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Episode 2028 Transcript:

00;00;01;14 - 00;00;05;10

Announcer

And now America's Healthcare Advocate, Cary Hall.

00;00;05;11 - 00;00;23;24

Cary Hall

Hello, America. Welcome to America's Healthcare Advocate show broadcasting coast to coast across the USA. Here on the HIA Radio Network, you can find out more about us by going to our website, AmericasHealthcareAdvocate.com. If you want to learn more about the show or you want to listen to these shows, once they are done and up, they are on our 15 podcast platforms.

00;00;23;24 - 00;00;44;02

Cary Hall

We're on everything from Rumble, to Spotify, you name it, we're on it, including iHeart Radio Audacy Radio on 15 platforms. We've got a YouTube channel, America's Healthcare Advocate. We've got over half a million views on the YouTube channel now. Thanks to all of you out there in our listening and viewing audience. And I want a little shout out this morning.

00;00;44;02 - 00;01;06;00

Cary Hall

We've got 238 affiliates around the country, but I want a little shout out this morning to KTTN 92.3 FM in Trenton, Missouri and KGOZ 101.5 FM in Trenton, Missouri as well. I want to thank them. We've been on the air up there for, I think, 20 years now, so it's been a long time, but we're very happy to still be on the air in Trenton, Missouri.

00;01;06;02 - 00;01;25;13

Cary Hall

All right. Joining me in studio today. We have multiple guests from Blue Cross and Blue Shield. Barron Roberts, Manager in Small Group Individual Sales. Barb Bins Broker Engagement and Development Sales in the Medicare side. And then Ryan Roth will be joining us in the last two segments of the show. He's the VP of Large Group.

00;01;25;13 - 00;01;28;02

Cary Hall

So welcome everybody from Blue Cross. This morning.

00;01;28;05 - 00;01;28;19

Barron Roberts

Thank you.

00;01;28;25 - 00;01;32;00

Cary Hall

It's been a minute, Barron, since you've been in here. You know what to me.

00;01;32;03 - 00;01;33;18

Barron Roberts

Yeah, yeah, couple of months.

00;01;33;21 - 00;01;48;03

Cary Hall

There there have been a lot of changes. There's a lot going on. There've been a lot of changes up at BlueKC. So let's just. This is going to be what I call the cornucopia show. We've got a lot to cover today. We're going to talk about Medicare. We're going to talk about ACA, Individual and Small Group.

00;01;48;08 - 00;02;09;06

Cary Hall

And we're going to talk about Large Group when Ryan comes on and some other products that that Blue Cross and Blue Shield is offering across the metro. But there's a lot of changes in the marketplace. I thought this would be a great time to do the show. Before we start rolling into open enrollment for all kinds of plans, both Medicare and individual and also small group renewals and large group renewals coming up.

00;02;09;06 - 00;02;21;09

Cary Hall

So that's why we're doing this today. So we can tell you all what's going on at BlueKC. So let's just start with the overall marketplace fair. There's a lot going on. There's going to be a lot going on this year.

00;02;21;11 - 00;02;53;01

Barron Roberts

There is a ton going on, a lot of changes in the marketplace. You know carriers are exiting the Medicare Advantage space as as we are, at the end of the year, every day we're getting new announcements and other carriers exiting certain markets, big names across the country. So ever changing environment. There's a lot of changes for prescription drug coverage this year, a lot of changes in legislation and regulatory requirements, etc. that are putting, some strain on the particularly the smaller health plans.

00;02;53;03 - 00;03;12;08

Barron Roberts

And so you're going to see a lot of, of new things this year. And a lot of changes. And I've heard some saying that, you know, plans will look like they did in 2015, you know, going back in time to, when we first entered the Medicare Advantage space and the benefits and all of that with it may well will drastically change.

00;03;12;11 - 00;03;18;12

Cary Hall

Wow, I that's the first time I've heard that one. Back to what it looked like in 2015. Yeah, yeah, that's been a while.

00;03;18;16 - 00;03;26;13

Barron Roberts

Yeah. That's a lot of pressure on the Medicare Advantage plans right now. And I think all of them are trying to figure out how they're going to actually, profit, being in this space.

00;03;26;13 - 00;03;45;23

Cary Hall

The pressure, just so we're clear about this is coming from CMS and the federal government, because they're changing reimbursements are changing all all different elements of these plans, making it more and more difficult. Here's the thing that’s interesting to me about this. On the Medicare Advantage side, you've got more people enrolled in Medicare Advantage now than are actually enrolled at original Medicare.

00;03;46;00 - 00;04;04;02

Cary Hall

But you're going to see that start to change, and you're going to probably see it or change a lot this year. Barb, let's talk about Medicare Supplements, because the Blue Cross Medicare Supplement is kind of near and dear to my heart because my wife and I have been on it for ten years. Yes, I am 75, chronologically challenged, like a lot of you.

