1 00:00:01,501 --> 00:00:05,538 And now America's Healthcare Advocate, Cary Hall. 2 00:00:06,106 --> 00:00:06,840 Hello, America. 3 00:00:06,840 --> 00:00:08,541 Welcome to America's Healthcare Advocate. 4 00:00:08,541 --> 00:00:11,678 Show broadcasting coast to coast across USA. 5 00:00:11,911 --> 00:00:16,249 Here on the HIA Radio Network, you can learn more about us going to our website. 6 00:00:16,249 --> 00:00:18,651 AmericasHealthcareAdvocate.com. 7 00:00:18,651 --> 00:00:22,622 Also your favorite podcast platform, SoundCloud, whatever it may be. 8 00:00:22,622 --> 00:00:24,858 Spotify, Rumble, all of them. 9 00:00:24,858 --> 00:00:29,095 We're on 16 of them and our YouTube channel, America's Healthcare Advocate. 10 00:00:29,095 --> 00:00:30,263 My producer today, Mr. 11 00:00:30,263 --> 00:00:31,998 Dave Thiessen, behind the cameras, 12 00:00:31,998 --> 00:00:35,068 doing what he always does, bringing all these shows together. 13 00:00:35,402 --> 00:00:38,438 They go up on our podcast platforms and our YouTube platform. 14 00:00:38,671 --> 00:00:41,441 And Garner Cowdrey, who is behind the microphones here 15 00:00:41,441 --> 00:00:44,277 in our beautiful Cumulus Studios. 16 00:00:44,277 --> 00:00:47,647 If you need help, if you are, chronologically challenged 17 00:00:47,647 --> 00:00:51,651 or you are looking for individual ACA, the lovely Carolee 18 00:00:51,651 --> 00:00:54,654 Steele at RPS Benefits by Design, will be happy to help you. 19 00:00:55,088 --> 00:00:58,591 You can reach her at 877-385-2224. 20 00:00:58,892 --> 00:01:00,760 And if you're looking for employer sponsored 21 00:01:00,760 --> 00:01:03,763 health insurance, Maria Ahlers is also happy to help you. 22 00:01:03,897 --> 00:01:07,867 They have access to all the great plans out there, including those brand new 23 00:01:08,268 --> 00:01:11,371 Blue Cross and Blue Shield plans are going to roll out this year. 24 00:01:11,771 --> 00:01:14,174 And so in studio with me, Mr. 25 00:01:14,174 --> 00:01:17,143 Barron Roberts from Blue Cross and Blue Shield of Kansas City. Welcome. 26 00:01:17,143 --> 00:01:18,344 Thanks, Cary. 27 00:01:18,344 --> 00:01:22,682 I haven't done a show like this, I think in probably six years. 28 00:01:22,882 --> 00:01:25,485 And now I'm going to tell you why I just said that. 29 00:01:25,485 --> 00:01:27,287 So here's what's going on in the ACA 30 00:01:27,287 --> 00:01:30,957 marketplace that I warned you this was going to happen some months ago. 31 00:01:31,324 --> 00:01:33,960 This is this is what we're looking at with carriers. 32 00:01:33,960 --> 00:01:37,797 Celtic Insurance increased this year 24.4%, 33 00:01:38,131 --> 00:01:41,134 Medica 29.2%. 34 00:01:41,201 --> 00:01:44,304 UnitedHealth Insurance 10.7%. 35 00:01:44,704 --> 00:01:46,172 You want to tell us what the Blue Cross 36 00:01:46,172 --> 00:01:48,842 and Blue Shield increase is going to be this year? Yeah. 37 00:01:48,842 --> 00:01:52,512 So in in Kansas we're looking at a -4.1%. 38 00:01:52,512 --> 00:01:54,581 And in Missouri a negative six. 39 00:01:54,581 --> 00:01:55,882 Did you hear what I just said. 40 00:01:55,882 --> 00:01:57,717 I reversed that Cary. 41 00:01:57,717 --> 00:01:59,486 That's all right. Yeah that's all right. 42 00:01:59,486 --> 00:02:03,223 The point is they’re actually going to be a premium reduction. 43 00:02:03,556 --> 00:02:07,494 Now the last time I did a radio broadcast where there was a decrease in premiums 44 00:02:07,627 --> 00:02:10,697 was Ron Rowe, about eight years ago, if I remember correctly. 45 00:02:10,930 --> 00:02:12,665 So it's been a while. All right. 46 00:02:12,665 --> 00:02:16,202 And this is a great piece of news for everybody in the Kansas City metro. 47 00:02:16,202 --> 00:02:17,470 So I'm going to repeat that. 48 00:02:17,470 --> 00:02:22,842 So they're looking at Missouri at a -4.4%. 49 00:02:23,076 --> 00:02:26,146 And in Kansas a -6.1%. 50 00:02:26,346 --> 00:02:29,549 So there must have been a lot of work went into this. 51 00:02:29,582 --> 00:02:32,552 If you're bucking the whole marketplace, 52 00:02:32,552 --> 00:02:35,355 okay, all the national carriers, etc., 53 00:02:35,355 --> 00:02:37,190 and you're coming in at numbers that are good, 54 00:02:37,190 --> 00:02:38,291 and then we're going to talk about 55 00:02:38,291 --> 00:02:40,460 some of the specific plans you're going to offer. 56 00:02:40,460 --> 00:02:41,561 They're going to be very different. 57 00:02:41,561 --> 00:02:43,429 But how did you guys get to this. 58 00:02:43,429 --> 00:02:47,167 Yeah we put a lot of work designing these new plans. 59 00:02:47,167 --> 00:02:49,702 We gathered member feedback from across the community. 60 00:02:49,702 --> 00:02:51,871 We gathered our broker partner feedback, 61 00:02:53,139 --> 00:02:53,673 months and 62 00:02:53,673 --> 00:02:56,676 months ago to put together plans that would fit, 63 00:02:57,443 --> 00:02:59,846 the members of our community. 64 00:02:59,846 --> 00:03:02,749 You know, it, 65 00:03:02,749 --> 00:03:05,185 when we talk about the independent Blue Cross plans, like Blue 66 00:03:05,185 --> 00:03:08,988 Cross of Kansas, Blue Cross of Nebraska, Blue Cross of Kansas City. 67 00:03:10,256 --> 00:03:12,592 You know, there's the tagline that always comes to mind for me 68 00:03:12,592 --> 00:03:14,861 when I look at that versus the big carriers. 69 00:03:14,861 --> 00:03:17,864 The big Aetna’s, the big UnitedHealthcare's. 70 00:03:18,064 --> 00:03:21,067 the Cygnus, and that is we're Main Street, not Wall Street. 71 00:03:21,768 --> 00:03:24,070 And you're right down here on Main Street. 72 00:03:24,070 --> 00:03:25,605 You know, you serve this market. 73 00:03:25,605 --> 00:03:27,840 You've been here for how many years? Over 85 Years. 74 00:03:27,840 --> 00:03:29,609 85 years in Kansas City. 75 00:03:29,609 --> 00:03:32,612 And you're able to come to the people in this city and say, 76 00:03:32,612 --> 00:03:37,850 we're going to cut premiums this year by 4.4% Missouri and 6% in Kansas. 77 00:03:37,917 --> 00:03:40,220 That's pretty significant. Absolutely. 78 00:03:40,220 --> 00:03:43,189 There's a lot going on in the ACA this year. 79 00:03:43,189 --> 00:03:46,593 You know, there's enhanced subsidies that are going away or expected to go away 80 00:03:46,593 --> 00:03:49,596 at the end of the year unless there's something that changes about that. 81 00:03:49,762 --> 00:03:52,765 You'll have a $5, additional premium 82 00:03:53,066 --> 00:03:56,102 applied to your bill if you don't go in and update your income. 83 00:03:56,469 --> 00:03:59,539 It's a very active open enrollment this year. 84 00:03:59,539 --> 00:04:03,843 And we would encourage everyone to go out and review their details 85 00:04:03,843 --> 00:04:06,846 within their marketplace account to ensure that they are getting, 86 00:04:07,113 --> 00:04:10,149 assessed the right premium for one, but also evaluate their options. 87 00:04:10,149 --> 00:04:13,419 And as you mentioned, we're giving decreases this year. 88 00:04:14,487 --> 00:04:16,723 We're going to be much more competitive. 89 00:04:16,723 --> 00:04:18,057 Well, you’re going to be much more competitive. 90 00:04:18,057 --> 00:04:19,292 And there's a tsunami coming. 91 00:04:19,292 --> 00:04:22,028 I've been telling people this for the last four months. 92 00:04:22,028 --> 00:04:24,631 Okay. I've done multiple shows on this. 93 00:04:24,631 --> 00:04:28,501 There's a tsunami coming that, no longer are you going to be able to self affirm. 94 00:04:28,768 --> 00:04:29,869 You're actually going to have to, 95 00:04:29,869 --> 00:04:32,538 you know, have documentation that says you made ‘X’. 96 00:04:32,538 --> 00:04:36,109 The automatically renewing subsidies are going from 400% 97 00:04:36,709 --> 00:04:40,980 of the poverty level back to 150 to 200, which is where they were 98 00:04:41,314 --> 00:04:44,317 before we had the expansion in 2021. 