Urban Call — Healthy Living Every Day!
Understanding the Affordable Care Act: What It Means for You Health care reform became law on March 23, 2010, when the Affordable Care Act (ACA) was signed by President Obama. For customers of Blue Cross and Blue Shield of North Carolina, the following provisions are effective: Dependents may stay on their parents’ plan until age 26, (the law also states that “dependents” do not have to live with their parents, be claimed as a dependent on tax returns, may be married and do not have to be enrolled in school). • Preventive care and medical screenings are covered in-network at 100 percent, with no cost sharing. This includes immunizations, U.S. Preventive Services Task Force-recommended services, and screenings for women, infants, children and adolescents. • Annual dollar limits on essential benefits are eliminated.
Visit SMSiUrbanCallHealth.com for basic health insurance information
Mentoring Our Children
Susan L. Taylor
Fighting Diabetes in Our Community
• Children under age 19 will no longer be subject to pre-existing condition waiting periods or exclusions and can’t be denied coverage. • Policies may only be rescinded for fraud or intentional misrepresentation on the part of the applicant.
Photo by Pete Souza
President Barack Obama, First Lady Michelle Obama, and their daughters, Sasha and Malia, in the Oval Office.
• There are no lifetime dollar limits on essential benefits. Health care costs continue to rise at an alarming rate. Americans are required to buy health insurance. For those who can’t afford it on their own, subsidies will be available to people who meet eligibility criteria: • Premium subsidies will be provided to lower the amount of premium the individual or family must pay for their coverage on a month-to-month basis. • Cost-sharing assistance will limit out-of-pocket costs (i.e., deductibles, coinsurance or copayments) that would otherwise be charged at the point of service. In order to obtain health insurance subsidies an individual must be a citizen or national of the United States, or a lawfully present immigrant who files a tax return. They must be enrolled in a plan offered through a Health Benefits Exchange (“Exchange”) and meet income guidelines (see page 9). If they are eligible for Medicaid or Medicare they generally will not need other insurance coverage.
Sandra Miller Jones
Segmented Marketing Services, Inc. Founder & CEO
Publisher, Urban Call; SMSi-Urban Call Marketing, Inc. President & CEO
From our family to yours Welcome to another edition of Urban Call. It is a great pleasure to work with Blue Cross and Blue Shield of North Carolina and the goal of helping more people have access to insurance through the Affordable Care Act. We know that health outcomes improve when access to appropriate medical care is available. We are happy that our SMSi Ambassadors will be out in the community helping people understand their new options. As always, our motto continues to be: Healthy Living Every Day!
You’re invited to attend a meeting in your community to learn about the Affordable Care Act. • See Community Health Forums, page 2
Urban Call — Healthy Living Every Day!
Blue Cross and Blue Shield of North Carolina’s mission For generations, Blue Cross and Blue Shield of North Carolina (BCBSNC) has offered its customers high quality health insurance at a competitive price and has led the charge toward better health and health care in the state. BCBSNC is a fully taxed, not-for-profit North Carolina company with headquarters in Chapel Hill and major operations centers in Durham and Winston-Salem. The company employs more than 4,000 North Carolinians and serves more than 3.7 million customers. BCBSNC is committed to making the health care system in North Carolina better. It works with doctors, hospitals and others to bring customers innovative solutions that simplify the health care system, improve efficiency and outcomes, and help rein in costs. BCBSNC customers have access to
one of the state’s largest network of providers and world-class customer service. Its networks include more than 97 percent of medical doctors and 99 percent of Brad Wilson hospitals in North President/CEO Carolina. BCBSNC employees work hard for their customers and the communities where they work and live. Since 1997, employees logged more than 352,000 volunteer hours at a value of over $6 million in donated time. Diversity initiatives are fully integrated in the culture, workforce, marketplace and the community.
