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Blue & You - Summer 2015

Are Vaccines Safe? - p5 Do you have a family doctor? - p6 Mending Jaxon’s Heart - p10 Financial Privacy Information - P18

Are Vaccines Safe? - p5
Do you have a family doctor? - p6
Mending Jaxon’s Heart - p10
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<strong>Summer</strong><br />

<strong>2015</strong><br />

A publication for the policyholders of the Arkansas <strong>Blue</strong> Cross and <strong>Blue</strong> Shield family of companies<br />

Communities all across<br />

Arkansas are enjoying<br />

new facilities for running,<br />

walking and even<br />

hiking thanks to the<br />

generosity of the<br />

<strong>Blue</strong> & <strong>You</strong> Foundation<br />

for a Healthier Arkansas.<br />

Are Vaccines<br />

Safe?<br />

page<br />

5<br />

Mending<br />

Jaxon’s Heart<br />

page<br />

10<br />

Financial Privacy<br />

Information<br />

page<br />

18


3 - Out of the <strong>Blue</strong><br />

12 - “Hit the Trail” with the<br />

<strong>Blue</strong> & <strong>You</strong> Foundation<br />

4 - Be part of the community immunity<br />

- Get immunized at zero cost<br />

- Get ready for the trails<br />

5<br />

6<br />

7<br />

8<br />

9<br />

10<br />

- Are vaccines safe?<br />

- Do you have a family doctor?<br />

- Welcome to Advantage Primary Care<br />

- Get immediate access to your health<br />

care information through My <strong>Blue</strong>print<br />

- Geo<strong>Blue</strong> – Take <strong>Blue</strong> with you!<br />

- Another way to buy diabetic supplies<br />

- Living Fearlessly: Mending Jaxon’s heart<br />

Jaxon McGarrah plays with his mother, Ashley McGarrah. Read how<br />

this family has handled his congenital heart defect with the help of<br />

Arkansas <strong>Blue</strong> Cross on page 10.<br />

14<br />

16<br />

17<br />

18<br />

19<br />

20<br />

- National Walk @ Lunch Day!<br />

- Central Arkansas Heart Walk<br />

- Arkansas needs more nurses<br />

- Arkansas Arts Center’s Children’s Theatre<br />

- Arkansas <strong>Blue</strong> Cross and <strong>Blue</strong> Shield<br />

Financial Information Privacy Notice<br />

- Customer Service Numbers<br />

- Boo with <strong>Blue</strong>!<br />

<strong>Summer</strong><br />

<strong>2015</strong><br />

EDITOR: Jennifer Gordon – bnyou-ed@arkbluecross.com • DESIGNER: Ryan Kravitz • PHOTOGRAPHER: Chip Bayer<br />

CONTRIBUTORS: Chip Bayer, Ben McVay and Alex Roberts VICE PRESIDENT of CORPORATE MARKETING: Karen Raley<br />

DIRECTOR of CORPORATE MARKETING: Kelly Whitehorn<br />

BLUE & YOU <strong>Summer</strong> <strong>2015</strong><br />

on the<br />

cover<br />

Walkers enjoy one of 15 trails and tracks funded by<br />

the <strong>Blue</strong> & <strong>You</strong> Foundation. See more on page 12.


