My Blue Cross of Kansas ACA Show-The cost of insurance premiums in the ACA are Going UP-What to Know
October 11, 2025 • 36 mins
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
Mark as Played
Transcript
Episode Transcript
Available transcripts are automatically generated. Complete accuracy is not guaranteed.
(00:01):
And now America's
Healthcare Advocate, Cary Hall.
Hello America,welcome to America's Healthcare Advocate.
Show.
Broadcasting coast to coast acrossUSA here on the HIA Radio Network.
My producers today Mr.
Garner Cowdrey
behind the microphones and Dave Thiessenbehind the cameras as always.
I'm Cary Hall,the host of America's Healthcare Advocate.
(00:23):
Thank you for joining us today
and making us one of the mostlistened to talk shows across the country.
And you know that you can always go upon our website or on our YouTube
channel and 16 podcast channelsto listen to these shows.
If you miss one oryou 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
(00:44):
for a couple of monthsnow because of what we see coming.
And the showtoday is going to focus on ACA.
We're going to talk a little bitabout small Group too,
but primarily what's going to happen
with the ACA plansas we get close to open enrollment.
So I'm going to sharea little something with everybody.
These are some predicted increase numbers
in states in and around the Midwest.
(01:06):
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 bea big disruptive year for ACA.
(01:29):
And by the way,Misty Is the director of ACA
and, Medicaid for Blue Cross BlueShield of Kansas,
and she's here todayto talk to us about that
and what they are doing to tryto help people.
In terms of containing costs and get themacross the board so it's shocking.
I haven't seen numbers like this.
I can't rememberthe last time I saw numbers like this.
(01:51):
No, this is unprecedented.
Thanks so much for having me.
And to your listeners,I'm really appreciative
to be here to help educate onwhat's going on.
But, yeah,these numbers are unprecedented.
We're doing our best to hold thatthe rates down we are going to be taking,
you know, a hit financially.
But we want to make surethat people have access to coverage.
And so we are working really hardto help improve health outcomes here
(02:11):
at Blue Cross Blue Shield of Kansas.
But yeah these rates are unprecedented.
And we've not seen anything like it.
Yeah. Now I will say this.
That level of increase does not applyto the Blue Cross Blue Shield plan,
but it certainly applies to a whole hostof other carriers I've seen out there.
And on top of that, topcause more confusion
and disruption in the marketplace: Aetna is leaving (02:29):
undefined
and 1 million people acrossthe country are losing their coverage.
So it's going to bea very disruptive year.
And I think what I'm trying to dowith these kinds of shows.
And thank you for being herebecause you're truly an expert at this,
is tell peoplewhat they need to do to get ready.
Yeah. Don't wait until No.
(02:52):
Because you know,
as I told you, I’m a
27 year recovering brokerfrom when I had Benefits by Design.
We even talked,
starting now,
throughout up until we get to the OpenEnrollment Period and it never failed.
People procrastinated and waited,and then they're all trying to get in
(03:13):
at the same time.
And it's very, very difficultand can cause a lot of frustration
and all the rest of it.
So it's farbetter to be proactive right now.
So what what are you telling peopleif they want to call you and consult?
What are you telling people.
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.
(03:35):
And so, you know,first of all, open enrollment for
this year is going to go until January15th of next year.
That's changing. So just be prepared.
But you know, get in early, startlooking at the plans.
Start looking at the prices.Go to healthcare.gov.
Go to our website bcbsks.comand start to look and see what the prices
are going to be in the impact to youbecause you're able to plug in
(03:58):
what prescription drugs you're using,what providers
you're using, and start to see whatthe price of impact is going to be to you.
Because it is going to be feltby the majority of Americans.
But if they call you guys andthey just want to talk to somebody, this.
That's where yeah.
This is where you're different than whatI call the conglomo carriers, okay?
Because your customer serviceis right there in Topeka. Yep.
(04:20):
It's Kansans Helping in Kansans.
You've won multiple awardsfor customer service
because people can actually calland talk to somebody.
Yes. Okay.
And you can also do thatwith your local broker.
Obviouslyif you've got a broker you've used
and he's helped you or she's helped you,that's what you should do.
As long as you can get in touchwith 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?
(04:44):
What's my plan going to look like?
Like, I'm one of those peoplethat had the Aetna plan.
I'm losing my coverage, you know, or I'mone of those people who just found out
I got my renewalletter and I have a 27% increase. Yes.
All right, So talka little bit about that. 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 themand they're they're fantastic.
(05:05):
They want to talk to our members.
They're not tryingto 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 productsthat are being offered.
So they're able to help you,
call the one 800 numberand they're able to,
you know, answer any questionsthat you maybe have.
(05:26):
We also have a great sales team, that isable to actually help answer questions.
And they're not trying to sell youa product.
They're just trying to find the productthat works best for you.
And so you're able to call eitherour customer service or our sales
team in-house and have those questions,Or also go to brokers
and be able to answer the questionsyou may have.
Yeah. Our customer serviceteam is second to none.
They have a very quick metricrelated to answering.
(05:49):
You know, a lot of peopledon't want to sit on a call
and wait and hold, be on hold.
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 backrepeatedly.
So they're they're wonderful.You've won multiple awards for this.
You continue to winmultiple awards for it.
And you know, I alwaysthis is the example I use when you
(06:10):
a lot of times people will call oneof these national carriers or one of these
call centers that’s advertising in whichwe see all the time on television.
You get (06:18):
“licensed brokers, call and they'll help you”.
You call and you ask a question like,
what hospitals are in Kansas Citynorth of the river?
And they're going, what river?
Yes, yes, I'm talking to somebodythat really understands the market here.
Okay.
So, you know, the same thing applies hereif you're out in Salina.
Yeah.
Or you're in Topeka or you're in Wichita.
(06:41):
Western Kansas, very, very rural area.
Yeah. Yeah.
That that's critical.
So it's important to know the stateand know what's available there.
And also how you marry up the providersto 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.
(07:05):
A lot of the carriers arn’t.
So address thatright before we go to break here. Yeah.
Just to clarify, we don't have Wyandotteand Johnson because BlueKC has it.
Yes, but 103 of 105 most of ourcompetitors or the other carriers are not.
They’re only in certain areas.
They tend to cherry pick areas.
We’re in the faryou know, we touch the Colorado border.
We go all the way to the frontier
(07:25):
side ofthe Kansas, frontier part of our state.
And so, yeah, it is a priorityfor us to serve all counties, regardless
of whether or not it's a profitor 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 priorityto be in all counties
regardless of what the, you know,margin is in that in that area.
(07:47):
That's one of the reasonswhy they're different.
You know what I like to sayabout 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'sHealthcare Advocate
broadcasting here on the HIARadio Network.
Coast to coast.
If you want information,you can go to the website.
BCBSKS.com.
(08:07):
That's BCBSKS.com.
The phone number.
Once again,
if you want to call one of thoselovely people
at their customer service centerand 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 HealthcareAdvocate here on the HIA Radio Network.
(08:29):
Coast to coast across USA.
Welcome back.
You're listening to America'sHealthcare Advocate show broadcasting
coast to coast across USA here on the HIARadio Network.
(08:49):
I want to do a shout out to KSAL 1150.
Our great affiliate up in Salina, Kansasis very happy to be on the air there,
and they're part of our familyfor America's Healthcare Advocate
broadcast me shows out throughoutKansas in the area around Salina.
I want to welcome them again.
Little shout out to all the folks up therein studio with me, Misty Snodgrass.
She is the director of ACAand Medicaid at Blue Cross
(09:12):
and Blue Shield of Kansas,and we're talking all things ACA.
