By CRISTINA JANNEY
Hays Post
The Chamber in Hays will soon be entering the first phase of its new health insurance program.
From Tuesday through Sept. 22, Heartland Benefits will make available health questionnaires to businesses that might be interested in joining the health insurance plan.
If a business is interested in participating in the plan, whose coverage year will start on Jan. 1, all the potential employees who might be covered in the plan need to fill out the online questionnaire.
The questionnaires will be used to determine the insurance pool and the rates for the group, said Joshua Sapp, president/CEO of Heartland Benefits Group.
The health questionnaire will only take about five minutes to complete, unless you have a large family, Sapp said. The questionnaires will be confidential, and The Chamber will not receive the information.
The link for the health questionnaire will be available in The Chamber's September newsletter as well as on its website.
The more people who participate in the insurance program, usually the better the rates, Sapp explained during a question-and-answer session last week at The Venue in Hays.
He said the program can offer insurance to a group as few as 15 individuals.
However, the concept of an association health plan is to include many businesses into one plan to spread the insurance risk and decrease costs, Sapp said.
"If you are with the traditional model of insurance, you are probably experiencing increase, after increase, after increase," he said. "Commonly we get decreases in benefits. We are getting worse benefits with an increase in cost over time.
"What we are trying to do with The Chamber by coming together and putting these cost-containment strategies in place is to reverse that trend."
Kansas law only recently changed to allow chambers of commerce to offer association insurance plans, Sapp said.
Participating in the health questionnaire does not obligate you to participate in the program. The underwriting period will be from Sept. 23 through Oct. 14, after which rates for the group will be released.
Individuals will not be obligated until enrollment, which begins Oct. 29 with final confirmation closing on Nov. 19.
There will be an employee population participation requirement of 65 percent of qualifying employees (excludes employees who have signed waivers).
Employees who are allowed to sign waivers would include employees who have insurance coverage through another carrier. For example, this could be a person who is covered under their spouse's insurance policy.
All employees are encouraged to complete a health questionnaire, even any of those employees who may likely waive coverage. If coverage is waived, then those employees will not be able to enroll at a later date, unless they meet a qualified life event, or until open enrollment of the next plan year.
Those desiring to participate in the plan must be a Chamber member in good standing (current on dues) and have a business membership status with The Chamber 30 days (Dec. 1) prior to the effective plan date.
The cost for Chamber membership for a sole proprietor is $280 annually with a $25 one-time initial sign-up fee.
Sarah Wasinger, Chamber executive director, said most businesses will save more on insurance than the cost of the Chamber membership. This health plan benefit will be available for all businesses, even sole proprietors, including farmers and ranchers.
"What Heartland Benefits Group is and how it differentiates from other brokers or advisers out there is we are working to find and mitigate as many costs as possible for our clients," Sapp said.
The Chamber’s health insurance plan is governed by a 13-member board that will make decisions for this health insurance plan. This board is comprised of local health care professionals/administrators, insurance experts, and small and large employer representation.
This team is ultimately responsible for maintaining a fiduciary responsibility for all who participate in the plan and keeping the best interest of the community’s health as the guiding principle for making decisions.
The program's funds will be in a trust. If the trust has funds in excess of what is needed to pay claims, the board can choose to increase benefits or decrease costs by, for example, allowing payers to skip a premium.
The focus of the program, Sapp said is to allow participants to see local doctors and use local pharmacies.
The program is offering three different health plans with varying deductibles as well as three different prescription coverage plans, which can be mixed and matched.
"It is not a one-size-fits-all, cookie cutter program. You can piece it together to meet your needs," Sapp said.
The plans will all be Affordable Care Act compliant, which means preventive care is covered. Because the plans will be ACA compliant, employers will be required to pay at least 50 percent of the least expensive single plan available.
Applicants also cannot be rejected for pre-existing conditions. Seasonal, part-time and 1099 employees are not eligible for the program.
Each business will receive their own invoice for the program.
You can learn more about The Chamber health insurance plan by visiting their website. Click here.