00;04;04;04 - 00;04;32;04

Cary Hall

And and, you know, I can't say enough about how that plan has worked for us. You know, my wife has suffered from a critical illness, heart failure, and when we needed specialty care and we had to go to WashU Barnes-Jewish to access, Doctor Alvarez, who is one of the top transplant surgeons in the country and who treats heart failure, we were able to do it very smoothly with no problems because we had the Blue Cross and Blue Shield Medicare supplement.

00;04;32;11 - 00;04;41;19

Cary Hall

So contrast the advantages of MedSup over the Med Advantage plans because there are some significant advantages in the Medicare Supplement. Barb.

00;04;41;22 - 00;05;11;18

Speaker 3

Sure. As we just heard in the Medicare Advantage network, right now, we're hearing change. We're hearing change of networks, change in provider, change in benefits, change in rates. The my friends and family that are 65 plus the one thing they don't like is change. And that's where a Medicare Supplement plan could be a great fit because they are predictable and they're consist and, predictable in that when you're looking at for a provider like you and your wife is have experienced, you can go anywhere that Medicare is accepted.

00;05;11;20 - 00;05;24;21

Speaker 3

So people like that, when you're sitting thinking about, what if I'm traveling? What if I have another house? You can go anywhere. Medicare is accepted. Consistent, meaning not a lot of change in benefits for, those for the Medicare Supplement plans.

00;05;24;21 - 00;05;39;12

Cary Hall

I think ours has changed at all. I don't I don't know what the premium increases have been, but they haven't been very big. I certainly have heard about it if they had for my wife, but they have not been. They have not been. And we've been on that plan for over ten years. So, they are consistent.

00;05;39;12 - 00;05;42;28

Cary Hall

That's one of the wonderful things about them, is the consistency with them.

00;05;43;01 - 00;05;52;27

Speaker 3

And for BlueKC, even our the consistency of our rates, our rates changed over the past ten years, an average of 3.7%, which is well below the market level.

00;05;53;00 - 00;05;54;10

Cary Hall

It's well below inflation.

00;05;54;13 - 00;06;18;27

Speaker 3

Yes yes, yes. Yeah. Good point, good point. So, we do have some changes coming out. On our BlueKC plans, we're actually adding three new plans. So our four existing plans are staying as is. We're adding three new plans. High deductible G, plan K and plan L, and we really want these to appeal. Or we think they will appeal to that Medicare Advantage demographic.

00;06;19;02 - 00;06;47;20

Cary Hall

So let's go. And here's and this is important to understand the biggest difference here for us. And the reason we've never done Medicare Advantage is access. It's really simple Medicare supplement. You can go anywhere in the country if you have to go to Barnes-Jewish, if you have to go to, you know, if you have to if you have to go to Mayo Clinic, whatever the case, you know, whatever the case may be, you have direct network access with these Medicare Supplement plans.

00;06;47;22 - 00;07;11;04

Cary Hall

So contrast that with the narrow networks on the Medicare Advantage plans. And here in the metro. So you're out. You heard me say hello to our folks, our friends up in Trenton. You're in Trenton, you're in Maryville. You're in Clinton, you're in Harrison. You know, talk about the access they have under the med sub plans, especially these new ones, versus access under a typical med advantage plan.

00;07;11;10 - 00;07;40;17

Speaker 3

Well, sometimes it's more difficult the more remote you get because the network is controlled by the the insurance provider. Right. So we've already seen some change on the MA side where with, different hospital networks wanting to pull out big ones. We're not talking a little small hospital, even a remote one. But even in the more metro areas, some of those, hospital networks wanting to pull out of the, the, the MA market, so there is change and you don't know if that's going to change in six months or mid-year.

00;07;40;19 - 00;07;43;09

Cary Hall

Yeah. And that's not the case with the med subs. Correct.

00;07;43;12 - 00;07;45;18

Speaker 3

You complete anywhere Medicare is accepted.

00;07;45;18 - 00;08;06;13

Cary Hall

Yeah, absolutely. So Barron, a little bit about these plans, this plan G overall. You know, you you all have developed some plans now plan K and plan L. And the purpose is to allow people to transition to you like Blue Cross. I mean, if if you like if you like Blue Cross, you want to stay in that Blue Cross network and you want that local customer service and everything else that goes with it.

00;08;06;16 - 00;08;08;21

Cary Hall

This is a way to do that. Talk a little bit about that.

00;08;08;21 - 00;08;20;20

Barron Roberts

Yeah. Yeah. Good point. You bring up their Cary. So first and foremost all of these Medicare Advantage members that are losing coverage at the end of the year with BlueKC will have a “guarantee issue right” into a Medicare Supplement plan.

00;08;20;20 - 00;08;32;28

Cary Hall

That's really important. I'm going to stop him and ask him to go back to that. Because when you move from a Medicare Advantage to a Med Sup, you go through underwriting. What you just heard is they're waiving the underwriting of by right or wrong.

00;08;32;28 - 00;08;44;07

Barron Roberts

Correct. Yep. So that is a requirement, put forth by CMS that indicates that we have to accept anybody who applies for a Medicare Supplement plan that's on our Medicare Advantage plan that is going away at the end of the year.

