Welcome to Episode 57 of The Spokesman Speaks podcast. In this episode, Farm Bureau Heath Plan Vice President Steve Kammeyer shares the unique benefits of the Farm Bureau Health Plan (which is designed for Iowans who don’t qualify for subsidies under the Affordable Care Act) and why the plan is offering subscribers a base rate reduction in 2021.


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Narrator: Since 1934 Iowa's farmers have turned to the Iowa Farm Bureau Spokesman as their trusted news source. Now the Spokesman Speaks. Listen in and hear from leading experts on topics important to farmers and agriculture. Now here's your host.

Andrew Wheeler: The November 2nd edition of the Spokesman Speaks podcast. I'm Andrew Wheeler and I know that many of you are looking at 2021 healthcare coverage options right now. So today's episode features a conversation about the Farm Bureau Health Plan, which is a comprehensive, affordable option. And it's designed for islands who don't qualify for subsidies under the Affordable Care Act. So is the Farm Bureau Health Plan, the right plan for you? Spokesman editor Dirck Steimel sat down with Farm Bureau Health Plan, Vice President Steve Kammeyer to discuss the plan to help you make your decision.

Dirck Steimel: Steve, Farm Bureau plan is heading into its third year. Tell us why Farm Bureau created the health plan and how it's helping islands. And how is it different than other plans?

Steve Kammeyer: The Genesis of the Farm Bureau Health Plan actually probably goes back almost 10 years when the Affordable Care Act was passed in Congress and signed into law by president Obama. Up until that point, we had provided we being the Iowa Farm Bureau Federation had provided health benefits to our members for almost 40 years. We had a long standing relationship with Wellmark here in the state of Iowa to provide a unique and competitive product that was unique to our members. It was the only place it could be bought. It was a long standing program that meant a lot to our members. What the Affordable Care Act did was took away some of that flexibility that we had in terms of creating those plans, designing those plans. So when the Affordable Care Act was actually implemented in 2014, we began to see some of those impacts right away over the first three or four years of Iowa implementing the ACA our per average premium in the state of Iowa went up about 300%. At the same time, deductibles were going up. Out-Of-Pocket maximums were going up. So people actually had less coverage and they were paying a lot more for it. Now the law also put into place something called advanced premium tax credits or subsidies. And so there's a lot of people that qualify for subsidies to help them pay for these premiums. And those subsidies obviously offset some of that premium increase. A lot of people don't see that. However, there are certain groups of people that don't qualify for those subsidies. Those would be people that either have too much income or those that may have access to other coverage through a group plan or something like that. A lot of those group plans, while you may have access to them, they're unaffordable. And because they're eligible for those group plans, they don't qualify for those subsidies. So they're charged or they're required to pay the full cost of those premiums. So you can imagine when premiums are going up 300% over a period of three or four years, how difficult that becomes for someone to be able to afford it. So we actually started talking about designing a plan back in 2017. We were looking at, you know, are there different things that we could do in 2018? A bill was introduced in the Iowa legislature. It was eventually passed and signed by Governor Reynolds that allowed us to offer a health benefit plan, not to be deemed health insurance. And the reason that last piece was important is it allowed us to operate the plan without every constraint of the Affordable Care Act. Now, what I will tell you is we've gone about building this so that it looks very closely to an ACA plan. It resembles very closely to an ACA plan. So, you know, we have comprehensive coverage, we're covering all the same things. We actually modeled our benefit plans. After some of those ACA plans, we have 100% preventive coverage. We have broad provider networks. We use the Wellmark's HMO network in Iowa, which gives us access to every hospital to probably 97 or 98% of the physicians in Iowa. The two primary differences between our plan and an ACA plan is we do have a $3 million lifetime maximum on the plan. So if anyone ever did hit $3 million in total benefits paid, their coverage would end. And we do have the ability to underwrite the risk. Meaning you do have to pass underwriting in order to qualify for the plan. I can tell you that of the people that we underwrite more than 80% of them pass that underwriting and are offered an opportunity to purchase the plan. And so those two differences was to price the plan and match the plan to the risks that we're writing. Therefore it allows us to have a lower cost for the plan.

Dirck Steimel: Can you give us some examples of the types of people who are helped by the Farm Bureau Health Plan?

