Episode 2130 notes

Misty Snodgrass is Director, ACA & Medicaid at Blue Cross Blue Shield of Kansas and she'll let us know what you Must Know if you have an ACA insurance plan.

MISTY: This is unprecedented. At BCBSKS we're doing our best to hold the rates down and even taking a hit financially. But we want to make sure that people in Kansas have access to coverage.

CARY: Like Misty said, they're more than happy to talk to you and just explain what's happening because there are a massive number of changes coming in the marketplace and ACA.

Misty leads the strategic and operational direction for the ACA line of business and oversees the Healthy Blue Medicaid partnership. She is responsible for ensuring regulatory compliance, financial performance, product and market strategy, and operational excellence. She is known for her compassionate, results-oriented approach as syays she prioritizes access, quality care, and member satisfaction—delivering sustainable success in a complex, highly regulated healthcare environment.

This is episode 2130 of America's Healthcare Advocate

Learn more about anything discussed on this program. Visit https://www.bcbsks.com/ or call 866-906-5253

Episode Producers: Audio: Garner Cowdry Camera: David Thiessen

As always, if you need help or have something to share contact me with this form on my website and let me know what's on your mind, issues you are dealing with, or other health, healthcare, and health insurance questions and concerns. Visit: https://www.americashealthcareadvocate.com/contact-us

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Announcer

And now America's Healthcare Advocate, Cary Hall.

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Cary Hall

Hello America, welcome to America's Healthcare Advocate. Show. Broadcasting coast to coast across USA here on the HIA Radio Network. My producers today Mr. Garner Cowdrey behind the microphones and Dave Thiessen behind the cameras as always. I'm Cary Hall, the host of America's Healthcare Advocate. Thank you for joining us today and making us one of the most listened to talk shows across the country.

00;00;28;08 - 00;00;47;09

Cary Hall

And you know that you can always go up on our website or on our YouTube channel and 16 podcast channels to listen to these shows. If you miss one or you want to listen to it during the week. So they're up there. So joining me in studio today, this is a show that I've wanted to do for a couple of months now because of what we see coming.

00;00;47;12 - 00;01;05;29

Cary Hall

And the show today is going to focus on ACA. We're going to talk a little bit about small Group too, but primarily what's going to happen with the ACA plans as we get close to open enrollment. So I'm going to share a little something with everybody. These are some predicted increase numbers in states in and around the Midwest.

00;01;06;02 - 00;01;41;23

Cary Hall

I've got the whole list of all 50 states. But let me give an example here. Kentucky's looking at a 29% increase. Indiana's looking at a 26% increase. Illinois 29%. Kansas on average is 30%. Joining me in studio now, Misty Snodgrass. It's going to be a big disruptive year for ACA. And by the way, Misty Is the director of ACA and, Medicaid for Blue Cross Blue Shield of Kansas, and she's here today to talk to us about that and what they are doing to try to help people.

00;01;41;26 - 00;01;51;11

Cary Hall

In terms of containing costs and get them across the board so it's shocking. I haven't seen numbers like this. I can't remember the last time I saw numbers like this.

00;01;51;12 - 00;02;08;01

Misty Snodgrass

No, this is unprecedented. Thanks so much for having me. And to your listeners, I'm really appreciative to be here to help educate on what's going on. But, yeah, these numbers are unprecedented. We're doing our best to hold that the rates down we are going to be taking, you know, a hit financially. But we want to make sure that people have access to coverage.

00;02;08;01 - 00;02;16;24

Misty Snodgrass

And so we are working really hard to help improve health outcomes here at Blue Cross Blue Shield of Kansas. But yeah these rates are unprecedented. And we've not seen anything like it.

00;02;16;26 - 00;02;37;08

Cary Hall

Yeah. Now I will say this. That level of increase does not apply to the Blue Cross Blue Shield plan, but it certainly applies to a whole host of other carriers I've seen out there. And on top of that, top cause more confusion and disruption in the marketplace: Aetna is leaving and 1 million people across the country are losing their coverage.

00;02;37;10 - 00;02;49;07

Cary Hall

So it's going to be a very disruptive year. And I think what I'm trying to do with these kinds of shows. And thank you for being here because you're truly an expert at this, is tell people what they need to do to get ready.

00;02;49;09 - 00;02;49;26

Misty Snodgrass

Yeah.

00;02;49;29 - 00;02;51;20

Cary Hall

Don't wait until

00;02;51;22 - 00;02;52;22

Misty Snodgrass

No.

00;02;52;24 - 00;03;15;00

Cary Hall

Because you know, as I told you, I’m a 27 year recovering broker from when I had Benefits by Design. We even talked, starting now, throughout up until we get to the Open Enrollment Period and it never failed. People procrastinated and waited, and then they're all trying to get in at the same time.

00;03;15;02 - 00;03;27;15

Cary Hall

And it's very, very difficult and can cause a lot of frustration and all the rest of it. So it's far better to be proactive right now. So what what are you telling people if they want to call you and consult? What are you telling people.

00;03;27;15 - 00;03;46;25

Misty Snodgrass

Yeah, no, I think I think that's a great question. I think this year is different than even the last few years, which have been a lot of a lot of changes. And so, you know, first of all, open enrollment for this year is going to go until January 15th of next year. That's changing. So just be prepared. But you know, get in early, start looking at the plans.

00;03;46;26 - 00;04;04;18

Misty Snodgrass

Start looking at the prices. Go to healthcare.gov. Go to our website bcbsks.com and start to look and see what the prices are going to be in the impact to you because you're able to plug in what prescription drugs you're using, what providers you're using, and start to see what the price of impact is going to be to you.

