Constitution of Wayne-Holmes Mutual Aid HCSM (Health Care Sharing Ministry)

Transcription

1 I. NAME: This organization shall be known as Wayne-Holmes Mutual Aid (herein referred to as WHMA ). II. PURPOSE: To provide a scriptural, systematic, and economic plan for members to share among themselves in the medical and burial expenses of our brotherhood. Look not every man on his own things, but every man also on the things of others. Phil 2:4 And whether one member suffer, all members suffer with it. 1 Cor. 12:26 Bear ye one another s burdens, and so fulfill the law of Christ. Gal 6:2 III. MEMBERSHIP: Eligibility for membership shall be determined by: A. Membership in a local Conservative Mennonite Congregation approved by the WHMA Board. 1. All children under 18 years of age are included with their parents. a) High school students turning eighteen (18) years of age during the school year will continue to be included with their parents through June 30 of that school year. b) Children in the process of being adopted will be recognized as part of the family when the child is placed with the member family. Pre-existing condition rules shall apply. 2. Receipt of completed application form and initial membership fee. 3. Any exception to the above are subject to the approval of the WHMA Board. 4. Members who no longer attend or commune in an approved Local Conservative Mennonite Congregation will receive a letter of closure by WHMA. 5. Members of WHMA who enter the mission field may continue their membership. However, people who are not currently members of WHMA, but want to join in order to go into missions will not be accepted. B. Associate Membership: An eighteen (18) month, non-renewable, temporary membership period with all the same terms, benefits and guidelines as a full membership. IV. ORGANIZATION: 1. The Associate Membership may be used when: a) People joining a member congregation who will lose their membership in another HCSM may join while becoming a member of said congregation. b) People immigrating from another country who will lose their national healthcare coverage may join while becoming a member of a member congregation. c) Applications for Associate Memberships must be applied for by the Pastor of the hosting congregation. 2. Associate members will forfeit their membership at the end of the eighteen (18) month period if they haven't become members of a member congregation. 3. Associate members shall notify the WHMA office when they have successfully joined a member congregation. If WHMA receives no communication within the eighteen month period the account will be sent a letter of closure. A.The WHMA Board shall be composed of seven individuals: 1. Executive Committee, consisting of: a) President b) Vice President c) Secretary d) Treasurer 2. Advisory Board consisting of: 1 of 6

2 a) Advisor b) Two (2) Members-At-Large 3. Selection and term of office: 4. Meetings: a) All members of the Board are required to be members of the WHMA. b) For the election of Board members who will serve in the roles of President, Vice President, Secretary, and Advisor, nominees shall be selected by the Board and presented by ballot to the ten (10) congregations participating in WHMA with the greatest number of members participating in WHMA determined as of January 1 of each year (the voting congregations ) for a vote. In determining the voting congregations, if two (2) or more congregations have an equal number of members for this purpose, such congregations shall have priority among themselves based on their length of participation in WHMA. The voting congregations may approve or reject the election of each nominee by majority vote. In the event the voting congregations reject the election of a nominee, the Board will promptly submit a new nominee for consideration. An elected Board member shall be elected to a four (4) year term. The terms of elected Board members shall be staggered. c) The Treasurer shall be appointed by the Board to a four (4) year term. d) The Members-At-Large shall be appointed by the Board to a two (2) year term. e) After the election and appointment of new Board members each year, the Board shall elect the Board members who shall serve in the roles of President, Vice President, Secretary, and Advisor by majority vote. f) Any vacancy in the Board shall be filled in the same manner as the office vacated by the departing Board member was originally filled and will be elected or appointed for the remainder of the departed member s term. V. DUTIES OF THE OFFICERS AND ADVISORS: a) The Board shall hold quarterly meetings and any two (2) Board members may call special meetings as needed. b) Five (5) Board members constitute a quorum. A. All Board Members are expected to attend all WHMA meetings. B. The President shall preside at all meetings of the organization. He shall present fairly all matters, conducting business according to Robert s Rules Of Order and perform other duties usually assigned to this office. C. The Vice President shall assist the President in the regular work of the office of the President and assume the duties of the President in his absence. D. The Secretary shall keep accurate records of all proceedings at each meeting of the organization. E. The Treasurer shall keep an accurate record of all the members, hold in trust all funds of the organization, and make such disbursements as called for by the Board. His books shall be audited once a year by a certified public accountant. F. The Advisory Board members shall have full voting privileges. VI. DUTIES OF MEMBERSHIP: A. Members are responsible for payment of their own medical bills. WHMA is not insurance and does not guarantee any payment of medical bills. B. Most healthcare providers will readily give discounts for prompt payment. It is the responsibility of each 2 of 6