We're going to do a little discussionabout group here as well.
But you heard in that last segment.
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 thatin a minute.
But what you need to know isthis is going to be a different year.
It's going to be tsunami.
(09:33):
There's going to be massive displacementand other issues going on.
Now's the time to get ahead of thisif you're on an ACA.
So let's just go through the dates. Yeah.
Because it gets a little confusingfor folks.
So it opens up on November 1st.
Then what happens.
Yeah.
So you're able to start selectingyour plans or even comparison shop.
But as you said start early.
(09:54):
Don't wait until the end of Decemberthinking that, oh, I'm
going to be able to be coveredJanuary 1st.
You need to be enrolled by December 15th,to be covered by January 1st,
or enroll by January 15thto be covered by February 1st.
There are some special enrollment periods,
but they're not the big special enrollmentperiod that used to be there.
So there are fewer events such as lifeevents, moving, pregnancy, having a child.
(10:16):
And so you really got to act nowand things are changing by the minute.
And so stay up to dateas to what's happening.
We're doing our bestto educate our members
about what's coming downand what the changes are occurring.
We're putting that in our renewal letters.
We're also putting information outvia social media,
and our website to make surepeople understand what's happening.
Because, you know, there'sbeen a lot of confusion, a lot of changes.
(10:37):
And so make sure you stay on top of itbecause you can't
wait because you're going to be,you know, delayed in your coverage.
And it is a major disruption in the ACAmarket.
Yeah, I cannot recalland 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.
And Blue Cross Blue ShieldKansas has been in market.
(10:59):
You were one of the pioneers. Yeah.
It was you guys.
Blue cross of Kansas CityI think were the first carriers.
We were Actually in the market.Approved and up and running.
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 increasesthat 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’lldo our best to educate our members.
(11:21):
Yeah.
You know, when you're 80 years plus,
I think people can realize the BlueCross of Kansas isn't going anywhere.
Just so you understand.
All right.
So let's talk about four and five Kansans
in the pastfound plans for $10 a month or less.
Yeah. It and then that's going to change.
That is going to changeokay. So let's just start with that one.
And what's going to happen to the subsidylevels and all the rest of it.
(11:43):
Yeah.
So you may or may not be awarethere were increased subsidies
that passed with the American Rescue Act.
Up to 400%. 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 expireat the end of this year.
And if they are not renewed by Congress,then that's when more and more
Kansasare going to be paying more and more.
(12:05):
Like you said, you know, $10 per month,it could jump to hundreds of dollars
per month.
Some estimates are it's going to increaseby like approximately 70% nationwide.
So it's just going to be depending onwhat your income is and also what
subsidies you're eligible for.
And so it's going to go back, if Congressdoesn't act, to the original subsidies
which are between is, you know,100 and 250% of federal poverty level.
(12:27):
And so make sure you're checking to seeif you're still eligible for subsidies,
because you may get a surprise billif you if you're not aware of it.
So the other thing is self-affirmation.
People being able to self affirm.
And that was allowed. Yep. It’snot allowed now.
There's a lot of changes coming.
You're going to. Talk about some of that.
And there's court casesactually on a lot of this stuff.
(12:48):
So it's changing by the day you know.
We talked about that off camerabefore the show. Absolutely.
And so some of the thingsthat you have to affirm
that you are making a certain amount,you're new going to have to provide
additional documentation.And so Tax returns.
Exactly.
You're going to provide concrete documentsas to what your income is versus
saying I do make this amount.
And so there's a lot of changes coming.
(13:08):
Make sure you're up to date with them.
We're going to keep our members informed
because there's court casesnow pending out there.
There's decisions being made.
So stay abreast of all the changesthat are coming.
And once again, if
this concernsyou, you can give them a call.
You can have a conversationjust to understand
what's happeningor where you're going to go.
All right.
(13:28):
And then you'll understandwhat 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.
Like Misty said,they're more than happy to talk to you
and just explain what's happening
because there are a massive numberof changes coming in the marketplace.
So what do you think's going to happennow when we see that
(13:52):
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.I think that's a good possibility.
We've estimated about 30% of Kansans,based upon the data,
are going to lose their healthinsurance coverage
because of the increased cost as wellas potentially subsidies going away.
(14:13):
And so we are doing our bestto 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 subsidiesor the cost sharing reductions.
We're actually prioritizing affordability.
We're working on various programsto make sure that we are,
trying to keep our costs and our rates lowso that we can serve
more and more Kansans.
(14:34):
That's our ultimate goal,is to serve more and more Kansans.
And that's what you guys do really wellbecause 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 fromsome of the national carriers.
You know, in the marketplace.
So talk a little bit about as far as,SEPs are concerned and qualifying events.
(14:59):
So we're going to go to break herein a few in about two minutes.
But let's do that first.
So you know it used to beyou could be able to sign up for,
you know, a special enrollmentperiod year round.
And that has changed.
And so we'renow only going to be available
to have special enrollment periodsfor “qualifying life events”.
So an example of a qualifying lifeevent would be a job loss.
(15:20):
We know a lot of people,especially in certain communities
there's layoffs occurring
and they're going to the marketplace, ACAgoing to healthcare.gov
or going to their local carrier'swebsite and selecting a plan.
And they are now only going to be ableto do that for a job loss or for,
the birth of a child orif they're moving into a different state.
And so that's going to be,a different thing.
(15:42):
You know, when everyou are able to do it much more broadly.
It's only going to be duringthose certain types of events.
And they're narrowing it.
And I'm going to guess, based on the factthat, you know,
the whole self-affirmation income thingand all the rest of its changed,
that you're going to have to be ableto present documentation
or show 100%.
(16:02):
Yeah.
And so it's more important than everto 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 outthe week of Christmas to get covered
It's probably not a good timeto be doing this.
No, no.
Yeah.
It's probably no,
not when you're trying to figure outhow am I going to pay
for all the Christmas presentsI bought. Okay.
And everything else is going on nowI got to figure this out
(16:24):
probably a good ideato get in front of this a little bit. Yes.
You need to start looking aheadnow, having conversations with, you know,
salesmen and your brokers,your customer service teams
to figure out what's happeningbecause it is really important
for getting a handleon what this is going to cost. Yeah.
And this is going tothis 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.
(16:48):
I've heard that over.
I've heard that from CEO of Blue Crossof Nebraska, Blue Cross of Kansas City.
And now you're sitting herelistening to Misty,
who's the director for ACA and Medicaid,say exactly the same thing
regarding Blue Cross BlueShield of Kansas.
So there's a lot comingand a lot of changes coming.
We'll be right back after the break.
We're going to talk a little bit moreabout how some of this is going to work,
(17:09):
and we'll get in the weeds a little bit onsome of the things that you need
to understand moving forward about costbenefits and all the rest of it.
And what are they offering atBlue Cross and Blue Shield of Kansas?
We'll be right back after the break.
You're listening to America'sHealthcare Advocate Broadcasting
here on the HIARadio Network coast to coast across USA.
(17:39):
Welcome back.
You're listening to America's
Healthcare Advocate showbroadcasting coast to coast across USA.
My producers today, Mr.
Dave Thiessen, Gardner Cowdrey in studiowith me, Misty Snodgrass.
She is the director of ACA and Medicaid.
You can obviously tellthis lady knows what she's talking about.
All right.
And this is kind of like drinking from afirehose for a lot of you out there today.
(18:00):
But the idea hereis to bring information to you
so you are preparedfor 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 panicin people about what do.
So the last thing you want to doas we've talked about is wait.
(18:20):
Which is why if you call that customerservice number at 866-906-
5253, that's not a sales number.
Those people are there to help you tryto understand what's in the marketplace.
