The Local 1014 Health Line - Spring 2023

Photo by James Anderson

BOARD OF TRUSTEES MESSAGE

BOARD OF TRUSTEES MESSAGE

The Local 1014 Health Plan Board of Trustees is proud to present the Spring 2023 edition of The 1014 Health Line.

Your Local 1014 Health Plan Board of Trustees is dedicated to providing the highest level of service to our members while remaining on the cutting edge of healthcare. In this issue, we provide a review of the Local 1014 Health Plan and how deductibles, copayments and other payment mechanisms work within the Plan. We also provide some tips from the Mayo Clinic on beating seasonal allergies and an update on our expanded erectile dysfunction benefit. Finally, we feature a guest article on the emotional barriers that can inhibit weight loss.

This summer we will also be launching our We Care Member Program which is designed to ensure that your experience with your healthcare plan is positive and reflects our appreciation for our members and their families. As we continue to push for better, more effective and personalized service for our members and their families, we will be looking for input from our plan members in our upcoming survey. Please be sure to watch out for that survey in your email within the next few weeks.

As always, it is an honor to serve our fellow members of the Los Angeles County Fire Department and their families. The Local 1014 Health Trust is committed to ensuring that we take care of our members and their families FOR LIFE.

As we continue to push for better, more effective and personalized service for our members and their families, we will be looking for input from our plan members in our upcoming survey.

HOW THE HEALTH PLAN WORKS

How The Local 1014 Health Plan Works

Whether you just enrolled in The Local 1014 Health Plan or if you’re already covered by our Plan, below are some important insurance terms for your reference. A more comprehensive explanation of the details and coverage below can be found in the 2019 Summary Plan Description at www.local1014medical.org.

Each calendar year, you must meet the annual deductible before The Local 1014 Health Plan will begin to pay most covered expenses.

There are two types of deductibles:

1.Individual deductible: $200 per person (the deductible applies separately to each covered person)

2.Family deductible: $600 per family. When the combined individual deductible of three or more family members equals the family deductible amount, the family deductible is met. If you cover only yourself and one dependent, the individual deductible applies to each of you. Expenses incurred in one calendar year cannot be used to meet the deductible for the following calendar year.

Note: Prescription drug, dental, and vision expenses do not apply to the annual deductible.

Annual Deductible Coinsurance

Once you meet the deductible, you share cost with The Local 1014 Health Plan (this is called coinsurance). When you go to an in-network provider, The Local 1014 Health Plan will pay 90% of most allowable expenses and you will pay the balance. When you go to an out-of-network provider, The Local 1014 Health Plan will pay 70% of reasonable and customary charges and you pay the balance.

Copayments

For certain covered expenses, you pay a predetermined fee called a copayment or “copay.” For emergency room visits, a separate copayment of $50 applies to each visit when the covered person is not admitted directly from the emergency room to the hospital for continued necessary acute care. The emergency room copay does not apply in the case of an accident, when directed to the emergency room by a physician, when the covered person is transported by ambulance or if there is a reason to believe that the covered person has an emergency medical condition.

Out-of-pocket limit

To protect you from mounting medical bills resulting from serious illness of injury, The Local 1014 Health Plan limits the amount of coinsurance you must pay each year after you meet the annual deductible.

oIf you use in-network providers, your annual out-of-pocket limit is 10% of allowable expenses, up to $1,000 for individual or family coverage.

oIf you use out-of-network providers, your annual out-of-pocket limit is 30% of allowable expenses, up to $1,500 for individual or family coverage, plus any amounts above reasonable and customary charges. Note: The $1,000 in-network out-of-pocket limit is combined with, or counts towards, the $1,500 out-of-network limit.

Once you have reached the annual out-of-pocket limit after meeting your deductible, The Local 1014 Health Plan will pay 100% of allowable expenses, up to the specific Plan limits, for the remainder of that calendar year. Annual deductibles, prescription drug or other copayments, non-covered expenses and amounts that exceed reasonable and customary charges do not count toward your out-of-pocket limit.

SEASONAL ALLERGIES

Seasonal allergies: Nip them in the bud

Spring means flower buds and blooming trees — and if you’re one of the millions of people who have seasonal allergies, it also means sneezing, congestion, a runny nose and other bothersome symptoms. Seasonal allergies — also called hay fever and allergic rhinitis — can make you miserable. But before you settle for plastic flowers and artificial turf, try these simple strategies to keep seasonal allergies under control.

Reduce your exposure to allergy triggers

To reduce your exposure to the things that trigger your allergy signs and symptoms:

–Stay indoors on dry, windy days. The best time to go outside is after a good rain, which helps clear pollen from the air.

–Avoid lawn mowing, weed pulling and other gardening chores that stir up allergens.

–Remove clothes you’ve worn outside and shower to rinse pollen from your skin and hair.

