's been inflated 2000%, they're not losing anything by giving discounts. Do you need to answer that question? But we work with providers and alongside the number and so we know the number of providers is a common after effect. So I think there's concern about, well, person gets this money and they pay the bill with it, we know whether they've got a discount, we know whether that's been paid. My son had a nearly $80,000 ACA with construction and I was getting updates from Samaritans saying we've talked to St. Louis St. Louis University and hadn't paid that bill yet. They said we've not paid your bill yet. I was just waiting and they giving me like a fifty to four month payment and I was just taking my time making payments and I was waiting for them to come in, was just trying make about payment. But we're following up continually making sure that those bills are paid and making sure the folks are using that money that they get. And if they don't, they still owe the provider. Were to choose to use it someplace else, they still owe that. That doesn't just go away and we would know if they got written off.

[Daisy Berbeco (Ranking Member)]: We are structured a little bit different, so we facilitate digitally. So just as churches now read, I can give my time in the bucket or not, they all got grappled through. So we connect our members when there's a medical bill that comes in directly from the provider. So we're working with them. So the providers are submitting the bills to us, and then we're able to connect our members digitally to one another.

[Lindsay (Medi-Share/Christian Care Ministry representative)]: And so those shares are moved into their individual bank account and a check is cut. So say if I had surgery or cancer treatment, their check comes out of my bank account and it's directly sent to the provider with my name on it. So we are the payment provider.

[Joel Noble (Samaritan Ministries International)]: And then we

[Lindsay (Medi-Share/Christian Care Ministry representative)]: also have a client team that works with if any of you provide some questions. Many of our bills, especially if double check their money off within thirty days, which is, know, too, right? When I used to have insurance, I remember going in for my surgery, they're like, Well, if you pay today, we'll knock off an extra $400 And so when we're able to, with our members, file their cash payments or non insurance providers who are working with us because of the time they gave in staff, we're able to facilitate for them.

[Speaker 0]: So it sounds like you're aware when payments are not being made, what actions do you take in that case?

[Joel Noble (Samaritan Ministries International)]: If someone doesn't pay their provider, then we would ask them why didn't you think the provider and if they forgot to tell us about a discount, eventually we would have to take some kind of action against them. I mean they joined, they've part of the faith agreement and everything else is, we're also raising that the money they receive from other members, they're going use with their healthcare costs so that they have agreed to that. Thank

[Speaker 0]: you. I have Lori, and then I have Chopper, and then I

[Daisy Berbeco (Ranking Member)]: have some questions. I just want to say that

[Speaker 0]: your comments about people do research.

[Leslie Goldman (Member)]: I think we all know that people don't do a lot of research. And I think we know people don't maybe know how to find 1099s and all the documents that you threw out there. And I just went on a couple of websites. One, if I'm using the right address, the Samaritan one is down. There's something wrong with it. So you might want to check on that. And then the other websites don't provide any information, really. So I think the fact that this bill is trying to get to information for consumers to know what's happening is really important because none of the information is readily available on any of the websites.

[Speaker 0]: And can I add to that? Because also, Submaritan, there is no website. It's down. But I was not able to pull up a $9.90 for Medishare, but I was able to pull up a $9.90 for Samaritan. And would it be accurate on the nine ninety that they raised over $55,000,000 in 2025, I think it was 2025 in revenue, but only paid out 2,460,000.00 in member assistance in medical bills. Would that be accurate? That's what the September is indicating.

[Joel Noble (Samaritan Ministries International)]: In our September?

[Speaker 0]: In Samaritan's September.

[Joel Noble (Samaritan Ministries International)]: So since we don't collect the money in, that wouldn't be what

[Speaker 0]: Well, does list all expenses for Samaritan, salaries, all of that, and between the buildings and employees, that accounts for about 52,000,000 of the 55,000,000 that's been taken in.

[Joel Noble (Samaritan Ministries International)]: Okay. Yeah, so that 55 is the admin, which is about 10% of what so we, in last calendar year, the amount that was shared member to member was about $472,000,000 Of that, about 10% was admin. So what you're looking at there is it's the admin that we've

[Randy Hultgren (Executive Director, Alliance for Health Care Sharing Ministries)]: had.

[Joel Noble (Samaritan Ministries International)]: So now it was given to other members because that doesn't come into us, that's always going work that for you. So it wouldn't be on the time.

[Speaker 0]: This bill would require that you report to Department of Financial Regulation actually how much you're collecting from members in Vermont and how much is being paid out, correct?

[Joel Noble (Samaritan Ministries International)]: Wouldn't, but the way it's worded, as Randy mentioned, is that's all pre discounted and what we've seen, frankly out of Colorado, is then they misrepresent that press and then call us the Wild West.

[Speaker 0]: Do they misrepresent it or do you feel as though you've been misrepresented in the press?

[Joel Noble (Samaritan Ministries International)]: What's the difference there? Yeah, so when the department's actually doing the interview, it would appear that they were misrepresented in that because we've been pretty clear and trying to talk to them before the lawsuit about these are discount that's representing that it didn't stop, which is once the final regulations were final regulations lawsuits happened. I mean, a lot of that was because of

[Speaker 0]: what was asked. Let's get to the top first question and then I actually have real questions other than Woah,

[Joel Noble (Samaritan Ministries International)]: real questions.