99 00:04:44,484 --> 00:04:45,952 Well, that's going away now. 100 00:04:45,952 --> 00:04:49,389 So there's going to be massive market disruption in the marketplace. 101 00:04:50,023 --> 00:04:53,660 Between 90 and 93% of Americans 102 00:04:53,660 --> 00:04:56,996 today on the ACA, have the enhanced subsidies. 103 00:04:56,996 --> 00:04:59,999 So 90 to 93% are going to be affected by these changes. 104 00:05:00,199 --> 00:05:01,367 That's huge. 105 00:05:01,367 --> 00:05:01,634 All right. 106 00:05:01,634 --> 00:05:05,371 And so what BlueCross has done is they've stepped up to the plate 107 00:05:05,672 --> 00:05:08,675 and said, we're going to buck the market trend. 108 00:05:08,908 --> 00:05:10,510 You guys are taking a risk here. 109 00:05:10,510 --> 00:05:11,944 There's no guarantee. 110 00:05:11,944 --> 00:05:14,380 You know this is going to work out for you guys in a year from now. 111 00:05:14,380 --> 00:05:17,784 You're not going to be going, oh, Lord, you know, but the fact that you're willing 112 00:05:17,784 --> 00:05:21,688 to make that commitment to this community after 80 years of serving 113 00:05:21,688 --> 00:05:24,757 this community says a lot about Blue Cross and Blue Shield of Kansas City. 114 00:05:25,425 --> 00:05:26,426 You know, most certainly. 115 00:05:26,426 --> 00:05:29,262 And we've done a lot of things to to get there. 116 00:05:29,262 --> 00:05:32,265 What we're looking at different care management programs. 117 00:05:32,432 --> 00:05:36,035 In addition to that, we're rolling out a brand new network in 2026. 118 00:05:36,035 --> 00:05:40,139 Will help us get to the pricing point that, members are looking for. 119 00:05:40,373 --> 00:05:40,640 Yeah. 120 00:05:40,640 --> 00:05:41,274 And that new network 121 00:05:41,274 --> 00:05:41,774 you’re going to have, 122 00:05:41,774 --> 00:05:44,777 we'll talk about that when we get into the next segment of the show. 123 00:05:45,111 --> 00:05:49,582 And then obviously, Spira Care and how that's going to fit into 124 00:05:49,582 --> 00:05:52,518 the equation is really interesting because we're seeing a lot of initiatives 125 00:05:52,518 --> 00:05:56,289 now for, primary care, direct primary care, 126 00:05:56,522 --> 00:05:59,792 getting away from the hospital models, the other models, 127 00:06:00,393 --> 00:06:03,129 which is kind of funny because how long Spira Care have been in existence. 128 00:06:03,129 --> 00:06:04,697 Yeah, since 2018. Okay. 129 00:06:04,697 --> 00:06:08,301 So I mean you the compliment Danette Wilson. 130 00:06:08,634 --> 00:06:09,102 Okay. 131 00:06:09,102 --> 00:06:09,769 For having, 132 00:06:09,769 --> 00:06:13,539 you know, the vision to say we're going to do something really different. 133 00:06:13,539 --> 00:06:17,276 I remember when everybody was like, this is never going to work. 134 00:06:17,710 --> 00:06:20,246 Well here we are in 2026. 135 00:06:20,246 --> 00:06:21,447 And guess what. 136 00:06:21,447 --> 00:06:24,450 Not only is it working, it's working phenomenally well. 137 00:06:24,517 --> 00:06:25,818 Yeah. Very well. 138 00:06:25,818 --> 00:06:30,723 Our members are reporting, 96% customer effort 139 00:06:30,723 --> 00:06:32,925 score at Spira Care, which is a true testament 140 00:06:32,925 --> 00:06:36,062 to the experience that they get there, the accessibility, 141 00:06:36,863 --> 00:06:40,800 and and being able to get to a provider that, keeps costs low. 142 00:06:41,234 --> 00:06:45,238 Let's give folks the dates when they can when this is all going to start with OEPs. 143 00:06:45,271 --> 00:06:50,042 For ACA, you'll have a shopping period or shopping window towards the tail 144 00:06:50,042 --> 00:06:52,678 end of October, so you can go out and see what 145 00:06:52,678 --> 00:06:54,680 the different prices and plans that are available. 146 00:06:54,680 --> 00:06:58,317 And then open enrollment starts November 1st 147 00:06:58,651 --> 00:07:01,754 up until December 15th for a 1/1 effective date. 148 00:07:02,321 --> 00:07:04,791 And then if you're enrolling for a 2/1 effective date, 149 00:07:04,791 --> 00:07:08,895 that enrollment can come in after December 15th up to January 15th. 150 00:07:09,162 --> 00:07:10,396 And that's it. 151 00:07:10,396 --> 00:07:10,963 That's it. 152 00:07:10,963 --> 00:07:11,297 Okay. 153 00:07:11,297 --> 00:07:14,867 So here's my admonition to all of you out there in the audience. 154 00:07:15,435 --> 00:07:17,870 All you folks like to procrastinate. 155 00:07:17,870 --> 00:07:20,940 This is one year where you better not procrastinate. 156 00:07:20,940 --> 00:07:22,175 Okay. 157 00:07:22,175 --> 00:07:23,976 You know, I'm going to give you the phone number, 158 00:07:23,976 --> 00:07:26,712 and I'm going to suggest you that you probably you ought to start 159 00:07:26,712 --> 00:07:30,483 making some calls and start talking to people and get ahead of this thing. 160 00:07:30,750 --> 00:07:33,352 So you can call the folks down at Blue Cross. 161 00:07:33,352 --> 00:07:34,620 They can they can chat with you. 162 00:07:34,620 --> 00:07:38,257 They can set up a time to talk to you after OEP, whatever you want to do. 163 00:07:38,491 --> 00:07:41,828 But you need to get ahead of this because once this tsunami hits, 164 00:07:42,528 --> 00:07:44,197 you guys are going to get buried. 165 00:07:44,197 --> 00:07:47,200 You're the only plan in town that’s offering decrease, 166 00:07:47,400 --> 00:07:48,401 you're going to get hammered. 167 00:07:48,401 --> 00:07:50,636 We're going to get a lot of calls. For sure. Yes, you are. 168 00:07:50,636 --> 00:07:52,705 And there's going to be a lot that has to happen here. 169 00:07:52,705 --> 00:07:56,776 So the phone number is 833-467-2145. 170 00:07:56,776 --> 00:08:00,012 833-467-2145. 171 00:08:00,279 --> 00:08:03,216 And the website is bluekc.com. Yes. Yep. 172 00:08:03,216 --> 00:08:03,483 All right. 173 00:08:03,483 --> 00:08:06,185 So if you want information you can go up to the website. 174 00:08:06,185 --> 00:08:08,087 But I would strongly suggest 175 00:08:08,087 --> 00:08:11,657 you start making arrangements to have these conversations now. 176 00:08:11,924 --> 00:08:14,393 So you're not caught at the last minute. 177 00:08:14,393 --> 00:08:16,729 Because as I said it's going to be a tsunami. 178 00:08:16,729 --> 00:08:17,964 There are a lot of changes coming. 179 00:08:17,964 --> 00:08:20,233 A lot of folks are going to be affected by these changes. 180 00:08:20,233 --> 00:08:21,367 We come back to the break. 181 00:08:21,367 --> 00:08:24,470 We'll talk some more about this and how and the new plans 182 00:08:24,470 --> 00:08:26,539 and the new network and all that they’re doing, 183 00:08:26,539 --> 00:08:29,242 and then we'll switch gears when we get to the third segment, 184 00:08:29,242 --> 00:08:30,877 and we'll start talking about what's going to happen 185 00:08:30,877 --> 00:08:33,946 to the small employer, because small employers on ACA 186 00:08:33,946 --> 00:08:37,316 type plans are also going to get hit with very significant increases. 187 00:08:37,650 --> 00:08:41,587 What is Blue Cross doing to address that, and how are they addressing that 188 00:08:41,587 --> 00:08:44,190 so they can help the small employer in the marketplace? 189 00:08:44,190 --> 00:08:45,091 Stay tuned. 190 00:08:45,091 --> 00:08:46,559 We'll be right back after the break. 191 00:08:46,559 --> 00:08:48,961 You're listening to America's Healthcare Advocate 192 00:08:48,961 --> 00:08:51,964 Broadcasting here on the HIA Radio Network. 193 00:08:52,031 --> 00:08:54,600 Coast to coast across USA. We've got more. 194 00:08:54,600 --> 00:08:55,535 Stay right there. 195 00:08:55,535 --> 00:08:57,203 That phone number once again. 196 00:08:57,203 --> 00:09:00,373 833-467-2145. 