Spring 2013
Member Benefits E-Direct
Designed specifically to keep NYSUT members informed
Issue 6
What the Affordable Care Act means to you Inside this issue: Theme Park Trips ..... .......................pg 6 Long-Term Care Insurance...............pg 7 Planning A Vehicle Purchase? ..........pg 8 Keep Your Health On Track.............pg 10
800 Troy-Schenectady Road Latham, NY 12110 800-626-8101 M-F 9:00 a.m. - 5:00 p.m. memberbenefits.nysut.org
NYSUT Member Benefits Trust NYSUT Member Benefits Corporation ŠCopyright 2013
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Table of Contents
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From the Director........................................................................................................................................ 3
Director Lynette Metz updates you about the ongoing monitoring of Member Benefits-endorsed programs along with information about new endorsed offerings.
What the Affordable Care Act means to you ..................................................................... 4 The Patient Protection and Affordable Care Act has quickly become a hotbed of controversy; we help break the Act down and let you know how it impacts you.
Keep your next theme park trip under control! ..................................................................6 We’ve compiled a number of tips to keep your next theme park adventure from going off the tracks.
Is long-term care insurance right for you? ...........................................................................7 Long-term care insurance helps to pay the high cost of custodial care and other expenses that a long-term illness can bring... but it’s not for everyone.
Planning a vehicle purchase?....................................................................................................8 Ask yourself these questions before making any purchase to find the right vehicle for you and your family.
Kids Corner: Acclimating pets with newborns .....................................................................9 Consider these tips to ease the adjustment process for pets when a new member of the family arrives in the home.
5 ways to keep your health on track.....................................................................................10 Check out these initiatives to incorporate some positive changes into your eating habits. Member Benefits E-Direct is a quarterly publication produced by NYSUT Member Benefits designed to educate NYSUT members about a variety of topics and issues of importance to them and their families. The goal of this e-newsletter is to serve as an educational and informative piece that helps our hardworking members to make better informed decisions in their lives. For information about any of our programs or about contractual endorsement arrangements with providers of endorsed programs, please contact NYSUT Member Benefits at 800-626-8101 or visit memberbenefits.nysut.org. Agency fee payers to NYSUT are eligible to participate in NYSUT Member Benefits-endorsed programs.
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From the Director Hello again, and welcome to the Spring 2013 issue of Member Benefits E-Direct! With temperatures finally warming up outside, things are also quickly heating up here at Member Benefits. We attended the NYSUT Representatives Assembly in Washington, D.C. in early April. At our booth located in the exhibit hall, we met with a number of delegates who indicated that they enjoy the various endorsed programs and services that we offer. Member Benefits representatives have been conducting site visits throughout the Northeast as part of our ongoing monitoring of our endorsed programs, including American General (Term Life & Catastrophe Major Medical insurance plans) in New Jersey; MetLife Auto & Home in Rhode Island; Feldman, Kramer & Monaco, P.C. (Legal Service Plan) on Long Island; and MetLife (grandfathered LongTerm Care Plan) in New York City. With the assistance of our consultants, we have also reviewed the July 1, 2013 Catastrophe Major Medical & Davis Vision Group Plans along with the January 1, 2014 Voluntary Dental Plan proposed rate renewals as part of our ongoing monitoring process. Member Benefits has also been working to spread a little cheer by returning money to participants in our Term Life and MetLife Auto & Home programs. The MB Trust Trustees recently voted to assist the 2,200 participants of our endorsed MetLife Auto & Home insurance program who incurred a home and/or auto claim as a result of Superstorm Sandy last fall.
We are assisting these participants with their claims by offsetting a portion of the deductible that was applied to the claim, up to $250. Approximately $500,000 of Member Benefits reserves is being used to provide this assistance. In addition, 70,000 participants of the Member Benefits-endorsed Term Life insurance program are receiving a refund as a result of positive claims experience. The refund amount is approximately 20% of a participant’s annual 2011-2012 plan year premium and will total close to $4.2 million – funded by the Plan’s reserves. We recently announced the return of long-term care for NYSUT members with the endorsement of New York Long-Term Care Brokers. Interest in this new program has been very strong so far with NYLTCB receiving a number of phone calls and inquiries about the various plans offered. Make sure to check out page seven of this for a helpful article about whether long-term care insurance is the right decision for you and your family. Look for a number of other new Member Benefits Corporation endorsements to be announced this fall. We are also currently in the process of developing a new Member Benefits website to be launched this fall. Development on this new site is moving quickly, and we think you’re going to be very pleased with the results. We encourage you to call us at 800-626-8101 or visit memberbenefits.nysut.org to learn more about the various endorsed programs and services that we offer. See you in three months!
