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Health

A Publication for Teachers Health Trust Participants

raxx

Spring 2017│Volume 16, Issue 2 For Teachers by Teachers

what’s in my plan?

EVERYTHING YOU NEED TO KNOW ABOUT YOUR PRESCRIPTION BENEFIT

FRESH & LOCAL

VOLUME 16, ISSUE 2

TIPS & TRICKS TO MAXIMIZE YOUR TRIP TO THE FARMERS MARKET

is mom brain real? A MUST-READ FOR MOMS


SPRING 2017 | HEALTH TRAXX TEACHERSHEALTHTRUST.ORG


contents SPRING 2017

VOLUME 16, ISSUE 2

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20

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in this issue LETTERS 4 BOARD OF TRUSTEES 5 FROM THE CEO

FEATURES 6 RX SAVINGS SOLUTIONS How to save money on your prescriptions

7 FREQUENTLY ASKED QUESTIONS

Your dental questions answered

8 ROAD TRIP

How to survive a family trip

9 FRESH & LOCAL

23 IN-NETWORK SPOTLIGHT

10 TRUST FINANCIAL REPORTS 18 THE ART OF MEDITATION

24 WELLDYNE RX

Tips and tricks to navigating the farmers market like a pro

Everything you need to know about Steinberg Diagnostic

Manage your pharmacy benefits through the member portal

Quick calming tips

25 IS MOM BRAIN REAL?

Support for a healthier life

26 FIVE STEPS TO MANAGE STRESS

19 HERE’S TO HEALTH

20 WHAT’S IN MY PLAN?

Everything you need to know about your prescription benefit

22 ASTHMA & SULFITE ALLERGIES

A must read for all moms

How WellHealth Online can help

27 QUICK COOKING

Five refreshing water recipes

Five foods to avoid if you have a sulfite allergy SPRING 2017 | HEALTH TRAXX TEACHERSHEALTHTRUST.ORG

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LETTERS

FROM THE BOARD Health Traxx is published quarterly by the Teachers Health Trust to help participants make life-saving decisions about health care. Although editorial content is based on sound medical information, we ask that you consult a healthcare professional regarding all medical concerns. We encourage you to keep copies of this news publication for the purpose of building a handy home medical reference guide or to recycle issues to friends and family. Any opinions expressed by an author or source whose article appears in this publication are solely the opinions of the author/source and do not necessarily reflect the views of the Trust. If you have questions or comments regarding this issue, e-mail the Trust at wellness@ teachershealthtrust.org, or write to Teachers Health Trust c/o Philip DiGiacomo, P.O. Box 96238, Las Vegas, NV 89193-6238.

CHAIRPERSON Michael Steinbrink VICE CHAIRPERSON Isela Stellato BOARD OF TRUSTEES David Tatlock Jodi Brant Cindy Johnson Molly Lehman Kerri Martinez Najera Cynthia Rapazzini Vikki Courtney, CCEA President CEO Gary Earl ADVERTISEMENTS

This publication is made in part by the generous donations of network providers and non-profit community organizations. Individuals or companies interested in advertising opportunities in Health Traxx should contact Philip DiGiacomo, Director of Communications, at wellness@teachershealthtrust. org or contact the Teachers Health Trust Wellness Division at (702) 866-6192. An advertisement in the Health Traxx publication does not mean the Trust endorses the provider or service. Ad purchase space is based on a first-come, first-served basis, and advertisers are preferred to be a part of the Teachers Health Trust Provider Network. Other organizations, such as non-profit local or national health agencies or for-profit companies with a valid business license, may advertise once approved by the Teachers Health Trust Special Events Committee.

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The race toward summer is well upon us now, and there is little doubt that most of you, like us, are spending most waking hours in an effort to ensure our students and our classrooms close out the year successfully. Those of us on the board who are equally absorbed in our year-end duties have found ourselves likewise absorbed in ensuring that your, and our, healthcare plan is sufficiently prepared to serve us as we go into the waning days of spring. Now that we are bringing the academic year to a close, the Trust can report a series of positive progressions, but also acknowledge that continued improvement and evolution must remain a keen focus for all of us. As we enter into the final stretch of the school year, we encourage you to get to know the benefits that are available, convenient and prevalent to you whether traveling or remaining local this summer (such as Telemedicine and Minute Clinic access). More excitingly, though, is our hope that you familiarize yourself with the brand new Grand Rounds benefit, which you can learn more about in this issue, and was effective as of April 3, 2017. This new offering provides much-needed access to second opinions and diagnosis reviews never before available to Trust participants. This cuttingedge benefit will coordinate with our local Case Management Team to assist you with medical concerns both large and small at no out-of-pocket cost to you or your family. We believe benefits such as Grand Rounds and others that were introduced for the 2017 calendar year are merely first steps in becoming the best healthcare plan possible. So what comes next? How else is your board steering the Trust toward improvement and innovation? These are good and important questions to be sure. The answer is that the summer months will be, as they always have been, dedicated to researching and implementing plan additions and refinements for the 2017-2018 school year and beyond. As we continue to evolve the Performance Plus Plan to better serve us all, we look forward to delivering an ever-improving best-in-class level of care for you and your family. This is a non-negotiable goal for the board and the Trust as a whole, and it is one that we are vigilant in our efforts to maintain. All of us with the Trust would like to thank all of you for your continued input and feedback over the last school year. Both the recognition of improvement as well as the critiques of challenges are important to our growth and success. There have been many tests and tasks as a result, but we continue to take them on with the knowledge that this plan must be one that serves our colleagues and community. We, by no means, believe that the job is done and will continue to push forward in our efforts to progress. With that said, we, like you, must now return to the arduous task of closing out our school year and wish you the best in your efforts. Here’s to a successful spring and joyous summer for you all. Michael Steinbrink, Chairman Board of Trustees Teachers Health Trust

