Episode 4 | Caring Beyond The Field: GigCare for Members

Transcript of Podcast Video

Transcripts have been lightly edited for clarity and readability. 

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Nic McCarthy: Welcome to At The Table with Central Valley Ag, the podcast where we sit down and talk about things that matter most to our member owners, farm families, and rural communities. Today's conversation goes beyond markets and operations as we're going to talk about people and the access to healthcare. CVA is proud to introduce GigCare, a new healthcare benefit opportunity designed to support our members, their families, and their employees who may not have access to traditional insurance. This is about creating room at the table and making sure the people behind the operations have the options, flexibility, and peace of mind to have insurance. Let's get into the details, and I would like to welcome this morning Chad Carlson and Ryan Stefan, both CVA employees that have been working on this with our guest today, Mr. Beau Reed. So welcome everybody. Thank you. Good morning. We'll kind of start off with introductions.

Ryan, why don't you introduce yourself to the members again, kind of your position and role, and we'll move to Chad.

Ryan Steffen: All right. So I'm Ryan Stefan, the CFO. I do all the financials. I was telling earlier that my parents didn't know what a CFO was and they thought I was a UFO. But yeah, I've been with CVA for eight years. I'm a farm boy up and from Minnesota. So love CVA and I'm glad we are able to offer this to the rural communities that we serve. Yeah. Thank you much and thanks for working on this for our members.

Chad Carlson: Oh, good morning. I'm Chad Carlson. I'm the senior vice president of talent for CVA. Been in the cooperative world for 27 years, six years here with CVA in this role. Family with four kids, understand the importance of healthcare. Throughout my career, I've seen healthcare costs go through the roof. And I've seen it. I'm a farm kid. I have family that's still farming and see the pressures that they're under. So being able to offer a solution here or a potential solution is pretty exciting.

Nic McCarthy: Very exciting. And then next we got Beau Reed from Holmes Murphy. Bo's been a partner of CVAs for a few years here and continues to work with Rick Smith, Peter and Chad and Ryan on our insurance needs. And I guess give us a little low down about Beau.

Beau Reid: Well, thank you. Yeah, I've been in the insurance business since 1992. So I've seen a lot of things change in the industry. I had my own firm for 12 years. Realized that I was going to need some more resources if I was going to continue to serve my clients. And so I moved to Holmes Murphy in 2004. So I've been there 21 years.

Nic McCarthy: Oh, wow.

Beau Reid: Helped lead our operation here in Nebraska for the last 13 or so, 14.

Nic McCarthy: Excellent.

Beau Reid: Been in it a while.

Nic McCarthy: Excellent. Yeah. And with the recent rekindling of Husker basketball, some may say the last great Husker basketball team was led by Beau Reed. I don't know. I think there was a lot

Beau Reid: Of good teams after our senior year, but we might have kicked it off there for

Chad Carlson: A while. You did. No. I've known Beau Reid a lot longer than he's knowing me just because I grew up watching him. Yeah.

Nic McCarthy: Well, it's on the court. It's exciting to see us compete again down there in Lincoln and-

Beau Reid: That was a big win on the road up in Illinois. That's a really good basketball team we beat. That was fun. Some big wins we've had. Happy for Coach Hoiberg. He's been through some growing pains, learning how to assemble a roster in the NIO era and also to assemble a Big 10 roster.

Nic McCarthy: Big 10 roster is probably the biggest thing. Absolutely. It's a brutal conference,

Beau Reid: Brutal. A lot of people come to coach in the big 10 say they're going to do what they do in the big 10 and that they're not going to get affected by what the big 10 is, but the grind, it's just unbelievable. It used to be 10 teams and nine games. Now it's what, 16 teams? Yeah. It's

Nic McCarthy: Insane. And from all over the country now, when you think about UCLA and Oregon and all those teams being in there, it's like, how can you stack anymore?

Beau Reid: We played Oregon one time on the road and I feel like that was the longest trip we ever took. It took forever to get there. It's in the middle of nowhere, Oregon too, by the way. You don't just fly straight into Eugene.

Nic McCarthy: Right. Well, we better get into business here. All right. Yeah. Let's dive into what we're going to call GigCare, which is an insurance option. Alternative option for what we believe will be good for our members. Probably one of the hardest things I think with healthcare today is with any option, this is not one that's going to solve the problem that we have in this country with healthcare and we're not here to get into a political conversation today, but I think gig care is going to be an option that's going to work for some of our members. It's probably not going to work for everybody. Just from my understanding, there's probably 10% that probably won't see a benefit or won't qualify for this, but it is an option. And I think through Holmes Murphy and the Gallagher process, we'll be able to explore what's the best option for our customers.