-- Lynette A. Metz Director, NYSUT Member Benefits Trust CEO, NYSUT Member Benefits Corporation
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What the Affordable Care Act means to you By Diana J. Lindsay, NYSUT Member Benefits
U.S. President Barack Obama signed the Patient Protection and Affordable Care Act – commonly known as the Affordable Care Act – into law on March 23, 2010. The goal of this law was to improve access to affordable health care for all Americans while reducing the overall cost of health care. The Affordable Care Act (the Act) has quickly become a hotbed of controversy, with supporters arguing that it has enhanced the quality of care for all Americans and dissenters claiming that it will lead to a shortage of health care professionals and higher drug costs. Our goal with this article is not to dispute either side; instead, we’d like to help take some of the confusion out of how the Act will affect you.
What it is According to Medicaid.gov, the Act provides Americans with better health security by putting in place comprehensive health insurance reforms that help to expand coverage; hold insurance companies accountable; lower health care costs; guarantee more choice for consumers; and enhance the quality of care for all Americans. The Act ended lifetime dollar amounts on the coverage of 105 million Americans while putting an end to pre-existing condition discrimination, limits on care and coverage cancellations. So what does all of this mean for you? All of your health insurance needs are now covered, right? And you would never need any supplemental insurance to cover additional costs, correct? Well, not exactly...
No more lifetime dollar maximums Although it’s true that the Affordable Care Act has effectively lifted lifetime dollar maximums on certain “essential” benefits such as inpatient hospice care, there may still be other benefits that have limits such as private duty nursing. In addition, deductibles and co-payments can increase each year without your control. Familiarize yourself with your Medicare coverage (if applicable) and any additional coverage you may have. To assist with this review, the Affordable Care Act requires that all group and individual health insurance issuers provide a consumer-friendly, easy-to-read Summary of Benefits and Coverage to participants; it’s important to review these documents thoroughly and retain them for future reference.
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Following the review, you may find that an insurance policy such as catastrophe major medical and/or long-term care insurance still has significance within your health insurance needs.
State laws can vary Individual states may already have health insurance laws that guarantee certain benefits now guaranteed in the Affordable Care Act. In situations like this, the state law remains in place for those specific benefits. New York state, for example, already had benefits in place concerning women’s health.
Grandfathered plans It’s important to keep in mind that the term “grandfathered” can mean a variety of things when it comes to insurance plans. A “grandfathered plan” is a group health plan that was in existence on the date of enactment of Health Care Reform – March 23, 2010. For example, the current Member Benefitsendorsed Catastrophe Major Medical program – designed to supplement basic health insurance – is considered a “grandfathered health plan” under the Affordable Care Act. As such, the current participants were able to benefit from enhancements such as the increase of the lifetime maximum from $2 million annually to unlimited for each covered individual. An additional enhancement – due to Health Care Reform – is the increase of the ambulance services benefit from $2,000 annually to covered at 100% for each eligible individual.
Public opinion on the Affordable Care Act has wavered since it was signed into law in March 2010; this could be due to confusion and a lack of understanding about how the Act affects the average American family.
Another example of the term “grandfathered” is our endorsed Long-Term Care program that was frozen on December 31, 2011 – thereby closing it to new enrollees. This was a result of MetLife’s decision to no longer underwrite longterm care insurance. The participants in the plan were “grandfathered,” meaning that participants in the plan as of December 31, 2011 will see no changes to their benefits and the policy will remain covered by MetLife; however, new applications are no longer being accepted.
Continually Changing The Affordable Care Act continues to change so it’s important to stay up-to-date about this important piece of legislation. Click here to learn more about the Act, including key features, timelines and valuable information about how it affects the average American family.
Diana J. Lindsay has been a Coordinator of Benefits for NYSUT Member Benefits for the past two years. Serving as the Program Specialist for both the Member Benefits-endorsed Catastrophe Major Medical & Long-Term Care Insurance Plans, Ms. Lindsay also has more than a decade of experience in the human resources field – giving her specific insight into how a law such as the Affordable Care Act affects the general American public.
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KEEP YOUR NEXT THEME PARK TRIP UNDER CONTROL! With the warmer weather finally here, are you beginning to make your summer plans? Thinking about planning that perfect theme park trip with the family, but not quite sure where to begin? Your friends at Member Benefits have compiled a number of helpful tips to make your excursion one for the ages! And remember that NYSUT members can purchase discounted theme park tickets through the Member Benefits-endorsed Working Advantage discount program. For more information, please call 800-626-8101 or visit memberbenefits.nysut.org.
8 tips for a better theme park experience 1. Do your homework beforehand – Take the time to do some online research before your trip and find out what the theme park’s major attractions are, which rides have the longest lines and approximate wait times to plan accordingly. Also, pay close attention to ageappropriate attractions if you’re traveling with little ones.
