SUMMER 2013 A publication for the policyholders of the Arkansas Blue Cross and Blue Shield family of companies
the HEALTH CARE LAW timeline JULY1 2013
SEPT.3 2013 OCT.1 2013 DEC.15 2013 JAN.1 2014
A new tool to help determine if you qualify for cost breaks launches on our website, arkansasbluecross.com
2014 health care plans become available for review on our website
Online marketplace opens
Final day to buy health insurance for a January 1, 2014 effective date
New health insurance plans begin
MAR.31 2014 Last day to sign up for health insurance
MPI 1624 6 /13
Representatives of Arkansas Blue Cross and Blue Shield are ready to help you. Call or come by one of our locations.
page
4
Live Fearless
Arkansas Blue Cross tops national customer survey
Financial Information Privacy Notice
page
page
page
10
15
22
of
OUT BLUE
ArkansasBlue employee Michael Stewart greets a customer at the Shackleford Crossings location.
3
Out of the Blue
4 7
The health care law and you
9
Meetings for small businesses
Upcoming changes under the health care law
15
Customers rank Arkansas Blue Cross as a top Blue Plan in the nation
16
Over-the-counter medicines
17 18
Your role in health care
Arkansas’ Health Care Independence Program: Do you qualify?
19
Member discounts Grants available for health programs
10
Live Fearless – our new advertising campaign
20
12
Fast food and asthma Binge drinking studies Lose weight the Healthy Weigh!
New ArkansasBlue health insurance store opens in Pine Bluff The “freedom” of short-term coverage
13 14
The Health Insurance Marketplace – how it might help you
Is memory loss from aging or lack of sleep? Maybe both. Blue News
SUMMER 2013
Will Arkansas have enough doctors?
22
Arkansas Blue Cross and Blue Shield – Financial Information Privacy Notice
23
Customer Service telephone numbers
24
Health care law timeline Blue &You is published four times a year by Arkansas Blue Cross and Blue Shield for the company’s members, health care professionals and other persons interested in health care and wellness.
Health information from sources outside of Arkansas Blue Cross and Blue Shield do not necessarily represent the official position of the company.
EDITOR: Jennifer Sullivan – bnyou-ed@arkbluecross.com • DESIGNER: Ryan Kravitz • PHOTOGRAPHER: Chip Bayer CONTRIBUTORS: Will Ballard, Chip Bayer, Gio Bruno, Matthew Creasman, Damona Fisher, Kristy Fleming, Lauren Green,Trey Hankins, Heather Iacobacci-Miller, Genny Kirchner, Kathy Luzietti, Wendy McCullar, Mark Morehead, Alex Roberts, Kelly Whitehorn and Stephen Wilson VICE PRESIDENT, COMMUNICATIONS and PRODUCT DEVELOPMENT: Karen Raley
2
on the cover BLUE & YOU SUMMER 2013
Sara Harris, ArkansasBlue team leader, consults with a customer about the upcoming health care law changes.
It has been a busy year for the health care industry, and it is only halfway through. We have seen remarkable progress made toward implementing provisions of the new health care law as they become effective, but I know many of you still have concerns about the changes yet to be implemented. You can rest assured that our team at Arkansas Blue Cross and Blue Shield has been working to determine how to best address these challenges.
Arkansas Medicaid expansion
Arkansas historically has had one of the most restrictive Medicaid programs in the country, and I applaud the bipartisan efforts of the Arkansas Legislature and Gov. Mike Beebe to create the Arkansas Medicaid private option that was signed into law in April. Arkansas is the first state in the nation to create a system allowing qualified low-income Arkansans to purchase subsidized private insurance through the state’s Health Insurance Marketplace, but other states are watching with interest. For the first three years, this program will be funded entirely with federal money. Expanding Medicaid to provide health care coverage to low income Arkansans is the right thing to do. It not only benefits people who are struggling financially, it benefits their families, the business owners who hire these workers, our health care providers and the state’s economy. Ultimately, we will see the benefits of a healthier population.
Controlling health care costs
Many of you may have heard news reports concerning increases in premium costs as a result of new regulations under the health care law. There are provisions of the law that will increase costs for some, but there will be both winners and losers under the new regulations.
a message from our President and CEO, MARK WHITE Why are costs increasing for some? The law requires the insurance industry to cover more services, offer some services at no cost to the member, and calculate premiums according to new guidelines. There also are a number of new taxes and fees included within the law. Certainly, most Americans understand that when you provide free or reduced-cost insurance to millions of people and cover more services, there will be a cost associated with it. In this issue of Blue & You, we explain some of the new provisions within the health care law and what we believe you can expect regarding your coverage. Some of you will find that your coverage will be less expensive in the future; for others, it will be more costly. Regardless of the impact, Arkansas Blue Cross has spent the past two years working to find solutions that will provide you and your family affordable insurance options. If you purchase health care coverage for you and your family on your own, we will be reaching out to you this summer to request a health insurance review. During a phone call or a visit we can cover any changes the law will require and make you aware of the most affordable choices available to you. It is important that you are informed about your options and you that maintain your “grandfathered” status until you have the information needed to aid in the decision process. Our customer support teams are
CHANGES continued on page 23 SUMMER 2013 BLUE & YOU
3
of
OUT BLUE
ArkansasBlue employee Michael Stewart greets a customer at the Shackleford Crossings location.
3
Out of the Blue
4 7
The health care law and you
9
Meetings for small businesses
Upcoming changes under the health care law
15
Customers rank Arkansas Blue Cross as a top Blue Plan in the nation
16
Over-the-counter medicines
17 18
Your role in health care
Arkansas’ Health Care Independence Program: Do you qualify?
19
Member discounts Grants available for health programs
10
Live Fearless – our new advertising campaign
20
12
Fast food and asthma Binge drinking studies Lose weight the Healthy Weigh!
New ArkansasBlue health insurance store opens in Pine Bluff The “freedom” of short-term coverage
13 14
The Health Insurance Marketplace – how it might help you
Is memory loss from aging or lack of sleep? Maybe both. Blue News
SUMMER 2013
Will Arkansas have enough doctors?
22
Arkansas Blue Cross and Blue Shield – Financial Information Privacy Notice
23
Customer Service telephone numbers
24
Health care law timeline Blue &You is published four times a year by Arkansas Blue Cross and Blue Shield for the company’s members, health care professionals and other persons interested in health care and wellness.
Health information from sources outside of Arkansas Blue Cross and Blue Shield do not necessarily represent the official position of the company.
EDITOR: Jennifer Sullivan – bnyou-ed@arkbluecross.com • DESIGNER: Ryan Kravitz • PHOTOGRAPHER: Chip Bayer CONTRIBUTORS: Will Ballard, Chip Bayer, Gio Bruno, Matthew Creasman, Damona Fisher, Kristy Fleming, Lauren Green,Trey Hankins, Heather Iacobacci-Miller, Genny Kirchner, Kathy Luzietti, Wendy McCullar, Mark Morehead, Alex Roberts, Kelly Whitehorn and Stephen Wilson VICE PRESIDENT, COMMUNICATIONS and PRODUCT DEVELOPMENT: Karen Raley
2
on the cover BLUE & YOU SUMMER 2013
Sara Harris, ArkansasBlue team leader, consults with a customer about the upcoming health care law changes.
It has been a busy year for the health care industry, and it is only halfway through. We have seen remarkable progress made toward implementing provisions of the new health care law as they become effective, but I know many of you still have concerns about the changes yet to be implemented. You can rest assured that our team at Arkansas Blue Cross and Blue Shield has been working to determine how to best address these challenges.
Arkansas Medicaid expansion
Arkansas historically has had one of the most restrictive Medicaid programs in the country, and I applaud the bipartisan efforts of the Arkansas Legislature and Gov. Mike Beebe to create the Arkansas Medicaid private option that was signed into law in April. Arkansas is the first state in the nation to create a system allowing qualified low-income Arkansans to purchase subsidized private insurance through the state’s Health Insurance Marketplace, but other states are watching with interest. For the first three years, this program will be funded entirely with federal money. Expanding Medicaid to provide health care coverage to low income Arkansans is the right thing to do. It not only benefits people who are struggling financially, it benefits their families, the business owners who hire these workers, our health care providers and the state’s economy. Ultimately, we will see the benefits of a healthier population.
Controlling health care costs
Many of you may have heard news reports concerning increases in premium costs as a result of new regulations under the health care law. There are provisions of the law that will increase costs for some, but there will be both winners and losers under the new regulations.
a message from our President and CEO, MARK WHITE Why are costs increasing for some? The law requires the insurance industry to cover more services, offer some services at no cost to the member, and calculate premiums according to new guidelines. There also are a number of new taxes and fees included within the law. Certainly, most Americans understand that when you provide free or reduced-cost insurance to millions of people and cover more services, there will be a cost associated with it. In this issue of Blue & You, we explain some of the new provisions within the health care law and what we believe you can expect regarding your coverage. Some of you will find that your coverage will be less expensive in the future; for others, it will be more costly. Regardless of the impact, Arkansas Blue Cross has spent the past two years working to find solutions that will provide you and your family affordable insurance options. If you purchase health care coverage for you and your family on your own, we will be reaching out to you this summer to request a health insurance review. During a phone call or a visit we can cover any changes the law will require and make you aware of the most affordable choices available to you. It is important that you are informed about your options and you that maintain your “grandfathered” status until you have the information needed to aid in the decision process. Our customer support teams are
CHANGES continued on page 23 SUMMER 2013 BLUE & YOU
3
the HEALTH CARE law ? “Will it impact my coverage?”
Whether your health insurance coverage will change as a result of new health care rules that go into effect January 1, 2014, depends on when you bought your health insurance and whether you bought it at work or on your own.
Medicare Plans
If you are on a Medicare Supplement plan, regardless of when it was purchased, you won’t see any changes to your plan coverage in 2014 as a result of the health care law. If you have a Medicare Advantage or Medicare Prescription Drug Plan, the process for notifying you about 2014 changes at the end of September 2013 remains unchanged as a result of the law.
Plans purchased before March 2010 If your health plan was in place before the law was passed in March 2010, whether purchased through your employer or on your own, you may have what is known as a “grandfathered” plan. A number of changes already have been made to these policies to meet new legal requirements. Changes include allowing children to stay on a parent’s health plan until their 26th birthday and removing lifetime dollar limits on some medical services. These plans will not see any big changes in 2014. If you are unsure whether your plan is grandfathered, call the customer service number on your ID card or contact your human resources administrator.
Employer Plans (purchased after March 2010) If you have coverage through a company with 100 or more employees, many changes required by the health care law already have been applied to your health plan. These required changes included removing any annual or lifetime dollar limits on certain medical services and adding preventive services if your plan did not include them. A major change that will be implemented relates to your total out-of-pocket cost. When this rule is put in place for your health plan, all deductibles, coinsurance and copayments will count toward your out-of-pocket maximum.
4
BLUE & YOU SUMMER 2013
If your employer employs 51 to 100 employees, similar changes will become effective in 2016. Employers with 50 or fewer employees are likely to see a number of changes to their coverage if the plan is not a grandfathered plan. The law requires that these health plans include a core set of benefits (essential health benefits) and cover preventive services at 100 percent with no member out-of-pocket costs. Among the preventive services provided with no cost sharing are colonoscopies and contraceptives. Also in 2014, your health plan will cover medical conditions that previously required a waiting period. Employers with two to 50 employees will be invited to attend meetings with Arkansas Blue Cross to discuss in detail how the health care law is impacting our employer customers (see article on page 9). After the meeting, employers will be contacted by their agent or an Arkansas Blue Cross representative, to determine the most affordable option for their organization.
Those who bought coverage on their own after March 2010 If you bought an individual or family health plan (not a Medicare plan) on your own and it was purchased after March 2010, you can keep the policy you currently have until December 30, 2014, with no changes. Some of our members will find the new health plans to be more desirable. You may receive a new kind of tax credit that lowers their monthly health plan costs. If that is the case, your agent or an Arkansas Blue Cross representative will make you aware of a more affordable option. New health care plans will cover preventive health benefits at 100 percent, will have no waiting periods for medical conditions and you will have guaranteed approval for health care coverage. Also, all deductibles, copayments and coinsurance will go toward your out-ofpocket maximum.