They're not there to try to sell yousomething like some of these high pressure
sales outfits you see on televisiononce again 866-906-5253 or BCBSKS.com.
(18:43):
All right.
So let's talk a little bit aboutsome of the plan differences plan designs.
And then specifically zeroin on these silver plans.
And what we're going to seewith these CSRs.
Yeah.
So I think that's a great questionbecause everybody's going to be shopping
and it can be really overwhelming.
I know whenever I've helped
a lot of friends that havewhat is what is the metal tier, what is
(19:03):
what is this MOOP,what is this deductible?
What are all these things meaning.
And so I think it's really importantto educate everyone on the benefits
they're choosing.
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 thereif you get a diagnosis?
And so I think it's really important.
One of the plans that we haveis a high deductible plan.
(19:23):
We are the only one that we know ofin market that has a high deductible plan.
So that gives members options for whatto choose for them.
And these costs, CSRs, those cost savingsreduction 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.
And so they're able to help, individualsthat have higher
(19:47):
specialist visits,be able to help offset those costs.
What do they have to do to get enrolledin a CSR type program?
So they're able to seeif they're eligible.
So there is some income eligibilityfor a CSR.
So it's not available to everybody.
But they are able to seeif they're at a certain
income level whether or notthey're eligible for those CSRs.
That between the 100 and 250% income. Yep.
So basically if you're in that categorythis can make a big difference.
(20:08):
But if you're not in that categorythen you can't enroll in it.
That's right.
That's right.
And about 93% of Kansans are in a 100or 250% in the ACA market.
That's what it was last year.
So we're hoping that a lot of individualsbe able to take advantage of them.
They just not may not be awarethat they're available for them.
Those are not necessarily available forma lot of these other carriers,
(20:29):
including that high deductable planthat we're going to talk about here
in a second.
So again, that's another reasonto reach out and get some information.
So let's talk about those highdeductible plans.
Because as I said while we're on the breakthere, you know, if you've got a house
with four tricycle motors running aroundand, you know, like my daughter,
up in Washington State,and she's at the E.R.
or she's at the urgent careor at the primary care every week.
(20:52):
Yeah, it's a weekly class.
They're all under the age of eight. Yes.
Okay. They’re on a scooter probably.
Thank you. And so?
So what she needs is very differentto 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 needand fit your budgets.
Talk about where do you see those plans.
(21:14):
And how do they work and how does thathelp people in the marketplace?
Yeah, no, that's a great question,everybody.
That's the
important part about shopping iswhat does it mean to you and your family?
You know, we can talk about whatevery one of these metal tiers are.
So gold is great
for individuals with chronic conditionsor families with ongoing needs,
or those that just want that comfort ofI want to have a consistent premium.
(21:36):
I'm not going to have a lot of co-paysand co-insurance when I go to the doctor.
So it's just kind of a peace of mind.
Decision.
The silver plans are really availablefor those individuals that are doing cost
saving and, reductions or thoseindividuals that are on those subsidies.
And so they're able to be kind of a morebalanced between the gold and the bronze.
They're able to give youa little bit of more peace of mind,
but they're going to havea higher deductible
(21:57):
or they're going to have a higher maximumout-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 differencebetween a maximum out-of-pocket.
Deductible is whenever what you payuntil the insurance kicks in,
and then the maximum out-of-pocketis what you would pay.
So if you have a $2,000 deductible, you'regoing to pay until that, $2,000 amount.
If you have a $10,000 maximumout-of-pocket,
(22:19):
you're only going to pay $10,000for the entire year for your coverage.
And so it's really importantto 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.
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 mindand some consistency
(22:40):
that lower maximum out-of-pocket,that lower deductible.
Those silver plansare kind of those balance.
People that are healthybut may have some income restrictions.
And so those are really greatto be a balanced option.
And then the bronze plans are availableto be able to serve,
those that are kind of the healthy,those that are really,
I don't need a lot of anything. Exactly.
But I need to knowif I wind up in the hospital.
(23:01):
I'm not going to have $150,000 bill.
Exactly.
You're kind of buying a piece of mind,essentially with a bronze plan.
So it's really greatfor 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 seeif they want to, select that high
deductible plan,you know, so that they're able to have
(23:21):
those services covered at a certain level,
but they want to have a lower,price point in their premiums.
So let's switch gears a little bit.
Let's talk about formularybecause this gets missed.
I remember who we had Benefits by Design.
When people come infor those appointments.
“Pleasebring a list of your prescription drugs”.
And they'd be like, why?
Because we want to make surethey're covered.
(23:43):
Yes, well, I have.
I have prescription coverage.
You think you have prescription coverage.
You may if you're on Jardiance
and your formulary doesn't cover Jardianceyou're paying for it.
Well, you know what that copay is?
I do because my wife's on it.
And before Medicare kicks inwith the big deductible that's out there.
Now, I was paying $400 a pop.
(24:05):
Okay, that's what it costs. So talk.
Why is that important for people?
And they need to ask those questions.
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 areand what's covered.
And so we're very transparent with that.
But there are different co-paysfor different types of metal tiers
(24:27):
and different types of plans.
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 tierlevels are going to do that.
But just because it says the amountand the tier level
doesn't meanthat it's going to be covered,
or there's not going to bea ton of steps to get there.
And so we really focus on trying to be,
more, probably more liberalwith our formularies.
(24:49):
That's a typical, Blues way.
We usually cover more thingsin our competitors, just because
we also want to keep people healthy.
We know that,
you know, prescription drugs are by farthe highest cost of our benefit.
But they arewhat also keep some people healthy.
And so we want peopleto take their medications
whether they have diabetesor hypertension,
because that ultimately keeps people outof the emergency room and the hospital.
(25:12):
So, our goal is to help improve outcomes,
but also helpreduce the total cost of care.
But you need to checkand see if your medications are covered.
You need to see if your PCP has coveredyour 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 choicemay or may not be covered.
And so it's really importantto look into that.
Well, and here's the thing okay.
(25:33):
We talked about some of the othercarriers.
You'rethe only one that's offering 103 counties.
One of the biggest complaintsthat I hear, especially in Nebraska
and Kansas, some other places, is peoplego on these other plans
and they don't realize there's okay,I live out in Hays. Yep.
I've got to drive 45 minutesto get to the primary care doc
(25:54):
because it's not in Hays.
He’s someplace elseor she's someplace else.
So you know that.
And because Kansas has so many ruralmarkets.
Yes, this is.
Critical.
It's absolutely vital,especially in the far parts
of the southwestand northwest part of our state.
But, you know,there is limited access to care.
You want to make sureyou have the provider of your choice
(26:14):
that you want to go to make surethat your plan is covering that provider.
And so it's really importantto see who your primary care doctor is.
And another thing that we're different iswe want you to go to your primary care.
We're not wanting younot to use your care.
We know how important primary careis in managing health conditions and,
you know, doing preventative screenings,referring you to mammograms, colonoscopy.
(26:35):
And so it's really importantwe encourage people to go get
their annual wellness visits,which not everybody does.
You know, they don't. Want you to not usetheir care.
We're looking I'm actually looking dailyto see who's not using our care,
because we are trying to find ways to goget them engaged, because we know
ultimatelyour 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
(26:56):
going to be a lot more headachesand a lot more pain with it.
And so they decided to come back to usand 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 thataffordability.
We're hoping in the next couple yearsthat we're going to not only be the
health care plan of choice, butwe're the most affordable choice as well.
That's more of what you'remission is about.
It's not about the quarterlyearnings report. No.
(27:17):
We have no shareholders.
Yeah. Yeah.
It's a little different approach.
It's a little different wayof doing things.