3 member to diligently pursue all available discounts. All discounts received from your healthcare provider shall be passed along to WHMA. Failure to do so constitutes fraud. Intentional violation of this may result in termination of membership. C. Advise your doctors and/or hospital that you are self-pay but part of a local Mennonite Church HCSM (Health Care Sharing Ministry). D. All funds received from WHMA for assistance with medical expenses must be promptly used for that purpose. Any other use of said funds constitutes fraud, and may result in termination of membership. E. Pay all membership fees when due. Members with membership fees delinquent at the end of the quarter forfeit their membership unless special arrangements have been made with the WHMA Board. 1. An account shall be in arrears if unpaid by the end of the quarter. The following quarter statement will show the unpaid balance in addition to the current quarterly amount plus a $30.00 late fee. The membership shall be forfeited if the total is not paid by the due date. Both the member as well as the member s Pastor will receive notification of said forfeiture. 2. Members who have forfeited their membership due to delinquency, cannot reapply for six months from date of forfeiture. Upon reapplying, all delinquent dues must be paid before they will be accepted back on the plan. Pre-existing conditions rules shall apply. F. Exercise care to keep claims to a minimum, seeking to be as fair in claiming benefits as you would have others be. G. Exercise any other assistance or compensation that is available before requesting assistance from WHMA, e.g. Workman s Compensation, insurance, Bureau for Children with Medical Handicaps, etc. H. Allow all disagreements to be settled by the WHMA Board (I Cor. 6:1-7). I. All members agree to forfeit any legal action against this association, its representatives, members, or healthcare providers. J. All members agree to notify the WHMA office when no longer attending the congregation they re registered under, or changing their membership to a different congregation. VII. CLAIMS: Members shall give evidence of claims by presenting to the Board an authentic itemized account of the charges before payment may be expected. A. When there is a claim: 1. Diligently pursue all available discounts from your healthcare provider. 2. Forward all invoices and discounts relating to this claim to WHMA. 3. Pay all bills within the specified discount period. VIII. FEES: The membership fees shall be set by the Board and may be changed as needed to compensate for members health care costs and to maintain a reasonable operating balance. IX. BENEFITS: A. Medical and Maternity cases are handled as follows: The member pays the first two thousand dollars ($2,000.00). Thereafter the member will be reimbursed by WHMA one hundred percent (100%) of each claim. Maximum out-of-pocket expenses will be four thousand dollars ($4,000.00) per individual, or six thousand dollars ($6,000.00) per family per year. 1. Dental cases shall only be reimbursed under the following conditions: a) As a result of an accident; or b) Non-elective dental surgery under anesthesia. 2.Ophthalmic cases shall only be reimbursed under the following conditions: a) As a result of an accident; or b) Non-elective surgery. 3 of 6

4 B. Chronic cases shall be defined as any case that continues beyond thirty-six (36) months of the initial claim. 1. If there are additional costs involved after thirty-six (36) months an annual deductible is required as in IX - A above C. Psychiatric cases shall be evaluated by the Board. The Board shall confer with the church leadership of claimant and decided on a case by case basis. Christian counseling shall be exhausted prior to considering psychiatric benefits. Approved cases shall be handled as described in IX - A above. D. Prescriptions. WHMA does not reimburse for prescriptions except as stated below. 1.The first six (6) months of a case as described in IX - A above. 2. After six (6) months the member shall pay the first seventy-five dollars ($75.00) per month, after which WHMA will reimburse seventy-five percent (75%) of the balance. These shall be paid quarterly but each month is figured separately. 3. In Medicare cases WHMA reimburses sixty-five percent (65%) of non-reimbursed prescription costs. E. Burial. WHMA will reimburse two thousand dollars ($2,000.00) for each burial. F. Automobile accidents. The medical benefits described in IX - A above will apply after two thousand dollars ($2,000.00). WHMA encourages members to have a minimum of two thousand dollars ($2,000.00) medical coverage on their auto policy. G. Medicare A & B enrollees. 1. Enrollment in only Medicare A is regarded by WHMA as not having Medicare at all. 2. If Medicare pays a portion of your bill, WHMA will reimburse one hundred percent (100%) of the remainder. 3. If Medicare does not pay at all, WHMA will reimburse sixty-five percent (65%) of the total. H. Rehab In Nursing Home. WHMA will reimburse for the first ten (10) days of rehab in a Nursing Home. I. Retention of Membership. Subject to compliance with III A above, the payment of membership dues and absence of fraud, members may retain membership in WHMA even after they develop a medical condition. X. CASES NOT COVERED (EXCLUSIONS / EXCEPTIONS): A. Pre-existing conditions for a period of ten (10) months after enrollment. Pre-existing shall be defined as any current or any previous medical condition for which you have received treatment, checkups, etc. within the past three (3) years, or any known or suspected condition. B. Sterilization or reversal procedures. C. Elective abortions. D. Treatment for sexually transmitted diseases. E. Fertility treatments and pregnancies resulting from fertility procedures. F. In vitro fertilization (IVF) and pregnancies resulting from IVF. G. Surrogate maternity procedures. H. Illness or injury resulting from alcohol, tobacco, or illegal drug use. I. Chiropractic care. J. Dental care except as specified in Article IX section A-1. K. Services in a nursing or convalescent home except as noted in IX-H above. L. Beautification or cosmetic treatment. M. Alternative treatments. 4 of 6