00;04;04;18 - 00;04;08;09

Misty Snodgrass

Because it is going to be felt by the majority of Americans.

00;04;08;11 - 00;04;11;23

Cary Hall

But if they call you guys and they just want to talk to somebody, this.

00;04;11;25 - 00;04;13;03

Misty Snodgrass

That's where yeah.

00;04;13;05 - 00;04;35;08

Cary Hall

This is where you're different than what I call the conglomo carriers, okay? Because your customer service is right there in Topeka. Yep. It's Kansans Helping in Kansans. You've won multiple awards for customer service because people can actually call and talk to somebody. Yes. Okay. And you can also do that with your local broker. Obviously if you've got a broker you've used and he's helped you or she's helped you, that's what you should do.

00;04;35;14 - 00;04;55;09

Cary Hall

As long as you can get in touch with them, do it. But otherwise they can call you, just talk to you and get get an understanding of, okay, what do I need to be concerned about? What's my plan going to look like? Like, I'm one of those people that had the Aetna plan. I'm losing my coverage, you know, or I'm one of those people who just found out I got my renewal letter and I have a 27% increase.

00;04;55;09 - 00;04;57;07

Cary Hall

Yes. All right, So talk a little bit about that.

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Misty Snodgrass

Happy to do it. We love our customer service team. They're actually part of the team I'm on. So we're able to work with them and they're they're fantastic. They want to talk to our members. They're not trying to get you off the phone. They are locally based in Kansas. You're able to answer, they're able to answer any questions, even about your claims, or your billing or what you may have and what the different kind of products that are being offered.

00;05;20;24 - 00;05;35;00

Misty Snodgrass

So they're able to help you, call the one 800 number and they're able to, you know, answer any questions that you maybe have. We also have a great sales team, that is able to actually help answer questions. And they're not trying to sell you a product. They're just trying to find the product that works best for you.

00;05;35;02 - 00;05;53;05

Misty Snodgrass

And so you're able to call either our customer service or our sales team in-house and have those questions, Or also go to brokers and be able to answer the questions you may have. Yeah. Our customer service team is second to none. They have a very quick metric related to answering. You know, a lot of people don't want to sit on a call and wait and hold, be on hold.

00;05;53;05 - 00;06;01;25

Misty Snodgrass

They answer very quickly. They answer your questions concisely, and their goal is to answer your questions on your first call. So you're not having to call back repeatedly. So they're they're wonderful.

00;06;01;27 - 00;06;27;26

Cary Hall

You've won multiple awards for this. You continue to win multiple awards for it. And you know, I always this is the example I use when you a lot of times people will call one of these national carriers or one of these call centers that’s advertising in which we see all the time on television. You get: “licensed brokers, call and they'll help you”. You call and you ask a question like, what hospitals are in Kansas City north of the river?

00;06;27;26 - 00;06;41;04

Cary Hall

And they're going, what river? Yes, yes, I'm talking to somebody that really understands the market here. Okay. So, you know, the same thing applies here if you're out in Salina. Yeah. Or you're in Topeka or you're in Wichita.

00;06;41;05 - 00;06;43;23

Misty Snodgrass

Western Kansas, very, very rural area. Yeah.

00;06;43;27 - 00;07;05;02

Cary Hall

Yeah. That that's critical. So it's important to know the state and know what's available there. And also how you marry up the providers to the program and all the rest of it. So that that's critical. I think. So before we go to break. We’ve got about two minutes left. You are in all counties in Kansas, all 103.

00;07;05;05 - 00;07;08;17

Cary Hall

A lot of the carriers arn’t. So address that right before we go to break here.

00;07;08;18 - 00;07;28;15

Misty Snodgrass

Yeah. Just to clarify, we don't have Wyandotte and Johnson because BlueKC has it. Yes, but 103 of 105 most of our competitors or the other carriers are not. They’re only in certain areas. They tend to cherry pick areas. We’re in the far you know, we touch the Colorado border. We go all the way to the frontier side of the Kansas, frontier part of our state.

00;07;28;15 - 00;07;47;15

Misty Snodgrass

And so, yeah, it is a priority for us to serve all counties, regardless of whether or not it's a profit or not for profit, mutually owned company. And so our focus is on serving Kansas, making sure we're improving health outcomes, reinvesting in our communities. And so it is a priority to be in all counties regardless of what the, you know, margin is in that in that area.

00;07;47;21 - 00;08;07;22

Cary Hall

That's one of the reasons why they're different. You know what I like to say about these local BlueCross plans? They’re main street, they're not Wall Street. We'll be right back after the break. You're listening to America's Healthcare Advocate broadcasting here on the HIA Radio Network. Coast to coast. If you want information, you can go to the website. BCBSKS.com.

00;08;07;28 - 00;08;41;25

Cary Hall

That's BCBSKS.com. The phone number. Once again, if you want to call one of those lovely people at their customer service center and they're happy to help you. 866-906-5253. 866-906-5253. Stay tuned. We'll be right back after the break. You're listening to America's Healthcare Advocate here on the HIA Radio Network. Coast to coast across USA.

00;08;41;27 - 00;09;04;14

Cary Hall

Welcome back. You're listening to America's Healthcare Advocate show broadcasting coast to coast across USA here on the HIA Radio Network. I want to do a shout out to KSAL 1150. Our great affiliate up in Salina, Kansas is very happy to be on the air there, and they're part of our family for America's Healthcare Advocate broadcast me shows out throughout Kansas in the area around Salina.