Steve Kammeyer: Yeah, certainly I can. I want to say right up front our plan, isn't designed to be an answer for everybody. For folks that have to buy their own insurance, because they don't have access to group coverage. And if they qualify for those subsidies, an ACA plan is absolutely probably the best choice for them. They're going to probably pay less, but if you don't qualify for those subsidies or you don't have access to affordable group coverage, that's really where it fits. So speaking recently to a young couple, they are 26, 27 years old. She was working off the farm just for benefits. So passion was being on the farm. They were trying to build something. They were trying to build something together. The Farm Bureau Health Plan allowed her to leave her employment to actually have health coverage for her and her husband at a level at, or a cost. So it was very similar to what she was paying in the group and actually a little less than what she was paying in the group. So it allowed her then to be on the farm working side by side with her husband, teacher plans are kind of interesting because a lot of educational institutions will pay a hundred percent of the premium for the member, but nothing for the family. So we've had teachers that, you know, young couples that are married, they both have individual coverage both paid for it a hundred percent. They have a baby. Now they have a family plan. It would cost them up to a thousand dollars a month to add that baby to the plan. So this is a good option for them. Early retirees, early retirees are another great example, folks that aren't yet ready. Aren't yet eligible for Medicare, but are leaving their employment at 56, 58, 62, 64, whatever it is. That's probably our second biggest demographic within the health plan is those folks that are retiring early. It's not designed for everybody. If you have access to affordable group coverage through your employer, that makes sense. If you have access to subsidies through the Affordable Care Act, that makes sense. But this plan does fit. A lot of people. The Affordable Care Act gave some people access to health insurance that they didn't have before because of their health status. But in the process of doing that, you took away access to health care for other people who now can't afford it. And so what the Farm Bureau Health Plan is designed to do is to give that access back to that group of people that isn't being helped by the Affordable Care Act or doesn't have access to that group coverage. So again, we recognize it's not a plan for everybody, but we think it's an absolute wonderful plan for a lot of people in the state of Iowa. And especially those members of ours, that because of the nature of their work farming, a small business, whatever it is, have to purchase their own health insurance.

Dirck Steimel: And it really goes back to Farm Bureau's roots of offering health care.

Steve Kammeyer: Absolutely. And I, as I said, we've been doing this now for almost 50 years. It's a longstanding benefit member benefit that we've had. It's one that we continue to take very seriously. It's one that we continue to feel a responsibility to deliver on every single day. And so, as we've designed this plan, as we've put this together, we've been very careful to make sure it's doing the right things for our members, that we're doing all the things that we would normally do with any type of insurance plan in terms of compliance and privacy and all the things that go along with that. But at the end of the day, you're right, it's here to serve our members. And that's what it was designed for.

Dirck Steimel: Steve, what are some of the enrollment options for Iowans who sign up for the health plan?

Steve Kammeyer: There are three different plan designs available. All of them basically cover the same benefits. It's just at what level they cover them. And as I said earlier, we kind of modeled those plans after the ACA plans that are out there. So we have one that has a, you know, about a $3,500 deductible. We have another one, that's a $6,000 deductible plan. And then we do have a high deductible health plan that's available. So if you're contributing to an HSA or something like that, all of the plans, as I said earlier, comprehensive in their coverage, they cover inpatient, outpatient, emergency room, preventive benefits, all the things that you would expect to plan to cover.

Dirck Steimel: How extensive is the coverage and the healthcare provider network that these enrollees can access through the health plan?

Steve Kammeyer: Yeah. So what I mentioned earlier was we utilize Wellmark as our administrator and we also utilize their HMO network. Their HMO network encompasses all the hospitals in the state of Iowa, probably 97 or 98% of physicians in Iowa. So, I mean, for the most part, every provider in the state of Iowa would be covered under this plan.

Dirck Steimel: And recently you lowered the rates for the plan. How does that affect enrollees? Why were you able to reduce the rates?

Steve Kammeyer: So we did recently announced that we were going to have a rate reduction for 2021. So for most enrollees, they will see a slight decrease in their rates for 2021. And again, it's going to be dependent on how old they are, how many people are in their family, what ages, et cetera, et cetera. But, but the majority of people will see a decrease in their rates, why we were able to do it, frankly, is because we had good experience. Our expected claims were down a little bit this year. We've had tremendous experience with Wellmark in terms of their provider network and the discounts that they're able to deliver. And that allows us to basically pass that onto our members. And that's really at the end of the day, we're here to serve the members and the best way for us to do that was to pass that savings onto them.

Dirck Steimel: The COVID-19 pandemic has affected almost everything in America. What impact has it had on healthcare coverage and in the U.S. and for the Farm Bureau plan?

Steve Kammeyer: So that's a great question. You know, there's so much about COVID that we don't know, and this is probably another one of those. What I can tell you is what the immediate impact has been. So a lot of people would think that when you have a pandemic like this, it's going to drive healthcare costs higher. And certainly for the treatment of this condition, it did. But if you'll recall back in March, when this first became more wide known and prevalent, there was a restriction placed on electro procedures. So people that were getting things like knee replacements and hip replacements and other things stopped getting them, a lot of people stopped going to the doctor, stopped going to their provider for routine care. o the net impact of that in the short term has actually been a reduction in healthcare costs. Now, what we don't know is what's the long-term implications of that. The majority of those things that were put off are going to be done. They're just going to be done a little later. So the fact that someone didn't have their knee replacement in April, they may now have it next April, or they may have it in December, whatever it is. So we don't anticipate that going away. It probably paused a lot of that. You know, the long term implications of, of the COVID costs themselves are really in, to be dependent on how widespread it continues, be, how soon a vaccine becomes available and all of the things that go along with that.