If you want help.
And you knowwe 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.
866-906-5253.
(27:38):
When I come back from the break,we're going to switch gears now
and talk to allyou small employers out there
about whatyou're going to expect to see on ACA
and what those plansare going to look like.
Stay right there. We'll be right backafter the break.
You're listening to America'sHealthcare Advocate
Broadcasting here on the HIARadio Network.
Coast to coast across the USA.
(27:59):
Stay there. We'll be right back.
Welcome back.
You're listening to America's HealthcareAdvocate show broadcasting coast to coast
across the USA here on the HIAradio network.
All our shows are posted on 16 podcastplatforms and on our YouTube channel.
(28:21):
Got about half a million visitsup there on that YouTube channel.
We're getting a lot of play.
And an awful lot of youare going to those podcasts.
So thank you so much for all of youthat 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 hitthe hardest, are the small employers.
(28:41):
Let's talk about what's in store for themthis year.
Yeah.
So we were actually able to hold our rateslower than our individuals.
So that's exciting for us. That'samazing, frankly.
So that's a big, so it's, you know, arounda 7 to 9% depending on kind of the plan
that's a significant improvementwith our small group.
That's been a priority for us.
We're workinghard to make it even more affordable.
(29:04):
And I'll tell you a little story, Cary,my dad, has been a Blue
cross Blue Shield of Kansas policyholder.
He's had a small business his entire life.
And has been with Blue Cross BlueShield of Kansas for over 40 years.
And so it's a priority.
I know how hard it is for small businessowners to me
to make that real expensive decisionevery month.
(29:24):
So everything that we're doingand every decision we're making is
how can we make it more affordable?
Because we want to be serving moreand more small, small groups in our area.
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 increaseI've heard in the country right now.
(29:45):
And I've my ears pretty closeto the ground that a lot of the stuff,
the other carriersare nowhere around there.
So that's a big deal.
But the other thingis, in addition to the cost,
there's the issue of being able to hiregood employees and the issue
being able to keep good employees.
If you can't give people the,
you know, the second questionthey ask is after what's my salary?
What are the benefits? Yep.
(30:06):
Okay.
Well, if you if you're going to hit peoplewith 20 and 30% increases
or cost shifting, let's raise deductible.
Raise the co-pays.
Oh, and you're going to have to pay morethan what you were paying
as an employee,because my contribution can't be as big.
That disrupts the whole workforce.Absolutely.
It's just an important benefit.
(30:27):
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.
The number two cost. Yep. Absolutely.
Sometimes even number one, you know.
A hundred percent. Yes.
(30:48):
And so I every timewe're making decisions, I think of my dad
and you know, every decisionhe had to make.
On whether or not, you know,can give your employees raises
because ofwhether or not costs are going up.
So we're doing our bestto make sure that we are,
preventing those,you know, significant rate increases.
We also have other optionsfor our members.
A lot of the products are very similarto our individual market.
(31:08):
So we have metal tiers.
We have a lot of ouremployers are in gold, as you can imagine.
They want to provide the most robustbenefits, 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 factorin, so feel free to give us a call.
We're happy to help
walk you through that and find the plansthat work best for you and
your employees.
Or use a broker if you're using a broker.
(31:29):
And a lot of small groupsdon'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 calledto go get his quotes for 20, 30 years.
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 gethard to keep the lowest rates possible.
(31:49):
Yeah.
And something you guys dois that if you are a small group employer,
you can call and get direct help anddirectly enroll if you need to do that.
So that's great.
Talk a little bit about the levelpremium plans.
And then you know, how importantis that moving forward for next year?
Yeah, we view our levels on itas an opportunity for employers
(32:10):
that want to manage their costbased 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 detailsjust because of the complexity.
We'll walk through what kind of historyyou guys have with your employees.
(32:31):
So it's different than choosing an ACAsmall group plan
where you're kind of a group rated.
That's kind of what a small group'syour group if you have,
you know, kind of a younger workforce,it might work better for you.
But it may not depending on
the health care costs associated.
So it's really important to reach outand find out if that's the best for you
as an employer or your employees,
(32:53):
and we'll be able to help you, walkyou through it, guide you.
And it's not
you know, our folks don't get paid morebecause they put you in one sort of plan.
It's really
the entire goal is to help you get coveredand your members to be covered.
And if they need somebody to come outand literally help them explain to you,
I know you guys do it. Yeah.
You're not going to get a lot of they'renot in a lot of the carriers to do that.
No, no ones going to your office.
(33:13):
I don't think there are anyto be really honest with you. No.
So let's talk a little bit about thatbecause here's the employer
trying to deal with what's going to happennext year with increases and changes.
And then typicallyin a small business, what
I always found when we were doingthis was the husband didn't do that.
If the wife worked in the business,she was the one that handled it.
So yeah. My mom is that my mom is.
(33:34):
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 bestfor the employees.
And so absolutely you canwe will come to your office gladly.
And we will walk you through it.
We will also after
we don't just sit there
and sell the product to youor try to get you on a certain product,
we actually come backand have conversations.
(33:54):
What's working?
Here's what's going on.
Here's some things we wantyour folks to be going to make sure
they're getting their annual wellnessvisits.
Go, go encourage themto go get their annual wellness visits,
because that helps you as an employerkeep costs down
well and also keeps your workforcehealthy.
We want to help with productivity,keeping your workforce healthy.
And so it's really important,to ask those questions.
(34:14):
We will send people to your office,
no matter if you have five employeesor 500 employees.
We really want to make surethat we're able to provide personalized,
service as well as details to helpyou answer your question.
They're very different approach.
Yes, extremely different approachtypically, than what people see out there.
And a great way of doing businesswith what you guys do.
Thank you very much for joining us today.
(34:35):
I think we like I said, I'msure everybody listening was like trying
to drink from a firehose on this thing,but it's critical that people understand.
So you're going to come back?
I will when we're going to gothrough the actual plans on the next show,
we're going to tell people, and here'swhy we're not doing it today.
This is changing week by week.
Not because of them, but because of what'sgoing on on the regulatory side.
(34:57):
The legislative side,and all the rest of it.
So the great news hereis, we'll have all that information.
You'll be back to do another showwith me. I'd be happy to.
Yeah.Thank you so much for coming up today.
She is Misty Snodgrass, over at Blue Crossand Blue Shield of Kansas.
You know, they have a very different wayof doing business.
If you’re with one of thosenational carriers out there.
You might want to ask themwhen the last time was
(35:18):
they sent a rep out to your shopto talk to your folks. Okay.
Probably didn't happen. If I had to guess.
Their focus is on the peoplein this state, you heard them say that
you know
they're doing everything they canto hold cost down 7 to 9% on small group.
I, I haven't seen that numberanywhere else period across the country.
So it's a very different wayof doing business.
(35:39):
that is they like to say it's Kansanshelping Kansans.
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 youwith 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 placesno one has ever been.
Remember,friends, is a funny thing about life.
(36:00):
If you refuse to accept anythingbut the very best, you most often get it.
Thank you for listening to America'sHealthcare Advocate show, broadcasting
coast to coast across the USA,here on the HIA Radio Network.
Goodbye America.
And now America's
Healthcare Advocate, Cary Hall.
Hello America,welcome to America's Healthcare Advocate.
Show.
Broadcasting coast to coast acrossUSA here on the HIA Radio Network.
My producers today Mr.
Garner Cowdrey
behind the microphones and Dave Thiessenbehind the cameras as always.
I'm Cary Hall,the host of America's Healthcare Advocate.
(00:23):
Thank you for joining us today
and making us one of the mostlistened to talk shows across the country.
