Self-funded plans are governed by the Federal Employee Retirement Income Security Act (ERISA) and are attractive because of the greater level of flexibility that comes with being able to tailor the plans based on the plan participant’s needs. Self-funded health plans allow for a more hands-on approach to the healthcare dollar. Feedback from health plan participants, along with claims utilization data, provide valuable information to make enhancements to the plans over time, thereby creating plan offerings that best fit the needs of its members. As self-funding matures over time, it allows for greater control and transparency of the health plan.
The 40 Square Consortium has six health plans from which to choose, giving you the opportunity to make a selection that best fits the needs of you, your family, and your employees. Similar to traditional health plans, self-funded plans have an annual deductible, coinsurance, and copays for which you are responsible.
Here are some of the benefits included with every plan:
40 Square offers a self-funded health plan with six benefit options to choose from. Additional benefits such as dental, vision, and life are also available. Self-funded health plans assume the financial risk for providing health care benefits. The 40 Square Consortium assumes the financial risk of the health plan being offered. Here’s how it works:
Who is eligible to be a 40 Square Co-op Member?
According to law, you must be considered an “employer” with at least one common law employee. The employer must actively work in production agriculture in Minnesota and file either Form 1065 or Schedule F with their income tax return or provide direct services to production agriculture in Minnesota.
I already belong to a co-op. Do I have to join this one?
Yes. In order to be eligible for the medical coverage offered by the 40 Square Health Plan Consortium, you must first become a member of the 40 Square Cooperative Solutions Cooperative.
What are the costs for joining the co-op?
You must purchase Voting Stock up-front, one-time, in an amount of $100 and Common Stock in the amount of $1,000. The Common Stock purchase will be paid over the first 12 months of membership.
Are my employees required to join the co-op?
No. Membership to the co-op is at the employer level. Employees will not have to join the co-op
Who is eligible to enroll in the 40 Square health plan?
Persons must be employed by an employer who is a member of the 40 Square Cooperative Solutions’ co-op and meet the 40 Square health plan eligibility rules.
When can I sign up?
Open enrollment begins November 1, 2017 and runs through December 15, 2017.
When does coverage start?
Coverage begins January 1, 2018 for those who enroll during the open enrollment period of November 1, 2017 through December 15, 2017.
Will I get an insurance card?
Yes, medical ID cards will be mailed directly to your home.
What medical provider network will I have?
How can I find an in-network doctor or clinic? Is my doctor covered?
Visit 40Square.coop and click the “Find a Doctor” link to search for doctors, a clinic, or see if your doctor is listed as an in-network provider.
What is covered under the plan? What will I have to pay out of pocket?
Please refer to the health plan offerings on 40Square.coop.
Are prescriptions covered?
Yes, prescription drug coverage, through MedTrakRx, as part of all offered health plans.
What will the cost of my premium be?
Premium rates are dependent on several factors such as age and zip code. Starting November 1st, you will be able to apply online to see your specific rates.
Do I have to pay for my employees or do they pay their own premiums?
The employer is responsible for making payment of premiums for all persons covered through the employer to the health plan. The monthly payments will be paid through an ACH (a.k.a: electronic account draft). The employer is responsible for determining the cost split of the employer share and employee share, if there is one.
As an employer, how long must I offer the health plan?
There is a three-consecutive year commitment requirement. If you terminate the health plan offering prior to the end of the three-year commitment, 40 Square Cooperative Solutions may retain all or a portion of your Common Stock purchase, at the discretion of the board.
As an employee, can I cancel my coverage if I don’t like it?
Open enrollment happens once per year and allows you to make changes at that time without a qualifying event. Outside of open enrollment, a qualifying event such as, marriage, divorce, a spouse’s open enrollment (this is not a complete list) is required to make a change mid-year for eligible employees.
Are these offerings Medicare eligible plans?
No, however, future offerings of the cooperative will be determined by the plan board.
Who do I call when I have questions or need help?
Once enrolled, you will receive your ID card, which will outline many helpful resources outlined on the back of the card. You can always call 40 Square Cooperative Solutions toll-free at 1-844-205-9579 or reach us by email at info@40Square.coop.