For nearly 70 years, Arkansas <strong>Blue</strong> Cross and<br />

<strong>Blue</strong> Shield has been trusted by Arkansans for<br />

affordable and reliable health insurance coverage,<br />

and it’s our privilege to count one in three people<br />

in our state as customers. Included in that number<br />

are thousands of individuals who gained coverage<br />

through the expansion of Medicaid—called the<br />

Private Option—made possible by the Affordable<br />

Care Act (ACA).<br />

This summer, a task force composed of members<br />

of the Arkansas Legislature is working to determine<br />

the future of this program, as well as the way<br />

we manage care for other low-income and more<br />

vulnerable residents of our state, such as people with<br />

disabilities. Because of our long history in Arkansas<br />

and the role we’ve played in implementing the<br />

federal requirements of the ACA, we have a unique<br />

perspective on the challenges and opportunities<br />

faced by the Health Care Reform Task Force as they<br />

work to improve our health care system.<br />

As the task force continues its important work,<br />

I encourage its members to consider several<br />

important points:<br />

1. It is hard to argue that Medicaid expansion<br />

hasn’t been good for the state. It has created<br />

jobs for many Arkansans, including 200 new<br />

positions at Arkansas <strong>Blue</strong> Cross. It has injected<br />

a billion federal dollars into our local economy<br />

and the impact will be multiplied the way all<br />

such infusions are. It has helped hospitals in<br />

the state get on more solid financial footing<br />

by dramatically decreasing the amount of<br />

uncompensated care they provide, and taken<br />

the pressure off of taxpayers who otherwise<br />

foot the bill for the uninsured who are forced to<br />

get their health care at the emergency room.<br />

Even when the state begins to absorb 10<br />

percent of the cost of the program in 2020 — an<br />

important and central issue in the debate about<br />

its continuation — it’s important to remember<br />

that Arkansas will be getting nine dollars back<br />

in economic benefit for every one dollar we<br />

invest. Not a bad return on investment. Let’s<br />

make sure that all Arkansans continue to<br />

benefit from this kind of economic boon by<br />

supporting some form of coverage expansion.<br />

2. We hope legislators look toward a free<br />

enterprise solution – one that is not overly<br />

controlled by the federal government and one<br />

that allows the market to provide Arkansans<br />

with high-quality, cost-efficient health coverage.<br />

Lawmakers took an enterprising approach<br />

when crafting the private option and many have<br />

since noted opportunities for improvement. An<br />

example would be removing incentives to drive<br />

unnecessary costs. Currently, the Private Option<br />

does not require patients to pay a copayment<br />

for a visit to the emergency room (a very<br />

expensive place to receive care). Yet the Private<br />

Option does require policyholders to pay a<br />

copayment when they visit a family practice<br />

doctor (a very affordable and usually more<br />

appropriate place to receive care). Commonsense<br />

solutions that address issues like these<br />

will go a long way in achieving real cost savings<br />

for the program, while giving people greater<br />

incentives for taking personal responsibility<br />

and making better health care choices. That’s<br />

how private business manages cost and this<br />

program should, too.<br />

At the same time, free markets recognize that<br />

doctors and hospitals will not provide medical<br />

services if they cannot cover their costs and<br />

make a reasonable margin. For too long, our<br />

members, as well as other Arkansans who have<br />

commercial insurance, have paid a “hidden<br />

tax” that is included in their health insurance<br />

premiums. This hidden tax takes the form of<br />

doctors and hospitals charging more than is<br />

required to cover the care of commercially<br />

“OUT OF THE BLUE”<br />

Continued on page 19<br />

<strong>Summer</strong> <strong>2015</strong> BLUE & YOU


Be part<br />

Community<br />

of the<br />

The recent multi-state outbreak<br />

of measles sparked concern<br />

about when — and if — people<br />

are getting immunizations. In<br />

2000, the Centers for Disease<br />

Control and Prevention (CDC)<br />

declared that the measles virus<br />

had been removed from the<br />

United States as it no longer<br />

had a constant presence in<br />

the country. But, communities<br />

of people who refuse to<br />

vaccinate are leaving the<br />

nation vulnerable to the<br />

re-establishment of the<br />

measles and other viruses.<br />

When a critical portion of a<br />

community is immunized<br />

against a contagious disease,<br />

most members of the<br />

community are protected<br />

against that disease because<br />

there is little opportunity for<br />

an outbreak. Even those<br />

who are not eligible for<br />

Immunity<br />

certain vaccines — such as<br />

infants, pregnant women,<br />

or people who have weak<br />

immune systems — get<br />

some protection because the<br />

spread of contagious disease<br />

is contained. This is known as<br />

“community immunity.”<br />

In the illustration to the right,<br />

the top box depicts a community<br />

in which no one is immunized<br />

and an outbreak occurs. In<br />

the middle box, some of the<br />

population is immunized but not<br />

enough to establish community<br />

immunity. In the bottom box, a<br />

critical portion of the population<br />

is immunized, protecting most<br />

community members.<br />

The principle of community<br />

immunity applies to control<br />

of a variety of contagious<br />

diseases, including the flu, measles,<br />

mumps, a stomach virus called<br />

rotavirus and types of pneumonia.<br />

“Unless your child has an<br />

immune deficiency as noted<br />

by his or her physician, a<br />

decision not to immunize your<br />

child is really a decision to<br />

allow your child to get one of<br />

these dreaded and potentially<br />

disabling or deadly diseases,”<br />

said Robert Griffin, senior vice<br />

president and chief medical<br />

officer for Arkansas <strong>Blue</strong> Cross<br />

and <strong>Blue</strong> Shield. “Early in my<br />

medical career I took care of<br />

many of these children who<br />

were institutionalized due to the<br />

complications of conditions that<br />

could be prevented today. Sadly,<br />

these illnesses appear to be<br />

returning as parents choose not<br />

to immunize their children.”<br />

<strong>Blue</strong> Cross and <strong>Blue</strong> Shield and its family of companies just made life a<br />

little easier. If you, or your dependents, are under age 65, you now can get important<br />

immunizations at your local pharmacy for no cost. Check out our list of vaccines and visit<br />

your local pharmacy for a fast, free vaccination. Here are some perks for going to your<br />

pharmacist for vaccinations:<br />

Prevent serious diseases<br />

Skip the waiting room<br />

Get immunized<br />

No doctor’s appointment necessary Zero cost to you<br />

at<br />

Don’t wait! Talk to your pharmacist today about the immunizations that may benefit you.<br />

get immunized<br />

zero{Arkansas<br />

It’s less expensive to prevent a disease than to treat one.<br />

cost Immunizations protect you from serious diseases and<br />

prevent the spread of others. By offering immunizations<br />

at the pharmacy, Arkansas <strong>Blue</strong> Cross makes it easier for<br />

you and your family to be immunized.<br />

4 BLUE & YOU <strong>Summer</strong> <strong>2015</strong><br />

This service is not available to members with Medicare health plans.<br />

If you are covered under a self-funded health plan administered by<br />

<strong>Blue</strong>Advantage Administrators of Arkansas, you should check with your<br />

plan administrator to find out if these benefits are available to you.<br />

Members with Medi-Pak<br />

Advantage and Medi-Pak<br />

supplement health plans<br />

have different benefits<br />

for immunizations that<br />

may not include 100<br />

percent coverage. Please<br />

call customer service for<br />

more information.