[Speaker 0]: I mean, I was

[Francis “Topper” McFaun (Vice Chair)]: I'm gonna use myself as an individual that is part of the organization. Five times I've been asked to send my check to And I didn't do it. Oh, all of a sudden I got sick and I submitted thing in to get some help. What happens to me? Do I get that help even though I didn't provide money when I was asked to do it to the SARA? Will I get that help? How do you deal with that if somebody doesn't

[Rep. Rob North (Ferrisburgh)]: feel there?

[Randy Hultgren (Executive Director, Alliance for Health Care Sharing Ministries)]: So part of the

[Joel Noble (Samaritan Ministries International)]: moral agreement you're making as a member is that you're going to keep up in your sharing. If someone is behind in their sharing, we reach out to them and find out why they're behind on it. The most common answer is I got a new job with insurance and I meant to drop, I just forgot to tell you, that's why I didn't send my share. If it's financial, someone's to say, we're just struggling financially, then we offer sponsorship, we have members that can pay their share and more and have picked up other members to help them pay their share. But if you're not actively sharing, there's a point where we take that as you don't want to be a member it any longer and you're deciding to leave the ministry by not sharing anymore.

[Daisy Berbeco (Ranking Member)]: And to your point, it's again we're having conversations with our members, this is a community, So if they're struggling, you know, we can give an example, when the hurricanes were getting very bad in the North Carolina and Georgia area, a lot of our members responded and gave above their monthly shares to make sure that those impacted by the hurricane, that their monthly shares would not lapse so they could focus on recovery. So that is really how we are a community in that. So if something still befalls you, you wanna make sure what that is, that we can work alongside you. And even too, Joel pointed out, for many of the states and their requirements too, what a true healthcare sharing is, say you decide to leave, but you had a medical leave that prior month, you still submit that bill and it is still eligible. Go through the process, the members will share it even if you have left membership to pursue something else because there's no contract. But again, this is a community that wants to come alongside you during this time.

[Randy Hultgren (Executive Director, Alliance for Health Care Sharing Ministries)]: I'll just mention real quickly too, just help sitting here in Orlando, but, I was able just to get on both websites. So samaritanministries.org, seems to be working well. Also, medashare.com. So if you wanna try and put those in, hopefully you'll be able to join just like, or, you know, see the the websites and very clear disclaimers and things that the websites have. So samaritanministries.org. And then I I know there's a lot of Samaritan things out there, but it's samaritanministries.org then metashare.com.

[Speaker 0]: Thank you for that. So I'm on MetaShare's website. Were you all set I'm on website.

[Francis “Topper” McFaun (Vice Chair)]: Thank you.

[Speaker 0]: So I have a couple of questions, and I just wanna give a caveat here that I spent twenty six years managing a billing department for a provider's office. So I come to this from that perspective. So on MediShare's website, very comprehensive website, Like it, they even present a copy of what someone's card would be, the Smith family, with 10 members of their family. So there's a payer ID. If you are not an insurance company, why would you have a payer ID, an electronic data exchange, EDI payer ID?

[Lindsay (Medi-Share/Christian Care Ministry representative)]: Our ministry does have networks. So our members, they can choose to use the networks. We get those network discounts. And so that's why, so again, when we said the provider is able to submit the bill electronically, It's just trying to step into that space to help ease kind of that fraudulence from that number. So they submit the bill, the provider does electronically. It's just to make it easier for the providers.

[Speaker 0]: So it's not an insurance company and yet the provider is now submitting a bill electronically through clearing house because we all know that they all go through cleaning houses. It also has a PHCS logo on it. Can you explain what PHCS is to the committee?

[Lindsay (Medi-Share/Christian Care Ministry representative)]: Oh goodness, that is the name of the network. I'll have to look at it real quick, but

[Speaker 0]: it is a network thing. Can you explain what a network is?

[Lindsay (Medi-Share/Christian Care Ministry representative)]: That we were able to obviously not be a part of the big red networks that the insurers are, but it is a group that we're able to, they're negotiating those contracted rates for certain medical services. So our members can receive those discounts when they go through the process.

[Speaker 0]: So I do want to explain what PHCS is. PHCS is a very large national provider network. They often contract with third party administrators or underwriters of smaller plans, and it allows people from all over the country to have access to network providers, and they have a contracted negotiated rate with those providers. So you're tapping into this network to be able to offer discounts for your members. So that means your members are really just getting the PHCS discount, correct?

[Daisy Berbeco (Ranking Member)]: So yes, if they choose to. I've heard some of our members, they just are going and negotiating their own rates, but that option is available to them should they wish to use that. There was also,

[Speaker 0]: you know, there's been, there was a lot of conversation, I think, around the inflated cost and yet able to negotiate down. So we have 14 hospitals, sixteen, eighteen, if you include some other companies. Let's go with 14 hospitals. All of them are nonprofit hospitals and every single one of our hospitals has a charge master for a self pay, which is often equivalent to our state Medicaid. Are you aware of that? People actually could be getting a larger discount if they just asked and used the self pay price rather than going through a network? Go ahead.