197 00:09:00,373 --> 00:09:02,308 Stay right there. We'll be right back after the break. 198 00:09:12,385 --> 00:09:13,085 Welcome back. 199 00:09:13,085 --> 00:09:16,589 You're listening to America's Healthcare Advocate show, broadcasting coast 200 00:09:16,589 --> 00:09:20,493 to coast across the USA here on the HIA Radio Network. 201 00:09:20,493 --> 00:09:21,460 Once again, you can find out 202 00:09:21,460 --> 00:09:25,364 more about us by going to the website AmericasHealthcareAdvocate.com. 203 00:09:25,364 --> 00:09:27,733 You have an email. You want to send me a note? 204 00:09:27,733 --> 00:09:28,501 Please do so. 205 00:09:28,501 --> 00:09:31,003 Go to the website. I'm happy to help you. Any way I can. 206 00:09:31,003 --> 00:09:35,207 I want a shout out to WNRP, AM 1620 207 00:09:35,207 --> 00:09:38,210 and FM 95.3 Pensacola, Florida. 208 00:09:38,344 --> 00:09:41,847 Happy to have those folks on board as part of America's Healthcare Advocate 209 00:09:41,847 --> 00:09:45,785 family broadcasting down there every Saturday at 8:00 in the morning. 210 00:09:46,352 --> 00:09:48,521 And we love Pensacola, Florida, by the way. 211 00:09:48,521 --> 00:09:50,990 So, all right, let's switch gears now. 212 00:09:50,990 --> 00:09:54,961 And we kind of gave people a little tease there. 213 00:09:55,094 --> 00:09:57,697 This new plan, which I'm hearing a lot. 214 00:09:57,697 --> 00:10:00,232 In fact, we just had the folks 215 00:10:00,232 --> 00:10:03,002 from RPS Benefits by Design up here, and they were talking about it. 216 00:10:03,002 --> 00:10:05,671 And you guys have had a big broker meeting the other day, 217 00:10:05,671 --> 00:10:09,542 and there's some pretty excited brokers out there to learn about this new plan 218 00:10:09,542 --> 00:10:11,210 that's coming in play, and what a difference 219 00:10:11,210 --> 00:10:13,746 it's going to make people. So let's talk about it. Yeah. 220 00:10:13,746 --> 00:10:14,880 What's it going to be called. Yep. 221 00:10:14,880 --> 00:10:16,916 It is going to be called the Simply Blue Plan. 222 00:10:16,916 --> 00:10:18,250 Simply Blue. All right. 223 00:10:19,719 --> 00:10:20,052 And we'll 224 00:10:20,052 --> 00:10:24,090 actually have three one in each metallic category. 225 00:10:24,090 --> 00:10:26,892 So gold, silver and bronze. 226 00:10:26,892 --> 00:10:28,628 We're pretty excited about it. 227 00:10:28,628 --> 00:10:29,462 At the 228 00:10:29,462 --> 00:10:32,898 smaller rollouts that we've done so far, brokers are getting excited about it. 229 00:10:32,965 --> 00:10:35,501 We had a group up here this morning. It's pretty excited about it. 230 00:10:35,501 --> 00:10:35,835 Yeah. 231 00:10:35,835 --> 00:10:38,838 So, the price point on that, that will be our lowest price plan 232 00:10:38,838 --> 00:10:40,473 that we have available. 233 00:10:40,473 --> 00:10:44,644 It'll be offered in the Johnson County, Wyandotte County and Jackson County 234 00:10:45,011 --> 00:10:46,479 metro area. Okay. 235 00:10:46,479 --> 00:10:49,615 And it'll be a part of what we call the Blue Metro Network. 236 00:10:49,649 --> 00:10:50,182 Okay. 237 00:10:50,182 --> 00:10:53,252 That'll consist of Saint Joseph, 238 00:10:53,452 --> 00:10:57,289 Saint Mary's University Health and Providence. 239 00:10:57,289 --> 00:11:00,092 And it also includes University Health Lakewood as well. 240 00:11:00,092 --> 00:11:02,161 Lakewood and then downtown. 241 00:11:02,161 --> 00:11:02,962 Yep. Okay. 242 00:11:02,962 --> 00:11:05,331 Then Providence Hospital over in Kansas City, Kansas. 243 00:11:05,331 --> 00:11:06,165 That was the other one. 244 00:11:06,165 --> 00:11:09,068 Saint Mary's down south. In Blue Spring. 245 00:11:09,068 --> 00:11:09,735 and Saint Joseph. 246 00:11:11,237 --> 00:11:13,706 So it’s a narrow network. 247 00:11:13,706 --> 00:11:16,208 But the price point is going to be. 248 00:11:16,208 --> 00:11:18,110 Much better. 249 00:11:18,110 --> 00:11:20,413 You know what people are going to have to do is be willing 250 00:11:20,413 --> 00:11:23,916 to accept a narrower network in order to get that price point. 251 00:11:24,250 --> 00:11:27,586 The good news is you're giving them an option. 252 00:11:27,887 --> 00:11:28,621 Absolutely. 253 00:11:28,621 --> 00:11:31,624 They're not going to see with the other carriers so 254 00:11:32,558 --> 00:11:35,728 you're addressing the issue by getting creative 255 00:11:35,728 --> 00:11:38,064 and giving them an option so that somebody, 256 00:11:38,064 --> 00:11:41,400 you know, if they do lose their subsidy and they need coverage, 257 00:11:41,400 --> 00:11:44,537 at least they can keep they can still stay in Blue Cross. The. 258 00:11:44,870 --> 00:11:45,671 Whole nine yards. 259 00:11:45,671 --> 00:11:46,405 Okay. 260 00:11:46,405 --> 00:11:48,841 Now is Spira Care accessible on those plans. 261 00:11:48,841 --> 00:11:53,079 So each one of those plans will have access to all nine Spira Care centers. 262 00:11:53,079 --> 00:11:54,346 That's huge. Yeah. All right. 263 00:11:54,346 --> 00:11:57,683 So now you just took primary care out of the equation 264 00:11:57,683 --> 00:12:00,686 from the standpoint did they have to drive to a facility. 265 00:12:00,753 --> 00:12:03,422 They've got one of the nine Spira Care centers. 266 00:12:03,422 --> 00:12:05,491 So you're connecting the two now. 267 00:12:05,491 --> 00:12:09,361 So all of their primary care, behavioral health, 268 00:12:09,695 --> 00:12:12,698 all the other things that go with that will be in Spira Care. 269 00:12:12,832 --> 00:12:14,400 Yeah, they'll have access to that. 270 00:12:14,400 --> 00:12:19,138 And, access to Spira Care is much faster than a traditional primary care. 271 00:12:19,271 --> 00:12:23,275 23 days to a typical wait to get in to see a primary care doctor. 272 00:12:23,275 --> 00:12:26,045 Then you get 7.5 minutes. 273 00:12:26,045 --> 00:12:28,848 That's the average time you get with your primary care. 274 00:12:28,848 --> 00:12:30,282 Little different. In Spira Care. 275 00:12:30,282 --> 00:12:33,219 Talk about. That. Yeah, yeah. So in Spira Care. 276 00:12:33,219 --> 00:12:35,721 You can get in and get your original orientation 277 00:12:35,721 --> 00:12:39,258 visit set up much earlier than traditional PCP office visits. 278 00:12:39,258 --> 00:12:43,629 And then on top of that for sick care or a little bit more urgent type care. 279 00:12:44,163 --> 00:12:45,197 You can get in to see Spira 280 00:12:45,197 --> 00:12:48,567 within a few days, if not the same day, depending on the circumstance. 281 00:12:49,001 --> 00:12:53,038 To me, when you're balancing that narrow network piece 282 00:12:53,372 --> 00:12:56,542 for cost effectiveness and but you're not saying to them, well, 283 00:12:56,542 --> 00:12:58,611 you're going to go find a new primary care provider. 284 00:12:58,611 --> 00:13:02,915 No, you can come to Spira Care and we'll take care of you here. 285 00:13:03,015 --> 00:13:06,385 We've got nine clinics around the Kansas City metro, 286 00:13:06,619 --> 00:13:10,790 so you're giving them an option where they've got primary care, taken care of. 287 00:13:11,056 --> 00:13:12,992 Whatever they need is right there. 288 00:13:12,992 --> 00:13:15,961 If they need major medical, they can go to one of the hospitals 289 00:13:15,961 --> 00:13:16,929 and get major medical. 290 00:13:16,929 --> 00:13:17,630 Absolutely. 291 00:13:17,630 --> 00:13:19,565 And hit on one more thing there Cary. 292 00:13:19,565 --> 00:13:22,568 Care at Spira Care is at no cost to members. 293 00:13:22,935 --> 00:13:25,871 So they've got easy access, affordable access. 294 00:13:25,871 --> 00:13:29,809 They'll have a great experience there and care is at no cost for Spira 295 00:13:29,809 --> 00:13:30,543 Care members. Yeah. 296 00:13:30,543 --> 00:13:32,878 So there's your there's your key takeaways right there. 