ARE VACCINES<br />

SAFE?<br />

Absolutely. Rumors linking<br />

vaccines to autism or autism<br />

spectrum disorder (ASD) likely<br />

began because symptoms of<br />

ASD typically appear in the<br />

second year of life, not long after<br />

vaccines are given. While the<br />

environmental causes of ASD<br />

are largely unknown, studies<br />

by the Institute of Medicine<br />

and the American Academy of<br />

Pediatrics, among others, have<br />

specifically shown that there<br />

is no relationship between<br />

vaccines and autism. The<br />

medical community considers<br />

vaccines to be very safe. The<br />

most common side effects are<br />

fever and mild rash.<br />

GET VACCINATED<br />

If you or your children aren’t<br />

vaccinated, you can get the<br />

vaccinations listed below for<br />

free at your local pharmacy.<br />

It’s never too late.<br />

Source: cdc.gov<br />

Visit your local pharmacy<br />

vaccines*<br />

Haemophilus Influenzae Type b (Hib)<br />

Hepatitis A<br />

Hepatitis B<br />

Herpes Zoster / Shingles<br />

Human Papillomavirus (HPV)<br />

Inactivated Poliovirus (polio)<br />

Influenza (flu)<br />

Children<br />

Adults<br />

Measles, Mumps, Rubella (MMR)<br />

Meningococcal<br />

Pneumococcal<br />

Rotavirus<br />

Tetanus<br />

Tetanus, Diphtheria and Pertussis (Tdap)<br />

Varicella (chickenpox)<br />

* Pharmacists in Arkansas can vaccinate children age 7 and older. Those between the ages of 7 and 18<br />

require a prescription from a physician for all immunizations except for the seasonal flu shot.<br />

<strong>Summer</strong> <strong>2015</strong> BLUE & YOU<br />

5


Do you have a<br />

family<br />

doctor?<br />

At Arkansas <strong>Blue</strong> Cross and <strong>Blue</strong> Shield, we want you to pick a<br />

family doctor to oversee your health. In fact, studies have shown<br />

that people with a family doctor have lower overall health care<br />

costs and are happier with their care.<br />

Why is this important now?<br />

In the past, you may never have had any problems<br />

finding a doctor. However, after the new health care law<br />

passed, thousands of Arkansans signed up for health<br />

insurance for the very first time. This made an already<br />

crowded health care system even more crowded.<br />

Arkansas <strong>Blue</strong> Cross wants to make sure you have a family<br />

doctor (or other primary care doctor, like a pediatrician<br />

or internist). If you’ve already chosen a family doctor, we<br />

would like to say thank you. <strong>You</strong>’ve taken an important step<br />

