3/15/2019|1
Consumer Protection Division
Arizona Department of Insurance
100 North 15
th
Avenue, Suite 102, Phoenix, AZ 85007-2624
Phone: (602) 364-2499 | Email: consumers @azinsurance.gov
ACONSUMERGUIDETO
SHORT‐TERMLIMITED‐DURATIONHEALTHINSURANCEPLANS
Short‐termlimited‐duration(STLD)healthinsuranceplanshavebeensoldinArizonaformany
years.SenateBill1109passedtheArizonaLegislatureandbecomeseffectiveinthesummerof
2019.ThelawallowsinsurerstosellSTLDplanswithlongercoverageperiods‐‐aninitialperiod
ofupto364days,andthereafter,renewalsorextensionsofcoveragesothatthetotalduration
isupto36months.
Theseplanscanhelpconsumerswho:
Don’totherwisehavehealthinsurance;
Experiencegapsincoverageandfindtheyneedtemporarycoverage;
Maybecomingofftheirparents’policies;
Arebetweenjobs;
Missedtheannualopenenrollmentperiodforpurchasingmajormedicalinsurance
fromthefederalHealthInsuranceMarketplace.
STLDplanscanalsobeanaffordableoptionforhealthyconsumerswhodonotqualifyfor
premiumsubsidiesandcost‐sharingbenefitsthroughtheHealthInsuranceMarketplace.
STLDpoliciesgenerallypayafixeddollaramountperdayorperservice,ratherthanpayingall
orapercentageoftheactualcostofcare.Someplanshavecontractedproviders,whichmay
helpreducetheamountofthemedicalcoststhepolicyholderisrequiredtopayformedical
services.
ShoppingTips
STLDpoliciescanvarywidelybetweeninsurers,soitisimportanttocomparisonshoptomake
surethatyoupurchaseapolicythatisrightforyou.
ManyinsuranceagentsonlysellplansforONEinsurer,soyoumayneedtocontactmultiple
insurersoragentstofindthepolicythatbestmeetsyourneeds,orfindanindependentagent
whocanhelpshopfortherightpolicyforyou.
STLDplansaresometimessoldasapackagewithotherlimited‐benefitpolicies,suchas
specified‐diseasepoliciesoraccidentandsicknessinsurance.
STLDplansarenotrequiredtocoveranyminimumkindsofcareoranyminimumamountof
benefits.Likewithanyinsurancepurchase,it’simportanttoreadthepolicycarefullytosee
what’sincludedandwhat’sexcluded,toasktheagentorinsurancecompanyrepresentative
questionsaboutthecostandbenefitsforeachpolicy,andtomakesurethatanythingthatyou
aretoldisreflectedwithintheinsurancepolicy.
ACONSUMERGUIDETOSHORT‐TERMLIMITED‐BENEFITHEALTHINSURANCEPLANS 3/15/2019
|2
QuestionstoAsk
IfyouarethinkingaboutpurchasingSTLDhealthinsurancecoverage,itisimportanttoask
questionsandtoconfirmthatthelanguageinthepolicyaddressesthoseissues.
WillthispolicycoverconditionsIalreadyhaveatthetimeIpurchasethepolicy?IfI
renewthepolicyorbuynewpolicies,willtheplanrenewal/extensioncoverconditionsI
developduringtheinitialpolicytermorwilltheconditionsbeconsideredpre‐existing
conditions?
Willthepolicycovermedicalcarethatisimportanttome,suchasprescriptiondrugs,
doctorvisits,emergencyroomvisits,hospitalization,laboratoryservices,imaging,
maternityandnewborncareormentalhealthdisorders?
Isthereawaitingperiodbeforetheplanwillcoverhealthcareservices?
Aretherelimitationsonthenumberofcoveredvisitsorthemaximumamountpayable
foraspecifictypeofservice?
Istherealimit(out‐of‐pocketmaximum)onwhatImayberequiredtopayduringthe
policyperiodformydeductible,coinsuranceandco‐payment?
Doesthepolicyincludeanannualorlifetimelimitontheamounttheinsurerwillpay?
