Wisconsin farmers, small businesses
benefiting from new health-care co-ops
By Anne Todd,
USDA Rural Development
isconsin is the first state to use the power of
cooperatives to bargain for adequate, costeffective
health insurance for agricultural
producers and small businesses. The concept
of using group purchasing power to bargain
for lower health insurance rates is not new. However, prior to
the enactment of Wisconsin’s landmark Co-op Care
legislation, only large organizations had the ability to conduct
these negotiations. Co-op Care extends those market
concepts to help smaller scale businesses, including farmers
and the self-employed.
The Farmers’ Health Cooperative is Wisconsin’s first
health purchasing co-op dedicated to farmers and agribusinesses.
Its formation was made possible by the
Co-op Care law. Like other co-ops, the Farmers’ Health
Cooperative will be owned and governed by its members,
who will be directly involved in future financial and benefitpackage
decisions. The initial cooperative board includes six
producers and three staff members of the Wisconsin
Federation of Cooperatives (WFC), the statewide advocacy
association for cooperative businesses.
Health co-op strikes chord with producers
After three years of extensive development work by WFC
and a number of dairy, farm supply and farm credit co-ops,
FHC health insurance plans became active on April 1.
Within just two days, thousands of people had already
requested information about the program, says project
coordinator Katie Mnuk. “This shows a clear demand from
farmers and agri-businesses for affordable health insurance
coverage,” says Mnuk.
The co-op’s mission is to provide Wisconsin’s 70,000
farmers — and the agri-businesses that directly serve them —
with access to affordable, comprehensive health insurance.
Farmers’ Health Cooperative is designed to use its power as a
cooperative entity to bargain for cost-effective coverage and
increase health care options for its members.
About 35 town meetings were held across the state during
the spring to discuss the plan with producers and rural small
business owners. WFC President and CEO Bill Oemichen says attendance was well beyond expectations. In the Green
Bay area alone, more than 600 producers attended meetings
during a three-day period.
After only five weeks of marketing the co-op program, the
number of producers and agricultural businesses that had
already signed up and paid their first insurance premiums was
rapidly nearing the number projected for the first year,
Oemichen noted.
The co-op’s marketing effort began Feb. 19 with a press
conference at the Wisconsin state capitol led by U.S. Senator
Herb Kohl, Governor Jim Doyle and Oemichen.
Aetna, one of the largest U.S. health care insurers, has
been selected to provide the health insurance for the
cooperative. Agri-Services Agency of New York (ASA) has
been selected as the plan administrator. ASA is a subsidiary of
Dairylea Cooperative. Now that the plans are active,
individual members can begin reaping the benefits of that
group purchasing power, backed by the expertise of a healthcare
industry leader as their provider.
FHC offers members a choice from among six different
enrollment plans, with deductibles ranging from $300 to
$5,000. Mnuk says these plans offer more comprehensive
benefits at lower prices than most could buy under an
individual plan. FHC members may choose from traditionally
structured, preferred provider organization plans, or take
advantage of the tax benefits available through coverage
under one of two high-deductible health savings account
compatible plans.
The various insurance products have been tailored to meet
the specific needs of the farming community, and include
coverage for injuries that occur on the farm. Also included is
coverage for $500 of preventive care per member per year,
maternity care and prescription drug coverage.
One of the co-op’s goals is to provide more predictable,
stable rates for its members. To be eligible to join the co-op,
applicants must be between the ages of 18 and 64, live or
work in Wisconsin, and derive at least 66 percent of their
income from farming.
An initial capitalization payment is required by state law,
and is returned after members have been enrolled for three
years. Other than that, the co-op charges a modest, $2
monthly membership fee that is collected as a portion of
members’ health insurance premiums.
Genesis of legislation
During the past several years, limited access to health care
and rising costs have become paramount concerns for rural
families. Often, producers’ only option has been to buy
individual health insurance plans that are significantly more
expensive than the group plans available to workers in other
professions.