297 00:13:32,878 --> 00:13:37,516 And you heard him say in the last segment, 96% of the people coming away 298 00:13:37,516 --> 00:13:41,153 from Spira Care are telling them they're doing a good job. 299 00:13:41,520 --> 00:13:42,688 All right. So if you're not going to 300 00:13:43,889 --> 00:13:44,490 make co-pays. 301 00:13:44,490 --> 00:13:46,892 You're not going to have to pay out-of-pocket costs for this. 302 00:13:46,892 --> 00:13:49,562 When you think about marrying that up with the plan, it's 303 00:13:49,562 --> 00:13:51,864 going to save you a significant amount of money. 304 00:13:51,864 --> 00:13:54,066 That sounds like a pretty win win deal to me. 305 00:13:54,066 --> 00:13:55,134 Yeah, absolutely. 306 00:13:55,134 --> 00:13:59,805 That is, taking total cost of care down for members and families for sure. 307 00:13:59,805 --> 00:14:01,674 So rolls out. Win. 308 00:14:01,674 --> 00:14:04,810 This will roll out, January 1st is a new product. 309 00:14:04,810 --> 00:14:06,545 Open enrollment starts 11/1. 310 00:14:06,545 --> 00:14:09,481 Great. Start looking for that plan starting 11/1. 311 00:14:09,481 --> 00:14:10,783 And if they want to call 312 00:14:10,783 --> 00:14:13,786 and just have a consultation with somebody and talk about that plan, 313 00:14:13,953 --> 00:14:16,922 they don't have to wait to open enrollment to make a phone call to say 314 00:14:16,922 --> 00:14:19,792 this isn't Medicare. Right? Okay. Right. 315 00:14:19,792 --> 00:14:19,992 Yeah. 316 00:14:19,992 --> 00:14:22,995 Where we got the thought police out there going, you can't call it. 317 00:14:22,995 --> 00:14:25,497 You can't talk to anybody. Yep. They can. So this is a different deal. 318 00:14:25,497 --> 00:14:28,200 This is ACA. So they can call anytime they want. 319 00:14:28,200 --> 00:14:31,170 If they've heard about this plan it's called Simply Blue. 320 00:14:31,470 --> 00:14:33,606 That's pretty easy right. Simply Blue. 321 00:14:33,606 --> 00:14:35,441 And there are three plans. 322 00:14:35,441 --> 00:14:38,344 There's there's the there's the gold. 323 00:14:38,344 --> 00:14:39,912 There's the silver and there's the bronze. 324 00:14:39,912 --> 00:14:42,081 So you've got three separate plans to offer. 325 00:14:42,081 --> 00:14:44,917 I assume there's going to have different deductibles. Correct. 326 00:14:44,917 --> 00:14:47,052 2000, 4000 and 6000. 327 00:14:47,052 --> 00:14:49,555 And the premiums all vary depending on the plan. Okay. 328 00:14:49,555 --> 00:14:52,524 So if you know, if you're if you're one of those folks 329 00:14:52,524 --> 00:14:55,561 that's chronologically challenged, you're in your 50s, 330 00:14:56,061 --> 00:14:59,298 you probably don't need a $2,000 deductible 331 00:14:59,298 --> 00:15:03,168 because you’re not running to the E.R., the urgent care and all the other things 332 00:15:03,168 --> 00:15:05,371 you're going to have to do with the household children. 333 00:15:05,371 --> 00:15:07,973 So you could go to a $5,000 deductible. 334 00:15:07,973 --> 00:15:09,842 Can that be tied to an HSA? 335 00:15:09,842 --> 00:15:12,811 So actually new for 2026, 336 00:15:13,512 --> 00:15:18,817 bronze and catastrophic plans will be eligible for HSA, compatibility. 337 00:15:18,984 --> 00:15:20,753 Okay. So that's huge. Yeah. 338 00:15:20,753 --> 00:15:23,589 And the thing about the HSA is that I always try to get people's 339 00:15:23,589 --> 00:15:26,792 heads is it money going in is tax deductible. 340 00:15:26,792 --> 00:15:29,161 So you made 100 grand. You're going to pay taxes on 100 grand. 341 00:15:29,161 --> 00:15:29,595 No you're not. 342 00:15:29,595 --> 00:15:32,131 You're going to take 6300 off that. 343 00:15:32,131 --> 00:15:34,099 It’s your money you're putting into your account. 344 00:15:34,099 --> 00:15:37,102 Oh and by the way, when you take it out it's tax free. 345 00:15:37,403 --> 00:15:39,905 So if you went to the higher deductible plan 346 00:15:39,905 --> 00:15:42,574 and you had to go have a surgical procedure, 347 00:15:42,574 --> 00:15:45,511 you've already got your deductible there to pay to get it done. 348 00:15:45,511 --> 00:15:46,145 Correct. 349 00:15:46,145 --> 00:15:48,647 And if you don't use it, you don't lose it. 350 00:15:48,647 --> 00:15:51,750 Unlike, Like an HRA or something like that. 351 00:15:51,750 --> 00:15:52,284 All right. 352 00:15:52,284 --> 00:15:54,753 This plan is not a flex. It's not an HRA. 353 00:15:54,753 --> 00:15:56,588 This money rolls over every year. 354 00:15:56,588 --> 00:16:00,092 So you can continue to add to it So if you put all those pieces together 355 00:16:00,759 --> 00:16:02,861 you got some answers here. Absolutely. 356 00:16:03,862 --> 00:16:05,664 And that's that's really kind of what BlueCross 357 00:16:05,664 --> 00:16:07,766 Kansas City has always been known for 358 00:16:07,766 --> 00:16:10,836 is that you have the answers and you're serving this community. 359 00:16:11,003 --> 00:16:12,805 And this is a great opportunity. 360 00:16:12,805 --> 00:16:15,240 You know, once again, they're called Simply Blue. 361 00:16:15,240 --> 00:16:18,711 I strongly suggest that you are the up on the website, yet. 362 00:16:19,011 --> 00:16:21,780 No. They won't be up on the website until late October. 363 00:16:21,780 --> 00:16:24,450 Okay, so. During the shopping season in. October, you can go up there. 364 00:16:24,450 --> 00:16:26,318 They'll be up there if you just want to call 365 00:16:26,318 --> 00:16:29,188 and have a conversation with him about this, you can do that. 366 00:16:29,188 --> 00:16:34,093 833-467-2145. 367 00:16:34,093 --> 00:16:35,294 833-467-2145. 368 00:16:35,294 --> 00:16:38,597 By the way, there are 1 million people out there across the country 369 00:16:38,597 --> 00:16:41,600 that are losing their coverage because Aetna’s pulling out of the market. 370 00:16:41,834 --> 00:16:44,837 You folks probably ought to be the ones on the phones first. 371 00:16:45,137 --> 00:16:45,804 Okay. 372 00:16:45,804 --> 00:16:48,874 And looking for these plans and to see what they can do because, 373 00:16:49,475 --> 00:16:52,811 come January 1st, all the Aetna plans are pulling the pin on ACA. 374 00:16:52,811 --> 00:16:54,146 They're going to be gone. 375 00:16:54,146 --> 00:16:57,149 And I and I read to you earlier what's going to happen with the other plans. 376 00:16:57,349 --> 00:17:00,085 They're going to be significant increases across the board. 377 00:17:00,085 --> 00:17:04,023 BlueKC continues to lead the way as the local hometown carrier. 378 00:17:04,189 --> 00:17:05,591 We'll be right back after the break. 379 00:17:05,591 --> 00:17:08,827 You're listening to America's Healthcare Advocate broadcasting 380 00:17:08,827 --> 00:17:12,998 here on the HIA Radio Network coast to coast across USA. 381 00:17:13,032 --> 00:17:15,334 Stay right there. We've got more in the next segment. 382 00:17:25,644 --> 00:17:26,278 Welcome back. 383 00:17:26,278 --> 00:17:29,314 You're listening to America's Healthcare Advocate show broadcasting 384 00:17:29,314 --> 00:17:33,218 coast to coast across USA here on the HIA Radio Network. 385 00:17:33,352 --> 00:17:35,154 My producer behind the microphones, Mr. 386 00:17:35,154 --> 00:17:36,955 Garner Cowdery behind the cameras, 387 00:17:36,955 --> 00:17:39,158 putting all these shows together as he does every week. 388 00:17:39,158 --> 00:17:39,992 Dave Thiessen 389 00:17:39,992 --> 00:17:44,229 in studio with me, Barron Roberts, BlueKC we're talking about the coming tsunami 390 00:17:44,630 --> 00:17:48,000 That's what's going to happen, both on the individual side 391 00:17:48,000 --> 00:17:51,403 and on the group side with anything associated with ACA. 392 00:17:51,937 --> 00:17:55,140 And how is that going to play out for all of you out there in the audience? 