And you know that you can always go upon our website or on our YouTube
channel and 16 podcast channelsto listen to these shows.
If you miss one oryou 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
(00:44):
for a couple of monthsnow because of what we see coming.
And the showtoday is going to focus on ACA.
We're going to talk a little bitabout small Group too,
but primarily what's going to happen
with the ACA plansas we get close to open enrollment.
So I'm going to sharea little something with everybody.
These are some predicted increase numbers
in states in and around the Midwest.
(01:06):
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 bea big disruptive year for ACA.
(01:29):
And by the way,Misty Is the director of ACA
and, Medicaid for Blue Cross BlueShield of Kansas,
and she's here todayto talk to us about that
and what they are doing to tryto help people.
In terms of containing costs and get themacross the board so it's shocking.
I haven't seen numbers like this.
I can't rememberthe last time I saw numbers like this.
(01:51):
No, this is unprecedented.
Thanks so much for having me.
And to your listeners,I'm really appreciative
to be here to help educate onwhat's going on.
But, yeah,these numbers are unprecedented.
We're doing our best to hold thatthe rates down we are going to be taking,
you know, a hit financially.
But we want to make surethat people have access to coverage.
And so we are working really hardto help improve health outcomes here
(02:11):
at Blue Cross Blue Shield of Kansas.
But yeah these rates are unprecedented.
And we've not seen anything like it.
Yeah. Now I will say this.
That level of increase does not applyto the Blue Cross Blue Shield plan,
but it certainly applies to a whole hostof other carriers I've seen out there.
And on top of that, topcause more confusion
and disruption in the marketplace: Aetna is leaving (02:29):
undefined
and 1 million people acrossthe country are losing their coverage.
So it's going to bea very disruptive year.
And I think what I'm trying to dowith these kinds of shows.
And thank you for being herebecause you're truly an expert at this,
is tell peoplewhat they need to do to get ready.
Yeah. Don't wait until No.
(02:52):
Because you know,
as I told you, I’m a
27 year recovering brokerfrom when I had Benefits by Design.
We even talked,
starting now,
throughout up until we get to the OpenEnrollment Period and it never failed.
People procrastinated and waited,and then they're all trying to get in
(03:13):
at the same time.
And it's very, very difficultand can cause a lot of frustration
and all the rest of it.
So it's farbetter to be proactive right now.
So what what are you telling peopleif they want to call you and consult?
What are you telling people.
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.
(03:35):
And so, you know,first of all, open enrollment for
this year is going to go until January15th of next year.
That's changing. So just be prepared.
But you know, get in early, startlooking at the plans.
Start looking at the prices.Go to healthcare.gov.
Go to our website bcbsks.comand start to look and see what the prices
are going to be in the impact to youbecause you're able to plug in
(03:58):
what prescription drugs you're using,what providers
you're using, and start to see whatthe price of impact is going to be to you.
Because it is going to be feltby the majority of Americans.
But if they call you guys andthey just want to talk to somebody, this.
That's where yeah.
This is where you're different than whatI call the conglomo carriers, okay?
Because your customer serviceis right there in Topeka. Yep.
(04:20):
It's Kansans Helping in Kansans.
You've won multiple awardsfor customer service
because people can actually calland talk to somebody.
Yes. Okay.
And you can also do thatwith your local broker.
Obviouslyif you've got a broker you've used
and he's helped you or she's helped you,that's what you should do.
As long as you can get in touchwith 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?
(04:44):
What's my plan going to look like?
Like, I'm one of those peoplethat had the Aetna plan.
I'm losing my coverage, you know, or I'mone of those people who just found out
I got my renewalletter and I have a 27% increase. Yes.
All right, So talka little bit about that. 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 themand they're they're fantastic.
(05:05):
They want to talk to our members.
They're not tryingto 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 productsthat are being offered.
So they're able to help you,
call the one 800 numberand they're able to,
you know, answer any questionsthat you maybe have.
(05:26):
We also have a great sales team, that isable to actually help answer questions.
And they're not trying to sell youa product.
They're just trying to find the productthat works best for you.
And so you're able to call eitherour customer service or our sales
team in-house and have those questions,Or also go to brokers
and be able to answer the questionsyou may have.
Yeah. Our customer serviceteam is second to none.
They have a very quick metricrelated to answering.
(05:49):
You know, a lot of peopledon't want to sit on a call
and wait and hold, be on hold.
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 backrepeatedly.
So they're they're wonderful.You've won multiple awards for this.
You continue to winmultiple awards for it.
And you know, I alwaysthis is the example I use when you
(06:10):
a lot of times people will call oneof these national carriers or one of these
call centers that’s advertising in whichwe see all the time on television.
You get (06:18):
“licensed brokers, call and they'll help you”.
You call and you ask a question like,
what hospitals are in Kansas Citynorth of the river?
And they're going, what river?
Yes, yes, I'm talking to somebodythat really understands the market here.
Okay.
So, you know, the same thing applies hereif you're out in Salina.
Yeah.
Or you're in Topeka or you're in Wichita.
(06:41):
Western Kansas, very, very rural area.
Yeah. Yeah.
That that's critical.
So it's important to know the stateand know what's available there.
And also how you marry up the providersto 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.
(07:05):
A lot of the carriers arn’t.
So address thatright before we go to break here. Yeah.
Just to clarify, we don't have Wyandotteand Johnson because BlueKC has it.
Yes, but 103 of 105 most of ourcompetitors or the other carriers are not.
They’re only in certain areas.
They tend to cherry pick areas.
We’re in the faryou know, we touch the Colorado border.
We go all the way to the frontier
(07:25):
side ofthe Kansas, frontier part of our state.
And so, yeah, it is a priorityfor us to serve all counties, regardless
of whether or not it's a profitor 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 priorityto be in all counties
regardless of what the, you know,margin is in that in that area.
(07:47):
That's one of the reasonswhy they're different.
You know what I like to sayabout 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'sHealthcare Advocate
broadcasting here on the HIARadio Network.
Coast to coast.
If you want information,you can go to the website.
BCBSKS.com.
(08:07):
That's BCBSKS.com.
The phone number.
Once again,
if you want to call one of thoselovely people
at their customer service centerand 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 HealthcareAdvocate here on the HIA Radio Network.
(08:29):
Coast to coast across USA.
Welcome back.
You're listening to America'sHealthcare Advocate show broadcasting
coast to coast across USA here on the HIARadio Network.
(08:49):
I want to do a shout out to KSAL 1150.
Our great affiliate up in Salina, Kansasis very happy to be on the air there,
and they're part of our familyfor America's Healthcare Advocate
broadcast me shows out throughoutKansas in the area around Salina.
I want to welcome them again.
Little shout out to all the folks up therein studio with me, Misty Snodgrass.
She is the director of ACAand Medicaid at Blue Cross
(09:12):
and Blue Shield of Kansas,and we're talking all things ACA.
We're going to do a little discussionabout group here as well.
But you heard in that last segment.
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 thatin a minute.
But what you need to know isthis is going to be a different year.
It's going to be tsunami.
(09:33):
There's going to be massive displacementand other issues going on.
Now's the time to get ahead of thisif you're on an ACA.
So let's just go through the dates. Yeah.
Because it gets a little confusingfor folks.
So it opens up on November 1st.
Then what happens.
Yeah.
So you're able to start selectingyour plans or even comparison shop.
But as you said start early.
(09:54):
Don't wait until the end of Decemberthinking that, oh, I'm
going to be able to be coveredJanuary 1st.
You need to be enrolled by December 15th,to be covered by January 1st,
or enroll by January 15thto be covered by February 1st.
There are some special enrollment periods,
but they're not the big special enrollmentperiod that used to be there.