00;09;04;15 - 00;09;20;18

Cary Hall

I want to welcome them again. Little shout out to all the folks up there in studio with me, Misty Snodgrass. She is the director of ACA and Medicaid at Blue Cross and Blue Shield of Kansas, and we're talking all things ACA. We're going to do a little discussion about group here as well. But you heard in that last segment.

00;09;20;18 - 00;09;41;00

Cary Hall

Now you're going to hear me repeat this. Don't wait until the last minute. Open enrollment is going to start here. We're going to talk about that in a minute. But what you need to know is this is going to be a different year. It's going to be tsunami. There's going to be massive displacement and other issues going on. Now's the time to get ahead of this if you're on an ACA.

00;09;41;00 - 00;09;48;12

Cary Hall

So let's just go through the dates. Yeah. Because it gets a little confusing for folks. So it opens up on November 1st. Then what happens.

00;09;48;12 - 00;10;06;11

Misty Snodgrass

Yeah. So you're able to start selecting your plans or even comparison shop. But as you said start early. Don't wait until the end of December thinking that, oh, I'm going to be able to be covered January 1st. You need to be enrolled by December 15th, to be covered by January 1st, or enroll by January 15th to be covered by February 1st.

00;10;06;11 - 00;10;21;24

Misty Snodgrass

There are some special enrollment periods, but they're not the big special enrollment period that used to be there. So there are fewer events such as life events, moving, pregnancy, having a child. And so you really got to act now and things are changing by the minute. And so stay up to date as to what's happening.

00;10;22;01 - 00;10;42;17

Misty Snodgrass

We're doing our best to educate our members about what's coming down and what the changes are occurring. We're putting that in our renewal letters. We're also putting information out via social media, and our website to make sure people understand what's happening. Because, you know, there's been a lot of confusion, a lot of changes. And so make sure you stay on top of it because you can't wait because you're going to be, you know, delayed in your coverage.

00;10;42;17 - 00;10;45;03

Misty Snodgrass

And it is a major disruption in the ACA market.

00;10;45;07 - 00;10;56;04

Cary Hall

Yeah, I cannot recall and I can't how many years ago when I was doing this, writing it from the day they started, you know, ACA, Obamacare, I've never seen anything quite like this.

00;10;56;10 - 00;10;59;00

Misty Snodgrass

And Blue Cross Blue Shield Kansas has been in market.

00;10;59;03 - 00;11;07;07

Cary Hall

You were one of the pioneers. Yeah. It was you guys. Blue cross of Kansas City I think were the first carriers. We were Actually in the market. Approved and up and running.

00;11;07;07 - 00;11;21;21

Misty Snodgrass

That's right. Yeah. And a lot of people left in 2017 and 2018, but not to the degree that is happening now or the rate increases that are happening. And we've stayed. We’ve stayed the journey. Our focus is on serving Kansans. And so we're going to be here to stay even through all the turmoil we’ll do our best to educate our members.

00;11;21;21 - 00;11;38;01

Cary Hall

Yeah. You know, when you're 80 years plus, I think people can realize the Blue Cross of Kansas isn't going anywhere. Just so you understand. All right. So let's talk about four and five Kansans in the past found plans for $10 a month or less. Yeah. It and then that's going to change.

00;11;38;01 - 00;11;38;27

Misty Snodgrass

That is going to change okay.

00;11;38;28 - 00;11;43;15

Cary Hall

So let's just start with that one. And what's going to happen to the subsidy levels and all the rest of it.

00;11;43;21 - 00;11;49;29

Misty Snodgrass

Yeah. So you may or may not be aware there were increased subsidies that passed with the American Rescue Act.

00;11;49;29 - 00;11;50;26

Cary Hall

Up to 400%.

00;11;50;26 - 00;12;09;28

Misty Snodgrass

Exactly. That exactly. And so there wasn't really a big cliff. You know, the last few years post-Covid, however, those are set to expire at the end of this year. And if they are not renewed by Congress, then that's when more and more Kansas are going to be paying more and more. Like you said, you know, $10 per month, it could jump to hundreds of dollars per month.

00;12;09;28 - 00;12;27;22

Misty Snodgrass

Some estimates are it's going to increase by like approximately 70% nationwide. So it's just going to be depending on what your income is and also what subsidies you're eligible for. And so it's going to go back, if Congress doesn't act, to the original subsidies which are between is, you know, 100 and 250% of federal poverty level.

00;12;27;24 - 00;12;35;11

Misty Snodgrass

And so make sure you're checking to see if you're still eligible for subsidies, because you may get a surprise bill if you if you're not aware of it.

00;12;35;14 - 00;12;41;17

Cary Hall

So the other thing is self-affirmation. People being able to self affirm. And that was allowed.

00;12;41;17 - 00;12;42;04

Misty Snodgrass

Yep.

00;12;42;07 - 00;12;43;00

Cary Hall

It’s not allowed now.

00;12;43;07 - 00;12;45;01

Misty Snodgrass

There's a lot of changes coming. You're going to.

00;12;45;01 - 00;12;45;26

Cary Hall

Talk about some of that.

00;12;46;08 - 00;12;50;07

Misty Snodgrass

And there's court cases actually on a lot of this stuff. So it's changing by the day you know.

00;12;50;07 - 00;12;52;03

Cary Hall

We talked about that off camera before the show.

