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Reliant will allow international missionaries to electively Opt Out of Reliant’s International Health Insurance Group Coverage. Reliant understands that some nations require residents to participate in the locally provided National Health Card plan and the costs of maintaining both coverages may be prohibitive. (But this alone is no reason to simply Opt Out).  International Missionaries are only allowed to opt out of Reliant’s group plans (medical and dental coverage) AFTER they enroll in and are ACCEPTED by the national government health plan provided by the host foreign country where the missionary is serving.  Reliant recommends that a missionary seriously consider carrying both coverages, if required to enroll in the locally provided National Health Care coverage.  It is fully allowable to be covered by both plans.  Most US citizens prefer to be treated in the US if a catastrophic illness occurs, which would be the case if they participate in both plans. 

In order to Opt Out of Reliant's International Health Insurance, the missionary must FIRST show adequate and official proof of national coverage to Reliant of their national government health plan in order to be given this exemption. Also, Reliant WILL NOT be held responsible for any gap in coverage that results from the missionary’s personal decision to opt out of the Reliant provided international medical and dental insurance. Financially, for any coverage Gap that results, the missionary will be 100 percent financial responsible to cover.

The election will be given under the following circumstances

• Missionary must sign a legal waiver that states they are willing electing to opt out of (or waive) Reliant provided international health insurance and are choosing to be 100 percent covered by the national government health plan of the host foreign country where they are serving.
• Missionary must provide Reliant with adequate and official proof of their national health plan coverage before their waiver can be approved. Until final approval is given, the missionary will continue to be covered under the Reliant group health plan.
• The missionary accepts 100 percent financial responsibility for their medical expenses not covered by the government national health plan they are enrolling in. So the missionary should make this decision to opt out with very careful thought, prayer, counsel and serious consideration.
• The missionary will be 100 percent responsible for securing any supplemental health insurance needed for their stateside furlough period and for any travel conducted outside of their host country. The missionary will NOT be eligible to enroll back into Reliant coverage simply for any stateside two to three month furlough period.
• Once the missionary elects to opt out of Reliant coverage, they will not be allowed to opt back in until the NEXT annual open enrollment period.  They missionary will remain on Reliant coverage thereafter (thus, no second Opt-Out waiver will be issued).

The election will NOT be given under this circumstance

• The opt out election is reserved ONLY for those missionaries deciding to join their host country’s national plan, and CANNOT be used by the Reliant missionary to simply seek out another alternative personal/family health insurance policy from an independent international insurance provider.

Salary Increase allowed for national health care premiums

Reliant missionaries may add the cost of National Health Care premiums to their monthly salary goals.   This will be done as follows: 

• The missionary is responsible to pay the premiums directly to the national government. 
• They will also add the cost of these monthly premiums to their International Support Goal Worksheet (SGW) in Section A – Monthly Salary. It will then be paid out to the missionary as additional taxable salary. 
• The new International SGW needs to be submitted and processed before changes can increase the paycheck.

Reimbursement of short-term supplemental health insurance travel policy for furlough/home service while in the U.S.

Reliant international missionaries who opt out of the Reliant health plan, will be eligible to taxably reimburse 100 percent of the cost of a short-term supplemental health insurance travel policy for traveling for themselves and their family members (e.g., to the USA for their 2 -3 month furlough). The missionary will need to submit this expense on a Reliant ministry reimbursement form as a taxable reimbursement. Any costs for medical claims that are incurred on furlough or while traveling, that not covered by their short-term supplemental health insurance travel policy will be 100 percent the responsibility of the missionary.

WARNING: Many online insurance carriers, who offer short-term supplemental health insurance travel policies, only offer limited coverage with limits or exclusions on many pre-existing conditions. Please make sure you are completely aware of these important details of the coverage and its limitations.

The missionary is making the decision to opt out 100 percent at their own risk. Thus, Reliant strongly recommends that any missionary decision to opt out of the Reliant International Health Insurance Plan be made very carefully, prayerfully and with much counsel. This decision may have significant consequences on a missionary’s health coverage and possibly their personal finances. Making the decision simply because it means less Reliant ministry support to raise can be a short-sighted reason and should NOT be made simply for that reason.

Here are additional issues to be considered:

1. Reliant International Health Plan provides excellent world-wide coverage for all our international missionaries. Many host country’s national health plans reduce (or possibly even eliminate) coverage benefits when traveling outside the host country or back to the USA. This will be a challenge when returning home to the United State for furlough or when traveling outside the host country for visa renewals, staff/pastors conferences, vacations, etc.
2. Reliant strongly recommends that the missionary consider short-term supplemental health insurance for any trips back to the USA for family, furlough, or other ministry reasons. We cannot stress enough the importance for the missionary and their family members to have adequate health insurance coverage while outside of their host country
3. As previously mentioned, many short-term supplemental health insurance policies for any travel back to the USA very often do not include coverage for pre-existing conditions. Reliant strongly recommends that the missionary obtain a short-term health plan policy that includes coverage for preexisting conditions. One such possible resource is www.insubuy.com. (NOTE: Reliant does not officially endorse this website, but is simply providing it as an information resource).
4. If the missionary ever needs extended medical treatment, this may need to take place back in their host country. For example, if the missionary is on the host country’s national health plan and gets diagnosed with cancer. And they really desire to come back to the States to be treated at the Mayo Clinic. The government’s national health plan may require them to be treated in the host country. Thus, choosing to opt out of Reliant’s health plan may result in such restrictions that the missionary must be willing to live with if they ever face a serious illness.
5. There may be waiting periods for certain coverages or pre-existing condition restrictions associated with joining a host country’s national health plan. The missionary needs to be fully aware of these.
6. Emergency medical evacuations will be affected by choosing a national host country health plan. You will lose the following coverages provided by Reliant’s International Health Plan:
   
   - Coverage at 100 percent (Deductible waived) of up to $20,000 for Repatriation of Remains
   - $1,000,000 per occurrence for Medical Evacuation Host country national plans may or may not provide these benefits. Reliant cannot be held responsible for any gap in coverage resulting from the missionary’s personal decision to opt out.
   
   
7. When opting out of Reliant coverage, the missionary is also taking full 100 percent responsibility for the financial consequences that may result from this decision. Therefore, any costs incurred for medical expenses and claims not covered by their host country’s national health plan will be the responsibility of the missionary.

If an international missionary desires to opt out of Reliant’s health plan and plans to enroll in their host country’s national health plan:

• They will be covered by Reliant’s global coverage until the missionary provides the Opt Out Request form and proof of National Health Coverage to Reliant.  
• The missionary needs to research to see if they qualify for the national health plan of their host country.
• The missionary needs to research the national health plan & compare it to Reliant’s Coverage Plan Benefits.
• The missionary should understand clearly what  the national health plan covers when traveling outside their host country.
• They should discuss this important decision with their family, supervisor and other missionaries.

Next steps for opting out of Reliant coverage

Missionary must first confirm that they are eligible for host country national health coverage, enroll and receive proof of coverage.  (Often this involves a page being added in a passport, or other identification cards.) 

Send the following to Reliant (email these to: international@reliant.org)

• Signed Benefits Refusal – Employee Waiver of Medical & Dental Benefits
• Official and adequate proof of their national health plan insurance coverage
• Updated International SGW to account for changes in medical premium expenses

Until final Reliant approval is given for opting out, the missionary will continue to be covered under Reliant’s International Health Plan.

Resources

• International Support Goal Worksheet (Excel)
• International Employee Waiver of Medical & Dental Benefits (PDF)