5. Dress appropriately – You won’t want to be lugging heavy travel bags around the theme park so make sure to wear comfortable clothes and shoes. Keep in mind that the park may also have restrictions on the number of bags that can be brought in. (Source: Wikihow.com)
(Source:Hotelandtransportation.com)
6. Try to limit purchases inside the park – This includes sunscreen, pain relievers, bandages, baby supplies, and refillable water bottles... unless necessary. Make sure to also bring some waterproof, re-sealable plastic bags to keep cameras and cell phones dry during water rides. (Source:Theme Park Insider)
2. Make a budget – Plan a budget for all of the expenses you’ll have on your trip, including airfare/driving expenses, hotels, tickets, food, souvenirs, etc. There can be a lot of temptation at theme parks so try not to go wild with unnecessary spending. (Source: Theme Park Insider)
3. Buy your tickets online in advance – If possible, buy your tickets in advance to save money on the regular price at the gate. However, keep in mind that most tickets are non-refundable so don’t buy them too far in advance. (Source:Theme Park Insider) 4. Arrive early/Check for weather – Plan to get to the park as early in the morning as possible to take advantage of the popular attractions before the lines begin to build up. You might want to take advantage of a day that calls for light rain or overcast conditions to help keep the crowds at bay. (Source: Hotelandtransportation.com)
7. Rent a locker if possible – If you plan on heading to a water park or major theme park, try to secure a locker so you can lock up valuables and not take a chance on them getting lost or stolen. 8. Pay with cash when possible – You can save between 10 and 20 percent on your family vacation simply by using cash for your trip and avoiding credit card interest charges. Using cash at the park also helps to curtail impulsive spending. And let’s be honest, do you really need that seven foot pink elephant you’ve been eyeing all day? (Source: Theme Park Insider)
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Is long-term care insurance right for you? The current national cost of in-home assistance is more than $50,000 per year for 44 hours per week of help (Cost of Care 2013 – Genworth). The national average cost per year for a private room in a nursing home is more than $125,000 (Cost of Care 2013 – Genworth).
Being forced to pay these costs without the benefits of a supplemental insurance policy could quickly deplete your life savings. As we all know, life can change in the blink of an eye. That’s where long-term care insurance comes into play... helping to pay the high cost of custodial care and other long-term care expenses that a long-term illness or injury can bring. This type of insurance is not for everyone, though. Is it a good idea for you and your family? Ask yourself the following questions from moneyover55.about.com before making your decision: 1. Do you lead a healthy lifestyle? Surprisingly, being healthy may mean that you are more likely to need care. Healthier people tend to live longer, whereas heart problems or cancer may take the unhealthy ones sooner. One of the benefits of long-term care insurance for a healthy person is that it can allow you to stay in your home and maintain your independence longer.
2. What does your family’s health history look like? While not always an accurate predictor of how your health will be, it’s important to consider the longevity and health of your grandparents, parents, aunts, uncles, and siblings.
3. Are you willing to spend your own assets down or depend on your family if you need care? What would happen if you broke a hip later in life? Or what if your mind remains fully alert, but you need help cooking, cleaning and dressing – and do not want to move in with a family member? Keep in mind that a program such as the New York State Partnership for Long-Term Care may also help to protect your assets in the event that a nursing home or in-home assistance was required.
If you decide that long-term care insurance is right for your family, make sure to do your homework before purchasing a policy. You may want to consider looking at the new long-term care insurance program endorsed by the NYSUT Member Benefits Trust – New York Long-Term Care Brokers. NYLTCB is a nationally-recognized insurance intermediary that offers access to discounted long-term care insurance plans from multiple highly-rated insurance companies (including the New York State Partnership for Long-Term Care) for eligible individuals from 18 to 84 years old. For more information about NYLTCB, call toll-free 888-884-0077.
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Planning a vehicle purchase? Deciding on the best vehicle to purchase for you and your family can often seem like a daunting task. There are literally dozens of variables to consider such as cost, color, performance, power, style, and safety. Ask yourself the following questions to find your ideal automobile:
1. What can I afford? You’ll want to keep the monthly payment for your vehicle around 20 percent or less of your net income. And you’ll also need to factor in the total cost of ownership such as insurance, maintenance and fuel. Check with your credit union or bank for loan pre-approval before you start shopping. Although dealer financing can be competitive, you could get a better rate if you use your own financing as leverage. Leasing is another option to consider. You may be able to get a vehicle that you couldn’t afford to buy and could even avoid a down payment. This also gives you the option of getting a new car every few years, and it will likely be under warranty for repairs.
2. How much space do I need? Do you have children or grandchildren? Consider vehicles that are easily accessible such as minivans. SUVs also offer plenty of
interior space, but often get lower gas mileage than cars. Crossover utility vehicles (CUVs) are another option to consider; they are built on an automobile platform but have more interior room than cars. Make sure not to overbuy on a vehicle on the chance that you will use it for a trip down the road. You can always rent a vehicle if you need to take a trip or transport items.