00;08;44;09 - 00;08;52;09

Cary Hall

So that's a big deal. And that's a very easy way for people to make this transition, improve their access and have one of these plans.

00;08;52;16 - 00;09;09;00

Barron Roberts

That's correct. So, we develop these three additional plans, High Deductible G, plan K and plan L Med Sup plans, that have lower premiums so that the G is looking anywhere between $51 and up, depending on your age and the state you're in.

00;09;09;03 - 00;09;13;02

Cary Hall

Are you serious? Yeah. $51 per month is remarkable. Yep.

00;09;13;08 - 00;09;31;26

Barron Roberts

The K and the L are in the 70, 80, $90 range, depending on, your age. That's the entry rate. If you're older than, 65, you may have a different rate, but, but yeah, the purpose was to provide plans that are affordable for members to be able to have the access they need in the area that they live in.

00;09;31;29 - 00;09;53;05

Cary Hall

When I come back from the break, I'm going to ask Barb to go into what is different about these from the standpoint of everyday access and what do you pay? What is your out-of-pocket look like on a Medicare Supplement plan like this versus a Medicare Advantage plan? Stay tuned. We'll be right back after the break. You're listening to America's Healthcare Advocate Broadcasting here on the HIA Radio Network.

00;09;53;11 - 00;10;00;05

Cary Hall

Coast to coast across the USA. We've got more. Don't go anywhere.

00;10;00;08 - 00;10;30;09

Steve Kuker

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00;10;30;13 - 00;10;59;19

Steve Kuker

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00;10;59;21 - 00;11;19;02

Cary Hall

Welcome back. You're listening to America's Healthcare Advocate show broadcasting coast to coast across the USA here on the HIA Radio Network. You know, all these shows are on the podcast. So if you want to, you know, tell somebody about this, maybe it's your spouse, maybe it's a friend, whatever. Podcast platforms, there are 15 of them. YouTube channel America's Healthcare Advocate.

00;11;19;02 - 00;11;33;19

Cary Hall

The shows are videotaped and put up there, so if you want to tell them about, they can go up, they can listen to the show. And just like we did it here live in the studio. Also, if you want to learn more about the products we've talked about, we're going to talk a little more about, you can go to BlueKC.com.

00;11;33;19 - 00;11;58;26

Cary Hall

That's the website BlueKC.com. Or you can call one 808 679014. Here's the thing. When you call one 808 679014, you're actually talking to somebody here in Kansas City. They're not sitting in Ohio or New York or Guatemala, okay. Or the Philippines. They're here, okay, right down there on Main Street. And here's another thing. You can actually go down there and meet with the representative if you want to do that.

00;11;58;26 - 00;12;28;09

Cary Hall

So there are multiple ways to get what the folks in Blue Cross and Blue Shield of Kansas City. And also obviously reach out to your local broker that will have all of this information as well. So let's go, Barb, and talk a little bit about, the Medicare Plan G and that, you know, you got G k an l that's too much to get into right now, but let's just let's do G so they get an understanding of how it works and why this can be an excellent benefit for people that want to exit the met advantage state, especially with all the changes that are coming.

00;12;28;09 - 00;12;29;07

Cary Hall

Barb.

00;12;29;09 - 00;12;47;10

Speaker 3

Well, with Met advantage members are used to kind of paying as they go. They they don't, pay a high premium or a premium, but then they're going to pay co-pays and co-insurance, etc.. So it's a little bit hard to predict what they're going to end up paying with a Medicare supplement like plan G. Typically it picks up where Medicare leaves off.

00;12;47;10 - 00;12;59;28

Speaker 3

They'll pay their premium, but then Medicare will typically pay about 80%. And then Medicare supplement. The plan picks up the other 20%. So it is very predictable for a member to kind of budget and understand what they're going to pay.

00;13;00;04 - 00;13;16;24

Cary Hall

Yeah. And it there's not that constant barren copay for this in a copay for that and a copay for something else. It's it's it's a little hard to get used to it if you're going to met advantage. Because believe me, under Medicare supplement, it's a whole different world the way it works, right?

00;13;16;25 - 00;13;21;16

Barron Roberts

Yeah, yeah. You're not going to get that feeling of having to pull out your checkbook every time you go to the doctor's office.

00;13;21;21 - 00;13;34;07

Cary Hall

Yeah, it makes a lot of difference. And the plans are very, very different. So in the way, in the way. And let's again a little bit about the network here in the KC Metro. If they're on the mid sub they've got a much broader network am I correct.

00;13;34;11 - 00;13;35;02

Barron Roberts

Absolutely.

00;13;35;02 - 00;13;56;03

Cary Hall

So you've got access to CU. You've got access to Saint Luke's. You've got access to the acres and you've you know and if you're up in Trenton you're up in Maryville. You've got access up there to the local rural hospitals. So all of that comes with these plans, right? Yes. So let's talk a little bit about the 365, because blue 365 is something that I have used.