The independent Blue Cross and Blue Shield of North Carolina Foundation has invested more than $87 million into North Carolina communities to improve the health of populations served by the state’s health care safety net, promote physical activity and healthy eating, and help North Carolina non-profits reach their goals. BCBSNC has earned the highest level of accreditation from the National Committee for Quality Assurance (NCQA) for its HMO (Personal Care Plan and Blue Care), Point of Service (MedPoint and Blue Choice), and PPO (Blue Options) health plans. BCBSNC joins the elite ranks of health plans nationwide whose level of service and clinical quality meet or exceed NCQA’s rigorous requirements for consumer protection and quality improvement.
See Community Health Forums in your area listed at
SMSi-Urban Call Marketing, Inc. Financial Services: Wanda Courts National Special Events Director: Joyce LeFlore Executive Assistants: Alexandria Smith, Avis Patterson Warehouse and Shipping: Bernard Archie, Aaron Fox
Segmented Marketing Services, Inc. SMSi Founding Chair and CEO: Sandra Miller Jones National Project Manager: Constance Harris Director Financial Services: Roslyn Hickman Director Operations: Tahnya Bowser
National Public Relations Manager: Tonya Monteiro National Senior Consultant: Nancy Lash National Logistics Manager: Camille Allen
For information on Urban Call — Healthy Living Every Day edition call (336) 759-7477 or e-mail President@ smsi-net.com. © 2013 SMSi-Urban Call Marketing Inc. Urban Call is published as part of a strategic alliance with World Media Enterprise. All rights reserved. Reproduction in whole or in part of any material in this publication without the written permission of SMSi-Urban Call Marketing, Inc. is expressly prohibited. Publishers reserve the right to accept or reject advertising. SMSi-Urban Call Marketing Inc., founded in 1978 in Winston-Salem, N.C., includes minority-owned national marketing, promotion and publishing companies that specialize in helping major companies and organizations better serve ethnic consumers. These companies distribute millions of free product samples, custom publications and consumer offers through national networks of African-American and Hispanic churches, beauty salons, barbershops, entertainment, health care and other networks. Urban Call™ and SMSi™ are registered trademarks of SMSi-Urban Call Marketing Inc..
SMSi Community of Networks URBAN CALL
Blue Cross and Blue Shield of North Carolina was recognized as one of the World's Most Ethical Companies by Ethisphere Institute, a leading international think tank dedicated to the creation, advancement and sharing of best practices in business ethics, corporate social responsibility, anti-corruption and sustainability. Each year, Ethisphere evaluates several thousand companies from around the world and recognizes those few that demonstrate a true commitment to ethical leadership, compliance practices and corporate social responsibility. Over 5,000 companies were reviewed and out of those, 145 companies were designated as World’s Most Ethical. * BCBSNC is one of the World’s Most Ethical Companies. Ethisphere Institute reviewed nominations from companies in more than 100 countries and 36 industries; the 2013 list includes a total of 145 organizations.
4265 Brownsboro Road, Suite 225 Winston-Salem, NC 27106-3425 SMSiUrbanCallMarketing.com SegmentedMarketing.com FAX: (336) 759-7212 PHONE: (336) 759-7477 President and CEO; Urban Call Publisher: Lafayette Jones Executive Editor: Alan Cronk Editorial Director: Rose Walsh Production Manager: Jodi S. Sarver Graphic Designer and Photo Director: Terrence Petree
Blue Cross and Blue Shield of North Carolina wins ethics award
Communities receive support The Basics Glossary FAQ Our Ambassadors Comunity Health Forums
Get Answers in Person/ Find a Community Health Forum in your area
Community Health Forums are being planned in North Carolina to update consumers on new insurance options that are available to those who need coverage by Jan. 1, 2014. These forums will be especially helpful to those who have never had insurance coverage, now mandated by the Affordable Care Act. In order to find a meeting time and place in your locale, visit SMSiUrbanCallHealth.com. Find out more about subsidies that are available and about the new and expanded benefits in all insurance plans. Meet the SMSi Community Ambassadors working in your community.