00;12;52;03 - 00;13;00;29

Misty Snodgrass

Absolutely. And so some of the things that you have to affirm that you are making a certain amount, you're new going to have to provide additional documentation. And so

00;13;00;29 - 00;13;01;11

Cary Hall

Tax returns.

00;13;01;16 - 00;13;08;13

Misty Snodgrass

Exactly. You're going to provide concrete documents as to what your income is versus saying I do make this amount. And so there's a lot of changes coming.

00;13;08;13 - 00;13;16;26

Misty Snodgrass

Make sure you're up to date with them. We're going to keep our members informed because there's court cases now pending out there. There's decisions being made. So stay abreast of all the changes that are coming.

00;13;16;26 - 00;13;40;11

Cary Hall

And once again, if this concerns you, you can give them a call. You can have a conversation just to understand what's happening or where you're going to go. All right. And then you'll understand what your choices are. If you're educated about what's going on, you can make a better decision. You know, you can always call them at 866-906-5253.

00;13;40;16 - 00;14;01;19

Cary Hall

Like Misty said, they're more than happy to talk to you and just explain what's happening because there are a massive number of changes coming in the marketplace. So what do you think's going to happen now when we see that coming in terms of the reduced subsidies, the increased costs, all the rest of it, it looks to me like a lot of people are going to start losing coverage.

00;14;01;19 - 00;14;24;29

Misty Snodgrass

I think that's a good possibility. We've estimated about 30% of Kansans, based upon the data, are going to lose their health insurance coverage because of the increased cost as well as potentially subsidies going away. And so we are doing our best to keep our rates low, and we're working on affordability. That is a top pillar of our company to make sure that we can have, you know, whether or not you're eligible for subsidies or the cost sharing reductions.

00;14;25;06 - 00;14;36;14

Misty Snodgrass

We're actually prioritizing affordability. We're working on various programs to make sure that we are, trying to keep our costs and our rates low so that we can serve more and more Kansans. That's our ultimate goal, is to serve more and more Kansans.

00;14;36;15 - 00;14;59;01

Cary Hall

And that's what you guys do really well because you're focused on Kansas. You're not in and serving all 103 counties that you serve. And that's a significantly different, task or goal rather than what we see from some of the national carriers. You know, in the marketplace. So talk a little bit about as far as, SEPs are concerned and qualifying events.

00;14;59;01 - 00;15;04;11

Cary Hall

So we're going to go to break here in a few in about two minutes. But let's do that first.

00;15;04;14 - 00;15;31;23

Misty Snodgrass

So you know it used to be you could be able to sign up for, you know, a special enrollment period year round. And that has changed. And so we're now only going to be available to have special enrollment periods for “qualifying life events”. So an example of a qualifying life event would be a job loss. We know a lot of people, especially in certain communities there's layoffs occurring and they're going to the marketplace, ACA going to healthcare.gov or going to their local carrier's website and selecting a plan.

00;15;31;25 - 00;15;47;08

Misty Snodgrass

And they are now only going to be able to do that for a job loss or for, the birth of a child or if they're moving into a different state. And so that's going to be, a different thing. You know, when ever you are able to do it much more broadly. It's only going to be during those certain types of events.

00;15;47;10 - 00;16;02;11

Cary Hall

And they're narrowing it. And I'm going to guess, based on the fact that, you know, the whole self-affirmation income thing and all the rest of its changed, that you're going to have to be able to present documentation or show 100%.

00;16;02;14 - 00;16;12;01

Misty Snodgrass

Yeah. And so it's more important than ever to explore what your options are and to get ahead of this before, you know, there's a lot of confusion or you're trying to figure this out the week of Christmas to get covered

00;16;12;03 - 00;16;13;23

Cary Hall

It's probably not a good time to be doing this.

00;16;13;25 - 00;16;15;13

Misty Snodgrass

No, no.

00;16;15;16 - 00;16;26;14

Cary Hall

Yeah. It's probably no, not when you're trying to figure out how am I going to pay for all the Christmas presents I bought. Okay. And everything else is going on now I got to figure this out probably a good idea to get in front of this a little bit.

00;16;26;14 - 00;16;39;11

Misty Snodgrass

Yes. You need to start looking ahead now, having conversations with, you know, salesmen and your brokers, your customer service teams to figure out what's happening because it is really important for getting a handle on what this is going to cost.

00;16;39;12 - 00;17;02;15

Cary Hall

Yeah. And this is going to this is going to hit a lot of Kansans. And you just heard Misty say they're anticipating 30% of the people being displaced in Kansas. I've heard that over. I've heard that from CEO of Blue Cross of Nebraska, Blue Cross of Kansas City. And now you're sitting here listening to Misty, who's the director for ACA and Medicaid, say exactly the same thing regarding Blue Cross Blue Shield of Kansas.

00;17;02;15 - 00;17;17;06

Cary Hall

So there's a lot coming and a lot of changes coming. We'll be right back after the break. We're going to talk a little bit more about how some of this is going to work, and we'll get in the weeds a little bit on some of the things that you need to understand moving forward about cost benefits and all the rest of it.

00;17;17;12 - 00;17;39;24

Cary Hall

And what are they offering at Blue Cross and Blue Shield of Kansas? We'll be right back after the break. You're listening to America's Healthcare Advocate Broadcasting here on the HIA Radio Network coast to coast across USA.