–Don’t hang laundry outside — pollen can stick to sheets and towels.

–Wear a face mask if you do outside chores.

Take extra steps when pollen counts are high

Seasonal allergy signs and symptoms can flare up when there’s a lot of pollen in the air. These steps can help you reduce your exposure:

–Check your local TV or radio station, your local newspaper, or the internet for pollen forecasts and current pollen levels.

–If high pollen counts are forecasted, start taking allergy medications before your symptoms start.

–Close doors and windows at night if possible or any other time when pollen counts are high.

–Avoid outdoor activity in the early morning when pollen counts are highest.

SEASONAL ALLERGIES

Keep indoor air clean

There’s no miracle product that can eliminate all allergens from the air in your home, but these suggestions may help:

–Use air conditioning in your house and car.

–If you have forced air heating or air conditioning in your house, use high-efficiency filters and follow regular maintenance schedules.

–Keep indoor air dry with a dehumidifier.

–Use a portable high-efficiency particulate air (HEPA) filter in your bedroom.

–Clean floors often with a vacuum cleaner that has a HEPAfilter.

Rinse your sinuses

Rinsing your nasal passages with saline solution (nasal irrigation) is a quick, inexpensive and effective way to relieve nasal congestion. Rinsing directly flushes out mucus and allergens from your nose.

Saline solutions can be purchased ready-made or as kits to add to water. If you use a kit or home-made saline solution, use bottled water to reduce the risk of infection.

Homemade solutions should have 1 quart (1 liter) of water, 1.5 teaspoons (7.5 milliliters) of canning salt and 1 teaspoon (5 milliliters) of baking soda.

Rinse the irrigation device after each use with clean water and leave open to air-dry.

SEASONAL ALLERGIES

Seasonal allergies...Continued...

Try an over-the-counter remedy

Several types of nonprescription medications can help ease allergy symptoms. They include:

Oral antihistamines: Antihistamines can help relieve sneezing, itching, a stuffy or runny nose, and watery eyes. Examples of oral antihistamines include cetirizine (Zyrtec Allergy), fexofenadine (Allegra Allergy) and loratadine (Claritin, Alavert).

Corticosteroid nasal sprays: These medications improve nasal symptoms. Examples include fluticasone propionate (Flonase Allergy Relief), budesonide (Rhinocort Allergy) and triamcinolone (Nasacort Allergy 24 Hour). Talk to your health care provider about long-term use of corticosteroid nasal sprays.

Cromolyn sodium nasal spray: This nasal spray can ease allergy symptoms by blocking the release of immune system agents that cause symptoms. It works best if treatment is started before exposure to allergens. It’s considered a very safe treatment, but it usually needs to be used 4 to 6 times daily.

Oral decongestants: Oral decongestants such as pseudoephedrine (Sudafed) can provide temporary relief from nasal stuffiness. Some allergy medications combine an antihistamine with a decongestant. Examples include cetirizine-pseudoephedrine (Zyrtec-D 12 Hour), fexofenadine-pseudoephedrine (Allegra-D 12 Hour Allergy and Congestion) and loratadine-pseudoephedrine (Claritin-D). Talk to your health care provider about whether the use of a decongestant is good for treating your allergy symptoms.

Alternative treatments

A number of natural remedies have been used to treat hay fever symptoms. Treatments that may improve symptoms include extracts of the shrub butterbur, spirulina (a type of dried algae) and other herbal remedies. Based on the limited number of well-designed clinical trials, there is not enough evidence to demonstrate the safety and effectiveness of these remedies. Results of studies of acupuncture have shown possible limited benefit, but the results of studies have been mixed.

Talk to your doctor before trying alternative treatments. Some herbal remedies can interact with medication so always check with your doctor.

SEASONAL ALLERGIES

When home remedies aren’t enough

For many people, avoiding allergens and taking nonprescription medications is enough to ease symptoms. But if your seasonal allergies are still bothersome, don’t give up. A number of other treatments are available.

If you have bad seasonal allergies, your health care provider may recommend that you have skin tests or blood tests to find out exactly what allergens trigger your symptoms. Testing can help determine what steps you need to take to avoid your specific triggers and identify which treatments are likely to work best for you.

For some people, allergy shots (allergen immunotherapy) can be a good option. Also known as desensitization, this treatment involves regular injections containing tiny amounts of the substances that cause your allergies. Over time, these injections reduce the immune system reaction that causes symptoms. For some allergies, treatment can be given as tablets under the tongue.

Source: Mayo Clinic, April 27, 2022, https://www.mayoclinic.org/diseases-conditions/hay-fever/in-depth/seasonal-allergies/art-20048343

WEIGHT LOSS BENEFITS

Weight Loss Benefit

Local 1014 continues to be committed to providing one of the most extensive weight loss benefit available. Due to changes in criteria, we now require a review of physician documentation by our 1014 Patient Care Coordinator to ensure weight loss criteria is met. This added step will ensure that our members receive the most appropriate treatment and that they are advancing their weight loss goal in the healthiest safest manner possible.