Blue Cross and Blue Shield of North Carolina (BCBSNC) sponsors community activities including the “Strive to Revive” program in black churches in which defibrillators — medical equipment that assists people with emergency heart problems — are distributed. 100 Black Men of America and the Harvey B. Gantt Center for African-American Arts & Culture in Charlotte have received assistance. A number of historically black colleges (HBCUs) in the state including North Carolina Agricultural & Technical State University’s school band and its Aggie Foundation have benefited. Other recipients: golf tournaments at Bennett College for women and Elizabeth City State University; health programs at North Carolina Central University and Johnson C. Smith University; a black alumni program at the University of North Carolina at Chapel Hill.
Urban Call â€” Healthy Living Every Day!
An independent licensee of the Blue Cross and Blue Shield Association. U9463, 8/13
What’s plan? your
Urban Call — Healthy Living Every Day!
You have a lot to think about when you are looking for a health insurance plan. It has to meet your specific needs, your budget and your life circumstances, and give you the protection you need. Here are some important steps: • Consider your life stage, where you are in life and how it will affect your health coverage needs. Are you just starting out? Raising a family? Self-employed or on your own? Between jobs? Need child-only coverage? • Compare plan options and learn what is available to you. • Review the benefits of each plan and see which plan best meets your needs. • Review your federal income tax report to see if you qualify for a federal subsidy. • Visit SMSiUrban CallHealth.com to learn more about community meetings.
Blue Advantage is a PPO (preferred provider organization) plan that gives members the traditional copayments and coinsurance that many are familiar with — so you know what to expect when you pay for primary care visits, specialist visits and prescription drugs.
Blue Advantage Saver is a PPO plan that allows members to make certain decisions about what beneﬁts they really need. For lower monthly premiums, choose a higher deductible. If some coverage beneﬁts are not needed, such as brand-name prescriptions, plans without that benefit are available, resulting in lower premiums.
The Enrollment Period starts Oct. 1 The Affordable Care Act mandates that individuals have insurance. Penalties will be assessed for those who do not have insurance. Outside of a few exceptions, anyone who does not purchase insurance during the enrollment period will not be able to do so until the next period (October 2015). Here is a timeline to remember: September 1: Enrollment begins in one month. You will receive your renewal/enrollment kit. Will you have changes or need new plan options?
October 1: New health care reform plans are available. Review your options and get a quote.
December 1: Deadline is approaching to make changes.
Blue Options HSA is a highdeductible health plan (HDHP), with more out-of-pocket expenses up front, but with lower premiums compared to a traditional copayment plan. It has the tax advantages of the health savings account.
Blue Value is a point-of-service (POS) product, which is an HMO with in-network and out-of-network beneﬁts with copayments for doctor visits and prescription drugs. BCBSNC has collaborated with providers across the state to offer a plan with a smaller, more streamlined network of providers.
Health Care Reform means new and expanded benefits The Health Care Reform Act means new or expanded benefits. These include: • Ambulatory patient services • Emergency services • Hospitalization • Maternity and newborn care covered • Increased benefits for mental health and substance use disorders
including behavioral health treatment • Prescription drugs • Rehabilitative and habilitative services and devices • Laboratory services • Preventive and wellness services and chronic disease management • Pediatric services, including oral and vision care
Urban Call — Healthy Living Every Day!
In a world of more than 7 billion people, it’s easy to feel like a number When it comes to your health, we make sure you’re not lost in the crowd With a team of employees and suppliers as diverse as the world around us, you can rest assured our medical care and outreach programs are tailored to what’s most important: you. It’s our approach to doing what’s best for our community, and it’s just another way we’re making healthcare remarkable.
Visit NovantHealth.org to discover how our healthcare works for you.
Urban Call — Healthy Living Every Day!