So Beau, maybe kick it off of what you think we should know about gig care and Ryan and Chad have worked with this. Let's have you two chime in on what you see with it also.

Beau Reid: I would just say we're at a unique point in history with healthcare. I mean, gosh, since the '90s, we've been saying there's going to be socialized medicine. It would surprise most people to know that more than 50% of our people actually do get insurance through a public entity, whether that's Medicare, Medicaid, et cetera. So the last couple years have been extremely difficult. And just in the last six months, some things have happened that will make this podcast something that most of your members will want to listen to. The exchanges across the country have gone up anywhere from 20 ... 24 is the average, but I mean, Texas is 33%. We've had some other ones that are as high as 40, 42. Nebraska's is in that 23% to 25% increase. And then you compound those big increases on the exchange plans with what's happened with our government, which was the expiration of some of the subsidy increases that the Biden administration put in place that moved subsidies from 150% of poverty to 400% of poverty.

And actually the expiration of those increased subsidies is what the government shut down over. So some people will be getting a 25% increase in their premiums and they will be losing their subsidies, which could result in an increase of more than 50% to some Nebraska citizens, some of your members in Kansas and South Dakota. 

Ryan Steffen: Iowa as well. 

Chad Carlson: That's a big shock. Yeah.

Beau Reid: You're hearing a lot of screaming about it right now.

Chad Carlson: I just had a farmer call a couple weeks ago. Her exchange rates are going, they're tripling and she was like, "I don't know what to do. I think we're just going to have to be uninsured for awhile." They couldn't afford it.

Beau Reid: Yeah. For years I've heard from, because I do a fair amount of business in Central Nebraska and for years we've heard from the agricultural community, health insurance might be the biggest rip off of anything that we've ever known. It's $10,000 for the deductible and it costs me 25,000 just for the premiums. I'm 35,000 in before the insurance company pays a dime. And I'm trying to understand how is this good for me and my family. So to your point, Nick, this isn't going to completely reverse all of that and change the game dramatically in that way, but this does open up kind of a unique opportunity for your members to potentially participate in what is truly a group health insurance program, not necessarily an individual plan. That's the main opportunity here.

Chad Carlson: And that's the opportunity that we get as employees. We're a part of a group plan.

Beau Reid: Yeah.

Chad Carlson: Our farmer owners aren't a part of that group plan. So that's what's exciting about this. And so maybe Bo, you can talk about how do the farmers become part of a group plan? How do they get to participate in this?

Beau Reid: Yeah. I think most people immediately think, "Well, this must be an association plan," but that's not what this is. There's an organization in Nebraska called Population Science Management, and they really aggregate information about wellness, people's habits, people's purchasing habits, things like that. And they've created an opportunity for people to become what we call working owners of that organization, which then in turn makes them eligible to participate in population science management's group health insurance plan, which is a Blue Cross Blue Shield of Nebraska plan.

Ryan Steffen: So tell me more about a working owner. Sounds like members have to do some work. What do they have to do?

Beau Reid: It's probably once or maybe twice a month, they will get a survey through the application that they're asked to download to their phones. The survey's anywhere from two to four questions on average. And it's things like, "How many times did you work out last week?" Just real benign behavioral questions that nothing around personal information that would be HIPAA protected. So they're trying to aggregate behaviors in patterns that could help them add what I would say value added benefits to the insurance plan to help hold down costs long term. So there's a lot of what we call point solutions out in the marketplace right now. Some of them directed at things like diabetes. So general questions about people's behaviors is very valuable in terms of when you start evaluating some of these point solutions, which ones will land with our population inside of population science management.

So that's kind of the thought behind it, but the government has said that that constitutes being a working owner if you're sharing data.

Chad Carlson: So a working owner, farmer, answers a few questions per month through their phone app, and do they get paid for it? They do. They do.

Beau Reid: Yeah. They'll get, I don't know, 10 to 20 bucks a month every time they do that. They will be compensated. Not enough to make a huge difference, just enough to constitute that employer working owner

Chad Carlson: Relationship. So then they'll receive a 1099 that calls them a working owner.