SPRING 2017 | HEALTH TRAXX TEACHERSHEALTHTRUST.ORG


MESSAGE FROM THE CEO

GARY EARL

Shifting Gears to Better Health Spring brings forth a strong sense of renewal, which provides the opportunity for visions and inspirations to bring our goals and creative energy to fruition. Both our collective and individual journeys continue to unfold in front of us much like the open road does from the seat of a bicycle. I have had the privilege and honor to cycle across our great nation twice while operating a series of health awareness and engagement tours that were aimed at improving the overall health and well-being of individuals, businesses and communities; one mile, one pedal, one person at a time. Spring always reminds me of the increase in training it took to accomplish our goals. It also makes me think about our goals as a Trust and our role to support each of your journeys for health. For each one of us, spring naturally creates opportunity to either restart or refresh our personal journeys. In the same way, the Teachers Health Trust is now entering into the next era of its renewal; a mission that is focused on improving the overall health, well-being and economics of our valued teachers and their families. The Trust is leaving behind, on the road, a vast majority of the obstacles and trials that threatened to flatten our tires and our determination to be both successful and sustainable. Although there are steep curves and mountain passes that will lie ahead, the Trust is well positioned to increase our speed and pull together as a strong and collaborative collective, working as one to ride toward the possibilities that lie ahead. The mountains that yet need to be climbed go far beyond those of the technical, organizational and financial trials that are fading into the past, and include our individual health conditions as well as behaviors. The past three decades have seen a dramatic rise in the percentage of the population that is diagnosed with chronic diseases, such as diabetes and childhood asthma. The incidence of these health conditions, compounded with other serious health issues, including obesity and stress, continue to increase on a year-over-year basis. They are eroding our overall health status and driving health care costs steadily upward at unsustainable speeds. Now, however, is our time to increase our commitment and our cadence by creating and investing in new and innovative programs and products that create engagement opportunities for our diverse health statuses. This effort, ultimately, will support keeping our healthy population healthy, shifting those with chronic conditions downward in the health risk compendium as well as fully supporting those with acute conditions in compassionate yet comprehensive ways. The results of improving our lives impact not only our physical, mental and economic health status, but go even further beyond these important standards in value. Our individual and collective productivity is increased in both the classroom and home. The outcome of our efforts to reach peak performance also trickle into our neighborhoods in the form of volunteerism, social cohesion, cultural awareness and even socioeconomic status. It is time that we look forward, as a team, to appreciate that totality of health is far more than health care. Our Trust team and our committed partners are increasing our speed, with a sharp eye to what lies ahead. We are working diligently and tirelessly to complete the framework for this new era of improvement. You will learn much more about it all as we continue to train for the tour that we will ride together this coming fall. In the meantime, I encourage you to consider your role in the journey. I personally wish you each and all a most positive, peaceful, safe and healthy spin into spring.

Gary Earl, CEO GEarl@teachershealthtrust.org SPRING 2017 | HEALTH TRAXX TEACHERSHEALTHTRUST.ORG

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How to get started:

FAQ

Looking to save money on prescriptions?

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SETUP YOUR SAVINGS ALERTS:

REVIEW AVAILABLE SAVINGS OPTIONS:

START SAVING ON PRESCRIPTIONS:

Visit portal.rxsavingssolutions.com and log on. Select “Member Login” or click “Register” if you’re a first-time visitor. Once you’ve logged on, you can adjust your preferences for text and email notifications by clicking “Profile” in the side navigation.

Any existing medications you or your family take will be displayed and you will be provided with all possible clinical and financial alternatives to maximize your savings. You can also use the search feature to view different medications and associated savings.

If savings are available on existing medications, you’ll receive instructions on how to review the new options with your doctor. When new savings are identified, you’ll receive personalized savings alerts via text or email based on your profile settings.

Don’t want to wait for an alert to start saving? Use the search feature after you log in to search medications and savings opportunities at pharmacies near your home!

Questions? Contact member services. Our member services team is staffed with Certified Pharmacy Technicians available to assist with prescription questions. They can be reached Monday – Friday from 7:00 AM – 8:00 PM CST at 1-800-268-4476 or info@rxsavingsllc.com.

rxsavingssolutions.com

SPRING 2017 | HEALTH TRAXX TEACHERSHEALTHTRUST.ORG


FREQUENTLY ASKED QUESTIONS

Your dental questions answered Q: What is my calendar year maximum? A: Your calendar year maximum is $1,500 per covered person per year. Q: When am I eligible for orthodontics? A: Orthodontics are only covered for dependents ages 18 and under that have been on the plan for two current, consecutive years.

Q: How many cleanings can I get in a calendar year? A: You can get as many as two cleanings in a calendar year. Q: How many periodontal maintenance cleanings do I get a year? A: Your health plan allows for four periodontal maintenance cleanings per calendar year.