00;13;56;03 - 00;14;17;07

Cary Hall

My wife has used, I wear hearing aids. They're very expensive. They're called phone X and they're about 2500 bucks apiece. We were able to get them for about 1500 bucks apiece. Because we access blue 365. So go into some of those benefits far, because there are a lot of things available there that are just not available.

00;14;17;09 - 00;14;19;06

Cary Hall

You know, on other plans.

00;14;19;08 - 00;14;41;14

Speaker 3

And it's easy to access. So first, all a member does is they go to blue 365 deals.com/BlueKC. All they need is their ID card. But to to your point with the hearing aid discounts on all tiers of hearing aids, they'll get a 30 to 60% discount. You can get discounts on rental cars. You can get even discounts on individual tickets to Disney up to $60.

00;14;41;21 - 00;14;55;15

Speaker 3

You can get 35% off frames. Do you have access to gyms? There's there's one tile that you can click on and for $19 a month. And you don't have to commit to all year, you have access. Or you can choose from up to 13,000 gyms.

00;14;55;17 - 00;15;05;28

Cary Hall

So that is significantly different, obviously. Let's switch gears. We got a little bit of time left in this segment being and talk about, you know, what's going to be available on with Spira Care on the small group plans this year.

00;15;05;28 - 00;15;29;29

Barron Roberts

We are rolling out a brand new spire, a care co-pay plan and small group, which ultimately was designed to allow for families that wanted to have access to Spira Care. The low cost here at Spira Care, but also low cost outside of Spira Care at Blue Select Plus providers. So this plan was designed with co-pays, for PCP and Blue Select Plus specialists.

00;15;29;29 - 00;16;05;26

Barron Roberts

Inpatient hospital, etc.. So previously we have had a plan design that is set up with the deductible and out-of-pocket and the Spira Care plan, and any care that's received outside of Spira Care is subject to the deductible. But this is, I think, a game changer and will allow people to enroll in the Spira Care plan and still access their their PCP if they want to or if they have families who want to see a pediatrician and who would like to see care outside of Spira Care at a low cost share that that that that plan makes it available.

00;16;05;29 - 00;16;07;14

Cary Hall

That's a pretty significant change.

00;16;07;14 - 00;16;25;05

Barron Roberts

Yeah. It, you know, the co-pays are very low for out of out of Spira Care, $75 for PCP. That's quote me right now, but I think it's 150 for a specialist. To to members that are seeking care outside of spire.

00;16;25;05 - 00;16;48;15

Cary Hall

But if they're inspira and they walk in, they're not paying anything. Correct. Yeah. Okay. Yeah. And so that's a big deal. Yeah, it is for sure. You're seeing your primary care physician. If you have behavioral health issues this is a big deal because there are there are other plans out there that offer access to primary care clinics, but I've never seen a plan yet that has the behavioral health element that Spira Care has.

00;16;48;15 - 00;16;49;25

Cary Hall

And talk about that a little bit. Yeah.

00;16;49;25 - 00;17;14;22

Barron Roberts

The behavioral health component is a is a is a key, with Spira Care and has been a major, major focal point for us. We've been wanting to focus on providing access to behavioral health resources as a component of spire, a care. We've gather data that supports that. We're addressing the care needs for behavioral health. 14% of members are attributed to ASpira Care.

00;17;14;22 - 00;17;18;26

Barron Roberts

PCP are leveraging the behavioral health component of Spira Care.

00;17;18;28 - 00;17;43;07

Cary Hall

That's remarkable. Yeah, yeah, we've actually had some of the clinicians here on the broadcast. And you know, it's it's nice to know that, you know, if you've got a child is having a problem or if you're having a problem with things. I was just literally on the phone before this broadcast, talking about a woman. We're trying to help with her GoFundMe page, and she's got an 18 and 19 year old, and this woman is critically ill, and the kids are suffering from anxiety and other issues.

00;17;43;07 - 00;17;53;17

Cary Hall

And so, you know, having a place where they can go and see somebody and talk to somebody and get some help without having to go outside. The system is a big deal, I think.

00;17;53;19 - 00;17;59;26

Barron Roberts

Yeah, absolutely. So, you know, when we design Spira Care and I think it dates dates back to 2015 when I was.

00;17;59;26 - 00;18;00;14

Cary Hall

There, I.

00;18;00;14 - 00;18;19;19

Barron Roberts

Read. Yeah, yeah. You know, we, we went about it in a way that, we want it to be a holistic approach. We wanted the PCP and the care guides to be the quarterback of the care and ensuring that there weren't medications that were conflicting each other, ensuring that the people were getting access to the, the, specialists that they were looking to see.

00;18;19;21 - 00;18;40;15

Barron Roberts

There weren't duplicative, duplicative appointments being set, which we see out there in the system today. So we see Spira Care addressing the care needs, and a lot of different ways, whether it be pharmacy, behavioral health, you know, primary care, lab work, X-rays, etcetera. There's a lot of services being that aspire, how.

00;18;40;15 - 00;18;42;24

Cary Hall

Many how many facilities around the metro.