in staying healthy.<br />

To select a family doctor:<br />

• Go to the website for your health plan:<br />

arkansasbluecross.com, healthadvantage-hmo.com<br />

or blueadvantagearkansas.com.<br />

• Go to the “Members” drop-down menu at the top<br />

of the page and select “Find a Doctor.”<br />

• Enter your member ID number or the type of<br />

health plan you have.<br />

• Choose to search by doctor’s name, location,<br />

specialty or hospital affiliation.<br />

When you have selected a family doctor, call and<br />

let us know, and we will update our records.<br />

1.<br />

3 REASONS<br />

to have a family doctor<br />

A family doctor may help improve<br />

your health. <strong>You</strong>r family doctor<br />

will make sure you and your family<br />

get the care you need, including<br />

checkups to keep you healthy.<br />

2.<br />

A family doctor may help you<br />

lower your out-of-pocket costs.<br />

Getting care from a family doctor<br />

is a smart way to spend your<br />

money on health care.<br />

3.<br />

A family doctor can save you time.<br />

No more waiting in a crowded<br />

emergency room when you’re sick!<br />

6 BLUE & YOU <strong>Summer</strong> <strong>2015</strong>


welcome to<br />

Advantage Primary Care is a new<br />

primary care clinic in Lowell that<br />

provides health care exclusively for<br />

members of Arkansas <strong>Blue</strong> Cross and<br />

<strong>Blue</strong> Shield and its family of companies.<br />

Washington Regional Medical Center<br />

staffs and operates the new clinic.<br />

Advantage Primary Care is a patientcentered<br />

medical home (PCMH). That<br />

means the medical team will identify<br />

services needed to improve your health<br />

and treat you as an individual. Patientcentered<br />

medical homes equip patients<br />

with the knowledge and tools they need<br />

to proactively manage their conditions<br />

and limit acute health care problems.<br />

They use evidence-based guidelines to<br />

drive care and track treatment results to<br />

improve patients’ care and experience.<br />

At Advantage Primary Care you get<br />

more one-on-one time with the<br />

physician, you can schedule same-day<br />

appointments when you are sick and<br />

the clinic offers flexible, convenient<br />

early morning and evening hours. If you<br />

currently don’t have a family doctor and<br />

live in the Lowell area, give Advantage<br />

Primary Care a try.<br />

Advantage Primary Care<br />

507 W. Monroe, Suite A<br />

Lowell, AR 72745<br />

479-463-8150<br />

We apologize for the inconvenience, but Arkansas<br />

<strong>Blue</strong> Cross Medicare members are not able to<br />

schedule visits at the clinic because the Centers<br />

for Medicare & Medicaid Services (CMS) requires<br />

that any provider clinic accepting Medicare<br />

patients must see Medicare patients with any<br />

health insurance carrier. For Advantage Primary<br />

Care to remain exclusive to Arkansas <strong>Blue</strong><br />

Cross members, the clinic is unable to accept<br />

appointments with Medicare members.<br />

<strong>Summer</strong> <strong>2015</strong> BLUE & YOU<br />

7


Get immediate access to your<br />

health care<br />

information<br />

through My <strong>Blue</strong>print<br />

My <strong>Blue</strong>print, our personalized<br />

member self-service center,<br />

is your fastest way to access<br />

information regarding your<br />

health care coverage —<br />

and now it’s even faster.<br />

When members registered<br />

for My <strong>Blue</strong>print before, they<br />

had to wait to gain full access<br />

to their information. Our new<br />

process allows you to have<br />

immediate access to all of the<br />

resources in our self-service<br />

center but still protects<br />

your personal health<br />

care information.<br />

“As we are evaluating our<br />

websites and identifying<br />

pain points for our members,<br />

this was an obvious area we<br />

could improve our members’<br />

experience,” said Trey Hankins,<br />

manager of eMarketing for<br />

Arkansas <strong>Blue</strong> Cross and <strong>Blue</strong><br />

Shield. “When someone registers<br />

for a website, their expectation<br />

is to have immediate access<br />

to the information they need.<br />

By removing the activation<br />

process, we’re meeting<br />

those expectations.”<br />

When you register for My <strong>Blue</strong>print you now get immediate<br />

access to the following:<br />

• claims history<br />

• benefits and coverage information<br />

• the ability to review your recent doctors’ visits<br />

• your personal health record<br />

• a tool to estimate your treatment costs<br />

• customer service functions<br />

• health resources<br />

All it takes to get complete access is your member ID card and a<br />

few minutes to create the account information. After you register,<br />

you will immediately receive an email confirming your registration.<br />

A letter will be sent to your home a few days later. If you did not<br />

register for My <strong>Blue</strong>print and you receive an email or letter saying<br />

you have, please contact Customer Service immediately.<br />

<strong>You</strong> even can access My <strong>Blue</strong>print on your phone and view<br />

your claims, your mobile ID card and who is covered on your<br />

plan. If you haven’t registered for My <strong>Blue</strong>print, do it today.<br />

8 BLUE & YOU <strong>Summer</strong> <strong>2015</strong><br />

This service is not available to members with Medicare health plans.


Take <strong>Blue</strong> with you!<br />

If you’re traveling abroad this summer, you can take peace of mind with you in the form of<br />

Geo<strong>Blue</strong> — the newly offered health insurance for international travelers. Geo<strong>Blue</strong> health<br />

plans cover short- and long-term trips and are perfect for:<br />

Business and leisure travelers<br />

Students<br />

Expatriates<br />

Mariners<br />

Groups<br />

Missionaries<br />

Travelers don’t have to be enrolled in an Arkansas <strong>Blue</strong> Cross and <strong>Blue</strong> Shield medical plan to<br />

sign up for Geo<strong>Blue</strong>. <strong>You</strong> can get coverage the day before you travel and keep it for however<br />

long or short your trip may be. As a Geo<strong>Blue</strong> member, you’ll receive lots of perks and have access to:<br />

• English-speaking doctors in 180 countries • Comprehensive coverage<br />

• Concierge support and tools to manage care • Emergency medical evacuation<br />

Pleasantly affordable and with low deductibles, you can take <strong>Blue</strong> with you wherever you go!<br />