We are here to help This summer we are asking our members with individual or family health plans (not Medicare plans) to call us or their agent or come in and let us check to see if a lower cost plan will be available under the new law. Our representatives are trained and ready to talk
?
with you. You can call us at 1-800-310-3778 or you can visit with us in person at one of our offices around the state. Arkansas Blue Cross has been providing Arkansans quality health plans at affordable prices for 65 years, and we look forward to working with you.
“Will it impact what I pay?”
For many Americans who are not on Medicare, the full implementation of the new health care law in 2014 may mean a change in what they pay monthly (called a premium). And there will be winners and losers. The extent to which the new rules will affect your health plan depends in part on when your coverage was purchased, and whether you get coverage through an employer or if you purchase coverage on your own for yourself and/or your family. The new changes will have the greatest impact on those who work for companies with 50 or fewer employees and those who buy coverage for themselves and their families on their own or through an agent. The amount you pay monthly (your premium) may increase or decrease as a result of four primary provisions contained in the new law. They are: • New taxes and fees • New requirements regarding what medical services must be covered by insurance policies • New rules concerning how insurance companies must calculate members’ monthly costs • The availability of tax credits or subsidies to help pay for health insurance for individuals and families who qualify
New Taxes and Fees New taxes and fees included in the law will have an impact on premiums. The money collected from these fees will be used to help pay for advance premium tax credits (commonly called subsidies) which will be available to Americans in low-to-middle income ranges to help pay for health insurance. These taxes and fees also will be used to fund research into effective medical practices, to help cover the cost of the Health Insurance Marketplaces that will be established in every state and to stabilize the insurance market in the early reform years. Industry experts project that the fee collected to help fund the tax credit alone will add 2-3 percent to the cost of health insurance. Collectively, the fees could add as much as 3-5 percent to individual and employer health plan premiums.
New Coverage Requirements Health plans sold to individuals and employers with 50 or fewer employees must cover a core set of medical services called “essential health benefits.” Many of these essential health benefits were covered by Arkansas Blue Cross health plans already, such as hospitalization and emergency care. Others were offered, but the buyer in some cases had the choice of whether to purchase the coverage, such as maternity and preventive care. Beginning in 2014, these coverage requirements no longer will be optional. In addition, more preventive services have been added and the health plan must pay 100 percent of the cost of these services.
LAW continued on page 6 SUMMER 2013 BLUE & YOU
5
the HEALTH CARE law ? “Will it impact my coverage?”
Whether your health insurance coverage will change as a result of new health care rules that go into effect January 1, 2014, depends on when you bought your health insurance and whether you bought it at work or on your own.
Medicare Plans
If you are on a Medicare Supplement plan, regardless of when it was purchased, you won’t see any changes to your plan coverage in 2014 as a result of the health care law. If you have a Medicare Advantage or Medicare Prescription Drug Plan, the process for notifying you about 2014 changes at the end of September 2013 remains unchanged as a result of the law.
Plans purchased before March 2010 If your health plan was in place before the law was passed in March 2010, whether purchased through your employer or on your own, you may have what is known as a “grandfathered” plan. A number of changes already have been made to these policies to meet new legal requirements. Changes include allowing children to stay on a parent’s health plan until their 26th birthday and removing lifetime dollar limits on some medical services. These plans will not see any big changes in 2014. If you are unsure whether your plan is grandfathered, call the customer service number on your ID card or contact your human resources administrator.
Employer Plans (purchased after March 2010) If you have coverage through a company with 100 or more employees, many changes required by the health care law already have been applied to your health plan. These required changes included removing any annual or lifetime dollar limits on certain medical services and adding preventive services if your plan did not include them. A major change that will be implemented relates to your total out-of-pocket cost. When this rule is put in place for your health plan, all deductibles, coinsurance and copayments will count toward your out-of-pocket maximum.
4
BLUE & YOU SUMMER 2013
If your employer employs 51 to 100 employees, similar changes will become effective in 2016. Employers with 50 or fewer employees are likely to see a number of changes to their coverage if the plan is not a grandfathered plan. The law requires that these health plans include a core set of benefits (essential health benefits) and cover preventive services at 100 percent with no member out-of-pocket costs. Among the preventive services provided with no cost sharing are colonoscopies and contraceptives. Also in 2014, your health plan will cover medical conditions that previously required a waiting period. Employers with two to 50 employees will be invited to attend meetings with Arkansas Blue Cross to discuss in detail how the health care law is impacting our employer customers (see article on page 9). After the meeting, employers will be contacted by their agent or an Arkansas Blue Cross representative, to determine the most affordable option for their organization.
Those who bought coverage on their own after March 2010 If you bought an individual or family health plan (not a Medicare plan) on your own and it was purchased after March 2010, you can keep the policy you currently have until December 30, 2014, with no changes. Some of our members will find the new health plans to be more desirable. You may receive a new kind of tax credit that lowers their monthly health plan costs. If that is the case, your agent or an Arkansas Blue Cross representative will make you aware of a more affordable option. New health care plans will cover preventive health benefits at 100 percent, will have no waiting periods for medical conditions and you will have guaranteed approval for health care coverage. Also, all deductibles, copayments and coinsurance will go toward your out-ofpocket maximum.
We are here to help This summer we are asking our members with individual or family health plans (not Medicare plans) to call us or their agent or come in and let us check to see if a lower cost plan will be available under the new law. Our representatives are trained and ready to talk
?
with you. You can call us at 1-800-310-3778 or you can visit with us in person at one of our offices around the state. Arkansas Blue Cross has been providing Arkansans quality health plans at affordable prices for 65 years, and we look forward to working with you.
“Will it impact what I pay?”
For many Americans who are not on Medicare, the full implementation of the new health care law in 2014 may mean a change in what they pay monthly (called a premium). And there will be winners and losers. The extent to which the new rules will affect your health plan depends in part on when your coverage was purchased, and whether you get coverage through an employer or if you purchase coverage on your own for yourself and/or your family. The new changes will have the greatest impact on those who work for companies with 50 or fewer employees and those who buy coverage for themselves and their families on their own or through an agent. The amount you pay monthly (your premium) may increase or decrease as a result of four primary provisions contained in the new law. They are: • New taxes and fees • New requirements regarding what medical services must be covered by insurance policies • New rules concerning how insurance companies must calculate members’ monthly costs • The availability of tax credits or subsidies to help pay for health insurance for individuals and families who qualify
New Taxes and Fees New taxes and fees included in the law will have an impact on premiums. The money collected from these fees will be used to help pay for advance premium tax credits (commonly called subsidies) which will be available to Americans in low-to-middle income ranges to help pay for health insurance. These taxes and fees also will be used to fund research into effective medical practices, to help cover the cost of the Health Insurance Marketplaces that will be established in every state and to stabilize the insurance market in the early reform years. Industry experts project that the fee collected to help fund the tax credit alone will add 2-3 percent to the cost of health insurance. Collectively, the fees could add as much as 3-5 percent to individual and employer health plan premiums.
New Coverage Requirements Health plans sold to individuals and employers with 50 or fewer employees must cover a core set of medical services called “essential health benefits.” Many of these essential health benefits were covered by Arkansas Blue Cross health plans already, such as hospitalization and emergency care. Others were offered, but the buyer in some cases had the choice of whether to purchase the coverage, such as maternity and preventive care. Beginning in 2014, these coverage requirements no longer will be optional. In addition, more preventive services have been added and the health plan must pay 100 percent of the cost of these services.
LAW continued on page 6 SUMMER 2013 BLUE & YOU
5
LAW continued from page 5 Because more services will be covered and the health plan will pay more of the cost, premiums will go up to cover the cost of these new health plan benefits.
New rules around determining your monthly costs Historically, insurance companies have considered a number of factors when calculating premiums for employers or individuals purchasing coverage. These factors include the health condition of the individual or the employees in an employer’s group plan. Those employers or individuals who have more health conditions are likely to use more medical services and are, therefore, charged a higher rate. Beginning in 2014, health insurers will not be allowed to consider health conditions in developing premiums. As a result, those who are less healthy may find their costs are less and those who are healthier will pay more in monthly premiums. Age also has been an important consideration in establishing premiums. Older people generally use more medical services and, therefore, pay more, while younger people who are not as likely to need expensive medical care pay less. Although age still will play a role in setting rates, there will not be as a great a range between the rate charged to a 24-year-old and the rate charged to a 60-year-old. Younger people can expect to pay higher rates when these rules are applied in 2014, and older people will pay less. These are two of a number of new rules regarding setting premiums that will begin in 2014 and will cause changes in how much people pay for coverage.
Advance premium tax credits Beginning in January 2014, many low- and middle-income Americans who do not have the opportunity to enroll in an employer’s health plan will be eligible to receive a new kind of tax credit that lowers monthly premiums. The amount of tax credit a household receives is based on their household income and family size. The lower the household income, the higher the tax credit.
6
BLUE & YOU SUMMER 2013
If you think your household may be eligible for an advance premium tax credit, please call Arkansas Blue Cross. We will help you determine if you meet the requirements and provide you with an estimate of what your premium might be after the tax credit is applied.
Arkansas Blue Cross has the information you need The health care law is complex and difficult to understand. Some of our members will benefit and others will not. You can count on Arkansas Blue Cross to provide the accurate and reliable guidance you need to understand how the health care law affects you and those you love. Please don’t make any changes to your health insurance coverage without talking to us first. If your current plan was issued before the law passed, keeping it may be your best option. And if you drop it, you can’t get it back. If you buy coverage on your own, call your agent or Arkansas Blue Cross or come by one of our locations for a health insurance review. We are ready to help you evaluate your options and select a plan that provides the coverage you want at the lowest cost. Call 1-800-310-3778 today.
the HEALTH INSURANCE Marketplace
?
Helping some Americans pay for health care
If you are one of millions of Americans under age 65 who will purchase a health plan this fall through the Health Insurance Marketplace (exchange), you may be eligible for a $0 premium plan or a new kind of tax credit that lowers your monthly premiums. The Health Insurance Marketplace is a website designed to determine if you are eligible for financial help to cover your health insurance costs. It also will help you and your family shop for and purchase health insurance. Americans may also contact the Health Insurance Marketplace by telephone. A Health Insurance Marketplace is being set up in each state, either by the state itself, by the federal government, or in Arkansas’ case, in partnership with the federal government. Each marketplace will be responsible for: • Creating and maintaining a consumer shopping website. • Providing access to all information necessary to determine if you are eligible for help paying for your premium or if you qualify for free coverage. • Helping consumers shop for and purchase health plans. • Making sure all health plans offered on the marketplace meet all the new regulations.
Why buy on the marketplace?
Many Americans will be eligible to receive advance premium tax credits (subsidies) if they purchase a health plan through the marketplace. An advance premium tax credit is a new tax credit that you can use to lower your monthly premium costs beginning January 1, 2014. (see chart below to see if you might qualify.) The amount of the advance premium tax credit that each household will receive is calculated by using their income, the size of their family and other factors. This new tax credit helps lower- and middle-income families. Some households, based on their income, will receive additional financial assistance when they receive medical care.
Essential health benefits
Every health plan sold to small employer groups and individuals on the Health Insurance Marketplace must include a core set of benefits established by the law. Many of these services are covered today by health plans sold by Arkansas Blue Cross. Others, such as preventive care and mental health services, are available to purchase as options, but going forward, those will be required.
If you are wondering if you will get a break on the monthly cost of your health insurance plan in 2014, we can give you a quick answer.
PEOPLE 1
$11,490
$15,282
$22,980
$34,470
Just visit our website, arkansasbluecross.com, and select “Will I qualify for a tax credit?,” and you can get an answer by answering two simple questions: household income and household size. That’s it.
2
$15,510
$20,628
$31,020
$46,530
3
$19,530
$25,975
$39,060
$58,590
4
$23,550
$31,322
$47,100
$70,650
5
$27,570
$36,668
$55,140
$82,710
The essential health benefits are included in the following 10 categories: 1. Ambulatory patient services 2. Emergency services 3. Hospitalization 4. Maternity and newborn care 5. Mental health and substance use disorder services, including behavioral health treatment 6. Prescription drugs 7. Rehabilitative and habilitative $45,960 services and devices 8. Laboratory services $62,040 9. Preventive and wellness services $78,120 and chronic disease management $94,200 10. Pediatric services, including oral and vision care $110,280
This “estimator” is for individuals or families who purchase their health insurance on their own (in other words, you do not have coverage through your employer). Glad we can help!
6
$31,590
$42,015
$63,180
$94,770
$126,360
7
$35,610
$47,361
$71,220
$106,830
$142,440
8
$39,630
$52,708
$79,260
$118,890
$158,520
Could you receive help with your health care costs? We can help you find out in just a few seconds. Literally.