Because farming can be dangerous (American farmers have
the third-highest rate for non-fatal injuries among all
occupational groups) and many producers do not carry
workers’ compensation insurance, the insurance industry
considers farmers a high-risk group. Several studies show that
Wisconsin farmers experience a high rate of work-related
injuries, and that as many as 82 percent of them don’t have
access to 24-hour medical care because of restrictions in their
policies.
WFC leaders felt that the situation was a crisis, and that a development and formation of Wisconsin health care co-ops,
and progress resumed with renewed vigor.
The Co-op Care goals are:
- To allow purchasing cooperative members to band
together to purchase insurance of better value than one
could purchase individually.
- To provide members with a comprehensive plan,
including coverage for preventive care and prescription
drugs.
- To provide members with rate stabilization.
- To advance quality measurement and consumerism in
health care purchasing decisions.
Under the Co-op Care law, the cooperative’s health
insurers must provide insurance coverage for a minimum of
three years. This is a unique provision that was intended to
provide stability to the cooperative.
Healthy Lifestyles Co-op seeks lower costs
The mission of the Healthy Lifestyles Cooperative (HLC),
based in Green Bay, is to stabilize insurance rates through
cooperative purchasing, while also emphasizing the need for
members to take personal responsibility for their well-being
by maintaining a healthy lifestyle. The focus on wellness is
what makes HLC unique.
Insurance plans sponsored by HLC became active on Jan.
1, making it one of the earliest health care co-ops in the state.
HLC serves a primarily urban area of northeast
Wisconsin. Like the Farmers’ Health Cooperative, HLC also
uses the collective power of a group of employers, who pool
their resources to purchase coverage as a group. Membership
is open to self-employed people, for-profit or nonprofit
corporations, trade or labor organizations, municipalities or
any partnership that does business in, or is principally located
in, Brown County.
To be eligible, members must also belong to a local farm cooperative, the Green Bay Area Chamber of Commerce or a
nonprofit resource group.
HLC began negotiating with carriers last summer to determine
which would provide the best overall program. Last September, the
co-op chose Destiny Health. Destiny offers an array of health savings
account-type plans or health reimbursement arrangements for the
co-op employer/members.
Although not well known in the United States, Destiny has been
successfully administering consumer-directed wellness programs
since 1992, starting in South Africa. It entered the U.S. market in
2000. Destiny’s innovative program motivates clients to participate
actively in their health care, and rewards them for making healthy
choices.
Destiny’s incentives measure is called the Vitality program, and
members earn “Vitality Bucks” which can be redeemed for rewards
of their choice. Vitality Bucks can also boost the value of members’
health accounts with Destiny.
Clients are required to take an annual health-risk assessment test
to determine their general health and identify areas for
improvement. Clients are provided with a personal health
nurse/coach at no extra cost, who helps them develop personal
wellness plans that will reduce future health risks and health costs.
As of April, 135 employer/members were participating in the
program, and more than 1,800 employees have already taken their
initial health-risk assessments test, a 90-percent response rate. In late
April, HLC announced that it is seeking members for a second pool.
Effects of Co-op Care initiative
Co-op Care backers say the law is having a spill-over effect, in
which competing insurance providers have lowered premiums and
raised benefits for producers in response to the packages offered
through the FHC. They note that one (non-cooperative) carrier has
begun advertising 24-hour coverage for farmers, similar to the coop’s
plan.
Oemichen, who is also president and CEO of the Minnesota
Association of Cooperatives, notes that Minnesota is close to passing
similar health-purchasing cooperative legislation.
The Co-op Care legislation has fostered development of a number
of health purchasing co-ops in various stages of development around
the state. Other projects (in addition to HLC) in the planning stages
include a cooperative for Wisconsin physicians, and cooperatives
providing health insurance coverage for small businesses in several
areas of the state.
According to Oemichen, Wisconsin’s novel approach of using
cooperatives to increase access to quality health care is attracting
significant interest from insurance companies, even some foreign
companies. WFC has received a number of inquiries from elected
officials and interested parties in a number of other states.
To learn more about Co-op Care, visit the WFC Web site:
www.wfcmac.coop. FHC’s website is: www.farmershealthcooperative
.com; HLC’s Web site is: www.healthylifestylescoop.org/.