To learn more about Geo<strong>Blue</strong>, go to arkansasbluecross.com, select “Looking for Insurance” and<br />

choose “Health Plans for Travelers.”<br />

Another way to buy diabetes supplies<br />

Arkansas <strong>Blue</strong> Cross and its family of<br />

companies have added another way for<br />

members with diabetes to purchase certain<br />

supplies. With a prescription from your<br />

physician, you now can buy diabetes test<br />

supplies at your local pharmacy. The supplies<br />

will be available at a preferred copayment<br />

amount or the cost will count toward<br />

your overall deductible and out-of-pocket<br />

maximum (depending on your coverage).<br />

• Meters (OneTouch brand)<br />

• Test strips (OneTouch brand)<br />

• Syringes • Lancets • Needles<br />

<strong>You</strong>r local pharmacist is a good resource<br />

for questions about medicine and supplies.<br />

Next time you need to refill your supplies,<br />

remember to visit your local pharmacy and<br />

bring your member ID card.<br />

Happy with how you get supplies?<br />

Other options for diabetes supplies are still available<br />

to you! Nothing changes if you order diabetes supplies<br />

from a durable medical equipment provider, or if you’re a<br />

member of the Diabetes Health Education program. <strong>You</strong> can<br />

continue to get your strips, lancets and other supplies the<br />

same way. The option to purchase at your local pharmacy<br />

is just another outlet to make buying diabetes testing<br />

supplies more convenient for our members.<br />

For a free One Touch meter,<br />

contact onetouch.orderpoints.com<br />

(Redemption code: BCBSAR708)<br />

or call 1-800-588-4456.<br />

If you are covered under a self-funded health plan administered by<br />

<strong>Blue</strong>Advantage Administrators of Arkansas, you should check with your<br />

plan administrator to find out if these benefits are available to you.<br />

OneTouch is owned by Johnson & Johnson, an independent<br />

company that provides diabetes meters to qualifying members<br />

of Arkansas <strong>Blue</strong> Cross and our family of companies.<br />

Members with Medi-Pak<br />

Advantage and Medi-Pak<br />

supplement health plans have<br />

different benefits for diabetes<br />

supplies. Please call customer<br />

service for more information.<br />

<strong>Summer</strong> <strong>2015</strong> BLUE & YOU<br />

9


Living Fearlessly:<br />

Jaxon<br />

mending<br />

’ s<br />

heart<br />

Jaxon “Jax” McGarrah’s big grin and twinkling eyes<br />

make it hard to believe this little boy was ever<br />

anything but the picture of health, but the pale pink<br />

scar down his chest is proof of a medical journey he<br />

and his family began long before he was even born.<br />

And, since his birth, Arkansas <strong>Blue</strong> Cross and <strong>Blue</strong><br />