Beau Reid: Yep. That 1099 is their ticket to participating in GigCare, which is the name of the product.

Ryan Steffen: Well, I think taking a few questions on a survey and getting paid 10 bucks for substantially potential cheaper insurance sounds like a pretty good deal. Yeah.

Beau Reid: As long as it's not a violation of their privacy. That was my big concern early on was I wanted to see those questions. And your leadership group at Central Valley Ag also was very adamant that they needed to see what those questions look like before they would ever agree to allow this to be shown to their members. So it's pretty benign.

Chad Carlson: So the big value of this is the premium savings. So talk a little bit about some of the comparisons that we've done, some of the examples of what potentially could be seen for savings for our farmer owners.

Beau Reid: Well, first off, most of the owners, if they buy insurance through the exchange, the insurance product that they purchase is what's called a narrow network product, which means they're limited to the hospital system that they can go to. And if they go anywhere else, they're not just out of network, they don't have coverage. This product is Blue Cross Blue Shield's broad network. So in the case of like a nearby community like Grand Island where you have a Bryan Health Hospital, you also have a CHI hospital there. A lot of times you have to choose between the two. In this product, you don't. They're both considered in network. So Blue Cross's broad network has 98% of the physicians in this state in network and 100% of the hospitals are considered to be in their network. So there shouldn't be anywhere that they can't access inside the healthcare system within our state and equally broad networks in South Dakota and Kansas, because I know you have some members there as well.

Chad Carlson: Yep. And Iowa also.

Beau Reid: Yeah.

Chad Carlson: Yeah. So talk about the comparisons that we did, deductibles, premiums.

Beau Reid: So we tried to match up a comparison- Comparing the exchange with GigCare. We tried to match up comparisons with comparable companies. So Blue Cross Blue Shield and their narrow network products on the exchange, United Healthcare, because they're pretty competitive in Kansas. And then obviously in Iowa against Wellmark, which is the Blue Cross program that's on the exchange there. There's some younger ages where the exchange is pretty competitive for those people, but the second you get into the mid 30s,the second that you add spouses, the second that you add dependents, those plans become unruly. They become very, very expensive very quickly. And that's where you've got a traditional four tiered premium structure here. So you've got employee only, employee spouse, employee child, and that could be six kids. Whereas on the exchange, you get charged per child, and then you've got a full family premium. So when we see dependents added and you're in the 30s and up, that's where this really shines. I mean, and we're talking for the examples that we provided for the board, it was anywhere from a couple thousand dollars of savings per year to almost $20,000 of savings per year. That's a lot of money.

Nic McCarthy: Yep. It was big. It was big. I think one of the key points that I think is going to be a little bit of a challenge in this is I think we have to have the realization that we're probably going to have some members that won't qualify. Maybe walk through Beau, the numbers and what those challenges are when they don't qualify and what options would they have after that.

Beau Reid: Yeah, that's good point, Nick. Right now, this program's been in Nebraska for almost two years, coming up on two years, 7% of the people that have applied have been denied. And normally the denials are around medications that are being taken that are what we call either genome therapy treatments or really high cost specialty medications where they aren't considered to be essential coverages by the Affordable Care Act. So as a self-funded health plan, they are not obligated to cover those types of medications. And in some instances, like I have a client that has a person that's taking a medication, it's $175,000 a month.

It's $1.9 million annually. And those are the kind of things that just kill health plans. And so the situation is once we evaluate it, if they're taking a medication like that, we try to assist them in understanding that being on the exchange plan is a better place for them to be, because those coverages are required to cover those types of medications on the exchange, whereas gig care does not. The other area where you might see people not qualify as if they're over the age of 65 and Medicare eligible, this coverage is only available for people under the age of 65. So there may be some members out there that are over 65, but their spouse isn't, or they may have children under the age of 26 that are still on their medical insurance. So this will be an option for those people in that way, but for them personally, it will not be.

Nic McCarthy: Right. And I think through the discussion, we've talked about the process of this that is going to be ... We'll show you how to start the process on CVACoop.com to get started. But I think in the process where we get to that point of working with Gallagher and going through the screen, there is an option if you do qualify or you don't qualify that they will help you kind of weigh out the best plan and what options are out there. With your current plan, you can bring the current plan. They're not going to try to sell against your current plan, but also kind of explore what other opportunities there are there.