The Health Insurance Marketplace will be open October 1 for people to purchase coverage that begins January 1.
Qualifying for a tax credit Federal Poverty Level – 2013 in family
100% 133% 200% 300% 400%
NOTE: Federal minimum wage employee working 50 weeks per year, 40 hours per week would earn $14,500.
LAW continued on page 8 SUMMER 2013 BLUE & YOU
7
LAW continued from page 5 Because more services will be covered and the health plan will pay more of the cost, premiums will go up to cover the cost of these new health plan benefits.
New rules around determining your monthly costs Historically, insurance companies have considered a number of factors when calculating premiums for employers or individuals purchasing coverage. These factors include the health condition of the individual or the employees in an employer’s group plan. Those employers or individuals who have more health conditions are likely to use more medical services and are, therefore, charged a higher rate. Beginning in 2014, health insurers will not be allowed to consider health conditions in developing premiums. As a result, those who are less healthy may find their costs are less and those who are healthier will pay more in monthly premiums. Age also has been an important consideration in establishing premiums. Older people generally use more medical services and, therefore, pay more, while younger people who are not as likely to need expensive medical care pay less. Although age still will play a role in setting rates, there will not be as a great a range between the rate charged to a 24-year-old and the rate charged to a 60-year-old. Younger people can expect to pay higher rates when these rules are applied in 2014, and older people will pay less. These are two of a number of new rules regarding setting premiums that will begin in 2014 and will cause changes in how much people pay for coverage.
Advance premium tax credits Beginning in January 2014, many low- and middle-income Americans who do not have the opportunity to enroll in an employer’s health plan will be eligible to receive a new kind of tax credit that lowers monthly premiums. The amount of tax credit a household receives is based on their household income and family size. The lower the household income, the higher the tax credit.
6
BLUE & YOU SUMMER 2013
If you think your household may be eligible for an advance premium tax credit, please call Arkansas Blue Cross. We will help you determine if you meet the requirements and provide you with an estimate of what your premium might be after the tax credit is applied.
Arkansas Blue Cross has the information you need The health care law is complex and difficult to understand. Some of our members will benefit and others will not. You can count on Arkansas Blue Cross to provide the accurate and reliable guidance you need to understand how the health care law affects you and those you love. Please don’t make any changes to your health insurance coverage without talking to us first. If your current plan was issued before the law passed, keeping it may be your best option. And if you drop it, you can’t get it back. If you buy coverage on your own, call your agent or Arkansas Blue Cross or come by one of our locations for a health insurance review. We are ready to help you evaluate your options and select a plan that provides the coverage you want at the lowest cost. Call 1-800-310-3778 today.
the HEALTH INSURANCE Marketplace
?
Helping some Americans pay for health care
If you are one of millions of Americans under age 65 who will purchase a health plan this fall through the Health Insurance Marketplace (exchange), you may be eligible for a $0 premium plan or a new kind of tax credit that lowers your monthly premiums. The Health Insurance Marketplace is a website designed to determine if you are eligible for financial help to cover your health insurance costs. It also will help you and your family shop for and purchase health insurance. Americans may also contact the Health Insurance Marketplace by telephone. A Health Insurance Marketplace is being set up in each state, either by the state itself, by the federal government, or in Arkansas’ case, in partnership with the federal government. Each marketplace will be responsible for: • Creating and maintaining a consumer shopping website. • Providing access to all information necessary to determine if you are eligible for help paying for your premium or if you qualify for free coverage. • Helping consumers shop for and purchase health plans. • Making sure all health plans offered on the marketplace meet all the new regulations.
Why buy on the marketplace?
Many Americans will be eligible to receive advance premium tax credits (subsidies) if they purchase a health plan through the marketplace. An advance premium tax credit is a new tax credit that you can use to lower your monthly premium costs beginning January 1, 2014. (see chart below to see if you might qualify.) The amount of the advance premium tax credit that each household will receive is calculated by using their income, the size of their family and other factors. This new tax credit helps lower- and middle-income families. Some households, based on their income, will receive additional financial assistance when they receive medical care.
Essential health benefits
Every health plan sold to small employer groups and individuals on the Health Insurance Marketplace must include a core set of benefits established by the law. Many of these services are covered today by health plans sold by Arkansas Blue Cross. Others, such as preventive care and mental health services, are available to purchase as options, but going forward, those will be required.
If you are wondering if you will get a break on the monthly cost of your health insurance plan in 2014, we can give you a quick answer.
PEOPLE 1
$11,490
$15,282
$22,980
$34,470
Just visit our website, arkansasbluecross.com, and select “Will I qualify for a tax credit?,” and you can get an answer by answering two simple questions: household income and household size. That’s it.
2
$15,510
$20,628
$31,020
$46,530
3
$19,530
$25,975
$39,060
$58,590
4
$23,550
$31,322
$47,100
$70,650
5
$27,570
$36,668
$55,140
$82,710
The essential health benefits are included in the following 10 categories: 1. Ambulatory patient services 2. Emergency services 3. Hospitalization 4. Maternity and newborn care 5. Mental health and substance use disorder services, including behavioral health treatment 6. Prescription drugs 7. Rehabilitative and habilitative $45,960 services and devices 8. Laboratory services $62,040 9. Preventive and wellness services $78,120 and chronic disease management $94,200 10. Pediatric services, including oral and vision care $110,280
This “estimator” is for individuals or families who purchase their health insurance on their own (in other words, you do not have coverage through your employer). Glad we can help!
6
$31,590
$42,015
$63,180
$94,770
$126,360
7
$35,610
$47,361
$71,220
$106,830
$142,440
8
$39,630
$52,708
$79,260
$118,890
$158,520
Could you receive help with your health care costs? We can help you find out in just a few seconds. Literally.
The Health Insurance Marketplace will be open October 1 for people to purchase coverage that begins January 1.
Qualifying for a tax credit Federal Poverty Level – 2013 in family
100% 133% 200% 300% 400%
NOTE: Federal minimum wage employee working 50 weeks per year, 40 hours per week would earn $14,500.
LAW continued on page 8 SUMMER 2013 BLUE & YOU
7
LAW continued from page 7 In addition, these essential health benefits must be covered with no annual or lifetime dollar limits. Preventive services, including women’s preventive care and birth control must be paid 100 percent by the health plan.
A person purchasing a Bronze plan will pay more when they receive health care but less month to month (their premium). A person purchasing a Platinum plan will pay more month to month, but pay less at the doctor’s office. (See chart below.)
Metallic plans
Because the law requires that insurance companies offer plans that only fit these levels, they are no longer allowed to offer plans that don’t fit the requirements. For instance, you won’t be able to purchase a plan to cover 75 percent of your medical costs. As a result of this regulation, health insurance companies will have to reduce the options available to small employers and individuals.
People often found that it was difficult to compare what their total cost would be from one plan to the next. It was easy to compare the monthly payments (premiums) but it was difficult to compare how much you would pay out of pocket for medical services. In an effort to make it easier for people to determine what they will pay for medical services, the health care law standardized the health plans on and off the Health Insurance Marketplace. Because these health plans are called Bronze, Silver, Gold and Platinum, they are referred to as Metallic Plans.
Arkansas Blue Cross can estimate any advance premium tax credits you may be eligible to receive and can help you select a health plan. You can buy an Arkansas Blue Cross plan on and off the marketplace. Call us at 1-800-310-3778 or come in for a health insurance review.
For instance, the lowest level of coverage, called the Bronze plan, is designed to cover 60 percent of your total health care costs.
Metallic Coverage
70%
*
60%
*
0%
BRONZE
SILVER
Our email address designated for the health care law questions is HCRinfo@arkbluecross.com. Send us an email and we will respond directly
6
5
2
4 3
1
90%*
Arkansas Blue Cross will hold meetings in 10 locations throughout the state during August and September. After the meetings, employers will be contacted by their agent or an Arkansas Blue Cross representative. We hope to see you at one of the following locations:
1
HOT SPRINGS
4
Thursday, August 8
9 2
8
JONESBORO
Tuesday, August 13
LITTLE ROCK
Wednesday, August 21
7
5
FAYETTEVILLE
Wednesday, August 28
Texarkana Country Club
8
Embassy Suites
6
MOUNTAIN HOME Thursday, August 29
ASU – Vada Sheid Development Center (The Sheid)
TEXARKANA
Wednesday, September 4
Holiday Inn City Center
Hilton Garden Inn
3
FORT SMITH
Tuesday, August 27
Hot Springs Convention Center
Embassy Suites
GOLD
PLATINUM
*NOTE: Percentage shows how much of your total health care costs this plan pays.
The health care law is complex and confusing, but Arkansas Blue Cross and Blue Shield is here to help. If you have questions regarding anything to do with the health care law, we want to hear from you in an email, post or tweet.
BLUE & YOU SUMMER 2013
80%
*
Employers with two to 50 employees are invited to attend meetings with Arkansas Blue Cross and Blue Shield representatives to discuss in detail how the health care law is impacting our employer customers.
EL DORADO
Wednesday, September 11 El Dorado Conference Center
9
PINE BLUFF
Thursday, September 12 Pine Bluff Convention Center
Meetings will be held at 1:30-3 p.m. in all locations.
? Have a question? Ask us!
8
businesses
7
100%
LEVELS
MEETINGS for SMALL
to you. We usually can get an answer back to you in a day or two. To find our corporate Facebook page, just search for Arkansas Blue Cross and Blue Shield. Our Twitter account is arkbluecross. If you are under 65 and have an individual or family health plan you purchased on your own or with the help of an agent, you can call your agent or call us for a health insurance review at 1-800-310-3778.
We love to hear from you!
$
The Arkansas Health Care Independence Program: Do you qualify?
The Arkansas Health Care Independence Program is a new program for low income Arkansans that will allow them to shop for and enroll in Arkansas Blue Cross and Blue Shield and other health care plans on the Health Insurance Marketplace. These health plans will be available at no cost to them. People who choose this program can use any of the doctors or hospitals that other
Arkansas Blue Cross members choose and will either pay nothing or very little when they receive medical care. Call us at 1-800-310-3778 to find out if you qualify. Beginning in October, we can help you enroll. On April 23, Arkansas Gov. Mike Beebe signed historic legislation approving a Medicaid expansion program in Arkansas, creating the Arkansas Health Care Independence Program.
SUMMER 2013 BLUE & YOU
9
LAW continued from page 7 In addition, these essential health benefits must be covered with no annual or lifetime dollar limits. Preventive services, including women’s preventive care and birth control must be paid 100 percent by the health plan.
A person purchasing a Bronze plan will pay more when they receive health care but less month to month (their premium). A person purchasing a Platinum plan will pay more month to month, but pay less at the doctor’s office. (See chart below.)
Metallic plans
Because the law requires that insurance companies offer plans that only fit these levels, they are no longer allowed to offer plans that don’t fit the requirements. For instance, you won’t be able to purchase a plan to cover 75 percent of your medical costs. As a result of this regulation, health insurance companies will have to reduce the options available to small employers and individuals.
People often found that it was difficult to compare what their total cost would be from one plan to the next. It was easy to compare the monthly payments (premiums) but it was difficult to compare how much you would pay out of pocket for medical services. In an effort to make it easier for people to determine what they will pay for medical services, the health care law standardized the health plans on and off the Health Insurance Marketplace. Because these health plans are called Bronze, Silver, Gold and Platinum, they are referred to as Metallic Plans.
Arkansas Blue Cross can estimate any advance premium tax credits you may be eligible to receive and can help you select a health plan. You can buy an Arkansas Blue Cross plan on and off the marketplace. Call us at 1-800-310-3778 or come in for a health insurance review.
For instance, the lowest level of coverage, called the Bronze plan, is designed to cover 60 percent of your total health care costs.
Metallic Coverage
70%
*
60%
*
0%
BRONZE
SILVER
Our email address designated for the health care law questions is HCRinfo@arkbluecross.com. Send us an email and we will respond directly
6
5
2
4 3
1
90%*
Arkansas Blue Cross will hold meetings in 10 locations throughout the state during August and September. After the meetings, employers will be contacted by their agent or an Arkansas Blue Cross representative. We hope to see you at one of the following locations:
1
HOT SPRINGS
4
Thursday, August 8
9 2
8
JONESBORO
Tuesday, August 13
LITTLE ROCK
Wednesday, August 21
7
5
FAYETTEVILLE
Wednesday, August 28
Texarkana Country Club
8
Embassy Suites
6
MOUNTAIN HOME Thursday, August 29
ASU – Vada Sheid Development Center (The Sheid)
TEXARKANA
Wednesday, September 4
Holiday Inn City Center
Hilton Garden Inn
3
FORT SMITH
Tuesday, August 27
Hot Springs Convention Center
Embassy Suites
GOLD
PLATINUM
*NOTE: Percentage shows how much of your total health care costs this plan pays.