[Joel Noble (Samaritan Ministries International)]: Do these hospitals as part of the favor on cash pay or charitable, do they require them to apply for Medicaid before they will

[Speaker 0]: No, not charity. This is their charge master. Their charge master has a self pay price, which is already discounted and it's often discounted at a pretty high amount.

[Joel Noble (Samaritan Ministries International)]: Okay, but is it similar to Blue Cross Blue Shield would pay for that same procedure?

[Speaker 0]: Actually, it's usually less. Less? Okay, great. It's usually less, but we would have to ask hospitals about that. My concern is, as we talked about, that people don't necessarily do much research and with the high cost of insurance, I feel like people are really looking for alternatives. And I'm deeply concerned that this is a market that there's no transparency with and that people think that they have insurance when really they don't have insurance. And I'm not quite sure why the requirement to report, know, the gate of the members of four forty two members, that is the first time that we have heard that. Because we've asked that question before and the answer is always we don't know because there's no reporting. And how can the state protect those four forty two individual members if we don't have the data. And I think that sharing ministries actually serve a role and a purpose, And I think that they work well for a lot of people. But I think that if you're really proud of what you're offering your members, you should be really proud about giving the information to our Department of Financial Regulation on the number of members you have, the amounts of premiums that, I'm sorry, member share that you're paying, how much you're paying out, how many claims you're receiving. You know, I talk about administrative burden a lot with our providers. There is a list on the card for MediShare about all the things that require pre authorization and you give a phone number for providers to call to get pre authorized. So you're putting an administrative burden on, but you're not an insurance company?

[Daisy Berbeco (Ranking Member)]: Right, we don't do preauthorization. There's no medical necessity that is done with that. It's just if there's like a major medical procedure, right? It's the opportunity to make sure that we're walking alongside those numbers, especially if it's a cancer plan or not, or we need to work with them. I just want to make sure that it's not putting off of we're determining if something is medically necessary.

[Lindsay (Medi-Share/Christian Care Ministry representative)]: That's between the doctor and the It

[Speaker 0]: does say mychristiancare.org/forproviders or call this number to pre notify online or download a form, check member eligibility and check service eligibility, that's an administrative burden on providers for something that's not in insurance. Think one last question. You had mentioned, I think Topper had asked the question, what if somebody just doesn't pay? How on earth would you know if one of your members didn't pay a provider? What mechanism is in place

[Joel Noble (Samaritan Ministries International)]: them to be able to

[Speaker 0]: make that determination?

[Lindsay (Medi-Share/Christian Care Ministry representative)]: The card is a little bit different since the providers are working with them directly. So we would know, they would call us. If the payment is, again, we're the one that's connecting members for the share amount, and then the check is cut out from that number. So again, if I'm in surgery, the bills come out of my personal bank account and send me direct payment to the provider. So I don't know how to really kind of answer. I have

[Speaker 0]: to get back on. But you wouldn't know the member share if the member share has been collected.

[Lindsay (Medi-Share/Christian Care Ministry representative)]: But we are, we're doing that digitally. So we're able to, like I said, connect our members. We oversee, we facilitate digitally the sharing. So there aren't like, checks that are being sent. That's why I don't speak on the Samaritan. So no, we know because we're helping cut that check out.

[Speaker 0]: If I have an office visit with a provider and the provider submits a claim for that office visit electronically through your EDI payer ID, and thirty days later, get an explanation as the provider, I get an explanation of benefits. It tells me how much is the cost share, which you actually do have on your card. I think it's $35 for an office visit. It tells me that the patient owes $35 and then it gives the member discounts. And then if there's any payment whatsoever,

[Lindsay (Medi-Share/Christian Care Ministry representative)]: then

[Speaker 0]: it'll say something like eligible for sharing. But how do you know that that patient has paid their $35 I'm asking you because there is no electronic mechanism for a provider to tell you whether or not a patient actually paid their cost share. That doesn't work with commercial insurances or any other.

[Lindsay (Medi-Share/Christian Care Ministry representative)]: We do get that. So we send out an explanation of sharing due to the member of what their personal responsibility would be. I could get more technical, but it is my understanding that we do receive. So if something is sent to the member, appears your responsibility is. If it's reached their eligible for sharing of the whole bill, then that check is cut directly to the female ballot. If there's still a portion that the member owes, that again is communicated. So that's why we are working with our members and providers and the doctors do regularly call us and check-in on the process. And our members are checking in too, like a border bill is during the review. So it's I can get back to you on that, but I've just not run across to my knowledge of only the ministry for five years that we're not aware of when a member is stuck at their responsibility.