Q: Are sealants covered? A: Yes, for permanent molars, every 24 months for dependents under the age of 19. Q: Is fluoride covered? A: Yes, fluoride is covered twice per calendar year for dependents under the age of 19 years of age.

Q: How many exams are covered? A: Each covered person under your plan is eligible for two exams per calendar. Q: Is root planning and scaling covered? A: Yes, root planning and scaling is limited to two per quadrant, per person per calendar year.

Q: Do you cover TMJ? A: Yes, TMJ appliances are limited to a lifetime maximum of $500 per covered person. TMJ testing services are covered under the medical plan.

More questions?

We’re here to help!

Member Services can answer your questions about benefits, claims, billing and more. Contact the team by email at serviceteam@teachershealthtrust.org, or by phone at (702) 794-0272. SPRING 2017 | HEALTH TRAXX TEACHERSHEALTHTRUST.ORG

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tips to survive a family

ROAD TRIP Whether you are in the car for three hours or 13, a family road trip can test the patience of any parent. Family road trips are still one of the most popular forms of vacation, and with gas prices continuing to stay at a reasonable rate, this summer is shaping up to see more people on the roads.

KEEP THE HUNGER BUGS AT BAY

curb carsickness

Purchase a clear tack box for your school-aged kids and fill it with their favorite healthy snacks, such as grapes, blueberries, carrot sticks, marshmallows, and cucumbers. You can also add a cracker, but limit sugary snacks because they won’t have anywhere to run that sugar out while they’re stuck in the car. If you have a toddler, pack frozen yogurt bites, mini pancakes and squeezable fruit.

The last thing anyone wants on a road trip is to be sick. Here are some things you can do to help a little one who gets sick on occasion:

STOP

DETOUR

ARE WE THERE YEt?

Entertainment outside of a tablet in the car can be tricky. The attention span of any kid is minimal. Don’t worry about playing a couple of movies in the car during a long trip, but here are some other ideas: Make car bingo cards that have car brands and see who wins. Laminate busy binders for kids to wash off if they want to start over.

Nearby getaways: Zion National Park (above), Bryce Canyon (center), Grand Canyon and Big Bear Lake.

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SPRING 2017 | HEALTH TRAXX TEACHERSHEALTHTRUST.ORG

Create travel grab bags that they can choose once an hour with a new toy or stuffed animal in it.

Talk to your doctor to see if there is anything they can prescribe to help during the long road trip. Buy pressure point bracelets they can wear during the trip. Keep mints nearby to settle rumbly tummies.

SLOW

EAT OUTSIDE

Skip eating inside a restaurant where the kids have to sit and wait even more. A lot of restaurants have curbside takeout that you can order in advance, find the nearest park, and let the kids run and play while you enjoy a healthy meal in the fresh air.


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FRESH LOCAL Knowing who grows your food and where it comes from, before it becomes a delicious dish for your family, is an important part of discovery at any age. A farmers market is the best place to pique your children or spouse’s curiosity in new foods.

make the most of your visit CONSIDER COMFORT AND THE ENVIRONMENT

PERFECTION IS FOR THE BIRDS

SHOW UP WITH AN OPEN MIND

Farmers markets are traditionally spread out in a park or shopping center, so wear comfortable shoes so you can spend time walking around seeing everything. Bringing a reusable bag isn’t make or break with vendors because most have plastic bags if you need them, but part of the local food movement is sustainability. Bring a regular reusable bag, and if you can, bring an insulated bag for cold items.

Blemished tomatoes, misshaped potatoes or uneven carrots may never make it to the grocery store, but they can be the centerpieces of your meal. Some research even suggests that rough produce contains more nutrients than their unblemished counterparts.

Lists are not a necessity here. Show up without one, and see where the produce stands take you. You will never know until you arrive, so have fun exploring each stand and finding new fruits and vegetables. If you can sample their produce or product, take advantage of this opportunity; you never know what you may end up liking. Once you have produce in hand, Google recipes and start cooking.

Be open minded, have fun and enjoy the farmers market sustainability movement

SMALL BILLS Bring smaller bills and change with you. You can pay with a credit card at most farmers markets, but there is usually a surcharge. If you give your children a few dollars and teach them how to buy produce, you may find that they will be more willing to try what they bought during their trip to the farmers market.

MORE THAN PRODUCE There is something for everyone at a farmers market. Enjoy everything from fresh smoothies and juices to homemade protein bars, local honey, kettle corn and sometimes fantastic family-owned restaurants and food trucks. SPRING 2017 | HEALTH TRAXX TEACHERSHEALTHTRUST.ORG

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Independent Auditor’s Report To the Board of Trustees Teachers Health Trust Las Vegas, Nevada