Beau Reid: Right. Yeah. I think once they go to cva.com or cvop.com, that's the website. Once they get directed to the call center with Gallagher, they will go through kind of a suitability type of conversation with a person that ultimately will become like a concierge to them.

And once they answer a few questions mainly around those medications, again, and obviously their age, those suitability things, because if they say, "Oh, well, you're in these two areas where this isn't going to be a viable option for you, " but we would certainly be willing to kind of help navigate a very complicated exchange and to help try to identify coverages that would be more affordable potentially than what you know. Because if you've ever seen someone try to go through the exchange, it's a very complicated process. There's almost 200 plans with four different carriers. It's super complicated and people get frustrated and they really don't know what to expect. They don't understand how to apply for subsidies even. So it's been a real nightmare for a lot of people. This will give them an advocate in their corner that will help explain all of those things.

And ideally, we hope that they're eligible and that this plan can help them save a lot of money for minimal involvement in terms of they have to answer a survey on their app once a month and they have to go through the process with this person on the phone, which could take as long as 30 minutes.

Chad Carlson: That's the nice part is you'll have somebody there to walk them through every question. Every step of the way. So the exchange has a very specific open enrollment period. Tell me about how you can get enrolled in GigCare.

Beau Reid: Yeah. Gig care, you can enroll at any time. And so if you've just been forced to sign up for a big increase and a loss of subsidy, you can still evaluate this. And because you only need to give a 30-day notice to terminate any of your coverages on the exchange, you can change over to this program at any time. So don't feel like you're locked in for another year at an unsustainable rate. Look at this program and see if it can help you.

Chad Carlson: And you can also call in anytime and ask them, "Hey, do a comparison. This is where I'm at now. These are my deductibles. This is the plan I'm in. " Do a comparison. If it works, great. If it doesn't- No harm, no problem. Yeah. Yeah. And we hope it helps as many people as possible, but the reality is, even if it's a portion of the population that we help, we're still helping some people. And the savings that we saw when you compare, it's unbelievable.

Chad Carlson: So how many individuals are inside the gig care plan right now? Is this a really small group? Is it blowing up?

Beau Reid: Yeah, it's blowing up. They're averaging 360 new enrollees per day, and it's up over 115,000 people enrolled. Now that's the Midwestern, so it's blowing up. At this time last year, they had 30,000 enrollees, so they've added nearly 100,000 people just this year. And the last six weeks has been insane since the loss of the subsidies became publicized and talked about since the exchanges announced the increases that they were getting ready to hand people.

Nic McCarthy: Yep. Well, for sure. I think it's an opportunity. And again, as we talked about the challenges that we have in the healthcare system, I think this is just another tool that we can look at and hopefully provide some solutions out there for what we have with challenges with the cost of healthcare today. So I just want to thank everybody. I mean, I know the holiday schedule here has been tough to juggle through and want to thank everybody for coming and we've kind of got to our ending point here.

Beau Reid: Can I just add one more thing? Yeah, sure. Because I think one of the things people fear is how much are you really going to change my insurance the way it works? This functions exactly the same way. You have a deductible, you have a family deductible, you have co-insurance percentages, you have office visit copays, unless you buy a HSA plan, and then you have out- of-pocket limits. This isn't some end run around traditional health insurance. It's very much the way that you currently see your health insurance. It's just we've got the broad network, the full Blue Cross Blue Shield network.

Nic McCarthy: A lot of comfort with that. 

Beau Reid: Yeah. A lot of comfort. I think that brand gives people some peace.

Nic McCarthy: Absolutely. And being not limited is a big thing. I mean, that was probably one of the biggest eye-openers for sure. Well, I want to thank everybody for joining today. And again, this is a topic that think of CVA is not going to be the expert into this. We are probably the marketing arm to get this to our members. So really, the teams at Holmes, Murphy, are going to be helping us through this journey, and we feel confident in their ability to do that. So thanks again for joining us today. Well, as a cooperative, CVA exists to serve its members, and that means supporting the whole operation, including the people who make it wrong. GigCare is one more way CVA is investing in access, flexibility, and long-term wellbeing for our member owners and rural communities. If today's conversations have sparked questions or interest, we encourage you to learn more and explore gig care and see if it's the right fit for your operation.

Go to the website, cvacoop.com and look for the button to click to learn more about GigCare. Thanks for joining us today at the table. We'll see you next time and have a great day. Thank you.

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