[Speaker 0]: If a provider receives an explanation of benefits that says that the patient owes $35 it then becomes incumbent upon provider to bill the patient that $35 And whether or not they receive that or not is never communicated to the insurance company or I'm sorry, to the share plan. And if you're if I'm sorry, but I'm talking speaking as somebody who's spent twenty six years in this, if you can tell me that some new mechanism has occurred in the last year or so to make that a possibility, then I would love to know that. I can tip on my behalf when I go

[Daisy Berbeco (Ranking Member)]: to the doctor because I'm a Medicare member. I mean, pay my 35. They make sure to collect IVMIT before they may see me before

[Joel Noble (Samaritan Ministries International)]: I leave. I'm making that payment

[Daisy Berbeco (Ranking Member)]: when I go see my doctor for my regular every day, then when I've gone to urgent care as well, some of those I've gained that and then paid just a regular amount, and then I'll get back a bill. That has been discounted and worked through, and then I paid my portion, or if it was above my sharing, if was eligible, then the ministry didn't have a check from my bank account to help them.

[Speaker 0]: Thank you. I think let's move on to Representative Demar. Did anyone have any other questions? I'm sorry, did I miss any hands?

[Joel Noble (Samaritan Ministries International)]: I saw a hand in here. I was gonna answer your question about many members are here and you don't know. I would say on the other hand, DFR has never reached out to any ministries to ask us unlike other states. Idaho, every single year the Department of Insurance reaches out, asks how many members we have and often asks for our audit send that to them. Wyoming just reached out, New Hampshire's reached out, Iowa's reached out. And so they have accurate numbers on us because they've monitored everybody, asked us and we've taken, because they want to understand our insured population.

[Speaker 0]: So you're saying that if we just didn't even have section 11 in this bill that DFR could call all of you and you would give all the information that's in section 11? Mean voluntarily you would give As

[Joel Noble (Samaritan Ministries International)]: it's written, we would provide much of the same info. I don't think the EFR needs to know who our third party vendors are. You've already outlawed insurance agents in a state for use and so this is copy paste from Colorado so then that's kind of the question. There's a handful of questions that are probably be entanglement with religious organizations but we already provide our members, I mean our members, we know how much came in the previous month, how much went out, that is all published in our newsletter every single month for our members. We have to do that for accreditation and we post that for our members and so they know what comes in every month so they can look and know. And so we are more than welcome to provide EFR with the same information you give our members. And so like I said, the way some of those questions are phrased, it provides misinformation, even the membership numbers, the way they ask it, it fits the numbers tremendously because they ask the question poorly, but we have to answer it, otherwise they leave us incompliant and reject our form and then it's $5,000 a day and they don't answer it the way they want to answer it.

[Speaker 0]: Actually, I did have another question about that because you mentioned it again. You're talking about how Colorado inflated the numbers, which essentially they gave the charge master the price, which they do with all others. But we're able to ascertain the real price of things because all of our claims from all of our payers go into Beacon Earth, which is our state healthcare database that correlates all this information so we know the real cost of care. Do you take your members' claims and submit them to Vermont Speakers' all payer, all claim database?

[Joel Noble (Samaritan Ministries International)]: Sure. Based on the way you described it, it sounds like that would apply to an insurance company, and we're not an insurance, we don't meet the definition of insurance. National Association of Insurance Commissioners has a pretty clear definition and I thought I was learning within that definition at all. So I mean, of networks or perhaps anything

[Speaker 0]: else. So we could get that information, but because you're not in insurance, you don't report to the doctors, so we don't really have accurate information.

[Joel Noble (Samaritan Ministries International)]: In the same way that a church that helps someone with their medical bills wouldn't provide that info, the same way we need, while it's more organized, it's essentially the same as a church in passing to have someone that had a medical need.

[Speaker 0]: Okay, thank you. Hi, representative. We're really super casual in healthcare. So have a seat,

[Joel Noble (Samaritan Ministries International)]: Rob. Thank you. Well,

[Rep. Rob North (Ferrisburgh)]: I gotta admit, it's kind of pleasant to be out of house environment for for a change. So thank you all, colleagues, for inviting me. For the record, my name is representative Rob North from Ferrisburg. Thank you, madam chair, and colleagues for having me and giving me the opportunity to come testify, this morning, still, it is morning, on H 585. So my testimony today, I submitted electronically, so it is online for everybody to look at. Depending on how much time I'm allotted, I may or may not be able to go through it all, so I welcome you to read it. So in my testimony today, I'm gonna briefly explain first how one particular health shared ministry works, the CHM or Christian Health Shared Ministries, just the one that I'm I happen to be a part of. I'll explain why section 10 of five eighty five is harmful, I believe, to healthcare sharing ministries in general. And I'm going share two real stories from two Vermonters, one of which is myself, who rely on CHM in our times of need to give us great joy and also give us great joy in helping others in their times of need. Christian Health Share Ministries, I'll just refer to it as CHM going forward, is headquartered in Ohio. It's a nonprofit 501c3 organization, and it was the nation's first and longest serving health cost sharing ministry. Since 1981, CHM has shared 100% of eligible medical bills and satisfied over 13,000,000,000 in healthcare costs for its members. CHM provides a faith based framework that allows believers to assist one another in times of medical need. So there are many other health sharing networks, health sharing organizations that exist throughout The United States and even in the world. Some are faith based and some are not. That discussion, I happened to be here earlier for that. And they each attract and serve their various members by the various benefits and cost models they have because there are variations between them as we've heard here already today. And here's just a brief list of some of the different providers. So MediShare, Liberty HealthShare, Samaritan Ministries, Christian HealthShare Ministries, the one I'm here participating in. Altrua HealthShare, Zion HealthShare, Sedera Health, which is a prominent non religious medical cost sharing community. OneShare Health offers other flexible programs. Solidarity Health, again, doesn't require a statement of faith. Not Well, not well, not well. Not Well,

[Daisy Berbeco (Ranking Member)]: yeah.