Independent Auditor’s Report

Report on theof Financial To the Board Trustees Statements We have audited accompanying financial statements of the Teachers Health Trust (the “Trust”), which Teachers Health the Trust comprise the statements of net assets available for plan benefits and of benefit obligations as of June 30, Las Vegas, Nevada 2016 and 2015, and the related statements of changes in net assets available for plan benefits and of changes in benefit obligations for the years then ended, and the related notes to the financial statements. Report on the Financial Statements Management’s for the Financial Statements We have auditedResponsibility the accompanying financial statements of the Teachers Health Trust (the “Trust”), which Trust management is responsible for the preparation andbenefits fair presentation of these financialas statements in comprise the statements of net assets available for plan and of benefit obligations of June 30, accordance with accounting principles generally accepted in the United States of America; this includes 2016 and 2015, and the related statements of changes in net assets available for plan benefits and of the design, andfor maintenance of internal control relevantnotes to thetopreparation and fair changes inimplementation, benefit obligations the years then ended, and the related the financial statements. presentation of financial statements that are free from material misstatement, whether due to fraud or error. Management’s Responsibility for the Financial Statements Trust management is responsible for the preparation and fair presentation of these financial statements in Auditor’s accordanceResponsibility with accounting principles generally accepted in the United States of America; this includes Our responsibility is to express opinion on these financial statements our audit. We the design, implementation, andanmaintenance of internal control relevantbased to theonpreparation and fair conducted our audit in accordance with auditing standards generally accepted in the United presentation of financial statements that are free from material misstatement, whether due toStates fraudofor America. Those standards require that we plan and perform the audit to obtain reasonable assurance about error. whether the financial statements are free of material misstatement. Auditor’s Responsibility An involves performing procedures toon obtain evidence about the amounts disclosures in Ouraudit responsibility is to express an opinion theseaudit financial statements based on ourand audit. We the financial statements. The procedures selected depend on the auditor’s judgment, including the conducted our audit in accordance with auditing standards generally accepted in the United States of assessment of thestandards risks of material of the financial whether due toassurance fraud or error. America. Those require misstatement that we plan and perform the statements, audit to obtain reasonable about In making those risk assessments, the auditor considers internal control relevant to the Trust’s preparation whether the financial statements are free of material misstatement. and fair presentation of the financial statements in order to design audit procedures that are appropriate in the not for the purpose of opinionabout on thethe effectiveness ofdisclosures the Trust’s in Ancircumstances, audit involves but performing procedures to expressing obtain auditanevidence amounts and internal control. Accordingly, we express selected no such opinion. Anthe audit also includes evaluating thethe the financial statements. The procedures depend on auditor’s judgment, including appropriateness of accounting policies used and the reasonableness of significant accounting estimates assessment of the risks of material misstatement of the financial statements, whether due to fraud or error. made by management, as well as evaluating the overall presentation of the financial statements. In making those risk assessments, the auditor considers internal control relevant to the Trust’s preparation and fair presentation of the financial statements in order to design audit procedures that are appropriate in We that the but audit we haveof obtained is sufficient andonappropriate to provide a basis for the believe circumstances, notevidence for the purpose expressing an opinion the effectiveness of the Trust’s our audit opinion. internal control. Accordingly, we express no such opinion. An audit also includes evaluating the appropriateness of accounting policies used and the reasonableness of significant accounting estimates made by management, as well as evaluating the overall presentation of the financial statements. We believe that the audit evidence we have obtained is sufficient and appropriate to provide a basis for our audit opinion. www.eidebailly.com

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5441 Kietzke Ln., Ste. 150 | Reno, NV 89511-2094 | T 775.689.9100 | F 775.689.9299 | EOE

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SPRING 2017 | HEALTH TRAXX TEACHERSHEALTHTRUST.ORG

www.eidebailly.com

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Opinion In our opinion, the financial statements referred to above present fairly, in all material respects, the financial status of the Teachers Health Trust as of June 30, 2016 and 2015, and the changes in its financial status for the years then ended in accordance with accounting principles generally accepted in the United States of America. Emphasis of Matters As discussed in Note 2 to the financial statements, as of June 30, 2016 and 2015 and for the years then ended, management of the Trust has elected to early adopt the guidance contained in Accounting Standards Update 2015-12 “Plan Accounting (Topics 960, 962, and 965) – (Part II): Plan Investment Disclosures” to simplify the investment disclosure requirements. Our opinion is not modified with respect to this matter. As discussed in Note 2 to the financial statements, as of June 30, 2016 and 2015 and for the years then ended, management of the Trust has elected to early adopt the guidance contained in Accounting Standards Update 2015-07, “Disclosures for Investments in Certain Entities That Calculate Net Asset Value per Share (or Its Equivalent)”, which requires that investments for which fair value is measured using the net asset value practical expedient be removed from the fair value hierarchy. Our opinion is not modified with respect to this matter. Report on Supplementary Information Our audit was conducted for the purpose of forming an opinion on the financial statements as a whole. The supplemental schedule of administrative expenses and the supplemental schedule of insurance premiums, together referred to as “supplemental information,” for the years ended June 30, 2016 and 2015, are presented for the purpose of additional analysis and are not a required part of the financial statements. Such information is the responsibility of the Trust’s management and was derived from and relates directly to the underlying accounting and other records used to prepare the financial statements. The information has been subjected to the auditing procedures applied in the audits of the financial statements and certain additional procedures, including comparing and reconciling such information directly to the underlying accounting and other records used to prepare the financial statements or to the financial statements themselves, and other additional procedures in accordance with auditing standards generally accepted in the United States of America. In our opinion, the information is fairly stated in all material respects in relation to the financial statements as a whole.