00;18;42;25 - 00;18;44;07

Barron Roberts

There's nine. There's nine.

00;18;44;07 - 00;19;15;23

Cary Hall

Facilities. Metro. You can find them on Wkyc.com. That's the website if you want information. One 808 679014 someone right here will be happy to chat with you. They've got a lot of options. They are the hometown carrier. There is a difference in the way they do things here than what you see with the conglomerate, large national carriers and I urge you to take a moment, whether you're a senior citizen or you're looking for individual coverage or even an employer with a small group, we're going to talk more about that to go up on the website and take a look or call your local broker could make a difference.

00;19;15;23 - 00;19;30;21

Cary Hall

We'll be right back after the break. You're listening to America's Healthcare Advocate Broadcasting here on the HIA Radio Network. Coast to coast across the USA. Don't go anywhere.

00;19;30;23 - 00;19;35;13

Cary Hall

You.

00;19;35;15 - 00;19;57;13

Cary Hall

Welcome back to America's health care. Ever getting in studio with me today, Ryan Roth and Barron Roberts from Blue Cross Blue Shield. We're now going to segue in to talking a little more about the individual products. Now we're going to talk a lot about the small group products and what's being offered out there. A lot of challenges to small business owners, a lot of issues that they're having to deal with regard these escalating cost of health care across the country.

00;19;57;13 - 00;20;21;08

Cary Hall

So we're going to talk about these plans because there are a lot of innovative pieces to these that are very different to some of the other things in the marketplace. If you want to learn more about these plans, you can go to the website BlueKC.com or call 1-800-867-9014 1-800-867-9014. They'll be happy to chat with you. As I said earlier, Blue Cross and Blue Shield people are right here in Kansas City.

00;20;21;11 - 00;20;42;24

Cary Hall

You're not calling Guatemala or you're not in the call center someplace in Illinois or or New York or whatever the case may be. So these are local folks that actually know what the networks in the hospitals look like here and the providers, and they could be very helpful to you if you want to call and get information. Once again, the number 1-800-867-9014 or the website BlueKC.com.

00;20;42;26 - 00;20;57;03

Cary Hall

All right there. And we touched on this just a moment ago with Barb. Let's get into a little more about the individual plans, because you've kind of expanded that and what's being offered this year on the individual Obamacare, ACA plans, as are commonly known in the marketplace.

00;20;57;05 - 00;21;23;19

Barron Roberts

We've got several ACA plans available this year coming up. And open enrollment starts November 1st. As a reminder, for anybody out there, we have varying products with varying networks. So we've got Blue Select, Blue Select Plus and Preferred Care Blue. And just to name some details of those networks, Blue Select Plus is probably our most restrictive network.

00;21;23;21 - 00;21;26;15

Barron Roberts

And then Preferred Care Blue is our broadest network.

00;21;26;15 - 00;21;30;10

Cary Hall

And so there's a price difference in those. So let's talk about that.

00;21;30;10 - 00;21;54;06

Barron Roberts

Yeah. Yeah. Absolutely. So as you look at plans that are available out there, you look at the networks, you look at the metallic level, you look at where you're at as well and what options are available to you. The broader the network, typically you're going to have more expensive cost because you're going to have access to more providers, smaller in the network, the inverse, etc. the metallic level will also impact your pricing.

00;21;54;06 - 00;22;14;10

Barron Roberts

So if you go from a bronze plan, which typically has a higher deductible, more out of pocket cost share up to a gold plan, a gold plan is going to have more out of pocket upfront, and in terms of premium, and then you'll have lower out-of-pocket costs as you go. And so as you're making those decisions. You've got to weigh all those different aspects of those of those plan designs.

00;22;14;10 - 00;22;35;28

Cary Hall

Yeah. And the problem with that is some people try to do this and they get confused. One of the things that people have a tendency to do is to go right to the bottom line, and they look at the price. That's great, except you better figure out what the benefits are before you jump on a price. Okay? And I urge you, we've had people on this show who have gone to the government websites and tried to do this, and then they found themselves in a nightmare.

00;22;35;28 - 00;22;48;07

Cary Hall

We did a great show on here with a woman who did that, had to go back and make a simple adjustment on a name change. And she lost her coverage. She didn't even know she lost it. She was pregnant and it took six months to get it back.

00;22;48;09 - 00;22;57;07

Cary Hall

That's why I'm telling you to take the time to call them, you know, here in Kansas City, let one of their reps walk you through the plans and help you with that if you need help.

00;22;57;11 - 00;23;22;12

Cary Hall

That number is 1-800-867-9014. Or go to your local broker who does this every day. There are a lot of moving pieces in this plan. You might find a bronze plan works really well. It's a narrow network. You don't, but if you don't have a lot going on, okay, you're maybe you're an empty nester at 55 or 60 and you're in really good health and you're not ready for Medicare.

00;23;22;14 - 00;23;24;05

Cary Hall

That might be a great fit for you, right?