3. What options do I need? Comfort and convenience features make motoring more pleasurable. The list of options can be long, so determine which ones you need most. Extra storage and a DVD & audio entertainment system may be helpful if you’re hauling children, while a global positioning system (GPS) may be essential for travelers who tend to get lost.
4. Do I want a fuelefficient vehicle? In general, the lighter the vehicle and smaller the engine, the less fuel it uses. Use the EPA estimated mileage sticker on the window to make comparisons. Hybrid vehicles – which are both gasoline- and electric-powered – deliver their best fuel economy in stop-and-go situations like city driving and are practical for daily commuters. Special thanks to MetLife Auto & Home for providing the content for this article.
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Kids Corner: Acclimating pets with newborns
For parents, bringing home your new little bundle of joy is a wonderful and priceless moment. But while you will most likely be overflowing with joy, keep in mind that the family dog(s) or cat(s) might have a very different perspective. Any way you slice it, you are likely to spend less time with your pets after the arrival of a new baby. While this is totally understandable to humans, the average dog or cat probably doesn’t understand this, which is why it’s important to condition your four-legged friends to positively associate the upcoming changes. Bringing your baby into a home with pets Before returning home with your newborn in tow, bring a blanket from the hospital to your pets with your baby’s scent on it. Praise them as they smell it; this will teach them to associate positive behavior with the scent of your new child. When you get home from the hospital with your newborn, take a few minutes to greet your pets and give them some attention – whether it be you or your spouse. As soon as you are physically able, make an effort to spend some quality time with your pets in order to dispel any anxiety on their part. Familiarize pets with your baby’s name Familiarizing your pet with the sound of your baby’s name is crucial. Say the baby’s name around your dog or cat in a positive tone. Tell your pet how excited you are and how much everyone will love each other. This will help to establish a positive association in your pet’s mind when she hears your baby’s name.
Positive praise is key Treat the first interactions between your pet and your baby the same as you did in the training sessions. Make it a point to feed your pet when the baby is crying, praise your dog when you walk around with the baby, or give your cat a treat when she approaches both of you in a calm and friendly fashion. No matter how great you think your pet is doing with your baby or child, though, NEVER leave your pets and baby unattended together. Pet behavior is simply not 100% predictable and babies – especially newborns – are fragile. Regular training will continue to reinforce your pet’s positive behavior. With patience and practice, your newborn and pets can learn to live as one happy family. For more information about the Member Benefits-endorsed pet insurance program, please call 800-626-8101 or visit memberbenefits.nysut.org. Special thanks to VPI Pet Insurance for providing the content for this article.
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5 ways to keep your health on track Answer this question: Do you truly consider the quality of the food that you’re putting into your body each day? If you answered “yes,” we congratulate you on leading a health-conscious life. However, if you’re like many Americans, it’s time for a wake-up call about what you’re eating! Consider the following initiatives to help incorporate some positive changes into your eating habits: 1. Get your sleep – Although people looking to lose
weight may not think about it, sleep deprivation can lead to increased cravings for high-carb foods and other poor eating decisions. Studies suggest that getting at least seven hours of sleep each night can significantly improve your chance of losing weight while on a diet.
2. Start the day on the right foot – Stretching
and warming up are the best ways to maximize your work out. Similarly, eating a balanced breakfast is the best way to get your metabolism running at its highest efficiency. Egg whites, English muffins, fruits, and yogurts are just a few great options for getting the most out of your day.
3. Get to know your “Superfoods” – There are
delicious, common foods found in supermarkets and grocery stores that contain superpowers. Foods that are disguised as a basic food yet jam packed with nutrients are known as “superfoods” and can help you lose weight the more you eat them. Edamame is a type of soybean that can be steamed or boiled that is jam packed with protein. The acai berry is another all-star on
the “superfood” team. It contains a significant amount of essential fatty acids like Omega 3 and Omega 6 and can strengthen the immune system, improve sleep, slow down aging, detox the body and even help to burn body fat.
4. Research true healthy foods – Grocery store labels can be very deceiving. Read the nutritional facts on items to get a real gauge on the health level of the product. “Healthier” foods such as smoothies, granola, packaged turkey, and energy bars can be deceiving as they often contain high calories, sugar and sodium levels.
5. Don’t dwell on what not to eat – Eating healthy should be a lifelong habit. Tempting yourself about what you shouldn’t eat will only distract you from moving forward. Instead, find recipes that are healthy alternatives to your favorite fattier foods. The next time you want to order another take-out pizza or throw a frozen processed pie in the oven, consider using fresh dough, olive oil, garlic, and fresh vegetables for a delicious AND healthier meal.
For more information about the Member Benefits-endorsed Dental Plan, please call 800-626-8101 or visit memberbenefits.nysut.org. Special thanks to ExamOne for providing the content for this article.
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