I. Requirements
a. Maintain an active membership in the Stratus Health Cooperative.
b. Pay $120 Annual Membership Fee.
c. Make monthly contributions according to need analysis.
d. Membership begins on receipt of Membership Fee.
II. Application for Membership
a. Each person(s) applying for membership must submit a Member Enrollment Application, pay the $120 membership fee and be accepted into the Program by the Stratus Health Cooperative.
b. If a person(s) does not qualify for membership, the fee will be returned.
c. Applications received after the 5th of the month will be effective on the 1st day of the following month
III. Membership Eligibility
a. Cooperative members of any age may apply for Stratus Health benefits
alone or combined with qualified dependent(s) provided all other qualifications are met.
b. Once an application is accepted, there is a 3-month waiting period before the Member
and qualified dependents are eligible for sharing assistance.
IV. Qualified Dependents
a. Member Spouse and unmarried dependent child(ren) up to age 25 may participate in
the Stratus Health Cooperative with a Dependent Membership as long as the Member is active.
b. Newborns must be added to by the Member to qualify for assistance.
c. Married dependents and unmarried dependents over the age of 25 must apply for their
own membership in the Stratus Health Cooperative.
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V. Financial Participation
a. The Annual Membership Fee of $120 due on 1st day of anniversary month each year.
b. The Monthly Contribution to Stratus Health, according to need analysis, is due on the 1st day of each month.
c. Monthly contributions are voluntary contributions that are non-refundable.
d. Once your membership is active, if your recurring monthly contribution is not received by the 15th of a participating month, your 3-month waiting period will restart.
e. Any returns by your financial institution will be assessed a $50 administrative fee.
VI. Needs Analysis
a. The voluntary monthly contribution of each member is based on a needs analysis that determines anticipated need based on the member age, medical condition, health
habits and desired plan.
b. The Member needs may be reevaluated on an annual basis at the request of the
member, or at any time deemed necessary by the Stratus Health Cooperative.
c. Inaccurate or missing information left out of the Member Application may cause ineligibility for assistance or loss of membership.
VII. Member Rights
a. You have the right to receive considerate, courteous service that respects your dignity
and personal privacy.
b. Your personal information and medical records will be handled in a confidential manner.
c. Your medical needs will be processed promptly and accurately once documentation is
received.
d. You will receive eligible sharing or assistance for medical treatments in a timely manner.
e. You will be informed of eligibility guidelines to help make educated choices about your
treatment.
f. You have the right to file an appeal whenever sharing is determined ineligible.
VIII. Member Responsibilities
a. You have the responsibility to treat medical professionals and personnel in a courteous manner.
b. You are responsible to maintain courteous and respectful communications with Stratus
Health employees.
c. Express opinions, concerns or complains constructively to the appropriate people.
d. Take charge of your own health, make positive decisions, seek appropriate care and
follow your medical professional’s instructions.
e. Communicate openly with your medical professionals. Provide accurate and pertinent
information to help them provide thorough assessment and proper treatments.
f. Participate in understanding and managing your health problems.
g. Understand the consequences of refusing recommended medical treatments.
h. Understand that refusing treatment may make future medical needs ineligible for
assistance.
Current Plan Options
Platinum
Gold Plus
Platinum
- Available only to healthy individuals with no chronic medical conditions requiring prescription care, no poor health habits (tobacco or drug use, overconsumption of alcohol, obesity as defined by BMI)
- Annual Unshared Amount $10,000 per individual followed by 80/20
- No coverage for accidental injury secondary to high risk activities
- Use with Health Savings Account (HSA)
Gold
Gold Plus
Platinum
- Available to all Stratus Members
- Annual Unshared Amount $5000 per individual followed by 80/20
- Eligibility based on needs analysis
- Use with Health Savings Account (HSA)
Gold Plus
Gold Plus
Gold Plus
- Available to all Stratus Members
- First $1000 per individual covered at 100% for eligible medical care
- (Includes dental cost sharing, chiropractic care, holistic medicine and up to $300 of nutritional supplements.
- Annual Unshared Amount $5000 per individual followed by 80/20
- Eligibility based on needs analysis
- Use with Health Savings Account (HSA)
IX. Eligible Medical Needs
a. Stratus Health utilizes an Open Network. This means that the Member is free to
choose any licensed medical provider or facility for medical treatment. There may be cost savings by selecting a Preferred Stratus Network Provider, if available in your area.
b. To request assistance for eligible medical needs, the Member is responsible to submit
standard billing forms and receipts to their personal Stratus Health advocate. Further
medical records may be required depending on the nature of the medical need.
c. Each request for assistance will be assessed based on the Member status, membership
plan, membership limitations and nature of the need.
d. Any medical records received greater than 90 days after treatment will be ineligible for
assistance.
e. Stratus Health is secondary to any health coverage or other forms of assistance
available to the Member.
f. Members are responsible for annual office visits to maintain a healthy relationship with
their licensed medical professional and to receive timely tests and procedures to
optimize their best health. Failure to do so may make advanced medical care ineligible
for assistance.
g. Assuming all criteria for eligibility are met, the following medical needs are considered
eligible for assistance;
- Office visits
- Urgent Care visits
- Maternity
- Medically necessary emergency room visits, tests and treatments
- Medically necessary surgery
- Physical therapy associated with eligible surgery or accidental injury
- Preauthorized tests and procedures
- Prescription costs
- Limited chiropractic care with Gold Plus plan
h. Maternity care eligibility starts after the Member has been active for 10 consecutive
months prior to conception. Eligibility for assistance starts at the time of conception
and continues through delivery for the mother and newborn. After delivery, the
newborn must be added to the Member plan to be eligible for continued assistance.
i. Preexisting conditions are evaluated during the Member needs analysis to determine
eligibility. Some conditions that put the cooperative sharing fund at risk may require a
waiver for membership.
X. Distribution of Cooperative Funds
a. All contributions accepted by Stratus Health are distributed according to participation and need. Stratus Health functions as a not-for-profit cooperative meaning that 100% of funds go to administration of the plan and member benefits.
b. The bulk of monthly Member contributions goes to the Stratus Cooperative Fund used to cover eligible requests for assistance from Members with excessive medical costs.
c. To protect the fund, no request for assistance may exceed 10% of the available fund. As
the fund grows, monies that exceed the group’s anticipated needs are returned to Members that made no requests for assistance during the previous fiscal year.