00;17;39;27 - 00;17;59;13

Cary Hall

Welcome back. You're listening to America's Healthcare Advocate show broadcasting coast to coast across USA. My producers today, Mr. Dave Thiessen, Gardner Cowdrey in studio with me, Misty Snodgrass. She is the director of ACA and Medicaid. You can obviously tell this lady knows what she's talking about. All right. And this is kind of like drinking from a firehose for a lot of

00;17;59;13 - 00;18;18;04

Cary Hall

you out there today. But the idea here is to bring information to you so you are prepared for what is about to happen. Because I've said this, you know, on a couple of shows I've done up to now, and I'm saying it again today, these changes are going to be massive, and there's going to be a lot of panic in people about what do.

00;18;18;07 - 00;18;42;26

Cary Hall

So the last thing you want to do as we've talked about is wait. Which is why if you call that customer service number at 866-906- 5253, that's not a sales number. Those people are there to help you try to understand what's in the marketplace. They're not there to try to sell you something like some of these high pressure sales outfits you see on television once again 866-906-5253 or BCBSKS.com.

00;18;43;02 - 00;18;53;20

Cary Hall

All right. So let's talk a little bit about some of the plan differences plan designs. And then specifically zero in on these silver plans. And what we're going to see with these CSRs.

00;18;53;24 - 00;19;10;28

Misty Snodgrass

Yeah. So I think that's a great question because everybody's going to be shopping and it can be really overwhelming. I know whenever I've helped a lot of friends that have what is what is the metal tier, what is what is this MOOP, what is this deductible? What are all these things meaning. And so I think it's really important to educate everyone on the benefits they're choosing.

00;19;10;28 - 00;19;23;14

Misty Snodgrass

Because you may go to the lowest price, but is it giving you the most value? Is it going to be there when you need it? Is it going to be there when you're sick? Is it going to be there if you get a diagnosis? And so I think it's really important. One of the plans that we have is a high deductible plan.

00;19;23;14 - 00;19;42;14

Misty Snodgrass

We are the only one that we know of in market that has a high deductible plan. So that gives members options for what to choose for them. And these costs, CSRs, those cost savings reduction plans are able to help, offset some of the costs associated with copays, co-insurance that might be able to, be there, there in the market, in the silver plans.

00;19;42;16 - 00;19;50;02

Misty Snodgrass

And so they're able to help, individuals that have higher specialist visits, be able to help offset those costs.

00;19;50;09 - 00;19;52;16

Cary Hall

What do they have to do to get enrolled in a CSR type program?

00;19;52;26 - 00;20;02;16

Misty Snodgrass

So they're able to see if they're eligible. So there is some income eligibility for a CSR. So it's not available to everybody. But they are able to see if they're at a certain income level whether or not they're eligible for those CSRs.

00;20;02;16 - 00;20;11;12

Cary Hall

That between the 100 and 250% income. Yep. So basically if you're in that category this can make a big difference. But if you're not in that category then you can't enroll in it.

00;20;11;13 - 00;20;24;28

Misty Snodgrass

That's right. That's right. And about 93% of Kansans are in a 100 or 250% in the ACA market. That's what it was last year. So we're hoping that a lot of individuals be able to take advantage of them. They just not may not be aware that they're available for them.

00;20;25;01 - 00;20;51;27

Cary Hall

Those are not necessarily available form a lot of these other carriers, including that high deductable plan that we're going to talk about here in a second. So again, that's another reason to reach out and get some information. So let's talk about those high deductible plans. Because as I said while we're on the break there, you know, if you've got a house with four tricycle motors running around and, you know, like my daughter, up in Washington State, and she's at the E.R. or she's at the urgent care or at the primary care every week.

00;20;52;01 - 00;20;55;21

Cary Hall

Yeah, it's a weekly class. They're all under the age of eight. Yes. Okay.

00;20;55;21 - 00;20;56;28

Misty Snodgrass

They’re on a scooter probably.

00;20;57;01 - 00;21;17;29

Cary Hall

Thank you. And so? So what she needs is very different to when somebody who's 55 or 6o needs. So talk about, where do those plans. You said that earlier the plan that's going to basically fit your need and fit your budgets. Talk about where do you see those plans. And how do they work and how does that help people in the marketplace?

00;21;17;29 - 00;21;36;19

Misty Snodgrass

Yeah, no, that's a great question, everybody. That's the important part about shopping is what does it mean to you and your family? You know, we can talk about what every one of these metal tiers are. So gold is great for individuals with chronic conditions or families with ongoing needs, or those that just want that comfort of I want to have a consistent premium.

00;21;36;19 - 00;21;54;05

Misty Snodgrass

I'm not going to have a lot of co-pays and co-insurance when I go to the doctor. So it's just kind of a peace of mind. Decision. The silver plans are really available for those individuals that are doing cost saving and, reductions or those individuals that are on those subsidies. And so they're able to be kind of a more balanced between the gold and the bronze.

00;21;54;07 - 00;22;05;29

Misty Snodgrass

They're able to give you a little bit of more peace of mind, but they're going to have a higher deductible or they're going to have a higher maximum out-of-pocket. And I think it's really important. A lot of folks are like, what's the difference between a deductible and what's the difference between a maximum out-of-pocket.

00;22;06;02 - 00;22;11;21

Misty Snodgrass

Deductible is whenever what you pay until the insurance kicks in, and then the maximum out-of-pocket is what you would pay.

00;22;11;21 - 00;22;31;05

Misty Snodgrass

So if you have a $2,000 deductible, you're going to pay until that, $2,000 amount. If you have a $10,000 maximum out-of-pocket, you're only going to pay $10,000 for the entire year for your coverage. And so it's really important to see how frequent of a user you are. So if you're going to be a higher utilizar of health care, you're going to have a chronic condition.