Meet the SMSi ambassadors
Sabrina Little & Travis Battle Wake County Ambassadors
Debra Macbeth & Antwaune Ingram Forsyth County Ambassadors
Seven ambassadors from SMSi-Urban Call Marketing, Inc. will visit community groups to educate about the Affordable Care Act and explain the insurance opportunities with Blue Cross and Blue Shield of North Carolina (BCBSNC). They will work with Community Advocate Partners (CAP) who will host presentations of 50 or more constituents. BCBSNC representatives will speak to the CAP groups organized by the Ambassadors. For more information, visit SMSiUrbanCallHealth.com.
John Tobias & Rev. Ervin Baker Mecklenburg County Ambassadors
Patrick Brooks Ambassador at large
BOARD OF DIRECTORS
North Carolina Mutual Life Insurance celebrates 115th anniversary Since its beginning in 1898, North Carolina Mutual Life Insurance Company has grown to become the nation’s largest door-to-door successful business institution. North Carolina Mutual is the oldest and largest AfricanAmerican life insurance James H. Speed Jr. company in the United President/CEO States. James H. Speed Jr., who assumed office in 2004 is its ninth president. This year the company is celebrating the 115th anniversary of its founding. “Our mission remains the same,” said James Speed, president of the company. “Our founders were concerned with the social uplift of AfricanAmericans, and we continue on with that goal. What is changing is the way we deliver that help,” he added. Starting out as a door to door operation, like most African-American companies, the North Carolina Mutual adopted the independent agent model in 2011. “Our agents can now sell a broader range of products,” said Kimberly Moore, director of marketing, “and that means we can serve more people.”
Bert Collins Chairman of the Board Former President and CEO North Carolina Mutual Life Insurance Co. Richard Moore CEO, First Bancorp Former North Carolina State Treasurer James H. Speed, Jr. President and CEO North Carolina Mutual Life Insurance Company Carol Moseley Braun Founder and President Good Food Organics Former Ambassador to New Zealand Former U.S. Senator Theodore W. Long, Jr. Certified Public Accountant Partner, Ernst & Young, Retired Dr. Phail Wynn Vice President; Durham and Regional Affairs, Duke University Joe L. Dudley Sr. President and CEO, Dudley Products, Inc.
Elliott Hall Attorney, Detroit law firm of Dykema Gossett Former Senior Vice President, Ford Motor Company Sandra Miller Jones Founder and Chairman, Segmented Marketing Services, Inc. Willie T. Closs, Jr. Former Executive Vice President, Chief Marketing Officer Gregory Levett, Sr. Founder and CEO, Gregory B. Levett & Sons Funeral Home & Crematory, Inc. Don Royster, Sr. Former president, Union National Life Insurance Company and Mutual Savings Life Insurance Co. Nathan T. Gossett Certified Public Accountant & Attorney, Retired Nathan Garrett Emeritus Member
Supporting partners join Blue Cross and Blue Shield of North Carolina in Community Health Forum initiative North Carolina Mutual Life Insurance, Novant Health, and Mechanics & Farmers Bank are joining Blue Cross and Blue Shield of North Carolina (BCBSNC) in a Community Health Forum initiative. “Our goal is to help people, especially those who have never had insurance before, to understand the Affordable Care Act and what it means for them and their families,” said Erik Pollack, director of new product development at BCBSNC. North Carolina Mutual Life Insurance Company is the only insurance company in North Carolina with a charter dated before 1900. It was founded to provide African-Americans access to insurance. Mechanics & Farmers Bank opened its doors in 1908 and was founded to give AfricanAmericans access to banking and financial services at the turn of the 20th century. Novant Health is a not-forprofit integrated system of 14 medical centers in 343 clinic locations in North Carolina, Virginia, South Carolina and Georgia, and has a corporate goal of serving diverse populations.
When you need a loan, weâ€™re here for you. Buying a home? Starting a business? Need a commercial construction or mortgage loan?
Mechanics and Farmers Bank can help. Visit one of our North Carolina lending officers.