393 00:17:55,607 --> 00:17:56,942 So we've talked about 394 00:17:56,942 --> 00:18:00,279 on the individual side and what Blue Cross is doing to lead the way. 395 00:18:00,779 --> 00:18:04,049 They're actually going to have premium reductions on the individual side. 396 00:18:04,416 --> 00:18:06,718 Right now we're going to switch gears here, and talk about 397 00:18:06,718 --> 00:18:09,822 what are the answers to the employers out there, the small group 398 00:18:09,822 --> 00:18:12,891 employer, the employer under the 100 lives. 399 00:18:12,991 --> 00:18:14,393 What are the answers to them? 400 00:18:14,393 --> 00:18:17,296 What is Blue Cross doing to address the issues 401 00:18:17,296 --> 00:18:18,363 that they're going to deal with? 402 00:18:18,363 --> 00:18:20,265 Because that's going to happen. 403 00:18:20,265 --> 00:18:20,599 All right. 404 00:18:20,599 --> 00:18:23,602 And if you're you know, you need to talk to your broker. 405 00:18:23,836 --> 00:18:27,039 If you don't talk to your broker, call the folks at Blue Cross and Blue Shield 406 00:18:27,372 --> 00:18:30,542 at 833-467-2145. 407 00:18:30,843 --> 00:18:35,080 If you want to have a conversation before you get to the point where you've got 408 00:18:35,080 --> 00:18:39,351 the renewal, now you're looking at a 20% increase that came from another carrier. 409 00:18:39,485 --> 00:18:41,253 you might want to give them a call and have a chat. 410 00:18:41,253 --> 00:18:43,322 All right. Let's talk about what you're going to do. 411 00:18:43,322 --> 00:18:43,622 Alright, 412 00:18:43,622 --> 00:18:47,793 how are you addressing this market and what are you doing to help employers 413 00:18:48,560 --> 00:18:51,530 deal with these issues and the brokers out there that are 414 00:18:51,530 --> 00:18:53,132 the ones representing your products? 415 00:18:53,132 --> 00:18:54,099 Yeah, absolutely. Gary. 416 00:18:54,099 --> 00:18:59,304 So we put a lot of work into the 2026 plan designs for small group. 417 00:18:59,671 --> 00:19:00,239 Number one. 418 00:19:00,239 --> 00:19:01,173 We went out and surveyed 419 00:19:01,173 --> 00:19:04,610 our broker community and asked them, what are employers asking for? 420 00:19:05,344 --> 00:19:06,512 We took those notes. 421 00:19:06,512 --> 00:19:11,183 We took, feedback from our team, and we developed new plan designs 422 00:19:11,183 --> 00:19:14,553 for 2026, to help reduce the overall, 423 00:19:15,053 --> 00:19:18,056 premiums on the baseline for employers. 424 00:19:18,056 --> 00:19:21,059 And you're confident this year's new rollouts, 425 00:19:21,493 --> 00:19:22,461 what are they going to look like? 426 00:19:22,461 --> 00:19:26,598 You know, we've already had a couple of smaller rollouts, our broker community 427 00:19:26,598 --> 00:19:28,433 and our brokers that we've presented 428 00:19:28,433 --> 00:19:31,036 in front of our pretty excited about these changes. 429 00:19:31,036 --> 00:19:35,274 We've got updates to Blue Select Plus eligibility, more members, 430 00:19:35,574 --> 00:19:36,441 will become eligible 431 00:19:36,441 --> 00:19:39,444 to enroll in Blue Select Plus, Blue Select Plus has Spira Care. 432 00:19:40,279 --> 00:19:42,714 We have brand new plan options. 433 00:19:42,714 --> 00:19:46,218 Some of them have higher deductibles, new plan designs. 434 00:19:46,218 --> 00:19:50,989 Some of them have no deductible on medical, whatsoever with fixed co-pays. 435 00:19:50,989 --> 00:19:53,458 So that's going to open up a lot of opportunity there. 436 00:19:53,458 --> 00:19:54,826 Run that by me one more time. 437 00:19:54,826 --> 00:19:56,528 No deductible on medical. 438 00:19:56,528 --> 00:20:01,533 And so we’ll have just co-pays on primary care office visits, specialist visits. 439 00:20:01,533 --> 00:20:04,536 And some of those plans have just co-pays on inpatient as well. 440 00:20:04,703 --> 00:20:06,405 That's going to be remarkable. 441 00:20:06,405 --> 00:20:06,605 Yeah. 442 00:20:06,605 --> 00:20:09,608 That's going to be that going to be a game changer for people. 443 00:20:09,741 --> 00:20:12,711 Let's go back to Blue Select Plus you talked about some things. 444 00:20:12,711 --> 00:20:15,080 So what are some of the things going to happen there. Yeah. 445 00:20:15,080 --> 00:20:18,483 So for Blue Select Plus, for many years now we've been getting questions 446 00:20:18,483 --> 00:20:21,987 and really requests to expand our Blue Select Plus eligibility. 447 00:20:21,987 --> 00:20:22,521 Right. 448 00:20:22,521 --> 00:20:28,360 So you know members that live in Miami County or right outside Johnson County, 449 00:20:30,262 --> 00:20:32,297 right outside Wyandotte County, 450 00:20:32,297 --> 00:20:34,967 we have employer groups that are within those counties 451 00:20:34,967 --> 00:20:38,070 today that have members that live just across the county. 452 00:20:38,070 --> 00:20:39,471 Line, right. 453 00:20:39,471 --> 00:20:43,342 That have not previously been eligible for Blue Select Plus or Blue Select 454 00:20:43,342 --> 00:20:44,810 Plus with Spira Care. Right. 455 00:20:44,810 --> 00:20:48,981 And so starting in 2026, we're actually opening up some eligibility 456 00:20:48,981 --> 00:20:52,084 there and allowing those members to enroll in Blue Select Plus and Spira. 457 00:20:52,384 --> 00:20:53,552 Wow. Yeah. 458 00:20:53,552 --> 00:20:55,354 So I think they're going to be excited. 459 00:20:55,354 --> 00:20:59,858 Those members that live in those counties will have, new plan options. 460 00:21:00,726 --> 00:21:03,862 The Spira Care experience if they enroll in the Spira Care plan. 461 00:21:04,696 --> 00:21:07,966 And those employers may be a little bit more open to offering, 462 00:21:08,467 --> 00:21:09,901 that plan option as well. 463 00:21:09,901 --> 00:21:10,102 Yeah. 464 00:21:10,102 --> 00:21:13,105 And the beauty of that is we talked about Spira Care in the last segment. 465 00:21:13,171 --> 00:21:16,041 We’ll touch on it again a little bit because the beauty of that 466 00:21:16,041 --> 00:21:19,845 is that the employer can say here we're going to go to a higher deductible, 467 00:21:20,345 --> 00:21:24,516 but all of your primary care, behavioral health, X-rays, 468 00:21:24,516 --> 00:21:27,519 labs, all that is going to be handled by Spira Care. 469 00:21:27,853 --> 00:21:28,053 All right. 470 00:21:28,053 --> 00:21:30,722 And if you need to be referred out, they'll take care of doing that. 471 00:21:30,722 --> 00:21:34,793 So you're taking away the biggest obstacle to care that people have. 472 00:21:34,793 --> 00:21:38,030 That is I can't afford a $50 copay, okay. 473 00:21:38,297 --> 00:21:41,233 Or a $75 copay to go to a specialist. 474 00:21:41,233 --> 00:21:41,900 Okay. 475 00:21:41,900 --> 00:21:44,903 But I can go to Spira Care and I don't have to pay anything. 476 00:21:45,137 --> 00:21:50,842 So now you're marrying that to this plan, which keeps affordability in line 477 00:21:51,243 --> 00:21:54,780 and also says to the employee, my employer really does care 478 00:21:54,780 --> 00:21:58,050 because they put this plan in place so that I can go to Spira Care, 479 00:21:58,250 --> 00:22:00,752 not just the employee, but the employees family as well 480 00:22:00,752 --> 00:22:02,321 up there on the plan, right? Right. 481 00:22:02,321 --> 00:22:06,458 and when you think about total cost of care savings, if you got a family of four 482 00:22:06,458 --> 00:22:09,461 of going to the provider every year on top of reduced 483 00:22:09,461 --> 00:22:12,731 premium, you're going to save a significant amount of money. 484 00:22:13,065 --> 00:22:15,033 Yeah. And you know, I've got six grandchildren. 