Understanding and Overcoming Emotional Barriers to Weight Loss

How many of us struggle with weight loss, frustrated when we achieve less than our desired results? Assuming you have ruled out possible medical causes contributing to difficulty with weight loss, some of the most powerful forces that can inhibit weight loss are the barriers that exist in our heads.

That being said, many of the emotional barriers to weight loss are not initially obvious, so it is important to identify common emotional barriers and be honest with yourself about how they might be affecting you. Once you better understand any psychological factors that may be holding you back, you may be better able to tackle them. Several common emotional barriers are described below.

How We Think About Weight Loss

If we think we’re going to fail, we are more likely to fail. Less-than-successful weight loss attempts in the past can contribute to self-defeating thoughts and/or the belief that we lack willpower. This may create the (false) belief that our destiny is to be stuck where we are now.

If you don’t believe you can lose the weight you want to lose, it will be extremely hard to do so. Skepticism and self-doubt can easily stand in the way of making lasting, positive lifestyle change.

All-or-nothing thinking

Many people attempting to lose weight focus solely on results, look for immediate progress, and tend to view any setbacks as failures (disproportionate to how others may view the setback in question). Sometimes setbacks experienced may lead people to abandon the healthy changes they are trying to implement. The pattern of thinking often becomes, “If I can’t do this exactly the way I want to do it, what’s the point of doing it at all?”

WEIGHT LOSS BENEFITS

Not prioritizing the changes we want to make

Many of us are busy and have many things demanding our attention and time. We may be regularly spread in multiple directions. But people who want to lose weight may, as a result of lacking the time or resources to plan nutritious meals, exercise, get enough sleep, and so on end up making choices that do not further this goal.

By sending ourselves the message, however unconscious it may be, that we don’t have time to address weight loss and other health goals, we are making it more challenging to find or set aside time to achieve these things. If we move this item up on our to-do list, we are more likely to remain aware of our desires and goals and less likely to make choices that will sabotage them.

How We Think About Ourselves

Negative body image

Adopting a positive body image is a challenge for many people. Though some may recognize they harbor a negative body image, they may not recognize how this is holding back their weight-loss attempts. Some may attempt to shame themselves into losing weight by repeating negative messages about how they look, but these internalized messages are generally more likely to frustrate a person and disrupt weight-loss attempts even more. Consequently, people then struggle to overcome these negative messages while also attempting to lose weight.

Ourselves vs. others

You are you. Your body is yours. Someone else’s body or weight-loss journey is their own. It may seem motivating to compare ourselves with others, but all too often this can lead to feelings of failure when we fall short in comparison. What works for one person might not work for another. Recognize that your weight-loss journey is yours alone. Your plan of action is yours alone. It can also help to keep in mind that bodies come in all shapes and sizes, and some desired sizes and shapes may simply be unattainable for certain body types.

WEIGHT LOSS BENEFITS

Weight Loss Benefit...Continued

Stress and Emotional Health

Life (or daily) stress

It may come as no surprise that, when we are going through a challenging time, the associated stress can affect both our appetite and how we typically respond to stress. Through past experiences, we have learned eating can often  bring comfort. While “emotional eating” and “comfort foods” often do make us feel good, eating in response to emotional cues or even simply out of habit can have the effect of reinforcing the patterns we are trying to overcome. Breaking these patterns can be much harder than we realize.

Mental health status

Similarly, many mental health conditions, depression among them, can affect both appetite and subsequent eating behavior. Depression is also often associated with decreased motivation, decreased self-efficacy, and lack of interest, all of which can negatively impact the ability to achieve goals. While depression (or stress, for that matter) may be associated with weight loss in some individuals, these changes may not be sustained, since they have not been achieved mindfully.

Overcoming Barriers to Weight Loss

Learn how to set goals that work for you

The goals that are most conducive to success are those that are realistic, specific, and attainable. If we want to see results, it is far better to adapt our ideal goals to fit these parameters than to wish for something that is abstract or unrealistic. By doing so, we are more likely to succeed.

WEIGHT LOSS BENEFITS

Make yourself accountable

After you make a commitment to yourself, share your plan with someone else. Articulating a plan to others can reinforce the level of commitment to the plan while also introducing social motivators. Setting reminders with digital technology or hanging up a motivating sign at home or in the office can also help us keep our goals in mind.

Modify your thinking

Pay attention to the messages you’re telling yourself, honing in on any negative or unproductive thoughts. Then consciously challenge these thoughts, replacing them with messages that reflect greater self-compassion. This is important to do in so any realm of personal thought, but particularly around weight management and body image. Our behaviors play a large role in weight loss, and our thinking really does help drive our behavior.