Dirck Steimel: You've noted that the Farm Bureau Health Plan offers year round enrollment. Why is that important to enrollees?

Steve Kammeyer: Yeah, it's important for us for a couple of reasons. I mean, unfortunately life doesn't always happen on a schedule. It doesn't always fit neatly into an open enrollment period at the end of the year. Now we know a lot of people look at their benefits, look at what they have for insurance during this period of time, late in the year, because that's, when you see open enrollment for the ACA plans, that's when you see open enrollment sometimes for the group plan. So a lot of people are taking a look at this time of year, but there's other times of the year that are important. I mean, people may go through a life change. They may add a family member. They may lose a family, whatever it may be. And again, the ACA allows some opportunities for those events. We basically allow year round, regardless of whether there was a life event or not. So why that's important. So take the example of the teacher. Their benefit plan runs from typically July one to June 30th. So, they may not know what those costs are going to be until midyear. So if they were pigeonholed into having to make a decision late in the year for six months down the road, they wouldn't be able to do that. This allows them or allow situations like that, where they have identified, Oh my gosh, this has changed a lot. We might want to look at the Farm Bureau Health Plan. That's an opportunity for them, but it really allows members to enroll at any point during the year

Dirck Steimel: More flexibility.

Steve Kammeyer: Yep.

Dirck Steimel: And it fits your life Better.

Steve Kammeyer: Yeah. Again, you don't have to, you don't have to stick to a quote schedule of here's when you hit, you have a six week period, and that's the only time you can enroll.

Dirck Steimel: Steve. This has been very enlightening. How can I ones find out more about the health plans and who should they contact?

Steve Kammeyer: So, I mean, what I would do is I would probably direct people first to our website. That's www.iowafbhealthplan.com. The website is going to have information for them, which will show them an outline of benefits. It'll have various forms. It has a pre enrollment checklist. If you want to look at, okay, what are the things I need to do before I enroll? What are things I want to think about? So there's a wealth of information out there. And then obviously I would have them contact their local Farm Bureau agent. Certainly if they have an agent and we hope most of you do contact that agent, they can help you with that. If you don't you can certainly go to www.fpfs.com and find an agent, or give us a call and we can help them.

Dirck Steimel: So, and that agent will help you through the process?

Steve Kammeyer: Yeah, the, the enrollment process does take place through an agent it's all electronic. So they will actually sit down with you, go through the questionnaire, you'll actually get it back, sent back to you electronically. So you'll have the opportunity to take a look at it and verify that everything's correct. Before you submit it to underwriting.

Andrew Wheeler: That's some good information from Steve to keep in mind, as you consider your health coverage options for 2021. If you think that the Farm Bureau Health Plan could be a good fit for you, head out to IowaFBhealthplan.com to learn more. And as we wrap up this episode of the Spokesman Speaks, I want to bring your attention to a couple more topics that are top of mind for a lot of folks right now, the first one is the election. So if you're hearing this on November 2nd or 3rd, and you haven't already voted, we encourage you to head out to IowaFarmBureau.com/farmersvote for any of those last minute questions you might have, including how, when or where to vote in this year's election or what kind of ID you'll need to bring with you to the polling place. The second announcement is going to be some welcome news for Hawkeye fans out there who are glad to see the return of college football and would like to turn their football tailgate into a homegate by playing the American needs, farmers home gate giveaway, which includes a quiz about the nutritional value of meat and how farmers are providing livestock care. You'll have a chance to win a prize package valued at more than a thousand dollars. The package includes a pop-up tailgate tent, a cooler $250 in meat, and much more just head out to IowaFarmBureau.com/homegategiveaway for your chance to win. And with that, we've reached the end of this episode of the Spokesman Speaks podcast. In addition to our next regularly scheduled episode on November 16th, we're going to have another special episode sometime in early November, which will feature a round table discussion with three leading ag economists. So be sure to subscribe in your favorite podcast app, because you won't want to miss these upcoming episodes. Thank you for all the work you do to serve agriculture and our entire state and thanks for listening to the Spokesman Speaks.

Narrator: Thank you for listening to the Spokesman Speaks, a podcast by Iowa Farm Bureau. Check out more podcasts and articles from the Spokesman at iowafarmbureau.com/Spokesman. You can also find and subscribe to the Spokesman Speaks Podcast on Apple Podcasts, Google Play, and other popular podcast apps. We appreciate your ratings and reviews and welcome your feedback at podcast@ifbf.org.

About The Spokesman Speaks Podcast
Since 1934, The Iowa Farm Bureau Spokesman has been Iowa’s leading agriculture news source, and today it has the largest readership of any ag newspaper in Iowa. While The Spokesman newspaper is available exclusively to Iowa Farm Bureau members, The Spokesman Speaks podcast is available publicly, providing the ag news and farmer education that matter most. You can find episodes of the podcast here or subscribe and listen in your favorite podcast app, such as Apple Podcasts, Google Podcasts, Spotify, iHeartRadio, Stitcher, TuneInRadio, or Radio.com.