Beginning January 1, 2019, there will be a new health pan option available for individuals, known as the Farm Bureau Health Plan. Here are a few facts about the plan.
Who is eligible for the plan? Individuals must be a resident of Iowa, a Farm Bureau member before application, and they must not be eligible form Medicare, Medicaid or group health insurance through an employer as well as able to answer underwriting questions.
Will the coverage be Affordable Care Act compliant? NO, this coverage is called a Health Benefit Plan, not health insurance therefore it is not confined to the rules of the Affordable Care Act. This means underwriting questions will assess the applicant(s) and not all of the 10 essential benefits will be covered. There is no coverage for bariatric surgery, no pediatric eye exams and limits on physical therapy visits along with a $3 million lifetime maximum for claims.
What network of providers? Farm Bureau is utilizing Wellmark Administrators to process claims and the Wellmark HMO network of providers. This network has 100% of the hospitals in Iowa and approximately 98% of the doctors. There is NO coverage outside the state of Iowa except for Emergency care.
There will be three plans available. A plan that is similar to a Silver, a Bronze and a High Deductible Health Plan that is HS A eligible. In the Silver and Bronze plan, the copays will continue even if the out of pocket is met.
In addition to the above there are some key elements to be aware of. There will be underwriting for this plan. Also, there is emphasis on detailed explanation of prior care and conditions. If the Farm Bureau Health Plan can prove there was a condition that was not disclosed, they can rescind coverage, return premiums and not pay claims.
Finally, loss of this coverage anytime during 2019 will NOT constitute an event to enroll in an Affordable Care Act plan. The Farm Bureau Health Plan is allowing both Farm Bureau agents and independent agents who are appointed with Wellmark to write these plans.
The Open Enrollment Period for individuals under age 65 begins November 1 and is open until December 15 for a January 1 effective date.
A little more about us:
The Business Warrior group has some of the industry’s top experts in all the areas your business needs to be successful. Amongst the contributors is Janis VanAhn, owner of Health Insurance Advisor, LLC. For 19 years Janis has worked in and around the health insurance industry initially providing service to agents and employers related to employee benefits, individual healthcare and Medicare, while more recently becoming appointed as an individual agent with various quality carriers to provide this service to individuals through her own business.
Four years ago Janis was ‘blessed’ with being let go from her job at an insurance ageny. Staying within insurance was her path…but in what capacity. 2010 was the year Janis began her career as an independent insurance agent specializing in health insurance. Finding quality, cost-effective healthcare for individuals and families under age 65 as well as working with those who are Medicare eligible truly was her passion. She has made this a true specialty and positioned herself as someone to work with whether it is a financial professional or property & casualty agent with a client that needs assistance, to a group of seniors turning 65 and they keep receiving Medicare information and are confused about what to do.
Janis enjoys the one on one contact with clients as well as looking forward to speaking to groups about healthcare. Her excitement for this industry is what drives her to stay in tune with Healthcare Reform and what is currently happening and what will happen with coverage from now to past 2014.
‘Educating individual and Medicare consumers to make informed choices’ is her mission because if people are educated and understand, they will make informed choices that they are comfortable with.