Shield has been helping the McGarrahs, through the<br />

guidance of Crystal Stanfield, a nurse case manager<br />

who specializes in pediatric conditions.<br />

“Having Arkansas <strong>Blue</strong> Cross has been a blessing<br />

in several ways,” Ashley said. “From people like<br />

Crystal to call with questions, the Personal Health<br />

Statements we get in the mail, to knowing that<br />

most doctors and hospitals take Arkansas <strong>Blue</strong><br />

Cross; all this takes stress off of me so I can focus<br />

on Jax and my family.”<br />

Twenty-one weeks into her pregnancy, Ashley went<br />

for a routine ultrasound — a screening most parents<br />

associate with getting to see their baby for the first<br />

time and maybe learning their child’s gender.<br />

During the ultrasound, however, it became clear<br />

that Jax’s heart wasn’t developing properly.<br />

Ashley’s doctor told her she would need to see<br />

doctors in Little Rock throughout her pregnancy<br />

and for the safe delivery of her son.<br />

While learning of Jax’s condition early in the<br />

pregnancy was terrifying for Ashley and Rick, her<br />

husband, it gave them much-needed time to become<br />

more familiar with Jax’s condition. They learned from<br />

a pediatric echocardiogram that Jax had tricuspid<br />

atresia, a problem with the right side of the heart,<br />

which is supposed to push blood to the lungs.<br />

Without the valve working properly, Jax’s blood<br />

wouldn’t be able to pick up oxygen in his lungs once<br />

he was born.<br />

Ashley settled into a routine of visiting once a<br />

month with an obstetrics doctor in Little Rock at the<br />

University of Arkansas for Medical Sciences (UAMS).<br />

On March 21, 2014, Ashley was given a cesarean<br />

(C-section) and Jax was immediately whisked away<br />

to Arkansas Children’s Hospital. Rick gave her the<br />

news that Jax’s oxygen level was good and he didn’t<br />

need immediate surgery or medications.<br />

That’s when Crystal began following the McGarrah<br />

family. As a pediatric nurse case manager, she<br />

checks the roster at Arkansas Children’s Hospital and<br />

contacts families who may need help.<br />

‘‘<br />

–<br />

Having Arkansas <strong>Blue</strong> Cross<br />

has been a blessing in several ways.<br />

Ashley McGarrah<br />

Crystal met with the McGarrahs to see if they needed<br />

anything and to answer questions they might have.<br />

An echocardiogram showed that the hole in the right<br />

chamber of the heart had started to close. He would<br />

have to have surgery eventually, but didn’t need it<br />

immediately.<br />

“They said if we could get him to eat we could go<br />

home instead of having surgery,” Ashley said. While<br />

the McGarrahs went back to Rogers with Jax, Ashley<br />

said she stayed in contact with Crystal and had her<br />

number on the refrigerator and in her purse.<br />

“I knew I could always pick up the phone and call<br />

Crystal,” she said.<br />

Jax did terrific at home until July 4, 2014, when he<br />

spiked a fever. After an ambulance ride to Little Rock,<br />

it was determined that he had a virus, but it was also<br />

time for him to have surgery on his heart.<br />

“July 17, 2014, was the hardest day of our lives,”<br />

Ashley wrote on Jax’s Facebook page, “I Heart Jax.”<br />

“We had to let Jax go, not knowing if he would make<br />

it through surgery.”<br />

Jax was born with two superior vena cava, a large<br />

vein that brings blood from the upper part of the<br />

body to the heart. Usually a person only has one.<br />

‘‘<br />

10 BLUE & YOU <strong>Summer</strong> <strong>2015</strong>


The heart of the matter<br />

Congenital heart defects are the most common<br />

birth defect, and the leading cause of birth defectrelated<br />

deaths worldwide.<br />

• One in every 125 babies is born with a CHD<br />

every year in the United States alone.<br />

• CHDs are 60 times more prevalent than<br />

childhood cancer.<br />

• 18 distinct types of congenital heart defects<br />

are recognized.<br />

• In the past 25 years, advances in the treatment<br />

of heart defects have enabled half a million<br />

U.S. children with serious CHDs to survive<br />

into adulthood.<br />

• Many heart defects can be detected by a<br />

routine ultrasound.<br />

Source: American Heart Association, heart.org<br />

What is case management?<br />

When you need it, case management is a powerful<br />

tool that can help you navigate the health care system.<br />

The registered nurses in our case management<br />

programs are required to have at least three years<br />

of clinical practice. Case managers can help you:<br />

• Maximize your health plan benefits.<br />

• Learn about your condition through<br />

health education.<br />

• Better understand and deal with the<br />

complexities of the health care system.<br />

• Identify less costly alternatives to expensive<br />

treatment settings, such as hospitalization.<br />

If you think case management could help you with<br />

a health condition, call the Arkansas <strong>Blue</strong> Cross<br />

office closest to you (see page 19).<br />

During the surgery the doctors<br />

had to move these veins from<br />

the heart and attach them to the<br />

pulmonary artery, making the<br />