[Rep. Rob North (Ferrisburgh)]: Netwell HealthCare. United Ruffa HealthShare, which is tailored to a to Jewish community. Universal HealthShare, open to members founded primarily with the unit Unitarian Universalist Period. What's that?

[Joel Noble (Samaritan Ministries International)]: It is called The one?

[Rep. Rob North (Ferrisburgh)]: Yeah. The Unitarian one is called Universal HealthShare. Universal HealthShare.

[Brian Cina (Member)]: It's very, universal health care.

[Rep. Rob North (Ferrisburgh)]: Yeah. Uniform health care. Okay. Yeah. Yeah. Yeah. In my Again, there's links. All these organizations have links in my written testimony that you keep those. The last one I have on my list, by no means is this list comprehensive. It just was a list that I pulled up, DPC Direct and HSA Secure. So let me just briefly explain to you specifically how CHM operates across the nation and here in Vermont. So CHM, like other health sharing groups, is not capital, NOT, not insurance. They

[Daisy Berbeco (Ranking Member)]: don't

[Rep. Rob North (Ferrisburgh)]: At least CHM doesn't specifically work with certain healthcare providers, thus they don't directly bill and pay for members' services themselves. Members contribute monthly based on the program they choose. CHM offers three levels of programs, bronze, silver, and gold. And members select their preferred doctors and their medical providers, whoever they want to use, whether it's MDs or DOs or naturopaths or holistic doctors or whomever they want to use, no affiliations necessary. There's generally no pre approval required, unlike insurance companies. Members present themselves, as has been noted here today, as uninsured. We are cash payers, so we use our credit card, we pay cashes with a check, or we work out a payment plan with the provider. I have to admit that's typically what I've done. Most providers are happy for you when you sit down to work out a payment plan with you over some payment period. And then so we, as the patient, directly are therefore responsible and pay for the services that we receive. Frankly, therefore usually receive, as has been noted already today, the cash pay discounts for services because they relieve the providers of having to go and work through the insurance company bureaucracy to get approvals and then get paid filing. They kind of like the idea of getting paid upfront or having a direct payment plan with them. And so, providers are usually quite happy with us as their customers. That's been my experience. So, because CHM's members recognize that we as members of CHM are kind of all in this together, we kind of treat each other like a community. And we want to make sure that we each, as members of the community, get the healthcare that we need. But we're also therefore sensitive to the costs that we each individually incur because we know that I got to share that with all of my fellow community members and they're going to have to pay for my bills. And that makes it very community oriented. And we're not just working with some big impersonal, oftentimes adversarial insurance company. So members often try to seek cost effective solutions to their healthcare needs. NCHM offers some tools, some online services to help members reduce their costs, to help find providers in their area. But these tools are completely voluntary. They're helpful. They're not burdensome or required. They don't get in the way of care or its availability. We don't need to use these tools. CHM just provides them for help if you want to use them. So once I've been treated, members receive our itemized bill, and then CHM happens to operate still old fashioned paper based. I love it, frankly. You fill out the forms with how much all of your itemized bills and literally snail mail them in. Again, I'm old fashioned. I kind of like that. But as we've heard already, different organizations do it differently. And so, once all of my paperwork has been submitted, then typically CHM pays that entire balance back directly to me within two to three months. My experience is it's been more like two months than three months. So once I receive that, then it's up to me to pay off any balance that I have with my providers. If I set up a payment plan, that's just convenient. So I don't have to put the whole, however much it is upfront. I can work a payment plan with them to pay several $100 a month. But that only lasts a couple of months because then I get the whole payment and just pay the whole thing off. What I find is it works exceptionally well. CHM has successfully operated exactly this way for about forty five years. And during that time, its members have shared more than $13,000,000,000 in medical bills with a total, and this is interesting, a total administrative operating cost of less than 10%. Not many insurance companies can claim that. Typically, they're in the 12% to 18% overhead operating cost range. CHM operates in all 50 states. CHM specifically has about 300 members in Vermont and 400,000 members countrywide. There's only one state, Colorado, and it's already been mentioned where there's some legislation that's remotely similar to what Vermont's looking at putting in place, and that's currently being litigated. Other states are all happy to have their citizens enjoy the benefits that CHM brings. So, the way it operates, I like to use this analogy, it's very similar to shopping at a food co op versus going to a grocery store. You have to pay membership to go to a food co op, but you're not going to find all the things at the food co op that you might find at a grocery store. You're going find the things that you're interested in. That's why you joined that co op. Cause they've got the local goat cheese and the cool stuff that I'm interested in, but I'm not going to find three packs of Costco pizza there. If I wanted three packs of Costco pizza, I'd go join Costco, which I do as well, I have to admit. It's not a perfect analogy, but it gives you the idea of how these operate differently from insurance, traditional insurance. And we don't require any additional reporting from food co ops. We just trust that the attorney general if any of those co ops were not operating properly, they were doing something weird with the membership fees that they were collecting, then the attorney general, we'd stick the attorney general on them and and it would all get taken care of. So there there's already clear ways of of dealing with fraudulent situations. Okay. So the language that's currently in section 10 of h five eighty would make it more difficult for any organization to serve members in Vermont by imposing a list of 19 detailed and some would claim burdensome and unnecessary reporting requirements on healthcare sharing ministries specifically. So as a five zero one(three) ministry, CHM already conducts audits and publicly shares annual information for tax purposes. CHM also provides very