00;22;31;05 - 00;22;48;19

Misty Snodgrass

You might have cancer, you may have HIV. Whatever your condition may be, you might be selecting a gold plan. It’s going to provide you peace of mind and some consistency that lower maximum out-of-pocket, that lower deductible. Those silver plans are kind of those balance. People that are healthy but may have some income restrictions.

00;22;48;19 - 00;22;58;00

Misty Snodgrass

And so those are really great to be a balanced option. And then the bronze plans are available to be able to serve, those that are kind of the healthy, those that are really,

00;22;58;02 - 00;22;59;00

Cary Hall

I don't need a lot of anything.

00;22;59;01 - 00;22;59;17

Misty Snodgrass

Exactly.

00;22;59;17 - 00;23;03;02

Cary Hall

But I need to know if I wind up in the hospital. I'm not going to have $150,000 bill.

00;23;03;04 - 00;23;27;12

Misty Snodgrass

Exactly. You're kind of buying a piece of mind, essentially with a bronze plan. So it's really great for healthy individuals. And so our high deductibles, we have them in multiple metal tiers. It's called our simple silver plan. And individuals are able to see if they want to, select that high deductible plan, you know, so that they're able to have those services covered at a certain level, but they want to have a lower, price point in their premiums.

00;23;27;15 - 00;23;45;03

Cary Hall

So let's switch gears a little bit. Let's talk about formulary because this gets missed. I remember who we had Benefits by Design. When people come in for those appointments. “Please bring a list of your prescription drugs”. And they'd be like, why? Because we want to make sure they're covered. Yes, well, I have.

00;23;45;06 - 00;24;05;12

Cary Hall

I have prescription coverage. You think you have prescription coverage. You may if you're on Jardiance and your formulary doesn't cover Jardiance you're paying for it. Well, you know what that copay is? I do because my wife's on it. And before Medicare kicks in with the big deductible that's out there. Now, I was paying $400 a pop.

00;24;05;14 - 00;24;12;22

Cary Hall

Okay, that's what it costs. So talk. Why is that important for people? And they need to ask those questions.

00;24;12;22 - 00;24;29;00

Misty Snodgrass

Your formulary is like one of those devil in the details, but no one goes to look at it. So you can actually go on healthcare.gov, or you can go on our website and find out, what our formularies are and what's covered. And so we're very transparent with that. But there are different co-pays for different types of metal tiers and different types of plans.

00;24;29;07 - 00;24;44;13

Misty Snodgrass

So if you're a chronic condition, you may have a 0 to $10 copay, depending on or even $20 depending on it. But the different tier levels are going to do that. But just because it says the amount and the tier level doesn't mean that it's going to be covered, or there's not going to be a ton of steps to get there.

00;24;44;13 - 00;25;04;24

Misty Snodgrass

And so we really focus on trying to be, more, probably more liberal with our formularies. That's a typical, Blues way. We usually cover more things in our competitors, just because we also want to keep people healthy. We know that, you know, prescription drugs are by far the highest cost of our benefit. But they are what also keep some people healthy.

00;25;04;24 - 00;25;18;18

Misty Snodgrass

And so we want people to take their medications whether they have diabetes or hypertension, because that ultimately keeps people out of the emergency room and the hospital. So, our goal is to help improve outcomes, but also help reduce the total cost of care. But you need to check and see if your medications are covered.

00;25;18;21 - 00;25;31;15

Misty Snodgrass

You need to see if your PCP has covered your primary care because there are. You know, you may think, oh, I'm going to go select this plan because it's the most affordable, but your primary care or the hospital of your choice may or may not be covered. And so it's really important to look into that.

00;25;31;17 - 00;25;58;06

Cary Hall

Well, and here's the thing okay. We talked about some of the other carriers. You're the only one that's offering 103 counties. One of the biggest complaints that I hear, especially in Nebraska and Kansas, some other places, is people go on these other plans and they don't realize there's okay, I live out in Hays. Yep. I've got to drive 45 minutes to get to the primary care doc because it's not in Hays. He’s someplace else or she's someplace else.

00;25;58;08 - 00;26;04;14

Cary Hall

So you know that. And because Kansas has so many rural markets. Yes, this is.

00;26;04;14 - 00;26;20;20

Misty Snodgrass

Critical. It's absolutely vital, especially in the far parts of the southwest and northwest part of our state. But, you know, there is limited access to care. You want to make sure you have the provider of your choice that you want to go to make sure that your plan is covering that provider. And so it's really important to see who your primary care doctor is.

00;26;20;20 - 00;26;40;25

Misty Snodgrass

And another thing that we're different is we want you to go to your primary care. We're not wanting you not to use your care. We know how important primary care is in managing health conditions and, you know, doing preventative screenings, referring you to mammograms, colonoscopy. And so it's really important we encourage people to go get their annual wellness visits, which not everybody does.

00;26;40;26 - 00;26;41;15

Cary Hall

You know, they don't.

00;26;41;15 - 00;26;58;10

Misty Snodgrass

Want you to not use their care. We're looking I'm actually looking daily to see who's not using our care, because we are trying to find ways to go get them engaged, because we know ultimately our folks stay with us for a while. Like you said, they'll go try out a new plan, maybe a little more cheaper, but they're going to realize there's going to be a lot more headaches and a lot more pain with it.

