Association Health Plan FAQs

Question: Why did the ABA decide to form its own healthcare plan?

Answer: For several years, member banks have asked whether the ABA can find a way for banks to come together in a large, viable healthcare plan to help reduce the costs banks are incurring for this important benefit. Forming an association healthcare plan not only reduces costs, but also allows for richer benefits.

While association health plans, or AHPs, are nothing new, an Executive Order “Promoting Healthcare Choice and Competition Across the United States” issued by President Trump in October 2017 led directly to the adoption of a new Department of Labor rules specifically designed to expand access to AHPs for existing associations like ABA.

In addition to the large group purchasing power, price flexibility options, rate stabilization measures, and consumer protection safeguards are part of the new framework, making AHPs attractive options.

In 2018, we engaged J. Smith Lanier & Co. to research the feasibility of an association health plan for member banks. With census information from 94 member banks, requests for proposals were made to multiple insurers. Based on our findings, we are offering a plan featuring Blue Cross Blue Shield of Alabama (BCBS) as our primary insurance provider.

 

Question: When did this plan become effective?

Answer: The ABA Healthcare Plan became effective April 1, 2019.

 

Question: Will this new plan save my bank money?

Answer: That is easily determined by a cost and benefits comparison. So far, dozens of banks have seen significant reductions in annual costs coupled with richer benefits for their employees.

 

Question: From what I understand, ABA’s plan requires covered employees to have two insurance cards. Is that true and, if so, why?

Answer: That is correct. All covered employees will receive two cards. The primary card will be a BCBS card, since BCBS is our primary insurance provider. BCBS will be the only deciding party as to whether any claim is paid or not as a covered item. Secondary coverage will be provided through Employee Benefit Services, Inc. (EBS), which will issue a second card to all covered employees, and EBS will automatically pay claims authorized by BCBS. The secondary coverage is not gap insurance coverage; it is designed to bridge coverage between BCBS and the enhanced benefits (i.e., Platinum, Gold or Silver) which your bank may choose.

As for filing claims, medical providers will simply file twice (electronically) on each claim. By providing a secondary layer of health insurance coverage, ABA’s plan may provide richer benefits at a lower cost, all with the potential for your bank to receive back unused accumulated funds at the end of each year.

 

Question: Are there additional coverages provided in ABA’s plan?

Answer: Actually, yes. In addition to the primary and secondary health coverage, our plan will also include two new benefits called Healthiest You and Best Doctors. Healthiest You is a program that provides 24-hour access to medical doctors, via telephone or the internet, who can diagnose, treat, and often prescribe for an array of medical issues. When traveling or when you prefer to avoid the doctor’s office, Healthiest You is a great option. Best Doctors provides extensive, independent medical reviews of diagnoses in order to help determine the best course of action for more challenging medical conditions. Both of these plans are included at no additional cost.

 

Question: Are we able to maintain the same elimination period (the waiting period between the hire date and the coverage date) that we currently have?

Answer: Yes. We need to know your desired elimination period so we can place your bank in the appropriate category.

 

Question: We understand there are different plans such as Platinum, Gold and Silver. Can our bank offer multiple plans to our employees?

Answer: Yes.

 

Question: How will our bank handle COBRA notices going forward?

Answer: COBRA administration for these benefits will be provided for your bank by our third-party administrator.

 

Question: Our bank’s plan renews later this year. If interested, may we join the ABA plan at another time?

Answer: Yes. Since our plan begins April 1, our annual renewals will also be April 1. Your bank may actually join our plan during any month; however, your initial term may be shorter by joining our plan mid-year. In other words, if your bank joins our plan August 1, your first renewal will come after eight months. And for plans presently with BCBS, year-to-date deductibles will transfer over.

 

Question: Will we still be able to use our same Blue Cross Blue Shield service representative?

Answer: Likely not. However, our plan will be managed by the larger group servicing department which provides a more exclusive level of one-on-one service.

 

Question: How will our bank be billed under the new plan?

Answer: ABA will contract with a third-party administrator to provide monthly billing. Banks will remit one monthly payment for all plans.

 

Question: What is needed for a price-and-benefits comparison for my bank, and where do I send this information?

Answer: For the comparison, a copy of your bank’s plan design, the bank’s billed rates for your health coverage, and how many people fall into the four tiers of coverage (employee/employee-spouse/employee-children/full family) is needed.

If your bank currently has GAP coverage, please be sure to include that in the information you send as that can drastically affect the final estimate.

This information should be emailed to Tom Younger, senior vice president, J. Smith Lanier & Co., at tyounger@jsmithlanier.com, or you may call Tom at 256-890-9027.