clear disclaimers explaining that we are not insurance. In fact, when I signed up, one of the forms I had to fill out to become a member, very clearly, one of this is not insurance. You are not signing up for insurance. And I had to sign the dotted line on that. So it's not like I could become a member by accident and not know that this is not insurance. It's very clearly stated right on the membership application. No way around it. While So, Vermont is one of the smaller states in the union, CHM has made a meaningful impact for Vermonters. And I will share my personal experience first. My personal experience with CHM has really been wonderful. It's been fantastic. I initially became a member after I retired from my engineering job at age 55 and needed some form of healthcare coverage. And so I had heard an advertisement on the radio and I checked it out. Actually, wasn't specifically for CHM, it was for another health sharing ministry, but that clued me into the concept. So I checked out all the various health sharing ministries and compared their costs and benefits and how they operated to, and I included traditional insurance and the Vermont Health Connect in that comparison. What I found is CHM to be the best fit for me at far less expensive than traditional insurance. In fact, once I got on it and I started using it, I wish I had rejected my company offered insurance plan way back when I was working and just started using CHM all along, it would have been far more beneficial for me. Even with my company paying 70% of my traditional high deductible plan premiums, it would still have been less expensive for me to switch to CHM all on my own rather than stay on the company plan. And the primary reason for that, I'll tell you, is because of the huge $12,000 annual deductible that I had to satisfy every year before I got any reimbursement from my traditional plan. Granted, was a high deductible plan, but it was the least expensive option. So my experience with CHM is that it essentially provides a zero deductible operation once it's all said and done. I'll explain it a little bit here because I've taken advantage of it a couple of times. So I've made use of my CHM benefits on two separate occasions for my own healthcare. I had COVID-nineteen and I have had Lyme disease twice, actually. I chose the CHM Gold plan, which is the lowest deductible and the highest maximum coverage levels. Of course, it's the highest priced one, but still less than traditional insurance. And that suited me best. At my gold level, I have a $500 per incident deductible. It's not per visit or per year, it's per incident. So if you break your leg, all of the hospital visits, all the doctors and everything associated with that broken leg, it's $500 deductible for the whole thing. So, for my COVID-nineteen experience, 500 deductible for my Lyme disease treatments, 500 deductible for the whole thing. But when you go, as been expressed here already, when you go to the hospital and you present yourself as a cash payer, they right off the bat give you, it's roughly a 40% discount. That in itself is very telling. We talk about that later. But that CHM counts that discount toward my deductible. That counts as my deductible. Now granted neither of these were multi tens of thousands of dollars. I think they were in the 5,000 to $10,000 range total billing. But 40% discount right off the top of even just $5,000 is $2,000 That's more than my $500 deductible. So I had all of my $3,000 remaining bill covered 100% with no out of pocket on my part. So completely satisfied my deductible in every case where I've used it. And so I had a 100% of my bills paid for these two incidents, and it all worked out seamlessly. So that's my personal experience. I'll care one other example. This one I received from CHM through their newsletter. It's an example of 64 year old CHM member in Chester, Vermont. In 2024, this member, whom I'll just call Rachel here to protect her privacy, was diagnosed with a dural anterior venous fistula. I'm not a doctor. It was in her spine. All right. Yeah. All right. We got some good healthcare folks. Excellent. It's a rare vascular condition involving an abnormal connection between an artery and a vein in the dura mater, which is the tough outer membrane that covers the spinal cord. So surgery is available to treat the neurological vascular disorder, but the complexity and rarity of the condition made the procedure very costly. Delaying treatment would have led to permanent nerve damage. So Rachel moved forward with the surgery. The total cost was $527,000 because she did not have traditional insurance, the self pay discounts were applied and reduced her total out of pocket responsibility to $119,917 You can see that's a significant discount because she was paying up front. So because she was a CHM member after paying her personal responsibility under her bronze membership, CHM members shared the full remaining amount. This allowed Rachel to pay off the entire bill. So in 2024 alone, CHM shared more than $430,000 across the 306 total needs here specifically in Vermont. So specifically in Vermont, 2024, 306 needs shared. That's not members. That's the total needs that were identified and shared by Vermont members covering $430,000 approximately. We've also seen an increase in bills shared from year over year here in Vermont demonstrating that CHM is working and the moderates are taking advantage of a good plan. While traditional insurance models often view increasing medical bills as a negative, CHM welcomes the opportunity to serve members during times of medical need. So what we do not welcome, I'll say, are additional regulatory requirements placed on a ministry that is already working for Vermonters at a time when health care costs and insurance premiums continue to rise, and CHM has been faithfully serving Vermonters for decades at a significantly lower cost, offering great benefit to Vermonters. However, the proposed language would impose reporting requirements that would increase the cost, making it harder for industries like ours to operate. So in closing, I respectfully ask CHM and other health care sharing ministries be allowed to continue operating freely in Vermont so they can preserve their ability to serve their members. Thank you for your time. And I I I might, finish with a with a question, and and I heard it mentioned earlier that that we're trying to protect Vermonters. And I'm just wondering, protect protect Vermonters from what? The the attorney general has the ability to to prosecute already, prosecute any fraudulent activity that's going on. So, I'm not quite sure what we would what these data collection that we're trying to impose on these sites and ministries actually protect the from. I have two additional member testimonials. I won't read them myself for you here. You you can read them online, and I think you've got the picture.