Reno, Nevada January 20, 2017

SPRING 2017 | HEALTH TRAXX TEACHERSHEALTHTRUST.ORG

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Teachers Health Trust

Statements of Net Assets Available for Plan Benefits June 30, 2016 and 2015

Assets Investments Receivables Related party receivable Prescription drug rebate receivable Rental income Total receivables Cash and cash equivalents Property and equipment (net of accumulated depreciation of $6,014,354 and $5,616,337, respectively) Other assets Prepaid expenses Total assets Liabilities Accounts payable for administrative expenses Cash overdraft Due to related party Deferred insurance contribution Line of credit Capital lease payable Total liabilities Net Assets Available for Plan Benefits

See Notes to Financial Statements 12 SPRING 2017 | HEALTH TRAXX TEACHERSHEALTHTRUST.ORG

2016

2015

$ 39,905,927

$ 62,404,793

14,270 1,631,641 37,500

17,866 2,133,292 -

1,683,411

2,151,158

33,404,214

550,222

5,591,022 22,945 1,287,553

5,802,435 12,338 271,196

81,895,072

71,192,142

496,242 25,000 231,497 91,600

924,202 589,682 25,000 209,554 3,001,725 148,207

844,339

4,898,370

$ 81,050,733

$ 66,293,772

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Teachers Health Trust

Statements of Changes in Net Assets Available for Plan Benefits Years Ended June 30, 2016 and 2015

Additions Contributions Clark County School District/Charter schools Employee deduction Retiree participants Self-pay, cobra, staff participants

2016

2015

$ 123,936,265 29,434,188 2,144,572 1,677,482

$ 117,808,041 29,076,629 1,261,724 2,003,511

157,192,507

150,149,905

Total contributions Investment income (loss) Net appreciation (depreciation) in fair value of investments Interest and dividends

(2,031,304) 1,798,852

(1,280,671) 1,512,086

Total investment income (loss)

(232,452)

231,415

Less investment manager fees

131,266

135,172

(363,718)

96,243

Net investment income (loss) Other income Total additions Deductions Insurance premiums Benefits paid for participants Medical Prescription drugs Dental Vision Total benefits paid for participants Administrative expenses Total deductions Net Increase (Decrease)

4,468,579

4,880,946

161,297,368

155,127,094

2,186,465

2,299,823

84,182,860 32,000,758 12,485,005 2,133,138

101,133,415 36,925,725 13,306,159 2,440,020

130,801,761

153,805,319

13,552,181

8,820,418

146,540,407

164,925,560

14,756,961

(9,798,466)

Net Assets - Retiree Health Trust

-

48,234,698

Net Assets Available for Benefits Beginning of Year

66,293,772

27,857,540

End of Year

See Notes to Financial Statements

$

81,050,733

$

66,293,772

SPRING 2017 | HEALTH TRAXX 4 TEACHERSHEALTHTRUST.ORG

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Teachers Health Trust

Statements of Benefit Obligations June 30, 2016 and 2015

Amounts Currently Payable to or for Participants, Beneficiaries, and Dependents Vision claims Medical and dental claims Prescription drugs Total currently payable

2016 $

202,545 1,517,160 1,363,370

2015 $

287,705 8,123,555 1,681,461

3,083,075

10,092,721

Other Current Benefit Coverage Obligations Claims incurred but not reported, at present value of estimated amounts

22,712,840

6,776,445

Postretirement Benefit Obligations Plan participants not yet fully eligible for benefits Other plan participants fully eligible for benefits Retirees Administrative fixed cost (unallocated)

20,455,000 69,399,000 10,142,000 -

58,942,000 16,131,000 7,332,000 3,156,000

Total postretirement benefit obligations

99,996,000

85,561,000

$ 125,791,915

$ 102,430,166

Total Benefit Obligations

See Notes to Financial Statements 14 SPRING 2017 | HEALTH TRAXX TEACHERSHEALTHTRUST.ORG

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Teachers Health Trust

Statements of Changes in Benefit Obligations Years Ended June 30, 2016 and 2015

Amounts Currently Payable to or for Participants, Beneficiaries, and Dependents Balance, beginning of year Claims reported and approved for payment Claims paid Balance, end of year Other Obligations for Current Benefit Coverage, at Estimated Amounts Balance, beginning of year Net change during year Balance, end of year Postretirement Benefit Obligations Balance, beginning of year Increase (decrease) during year attributed to: Merger of Retiree Health Trust obligation Normal cost Interest Administrative expenses Benefits paid Plan design changes Actuarial (gains)/losses Balance, end of year Total Benefit Obligations, at End of Year

See Notes to Financial Statements

2016

2015

$ 10,092,721 125,978,580 (132,988,226)

$

7,996,055 158,201,808 (156,105,142)

3,083,075

10,092,721

6,776,445 15,936,395

5,818,747 957,698

22,712,840

6,776,445

85,561,000

-

5,927,000 4,280,000 (276,000) (585,000) 5,089,000

114,336,000 8,124,000 5,583,000 (389,000) (1,775,000) (11,654,000) (28,664,000)

99,996,000

85,561,000

$ 125,791,915

$ 102,430,166

SPRING 2017 | HEALTH TRAXX 6 TEACHERSHEALTHTRUST.ORG

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Teachers Health Trust

Schedule of Administrative Expenses Years Ended June 30, 2016 and 2015

Staff salaries and benefits Claims administration Accounting and administrative Participant services Support services Provider services Information technology Clinical initiatives Document imaging Wellness and health programs