The health care law is complex and confusing, but Arkansas Blue Cross and Blue Shield is here to help. If you have questions regarding anything to do with the health care law, we want to hear from you in an email, post or tweet.
BLUE & YOU SUMMER 2013
80%
*
Employers with two to 50 employees are invited to attend meetings with Arkansas Blue Cross and Blue Shield representatives to discuss in detail how the health care law is impacting our employer customers.
EL DORADO
Wednesday, September 11 El Dorado Conference Center
9
PINE BLUFF
Thursday, September 12 Pine Bluff Convention Center
Meetings will be held at 1:30-3 p.m. in all locations.
? Have a question? Ask us!
8
businesses
7
100%
LEVELS
MEETINGS for SMALL
to you. We usually can get an answer back to you in a day or two. To find our corporate Facebook page, just search for Arkansas Blue Cross and Blue Shield. Our Twitter account is arkbluecross. If you are under 65 and have an individual or family health plan you purchased on your own or with the help of an agent, you can call your agent or call us for a health insurance review at 1-800-310-3778.
We love to hear from you!
$
The Arkansas Health Care Independence Program: Do you qualify?
The Arkansas Health Care Independence Program is a new program for low income Arkansans that will allow them to shop for and enroll in Arkansas Blue Cross and Blue Shield and other health care plans on the Health Insurance Marketplace. These health plans will be available at no cost to them. People who choose this program can use any of the doctors or hospitals that other
Arkansas Blue Cross members choose and will either pay nothing or very little when they receive medical care. Call us at 1-800-310-3778 to find out if you qualify. Beginning in October, we can help you enroll. On April 23, Arkansas Gov. Mike Beebe signed historic legislation approving a Medicaid expansion program in Arkansas, creating the Arkansas Health Care Independence Program.
SUMMER 2013 BLUE & YOU
9
When was the last time you felt … FREE? Free of worry? Free of fear? Free of uncertainty? It’s time to uncover that feeling again. Because you are protected … with the compassion of a CROSS that’s been trusted for 65 YEARS; the security of a SHIELD accepted by more than 90 PERCENT of doctors and specialists. And the power of a card that opens doors in IN ALL 50 STATES. Giving you the freedom to love. To dream. To dare. To believe. To laugh. To dance like no one is watching. An independent licensee of the Blue Cross and Blue Shield Association.
Arkansas Blue Cross and Blue Shield.
LIVE FEARLESS
You’ve likely seen and heard our new messages on television and radio for several weeks now. What is it all about? Health care financing was invented during the Great Depression, and with a new health care revolution on the horizon, we know you may have concerns. Arkansans have come to rely on Arkansas Blue Cross and Blue Shield for more than six decades — and you still can.
with the card that opens doors in 50 states
An independent licensee of the Blue Cross and Blue Shield Association.
An independent licensee of the Blue Cross and Blue Shield Association.
We’ll be here to guide you through this rapidly evolving health care landscape. Giving you strength to be fearless, even in the face of change. Contact us about affordable health coverage to protect you and your family. So you can Live Fearless.
10
BLUE & YOU SUMMER 2013
SUMMER 2013 BLUE & YOU
11
When was the last time you felt … FREE? Free of worry? Free of fear? Free of uncertainty? It’s time to uncover that feeling again. Because you are protected … with the compassion of a CROSS that’s been trusted for 65 YEARS; the security of a SHIELD accepted by more than 90 PERCENT of doctors and specialists. And the power of a card that opens doors in IN ALL 50 STATES. Giving you the freedom to love. To dream. To dare. To believe. To laugh. To dance like no one is watching. An independent licensee of the Blue Cross and Blue Shield Association.
Arkansas Blue Cross and Blue Shield.
LIVE FEARLESS
You’ve likely seen and heard our new messages on television and radio for several weeks now. What is it all about? Health care financing was invented during the Great Depression, and with a new health care revolution on the horizon, we know you may have concerns. Arkansans have come to rely on Arkansas Blue Cross and Blue Shield for more than six decades — and you still can.
with the card that opens doors in 50 states
An independent licensee of the Blue Cross and Blue Shield Association.
An independent licensee of the Blue Cross and Blue Shield Association.
We’ll be here to guide you through this rapidly evolving health care landscape. Giving you strength to be fearless, even in the face of change. Contact us about affordable health coverage to protect you and your family. So you can Live Fearless.
10
BLUE & YOU SUMMER 2013
SUMMER 2013 BLUE & YOU
11
Fast Food and Asthma We all know fast food isn’t exactly ideal for us. But, if your child has asthma, you may have even more of a reason to cut out the fast food. A recent study published in Thorax (a respiratory medical journal, suggests that consuming fast food more than three times a week can lead to an increase in the severity of their asthma. While the findings do not show that fast food is the cause of asthma, they do suggest that children with asthma who eat fast food often have more severe asthma than children who do not eat fast food often. Why? It appears that it may be due to the high levels of saturated and trans fats and sugar found in fast food; all of which are known to affect the immune system. Sources: Healthyliving.msn.com / Usnews.com
Studies tie binge drinking to future heart disease and liver damage Young people who party too hard may regret it later in life, according to recent studies on alcohol’s lasting effects on health. In research published in the Journal of the American College of Cardiology and in Alcoholism: Clinical & Experimental Research, binge drinking has been identified as a significant risk factor for both heart disease and liver damage later in life. In the study regarding heart health, researchers looked at two groups of healthy nonsmoking students, ages 18 to 25. One group had a history of binge drinking and the other group did not drink heavily. The study found that binge drinkers had impaired function in two cell types that control blood flow. These vascular changes can be a precursor to hardening of the arteries, heart attack and stroke. The study focused on liver damage in binge drinkers found that over time binge drinking can sensitize the liver and make it prone to more subsequent damage. High levels of alcohol were found to create an inflammatory response in the liver, sending out various damaging signals to systems in the body. Both studies cautioned against the notion that being young and healthy can protect people from poor lifestyle behaviors or choices.
12
Source: Journal of the American College of Cardiology; Alcoholism: Clinical & Experimental Research
BLUE & YOU SUMMER 2013
SPECIAL NOTICE: *Arkansas State and Public School Employees can enroll in a weight-loss program administered by the Employee Benefits Division. Call 1-877-815-1017 for more information. **Medi-Pak® Medicare supplement and Medi-Pak Rx insurance policyholders are not eligible for The Healthy Weigh! program.
Lose weight The Healthy Weigh! Education Program is free for members of Arkansas Blue Cross and Blue Shield, Health Advantage (except ARBenefits members*), Blue Cross and Blue Shield Service Benefit Plan (Federal Employee Program), Medi-Pak Advantage (PFFS), MediPak Advantage PPO, and eligible members of BlueAdvantage Administrators of Arkansas.** To enroll, complete the attached enrollment form and return it in the self-addressed, postage-paid envelope included in this magazine. The program starts when you enroll. After enrollment, you will begin to receive information through the mail, which you can read in the privacy of your own home and at your own pace. The program is completely voluntary, and you may leave the program at any time. If you have further questions about the program, call the Health Education Program’s toll-free number at 1-800-686-2609.
Is memory loss from aging or lack of sleep?
maybe both
The benefits of a good night’s sleep on the body are well known, but did you know it is also beneficial for your brain? New findings are making strong correlations between sleep and memory, and are shedding light on why older people may have trouble with both. A study by the National Institutes of Health’s National Institute on Aging found a marked difference in the brain-wave activity of younger people and older people while they sleep. Looking deeper into the difference, they found that the lack of deep sleep in seniors prevents their brains from storing memories in the location of the brain used for recalling them over the long term. Instead their brains leave memories stored in the portion of the brain that is used for short-term memory. So, if you find yourself struggling to recall facts, or having more frequent “it’s-just-onthe-tip-of-my-tongue” moments, make sleep a priority.
How can you get better sleep? • Turn off electronics a couple of hours before bedtime. • Avoid nicotine, caffeine and alcohol in the evening.
• Keep pets and children out of the bed. • Take a hot shower or bath before going to bed.
• Exercise in the late afternoon.
• When you wake up in the morning, open the blinds or step outside as soon as possible. Sunlight helps regulate your biological clock.
• Keep your room cool and dark. Place black tape over electronic lights if necessary.
• Seek medical help if you have a sleep problem, especially if it includes snoring.
• Stick to a schedule; don’t sleep late on weekends.
Simply complete, sign and return the attached enrollment form in the self-addressed, postage-paid envelope to join The Healthy Weigh!
SUMMER 2013 BLUE & YOU
13
Fast Food and Asthma We all know fast food isn’t exactly ideal for us. But, if your child has asthma, you may have even more of a reason to cut out the fast food. A recent study published in Thorax (a respiratory medical journal, suggests that consuming fast food more than three times a week can lead to an increase in the severity of their asthma. While the findings do not show that fast food is the cause of asthma, they do suggest that children with asthma who eat fast food often have more severe asthma than children who do not eat fast food often. Why? It appears that it may be due to the high levels of saturated and trans fats and sugar found in fast food; all of which are known to affect the immune system. Sources: Healthyliving.msn.com / Usnews.com
Studies tie binge drinking to future heart disease and liver damage Young people who party too hard may regret it later in life, according to recent studies on alcohol’s lasting effects on health. In research published in the Journal of the American College of Cardiology and in Alcoholism: Clinical & Experimental Research, binge drinking has been identified as a significant risk factor for both heart disease and liver damage later in life. In the study regarding heart health, researchers looked at two groups of healthy nonsmoking students, ages 18 to 25. One group had a history of binge drinking and the other group did not drink heavily. The study found that binge drinkers had impaired function in two cell types that control blood flow. These vascular changes can be a precursor to hardening of the arteries, heart attack and stroke. The study focused on liver damage in binge drinkers found that over time binge drinking can sensitize the liver and make it prone to more subsequent damage. High levels of alcohol were found to create an inflammatory response in the liver, sending out various damaging signals to systems in the body. Both studies cautioned against the notion that being young and healthy can protect people from poor lifestyle behaviors or choices.
12
Source: Journal of the American College of Cardiology; Alcoholism: Clinical & Experimental Research
BLUE & YOU SUMMER 2013
SPECIAL NOTICE: *Arkansas State and Public School Employees can enroll in a weight-loss program administered by the Employee Benefits Division. Call 1-877-815-1017 for more information. **Medi-Pak® Medicare supplement and Medi-Pak Rx insurance policyholders are not eligible for The Healthy Weigh! program.
Lose weight The Healthy Weigh! Education Program is free for members of Arkansas Blue Cross and Blue Shield, Health Advantage (except ARBenefits members*), Blue Cross and Blue Shield Service Benefit Plan (Federal Employee Program), Medi-Pak Advantage (PFFS), MediPak Advantage PPO, and eligible members of BlueAdvantage Administrators of Arkansas.** To enroll, complete the attached enrollment form and return it in the self-addressed, postage-paid envelope included in this magazine. The program starts when you enroll. After enrollment, you will begin to receive information through the mail, which you can read in the privacy of your own home and at your own pace. The program is completely voluntary, and you may leave the program at any time. If you have further questions about the program, call the Health Education Program’s toll-free number at 1-800-686-2609.
Is memory loss from aging or lack of sleep?
maybe both
The benefits of a good night’s sleep on the body are well known, but did you know it is also beneficial for your brain? New findings are making strong correlations between sleep and memory, and are shedding light on why older people may have trouble with both. A study by the National Institutes of Health’s National Institute on Aging found a marked difference in the brain-wave activity of younger people and older people while they sleep. Looking deeper into the difference, they found that the lack of deep sleep in seniors prevents their brains from storing memories in the location of the brain used for recalling them over the long term. Instead their brains leave memories stored in the portion of the brain that is used for short-term memory. So, if you find yourself struggling to recall facts, or having more frequent “it’s-just-onthe-tip-of-my-tongue” moments, make sleep a priority.
How can you get better sleep? • Turn off electronics a couple of hours before bedtime. • Avoid nicotine, caffeine and alcohol in the evening.