00;26;58;10 - 00;27;12;25

Misty Snodgrass

And so they decided to come back to us and they're like, you're kind of worry free for us, but you're a little bit more. You might be a little bit more expensive, but we're working to do that affordability. We're hoping in the next couple years that we're going to not only be the health care plan of choice, but we're the most affordable choice as well.

00;27;12;28 - 00;27;17;22

Cary Hall

That's more of what you're mission is about. It's not about the quarterly earnings report. No.

00;27;17;24 - 00;27;19;00

Misty Snodgrass

We have no shareholders.

00;27;19;02 - 00;27;37;01

Cary Hall

Yeah. Yeah. It's a little different approach. It's a little different way of doing things. If you want help. And you know we keep urging you to keep this in mind. You know, write the phone number down or, you know, look up at their website BCBSKS.com or give them a call at 866-906-5253.

00;27;37;01 - 00;27;38;29

Cary Hall

866-906-5253.

00;27;38;29 - 00;27;49;29

Cary Hall

When I come back from the break, we're going to switch gears now and talk to all you small employers out there about what you're going to expect to see on ACA and what those plans are going to look like.

00;27;49;29 - 00;28;08;02

Cary Hall

Stay right there. We'll be right back after the break. You're listening to America's Healthcare Advocate Broadcasting here on the HIA Radio Network. Coast to coast across the USA. Stay there. We'll be right back.

00;28;08;04 - 00;28;28;10

Cary Hall

Welcome back. You're listening to America's Healthcare Advocate show broadcasting coast to coast across the USA here on the HIA radio network. All our shows are posted on 16 podcast platforms and on our YouTube channel. Got about half a million visits up there on that YouTube channel. We're getting a lot of play. And an awful lot of you are going to those podcasts.

00;28;28;10 - 00;28;44;13

Cary Hall

So thank you so much for all of you that listen on all 240 stations around the country, we appreciate all that too. So let's change topics a little bit. So the people that have been hit the hardest, are the small employers. Let's talk about what's in store for them this year.

00;28;44;15 - 00;28;50;06

Misty Snodgrass

Yeah. So we were actually able to hold our rates lower than our individuals. So that's exciting for us.

00;28;50;08 - 00;28;51;04

Cary Hall

That's amazing, frankly.

00;28;51;07 - 00;29;10;20

Misty Snodgrass

So that's a big, so it's, you know, around a 7 to 9% depending on kind of the plan that's a significant improvement with our small group. That's been a priority for us. We're working hard to make it even more affordable. And I'll tell you a little story, Cary, my dad, has been a Blue cross Blue Shield of Kansas policyholder.

00;29;10;20 - 00;29;28;24

Misty Snodgrass

He's had a small business his entire life. And has been with Blue Cross Blue Shield of Kansas for over 40 years. And so it's a priority. I know how hard it is for small business owners to me to make that real expensive decision every month. So everything that we're doing and every decision we're making is how can we make it more affordable?

00;29;28;24 - 00;29;32;16

Misty Snodgrass

Because we want to be serving more and more small, small groups in our area.

00;29;32;19 - 00;29;50;03

Cary Hall

And here's the thing. In addition to the fact that it's difficult for small employers, they have to deal with this. And by the way, 7 to 9%, that's the lowest increase I've heard in the country right now. And I've my ears pretty close to the ground that a lot of the stuff, the other carriers are nowhere around there.

00;29;50;03 - 00;30;14;28

Cary Hall

So that's a big deal. But the other thing is, in addition to the cost, there's the issue of being able to hire good employees and the issue being able to keep good employees. If you can't give people the, you know, the second question they ask is after what's my salary? What are the benefits? Yep. Okay. Well, if you if you're going to hit people with 20 and 30% increases or cost shifting, let's raise deductible.

00;30;15;04 - 00;30;24;28

Cary Hall

Raise the co-pays. Oh, and you're going to have to pay more than what you were paying as an employee, because my contribution can't be as big. That disrupts the whole workforce.

00;30;24;28 - 00;30;42;08

Misty Snodgrass

Absolutely. It's just an important benefit. We all, are passionate about, having health insurance, being able to cover it for our individuals, our employees and our families. And so we're really, really focused on that. It is a big, big bite out of every, employer's budget.

00;30;42;08 - 00;30;43;08

Cary Hall

The number two cost.

00;30;43;08 - 00;30;46;22

Misty Snodgrass

Yep. Absolutely. Sometimes even number one, you know.

00;30;46;25 - 00;30;48;09

Cary Hall

A hundred percent. Yes.

00;30;48;12 - 00;31;04;00

Misty Snodgrass

And so I every time we're making decisions, I think of my dad and you know, every decision he had to make. On whether or not, you know, can give your employees raises because of whether or not costs are going up. So we're doing our best to make sure that we are, preventing those, you know, significant rate increases.

00;31;04;00 - 00;31;22;01

Misty Snodgrass

We also have other options for our members. A lot of the products are very similar to our individual market. So we have metal tiers. We have a lot of our employers are in gold, as you can imagine. They want to provide the most robust benefits, but that may not be what your your employees may need. Depending on the age of your workforce, there's a lot of things that can factor in, so feel free to give us a call.

00;31;22;01 - 00;31;40;18

Misty Snodgrass

We're happy to help walk you through that and find the plans that work best for you and your employees. Or use a broker if you're using a broker. And a lot of small groups don't use brokers all the time. But sometimes they do. And if they're able to just call, you know, my dad has known, his individual person that he's called to go get his quotes for 20, 30 years.