So there are fewer events such as lifeevents, moving, pregnancy, having a child.
(10:16):
And so you really got to act nowand things are changing by the minute.
And so stay up to dateas to what's happening.
We're doing our bestto educate our members
about what's coming downand what the changes are occurring.
We're putting that in our renewal letters.
We're also putting information outvia social media,
and our website to make surepeople understand what's happening.
Because, you know, there'sbeen a lot of confusion, a lot of changes.
(10:37):
And so make sure you stay on top of itbecause you can't
wait because you're going to be,you know, delayed in your coverage.
And it is a major disruption in the ACAmarket.
Yeah, I cannot recalland 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.
And Blue Cross Blue ShieldKansas has been in market.
(10:59):
You were one of the pioneers. Yeah.
It was you guys.
Blue cross of Kansas CityI think were the first carriers.
We were Actually in the market.Approved and up and running.
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 increasesthat 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’lldo our best to educate our members.
(11:21):
Yeah.
You know, when you're 80 years plus,
I think people can realize the BlueCross of Kansas isn't going anywhere.
Just so you understand.
All right.
So let's talk about four and five Kansans
in the pastfound plans for $10 a month or less.
Yeah. It and then that's going to change.
That is going to changeokay. So let's just start with that one.
And what's going to happen to the subsidylevels and all the rest of it.
(11:43):
Yeah.
So you may or may not be awarethere were increased subsidies
that passed with the American Rescue Act.
Up to 400%. 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 expireat the end of this year.
And if they are not renewed by Congress,then that's when more and more
Kansasare going to be paying more and more.
(12:05):
Like you said, you know, $10 per month,it could jump to hundreds of dollars
per month.
Some estimates are it's going to increaseby like approximately 70% nationwide.
So it's just going to be depending onwhat your income is and also what
subsidies you're eligible for.
And so it's going to go back, if Congressdoesn't act, to the original subsidies
which are between is, you know,100 and 250% of federal poverty level.
(12:27):
And so make sure you're checking to seeif you're still eligible for subsidies,
because you may get a surprise billif you if you're not aware of it.
So the other thing is self-affirmation.
People being able to self affirm.
And that was allowed. Yep. It’snot allowed now.
There's a lot of changes coming.
You're going to. Talk about some of that.
And there's court casesactually on a lot of this stuff.
(12:48):
So it's changing by the day you know.
We talked about that off camerabefore the show. Absolutely.
And so some of the thingsthat you have to affirm
that you are making a certain amount,you're new going to have to provide
additional documentation.And so Tax returns.
Exactly.
You're going to provide concrete documentsas to what your income is versus
saying I do make this amount.
And so there's a lot of changes coming.
(13:08):
Make sure you're up to date with them.
We're going to keep our members informed
because there's court casesnow pending out there.
There's decisions being made.
So stay abreast of all the changesthat are coming.
And once again, if
this concernsyou, you can give them a call.
You can have a conversationjust to understand
what's happeningor where you're going to go.
All right.
(13:28):
And then you'll understandwhat 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.
Like Misty said,they're more than happy to talk to you
and just explain what's happening
because there are a massive numberof changes coming in the marketplace.
So what do you think's going to happennow when we see that
(13:52):
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.I think that's a good possibility.
We've estimated about 30% of Kansans,based upon the data,
are going to lose their healthinsurance coverage
because of the increased cost as wellas potentially subsidies going away.
(14:13):
And so we are doing our bestto 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 subsidiesor the cost sharing reductions.
We're actually prioritizing affordability.
We're working on various programsto make sure that we are,
trying to keep our costs and our rates lowso that we can serve
more and more Kansans.
(14:34):
That's our ultimate goal,is to serve more and more Kansans.
And that's what you guys do really wellbecause 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 fromsome of the national carriers.
You know, in the marketplace.
So talk a little bit about as far as,SEPs are concerned and qualifying events.
(14:59):
So we're going to go to break herein a few in about two minutes.
But let's do that first.
So you know it used to beyou could be able to sign up for,
you know, a special enrollmentperiod year round.
And that has changed.
And so we'renow only going to be available
to have special enrollment periodsfor “qualifying life events”.
So an example of a qualifying lifeevent would be a job loss.
(15:20):
We know a lot of people,especially in certain communities
there's layoffs occurring
and they're going to the marketplace, ACAgoing to healthcare.gov
or going to their local carrier'swebsite and selecting a plan.
And they are now only going to be ableto do that for a job loss or for,
the birth of a child orif they're moving into a different state.
And so that's going to be,a different thing.
(15:42):
You know, when everyou are able to do it much more broadly.
It's only going to be duringthose certain types of events.
And they're narrowing it.
And I'm going to guess, based on the factthat, you know,
the whole self-affirmation income thingand all the rest of its changed,
that you're going to have to be ableto present documentation
or show 100%.
(16:02):
Yeah.
And so it's more important than everto 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 outthe week of Christmas to get covered
It's probably not a good timeto be doing this.
No, no.
Yeah.
It's probably no,
not when you're trying to figure outhow am I going to pay
for all the Christmas presentsI bought. Okay.
And everything else is going on nowI got to figure this out
(16:24):
probably a good ideato get in front of this a little bit. Yes.
You need to start looking aheadnow, having conversations with, you know,
salesmen and your brokers,your customer service teams
to figure out what's happeningbecause it is really important
for getting a handleon what this is going to cost. Yeah.
And this is going tothis 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.
(16:48):
I've heard that over.
I've heard that from CEO of Blue Crossof Nebraska, Blue Cross of Kansas City.
And now you're sitting herelistening to Misty,
who's the director for ACA and Medicaid,say exactly the same thing
regarding Blue Cross BlueShield of Kansas.
So there's a lot comingand a lot of changes coming.
We'll be right back after the break.
We're going to talk a little bit moreabout how some of this is going to work,
(17:09):
and we'll get in the weeds a little bit onsome of the things that you need
to understand moving forward about costbenefits and all the rest of it.
And what are they offering atBlue Cross and Blue Shield of Kansas?
We'll be right back after the break.
You're listening to America'sHealthcare Advocate Broadcasting
here on the HIARadio Network coast to coast across USA.
(17:39):
Welcome back.
You're listening to America's
Healthcare Advocate showbroadcasting coast to coast across USA.
My producers today, Mr.
Dave Thiessen, Gardner Cowdrey in studiowith me, Misty Snodgrass.
She is the director of ACA and Medicaid.
You can obviously tellthis lady knows what she's talking about.
All right.
And this is kind of like drinking from afirehose for a lot of you out there today.
(18:00):
But the idea hereis to bring information to you
so you are preparedfor 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 panicin people about what do.
So the last thing you want to doas we've talked about is wait.
(18:20):
Which is why if you call that customerservice number at 866-906-
5253, that's not a sales number.
Those people are there to help you tryto understand what's in the marketplace.
They're not there to try to sell yousomething like some of these high pressure
sales outfits you see on televisiononce again 866-906-5253 or BCBSKS.com.
(18:43):
All right.
So let's talk a little bit aboutsome of the plan differences plan designs.
And then specifically zeroin on these silver plans.
And what we're going to seewith these CSRs.
Yeah.
So I think that's a great questionbecause everybody's going to be shopping
and it can be really overwhelming.
I know whenever I've helped
a lot of friends that havewhat is what is the metal tier, what is
(19:03):
what is this MOOP,what is this deductible?
What are all these things meaning.
And so I think it's really importantto educate everyone on the benefits
they're choosing.
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 thereif you get a diagnosis?
And so I think it's really important.
One of the plans that we haveis a high deductible plan.
(19:23):
We are the only one that we know ofin market that has a high deductible plan.