• Keep pets and children out of the bed. • Take a hot shower or bath before going to bed.
• Exercise in the late afternoon.
• When you wake up in the morning, open the blinds or step outside as soon as possible. Sunlight helps regulate your biological clock.
• Keep your room cool and dark. Place black tape over electronic lights if necessary.
• Seek medical help if you have a sleep problem, especially if it includes snoring.
• Stick to a schedule; don’t sleep late on weekends.
Simply complete, sign and return the attached enrollment form in the self-addressed, postage-paid envelope to join The Healthy Weigh!
SUMMER 2013 BLUE & YOU
13
Customers Rank Arkansas Blue Cross as a top Blue Plan in the Nation
NEWS
Arkansas Blue Cross and Blue Shield is one of the best Blue Plans in the nation in providing valuable products, excellent customer service and gaining the trust of members, according to a national survey of Blue Plan members. A recent consumer brand index (CBI), a tool for understanding consumers’ perceptions of a brand or company, was developed for the Blue Cross and Blue Shield Association to determine how all the Blue Plan markets rank with their members. There are 38 Blue Plans across the United States, but the survey was more in-depth and actually involved 61 individual markets. The survey focused on three primary areas:
Arkansas Blue Cross provides family fun for members Arkansas Blue Cross and Blue Shield members enjoyed a variety of family-friendly activities earlier this year. We appreciate our members and always are looking for opportunities to add value to our relationship. And, there is more to come! Families at the Hop on Over Easter Party at ArkansasBlue enjoyed dancing and playing games with Radio Disney. And, two lucky families won season passes to the Museum of Discovery and the Little Rock Zoo along with beach towels, insect repellent, sunscreen, first-aid kits, bubbles and more. ArkansasBlue is Arkansas’ first health insurance store, located in the Shackleford Crossings shopping center in Little Rock.
1.
The Easter Bunny and BlueAnn Ewe interact with a young admirer at the ArkansasBlue Easter party.
During the Night at the Museum Pajama Party in June at the Museum of Discovery in Little Rock, parents and children went on a scavenger hunt in the Arkansas Blue Cross and Blue Shield Amazing You Gallery for a chance to win prizes, and shared healthy snacks in the Gigabyte room. BlueAnn Ewe was on hand to dance with the kids and point out clues in the gallery. While all of our members could get in free to the event, we also gave away 300 tickets to non-members at ArkansasBlue. As part of our title sponsorship of the Arkansas Blue Cross and Blue Shield Amazing You Gallery inside the Museum of Discovery (designed to teach youth and families about the body and how to keep it healthy), we have two member-appreciation days each year. Mark your calendar — the next member-appreciation day at the Museum of Discovery will be on Grandparent’s Day, Sunday, September 8.
Walk at Lunch April 24 was National Walk @ Lunch Day (NW@LD), and Arkansas Blue Cross and Blue Shield; Arkansas Center for Health Improvement; Me, Myself and I Workout; Arkansas Department of Human Services; Arkansas Workers’ Compensation; and the Arkansas Plant Board employees walked together to the Little Rock River Market. NW@LD is an event designed to encourage employees to spend part of their lunch break on this day walking in an effort to promote fitness and encourage regular worksite wellness activities. NW@LD is part of the Blue Cross and Blue Shield Association’s Walking Works program.
14
BLUE & YOU SUMMER 2013
Did the Plan meet expectations? 2. Is the Plan a company you can trust? 3. How do you feel and think about the Plan?
Out of a possible 100 points, Arkansas Blue Cross received an overall score of 82, tying two other Blue Plan markets for the top score in the nation. The median score nationwide was 76. Members were asked, based on everything they have seen, heard, read or experienced, how they think about their Plan on a scale of 1 to 10. A score with a plus sign indicates that the score was significantly different than the system-wide results. So how did Arkansas Blue Cross do, question-by-question?
Did your Plan meet expectations? Is your Plan a company you can trust? How do you feel and think about your Plan? Arkansas Blue Cross: 8.6 Arkansas Blue Cross: 8.2 Arkansas Blue Cross: 8.3 + Blue Plan national average: 8.0 Blue Plan national average: 7.8 Blue Plan national average: 7.7 +
+
“We are pleased that our members think so highly of us,” said Karen Raley, vice president of Communications and Product Development at Arkansas Blue Cross. “We put our members first in everything we do and these survey results let us know that our members recognize that.” It is that “member first” attitude permeating every division within Arkansas Blue Cross that makes it difficult to pinpoint who should get the most credit for the glowing CBI results. Customer Service and other employees who interact directly with members leave a lasting impression of the company as a whole. The Communications team provides a Web presence that is user-friendly and informative. New member welcome kits provide vital information right up front that help members more completely understand their benefits. “It takes all of us to deliver the kind of service our members deserve, and all of our employees should be pleased with these excellent ratings,” said Karen. “However, we have no intention of relaxing now. Our industry as a whole is facing unprecedented challenges, and we need to raise the bar — for ourselves and for Arkansas Blue Cross. Our customers deserve that.”
Heart Walk 2013 Arkansas Blue Cross had a great team showing at the Heart Walk held April 20 at Burns Park in North Little Rock. Employees and their family members walked together to show their support for heart disease research. Blue definitely cares!
SUMMER 2013 BLUE & YOU
15
Customers Rank Arkansas Blue Cross as a top Blue Plan in the Nation
NEWS
Arkansas Blue Cross and Blue Shield is one of the best Blue Plans in the nation in providing valuable products, excellent customer service and gaining the trust of members, according to a national survey of Blue Plan members. A recent consumer brand index (CBI), a tool for understanding consumers’ perceptions of a brand or company, was developed for the Blue Cross and Blue Shield Association to determine how all the Blue Plan markets rank with their members. There are 38 Blue Plans across the United States, but the survey was more in-depth and actually involved 61 individual markets. The survey focused on three primary areas:
Arkansas Blue Cross provides family fun for members Arkansas Blue Cross and Blue Shield members enjoyed a variety of family-friendly activities earlier this year. We appreciate our members and always are looking for opportunities to add value to our relationship. And, there is more to come! Families at the Hop on Over Easter Party at ArkansasBlue enjoyed dancing and playing games with Radio Disney. And, two lucky families won season passes to the Museum of Discovery and the Little Rock Zoo along with beach towels, insect repellent, sunscreen, first-aid kits, bubbles and more. ArkansasBlue is Arkansas’ first health insurance store, located in the Shackleford Crossings shopping center in Little Rock.
1.
The Easter Bunny and BlueAnn Ewe interact with a young admirer at the ArkansasBlue Easter party.
During the Night at the Museum Pajama Party in June at the Museum of Discovery in Little Rock, parents and children went on a scavenger hunt in the Arkansas Blue Cross and Blue Shield Amazing You Gallery for a chance to win prizes, and shared healthy snacks in the Gigabyte room. BlueAnn Ewe was on hand to dance with the kids and point out clues in the gallery. While all of our members could get in free to the event, we also gave away 300 tickets to non-members at ArkansasBlue. As part of our title sponsorship of the Arkansas Blue Cross and Blue Shield Amazing You Gallery inside the Museum of Discovery (designed to teach youth and families about the body and how to keep it healthy), we have two member-appreciation days each year. Mark your calendar — the next member-appreciation day at the Museum of Discovery will be on Grandparent’s Day, Sunday, September 8.
Walk at Lunch April 24 was National Walk @ Lunch Day (NW@LD), and Arkansas Blue Cross and Blue Shield; Arkansas Center for Health Improvement; Me, Myself and I Workout; Arkansas Department of Human Services; Arkansas Workers’ Compensation; and the Arkansas Plant Board employees walked together to the Little Rock River Market. NW@LD is an event designed to encourage employees to spend part of their lunch break on this day walking in an effort to promote fitness and encourage regular worksite wellness activities. NW@LD is part of the Blue Cross and Blue Shield Association’s Walking Works program.
14
BLUE & YOU SUMMER 2013
Did the Plan meet expectations? 2. Is the Plan a company you can trust? 3. How do you feel and think about the Plan?
Out of a possible 100 points, Arkansas Blue Cross received an overall score of 82, tying two other Blue Plan markets for the top score in the nation. The median score nationwide was 76. Members were asked, based on everything they have seen, heard, read or experienced, how they think about their Plan on a scale of 1 to 10. A score with a plus sign indicates that the score was significantly different than the system-wide results. So how did Arkansas Blue Cross do, question-by-question?
Did your Plan meet expectations? Is your Plan a company you can trust? How do you feel and think about your Plan? Arkansas Blue Cross: 8.6 Arkansas Blue Cross: 8.2 Arkansas Blue Cross: 8.3 + Blue Plan national average: 8.0 Blue Plan national average: 7.8 Blue Plan national average: 7.7 +
+
“We are pleased that our members think so highly of us,” said Karen Raley, vice president of Communications and Product Development at Arkansas Blue Cross. “We put our members first in everything we do and these survey results let us know that our members recognize that.” It is that “member first” attitude permeating every division within Arkansas Blue Cross that makes it difficult to pinpoint who should get the most credit for the glowing CBI results. Customer Service and other employees who interact directly with members leave a lasting impression of the company as a whole. The Communications team provides a Web presence that is user-friendly and informative. New member welcome kits provide vital information right up front that help members more completely understand their benefits. “It takes all of us to deliver the kind of service our members deserve, and all of our employees should be pleased with these excellent ratings,” said Karen. “However, we have no intention of relaxing now. Our industry as a whole is facing unprecedented challenges, and we need to raise the bar — for ourselves and for Arkansas Blue Cross. Our customers deserve that.”
Heart Walk 2013 Arkansas Blue Cross had a great team showing at the Heart Walk held April 20 at Burns Park in North Little Rock. Employees and their family members walked together to show their support for heart disease research. Blue definitely cares!
SUMMER 2013 BLUE & YOU
15
FROM the PHARMACIST Over-the-counter medicines
by TREY GARDNER, Pharm D., Arkansas Blue Cross and Blue Shield
Access + Knowledge = Power More and more, Americans can go to their favorite grocery store instead of to the doctor when they need medicine. This immediate access to medicine to treat an ailment gives us immense power over our health, but it must be balanced by the knowledge to use the medicine correctly. The following information from the U.S. Food and Drug Administration (FDA) provides some great advice for using over-thecounter (OTC) medicines responsibly. The FDA determines whether medicines are prescription (Rx) or OTC. The FDA also decides when a prescription medicine is safe enough to be sold directly to consumers, a regulatory process known as Rx-to-OTC switch. More than 700 products sold over the counter today use ingredients or dosage strengths available only by prescription 30 years ago. With new opportunities in self-medication come new responsibilities and an increased need for knowledge. The FDA and the Consumer Healthcare Products Association (CHPA) have prepared the following information to help Americans take advantage of self-care opportunities.
OTC know-how: It’s on the label You wouldn’t ignore your doctor’s instructions for using a prescription medicine; so don’t ignore the label when taking an OTC medicine. Here’s what to look for: • Product name • Active ingredients — therapeutic substances in medicine • Purpose — product category (such as antihistamine, antacid or cough suppressant) • Uses — symptoms or diseases the product will treat or prevent • Warnings — when not to use the product, when to stop taking it, when to see a doctor and possible side effects • Directions — how much to take, how to take it, and how long to take it • Other information — such as storage information • Inactive ingredients — substances such as binders, colors or flavoring Make sure you are reading the label correctly. Always use enough light. It usually takes three times more light to read the same line at age 60 than at age 30. If necessary, use your glasses or contact lenses when reading labels. Always remember to look for the statement describing the tamper-evident feature(s) before you buy the product and when you use it. When it comes to medicines, more does not necessarily mean better. You should never misuse OTC medicines by taking them longer or in higher doses than the label recommends. Symptoms that persist are a clear signal it’s time to see a doctor.