[Speaker 0]: I just want to answer that question. The attorney general can only protect consumers when it's a regulated industry, and this is completely unregulated, which is why this section is in here. I just want to how many different sharing plans did you mention at the beginning of your testimony?

[Rep. Rob North (Ferrisburgh)]: Yeah, over a dozen.

[Speaker 0]: So it sounds like you've got a really great one, but what about the other 11? Do you know about them?

[Rep. Rob North (Ferrisburgh)]: Not specifically, no.

[Speaker 0]: Neither does DFR, And I think that's the concern here. Any questions?

[Daisy Berbeco (Ranking Member)]: Any questions?

[Francis “Topper” McFaun (Vice Chair)]: No, I don't have.

[Speaker 0]: Go ahead. So DFR could reach out and get the information they need? Believe DFR testified to last week on this, and I believe they indicated that they had no access to this information, which is why they supported this. But we can ask them again. We can certainly ask them again. I have one question for you. So you indicated that you set up a payment plan with your provider and that it often takes three months to pay.

[Rep. Rob North (Ferrisburgh)]: To get the payment from CHM to me, yes.

[Speaker 0]: So you pay your provider in installments until you receive reimbursement?

[Rep. Rob North (Ferrisburgh)]: My experiences.

[Daisy Berbeco (Ranking Member)]: Does your provider have

[Speaker 0]: to bill you every single month? Like what, you get a bill every single month with your balance? Let's see. How did they do that? I think we just set

[Rep. Rob North (Ferrisburgh)]: it up electronically directly out of my checking account. That's why I set it up with the with the provider.

[Daisy Berbeco (Ranking Member)]: Do you

[Speaker 0]: pay interest on effectively the loan, the three month loan that you've taken from your provider?

[Rep. Rob North (Ferrisburgh)]: That's up to the provider. They may have charged me some interest. Don't recall whether they did or not. I know they basically asked me, how much can you afford? How much do want to pay each month? And I said, I don't know. How's $500? And they're like, sure. That sounds good. So we just went with that. And maybe they included some interest in that. I don't know. But the amount that they identified, the amount they identified probably would have had to include that would have to have been notified to me upfront, and I don't remember seeing that. So I doubt it. I doubt they included any interest in that, because once I paid off the final bill, it was just whatever the final bill was.

[Speaker 0]: I'm not sure I've ever heard of a provider charging interest on what is effectively a loan. I mean, if you put it on your if you put the whole amount on your credit card, you'd be getting your credit card interest every single month until you paid it back. So it is your provider essentially giving you an interest free loan. I have Leslie and I have out And then we got to finish up because we have to get somewhere. Mary Block was here from GFR, and she testified that she didn't have access to that information. They dropped it written in our website, but maybe we could get something from her sort of of their experience or what their access might be to this data. We'll ask them again. I think DFR is going be in the room this afternoon.

[Allen “Penny” Demar (Member)]: Question. I guess I heard that Tisperidone Ministries has four forty two members in Vermont. I think I heard you say 300 members. Roughly. The other 12 you mentioned are 10. Are they associated in Vermont also? I don't know. Okay. So I'm just curious. Right now, we're looking at over 700 people that we're servicing in Vermont. Just between the two.

[Rep. Rob North (Ferrisburgh)]: Just between

[Joel Noble (Samaritan Ministries International)]: the two.

[Speaker 0]: So the numbers you gave is just your CHM. Just your CHM and the other one is just for Samaritan. How members in Vermont are MediShare?

[Daisy Berbeco (Ranking Member)]: We have two forty three members, so 114 households.

[Speaker 0]: Okay, so it's about a thousand I guess, right?

[Joel Noble (Samaritan Ministries International)]: Of three. I think three pretty much. At the beginning you wrote down the trade association?

[Speaker 0]: Yes.

[Joel Noble (Samaritan Ministries International)]: And so the trade association had us up on our website, it's aahcsm.org, a state by state number for the ministries that are part of that trade association also. So if you're looking for kind of the combined number of the large ministries, that's available on our website. Great, thank you.