485 00:22:15,033 --> 00:22:18,904 And I can assure you that my two daughters with those six children, 486 00:22:19,738 --> 00:22:24,710 there is not a week goes by that there is not a visit at the urgent care, the E.R. 487 00:22:24,876 --> 00:22:27,879 or some specialist doctor that they've got to go to 488 00:22:28,380 --> 00:22:30,782 because there's a new issue we've got to deal with. 489 00:22:30,782 --> 00:22:31,483 Okay. 490 00:22:31,483 --> 00:22:36,188 So for families, to me, this just seems to make an awful lot of sense. 491 00:22:36,621 --> 00:22:39,624 Yep. And those care centers also offer, 492 00:22:40,058 --> 00:22:42,861 services that support pediatric care as well. 493 00:22:42,861 --> 00:22:46,631 So if there's younger children there, they can help them as well. 494 00:22:46,898 --> 00:22:49,501 Yeah. So we've got nine locations around the metro. 495 00:22:49,501 --> 00:22:50,268 Where are. They? 496 00:22:50,268 --> 00:22:51,603 Yeah, absolutely. Cary. 497 00:22:51,603 --> 00:22:56,208 So, Tiffany, Liberty, Legends, Shawnee, Olathe, 498 00:22:56,441 --> 00:23:00,345 Overland Park, Independence, Lee's Summit and Crossroads. 499 00:23:00,612 --> 00:23:02,447 Well, you've got one almost everywhere in the city. 500 00:23:02,447 --> 00:23:05,250 All over the city. Nine locations for Spira Care. 501 00:23:05,250 --> 00:23:08,019 Anywhere in the city you have access to Spira Care. 502 00:23:08,019 --> 00:23:10,689 So in other words, there's some places close to you. 503 00:23:10,689 --> 00:23:11,189 Yeah. Okay. 504 00:23:11,189 --> 00:23:14,726 You're not going to have to drive 45 minutes to an hour to get to a facility. 505 00:23:14,826 --> 00:23:15,460 Right. 506 00:23:15,460 --> 00:23:18,330 And the whole the whole concept of putting the Spira Care’s 507 00:23:18,330 --> 00:23:21,566 all around the Kansas City community, if you look there, really circled 508 00:23:21,566 --> 00:23:24,870 all within the 435 interstate. 509 00:23:24,870 --> 00:23:28,106 So any member within the Kansas City community 510 00:23:28,106 --> 00:23:30,976 should be able to get to a Spira Care within 10 to 15 minutes. 511 00:23:30,976 --> 00:23:33,044 And this is the solution. 512 00:23:33,044 --> 00:23:37,449 That as an employer, you really need to take a look at. 513 00:23:37,649 --> 00:23:42,087 If you want to keep your employees happy, give them a benefit that’s going to mean 514 00:23:42,087 --> 00:23:45,957 something to them and, give them access to the kind of care they need. 515 00:23:46,091 --> 00:23:47,626 This is an opportunity to do that. 516 00:23:47,626 --> 00:23:48,260 Talk a little bit 517 00:23:48,260 --> 00:23:51,696 before we go to break about level funded, fully insured in the ACA. 518 00:23:51,696 --> 00:23:55,600 Our Level Funded, option for 5 to 99 519 00:23:55,600 --> 00:23:58,603 size employers, 5 to 9 enrolled employees. 520 00:23:59,571 --> 00:24:02,707 That option is available for the small groups. 521 00:24:03,175 --> 00:24:06,178 A lot of groups are finding those options to be 522 00:24:07,112 --> 00:24:10,348 you know, a great product, an affordable product. 523 00:24:10,615 --> 00:24:13,952 It is a very attractive and growing market in that space. 524 00:24:14,653 --> 00:24:16,822 For ACA, that's 2 to 50. 525 00:24:16,822 --> 00:24:19,524 2 to 50 enrolled employees. 526 00:24:19,524 --> 00:24:24,863 And then for fully insured, underwritten, it's 51 to 99 enrolled employees. 527 00:24:24,863 --> 00:24:27,032 So explain that because that that. 528 00:24:27,032 --> 00:24:29,468 I'm an employer now I've got 75 employees. 529 00:24:29,468 --> 00:24:34,473 So if I want to move to it and I and my workforce is trending below 45. 530 00:24:35,340 --> 00:24:38,310 So now I know that you know that if they're trending 531 00:24:38,310 --> 00:24:41,313 below 45, they're going to be a healthier bunch, right? 532 00:24:41,813 --> 00:24:42,380 They ought to be. 533 00:24:42,380 --> 00:24:47,552 We'll make an assumption that they're reasonably healthy. 534 00:24:47,552 --> 00:24:48,053 Okay. 535 00:24:48,053 --> 00:24:51,756 So having said that, when they go to that model, 536 00:24:51,923 --> 00:24:55,961 they're going to be judged on that group as a group, not being judged 537 00:24:55,961 --> 00:24:58,263 on this giant pool of people over here 538 00:24:58,263 --> 00:25:00,031 with ACA, a lot of sick people and other people on it. 539 00:25:00,031 --> 00:25:01,533 It gives them an opportunity 540 00:25:01,533 --> 00:25:03,502 if they've got a pretty healthy group or 541 00:25:03,502 --> 00:25:05,504 group that doesn't have a lot of major issues 542 00:25:05,504 --> 00:25:07,472 where they can actually put a program together, 543 00:25:07,472 --> 00:25:10,942 that really is kind of tailored to what they need, correct? Yep. 544 00:25:10,942 --> 00:25:14,513 And in addition to all the planned changes, the new plans we have coming out, 545 00:25:14,513 --> 00:25:18,216 we've also opened up our underwriting guidelines Cary. 546 00:25:18,316 --> 00:25:20,185 Oh really? In addition to. That. 547 00:25:20,185 --> 00:25:22,487 Well, that's a big deal. It is a huge deal. 548 00:25:22,487 --> 00:25:23,622 Yeah okay. 549 00:25:23,622 --> 00:25:26,291 So explain what that means because I'm sure the audience out there 550 00:25:26,291 --> 00:25:28,026 what does that mean. They opened up their underwriting. 551 00:25:28,026 --> 00:25:28,293 Yeah. 552 00:25:28,293 --> 00:25:32,430 So, we're making it easier for employer groups to apply for coverage. 553 00:25:32,797 --> 00:25:36,635 Those that have at least ten or more enrolled employees on the plan. 554 00:25:37,502 --> 00:25:40,071 And so what I mean by that is we need a 555 00:25:40,071 --> 00:25:44,376 we need a group census with at least ten or more enrolled on the plan. 556 00:25:44,376 --> 00:25:46,278 We need that group app. 557 00:25:46,278 --> 00:25:49,080 And we need a couple of other pieces of information and we can turn around 558 00:25:49,080 --> 00:25:52,517 and quote that group on, level funded or fully insured? 559 00:25:53,418 --> 00:25:55,887 51 and 99. You know, that's pretty amazing. 560 00:25:56,821 --> 00:25:59,791 You've got a suite of products here. 561 00:25:59,791 --> 00:26:02,460 Yeah. I'm kind of talking to the broker audience now a little bit. 562 00:26:02,460 --> 00:26:05,163 You've got a suite of products here that are addressing 563 00:26:05,163 --> 00:26:08,133 concerns in the marketplace, and I'm not seeing this anywhere else. 564 00:26:08,533 --> 00:26:11,536 I'm not seeing it from the other carriers out there. 565 00:26:11,570 --> 00:26:13,872 I'm seeing carriers pull out of the marketplace, 566 00:26:13,872 --> 00:26:17,375 and I'm seeing articles in the Wall Street Journal, other places talking about 567 00:26:17,375 --> 00:26:20,512 how difficult it's going to be for them to continue this year. 568 00:26:20,612 --> 00:26:23,782 But you're seeing something completely different here by the hometown carrier. 569 00:26:24,482 --> 00:26:28,253 And if you're the broker out there, you really need to engage in this. 570 00:26:28,253 --> 00:26:31,356 If you haven't gotten to one of their seminars, the webinars 571 00:26:31,356 --> 00:26:34,960 to learn about these products, you need to because you're going to be getting calls 572 00:26:35,660 --> 00:26:38,997 from your clients, who are going to hear this show 573 00:26:39,397 --> 00:26:42,367 and the commercials run during the week where we talk about these kind of things. 574 00:26:42,367 --> 00:26:43,768 They're going to ask you, 575 00:26:43,768 --> 00:26:46,271 why haven’t you been telling me about that new Blue Cross plan? 576 00:26:46,271 --> 00:26:46,705 Okay. 577 00:26:46,705 --> 00:26:49,341 Because they're going to be a host of new Blue Cross plans. 578 00:26:49,341 --> 00:26:50,342 They're going to address, 579 00:26:51,476 --> 00:26:53,278 what's going to happen in this marketplace. 580 00:26:53,278 --> 00:26:55,080 And I'll repeat what I said earlier. 