00;23;24;11 - 00;23;42;21

Barron Roberts

Yeah, yeah. I think you need to look at your budget, understand where you're at, what health care services that you're going to need. And then I do recommend, as Cary mentioned, to, you know, give us a call or call your local broker to figure out and navigate this, this crazy space.

00;23;42;23 - 00;24;07;06

Cary Hall

You said it right there. Navigate the crazy space. You know, the other thing is, for instance, I think, you know, a lot of people land on the silver plans because they work really well. And you've got kind of the, a larger network. Prices are still reasonably, you know, under control with regard to the cost. And, if you've got children, you've got you need access, you need all those those are things that you can do with the silver plan as well.

00;24;07;08 - 00;24;17;21

Barron Roberts

Yeah, absolutely. That's like the middle tier, middle tier plans that are available. It's, kind of hybrid zone between the bronze and the gold and it might be a viable spot for somebody.

00;24;17;25 - 00;24;22;11

Cary Hall

And how does how do those plans interface with, Spira Care now?

00;24;22;14 - 00;24;36;15

Barron Roberts

Yeah. So we have, various plans that have access to Spira Care to find out more about those plans and which ones do I recommend calling out to your broker to walk through each one of those. But some of the plans that we do have available have access to Spira Care.

00;24;36;15 - 00;24;54;19

Cary Hall

So it's important to understand that because there's a way where you can lower costs by using Spira Care, but have this great unlimited access to the primary care clinics with everything as we've talked about behavioral health, there's X-rays, labs, all these things come as part of that package. And that's a great way for you to be able to do that.

00;24;54;19 - 00;25;15;06

Cary Hall

So so if you're looking in the individual market, this is a great year to talk to the folks at BlueKC. Ryan, let's segue into the small group model because small business owners, I hear this all the time, are struggling with costs and are struggling with how they're going to manage to provide benefits for their employees, but keep it a cost, keep it in line with the cost.

00;25;15;06 - 00;25;20;11

Cary Hall

It's reasonable. Let's talk about what BlueKC is offering this year because you have some unique offerings, right?

00;25;20;11 - 00;25;42;28

Ryan Roth

Sure we do. We have a number of different options and I'll start off by mentioning that small group has been very competitive in recent years. So if you haven't looked at a small group plan with BlueKC in recent years, I would encourage you to do so. We have a variety of price points, from inexpensive plans to really rich benefits that tend to be more expensive in all kinds of funding types.

00;25;42;28 - 00;26;09;16

Ryan Roth

So I'll start with ACA. Just as Barron had mentioned, in the individual market, we have ACA plans and small group as well. For employers with 2 to 50 employees. Number of options available within ACA, we have fully insured options from 51 to 99, array of plans available there as well. And then a real popular plan that we've been, selling for several years now is our Level Funded ASO.

00;26;09;23 - 00;26;39;09

Ryan Roth

And it's available for available for 5 to 99. That's been a significant growth place for us. It is an underwritten plan like fully insured is. So your employees have to go through an underwriting process to set your rate different than what it is from ACA, but very popular and growing because, they tend to be if you're if you're a healthy group, it tends to be less expensive plan potentially than ACA could be.

00;26;39;11 - 00;26;43;29

Ryan Roth

And you have the ability to get a refund if you run better than expected at the end of the year.

00;26;44;00 - 00;27;02;20

Cary Hall

Yeah. So that's that's a great piece. And we used to do that a lot with clients. And we had Benefits by Design. And those plans are great because employers know you're trending to a group where, you know, they're under age 50 and they're in reasonably good health. Maybe you've got 1 or 2 people with problems, but those plans can work really well, and there is some cost sharing there.

00;27;02;20 - 00;27;18;06

Cary Hall

But it's a chance for you to pull some money back in at the end of the year if you have a great year. Correct? Yeah. So that's different talk a little bit about the other plans and access to Spira Care on Group, because you know what? I'm hearing some people out there is when they get into Spira Care, they're not going anywhere after that.

00;27;18;09 - 00;27;33;13

Cary Hall

They love it. You know, you've got you've got a, you know, a satisfaction rate of over 90%. It's really quite remarkable what you know, what you're doing. Talk about why that. Why. That's something employers can offer their employees. And it knocks down the barriers to access.

00;27;33;13 - 00;27;55;20

Ryan Roth

Ryan Spira Care has been extremely popular for us over the last few years, and it's available in all segments. So as Barb and Barron had mentioned earlier, it's available on or Medicare options are ACA options. It's available in small group. It's available in large group, not on every single plan, but a number of them have those Spira Care options available.

00;27;55;22 - 00;28;19;00

Ryan Roth

Why is it so popular? It's it's easy and includes a lot of services. So when you go it's advanced primary care. When you go into a facility, it's clean. You get in very quickly. You don't have to wade into a wait in a waiting room for a long period of time. There's a number of services included. You can get X-rays, you can get lab work, behavioral health.