16
BLUE & YOU SUMMER 2013
PHARMACY continued on page 21
the DOCTOR’S corner by CONNIE MEEKS, M.D. – Corporate Medical Director
Your role in health care
Arkansas Blue Cross and Blue Shield
Health care is changing in many ways to provide the highest quality of care while keeping costs down. Doctors and their care teams, hospitals, insurance companies, employers and many others are learning their roles as part of this new approach. What you may not realize, however, is that you are a vital part of that change. On its most basic level, health care is between the person who delivers care and the person who receives it. To achieve better health outcomes, patients must make good decisions based on complete information. If you’ve been in your doctor’s office recently, you may have noticed some changes. The clinic may be using an electronic medical record. Computerized records make it easier to keep up with current and past problems, medication lists, recommended screening tests, lab results and needed immunizations. Some doctors and facilities have developed systems to securely share your information so those who need to know a test result will have access to it rather than delaying care or repeating the test. There may be someone in the clinic who is coordinating care between specialists or the emergency room and your doctor. To improve the clinic’s efficiency, you may be asked for feedback about clinic services. Specialists and primary care doctors are communicating more in order to monitor costs and improve your care. To achieve the highest quality of care, both underuse and overuse of health care resources must be avoided. With some of the new payment methods, your doctor may be eligible for higher payments if his patients receive appropriate tests that have proven beneficial. The health maintenance your doctor recommends is to prevent or delay more serious illness, and you should benefit from following his advice and changing behaviors. You may be asked to participate in an education program for a condition like diabetes or
low back pain. If your doctor recommends a screening or a behavior change, consider his advice. Take personal responsibility and recognize that routine care is an investment in better health for the long term. In contrast, there are some overused procedures that have not proven effective. Leading medical specialty societies have teamed up with Consumer Reports to spread the word that doctors and patients should have important conversations to decrease the practice of ordering unnecessary tests and procedures. The Choosing Wisely campaign focuses on lists of “Five Things Physicians and Patients Should Question,” created by each participating specialty group. For instance, the specialty group for family doctors recommends that electrocardiograms or other cardiac screenings for low-risk patients without symptoms should not be ordered. Pediatricians recommend against cough and cold medicines for respiratory illnesses in children under four years of age. Doctors will be spending more time discussing with patients why certain tests may or may not be needed. Your part in this is to be open to discussions with your doctor and to understand that there are new expectations for him to provide advice supported by evidence, discuss options and gain your cooperation in a plan of care. This is shared decision making, so there is an expectation that you will participate and follow through with decided plans. The goal of improved personal health is not only that it is good for patients, but that it will contribute to the improved financial health of our country. The effort begins with you taking responsibility.
Source: Choosing Wisely campaign, choosingwisely.org
SUMMER 2013 BLUE & YOU
17
FROM the PHARMACIST Over-the-counter medicines
by TREY GARDNER, Pharm D., Arkansas Blue Cross and Blue Shield
Access + Knowledge = Power More and more, Americans can go to their favorite grocery store instead of to the doctor when they need medicine. This immediate access to medicine to treat an ailment gives us immense power over our health, but it must be balanced by the knowledge to use the medicine correctly. The following information from the U.S. Food and Drug Administration (FDA) provides some great advice for using over-thecounter (OTC) medicines responsibly. The FDA determines whether medicines are prescription (Rx) or OTC. The FDA also decides when a prescription medicine is safe enough to be sold directly to consumers, a regulatory process known as Rx-to-OTC switch. More than 700 products sold over the counter today use ingredients or dosage strengths available only by prescription 30 years ago. With new opportunities in self-medication come new responsibilities and an increased need for knowledge. The FDA and the Consumer Healthcare Products Association (CHPA) have prepared the following information to help Americans take advantage of self-care opportunities.
OTC know-how: It’s on the label You wouldn’t ignore your doctor’s instructions for using a prescription medicine; so don’t ignore the label when taking an OTC medicine. Here’s what to look for: • Product name • Active ingredients — therapeutic substances in medicine • Purpose — product category (such as antihistamine, antacid or cough suppressant) • Uses — symptoms or diseases the product will treat or prevent • Warnings — when not to use the product, when to stop taking it, when to see a doctor and possible side effects • Directions — how much to take, how to take it, and how long to take it • Other information — such as storage information • Inactive ingredients — substances such as binders, colors or flavoring Make sure you are reading the label correctly. Always use enough light. It usually takes three times more light to read the same line at age 60 than at age 30. If necessary, use your glasses or contact lenses when reading labels. Always remember to look for the statement describing the tamper-evident feature(s) before you buy the product and when you use it. When it comes to medicines, more does not necessarily mean better. You should never misuse OTC medicines by taking them longer or in higher doses than the label recommends. Symptoms that persist are a clear signal it’s time to see a doctor.
16
BLUE & YOU SUMMER 2013
PHARMACY continued on page 21
the DOCTOR’S corner by CONNIE MEEKS, M.D. – Corporate Medical Director
Your role in health care
Arkansas Blue Cross and Blue Shield
Health care is changing in many ways to provide the highest quality of care while keeping costs down. Doctors and their care teams, hospitals, insurance companies, employers and many others are learning their roles as part of this new approach. What you may not realize, however, is that you are a vital part of that change. On its most basic level, health care is between the person who delivers care and the person who receives it. To achieve better health outcomes, patients must make good decisions based on complete information. If you’ve been in your doctor’s office recently, you may have noticed some changes. The clinic may be using an electronic medical record. Computerized records make it easier to keep up with current and past problems, medication lists, recommended screening tests, lab results and needed immunizations. Some doctors and facilities have developed systems to securely share your information so those who need to know a test result will have access to it rather than delaying care or repeating the test. There may be someone in the clinic who is coordinating care between specialists or the emergency room and your doctor. To improve the clinic’s efficiency, you may be asked for feedback about clinic services. Specialists and primary care doctors are communicating more in order to monitor costs and improve your care. To achieve the highest quality of care, both underuse and overuse of health care resources must be avoided. With some of the new payment methods, your doctor may be eligible for higher payments if his patients receive appropriate tests that have proven beneficial. The health maintenance your doctor recommends is to prevent or delay more serious illness, and you should benefit from following his advice and changing behaviors. You may be asked to participate in an education program for a condition like diabetes or
low back pain. If your doctor recommends a screening or a behavior change, consider his advice. Take personal responsibility and recognize that routine care is an investment in better health for the long term. In contrast, there are some overused procedures that have not proven effective. Leading medical specialty societies have teamed up with Consumer Reports to spread the word that doctors and patients should have important conversations to decrease the practice of ordering unnecessary tests and procedures. The Choosing Wisely campaign focuses on lists of “Five Things Physicians and Patients Should Question,” created by each participating specialty group. For instance, the specialty group for family doctors recommends that electrocardiograms or other cardiac screenings for low-risk patients without symptoms should not be ordered. Pediatricians recommend against cough and cold medicines for respiratory illnesses in children under four years of age. Doctors will be spending more time discussing with patients why certain tests may or may not be needed. Your part in this is to be open to discussions with your doctor and to understand that there are new expectations for him to provide advice supported by evidence, discuss options and gain your cooperation in a plan of care. This is shared decision making, so there is an expectation that you will participate and follow through with decided plans. The goal of improved personal health is not only that it is good for patients, but that it will contribute to the improved financial health of our country. The effort begins with you taking responsibility.
Source: Choosing Wisely campaign, choosingwisely.org
SUMMER 2013 BLUE & YOU
17
WILL ARKANSAS
have enough
Member Discounts
DOCTORS?
The Blue &You Foundation funds a study to find out The Blue & You Foundation for a Healthier Arkansas recently collaborated with the Arkansas Center for Health Improvement (ACHI) to fund a study examining the current and future numbers of physicians and specialists statewide. The report, Arkansas Health Care Workforce: A Guide for Policy Action,
The following are a few highlights from the report:
Arkansas
Health Care Workforce
provides a unique, multi-dimensional look at how and where health care is provided in Arkansas. This includes location, office capacity, acceptance of patients covered by Medicare and Medicaid and the patient experience. Previous studies either have been national in scope and based on raw population-to-physician ratios or have relied solely on survey information. A Guide for Policy Action
Funded by:
March 2013
According to Patrick O’Sullivan, executive director of the Blue & You Foundation, the report provides a much-needed resource for informing policy decisions that will result in meaningful solutions for improving the health care system in Arkansas. “Much discussion has centered on the idea that we have a serious statewide shortage of doctors and that this shortage will worsen due to an aging health care workforce,” Patrick said. “At the same time, there has been a lack of consistent data to demonstrate the real picture in Arkansas. ACHI has proven expertise for using information from various sources to pull together a big picture and identify policy implications. The Blue & You Foundation is pleased to have partnered with ACHI to provide policymakers and stakeholders a guide for important decisions.” The information in the report shows not only the number of medical professionals needed, but where they will be needed. The report describes a severe shortage in the southeast and southwest regions, but points to an excess supply in central Arkansas. On a positive note, many clinic managers surveyed said they expect to keep their present staff and in many cases have plans to add new clinicians.
18
BLUE & YOU SUMMER 2013
Metabolic Research Centers
• While there is a shortage of primary care physicians, the presence in Arkansas of physician extenders, like advanced practice nurses and physician assistants, make up all but 4 percent of the shortfall in the supply of primary care clinicians. • There are critical shortages of primary care physicians and physician extenders in some rural areas and a potential oversupply in urban areas. • Primary care clinicians may approach the needed number statewide by 2020, but shortages will remain in rural parts of the state unless incentives are put in place. • Creative solutions may involve policies regarding expanded insurance coverage, transportation resources and use of information technology.
Enjoy a 10 percent discount on all new program enrollment fees at the Metabolic Research Center, a weight management company with locations in Bentonville, Fort Smith, Fayetteville, Conway and Little Rock. The Metabolic program is unique because it addresses the root cause of disorder eating and recurring weight gain. Their personalized approach helps clients by identifying why as well as what they eat. They recognize and affirm the unique and intrinsic worth of each individual by this one-on-one approach. The programs at Metabolic were designed by the nation’s foremost experts in the field of disorder eating and are administered nationally through Metabolic Research Centers. Metabolic Research Center offers to deliver high-quality, cost-effective services and products to the clients they serve.
Save on Jenny Craig As our member, you can choose a FREE 30-Day Program* or 25 percent off a Premium Program* from Jenny Craig.® Just print the coupon on the national and statewide discounts page on any of our websites. Pick a program that works with you, not against you! MyDays is a flexible, new weigh-loss choice that gives you the structure you need to stay on track and the freedom to live your life. Eat five days of Jenny and two days of your own healthy choices. Your consultant will help you find the program that fits your real life. It’s about progress, not perfection. Your personal consultant will help you stay on track every step of the way. Jenny has two options for consultations: • Get weekly, face-to-face support and motivation at one of more than 600 locations. * Plus the cost of food and shipping, if applicable. At participating centers. Restrictions apply.
Demand greater than supply Little or no supply shortage Demand 20% or more
Demand = Supply (+ 9%)
Demand 10% to 19%
Supply 10% or more
Adequacy of Supply and Demand of Primary Care Providers by County (2012)
To learn more about the report, go to the ACHI website, achi.net.
• Enjoy the convenience and privacy of getting your support and motivation on the phone each week.
Grants available for health programs
JULY15 deadline
Programs to improve the health of Arkansans, whether in a small town or throughout the state, have until July 15 to submit applications for grants from the Blue & You Foundation for a Healthier Arkansas. The grants of $5,000 to $150,000 may be used for general operational or specific program support for an existing or new program. Any public charity, public school, government agency or non-profit hospital in Arkansas is eligible to apply; however, grants are not made to individuals. Funds must be used to produce positive health outcomes for Arkansans. The grants will be awarded in November to fund health improvement programs during 2014. Information about the grants and the online application submission process can be found at blueandyoufoundationarkansas.org.
SUMMER 2013 BLUE & YOU
19
WILL ARKANSAS
have enough
Member Discounts
DOCTORS?
The Blue &You Foundation funds a study to find out The Blue & You Foundation for a Healthier Arkansas recently collaborated with the Arkansas Center for Health Improvement (ACHI) to fund a study examining the current and future numbers of physicians and specialists statewide. The report, Arkansas Health Care Workforce: A Guide for Policy Action,
The following are a few highlights from the report:
Arkansas
Health Care Workforce
provides a unique, multi-dimensional look at how and where health care is provided in Arkansas. This includes location, office capacity, acceptance of patients covered by Medicare and Medicaid and the patient experience. Previous studies either have been national in scope and based on raw population-to-physician ratios or have relied solely on survey information. A Guide for Policy Action
Funded by:
March 2013
According to Patrick O’Sullivan, executive director of the Blue & You Foundation, the report provides a much-needed resource for informing policy decisions that will result in meaningful solutions for improving the health care system in Arkansas. “Much discussion has centered on the idea that we have a serious statewide shortage of doctors and that this shortage will worsen due to an aging health care workforce,” Patrick said. “At the same time, there has been a lack of consistent data to demonstrate the real picture in Arkansas. ACHI has proven expertise for using information from various sources to pull together a big picture and identify policy implications. The Blue & You Foundation is pleased to have partnered with ACHI to provide policymakers and stakeholders a guide for important decisions.” The information in the report shows not only the number of medical professionals needed, but where they will be needed. The report describes a severe shortage in the southeast and southwest regions, but points to an excess supply in central Arkansas. On a positive note, many clinic managers surveyed said they expect to keep their present staff and in many cases have plans to add new clinicians.