TPA management fees ACA transitional reinsurance and PCORI fees Depreciation expense Claims processing expenses Postage and delivery Professionals fees Legal fees Benefit communications Building expenses Utilities expenses Computer supplies and expenses Audit and actuarial fees Health education programs Fiduciary liability insurance Photocopying expenses Printing expenses Insurance expenses Bank fees, interest, and penalty Outside services Publications, subscriptions, and dues Trustees conference and meeting expenses Employee related expenses Miscellaneous expenses Office supplies and expenses Rental expenses Business personal property tax Health Traxx newsletter Staff training and conference Total

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SPRING 2017 | HEALTH TRAXX TEACHERSHEALTHTRUST.ORG

2016 $

695,975 941,206 663,529 432,696 334,689 216,140 166,366 132,629 111,239

2015 $

1,084,528 1,078,670 903,645 589,250 352,465 312,024 270,464 191,559 148,606

3,694,469

4,931,211

6,160,212 1,390,095 398,016 255,350 173,963 230,287 263,588 232,282 112,037 83,571 44,190 174,400 18,767 62,893 35,496 37,224 41,491 27,630 41,483 14,555 1,948 5,671 18,769 10,339 8,792 5,361 4,360 4,942

1,925,791 397,461 256,628 189,379 167,423 137,847 129,653 109,392 76,423 61,691 61,100 51,955 51,262 42,403 39,690 39,481 30,744 23,299 19,796 19,239 14,616 11,475 9,321 9,132 6,710 5,577 1,719

$ 13,552,181

$

8,820,418

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Teachers Health Trust

Schedule of Insurance Premiums Years Ended June 30, 2016 and 2015 2016 Group Term Life Insurance - Lincoln National Life Utilization Management - Health Care Partners/Telligen Behavioral Health - Human Behavioral Institute Vision PPO Network - Vision Service Plan Retiree Premium - United Healthcare/Secure Horizons Medical PPO Network - Coalition of America

2015

$

1,284,460 272,334 229,138 166,372 152,414 81,747

$

1,212,114 538,293 226,328 164,159 111,910 47,019

$

2,186,465

$

2,299,823

NOTE: This Trust Financial Statement is available for review and/or download by visiting the Financials page found at www.teachershealthtrust.org.

SPRING 2017 | HEALTH TRAXX 20 TEACHERSHEALTHTRUST.ORG

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Art of the

Meditation

Meditation is an ancient tradition that can help relax and focus the mind, calm your breathing, and even lower blood pressure! If you are a beginner, follow these steps to practice mindfulness: Adjust your body into a comfortable pose, whether that is lying down on a mat or sitting with your legs crossed. You should not be in any pain or discomfort. Close your eyes lightly. Do not hold any tension around your eyes. Begin breathing naturally. Do not focus on how long each breath is or try to hold your breath. Bring your attention to how your breathing affects your body. Feel your lungs expand and contract. Notice how your breath sounds as you inhale and exhale. If your thoughts begin to wander, bring your focus back to your breath. Do this process for 2-3 minutes when you first begin. As you are able to focus for longer periods of time, increase the duration of your meditation time. Keep a journal of thoughts by your side and write how you feel each time you meditate. Follow your progress over time.

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SPRING 2017 | HEALTH TRAXX TEACHERSHEALTHTRUST.ORG

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WHAT’S IN MY PLAN THIS MONTH’S SPOTLIGHT ON PRESCRIPTION BENEFITS ADVANCED CONTROL FORMULARY™

The Advanced Control Formulary™ for Teachers Health Trust is a guide within select therapeutic categories for clients, plan members and health care providers. Generics should be considered the first line of prescribing. If there is no generic available, there may be more than one brand-name medicine to treat a condition. These preferred brand-name medicines are listed to help identify products that are clinically appropriate and costeffective. Generics listed in therapeutic categories are for representational purposes only. This is not an allinclusive list. This list represents brand products in CAPS, branded generics in upper- and lowercase italics, and generic products in lowercase italics. Your benefit plan provides you with a prescription benefit program. Ask your doctor to consider prescribing, when medically appropriate, a preferred medicine from this list. Take this list along when you or a covered family member sees a doctor.

• Your administrator may contact your doctor after receiving your prescription to request consideration of a drug list product or generic equivalent. This may result in your doctor prescribing, when medically appropriate, a different brand-name product or generic equivalent in place of your original prescription. • In most instances, a brand-name drug for which a generic product becomes available will be designated as a nonpreferred option upon release of the generic product to the market. See the full list at teachershealthtrust.org under Participants - Plan Benefits.

REDUCTION OF OUT-OFPOCKET COSTS FOR PRESCRIPTIONS

Throughout 2016, the most passionate feedback that the Trust received with respect to desired benefit changes was related to the out-of-pocket costs for prescription drugs.

Please note: • Your specific prescription benefit plan design may not cover certain products or categories, regardless of their appearance in this document. Products recently approved by the U.S. Foodand Drug Administration (FDA) may not be covered upon release to the market.

The Trust took your concerns to heart and spent the better portion of the year determining how these costs could be brought down. The Trust is happy to state that we were successful in this endeavor, and were able to reduce the maximum out-ofpocket costs by 50 percent for four tiers of prescription drugs:

• Your prescription benefit plan design may alter coverage of certain products or vary copayment amounts based on the condition being treated.

Retail 30-Day Prescriptions Generic medications over $25 out-ofpocket maximums have been reduced from $100 to $50.

• You will be responsible for the full cost of products that are excluded from coverage.

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SPRING 2017 | HEALTH TRAXX TEACHERSHEALTHTRUST.ORG

Preferred formulary out-of-pocket maximums have been reduced from $200 to $100.