So that gives members options for whatto choose for them.
And these costs, CSRs, those cost savingsreduction 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.
And so they're able to help, individualsthat have higher
(19:47):
specialist visits,be able to help offset those costs.
What do they have to do to get enrolledin a CSR type program?
So they're able to seeif they're eligible.
So there is some income eligibilityfor a CSR.
So it's not available to everybody.
But they are able to seeif they're at a certain
income level whether or notthey're eligible for those CSRs.
That between the 100 and 250% income. Yep.
So basically if you're in that categorythis can make a big difference.
(20:08):
But if you're not in that categorythen you can't enroll in it.
That's right.
That's right.
And about 93% of Kansans are in a 100or 250% in the ACA market.
That's what it was last year.
So we're hoping that a lot of individualsbe able to take advantage of them.
They just not may not be awarethat they're available for them.
Those are not necessarily available forma lot of these other carriers,
(20:29):
including that high deductable planthat we're going to talk about here
in a second.
So again, that's another reasonto reach out and get some information.
So let's talk about those highdeductible plans.
Because as I said while we're on the breakthere, you know, if you've got a house
with four tricycle motors running aroundand, you know, like my daughter,
up in Washington State,and she's at the E.R.
or she's at the urgent careor at the primary care every week.
(20:52):
Yeah, it's a weekly class.
They're all under the age of eight. Yes.
Okay. They’re on a scooter probably.
Thank you. And so?
So what she needs is very differentto 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 needand fit your budgets.
Talk about where do you see those plans.
(21:14):
And how do they work and how does thathelp people in the marketplace?
Yeah, no, that's a great question,everybody.
That's the
important part about shopping iswhat does it mean to you and your family?
You know, we can talk about whatevery one of these metal tiers are.
So gold is great
for individuals with chronic conditionsor families with ongoing needs,
or those that just want that comfort ofI want to have a consistent premium.
(21:36):
I'm not going to have a lot of co-paysand co-insurance when I go to the doctor.
So it's just kind of a peace of mind.
Decision.
The silver plans are really availablefor those individuals that are doing cost
saving and, reductions or thoseindividuals that are on those subsidies.
And so they're able to be kind of a morebalanced between the gold and the bronze.
They're able to give youa little bit of more peace of mind,
but they're going to havea higher deductible
(21:57):
or they're going to have a higher maximumout-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 differencebetween a maximum out-of-pocket.
Deductible is whenever what you payuntil the insurance kicks in,
and then the maximum out-of-pocketis what you would pay.
So if you have a $2,000 deductible, you'regoing to pay until that, $2,000 amount.
If you have a $10,000 maximumout-of-pocket,
(22:19):
you're only going to pay $10,000for the entire year for your coverage.
And so it's really importantto 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.
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 mindand some consistency
(22:40):
that lower maximum out-of-pocket,that lower deductible.
Those silver plansare kind of those balance.
People that are healthybut may have some income restrictions.
And so those are really greatto be a balanced option.
And then the bronze plans are availableto be able to serve,
those that are kind of the healthy,those that are really,
I don't need a lot of anything. Exactly.
But I need to knowif I wind up in the hospital.
(23:01):
I'm not going to have $150,000 bill.
Exactly.
You're kind of buying a piece of mind,essentially with a bronze plan.
So it's really greatfor 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 seeif they want to, select that high
deductible plan,you know, so that they're able to have
(23:21):
those services covered at a certain level,
but they want to have a lower,price point in their premiums.
So let's switch gears a little bit.
Let's talk about formularybecause this gets missed.
I remember who we had Benefits by Design.
When people come infor those appointments.
“Pleasebring a list of your prescription drugs”.
And they'd be like, why?
Because we want to make surethey're covered.
(23:43):
Yes, well, I have.
I have prescription coverage.
You think you have prescription coverage.
You may if you're on Jardiance
and your formulary doesn't cover Jardianceyou're paying for it.
Well, you know what that copay is?
I do because my wife's on it.
And before Medicare kicks inwith the big deductible that's out there.
Now, I was paying $400 a pop.
(24:05):
Okay, that's what it costs. So talk.
Why is that important for people?
And they need to ask those questions.
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 areand what's covered.
And so we're very transparent with that.
But there are different co-paysfor different types of metal tiers
(24:27):
and different types of plans.
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 tierlevels are going to do that.
But just because it says the amountand the tier level
doesn't meanthat it's going to be covered,
or there's not going to bea ton of steps to get there.
And so we really focus on trying to be,
more, probably more liberalwith our formularies.
(24:49):
That's a typical, Blues way.
We usually cover more thingsin our competitors, just because
we also want to keep people healthy.
We know that,
you know, prescription drugs are by farthe highest cost of our benefit.
But they arewhat also keep some people healthy.
And so we want peopleto take their medications
whether they have diabetesor hypertension,
because that ultimately keeps people outof the emergency room and the hospital.
(25:12):
So, our goal is to help improve outcomes,
but also helpreduce the total cost of care.
But you need to checkand see if your medications are covered.
You need to see if your PCP has coveredyour 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 choicemay or may not be covered.
And so it's really importantto look into that.
Well, and here's the thing okay.
(25:33):
We talked about some of the othercarriers.
You'rethe only one that's offering 103 counties.
One of the biggest complaintsthat I hear, especially in Nebraska
and Kansas, some other places, is peoplego on these other plans
and they don't realize there's okay,I live out in Hays. Yep.
I've got to drive 45 minutesto get to the primary care doc
(25:54):
because it's not in Hays.
He’s someplace elseor she's someplace else.
So you know that.
And because Kansas has so many ruralmarkets.
Yes, this is.
Critical.
It's absolutely vital,especially in the far parts
of the southwestand northwest part of our state.
But, you know,there is limited access to care.
You want to make sureyou have the provider of your choice
(26:14):
that you want to go to make surethat your plan is covering that provider.
And so it's really importantto see who your primary care doctor is.
And another thing that we're different iswe want you to go to your primary care.
We're not wanting younot to use your care.
We know how important primary careis in managing health conditions and,
you know, doing preventative screenings,referring you to mammograms, colonoscopy.
(26:35):
And so it's really importantwe encourage people to go get
their annual wellness visits,which not everybody does.
You know, they don't. Want you to not usetheir care.
We're looking I'm actually looking dailyto see who's not using our care,
because we are trying to find ways to goget them engaged, because we know
ultimatelyour 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
(26:56):
going to be a lot more headachesand a lot more pain with it.
And so they decided to come back to usand 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 thataffordability.
We're hoping in the next couple yearsthat we're going to not only be the
health care plan of choice, butwe're the most affordable choice as well.
That's more of what you'remission is about.
It's not about the quarterlyearnings report. No.
(27:17):
We have no shareholders.
Yeah. Yeah.
It's a little different approach.
It's a little different wayof doing things.
If you want help.
And you knowwe 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.
866-906-5253.
(27:38):
When I come back from the break,we're going to switch gears now
and talk to allyou small employers out there
about whatyou're going to expect to see on ACA
and what those plansare going to look like.
Stay right there. We'll be right backafter the break.
You're listening to America'sHealthcare Advocate
Broadcasting here on the HIARadio Network.
Coast to coast across the USA.
(27:59):
Stay there. We'll be right back.
Welcome back.
You're listening to America's HealthcareAdvocate show broadcasting coast to coast
across the USA here on the HIAradio network.
All our shows are posted on 16 podcastplatforms and on our YouTube channel.
(28:21):
Got about half a million visitsup there on that YouTube channel.
We're getting a lot of play.
And an awful lot of youare going to those podcasts.