00;28;19;00 - 00;28;41;14

Ryan Roth

Is there all age ranges. So we have, doctors that serve children all the way up to, to Medicare age and everywhere in between. So we've just found that you also get a lot of time and attention from the doctors when you're there. So they really spend the time they're not trying to churn and get to, to a number of patients per day, per day.

00;28;41;19 - 00;28;50;03

Ryan Roth

They want to spend the time with you, the quality time to make sure that they're they're getting your issue resolved or addressed as effectively as possible.

00;28;50;03 - 00;29;08;24

Cary Hall

So here's a handy little piece of information. Do you know the average time a person has spent with a primary care physician in this country? It's 7.5 minutes. That's it. 7.5 minutes. Okay. You might be there for an hour, but you're going to see the doctor for 7.5 minutes. What Ryan just said about Spira Care, that's a huge difference.

00;29;08;24 - 00;29;23;20

Cary Hall

When you go in and sit down with that doctor, that nurse practitioner, that clinician, whatever it may be, they've got the time. They've got the time to listen to you, they've got the time to talk to you, and they've got the time to help you deal with your health issues. It's a big deal and it makes a difference.

00;29;23;20 - 00;29;46;21

Cary Hall

And I'll tell you something else. If you're an employer, your employees are going to love that, okay? They're going to love it because it's a great way to receive primary care and feel like you're actually being listened to. If you want more information, go to the website BlueKC.com BlueKC.com. The phone number 1-800-867-9014. What are there folks who are happy to answer the phone and help you?

00;29;46;23 - 00;30;01;25

Cary Hall

And also talk to your local broker. If you've got a broker you work with, get on the phone and give them a call and have him tell you about these plans. They might make a big difference for you. We'll be right back after the break. You're listening to America's Healthcare Advocate Broadcasting here on the HIA Radio Network.

00;30;02;00 - 00;30;07;25

Cary Hall

Coast to coast across the USA.

00;30;07;28 - 00;30;34;08

Cary Hall

Welcome back. You're listening to America's Healthcare Advocate show, broadcasting coast to coast across the USA. My producer behind the microphone, Mr. Darrin Wilhite behind the camera and the lights. Mr. Dave Thiessen in studio with me. Barron Robertson, Ryan Roth from Blue Cross, Blue Shield of Kansas City. You know, we're doing this show because here we go into open enrollment for AEP and open enrollment for the individual plans in November for Obamacare, ACA.

00;30;34;08 - 00;30;53;23

Cary Hall

And then you've got renewal coming up on all types of group plans. Do yourself a favor, okay? Take the time to take a look at what BlueKC is offering. Compare it, look at it, and look at the Spira Care plans. Look at the at the different level plans the bronze, the silver, the gold on the individual side and look at their small group plans.

00;30;53;23 - 00;31;12;05

Cary Hall

There's a reason why they're the number one carrier in the Kansas City metro. There's a reason for that. A lot of it has to do with the pricing and the benefits, but also their customer service, which again, I'll reiterate, is right here in Kansas City. There's a reason they won all those J.D. Power Awards. And it was because what they do they do really well.

00;31;12;06 - 00;31;19;29

Cary Hall

There is a difference. So you need to correct me on Spira Care. So I said 90% satisfaction. Go ahead. Yeah.

00;31;19;29 - 00;31;29;29

Barron Roberts

Thanks, Cary. So, and we'll hit on those J.D. power words here in a minute. But, so for, Spira Care, our customer effort score at Spira Care is 95%.

00;31;30;01 - 00;31;40;03

Cary Hall

You know that. Really? That's remarkable. Think of something else in today's world where customer service score is 95%, I'd like to know, okay. Because to me that's remarkable.

00;31;40;03 - 00;32;08;22

Barron Roberts

It is pretty outstanding. So just in general, from a market perspective, the customer effort score lands close to 65% across health plans. BlueKC lands at 74% today and Spira Care lands at 95%. So members that go to Spira Care are very happy. And I'll just note that this is an outside firm third party that's measuring these results. And BlueKC employees pride ourselves and are rewarded based upon our customer effort score.

00;32;08;25 - 00;32;27;25

Cary Hall

Yeah. And it's a big difference. It always has been. And and that's to me, you know, there's a lot to be said for that, especially when you're dealing with you're an employer with employees. You don't want them coming back at you going, I can't get anybody to answer the phone. I can't get anybody to help me. That's not going to happen to BlueKC.

00;32;27;27 - 00;32;38;18

Cary Hall

Ryan, Let's switch gears a little bit now and talk about, no increases in some of the some of the other benefits that are being offered. And people love to hear about no increases, right? Yeah.

00;32;38;18 - 00;33;11;02

Ryan Roth

That's correct. In our small group segment, our dental vision and our life insurance offering, which our life insurance offering is through USAble no increases for 2025 on any of those plans. So we've had very good, consistency over the course of the last few years with low to no increases on those products. Very nice to have that where you, you, you know, that price consistency with, inflation the way it is right now in so many other areas, it's nice to know you're not getting an increase there.