5 N. Ophthalmic treatment except as specified in Article IX, section A-2. O. Medical equipment such as hearing aids, wheelchairs, hospital beds, etc. Exception: WHMA will reimburse for the initial cost of CPAP machine for sleep apnea treatment. P. Injuries resulting from commonly recognized dangerous use of recreational vehicles. Q. Transportation to receive medical treatment. R. Ambulance and air evacuations in non-emergent situations. S. Costs resulting from a suicide or attempted suicide. T. Any exceptions to the above are subject to the approval of the WHMA board. XI. AMENDMENTS: The Constitution may be amended in the following order: A. The WHMA Board may from time to time find it necessary to amend portions of the Constitution. Notifications, quorum, and voting percentages apply as described in B, C, and D below. B. Members may present to the Board in writing, proposed amendments for consideration with signatures from at least twenty (20) members. C. At least fifteen (15) days notice to all members shall be given prior to the time of the meeting, stating the issues under consideration. D. The members present for the meeting shall constitute the quorum. E. A two-thirds (2/3) majority of those voting shall be necessary to propose the amendments to the voting congregations. F. The voting congregations may approve the amendments to the Constitution by a majority vote. XII. TAX-EXEMPT PURPOSE: WHMA is organized exclusively for charitable and religious purposes under section 501(c)(3) of the Internal Revenue Code, or corresponding section of any future federal tax code. No part of the net earnings of WHMA shall inure to the benefit of, or be distributable to its members, directors, officers, or other private persons, except that WHMA shall be authorized and empowered to pay reasonable compensation for services rendered and to make payments and distributions in furtherance of the exempt purposes set forth herein. No substantial part of the activities of WHMA shall be the carrying on of propaganda, or otherwise attempting to influence legislation, and WHMA shall not participate in, or intervene in (including the publishing or distribution of statements) any political campaign on behalf of or in opposition to any candidate for public office. Notwithstanding any other provision of this Constitution, WHMA shall not carry on any other activities not permitted to be carried on (a) by an organization exempt from federal income tax under section 501(c)(3) of the Internal Revenue Code, or the corresponding section of any future federal tax code, or by (b) by an organization, contributions to which are deductible under section 170(c)(2) of the Internal Revenue Code, or the corresponding section of any future federal tax code. XIII. DISSOLUTION: Upon dissolution of WHMA, assets shall be distributed to one or more participating congregations of WHMA if and only if such congregation or congregations are exempt under section 501(c) (3) of the Internal Revenue Code, or corresponding section of any future tax code, but if no such congregation exists, or is exempt under section 501(c)(3) of the Internal Revenue Code, or corresponding section of any future tax code, then upon the dissolution of WHMA, assets shall be distributed for one or more exempt purposes within the meaning of section 501(c)(3) of the Internal Revenue Code, or corresponding section of any future federal tax code, or shall be distributed to the federal government, or to a state or local government, for a public purpose. Any such assets not so disposed of shall be disposed of by a court of competent jurisdiction of the county in which the principal office of WHMA is then located, exclusively for such purposes or to such organization or organizations, as said court shall determine, which are organized and operated exclusively for such purposes. 5 of 6

6 This Constitution was revised on, March We, the undersigned President and Secretary of the Wayne-Holmes Mutual Aid, hereby certify that the above was duly adopted by the members of Wayne- Holmes Mutual Aid on the date set forth above. President: Marvin J Miller Date Signature: Print name: Secretary: Roger Schrock Date Signature: Print name: 6 of 6