581 00:26:55,080 --> 00:26:58,883 We're going to see a tsunami in changes this year on the ACA. 582 00:26:58,883 --> 00:27:00,785 Small group side across the board. 583 00:27:00,785 --> 00:27:03,355 Impacted by all the changes that are happening. 584 00:27:03,355 --> 00:27:05,457 And it's important for you to get ahead of that. 585 00:27:05,457 --> 00:27:10,629 833-467-2145 if you're an employer, okay? 586 00:27:10,629 --> 00:27:13,665 And you just want to have a conversation, they're happy to do it. 587 00:27:13,665 --> 00:27:16,668 833-467-2145 588 00:27:16,768 --> 00:27:20,705 or the website bluekc.com, bluekc.com. 589 00:27:20,705 --> 00:27:23,308 We'll be right back after the break to wrap it up, stay tuned. 590 00:27:23,308 --> 00:27:25,710 You're listening to America's Healthcare Advocate 591 00:27:25,710 --> 00:27:28,647 broadcasting here on the HIA Radio Network. 592 00:27:28,647 --> 00:27:30,548 Coast to coast across the USA. 593 00:27:30,548 --> 00:27:33,551 Don't go anywhere. 594 00:27:37,889 --> 00:27:38,490 Welcome back. 595 00:27:38,490 --> 00:27:42,327 You're listening to America's Healthcare Advocate show, broadcasting coast to coast 596 00:27:42,327 --> 00:27:45,397 across the USA here on the HIA Radio Network. 597 00:27:45,397 --> 00:27:46,364 You know, 598 00:27:46,364 --> 00:27:49,067 I do these shows to get information out to all of you 599 00:27:49,067 --> 00:27:51,069 about what's going to happen in the marketplace. 600 00:27:51,069 --> 00:27:55,006 I got I have BlueKC up here today to tell us what they're doing 601 00:27:55,040 --> 00:27:59,077 to address the concerns that people are going to have as we get closer to renewal 602 00:27:59,277 --> 00:28:02,847 on the individual side and on the employer sponsored health care side. 603 00:28:02,914 --> 00:28:04,549 They've got answers. 604 00:28:04,549 --> 00:28:06,785 They've been here for 83 years, okay? 605 00:28:06,785 --> 00:28:09,120 They've got answers. They're the hometown carrier. 606 00:28:09,120 --> 00:28:12,824 They're the only carrier in this market that's actually reducing premiums 607 00:28:12,824 --> 00:28:14,292 on the individual side. 608 00:28:14,292 --> 00:28:18,563 So again, if you're a broker or if you're an employer or an individual 609 00:28:18,563 --> 00:28:24,202 and you want information 833-467-2145 is the phone number. 610 00:28:24,302 --> 00:28:26,938 They're happy to talk to you and get you set up for 611 00:28:26,938 --> 00:28:31,743 what's going to come down the pike this year 833-467-2145. 612 00:28:31,743 --> 00:28:34,212 And the website bluekc.com. 613 00:28:34,212 --> 00:28:36,815 All right, let's go back to Spira Care a little bit 614 00:28:36,815 --> 00:28:39,718 because this is such a unique value proposition. 615 00:28:39,718 --> 00:28:43,655 Now, and, you know, it's funny, you don't have to wait 616 00:28:43,655 --> 00:28:45,857 23 days to get in to see a doctor. Yeah. 617 00:28:45,857 --> 00:28:48,626 And the visit is probably going to last longer than 7.5 minutes. 618 00:28:48,626 --> 00:28:49,094 Right. 619 00:28:49,094 --> 00:28:51,763 I know the average visit with Spira Care is about 30 minutes. 620 00:28:51,763 --> 00:28:54,666 Okay. But it's it's a very different care model. 621 00:28:54,666 --> 00:28:56,234 So talk a little bit about that 622 00:28:56,234 --> 00:29:00,371 and why that is really something both employers individuals should consider. So 623 00:29:00,405 --> 00:29:04,576 you know starting off with just the Spira Care story, we rolled it out in 2018. 624 00:29:05,310 --> 00:29:08,847 Over time, we've added more care centers across the Kansas City community. 625 00:29:09,581 --> 00:29:11,282 We're up to nine so far. 626 00:29:12,317 --> 00:29:13,118 With that, 627 00:29:13,118 --> 00:29:16,654 the idea was to ensure that every member within Kansas City 628 00:29:16,654 --> 00:29:20,425 could have access to Spira Care easily and relatively close. 629 00:29:20,792 --> 00:29:23,762 So each member can get to a Spira Care center 630 00:29:23,762 --> 00:29:27,499 within 10 to 15 minutes at least, that was the design that we had in mind. 631 00:29:28,066 --> 00:29:28,900 And it worked. 632 00:29:28,900 --> 00:29:29,701 Yeah, yeah. 633 00:29:29,701 --> 00:29:33,004 Members are you know, reporting a great experience there. 634 00:29:33,204 --> 00:29:37,142 We grade ourselves on the customer effort score of our members 635 00:29:37,142 --> 00:29:40,145 not only the Blue Cross members, but also our Spira Care members. 636 00:29:41,012 --> 00:29:42,981 And for the those Spira Care members, 637 00:29:42,981 --> 00:29:45,984 the customer effort score is 96%. 638 00:29:45,984 --> 00:29:48,720 And just to put it in perspective, 639 00:29:48,720 --> 00:29:50,955 you know, gold plans, 640 00:29:50,955 --> 00:29:54,392 industry best is right around 72%. 641 00:29:54,392 --> 00:29:56,127 So holy cow. 642 00:29:56,127 --> 00:29:58,429 Are you serious? We're getting great. 643 00:29:58,429 --> 00:30:01,432 Great feedback from members on the experience that they have at Spira Care. 644 00:30:01,499 --> 00:30:04,803 And have you got the capacity to handle what's going to be coming down the pike? 645 00:30:05,103 --> 00:30:06,671 Because I got a funny feeling, pal. 646 00:30:06,671 --> 00:30:08,573 Your phones are going to be ringing. Yeah, yeah. 647 00:30:08,573 --> 00:30:09,841 We do. 648 00:30:09,841 --> 00:30:13,845 Each of our care centers have capacity to continue to grow and grow membership. 649 00:30:14,612 --> 00:30:16,948 Some of the newer ones have even additional capacity 650 00:30:16,948 --> 00:30:19,951 to have additional rooms in there that they can add on. 651 00:30:20,251 --> 00:30:24,455 So, we're pretty confident our, the growth opportunities we have ahead for 2026. 652 00:30:24,622 --> 00:30:28,293 So there is one component about Spira Care that I always thought was unique 653 00:30:28,293 --> 00:30:30,128 because nobody else does this. 654 00:30:30,128 --> 00:30:33,131 I mean, there are there are other models out there for direct primary care. 655 00:30:33,565 --> 00:30:37,202 But your behavioral health, I mean, this is a big deal to Erin it's a big deal 656 00:30:37,202 --> 00:30:41,539 to Jenny, you know, Christina Lively, all the C-suite people at Blue Cross. 657 00:30:41,873 --> 00:30:44,309 Talk a little bit about that and the fact that, 658 00:30:44,309 --> 00:30:46,277 you know, it's right there in the center. 659 00:30:46,277 --> 00:30:49,981 You don't get referred out to go see somebody outside. 660 00:30:50,215 --> 00:30:52,283 You can start right there in behavioral health. 661 00:30:52,283 --> 00:30:56,988 And to me, this is important, especially for people with kids these days 662 00:30:57,422 --> 00:31:01,292 that are dealing with issues, whether it's, you know, cyber bullying 663 00:31:01,292 --> 00:31:04,295 or what's going on at school or just some of the talk a little bit 664 00:31:04,295 --> 00:31:07,031 about that whole behavioral health piece and how that fits. 665 00:31:07,031 --> 00:31:10,134 Because I think that separates Spira Care from everything else out there. 666 00:31:10,268 --> 00:31:10,902 Yeah, yeah. 667 00:31:10,902 --> 00:31:14,839 So, as you mentioned, it's very important at BlueKC 668 00:31:14,839 --> 00:31:18,109 you know, our leadership team, all of our all of our team members, 669 00:31:18,743 --> 00:31:22,113 to provide access to behavioral health services, 670 00:31:22,113 --> 00:31:24,682 not only at Spira Care, but also through all of our apps 671 00:31:24,682 --> 00:31:28,453 and all of our resources and mindful, we've got a ton of resources available. 672 00:31:28,453 --> 00:31:31,890 But at Spira Care, we did integrate behavioral health care, 673 00:31:32,490 --> 00:31:35,760 to ensure that members had access to that service. 