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Ohio Farm Bureau has a long history of addressing the needs of its members across the agricultural industry. These initiatives have often required bold, innovative steps to develop unique solutions for complex issues. One persistent challenge for a significant segment of its membership has been access to affordable health care. In response, Ohio Farm Bureau is pursuing an option that would provide a competitive and innovative alternative for members who do not easily fit into traditional health plan coverage. To achieve this goal, the organization is seeking legislative authority to offer an additional health care coverage option to its members.

Q: Why should Ohio Farm Bureau be granted this authority?

For more than 100 years, Ohio Farm Bureau has taken bold steps to address the evolving needs of its members. As an organization dedicated to advocating for and serving agricultural and rural communities, its work contributes to improving the quality of life for Ohioans.

With members in all 88 counties and a well-established organizational structure, Ohio Farm Bureau is uniquely positioned to provide an innovative solution for individuals who do not fit traditional health insurance models. Few, if any, organizations possess the network and resources necessary to implement such an initiative effectively.

Health care policy in the United States has long recognized the need for flexibility, granting reasonable autonomy to self-insured groups that use their own resources to cover their populations. Self-insured businesses, for example, are exempt from state regulations due to their categorization, a precedent reflected in health care policies across all 50 states. Even the Affordable Care Act acknowledges the role of self-insured groups by allowing them the flexibility to design customized plans.

Farm Bureau organizations in several states, including Indiana, Iowa, Kansas, Nebraska, North Dakota, South Dakota, Texas and Tennessee, have successfully provided health plans to their members. Tennessee Farm Bureau, in particular, has more than 70 years of experience in this space, leveraging technological advancements to offer quality, affordable health products. The success of Tennessee’s model has laid the groundwork for other state Farm Bureaus to pursue similar options.

Ohio Farm Bureau has been actively working to address the health care concerns of its members for many years. In 2017, it launched the OFB Health Benefits Plan, a self-funded Multiple Employer Welfare Arrangement medical plan designed to help the agricultural sector and related businesses manage rising medical costs while promoting a healthier Ohio. Despite this investment, gaps in affordable and reliable health care coverage for individuals still exist.

Q: Is this option insurance?

No. While the term “insurance” is often used broadly, it has a specific legal definition under state regulations. A fully insured product is subject to state oversight, whereas self-insured employer groups and similar models are not legally classified as “insurance.” The proposed legislation would allow Ohio Farm Bureau to offer its members health coverage that falls outside the traditional insurance category.

Because these plans would not be classified as insurance, Ohio Farm Bureau would have the flexibility to consider individual health circumstances and design coverage options that better meet the needs of its members. These plans would be supported by contractual obligations, the resources of Ohio Farm Bureau and its affiliated companies, and reinsurance. Coverage would also include access to an expansive national provider network.

Q: What could Ohio Farm Bureau Health Plans cover?

Through a third-party administrator, Ohio Farm Bureau health plans could offer coverage featuring many essential health benefits, including: office visits, hospitalization and telemedicine; prescription drug benefits; preventive, routine and wellness services; maternity, newborn and pediatric care; mental health and substance abuse counseling and treatment; emergency room services; dental and vision coverage; outpatient services; rehabilitative services and devices; and laboratory services, just to name a few. 

Q: How does the plan achieve cost savings OR will people be denied coverage?

Each applicant would be individually rated based on their medical history. This process would enable Ohio Farm Bureau to offer coverage at a significantly lower cost compared to similar ACA-compliant plans. However, some applicants may not qualify for coverage to achieve these savings. In certain cases, individuals with pre-existing conditions may face waiting periods before coverage begins. The overarching goal would be to provide coverage to as many members as possible.

Experience in Tennessee has shown that nearly nine out of 10 applicants are approved for coverage. For individuals who do not qualify, existing health care options would remain available. By introducing this new option, Ohio Farm Bureau aims to expand choice and increase the number of insured individuals in Ohio.

Q: What happens if a member gets sick? Will a member lose coverage?

Once accepted, Ohio Farm Bureau members would not lose their coverage as long as they continue paying their premiums. Coverage would be available without the threat of cancellation due to health conditions. However, premium rates could change over time based on the overall performance of the risk pool or as individuals age.

Q: What if there’s a dispute? Who do members contact with a complaint or appeal?

Farm Bureau Health Plans would be subject to Ohio consumer protection laws through the Ohio Attorney General’s office. Additionally, the organization would voluntarily adhere to ACA-mandated appeal structures for coverage denials, including both internal and external review processes. To further ensure public confidence, Farm Bureau would incorporate a grievance process equivalent to ACA standards into its contracts. Any individual with concerns would have the option to file a complaint with the attorney general.

Q: Who will benefit from Ohio Farm Bureau’s health plans?

The primary beneficiaries of these plans would be Ohio Farm Bureau members in all 88 counties who lack access to employer-based group insurance or who work in roles where securing health benefits is challenging. These individuals would largely include farmers, agricultural workers, and those who do not qualify for significant ACA subsidies.

Beyond individual members, the plan is expected to reduce the number of uninsured individuals in Ohio, support rural hospitals, and improve the overall quality of life in rural communities.