Kim D. Saunders President/CEO
Meet our lending team Piedmont Triad: Greensboro, Winston-Salem
Evelyn P. Acree, Senior Vice President Piedmont Triad Regional Executive
Tamica H. Smith Banking Center Service Manager, Relationship Manager
Tanya Dial-Bethune Senior Vice President City Executive
Reginald Godette Banking Center Service Manager, Relationship Manager
Soberina F. Traywick Senior Vice President City Executive
Samuel T. Gibson III Vice President Relationship Manager
James E. Sansom Senior Vice President Chief Lending Officer
Queron U. Smith Senior Vice President City Executive
Weâ€™re in your community. Celebrating 105 years of community development, corporate citizenship, and committed customer care. 105 years of success, built on successful customer relationships. DURHAM | RALEIGH | CHARLOTTE | WINSTON-SALEM | GREENSBORO | WWW.MFBONLINE.COM | 1-800-433-8283
Urban Call — Healthy Living Every Day!
Role Model Beyond Beauty art to tour nationally The Role Model Beyond Beauty art exhibit launched during the National Black Theatre Festival in Winston-Salem is being scheduled for a national tour in 2014-2016. It will visit large scale AfricanAmerican events in Charlotte, Atlanta, Chicago and New Orleans. The total collection, which has grown to 177 women of color, was developed over 20 years through Lafayette Jones’ column, “Role Model Beyond Beauty” in Sophisticate’s Black Hair Styles and Care Guide, the best selling hair care magazine for women of color. Artist Leo Rucker was commissioned to paint the pastel portraits, which appear with a story about the women who are accomplished in their careers and distinguished by community service. The collection includes a variety of women: Rosa Parks, civil rights icon and activist; Dorothy Height, chair/president emeritus, National Council Negro Women; Carol Mosley Braun, former U.S. Senator and
Rosa Parks Civil Rights Icon and Activist
Dorothy Height Chair/President Emeritus Nat’ll Council of Negro Women
former ambassador to New Zealand; Sylvia Sprinkle Hamlin, executive producer, National Black Theater Festival; Chilli Thomas, recording artist and advocate for young women. It is estimated that 200 million people worldwide have seen the role models in the magazine which is distributed in 40,000 black beauty salons and can be purchased at major retailers like Walmart, Walgreens, Kmart , CVS and Sally Beauty stores . The publication and the column have a black
Sylvia Sprinkle Hamlin Executive Producer National Black Theater Festival
Carol Moseley Braun Former U.S. Senator and Ambassador to New Zealand
women’s bi-monthly global readership of 1.6 million in the top 50 markets in the United States and in West Africa (Ghana, Ivory Coast); South Africa (Cape Town, Johannesburg), London, Paris, Milan , Caribbean and South America ( Brazil) . To view the art exhibit opening at Winston-Salem’s Sawtooth Gallery, visit the SMSi-Urban Call Marketing YouTube Channel. (http://youtu.be/2VHP8iadIB8). Visit RoleModelBeyondBeauty.com
Novant Health—making health care remarkable Deborah Ashton, Ph.D., is the first chief diversity officer of Novant Health. She is implementing a comprehensive diversity strategy that impacts all aspects of the health care system, including patients, employees, suppliers, Deborah Ashton, communities Ph.D. and services. One health problem Vice President the Diversity & Chief Diversity Action Committee Officer has focused on is diabetes. “Diabetes is targeted because it impacts overall wellness and disproportionately impacts women and people of color,” she said in a case study in Diversity Executive magazine (http://read.diversity-executive. com). She noted that strokes, which have a better outcome when 911 is called immediately, are also an area of concern. The African-American community can be reluctant to call the emergency help line, she notes. A Harvard-trained, licensed clinical psychologist, Ashton served as a diversity consultant and strategist in Chicago, and diversity director for HarleyDavidson, Inc. in Milwaukee, Wis.
