Cooperative Network Federal Dairy Issues Forum

Transcription

1 Cooperative Network Federal Dairy Issues Forum DoubleTree, Rochester Thursday, October 26, 2017

2 Purpose and Mission

3 Purpose and Mission To bring quality, sustainable health care coverage to Minnesota s agricultural community Self-funded plan, designed to use a large group-like rating for farmers, their families, employees and their families 15+ years cooperative effort Cooperative Network and United Farmers Cooperative, Winthrop, Minn. Many legislative efforts, including a Congressional appropriation Rules changed and evolved 40 Square formed as a 308B co-op in 2009 With recent state legislative changes, 40 Square is now able to sponsor a joint self-insurance plan, regulated by the federal government, which will be funded through a trust 3

4 40 Square Cooperative Solutions is about: Trust Transparency Ownership

5 40 Square Co-op Ownership 308B Stock Ownership Explanation Stock capitalizes the co-op Voting Stock: $ Plan participants only One member (employer), one vote One share per employer Common Stock Class A Voting: Plan participants only, $1,000 per employer (one time) Class B Voting: Investor stock, $5,000 per share Class C Non-voting: Investor stock, $5,000 per share Preferred Stock Non-voting $1,000 per share Return on investment 5

6 40 Square Structure

7 Structure 40 Square Cooperative Solutions Required by State and Federal Law Plan sponsors Joint Self-insured Plan Funded through Trust The Consortium (a.k.a.) MEWA

8 40 Square Co-op: Governance & Structure 51% Governance Eligible Purchasing Members/Patrons 49% Governance Investment Partners The co-op is governed by a board of directors, elected by its members/patrons 8

9 Co-op Formative Board of Directors Producer Members: Robby Gieseke, Nicollet Chairman Kevin Lauwagie, Winthrop Steve Schlangen, Albany Vice Chairman Dean Sonnabend, Vernon Center Cole Trebesch, Springfield Investor Members: Cooperative Network: Curt Eischens, Minneota United Farmers Cooperative: Jeff Nielsen - Secretary/Treasurer Advisory Members: EBSO: Terri Moxley, Saint Paul General Counsel: Rich Sobalvarro, Saint Cloud 9

10 40 Square Consortium: Governance & Structure The 40 Square Consortium, separate from the co-op, will be governed by a separate board of directors, elected by consortium members Consortium Steering Committee Members: Robby Gieseke, Nicollet Kevin Lauwagie, Winthrop Steve Schlangen, Albany Dean Sonnabend, Vernon Center Cole Trebesch, Springfield The participants have an ownership interest in 100% of the Trust. This is very unique to 40 Square and it s members. 10

11 Becoming a Member of 40 Square According to the law, to become a member, they must be an employer (a farmer) who: Actively works in production agriculture in Minnesota Files either Form 1065 or Schedule F with your income tax return or provide direct services to production agriculture in Minnesota (farm corporations) Purchase Voting Stock in an amount of $ Purchase Common Stock of $1,000 over the first year Three-consecutive year commitment Has a minimum of one Common Law employee See 40 Square Consortium Common Law Employee Tool handout 11

12 Common Law Employee Simplified 40 Square Consortium eligibility requires the employer (farmers) to prove he/she had an employee Example: spouse hired to do bookkeeping and paid a wage = an employee Example: hired harvest help and paid them a wage = an employee Example: hired labor to mow lawn, using your equipment = an employee In each of these cases, a W-2 must be provided to the employee very common practice for many farmers today ***This is not tax or legal advice. Please consult with your accountant or business attorney. *** 12

13 40 Square Consortium Health Plan

14 Self-Funding (The Plan) Self-funded health plans assume the financial risk. Here is how it works: A Trust is established and is funded by premiums Stop-loss (reinsurance) is purchased to limit the risk and protect the health plan: Munich Reinsurance America Individual Aggregate Contract structure: 12/24 Actuarial review every month for reserves Federal grant funds 14

15 The Value of Self-Funding Managed by a third party administrator (TPA) Greater level of flexibility Claim utilization and reporting Able to tailor the plans based on population s needs 15

16 Medical Plans Vendor Partners 16

17 Medical Plans Handout 17

18 Medical Plans: Highlights All plans are ACA compliant and include the following: No lifetime limits, no pre-existing conditions Routine preventive care paid at 100% Doctor office visits, subject to a deductible or copay Prescription drugs, subject to a deductible or copay Hospital care, inpatient, outpatient and emergency room National Provider Network - Cigna 24/7 Telemedicine HealthiestYou Patient Advocacy - Alithias 18

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20 WE RE KICKING APPS AND TAKING CLAIMS Did You Know??? of all ER, urgent care, and doctor office visits can be safely handled over the phone or app. - Wellness Council of America congratulations your healthcare just got a whole lot easier!! 20

21 WE RE KICKING APPS AND TAKING CLAIMS Telehealth Doctors Licensed and Reside in the US All Board Certified, Licensed Physicians Diagnose, Treat and Prescribe Largest Telehealth Network in the Country 24/7 Access Service Available in 49 states (excluding Arkansas) We can handle over 70% of your typical doctor s office visits with NO CONSULT FEES! congratulations your healthcare just got a whole lot easier!! 21

22 Concierge Care Navigation Care Advocates will help members: Understand health coverage offered through the plan Understand how a claim was billed or paid Access services that require pre-certification or prior authorization Find in-network or preferred providers in their area Understand tests, treatments and medications recommended or prescribed by your physician Navigate services around complex medical conditions Resolve balance billing or duplicate billing issues Coordinate payments between multiple benefit plans Coordinate care and connect members with the appropriate support services for members medical needs 22

23 How Do the Plans Get Priced and Paid? Each person s premium is determined by: Zip Code Age Plan choice Medical background All individuals are guaranteed an offer See back of brochure for illustrative pricing example and go online to 40Square.coop to create your own personal estimate Employer (farmer s) premium payment via automatic withdrawal (a.k.a: ACH) 23

24 What s Next? Open Enrollment Who Can Help

25 What s Next? 1. Get a Quick Estimate on 2. Look online for your medical providers (doctors) 3. Attend community informational meeting 4. Discuss options with your family and broker/agent 5. Enroll during Open Enrollment November 1 st through December 15 th 25

26 Website: 26

27 Get an Estimate 27

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29 Find your doctor: 29

30 Working with Local Brokers and Agents AdvisorNetFounded in 1959 Minnesota-based independent insurance Brokerage General Agency Large network of independent insurance agents and financial advisors throughout Minnesota and the U.S. Licensed in all 50 states Provide agents and clients with access to a large and competitive mix of insurance companies and products Health, Medicare, Life, Disability, Long Term Care Farm transfer, estate and charitable planning Our independence allows for total objectivity with a focus on clients 30

31 Working with Local Brokers and Agents Training through 40 Square and AdvisorNet Allows farm families to continue to work with their trusted health insurance advisors Answer questions about the 40 Square plans Offer alternatives to the 40 Square plans when appropriate Will assist you with the application and enrollment process Available to assist with other non-health insurance-related insurances or planning needs 31

32 Why 40 Square? Engage you in future plan decisions Seek long-term sustainable health care costs Empower you through education Provide quality health plan options Create trust through transparency Will give a voice to the agricultural community YOU own your co-op and health plan 32

33 Thank You! Char Vrieze Project Manager Phone: