Until recently, employees of Alaska Village Electric Cooperative(AVEC) who fell ill while working in the extremely remote areas the co-op serves had two choices for care.

“They could have a prescription called into a local clinic at the closest hub community or go all the way back to Anchorage,” says Meera Kohler, AVEC’s recently retired president and CEO and Alaska’s representative on the NRECA board of directors. “It’s an hour in a jet, depending on where you’re coming from. And you’re not going to fly back just because you’re feeling lousy.”

More often, Kohler says, “you’re going to stay where you are and fight it.”

Situations like this are extreme but not altogether uncommon in the far-flung territories of many electric cooperatives. And they’re what led NRECA to look for ways to broaden the reach of its medical plan.

“People were either putting off routine medical care or incurring increased expenses due to the lack of proximity,” says Peter Baxter, NRECA’s senior vice president of Insurance & Financial Services. “We knew we could do better for our membership, so we began evaluating a solution to meet this need.”

After an analysis and a yearlong pilot program, the NRECA Medical Plan in 2018 rolled out Teladoc®, a service that provides access to board-certified physicians for non-emergency care through phone, web and mobile app.

This “go the extra mile” approach has been a defining characteristic of the teams that manage the NRECA Medical Plan since it launched in 1958, Baxter says.

“It’s simply how we do business,” he says. “It’s part of our values.”

Those values were evident this past year as co-op employees navigated the uncertainty and impacts of the COVID-19 pandemic.

Software and other systems were quickly put in place so NRECA teams could work from home while still responding to member needs. When the program’s regular roster of conferences and other in-person meetings were no longer doable, virtual alternatives were created. And the volume of outreach to co-ops increased as NRECA communicated plan updates and resources in response to evolving federal pandemic response measures.

“Maintaining contact and outreach during the pandemic has been our No. 1 priority,” Baxter says. “The importance we place on talking to—and listening to—our members is what makes us different.”

‘Co-op input is huge’

As a West Coast field representative for NRECA, Erik Hayes often travels up to three weeks per month to talk to co-op management and employees about their benefit program.

Hayes is part of a system of client services teams that include Cooperative Benefits Administrators Inc., benefit service representatives and a call center based in Lincoln, Nebraska, that, in addition to their primary functions, act as conduits for information on co-ops’ evolving service and coverage needs.

“Co-op input is pretty huge for us,” says Hayes, who’s been meeting virtually with co-ops from his home in Washington state since the pandemic began.

NRECA also has two advisory groups composed of member co-ops from across the country that meet twice a year with NRECA staff to discuss product enhancements and review plan or industry issues. Co-ops that serve on these groups frequently pilot programs before they’re rolled out to the broader membership.

“We actively seek the feedback of our member co-ops through multiple channels so we can learn about the evolving needs of plan participants,” says Krista Britton, NRECA’s vice president of member benefit services. “We take that feedback and use it to implement plan enhancements specifically tailored to their unique needs.”

Earlier this year, after reviewing medical claims data and member feedback, the plan began offering access to the Joint & Spine Surgery Centers of Excellence to address the physical impacts associated with utility operations.

“This program is a great example of the kind of thing we’re always thinking about: how to evolve the plans to meet co-ops’ changing needs,” Britton says.

Tailored programs

Lake Region Electric Association in Webster, South Dakota, appreciates the regular contact and the fact that their feedback is treated equally with a workforce of just 21 employees. Despite the co-op’s small size, workers and family members can choose among several levels of coverage to customize plans.

“We probably rely on NRECA and their resources more so than a big co-op,” says Timothy McIntyre, the co-op’s general manager and CEO and a member of the NRECA Benefit Product Advisory Group. “The small co-ops pay the bills too, and they make sure the programs benefit large and small co-ops.”

Employees of the northeast South Dakota co-op “wear a lot of different hats,” says McIntyre, and NRECA’s constant outreach efforts are invaluable. “I can’t have one employee designated as a benefits administrator. My financial officer handles HR and benefits.”

GreyStone Power Corp. has offered the medical plan to its 260 employees since 2014 and helped pilot a successful weight loss program about three years ago.

“There’s been a great dialogue, and you really feel like your voice is heard,” says James Wright, the Hiram, Georgia, co-op’s vice president of corporate services. “It’s a huge win for the co-ops.”

Tailored programs build value, Baxter says, but equally important is affordability and cost stability. He says the plan has seen a major boost in both since 2014, when NRECA transitioned from a patchwork of local coverage providers to a national network through UnitedHealthcare. As a result, the plan has saved more than a billion dollars.

“This was a multiyear initiative that has resulted in a more competitive and comprehensive program that’s realizing substantial cost savings without sacrificing quality or customer service,” Baxter says.

Extra efforts

Baxter says dozens of co-op leaders have reached out to him over the past year to thank him and the team for their extra effort during the pandemic.

“I’ve spoken to a lot of folks who have said that with all the disruptions COVID has created, not having to worry about their employees’ health coverage has been a great relief,” he says. “Hearing that our members know they can rely on us, especially during extraordinary circumstances like we’ve seen this year, really solidifies that relationship.”

He says there have been several occasions during the pandemic where they made extra efforts to help co-ops.

The federal Coronavirus Aid, Relief and Economic Security (CARES) Act was passed in March 2020 and required health care providers to, among other measures, temporarily waive copays for COVID-19 diagnostic tests, associated provider visits and COVID-19 vaccinations. NRECA’s plan quickly implemented these and supplemented that with additional temporary measures, including waivers for telemedicine consultation fees and pharmacy refill restrictions.

In late 2020, NRECA drew on reserves in order to hold 2021 base premium rates for the Group Benefits Program at the 2020 level.

“We recognize the financial impacts from the pandemic that our members are facing now and in the coming months,” Baxter says. “This action allows us to provide some relief at a time when cash flow may be tight.”

Those and other relief elements, along with a noticeable increase in outreach to benefits administrators over the past year, have helped co-ops focus on the important things, like taking care of their employees so they in turn can serve the membership, says Stephanie Deal, director of human resources at Central Electric Cooperative, based in Parker, Pennsylvania.

“I was able to concentrate on the daily challenges I faced knowing my co-op’s employees didn’t have to worry about their benefit programs,” she says.

Now, as the race is on to distribute COVID-19 vaccines, NRECA is collaborating with advisers and vendors to provide educational information to plan participants and ensuring vaccine claims are paid at the in-network rate regardless of where the shot is administered.

“This past year has been a test,” Baxter says. “But what it’s shown us is that the NRECA Medical Plan is fully capable of adapting quickly and effectively to help our members even in the most extreme of challenges.”