blood go directly to his lungs to<br />

get oxygen. He will need to have<br />

a similar surgery for the vein from<br />

his lower body in the future.<br />

Crystal stayed with the McGarrahs<br />

during the surgery. “She hung out<br />

with us and it was great,” Ashley<br />

said. “It was very relieving and<br />

comforting to have a pediatric<br />

nurse there who could answer<br />

questions we had.”<br />

Jax made it through the<br />

surgery, but the next day he had<br />

complications. “We were at<br />

dinner when we got a call from<br />

the cardiologist,” Ashley said.<br />

They were told that the first<br />

surgery went well, but the<br />

pressure in his head was too<br />

high, which was causing swelling.<br />

The surgeons had to put bands<br />

around his pulmonary artery to<br />

restrict the blood flow and even<br />

out the pressure. Jax’s second<br />

surgery went smoothly and within<br />

a week they were headed back<br />

to Rogers. In August, Jax saw his<br />

pediatrician and cardiologist and<br />

got very good reports from both.<br />

After a few months of healing, Jax<br />

and his family have been doing<br />

what they can to teach more<br />

people about congenital heart<br />

defects (CHD). Jax already has<br />

been to two Heart Walks for the<br />

American Heart Association. Big<br />

sister Kira, 11, made more than<br />

300 hearts out of flour, salt and<br />

water, painted them and handed<br />

them out during events. She also<br />

has attended three Jump Rope for<br />

Heart events, given presentations<br />

and even wrote a song about her<br />

brother. Middle brother, Malaki, 2,<br />

has helped as much as he can.<br />

“The more people we can<br />

make aware of CHD, the better,”<br />

said Ashley.<br />

A faint pink scar is the<br />

only sign that Jax<br />

had surgery for his<br />

congenital heart defect.<br />

The McGarrah family, Rick, sister<br />

Kira, Ashley, brother Malaki and Jax,<br />

visit with Arkansas <strong>Blue</strong> Cross<br />

nurse case manager Crystal<br />

Stanfield (right, holding Jax).<br />

<strong>Summer</strong> <strong>2015</strong> BLUE & YOU 11


Students and teachers try out the new track at<br />

Holcomb Elementary School in Fayetteville.<br />

There literally are miles of trails<br />

and tracks across Arkansas<br />

that were not there just a few<br />

short years ago. Some are paved<br />

while others give you a chance<br />

to get your hiking boots dirty.<br />

Many are equipped with outdoor<br />

exercise stations, benches and<br />

picnic tables — 15 of them<br />

are the result of grants from<br />

the <strong>Blue</strong> & <strong>You</strong> Foundation for<br />

a Healthier Arkansas.<br />

Since 2003, the <strong>Blue</strong> & <strong>You</strong><br />

Foundation has awarded $1,273,551<br />

to 15 communities across Arkansas<br />

to help them construct hiking trails<br />

and walking/running tracks for the<br />

benefit of their citizens.<br />

“Many towns in Arkansas don’t<br />

have a safe, attractive and<br />

convenient place for people to<br />

walk or run and enjoy some time<br />

exercising,” said Patrick O’Sullivan,<br />

executive director of the <strong>Blue</strong> &<br />

<strong>You</strong> Foundation. “By helping to<br />

fund the construction of walking<br />

trails and exercise stations<br />

along the trails, we hope to give<br />

Arkansans a pleasant location to<br />

regularly enjoy some exercise,<br />

fresh air and family fun.”<br />

12 BLUE & YOU <strong>Summer</strong> <strong>2015</strong><br />

The Return<br />

on Investment<br />

Does the return on this<br />

investment justify the cost?<br />

It’s a fair question. Let’s look at<br />

one community’s experience.<br />

According to Holly Johnson,<br />

director of development for<br />

Fayetteville Public Schools, the<br />

repairs to and construction of<br />

running/walking/biking tracks at<br />

four schools have encouraged<br />

exercise and outdoor activities<br />

for students and their families.<br />

“Many students either walk<br />

to school or ride their bikes<br />

to school each day,” she said.<br />

“Having a track at the local school<br />

encourages this physical activity<br />

and provides students with a place<br />

to practice their bicycle safety.”<br />

In fact, more than 2,000 students<br />

will use the tracks, because they<br />

are used in physical education<br />

classes. And, the tracks continue<br />

to see use even when school<br />

is out. “We often see families<br />

Students gather to celebrate<br />

the ribbon cutting for the new<br />

walking track at Happy Hollow<br />

Elementary School in Fayetteville.<br />

using these tracks for exercise<br />

before and after school and on<br />

the weekends, too,” said Holly.<br />

“Just in the past five years there<br />

has been an explosion of interest<br />

in walking, hiking and biking on<br />

the trail systems being developed<br />

across Arkansas. We can see that<br />

increased interest in physical<br />

fitness and outdoor activity on a<br />

smaller scale right here in our own<br />

school community through the use<br />

of the elementary school tracks.”<br />

Holly is quick to credit the<br />

<strong>Blue</strong> & <strong>You</strong> Foundation<br />

for making it possible.