DoIhavetojoinanassociationtopurchasetheSTLDplan?Ifyes,whatisthemonthly
costfortheassociation?
OtherThingsYouShouldKnow
10‐dayRighttoReturn.Whenyoureceiveyourpolicy,youshouldimmediatelyandcarefully
reviewthetermsandconditionstodetermineifthepolicymeetsyourhealthcareneeds.Ifthe
policyisnotrenewableandyoudecidethatyoudonotwantthepolicy,youhavea10‐dayright
toreturnthepolicyforafullrefund.
HealthCareAppeals.Ifyourinsurerdeniesyourrequestforahealthcareserviceordeniesa
claimforservicesthatyouhavealreadyreceived,youmayhavetherighttoappealthedenial.
Alongwiththepolicy,theinsurermustalsoprovideyouwithaHealthCareAppealsPacketthat
explainsyourappealrights.
InquiriesandComplaints.Ifyouhavequestionsorconcernsaboutshort‐termhealthinsurance,
youmaycontacttheArizonaDepartmentofInsuranceConsumerAssistanceSectionbye‐mail
at[email protected],orbyphoneat602‐364‐2499or800‐325‐2548(tollfree,in‐
state).IfyoubelievethataninsurancecompanyorinsuranceprofessionalviolatedArizonalaw,
pleasevisitourwebsitetohelpyoudeterminewhetheryoushouldfileacomplaintortakea
differentapproachtowardresolvingyourproblem.
ACONSUMERGUIDETOSHORT‐TERMLIMITED‐BENEFITHEALTHINSURANCEPLANS 3/15/2019
|3
RequiredNoticeforConsumerProtection
AllSTLDpoliciesmustdisplaythefollowingnoticeonthepolicyandinanyapplicationmaterials
in14‐pointtype:
NOTICE
THIS COVERAGE IS NOT REQUIRED TO COMPLY WITH CERTAIN
FEDERAL MARKET REQUIREMENTS FOR HEALTH INSURANCE,
PRINCIPALLY THOSE CONTAINED IN THE AFFORDABLE CARE ACT.
BE SURE TO CHECK YOUR POLICY CAREFULLY TO MAKE SURE YOU
ARE AWARE OF ANY EXCLUSIONS OR LIMITATIONS REGARDING
COVERAGE OF PREEXISTING CONDITIONS OR HEALTH BENEFITS
(SUCH AS HOSPITALIZATION, EMERGENCY SERVICES, MATERNITY
CARE, PREVENTIVE CARE, PRESCRIPTION DRUGS AND MENTAL
HEALTH AND SUBSTANCE USE DISORDER SERVICES). YOUR
POLICY MIGHT ALSO HAVE LIFETIME OR ANNUAL DOLLAR LIMITS
ON HEALTH BENEFITS, OR BOTH. IF THIS COVERAGE EXPIRES OR
YOU LOSE ELIGIBILITY FOR THIS COVERAGE, YOU MIGHT HAVE TO
WAIT UNTIL AN OPEN ENROLLMENT PERIOD TO GET OTHER
HEALTH INSURANCE COVERAGE.
ListofShort‐termLimited‐duration(STLD)InsuranceCompanies
TheArizonaDepartmentofInsuranceprovidesthislistofinsurersofferingshort‐term,limited‐
duration(STLD)insurancetoencourageArizonaconsumerstocomparisonshopbefore
purchasinganSTLDpolicy.Pleasenotethatthislistdoesnotrepresentanendorsementofany
individualcompanybytheArizonaDepartmentofInsurance.Thislistmaynotincludeall
companiescurrentlyofferingSTLDinsuranceinArizona.
GoldenRuleInsuranceCompany 317‐290‐8100
EverestReinsuranceCompany 908‐604‐3253
FreedomLifeInsuranceCompanyofAmerica 800‐387‐9027
IndependenceAmericanInsuranceCompany 212‐355‐4141
LifeShieldNationalInsuranceCompany 800‐314‐5594
MadisonNationalLifeInsuranceCompany 212‐355‐4141
NationalHealthInsuranceCompany 888‐781‐0580
StandardSecurityLifeInsuranceofNewYork 212‐355‐4141