So thank you so much for all of youthat 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 hitthe hardest, are the small employers.
(28:41):
Let's talk about what's in store for themthis year.
Yeah.
So we were actually able to hold our rateslower than our individuals.
So that's exciting for us. That'samazing, frankly.
So that's a big, so it's, you know, arounda 7 to 9% depending on kind of the plan
that's a significant improvementwith our small group.
That's been a priority for us.
We're workinghard to make it even more affordable.
(29:04):
And I'll tell you a little story, Cary,my dad, has been a Blue
cross Blue Shield of Kansas policyholder.
He's had a small business his entire life.
And has been with Blue Cross BlueShield of Kansas for over 40 years.
And so it's a priority.
I know how hard it is for small businessowners to me
to make that real expensive decisionevery month.
(29:24):
So everything that we're doingand every decision we're making is
how can we make it more affordable?
Because we want to be serving moreand more small, small groups in our area.
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 increaseI've heard in the country right now.
(29:45):
And I've my ears pretty closeto the ground that a lot of the stuff,
the other carriersare nowhere around there.
So that's a big deal.
But the other thingis, in addition to the cost,
there's the issue of being able to hiregood employees and the issue
being able to keep good employees.
If you can't give people the,
you know, the second questionthey ask is after what's my salary?
What are the benefits? Yep.
(30:06):
Okay.
Well, if you if you're going to hit peoplewith 20 and 30% increases
or cost shifting, let's raise deductible.
Raise the co-pays.
Oh, and you're going to have to pay morethan what you were paying
as an employee,because my contribution can't be as big.
That disrupts the whole workforce.Absolutely.
It's just an important benefit.
(30:27):
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.
The number two cost. Yep. Absolutely.
Sometimes even number one, you know.
A hundred percent. Yes.
(30:48):
And so I every timewe're making decisions, I think of my dad
and you know, every decisionhe had to make.
On whether or not, you know,can give your employees raises
because ofwhether or not costs are going up.
So we're doing our bestto make sure that we are,
preventing those,you know, significant rate increases.
We also have other optionsfor our members.
A lot of the products are very similarto our individual market.
(31:08):
So we have metal tiers.
We have a lot of ouremployers are in gold, as you can imagine.
They want to provide the most robustbenefits, 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 factorin, so feel free to give us a call.
We're happy to help
walk you through that and find the plansthat work best for you and
your employees.
Or use a broker if you're using a broker.
(31:29):
And a lot of small groupsdon'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 calledto go get his quotes for 20, 30 years.
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 gethard to keep the lowest rates possible.
(31:49):
Yeah.
And something you guys dois that if you are a small group employer,
you can call and get direct help anddirectly enroll if you need to do that.
So that's great.
Talk a little bit about the levelpremium plans.
And then you know, how importantis that moving forward for next year?
Yeah, we view our levels on itas an opportunity for employers
(32:10):
that want to manage their costbased 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 detailsjust because of the complexity.
We'll walk through what kind of historyyou guys have with your employees.
(32:31):
So it's different than choosing an ACAsmall group plan
where you're kind of a group rated.
That's kind of what a small group'syour group if you have,
you know, kind of a younger workforce,it might work better for you.
But it may not depending on
the health care costs associated.
So it's really important to reach outand find out if that's the best for you
as an employer or your employees,
(32:53):
and we'll be able to help you, walkyou through it, guide you.
And it's not
you know, our folks don't get paid morebecause they put you in one sort of plan.
It's really
the entire goal is to help you get coveredand your members to be covered.
And if they need somebody to come outand literally help them explain to you,
I know you guys do it. Yeah.
You're not going to get a lot of they'renot in a lot of the carriers to do that.
No, no ones going to your office.
(33:13):
I don't think there are anyto be really honest with you. No.
So let's talk a little bit about thatbecause here's the employer
trying to deal with what's going to happennext year with increases and changes.
And then typicallyin a small business, what
I always found when we were doingthis was the husband didn't do that.
If the wife worked in the business,she was the one that handled it.
So yeah. My mom is that my mom is.
(33:34):
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 bestfor the employees.
And so absolutely you canwe will come to your office gladly.
And we will walk you through it.
We will also after
we don't just sit there
and sell the product to youor try to get you on a certain product,
we actually come backand have conversations.
(33:54):
What's working?
Here's what's going on.
Here's some things we wantyour folks to be going to make sure
they're getting their annual wellnessvisits.
Go, go encourage themto go get their annual wellness visits,
because that helps you as an employerkeep costs down
well and also keeps your workforcehealthy.
We want to help with productivity,keeping your workforce healthy.
And so it's really important,to ask those questions.
(34:14):
We will send people to your office,
no matter if you have five employeesor 500 employees.
We really want to make surethat we're able to provide personalized,
service as well as details to helpyou answer your question.
They're very different approach.
Yes, extremely different approachtypically, than what people see out there.
And a great way of doing businesswith what you guys do.
Thank you very much for joining us today.
(34:35):
I think we like I said, I'msure everybody listening was like trying
to drink from a firehose on this thing,but it's critical that people understand.
So you're going to come back?
I will when we're going to gothrough the actual plans on the next show,
we're going to tell people, and here'swhy we're not doing it today.
This is changing week by week.
Not because of them, but because of what'sgoing on on the regulatory side.
(34:57):
The legislative side,and all the rest of it.
So the great news hereis, we'll have all that information.
You'll be back to do another showwith me. I'd be happy to.
Yeah.Thank you so much for coming up today.
She is Misty Snodgrass, over at Blue Crossand Blue Shield of Kansas.
You know, they have a very different wayof doing business.
If you’re with one of thosenational carriers out there.
You might want to ask themwhen the last time was
(35:18):
they sent a rep out to your shopto talk to your folks. Okay.
Probably didn't happen. If I had to guess.
Their focus is on the peoplein this state, you heard them say that
you know
they're doing everything they canto hold cost down 7 to 9% on small group.
I, I haven't seen that numberanywhere else period across the country.
So it's a very different wayof doing business.
(35:39):
that is they like to say it's Kansanshelping Kansans.
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 youwith 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 placesno one has ever been.
Remember,friends, is a funny thing about life.
(36:00):
If you refuse to accept anythingbut the very best, you most often get it.
Thank you for listening to America'sHealthcare Advocate show, broadcasting
coast to coast across the USA,here on the HIA Radio Network.
Goodbye America.
Popular Podcasts
Las Culturistas with Matt Rogers and Bowen Yang
Ding dong! Join your culture consultants, Matt Rogers and Bowen Yang, on an unforgettable journey into the beating heart of CULTURE. Alongside sizzling special guests, they GET INTO the hottest pop-culture moments of the day and the formative cultural experiences that turned them into Culturistas. Produced by the Big Money Players Network and iHeartRadio.
Crime Junkie
Does hearing about a true crime case always leave you scouring the internet for the truth behind the story? Dive into your next mystery with Crime Junkie. Every Monday, join your host Ashley Flowers as she unravels all the details of infamous and underreported true crime cases with her best friend Brit Prawat. From cold cases to missing persons and heroes in our community who seek justice, Crime Junkie is your destination for theories and stories you won’t hear anywhere else. Whether you're a seasoned true crime enthusiast or new to the genre, you'll find yourself on the edge of your seat awaiting a new episode every Monday. If you can never get enough true crime... Congratulations, you’ve found your people. Follow to join a community of Crime Junkies! Crime Junkie is presented by audiochuck Media Company.
Stuff You Should Know
If you've ever wanted to know about champagne, satanism, the Stonewall Uprising, chaos theory, LSD, El Nino, true crime and Rosa Parks, then look no further. Josh and Chuck have you covered.