Jesse Cureton is chief consumer officer for Novant Health, overseeing strategic planning, marketing and public relations, the foundations, corporate health and other business development functions. In this role, he oversees Jesse Cureton all aspects Executive Vice of the Novant Health customer President & experience. Chief Consumer Cureton is Officer responsible for identifying, designing and executing on services, products and outreach efforts that further create a remarkable patient experience. Prior to joining Novant Health, he was regional executive, managing director for U.S. Trust, Bank of America Private Wealth Management. He graduated from the University of North Carolina at Chapel Hill and has a master’s in business administration from Queens University of Charlotte. Kevin J. Price is the first manager of supplier diversity for Novant Health. He works with business owners, community leaders, chambers of commerce, elected
officials and non-profit organizations, and raises awareness of Novant Health's commitment to building a diverse supplier network. The initiative involves expanding the supplier network to include more businesses owned by women, minorities, Kevin J. Price veterans and Manager, physicallychallenged Supplier Diversity individuals. Novant & Performance established a Supplier DAC to help diverse suppliers better understand Novant Health and the health care industry’s needs. Price graduated from the University of North Carolina at Greensboro. He has master’s degrees in both health and business administration from Pfeiffer University in Charlotte. Novant's 24,400 employees and physician partners care for patients and communities in North Carolina, Virginia, South Carolina and Georgia. The health system has received a Carolinas Minority Supplier Development Council PublicPrivate Sector award as well as a supplier diversity award from the Voluntary Hospitals of America.
Type 2 diabetes can be managed Type 2 diabetes (formerly called adultonset diabetes) has increased 30 percent in the last decade and accounts for 90 to 95 percent of the 16 million Americans with diabetes. Even more alarming, type 2 diabetes is being diagnosed more frequently in adolescents and young adults. Among people aged 30-39, diabetes Singer LaBelle increased a has diabetes and staggering 70 enjoys good food. percent. AfricanHer cookbook is Americans are Patti LaBelle’s more than one Lite Cuisine. and a half times
as likely as whites to get diabetes. Scientific evidence shows that aggressive management of diabetes can significantly delay or prevent Jerry Stackhouse, the serious NBA basketball complications All-Star, founded of the disease — the Triple Threat kidney failure, blindness, and Foundation and toe, foot, or leg a Healthy Living amputations. Initiative aimed at Controlling diabetes prevenblood sugar tion for young levels also people. reduces risk for heart disease, the major killer of people with diabetes. For more information about controlling diabetes, call (800) 860-8747 or visit the National Diabetes Education Program website at ndep.nih.gov.
Urban Call — Healthy Living Every Day!
Frequently asked questions
Blue Cross and Blue Shield of North Carolina experts Health care reform is for everyone. Blue Cross and Blue Shield of North Carolina is hosting statewide meetings to assist consumers who want to know more about it.
Roy Watson Jr. Director, Small Group & Individual Under 65 Sales
Montressa Sneed Regional Sales Manager
Erik Pollack New Product Development Manager
Jasmine Smith Senior Program Manager, Community Relations
Income figure key to lower insurance cost Subsidies will be available to low- and middle-income Americans purchasing insurance based on household size, income and access to other affordable coverage. In the chart at the right the Federal Poverty Level (FPL) for various household sizes is listed in the first column (100 percent). For example, a family of four whose income ranges from $23,550 to $94,200 may be eligible for assistance. Those whose income is on the lower end of the scale will receive the most government assistance. After family income exceeds 400 percent of the poverty level, assistance is generally unavailable.
1 2 3 4 5 6 7 8
$11,490 $15,510 $19,530 $23,550 $27,570 $31,590 $35,610 $39,630 $4,020
$15,282 $20,628 $25,975 $31,322 $36,668 $42,015 $47,361 $52,708 $5,347
$17,235 $23,265 $29,295 $35,325 $41,355 $47,385 $53,415 $59,445 $6,030
$22,980 $31,020 $39,060 $47,100 $55,140 $63,180 $71,220 $79,260 $8,040
$34,470 $46,530 $58,590 $70,650 $82,710 $94,770 $106,830 $118,890 $12,060
$45,960 $62,040 $78,120 $94,200 $110,280 $126,360 $142,440 $158,520 $16,080
For each additional person add
➤ The uninsured or those who need to purchase individual insurance will find Community Health Forums especially helpful. Review this income table to see if you may be eligible for assistance to lower your insurance costs. More questions? Visit SMSiUrbanCallHealth.com to find a meeting in your area.