674 00:31:35,760 --> 00:31:40,465 And there is screenings that occur within the Spira Care centers to help understand 675 00:31:40,465 --> 00:31:43,835 if members need that type of care and we help get them there. 676 00:31:44,402 --> 00:31:44,669 Yeah. 677 00:31:44,669 --> 00:31:47,672 And, you know, for the mother, you know, that’s 678 00:31:47,672 --> 00:31:51,042 got 2 or 3 children and she's got one that's having a problem. 679 00:31:51,476 --> 00:31:53,745 She doesn't have to worry about going someplace else. 680 00:31:53,745 --> 00:31:55,680 She can go to Spira Care 681 00:31:55,680 --> 00:31:58,983 and that child can be privately counseled, whatever they need to do. 682 00:31:59,651 --> 00:32:01,786 And the whole thing works like it's supposed to. 683 00:32:01,786 --> 00:32:02,120 Yeah. 684 00:32:02,120 --> 00:32:05,223 So, in addition to that, there's no cost at Spira Care. 685 00:32:05,323 --> 00:32:07,225 Well, that's that's a big piece, right? 686 00:32:07,225 --> 00:32:10,295 Yeah, yeah, it's the, you know, all the co-pays are gone. 687 00:32:10,762 --> 00:32:14,198 So, you know, that's critical to talk about some of the other services 688 00:32:14,198 --> 00:32:15,033 that Spira Care offers. 689 00:32:15,033 --> 00:32:17,735 You I know labs and X-rays are available in certain facilities. 690 00:32:17,735 --> 00:32:19,804 How are you handling prescription drugs. 691 00:32:19,804 --> 00:32:20,872 The rest of it. 692 00:32:20,872 --> 00:32:21,172 Yeah. 693 00:32:21,172 --> 00:32:25,243 So, each of our Spira Care plans have, prescription drug, 694 00:32:25,810 --> 00:32:29,781 model plans that enable, low cost for prescriptions. 695 00:32:29,781 --> 00:32:33,151 So tier one and tier two are co-pays, and then tier three, 696 00:32:33,484 --> 00:32:36,955 typically have a level of coinsurance. But, 697 00:32:38,222 --> 00:32:40,591 the Spira Care centers will refer out 698 00:32:40,591 --> 00:32:44,262 those prescription drug needs to, local pharmacies that are in network 699 00:32:44,262 --> 00:32:46,731 so members can get access to those prescriptions. 700 00:32:46,731 --> 00:32:49,067 So that's all part of the plan. 701 00:32:49,067 --> 00:32:52,070 They don't have to go deal with another plan or some other issue. 702 00:32:52,070 --> 00:32:53,604 That's all going to be handled through the Spira Care facility. 703 00:32:53,604 --> 00:32:54,739 It's all built in. 704 00:32:54,739 --> 00:32:55,173 Okay. 705 00:32:55,173 --> 00:32:58,176 That that that's pretty significant in terms of how that works. 706 00:32:58,176 --> 00:33:01,312 Are you doing anything with urgent care after hours visits? 707 00:33:01,579 --> 00:33:01,813 Yeah. 708 00:33:01,813 --> 00:33:02,981 So some of the care centers 709 00:33:02,981 --> 00:33:05,550 have not only they have after hours visits, 710 00:33:05,550 --> 00:33:07,852 but some of them are open on the weekends as well in case. 711 00:33:07,852 --> 00:33:09,454 That's new because that. Yeah. 712 00:33:09,454 --> 00:33:10,288 Okay. That's that's. 713 00:33:10,288 --> 00:33:10,421 Yeah. 714 00:33:10,421 --> 00:33:14,492 So it's, you know, you have to call and make sure, you find out 715 00:33:14,492 --> 00:33:17,829 which care center is open on the weekends because they are rotating. 716 00:33:17,829 --> 00:33:21,199 So we always advise members to call and schedule appointments. 717 00:33:21,966 --> 00:33:22,433 You know, if they, 718 00:33:22,433 --> 00:33:24,936 if they need to get in at that point in time that they can do that. 719 00:33:24,936 --> 00:33:28,339 And can they make appointment just a regular appointment. 720 00:33:28,339 --> 00:33:30,641 They go online and make that appointment a line. 721 00:33:30,641 --> 00:33:31,676 Definitely. 722 00:33:31,676 --> 00:33:35,446 So what we always recommend is that for that very first appointment, 723 00:33:35,446 --> 00:33:37,115 the consultation appointment to go ahead 724 00:33:37,115 --> 00:33:39,384 and make that call, once you're in the system, 725 00:33:39,384 --> 00:33:43,187 then you can make all of your regularly scheduled appointments on online. 726 00:33:43,554 --> 00:33:47,458 So you go and you have that initial visit usually takes about 45 minutes 727 00:33:47,458 --> 00:33:49,327 to an hour. Where they actually sit down right 728 00:33:49,327 --> 00:33:52,997 and listen to what it's not 7.5 minutes, right? 729 00:33:53,031 --> 00:33:53,297 Okay. 730 00:33:53,297 --> 00:33:56,601 It's a real opportunity to sit down and talk to the provider 731 00:33:56,968 --> 00:33:59,904 and let them hear about your health history and what you do. 732 00:33:59,904 --> 00:34:00,238 Yeah. 733 00:34:00,238 --> 00:34:05,009 And the Spira Care experience is a lot different than a traditional, experience 734 00:34:05,209 --> 00:34:06,344 or the PCP office. 735 00:34:06,344 --> 00:34:09,714 They have consultative rooms with comfortable seating in there. 736 00:34:09,714 --> 00:34:10,415 With a table. 737 00:34:10,415 --> 00:34:13,217 You can you can talk eye to eye with the provider that's there. 738 00:34:13,217 --> 00:34:14,619 I mean, you're not doing this. Yeah. 739 00:34:14,619 --> 00:34:18,156 The doctor's over here on the computer and you're here. 740 00:34:18,189 --> 00:34:21,959 The doctor's over here filling in the computer screen. 741 00:34:22,060 --> 00:34:24,529 Oh, you're 7.5 minutes is up next, right? 742 00:34:24,529 --> 00:34:26,497 Yeah, it's a little different. Most of the time. 743 00:34:26,497 --> 00:34:29,000 You spend less than 7.5 minutes sitting in the waiting room. 744 00:34:29,000 --> 00:34:29,867 Yeah, I know. 745 00:34:29,867 --> 00:34:30,668 You take it back. 746 00:34:30,668 --> 00:34:36,007 So, the design, the features, the view, the experience is, 747 00:34:38,342 --> 00:34:39,243 wonderfully different. 748 00:34:39,243 --> 00:34:41,479 It is. Thank you for doing this today. Yeah. 749 00:34:41,479 --> 00:34:42,480 We're going to get you back. 750 00:34:42,480 --> 00:34:44,916 Okay. When the brand new group plans are released. 751 00:34:44,916 --> 00:34:47,485 So we can tell the audience what's going on there. Yeah. 752 00:34:47,485 --> 00:34:51,222 So if you're a broker, if you're an individual, if you're an employer, 753 00:34:52,023 --> 00:34:55,059 there are changes coming, and these folks can help you through that. 754 00:34:55,059 --> 00:34:57,662 They've got a product that can fit your budget and fit your needs. 755 00:34:57,662 --> 00:34:59,464 I don't care what it is. 756 00:34:59,464 --> 00:35:05,203 And you marry this up with the Spira Care model and you've got a value proposition. 757 00:35:05,203 --> 00:35:08,106 It's hard to beat if you want information, if you want help. 758 00:35:08,106 --> 00:35:11,175 877-467-2145. 759 00:35:11,175 --> 00:35:14,278 877-467-2145. 760 00:35:14,612 --> 00:35:17,582 You know, I've been a, my wife and I've been Blue Cross and Blue Shield 761 00:35:17,782 --> 00:35:20,852 members for, I think, the last 35 years. 762 00:35:21,119 --> 00:35:22,787 It's been a long time. Okay. 763 00:35:22,787 --> 00:35:24,055 Local customer service. 764 00:35:24,055 --> 00:35:26,791 They're good people and they do what they do really well. 765 00:35:26,791 --> 00:35:29,127 So thanks again for coming up here again today. 766 00:35:29,127 --> 00:35:32,130 And now I leave you with this thought from Doctor Martin Luther King. 767 00:35:32,163 --> 00:35:35,266 Americans must learn to live together as brothers and sisters, 768 00:35:35,633 --> 00:35:38,636 or we will surely perish together as fools. 769 00:35:38,703 --> 00:35:40,471 Truer words are never spoken. 770 00:35:40,471 --> 00:35:42,974 Thank you for listening to America's Healthcare Advocate 771 00:35:42,974 --> 00:35:45,977 broadcasting here on the HIA Radio Network. 772 00:35:46,010 --> 00:35:48,246 Coast to coast across the USA.