Learn to regularly manage stress

Ideally, stress management techniques will be a part of your daily routine. Developing healthy coping responses to stress can be helpful for many reasons, reducing emotional eating among them. Prioritizing regular self-care can be one way to help manage stress.

Educate yourself about weight loss

Many of us want to lose weight. When we struggle, when our attempts fail, or when we gain back weight we have lost, we may wonder what we are doing wrong. But knowledge is power, and making a plan based on misleading information is likely to inhibit progress. Weight loss does not have to cost a lot of money, nor does it require a gym membership. There is a lot of data that supports the type of approaches that can be effective—and those that are often less effective. Trending diets, expensive meal plans, and other fads may seem to yield results for others, and they may indeed yield results for anyone at first, but they are less likely to lead to lasting behavioral change.

WEIGHT LOSS BENEFITS

Weight Loss Benefit...Continued

Seek outside support

There is help out there. An entire industry, in fact. A variety of professionals can help you meet your weight-loss goals, not just for the immediate future, but for the long term. Many of these professionals also have a solid understanding of the role that emotions can play in weight management and/ or obesity. Finding a professional you enjoy working with, and/or a program or group you enjoy participating in, can make all the difference to your goals.

Talk it out

If you struggle to lose weight, consider speaking to a therapist about any emotional causes that may be contributing to these challenges. Many therapists or other trained professionals can help provide support and education to help identify and explore barriers that may be holding you back.

Source: GoodTherapy.org

The goals that are most conducive to success are those that are realistic, specific, and attainable. If we want to see results, it is far better to adapt our ideal goals to fit these parameters than to wish for something that is abstract or unrealistic. By doing so, we are more likely to succeed.

ERECTILE DYSFUNCTION

BENEFITS UPDATE: Erectile dysfunction (ED)

Erectile dysfunction (ED) is the inability to get and keep an erection firm enough for sex. Having erection trouble from time to time isn't necessarily a cause for concern. If erectile dysfunction is an ongoing issue, however, it can cause stress, affect your self-confidence and contribute to relationship problems. Problems getting or keeping an erection can also be a sign of an underlying health condition that may require investigation and treatment.

We are pleased to announce that The Local 1014 Health Plan has expanded our coverage of ED drugs to include Cialis at 2.5mg and 5mg which is prescribed for daily use. Thirty pills for a 30- day supply will be covered. Additionally, the quantity for all intermittently used drugs will be increased to 12 pills for a 30 day supply and 36 pills for a 90 day supply.

If you're concerned about erectile dysfunction, do not let embarrassment keep you from talking to your physician. Sometimes, treating an underlying condition is enough to reverse erectile dysfunction. In other cases, medications or other direct treatments might be beneficial.

Photo by Jensen Photography

Skillet S t eak with Mushroom Sauce

Skillet Steak with Mushroom Sauce

Servings: 4

Prep Time: 20 mins

This steak, broccolini and pea dinner is a one-skillet meal that will be on your table in just 25 minutes! The pan drippings combine with mushrooms, broth and grainy mustard to make a thick and delicious sauce.

Additional Time: 5 mins

Total: 25 mins

Ingredients:

12 ounces boneless beef top sirloin steak, cut 1 inch thick and trimmed

2 teaspoons salt-free steak grilling seasoning, such as Mrs. Dash®

2 cloves garlic, minced

½ teaspoon salt, divided

2 teaspoons canola oil

6 ounces broccolini, trimmed

2 cups frozen peas

1 teaspoon chopped fresh thyme

3 cups sliced fresh mushrooms

1 cup unsalted beef broth

1 tablespoon whole-grain mustard

2 teaspoons cornstarch

Directions:

1

Preheat oven to 350°F. Sprinkle steak with steak seasoning, garlic and 1/4 teaspoon salt. Heat oil in a 12-inch cast-iron skillet over medium-high heat. Add the steak and broccolini. Cook for 4 minutes, turning the broccolini once (do not turn the steak). Place peas around the steak; sprinkle with thyme. Transfer the skillet to oven and bake until the steak is medium-rare (145°F), about 8 minutes. Transfer the steak and vegetables to a plate (leave the drippings in the pan); cover and keep warm.

2

Add mushrooms to the drippings in the pan. Cook over medium-high heat for 3 minutes, stirring occasionally. Whisk broth, mustard, cornstarch and the remaining ¼ teaspoon salt in a small bowl or measuring cup; add to the pan with the mushrooms. Cook, stirring, until thick and bubbly, about 1 to 2 minutes. Cook, stirring, for 1 minute more.

Nutrition Facts (per serving)

231 7g 18g 26g

Calories Fat Carbs Protein

Source: Eating Well website, November, 12.2018, https://www.eatingwell.com/recipe/266579/skillet-steak-with-mushroom-sauce/?print

Photo by James Anderson