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Support

FAQ & Glossary

Keep reading to find answers to questions about your plan, enrolling, how it works, or to learn some important definitions.
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Enrollment

Do you have plans available in every state?

Yes, plans are available in all 50 states.

Can I enroll in just dental or vision plans?

Yes, you can enroll in dental and vision plans without bundling them with medical.

About Clearwater

What does Clearwater Benefits do?

Clearwater Benefits is a healthcare vendor. Clearwater Benefits offers a wide variety of high quality, highly affordable healthcare solutions tailored to meet individuals’ unique needs via traditional insurance plans, healthshare-based solutions, and supplemental insurance offerings.

Major Medical Plans

Major Medical are all-insurance plans, offering lower costs and better benefits than most plans found in the Marketplace. Members can enjoy a range of deductible options, low copays, lower max out-of-pocket, and affordable premiums. These plans have no limitations, such as pre-existing conditions or age, and have the most robust coverage of all our products.

When does my plan start?

For Major Medical plans, open enrollment is November 1 through December 31. Your plan effective date during open enrollment is January 1. For those that enroll outside of open enrollment, your effective date is on the first of the month following a full 60-day waiting period.

Can I switch my plan?

You can switch plans at the 1-year renewal date.  To switch before then, you must have a qualifying life event.

How do I cancel my plan?

To cancel your plan, contact members@clearwaterhealth.com. In order to cancel your plan, you must have a qualifying life event. You have 31 days from the date of your qualifying life event to notify us of the qualifying life event in order to cancel your plan. Your policy will terminate at the end of the month from the date we receive your qualifying life event documentation.

Glossary

 
Annual Maximum

The annual maximum is the amount that a member will pay before the ClearShare community shares in medical expenses. The annual maximum is also known as your personal responsibility. ClearShare has three primary levels of personal responsibility: $1000, $2500, and $5000. The lower your personal responsibility, the higher your monthly contribution will be. 

All qualifying medical expenses submitted after the Annual Maximum is met are shareable with the ClearShare community at one hundred percent. You are only responsible for the annual maximum once each plan year based on your effective date. There is no annual or lifetime limit. 

Service copays are not included in the annual maximum. Members who are also part of an HSA MEC, service related costs that apply to the member’s deductible are not part of the annual maximum.

Dependent

The head of the household’s spouse or unmarried child(ren) under the age of 26, who are the head of household’s dependent by birth, legal adoption, or marriage, and who are participating under the same combined membership. Unmarried children under 26 years of age may participate in the membership as a dependent.

Effective Date

The date a person’s membership begins.

Healthcare Sharing

Healthcare Sharing, also known as medical cost sharing or a healthshare, is a nonprofit program that provides an organized structure for a community of members to contribute toward each other’s medical costs.

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Health Savings Account (HSA)

A Health Savings Account (HSA) is a tax-advantaged savings account you can use to pay for qualified medical expenses.

Licensed Medical Professional

An individual who has successfully completed a prescribed program of study in a variety of health fields and who has obtained a license or certificate indicating his or her competence to practice in that field (MD, DO, ND, NP, PT, PA, Chiropractor etc.)

Minimum Essential Coverage (MEC)

Minimum essential coverage is the minimum amount of coverage that is considered essential by the Affordable Care Act. Things that are not considered minimum essential coverage include only supplemental plans, coverage for only a specific condition, and worker’s compensation.