Mail Order 90-Day Prescriptions Generic medications over $25 out-of-pocket maximums have been reduced from $300 to $150. Preferred formulary out-ofpocket maximums have been reduced from $600 to $300.

EMERGENCY DRUG LIST

In 2016, we saw astronomical increases to emergency drugs such as the Epi-Pen. While the Trust had no control over these increases, it has been determined that these drugs could be added into a separate formulary tier in order to reduce your out-ofpocket costs. The following prescription drugs were added to the formulary for 2017 with an out-of-pocket maximum of $100: • Epi-Pen • Epi-Pen Jr. • Glucagon Emergency Kit • Narcan Nasal Spray


FEATURES The final decision on which drug you receive is up to your doctor. Therefore, you should always review your prescriptions with your physician to determine if there is an alternative drug that may be available at a lower cost to you. A formulary list is available at teachershealthtrust.org.

VACATION REFILLS

If you will require your medication while traveling, you may fill an additional 30-day supply through a retail pharmacy one time per calendar year.

HOW TO USE AN IN-NETWORK RETAIL PHARMACY

Filling your prescription is easy. Present your Trust ID card to the In-Network Pharmacy and pay the appropriate copayment per prescription. There is no claim form to complete. If your physician prescribes your medications as “dispense as written” when there may be a lower cost preferred drug or a generic equivalent, the pharmacist may call your doctor to discuss other dispensing options.

Your benefits under the Performance Plus Plan also include coverage for both generic and brand-name prescription drugs obtained in one of three ways: at exclusive in-network retail pharmacies, at all other in-network retail pharmacies or through WellDyne Rx Mail Order or Specialty Program.

DIFFERENCES BETWEEN GENERIC & PREFERRED DRUGS Generic drugs contain the same active ingredients as—and is equivalent in strength and dosage to—the original brand-name drug. Preferred drugs have been carefully selected based on their clinical effectiveness and cost savings to you and the Trust. The copayments for preferred drugs are lower than the copayments for non-preferred drugs. A list of preferred drugs is sometimes known as a formulary. Non-preferred drugs are not on the preferred drug list. The copayments for non-preferred drugs are higher than the copayments for preferred drugs.

EXCLUSIVE, IN-NETWORK & NON-PREFERRED RETAIL PHARMACIES Exclusive pharmacies, which are contracted, include CVS, Walmart, Sam’s Club, Von’s and Lin’s Supermarket (Overton, NV). A complete list including preferred and non-preferred retail pharmacies is available on MedImpact’s website at mp.medimpact.com. MAIL ORDER PHARMACY A pharmacy owned and operated by WellDyne Rx is used primarily for filling maintenance medication for treatment of ongoing health conditions,such as high blood pressure. All medications are delivered, postage paid, to your home. NON-PREFERRED PHARMACIES Non-preferred pharmacies are covered at the same price, but also have the Pharmacy Choice Fee.

PCMH REMINDER Please remember that you can change your provider once per quarter. You can request a change by reaching out to your Healthcare Advocate at 855-404-9355, or by downloading the form from teachershealthtrust. org and emailing it to advocates@ wellhealthqc.com. Any changes made will be reflected July 1.

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&

Asthma sulfite Allergies

S

ulfites are a common additive that is in many foods and drugs; they help extend the shelf life. However, around 10 percent of people have been diagnosed with asthma and an allergy to sulfites, which may be life threatening. There are five common foods that many people do not realize have sulfites. If ingested by someone with asthma and an allergy, it could potentially trigger anaphylactic shock.

DRIED FRUIT

SOME TOPPINGS

WINE OR BEER

Most kinds of dried fruit include sulfites to preserve and stretch out the lifetime of the food. The additive potassium bisulfite or sodium sulfite printed on the package is a warning sign because these are some of the most problematic additives to those suffering from asthma.

Pickles, relishes, some salad dressing mixes, horseradish sauce and sauerkraut all contain sulfites as a preservative. Indulging in these foods may trigger your symptoms.

You guessed it; sulfites are why these adult beverages ended up on the list. Research has also linked beer and wine to wheezing, sneezing and occasional watery eyes to asthmatics.

PACKAGED POTATOES Take the extra time to wash and peel your own potatoes for dinner. If you read through the ingredients on packaged potatoes, you will spot more preservatives that can cause an issue, particularly sodium bisulfite.

SHRIMP Whether it is frozen or prepared, sulfites are used to discourage growth of black spots. These sulfites are not healthy for anyone with asthma.

Check the labels on your foods. Talk to your doctor if you have asthma, and ask for a test called a controlled sulfite challenge. This can help you determine if you have an allergy to sulfites. Happily, according to federal law, sulfites cannot be added to foods that are intended to be eaten raw, such as fruits and vegetables.

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IN-NETWORK SPOTLIGHT ABOUT In 1958, Dr. Leon Steinberg came to Las Vegas to help Sunrise Hospital build the first radiology center in Southern Nevada. Through his experience in the hospital setting, he saw a need for a more patient-friendly option for medical imaging, so he struck out to build such a practice. With his son, David, and Dr. Mark Winkler as his partners, Dr. Leon opened the first SDMI office in 1988. Their standards of excellence in patient care and in technology have brought national and international recognition from the medical imaging and health care communities. SDMI is designated as a Diagnostic Imaging Center of Excellence by the American College of Radiology, its highest honor. The practice has also submitted voluntarily to the Accreditation Association for Ambulatory Health Care (AAAHC) to give you, the patient, the utmost confidence in SDMI’s ability to provide you with the appropriate and highest quality of healthcare possible.