18
BLUE & YOU SUMMER 2013
Metabolic Research Centers
• While there is a shortage of primary care physicians, the presence in Arkansas of physician extenders, like advanced practice nurses and physician assistants, make up all but 4 percent of the shortfall in the supply of primary care clinicians. • There are critical shortages of primary care physicians and physician extenders in some rural areas and a potential oversupply in urban areas. • Primary care clinicians may approach the needed number statewide by 2020, but shortages will remain in rural parts of the state unless incentives are put in place. • Creative solutions may involve policies regarding expanded insurance coverage, transportation resources and use of information technology.
Enjoy a 10 percent discount on all new program enrollment fees at the Metabolic Research Center, a weight management company with locations in Bentonville, Fort Smith, Fayetteville, Conway and Little Rock. The Metabolic program is unique because it addresses the root cause of disorder eating and recurring weight gain. Their personalized approach helps clients by identifying why as well as what they eat. They recognize and affirm the unique and intrinsic worth of each individual by this one-on-one approach. The programs at Metabolic were designed by the nation’s foremost experts in the field of disorder eating and are administered nationally through Metabolic Research Centers. Metabolic Research Center offers to deliver high-quality, cost-effective services and products to the clients they serve.
Save on Jenny Craig As our member, you can choose a FREE 30-Day Program* or 25 percent off a Premium Program* from Jenny Craig.® Just print the coupon on the national and statewide discounts page on any of our websites. Pick a program that works with you, not against you! MyDays is a flexible, new weigh-loss choice that gives you the structure you need to stay on track and the freedom to live your life. Eat five days of Jenny and two days of your own healthy choices. Your consultant will help you find the program that fits your real life. It’s about progress, not perfection. Your personal consultant will help you stay on track every step of the way. Jenny has two options for consultations: • Get weekly, face-to-face support and motivation at one of more than 600 locations. * Plus the cost of food and shipping, if applicable. At participating centers. Restrictions apply.
Demand greater than supply Little or no supply shortage Demand 20% or more
Demand = Supply (+ 9%)
Demand 10% to 19%
Supply 10% or more
Adequacy of Supply and Demand of Primary Care Providers by County (2012)
To learn more about the report, go to the ACHI website, achi.net.
• Enjoy the convenience and privacy of getting your support and motivation on the phone each week.
Grants available for health programs
JULY15 deadline
Programs to improve the health of Arkansans, whether in a small town or throughout the state, have until July 15 to submit applications for grants from the Blue & You Foundation for a Healthier Arkansas. The grants of $5,000 to $150,000 may be used for general operational or specific program support for an existing or new program. Any public charity, public school, government agency or non-profit hospital in Arkansas is eligible to apply; however, grants are not made to individuals. Funds must be used to produce positive health outcomes for Arkansans. The grants will be awarded in November to fund health improvement programs during 2014. Information about the grants and the online application submission process can be found at blueandyoufoundationarkansas.org.
SUMMER 2013 BLUE & YOU
19
ArkansasBlue OPENS IN PINE BLUFF
new
health insurance store
Residents of Pine Bluff and southeast Arkansas can speak face to face with health insurance experts at the new ArkansasBlue office at 509 Mallard Loop Drive in Pine Bluff. Health insurance experts at the new location will provide Arkansas Blue Cross and Blue Shield members and insurance shoppers with information about Arkansas Blue Cross insurance plans, advice on which plan best covers them and fits their budget, as well as assistance with questions or concerns they may have about purchasing or choosing health insurance. ArkansasBlue also will provide visitors with information on dental and other insurance plans. And, with the full implementation of the health care law approaching in 2014, visitors who have purchased individual or family health insurance plans can come in for health insurance reviews to see how new regulations will impact their health insurance coverage and cost.
The “freedom” of short-term coverage Whether you need coverage for one month or a longer period, Arkansas Blue Cross and Blue Shield has a solution for you. We have affordable plans designed to provide coverage for the length of time you need it. Essential Blue Freedom is a comprehensive health insurance policy that lasts 364 days, with the freedom to reapply for coverage. It is available to Arkansas residents age 64 and younger who are not eligible for Medicaid or Medicare.
20
BLUE & YOU SUMMER 2013
“Arkansas Blue Cross has operated a fullservice office in Pine Bluff since 1994, serving members in a 13-county area with customer service, individual and group product sales and marketing, medical management and provider services,” said Dwayne Pierce, regional executive. “Our new location will allow us to expand our services and provide more oneon-one counseling about health and dental insurance for individuals and families, especially with the implementation of the new health insurance law approaching.”
PHARMACY continued from page 16 Be sure to read the label for each product you purchase. Just because two or more products are from the same brand family doesn’t mean they are meant to treat the same conditions or contain the same ingredients. Remember, if you read the label and still have questions, talk to a doctor, nurse or pharmacist.
Medicine Interactions Although mild and relatively uncommon, interactions involving OTC medicines can produce unwanted results or make medicines less effective. It’s especially important to know about medicine interactions if you’re taking Rx and OTC medicines at the same time.
Walk-in members and shoppers also can pick up informational brochures or digitally walkthrough an online shopping experience with an Arkansas Blue Cross representative.
Some medicines also can interact with foods and beverages, as well as with health conditions such as diabetes, kidney disease and high blood pressure.
Arkansas Blue Cross opened Arkansas’ first health insurance store in 2011 in Little Rock to help Arkansans better understand health insurance products and how they work. The flagship store has proven to be a resource for people needing health insurance answers, and a gathering place for fun and informative events.
Here are a few medicine interaction cautions for some common OTC ingredients:
With the changes in the health insurance industry, some people will find they need a health insurance policy to fill a gap in coverage, or they may be looking for a more affordable solution with comprehensive coverage.
It offers affordable copayments for doctor visits as well as prescription drug coverage. Your application is subject to a medical review, and a waiting period for pre-existing conditions may apply, but if you have no major health problems and you are looking for comprehensive coverage at a great rate, it may be the solution you need.
What happens after day 364? You have the opportunity to reapply for another Essential Blue Freedom policy issued after answering a few simple healthrelated questions and by meeting certain medical criteria. If you fall outside the ranges, don’t worry — you still may qualify for reissue; however, your application will be subject to review. If you think Essential Blue Freedom is an option for you, call us at 1-800-392-2583! We’d love to talk with you.
• Avoid alcohol if you are taking antihistamines, cough/cold products with the ingredient dextromethorphan, or medicines that treat sleeplessness. • Do not use medicines that treat sleeplessness if you are taking prescription sedatives or tranquilizers. • Check with your doctor before taking products containing aspirin if you’re taking a prescription blood thinner or if you have diabetes or gout. • Do not use laxatives when you have stomach pain, nausea or vomiting. • Unless directed by a doctor, do not use a nasal decongestant if you are taking a prescription medicine for high blood pressure or depression, or if you have heart or thyroid disease, diabetes, or prostate problems. This is not a complete list. Read the label! Medicine labels change as new information becomes available. That’s why it’s important to read the label each time you take medicine.
Time for a Medicine Cabinet Checkup? • Be sure to look through your medicine supply at least once a year. • Always store medicines in a cool, dry place or as stated on the label. • Throw away any medicines that are past the expiration date. • To make sure no one takes the wrong medicine, keep all medicines in their original containers.
Protect Yourself Against Tampering
Makers of OTC medicines seal most products in tamper-evident packaging (TEP) to help protect against criminal tampering. TEP works by providing visible evidence if the package has been disturbed. But OTC packaging cannot be 100 percent tamper-proof. Here’s how to help protect yourself: • Be alert to the tamper-evident features on the package before you open it. These features are described on the label. • Inspect the outer packaging before you buy it. When you get home, inspect the medicine inside. • Don’t buy an OTC product if the packaging is damaged. • Don’t use any medicine that looks discolored or different in any way. • If anything looks suspicious, be suspicious. Contact the store where you bought the product. Take it back! • Never take medicines in the dark.
Source: The U.S. Food and Drug Administration and the Consumer Healthcare Products Association (CHPA)
SUMMER 2013 BLUE & YOU
21
ArkansasBlue OPENS IN PINE BLUFF
new
health insurance store
Residents of Pine Bluff and southeast Arkansas can speak face to face with health insurance experts at the new ArkansasBlue office at 509 Mallard Loop Drive in Pine Bluff. Health insurance experts at the new location will provide Arkansas Blue Cross and Blue Shield members and insurance shoppers with information about Arkansas Blue Cross insurance plans, advice on which plan best covers them and fits their budget, as well as assistance with questions or concerns they may have about purchasing or choosing health insurance. ArkansasBlue also will provide visitors with information on dental and other insurance plans. And, with the full implementation of the health care law approaching in 2014, visitors who have purchased individual or family health insurance plans can come in for health insurance reviews to see how new regulations will impact their health insurance coverage and cost.
The “freedom” of short-term coverage Whether you need coverage for one month or a longer period, Arkansas Blue Cross and Blue Shield has a solution for you. We have affordable plans designed to provide coverage for the length of time you need it. Essential Blue Freedom is a comprehensive health insurance policy that lasts 364 days, with the freedom to reapply for coverage. It is available to Arkansas residents age 64 and younger who are not eligible for Medicaid or Medicare.
20
BLUE & YOU SUMMER 2013
“Arkansas Blue Cross has operated a fullservice office in Pine Bluff since 1994, serving members in a 13-county area with customer service, individual and group product sales and marketing, medical management and provider services,” said Dwayne Pierce, regional executive. “Our new location will allow us to expand our services and provide more oneon-one counseling about health and dental insurance for individuals and families, especially with the implementation of the new health insurance law approaching.”
PHARMACY continued from page 16 Be sure to read the label for each product you purchase. Just because two or more products are from the same brand family doesn’t mean they are meant to treat the same conditions or contain the same ingredients. Remember, if you read the label and still have questions, talk to a doctor, nurse or pharmacist.
Medicine Interactions Although mild and relatively uncommon, interactions involving OTC medicines can produce unwanted results or make medicines less effective. It’s especially important to know about medicine interactions if you’re taking Rx and OTC medicines at the same time.
Walk-in members and shoppers also can pick up informational brochures or digitally walkthrough an online shopping experience with an Arkansas Blue Cross representative.
Some medicines also can interact with foods and beverages, as well as with health conditions such as diabetes, kidney disease and high blood pressure.
Arkansas Blue Cross opened Arkansas’ first health insurance store in 2011 in Little Rock to help Arkansans better understand health insurance products and how they work. The flagship store has proven to be a resource for people needing health insurance answers, and a gathering place for fun and informative events.
Here are a few medicine interaction cautions for some common OTC ingredients:
With the changes in the health insurance industry, some people will find they need a health insurance policy to fill a gap in coverage, or they may be looking for a more affordable solution with comprehensive coverage.
It offers affordable copayments for doctor visits as well as prescription drug coverage. Your application is subject to a medical review, and a waiting period for pre-existing conditions may apply, but if you have no major health problems and you are looking for comprehensive coverage at a great rate, it may be the solution you need.
What happens after day 364? You have the opportunity to reapply for another Essential Blue Freedom policy issued after answering a few simple healthrelated questions and by meeting certain medical criteria. If you fall outside the ranges, don’t worry — you still may qualify for reissue; however, your application will be subject to review. If you think Essential Blue Freedom is an option for you, call us at 1-800-392-2583! We’d love to talk with you.
• Avoid alcohol if you are taking antihistamines, cough/cold products with the ingredient dextromethorphan, or medicines that treat sleeplessness. • Do not use medicines that treat sleeplessness if you are taking prescription sedatives or tranquilizers. • Check with your doctor before taking products containing aspirin if you’re taking a prescription blood thinner or if you have diabetes or gout. • Do not use laxatives when you have stomach pain, nausea or vomiting. • Unless directed by a doctor, do not use a nasal decongestant if you are taking a prescription medicine for high blood pressure or depression, or if you have heart or thyroid disease, diabetes, or prostate problems. This is not a complete list. Read the label! Medicine labels change as new information becomes available. That’s why it’s important to read the label each time you take medicine.