Organizations support minority business development
“From 2004-2012, the Institute worked with over 8,000 minority and women owned businesses. Their clients received over $235 million in contracts, $224 million in financial transactions and created over 2,000 jobs.” Andrea Harris, President North Carolina Institute of Minority Economic Development
The Carolinas Minority Supplier Development Council enhances business opportunities for minority-owned companies by providing support through networking opportunities with corporate members and promoting minority business development. Major corporations, financial institutions, government agencies, and universities that operate within North or South Carolina are members. The council has over 170 corporate members and approximately 425 certified minority-owned businesses. The North Carolina Institute of Minority Economic Development is a statewide nonprofit with a mission to build the asset base of underdeveloped populations through economic development strategies that build businesses, create jobs, and sustain institutions vital to economically vibrant and socially responsible communities. Andrea Harris has been at the helm of the non-profit for 25 years. Priscilla Wallace serves in a dual capacity as the vice president of the Charlotte Minority Economic Development Initiative (CMEDI) as well as of the Carolinas Minority Supplier Development Council, Inc. (CMSDC).
“I’m excited about the opportunity of connecting our corporate members with minority enterprises to create an environment that is conducive to the bottom line in business.” Eric Watson, President Carolinas Minority Supplier Development Council, Inc.
Do I qualify for a subsidy? On Oct. 1 you can go to the federal exchange or bcbsnc.com to help determine your eligibility. If I have diabetes will I have to pay a lot more for my insurance? Rates are no longer determined on health conditions. A number of different factors now determine your rates and subsidy amount. What is the federal exchange? It is a government-run website that will allow you to compare different health plans, purchase a plan, and receive a subsidy (if you’re eligible.) Do I have to go to an exchange to receive a subsidy? Yes. Do I have to go to a federal exchange to receive a subsidy? No. You can apply to Blue Cross and Blue Shield North Carolina. The company will then link you to a federal exchange. What is the enrollment period? It is the only time you can sign up for new insurance plans under the Affordable Care Act. Enrollment begins Oct. 1, 2013 to March 31, 2014. After that the annual enrollment will be Oct. 15 –Dec. 7. What is actuarial value? It is the percentage of covered costs that the plan expects to pay for an enrollee. Are catastrophic plans open to everyone? No, you must be under 30 years old or have a hardship exemption. For a glossary of terms, see page 10.
Urban Call — Healthy Living Every Day!
Mechanics and Farmers Bank has long history of service in North Carolina At the turn of the 20th century, AfricanAmericans had few opportunities to obtain financing for their business ventures or homes, to safely place money on deposit and earn interest. To meet these needs nine businessmen from various professions chartered the Mechanics and Farmers Bank (M&F Bank) in 1907; the bank opened in 1908. Today, Kim D. Saunders is the president and CEO, the second woman to hold the bank’s highest office. She has a degree in economics from the Wharton School of Finance and Commerce at the University of Pennsylvania in Philadelphia. “The bank’s mission is a commitment to promoting personal and community development. This mission is the core
Mentoring champions Susan L. Taylor notes that mentoring has the power to transform the young. Denzel Washington, actor author of the book, A Hand to Guide Me, has been a national spokesman for the Boys & Girls Club of America. Susan L. Taylor, editor in chief emeritus of Essence magazine and founder of the National CARES Mentoring Movement, Inc. Steve Harvey, entertainer and TV/ event host of Teen Disney Dreamers Academy.