[Daisy Berbeco (Ranking Member)]: Any other questions? Yes. I was just wondering, of these, given that the, I guess the hope is that we're glad you had a great experience. Yeah. It sounds amazing.

[Speaker 0]: Yes. We should know about it soon.

[Daisy Berbeco (Ranking Member)]: Given that what we're trying to do or what we're thinking about making sure we have information so that folks are protected in case payments aren't made on their behalf, or if it falls short of what they actually need, unlike the experience you described. There are 19 things here, maybe, and if you've looked it over to see which ones are particularly burdensome, I don't have a list right now, but I can think of some really, maybe essential information, but maybe not so burdensome, so I don't know if you had an alternative like beats wouldn't be too bad.

[Rep. Rob North (Ferrisburgh)]: Like a narrowed down list of things that, yeah, I think the trade association would be the perfect folks to ask that. I mean, I'm not directly involved in it, other than very And recipient of the

[Daisy Berbeco (Ranking Member)]: do we know in the state how many of these organizations there are in Vermont?

[Joel Noble (Samaritan Ministries International)]: I would say there's probably a dozen, if I had a yes, and we'd be happy to give you a list of reporting. We offered an alternative list in Colorado which was rejected, we could provide you that same information you have. If you're looking for an alternative list, maybe some wage to get in front

[Daisy Berbeco (Ranking Member)]: of you.

[Rep. Rob North (Ferrisburgh)]: One other thing, I'm happy to share what my cost is, I don't if you would be interested Yes, in my monthly fee is $341 per month.

[Speaker 0]: Is that for an individual?

[Rep. Rob North (Ferrisburgh)]: Just me personally, as an individual, 61, 60 years old now. But I have the maximum, maximum gold plan. So I got the gold plus there's CHM offers this thing called Brother's Keeper, takes your max I think the maximum limit covered for in the gold plan is a million dollars, but that Brother's Keeper rider, you call it rider, but an additional fee takes unlimited coverage. And my deductible is only $500 and that's $340 more.

[Speaker 0]: I did have one question that I just wanted to, I think I wanted to put on the record and it's a question for you as well as do you sign a release of information when you sign up for this plan where they can request your medical information?

[Rep. Rob North (Ferrisburgh)]: Let's see, in like for pre existing conditions and that kind of stuff?

[Speaker 0]: Or anything.

[Rep. Rob North (Ferrisburgh)]: That is a good question. It was a while ago when I signed up. I think the application had like, are you a smoker? Those types of questions.

[Speaker 0]: For you, do you ever request office visit notes, complete medical records before you put in for sharing?

[Lindsay (Medi-Share/Christian Care Ministry representative)]: Our members did just vote. That went out to, we have what's called a member security committee. So those are members. That was one of the things actually, there was a recent vote on an update to our guidelines. So that went out to membership and the membership did vote in support of requiring the three years of submission for medical records into the ministry. The members are the ones that voted and requested back.

[Speaker 0]: Even before they could become part

[Lindsay (Medi-Share/Christian Care Ministry representative)]: of the During that time, right in the beginning. So then too, that they're able to, as the representative said, money disclose as well, if they're smoking or any of that other kind of medical history, but now that they've opted to just submit their three years of medical records. So if you receive a claim,

[Speaker 0]: do you ever request office visit notes before you pay that claim?

[Lindsay (Medi-Share/Christian Care Ministry representative)]: I think it's just in the general process of the bill when the bill is submitted.

[Speaker 0]: So that's a yes, that you request the medical record to go before you approve the claim, you look at the-

[Lindsay (Medi-Share/Christian Care Ministry representative)]: Not approved, it's just again looking at is that medical procedure eligible for sharing? So if it's on that list, then that is generally processed quickly there. Again, we're not looking at what the procedure should have been or not without the recommendation of the doctor. It's just, is it eligible for sharing for a good number of other guidelines again? So can you,

[Speaker 0]: I don't know the right word, I'll just say a word, reject an applicant based on their three year medical record that you've received. So we have a conversation, it's

[Daisy Berbeco (Ranking Member)]: not about rejection, right? Again, you're wanting to make sure that healthcare sharing is a good fit. We never want a member to come in and then they are burdened with something because it's not eligible for sharing. So that's why those early conversations with our members to make sure, are we a good fit? And if it's not a good fit because they determine they have a high level of needs, but some still decide to join the ministry. But we try to have those upfront conversations because again, we want someone to pick a healthcare option that meets their family's needs and not left without being part of the community or choosing traditional insurance to navigate their health care. Do you have specific things that

[Speaker 0]: are not eligible for sharing?

[Daisy Berbeco (Ranking Member)]: Yes. It's mostly within our guidelines. What types of things? Is there anything specific that we're

[Speaker 0]: Is there any specific type of

[Daisy Berbeco (Ranking Member)]: Share guidelines? Share all just online. Yeah,

[Speaker 0]: It'd be great if you

[Daisy Berbeco (Ranking Member)]: could share them and put it Yes, in that would be good.

[Speaker 0]: Okay, really do have to end because a lot of us have to get something that started five minutes ago. So thank you everybody.