00;33;11;05 - 00;33;22;07

Ryan Roth

You can bundle those products with our medical. It's nice easy package. So that it can come on one ID card. So it's a good batch of products to bundle together.

00;33;22;13 - 00;33;36;09

Cary Hall

So you know we've learned and I've had that dental plan for I don't know how many years long before we ever got Medicare was still on it. Talk a little bit about because a lot of bit of improvements were made over the years to the BlueKC Dental plan. In terms of network talk a little bit about that.

00;33;36;09 - 00;33;57;25

Ryan Roth

Yeah, yeah, we have we have a strong network in the Kansas City area. It's as you had mentioned, we've added dentists over the course of years. So it's in a good place. Now. Additionally, I would say that when it comes to those products, we just hear repeatedly that customers are very happy with those products. Not many complaints.

00;33;57;27 - 00;34;06;06

Cary Hall

And then there's some other opportunities that are discounts being offered under under the various plans. So let's talk a little about some of those that come with the BlueKC program.

00;34;06;06 - 00;34;33;15

Barron Roberts

Absolutely. So BlueKC members have access to what we call Blue 365 deals. It's our discount program that's available to our members. That includes discounted gym memberships, discounts off hearing aids, travel services, rental cars, Disney experiences. And there is a whole slew of different services and products that have discounts just for being a blue Cross member.

00;34;33;17 - 00;34;37;05

Cary Hall

And that's available all across all the product lines now.

00;34;37;05 - 00;34;42;05

Barron Roberts

Yep, yep. For each member at BlueKC, they've got access to the blue 365 deals.

00;34;42;05 - 00;35;03;27

Cary Hall

So whether they're on, one of the Medicare supplement plans or whether they're on an ACA individual plan or whether they're on, a group health insurance plan, all of those benefits that we're talking about come through that includes, discounts on glasses, hearing aids. I talked about all these other things, gym memberships, etc. that are available through the blue.

00;35;03;27 - 00;35;13;29

Cary Hall

Casey. 365 it really is a benefit that you can use. It's not just a lot of fluff out there. That's really something people can drill down on. It makes a difference and it makes a cost difference to people.

00;35;13;29 - 00;35;24;29

Barron Roberts

Yeah, yeah. When you're looking at all of your expenses throughout the year, you know, this is, you know, you're looking at your medical expenses. But this also helps support some of those other expenses that you might have already in your in your life.

00;35;25;01 - 00;35;40;12

Cary Hall

Right. You know, we talk a lot about about the volatility in the marketplace. You know, on the, on the on the, on the Medicare side, etc., etc.. You know, why should employers take the time to take a look at what the plans are? The BlueKC's offering, especially on the small group side.

00;35;40;13 - 00;36;03;00

Barron Roberts

Yeah, yeah. And I would say this really applies across segments, whether it's individual small group or large group. You're going to get outstanding customer service, as you had mentioned a couple times in the other segments, we pride ourselves in a local team that's really ingrained in the community. In addition to the customer service, we have price stability in the small group segment year in and year out.

00;36;03;02 - 00;36;09;12

Barron Roberts

We've had that price stability where we don't have the large swings up and down in price, like many of our competitors do.

00;36;09;17 - 00;36;14;03

Cary Hall

And how long does Blue Cross Blue Shield been in Kansas City and servicing the Kansas City metro?

00;36;14;04 - 00;36;15;16

Barron Roberts

Yeah, well, over 85 years.

00;36;15;16 - 00;36;37;02

Cary Hall

Okay. There you have it. Okay. 85 years. And they're not going anywhere. They're here. They're they're our hometown carrier. There are a lot of advantages. There's a reason why, you know, when we had the when we had Benefits by Design, our plan was the Blue Cross Blue Shield plan on the group side. There's a reason why Laurie and I have been Blue Cross and Blue Shield members for ever since we moved to Kansas City 30 some years ago.

00;36;37;02 - 00;36;55;22

Cary Hall

So there's a difference in these products is the difference in service and something you need to understand. Especially I urge you, if you're an employer, take the time to look at what they're offering. If you're tired of your employees coming back to you and saying, I had to call the one 800, nobody cares. Nobody's helping me. I've been transferred to three different departments.

00;36;55;26 - 00;37;05;04

Cary Hall

That's what happens with these large national plans. That is not what happens with BlueKC. It's very different. It's a different model that the hometown carrier for a reason.

00;37;05;07 - 00;37;31;21

Cary Hall

You're talking to somebody that you go to church with to the grocery store, with, that’s probably on your PTA somewhere. So there is a reason. That's why I suggest that if you want information 1-800-867-9014 1-800-867-9014 the website BlueKC.com. And now I leave you with this thought from Doctor Martin Luther King America's must learn to live together as brothers and sisters, or we will surely perish together as fools.

00;37;31;23 - 00;37;36;18

Cary Hall

Those words were never truer than they are today. Thank you for listening to America's Healthcare Advocate.

00;37;36;25 - 00;37;42;00

Unknown

Goodbye, America.

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Unknown

00;37;46;14 - 00;37;48;25

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