of our business, and we Business Administration loans, as remain true to the values well as lines of credit. that have stood the test Consumer and residential of time. Helping people loans are also available. Loan build stronger lives, both decisions are made locally at personally and professionally, competitive rates and terms. and helping businesses and Depository products offered community institutions are demand deposit accounts, Kim D. Saunders grow and develop, are the savings accounts and certificates President/CEO philosophical tenets that of deposit. The bank offers inform our decisions and credit cards, debit cards, guide our actions,” said ATM’s, electronic banking, cash Saunders. management and remote deposit capture. Financial services include loan and “We promote community deposit related products and services. development,” said Saunders, “by Types of commercial loans include providing financial and advisory services term, construction, mortgage, business that aid small- and moderate-sized acquisition and expansion and Small businesses and organizations that are
Glossary of terms Health Care Reform has its own language. Here are the most commonly used terms: Affordable Care Act (ACA) The law intended to address issues with our health care system by increasing access to health insurance, introducing reform and improving quality. Also referred to as the Patient Protection and Affordable Care Act (PPACA). Beneﬁt Period The speciﬁed period of time during which charges for covered services provided to a policy member must be incurred in order to be eligible for payment. Coinsurance The percentage of covered medical expenses paid after the deductible is met. Coinsurance Max The total amount of coinsurance you’re required to pay for covered services in a year. Once you reach the coinsurance maximum, you will not have to pay any more for coinsurance for covered medical expenses for the remainder of the year. Copayment A ﬁxed dollar amount you may pay for a covered service at the time you receive it. Copayments can vary depending on the service. Deductible The amount you owe for certain covered services during a beneﬁt period before your health insurance begins to pay. Enrollment Period Generally the only time to switch to a new plan.
Federal Poverty Level (FPL) A measure of income level (by family size) that determines eligibility for premium tax credits. For example, a family of four that makes less than $94,200 a year may be eligible for help. Formulary The list of drugs available on an insurance plan. Grandfathered Refers to health insurance plans that were in effect prior to March 23, 2010 and that have not undergone specific changes. The ACA allows grandfathered plans to be exempt from some ACA requirements. Health Insurance Marketplace An online insurance marketplace where individuals can compare, shop for and buy qualified health insurance plans. Also known as an “Exchange. Health Care Reform (HCR) The changes that will occur on January 1, 2014 as a result of the comprehensive health care reform law known as the Affordable Care Act. Pre-Existing Condition A condition, disease, illness or injury for which medical advice, diagnosis, care or treatment was received or recommended within a specified time period prior to
committed to supporting and building the community in which they are located,” she added. The bank has been the distinction of being a North Carolina Community Development Financial Institution (CDFI). It focuses on underserved people, small and entrepreneurial businesses, and organizations, and has received recognition for community service. It is a subsidiary of M&F Bancorp, Inc., a one-bank holding company headquartered in Durham, N.C. The company’s common stock is quoted in the over-the-counter market through the OTC Bulletin Board under the symbol “MFBP.” Visit mfbonline.com; call (800) 433-8283.
enrolling in health plan. Pregnancy and genetic information are not considered preexisting conditions. Premium The amount paid to keep an insurance policy active. Premiums are separate from other health insurance out-of-pocket costs. Premium Tax Credits These will be made available to low and middle-income Americans and applied to health insurance premiums. Cost Sharing Reductions will limit a plan's maximum outof-pocket costs. Preventive Care Medical services related to the prevention of disease, provided by or upon the direction of a doctor or other provider. Provider A hospital, non-hospital facility, doctor or other provider, accredited, licensed or certified where required in the state of practice, performing within the scope of license or certification. All services performed must be within the scope of license or certification to be eligible for reimbursement. Subsidy A tax credit or a cost-sharing reduction to assist individuals purchasing insurance. They are based on income levels, household size, and access to other affordable coverage.
Find useful information about the Affordable Care Act Need more information? Visit the SMSi website at right. Blue Cross and Blue Shield of North Carolina, the U.S. Department of Health and Human Services (HHS) and the White House also have information sites.
• SMSiUrbanCallHealth.com • BCBSNC.com (Health Care Reform) • Whitehouse.gov/blog (Affordable Care Act) • HHS.gov/healthcare (African-American)
An independent licensee of the Blue Cross and Blue Shield Association. U9463, 8/13