Time for a Medicine Cabinet Checkup? • Be sure to look through your medicine supply at least once a year. • Always store medicines in a cool, dry place or as stated on the label. • Throw away any medicines that are past the expiration date. • To make sure no one takes the wrong medicine, keep all medicines in their original containers.
Protect Yourself Against Tampering
Makers of OTC medicines seal most products in tamper-evident packaging (TEP) to help protect against criminal tampering. TEP works by providing visible evidence if the package has been disturbed. But OTC packaging cannot be 100 percent tamper-proof. Here’s how to help protect yourself: • Be alert to the tamper-evident features on the package before you open it. These features are described on the label. • Inspect the outer packaging before you buy it. When you get home, inspect the medicine inside. • Don’t buy an OTC product if the packaging is damaged. • Don’t use any medicine that looks discolored or different in any way. • If anything looks suspicious, be suspicious. Contact the store where you bought the product. Take it back! • Never take medicines in the dark.
Source: The U.S. Food and Drug Administration and the Consumer Healthcare Products Association (CHPA)
SUMMER 2013 BLUE & YOU
21
Arkansas Blue Cross and Blue Shield –
Financial Information Privacy Notice At Arkansas Blue Cross and Blue Shield and its affiliates (including HMO Partners, Inc. d/b/a Health Advantage), we understand how important it is to keep your private information just that — private. Because of the nature of our business, we must collect some personal information from our members, but we also are committed to maintaining, securing and protecting that information.
Customer Information Arkansas Blue Cross and its affiliates only compile information necessary for us to provide the services that you, our member, request from us and to administer your business. We collect non-public personal financial information (defined as any information that can be tied back to a specific person and is gathered by any source that is not publicly available) about our members from: • Applications for insurance coverage. The application includes information such as name, address, personal identifiers such as Social Security number, and medical information that you authorize us to collect. • Payment history and related financial transactions from the purchase and use of our products. • Information related to the fact that you have been or currently are a member.
Arkansas Blue Cross 1-800-238-8379 Health Advantage 1-800-843-1329 Self-funded group members should call Customer Service using the toll-free telephone number on their ID card.
22
Sharing of Information Arkansas Blue Cross and its affiliates do not disclose, and do not wish to reserve the right to disclose, non-public personal information about you to one another or to other parties except as permitted or required by law. Examples of instances in which Arkansas Blue Cross and its affiliates will provide information to one another or other third parties are: • To service or process products that you have requested. • To provide information as permitted and required by law to accrediting agencies. • To provide information to comply with federal, state or local laws in an administrative or judicial process.
CHANGES continued from page 3 ready to provide you with the information you need to make a good decision for you and your family. You also can request a review with an agent if you have one, or you can go to one of our locations throughout the state. If you are age 65 or older and have coverage through one of our Medicare products, there should be no changes to your health plan until 2016 as a result of the health care law. We will discuss those changes in future issues. If you are an employer with two to 50 employees, you will be receiving information regarding Arkansas Blue Cross meetings being held throughout the state to help our employer customers learn how the new regulations may impact their businesses. Afterward, you will be contacted by an agent or an Arkansas Blue Cross representative to discuss your situation in more
detail. Until then, our advice is that you not make any changes to your health plan. If you are an employer with 51 or more employees, you likely already have been discussing options with an agent or Arkansas Blue Cross representative. If not, I encourage you to do so in the coming months. At Arkansas Blue Cross, we are concerned with making health care affordable for everyone. We applaud the efforts of our state for coming up with a unique solution to take care of the many Arkansans who can’t afford health care. And, we will continue to provide our members with the most affordable health care coverage available by finding solutions that work within health care reform regulations and giving our members the protection they deserve.
How We Protect Your Information Arkansas Blue Cross and its affiliates use various security mechanisms to protect your personal data including electronic and physical measures as well as company policies that limit employee access to non-public personal financial information. Improper access and use of confidential information by an employee can result in disciplinary action up to and including termination of employment.
Disclosure of Privacy Notice Arkansas Blue Cross and its affiliates recognize and respect the privacy concerns of potential, current and former customers. Arkansas Blue Cross and its affiliates are committed to safeguarding this information. This Financial Information Privacy Notice is provided to our members as required by state regulation to explain how we handle their non-public financial information. It is also available on our website at arkansasbluecross.com or from our Customer Service Call Centers. Our customer service areas are open from 8 a.m. to 4:30 p.m., Central time, Monday through Friday.
CUSTOMER SERVICE NUMBERS May we help? For customer service, please call:
LITTLE ROCK Number (501)
TOLL FREE Number
Medi-Pak® members 378-3062 1-800-338-2312 ® Medi-Pak Advantage members 1-877-233-7022 ® Medi-Pak Rx members 1-866-390-3369 Arkansas Blue Cross members 378-2010 1-800-238-8379 • Pharmacy questions 1-800-863-5561 • Specialty Rx pharmacy questions 1-866-295-2779 Health Advantage members 378-2363 1-800-843-1329 • Pharmacy questions 1-800-863-5567 BlueAdvantage members 378-3600 1-888-872-2531 • Pharmacy questions 1-888-293-3748 Federal Employee members 378-2531 1-800-482-6655
Prefer to speak with someone close to home? Call or visit one of our offices near you: • ArkansasBlue
— Little Rock 2612 S. Shackleford Rd., Suite J 1-501-378-2222
• Fayetteville
516 East Millsap Rd., Suite 103
• Fort
Smith 3501 Old Greenwood Rd., Suite 5 1-866-254-9117
• Hot
Springs 100 Greenwood Ave., Suite C
• Jonesboro
707 East Matthews Ave.
• Little
Rock 601 Gaines Street
Looking for health or dental insurance? We can help!
• Pine
For individuals, families For employer groups*
• Texarkana
378-2937 1-800-392-2583 378-3070 1-800-421-1112
*Arkansas Blue Cross, Health Advantage and BlueAdvantage Administrators of Arkansas
1-800-817-7726
Bluff 509 Mallard Loop 1710 Arkansas Boulevard
1-800-588-5733 1-800-299-4124 1-800-421-1112 1-800-236-0369 1-800-470-9621
Visit our websites for more information:
arkansasbluecross.com • healthadvantage-hmo.com • blueadvantagearkansas.com • blueandyoufoundationarkansas.org
BLUE & YOU SUMMER 2013
SUMMER 2013 BLUE & YOU
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Arkansas Blue Cross and Blue Shield –
Financial Information Privacy Notice At Arkansas Blue Cross and Blue Shield and its affiliates (including HMO Partners, Inc. d/b/a Health Advantage), we understand how important it is to keep your private information just that — private. Because of the nature of our business, we must collect some personal information from our members, but we also are committed to maintaining, securing and protecting that information.
Customer Information Arkansas Blue Cross and its affiliates only compile information necessary for us to provide the services that you, our member, request from us and to administer your business. We collect non-public personal financial information (defined as any information that can be tied back to a specific person and is gathered by any source that is not publicly available) about our members from: • Applications for insurance coverage. The application includes information such as name, address, personal identifiers such as Social Security number, and medical information that you authorize us to collect. • Payment history and related financial transactions from the purchase and use of our products. • Information related to the fact that you have been or currently are a member.
Arkansas Blue Cross 1-800-238-8379 Health Advantage 1-800-843-1329 Self-funded group members should call Customer Service using the toll-free telephone number on their ID card.
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Sharing of Information Arkansas Blue Cross and its affiliates do not disclose, and do not wish to reserve the right to disclose, non-public personal information about you to one another or to other parties except as permitted or required by law. Examples of instances in which Arkansas Blue Cross and its affiliates will provide information to one another or other third parties are: • To service or process products that you have requested. • To provide information as permitted and required by law to accrediting agencies. • To provide information to comply with federal, state or local laws in an administrative or judicial process.
CHANGES continued from page 3 ready to provide you with the information you need to make a good decision for you and your family. You also can request a review with an agent if you have one, or you can go to one of our locations throughout the state. If you are age 65 or older and have coverage through one of our Medicare products, there should be no changes to your health plan until 2016 as a result of the health care law. We will discuss those changes in future issues. If you are an employer with two to 50 employees, you will be receiving information regarding Arkansas Blue Cross meetings being held throughout the state to help our employer customers learn how the new regulations may impact their businesses. Afterward, you will be contacted by an agent or an Arkansas Blue Cross representative to discuss your situation in more
detail. Until then, our advice is that you not make any changes to your health plan. If you are an employer with 51 or more employees, you likely already have been discussing options with an agent or Arkansas Blue Cross representative. If not, I encourage you to do so in the coming months. At Arkansas Blue Cross, we are concerned with making health care affordable for everyone. We applaud the efforts of our state for coming up with a unique solution to take care of the many Arkansans who can’t afford health care. And, we will continue to provide our members with the most affordable health care coverage available by finding solutions that work within health care reform regulations and giving our members the protection they deserve.
How We Protect Your Information Arkansas Blue Cross and its affiliates use various security mechanisms to protect your personal data including electronic and physical measures as well as company policies that limit employee access to non-public personal financial information. Improper access and use of confidential information by an employee can result in disciplinary action up to and including termination of employment.
Disclosure of Privacy Notice Arkansas Blue Cross and its affiliates recognize and respect the privacy concerns of potential, current and former customers. Arkansas Blue Cross and its affiliates are committed to safeguarding this information. This Financial Information Privacy Notice is provided to our members as required by state regulation to explain how we handle their non-public financial information. It is also available on our website at arkansasbluecross.com or from our Customer Service Call Centers. Our customer service areas are open from 8 a.m. to 4:30 p.m., Central time, Monday through Friday.
CUSTOMER SERVICE NUMBERS May we help? For customer service, please call:
LITTLE ROCK Number (501)
TOLL FREE Number
Medi-Pak® members 378-3062 1-800-338-2312 ® Medi-Pak Advantage members 1-877-233-7022 ® Medi-Pak Rx members 1-866-390-3369 Arkansas Blue Cross members 378-2010 1-800-238-8379 • Pharmacy questions 1-800-863-5561 • Specialty Rx pharmacy questions 1-866-295-2779 Health Advantage members 378-2363 1-800-843-1329 • Pharmacy questions 1-800-863-5567 BlueAdvantage members 378-3600 1-888-872-2531 • Pharmacy questions 1-888-293-3748 Federal Employee members 378-2531 1-800-482-6655
Prefer to speak with someone close to home? Call or visit one of our offices near you: • ArkansasBlue
— Little Rock 2612 S. Shackleford Rd., Suite J 1-501-378-2222
• Fayetteville
516 East Millsap Rd., Suite 103
• Fort
Smith 3501 Old Greenwood Rd., Suite 5 1-866-254-9117
• Hot
Springs 100 Greenwood Ave., Suite C
• Jonesboro
707 East Matthews Ave.
• Little
Rock 601 Gaines Street
Looking for health or dental insurance? We can help!
• Pine
For individuals, families For employer groups*
• Texarkana
378-2937 1-800-392-2583 378-3070 1-800-421-1112
*Arkansas Blue Cross, Health Advantage and BlueAdvantage Administrators of Arkansas
1-800-817-7726
Bluff 509 Mallard Loop 1710 Arkansas Boulevard
1-800-588-5733 1-800-299-4124 1-800-421-1112 1-800-236-0369 1-800-470-9621
Visit our websites for more information:
arkansasbluecross.com • healthadvantage-hmo.com • blueadvantagearkansas.com • blueandyoufoundationarkansas.org
BLUE & YOU SUMMER 2013
SUMMER 2013 BLUE & YOU
23
SUMMER 2013 A publication for the policyholders of the Arkansas Blue Cross and Blue Shield family of companies
the HEALTH CARE LAW timeline JULY1 2013
SEPT.3 2013 OCT.1 2013 DEC.15 2013 JAN.1 2014
A new tool to help determine if you qualify for cost breaks launches on our website, arkansasbluecross.com
2014 health care plans become available for review on our website
Online marketplace opens
Final day to buy health insurance for a January 1, 2014 effective date
New health insurance plans begin
MAR.31 2014 Last day to sign up for health insurance
MPI 1624 6 /13
Representatives of Arkansas Blue Cross and Blue Shield are ready to help you. Call or come by one of our locations.
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Live Fearless
Arkansas Blue Cross tops national customer survey
Financial Information Privacy Notice
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