THE BENEFIT - RADIOLOGY/DIAGNOSTIC FREESTANDING DIAGNOSTIC FACILITY $0 copayment (deductible does not apply)

HOSPITAL/FACILITY

20% coinsurance (deductible does not apply) Radiology coinsurance only applies when facility copayment does not

PCP OFFICE

ALL OTHER IN-NETWORK PROVIDERS

20% coinsurance with a referral (deductible does no apply); 20% coinsurance after $600 deductible without a referral

OUT-OF-NETWORK

40% coinsurance after deductible, plus any charges over Eligible Medical Expenses*

20% coinsurance X-rays of chest, spine, pelvis and extremities, abdomen; ultrasound of abdomen, dexa bone density (deductible does not apply) All other radiology services in PCP office are not covered

LOCATIONS NORTHWEST •

2767 N Tenaya Way Las Vegas, NV 89128

6925 N Durango Dr Las Vegas, NV 89149

SOUTHWEST •

9070 W Post Road Las Vegas, NV 89148

PARADISE •

2950 S Maryland Pkwy Las Vegas, NV 89109

HENDERSON •

2850 Siena Heights Dr Henderson, NV 89052

4 Sunset Way Bldg D Henderson, NV 89014

DOWNTOWN •

800 Shadow Lane Las Vegas, NV 89106 SPRING 2017 | HEALTH TRAXX TEACHERSHEALTHTRUST.ORG

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Register Online

When you register online, you’ll have access to all your benefits information, a pharmacy locater, a medication pricing tool, and health and wellness tips. We’ll also be able to quickly let you know about any changes you need to be aware of in your plan or drug information. It’s easy to register!

Ready to get started? Just follow the steps below. 1

Go to www.WellDyneRx.com. Click on “Member Registration.”

2

Enter your plan information.

3

Set up your account profile.

4

Let us know about any allergies or health conditions.

5

If you will be using our Prescription Delivery Service, provide a payment method (credit, debit, FSA or HSA card) to speed up the ordering process.

Get Started! If you have questions, please visit www.WellDyneRx.com or call the Member Services number shown on your member ID card. www.WellDyneRx.com WDRx.MC-E.COFL.2104

SPRING 2017 | HEALTH TRAXX TEACHERSHEALTHTRUST.ORG

9.2016 ©WellDyneRx


is

MOM

I

BRAIN real?

f you have ever poured yourself a glass of water, only to see you are holding a bowl, or walked into a room and not remembered why you are there, you may have mom brain.

There are two theories based around mom brain. The first is that priorities are changed, which is an understatement when adding a new member to your family. With the stress from the changes and lack of sleep, it is no wonder you start to forget things. The second theory is that your hormones have decided to throw a party and not invite you.

Studies have shown that there are 15-40 times more progesterone and estrogen in the brain during pregnancy. You also have to remember the heightened love hormone, oxytocin. You are constantly pre-occupied with how much love you have, and if you are breastfeeding, the hormones do not settle until a few months after you stop.

FORGETFULNESS

You may forget what you said just seconds ago or what someone just said to you. You could also forget what you were supposed to be doing or what you just finished doing. It should pass, but in the meantime, you can keep a notebook with you and write things down. You can also set reminders on your phone that beep when it is time to complete tasks.

EMOTIONAL WRECK

Mom brain can also cause constant irrational crying, frustration and an emotional roller coaster during and after pregnancy. It is not something that you can control, so it is best to surround yourself with a caring village and not be afraid to take stock in tissues and time with friends.

YOUR FOCUS IS NONEXISTENT

A woman walks into a room. I know, it is not time for jokes. In fact, focus is the number one complaint of mom brain, and it is okay because your tiny human takes enough focus for five people’s brains combined. Just laugh, and one day your focus will return. Overall, mom brain is brought on by lack of sleep, which is not something you receive a lot of in the early days. Remember to sleep when you can, and when you are ready, begin physical activity including yoga and meditation, which aid in focus and centering.

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3

1

metabolism jumpstart

Immunity Boost 2 glowy skin aiding 4 digestion ½ grapefruit, sliced

A few sprigs of rosemary 2 strawberries, sliced

4-6 strawberries, hulled and quartered ½ lemon, sliced

Small handful of basil, scrunched

2 oranges, sliced

Handful of organic blueberries

Small handful of sliced ginger 2 pears, sliced

QUICK COOKING You’ve heard that you need to drink half your body weight in ounces a day to maintain your health. For some, the thought of drinking water is daunting because they don’t like the taste. However, water helps our digestion, skin, nails, energy levels and more. For each recipe, alternate layers of ice and fruit, and then pour in water. Let sit for 45 minutes and drink throughout the day.

5 slow aging Handful of organic raspberries 2 limes, sliced 2 mangoes, sliced

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Teachers Health Trust Health Traxx: Volume 16 | Issue 2 | Spring 2017  

A quarterly publication by the Teachers Health Trust.

Teachers Health Trust Health Traxx: Volume 16 | Issue 2 | Spring 2017  

A quarterly publication by the Teachers Health Trust.

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