00;31;40;18 - 00;31;49;26

Misty Snodgrass

I mean, our individual that our employees stay forever, you know, so they're very knowledgeable. They have relationships, which is a big thing. And they're working to fight hard to get hard to keep the lowest rates possible.

00;31;49;26 - 00;32;06;23

Cary Hall

Yeah. And something you guys do is that if you are a small group employer, you can call and get direct help and directly enroll if you need to do that. So that's great. Talk a little bit about the level premium plans. And then you know, how important is that moving forward for next year?

00;32;06;26 - 00;32;26;17

Misty Snodgrass

Yeah, we view our levels on it as an opportunity for employers that want to manage their cost based upon their population that they, their employees that they have, you know, and so we, we have a lot of level funded plans. They are very specific to the employer. So it's hard to give a lot of details just because of the complexity.

00;32;26;17 - 00;32;43;08

Misty Snodgrass

We'll walk through what kind of history you guys have with your employees. So it's different than choosing an ACA small group plan where you're kind of a group rated. That's kind of what a small group's your group if you have, you know, kind of a younger workforce, it might work better for you.

00;32;43;10 - 00;32;59;20

Misty Snodgrass

But it may not depending on the health care costs associated. So it's really important to reach out and find out if that's the best for you as an employer or your employees, and we'll be able to help you, walk you through it, guide you. And it's not you know, our folks don't get paid more because they put you in one sort of plan.

00;32;59;25 - 00;33;03;23

Misty Snodgrass

It's really the entire goal is to help you get covered and your members to be covered.

00;33;03;29 - 00;33;12;20

Cary Hall

And if they need somebody to come out and literally help them explain to you, I know you guys do it. Yeah. You're not going to get a lot of they're not in a lot of the carriers to do that.

00;33;12;20 - 00;33;13;23

Misty Snodgrass

No, no ones going to your office.

00;33;13;26 - 00;33;29;06

Cary Hall

I don't think there are any to be really honest with you. No. So let's talk a little bit about that because here's the employer trying to deal with what's going to happen next year with increases and changes. And then typically in a small business, what I always found when we were doing this was the husband didn't do that.

00;33;29;06 - 00;33;32;25

Cary Hall

If the wife worked in the business, she was the one that handled it. So yeah.

00;33;32;25 - 00;33;46;27

Misty Snodgrass

My mom is that my mom is. But she was there. She helped with the accounting and stuff, so she was always looking at that. And she's helping to look at what's best for the employees. And so absolutely you can we will come to your office gladly. And we will walk you through it.

00;33;46;27 - 00;34;08;23

Misty Snodgrass

We will also after we don't just sit there and sell the product to you or try to get you on a certain product, we actually come back and have conversations. What's working? Here's what's going on. Here's some things we want your folks to be going to make sure they're getting their annual wellness visits. Go, go encourage them to go get their annual wellness visits, because that helps you as an employer keep costs down well and also keeps your workforce healthy.

00;34;08;26 - 00;34;24;26

Misty Snodgrass

We want to help with productivity, keeping your workforce healthy. And so it's really important, to ask those questions. We will send people to your office, no matter if you have five employees or 500 employees. We really want to make sure that we're able to provide personalized, service as well as details to help you answer your question.

00;34;24;29 - 00;34;43;05

Cary Hall

They're very different approach. Yes, extremely different approach typically, than what people see out there. And a great way of doing business with what you guys do. Thank you very much for joining us today. I think we like I said, I'm sure everybody listening was like trying to drink from a firehose on this thing, but it's critical that people understand.

00;34;43;08 - 00;34;44;13

Cary Hall

So you're going to come back?

00;34;44;13 - 00;34;44;25

Misty Snodgrass

I will

00;34;44;26 - 00;34;59;06

Cary Hall

when we're going to go through the actual plans on the next show, we're going to tell people, and here's why we're not doing it today. This is changing week by week. Not because of them, but because of what's going on on the regulatory side. The legislative side, and all the rest of it.

00;34;59;06 - 00;35;04;20

Cary Hall

So the great news here is, we'll have all that information. You'll be back to do another show with me.

00;35;04;20 - 00;35;05;13

Misty Snodgrass

I'd be happy to.

00;35;05;14 - 00;35;21;01

Cary Hall

Yeah. Thank you so much for coming up today. She is Misty Snodgrass, over at Blue Cross and Blue Shield of Kansas. You know, they have a very different way of doing business. If you’re with one of those national carriers out there. You might want to ask them when the last time was they sent a rep out to your shop to talk to your folks.

00;35;21;01 - 00;35;42;14

Cary Hall

Okay. Probably didn't happen. If I had to guess. Their focus is on the people in this state, you heard them say that you know they're doing everything they can to hold cost down 7 to 9% on small group. I, I haven't seen that number anywhere else period across the country. So it's a very different way of doing business. that is they like to say it's Kansans helping Kansans.

00;35;42;14 - 00;35;58;24

Cary Hall

As I like to say they’re main street, they're not Wall Street. So they're very different at what they do. And now, ladies and gentlemen, I leave you with this thought from Albert Einstein, the one who follows the crowd, they usually get no further than the crowd, the one who walks alone is likely to find himself in places no one has ever been.

00;35;58;26 - 00;36;13;16

Cary Hall

Remember, friends, is a funny thing about life. If you refuse to accept anything but the very best, you most often get it. Thank you for listening to America's Healthcare Advocate show, broadcasting coast to coast across the USA, here on the HIA Radio Network.

00;36;13;18 - 00;36;14;29

Cary Hall

Goodbye America.