1.<br />

11.<br />

9.<br />

4.<br />

13.<br />

12.<br />

2.<br />

5.<br />

15.<br />

3.<br />

14.<br />

School staff at Crossett Elementary<br />

School supervise the unwrapping<br />

and installation of one of 15<br />

exercise stations along the trail.<br />

Exercise stations are visible in the<br />

background of the walking trail at<br />

Sutton Elementary in Fort Smith,<br />

which is open to the community.<br />

“We are grateful for the investment<br />

the <strong>Blue</strong> & <strong>You</strong> Foundation has made,”<br />

she said. “It will pay dividends in our<br />

community for years to come.”<br />

That is why the <strong>Blue</strong> & <strong>You</strong><br />

Foundation plans to fund similar<br />

projects — so healthy dividends will<br />

be reaped all across Arkansas.<br />

“The beauty of these trails, in<br />

addition to their natural beauty, is<br />

that they will last many years and<br />

add more years to the lives of our<br />

fellow citizens,” said Patrick. “We<br />

consider it a healthy investment in<br />

the people of Arkansas.”<br />

1.<br />

2.<br />

3.<br />

4.<br />

5.<br />

6.<br />

7.<br />

8.<br />

9.<br />

10.<br />

11.<br />

12.<br />

13.<br />

14.<br />

15.<br />

10.<br />

Communities Receiving Grants<br />

8.<br />

7. 6.<br />

City of Cave Springs<br />

Built a new trail to comply with Americans<br />

with Disabilities Act.<br />

City of Fairfield Bay<br />

Built an outdoor walking trail with nine exercise stations.<br />

City of Gosnell<br />

Extended an existing walking trail.<br />

City of Greenland<br />

Built a walking trail with exercise stations.<br />

City of Jonesboro<br />

12 exercise stations were added to an existing trail.<br />

City of Lake Village<br />

Expanded walking trails, added exercise stations and<br />

improved a farmers market and free fitness center.<br />

City of Portland<br />

Built a new walking trail.<br />

Crossett Elementary School<br />

Built a walking trail with exercise stations.<br />

Fayetteville School District<br />

Built or improved walking trails at four local schools.<br />

Magnolia Hospital Foundation<br />

Renovated a hospital wellness park.<br />

Piggott Parks and Recreation<br />

Built a new hiking trail.<br />

Searcy County<br />

Upgraded an existing walking trail.<br />

Sutton Elementary School in Fort Smith<br />

Provided increased exercise opportunities to local<br />

fitness program.<br />

Woodlawn School District in Rison<br />

Built a fitness trail with exercise stations.<br />

Wynne Public Schools<br />

Added exercise stations to existing walking trails.<br />

<strong>Summer</strong> <strong>2015</strong> BLUE & YOU<br />

13


Get ready<br />

for<br />

the<br />

14 BLUE & YOU <strong>Summer</strong> <strong>2015</strong><br />

T<br />

here are a few things to think about before<br />

you hit the trails. <strong>You</strong> need to prepare! Research<br />

trails’ difficulty levels and pick ones suited to<br />

your abilities. <strong>You</strong> can look up trail ratings and<br />

descriptions online or contact the appropriate<br />

parks and recreation department.<br />

Once you’ve found one, check the weather and<br />

dress accordingly (but remember weathermen<br />

aren’t perfect). It’s best to dress in layers and to<br />

bring some kind of rain cover. Avoid cotton — it<br />

does a terrible job of wicking away moisture,<br />

which can lead to chafing, overheating or cooling<br />

or worse. Instead, wear synthetic fabrics, fleece<br />

or wool. <strong>You</strong>r shoe choice should depend on your<br />

terrain and what you’re carrying—more difficult<br />

trails and heavier loads require sturdier footwear.<br />

If your trail doesn’t have a lot of tree coverage,<br />

try to schedule your hike in the morning, when<br />

UV rays are weakest. Sunscreen, sunglasses<br />

and a hat are must-haves regardless of when<br />

you go or how much shade you’ll have.


Even short hikes require gear, so be sure to<br />

bring a comfortable backpack or daypack<br />

where you can carry the following:<br />

• Map and compass (smartphone doesn’t count)<br />

• Plenty of water and a way to purify any you find<br />

• Food (trail mix is great because it will help<br />

replace the salts you sweat out)<br />

• A fire starter, light, knife or multipurpose tool,<br />

and whistle for emergencies<br />

• First aid kit, including an antihistamine<br />

for allergens<br />

• Water shoes<br />

• Extra socks<br />

• Insect repellent<br />

S<br />

taying hydrated is important, especially<br />

in the hot summer when you’re already<br />

sweating, so drink lots of water in the<br />

hours before you go. <strong>You</strong>’ll want to<br />

drink about a quart of water per hour<br />

during your hike. If children are with you,<br />

make sure they’re drinking their water,<br />

too! Early signs of dehydration include<br />

headache, lack of appetite from nausea,<br />

dizziness and dark urine. If you suspect<br />

you’re dehydrated, rest in the shade<br />

and drink more water.<br />

Before you start the hike, let people know<br />

where you’re hiking and when you expect<br />

to be back so they can keep an eye out for<br />

your safe return. Once you’re on the trail,<br />

remember a few key things:<br />

• Stay on the trail to preserve the area’s<br />

beauty and habitat<br />

• Observe wildlife from a distance and<br />

don’t feed the animals<br />

• Be wary of poison ivy and the like;<br />

“Leaves of three, let it be”<br />

• Look for spiders, insects and snakes before<br />

you reach into or step on or over things<br />

• Pack out what you pack in—that means<br />

everything!<br />

And finally, make sure you allow yourself<br />

enough time to truly enjoy the fresh air,<br />

peace and simplicity of nature. It’s good<br />

for the heart and soul!<br />

<strong>Summer</strong> <strong>2015</strong> BLUE & YOU<br />

15


NEWS<br />

National Walk @ Lunch Day<br />

Arkansas <strong>Blue</strong> Cross and <strong>Blue</strong> Shield employees,<br />

clad in their blues and comfy shoes, took to the<br />

streets on April 29 to celebrate National Walk<br />

@ Lunch Day (NW@LD). They were joined by<br />

employees of other local businesses in the<br />

walk around downtown Little Rock to the<br />

State Capitol building.<br />

NW@LD is an event designed to encourage<br />

employees to spend part of their lunch<br />

walking in an effort to promote fitness<br />

and encourage regular worksite wellness<br />

activities. NW@LD is part of the <strong>Blue</strong> Cross<br />

and <strong>Blue</strong> Shield Association’s Walking<br />

Works program.<br />

Central Arkansas Heart Walk<br />

18 16 BLUE & YOU <strong>Summer</strong> <strong>2015</strong><br />

More than 130 Arkansas <strong>Blue</strong> Cross and<br />

<strong>Blue</strong> Shield employees and their families<br />

participated in the Central Arkansas Heart<br />

Walk on April 25. Arkansas <strong>Blue</strong> Cross’<br />

employee team, Team Fearless, joined other<br />

central Arkansans at Burns Park to help the<br />

fight against heart disease and stroke.<br />

As a special fundraiser, a flash mob of<br />

executives and employees (with the help<br />

of a talented choreographer) performed<br />

at the walk, and, although their dance<br />

technique didn’t exceed expectations, the<br />

fundraising certainly did. Arkansas <strong>Blue</strong><br />

Cross employees raised $16,490 this year for<br />

the American Heart Association.


Arkansas needs more nurses<br />

Two grants help train nurses in Arkansas<br />

This spring, Arkansas <strong>Blue</strong> Cross and<br />

<strong>Blue</strong> Shield awarded grants of<br />

$250,000 each to the Baptist Health<br />

Foundation to fund an endowed<br />

nursing scholarship and to the<br />

Arkansas State University College<br />

of Nursing and Health Professions<br />

to fund an endowed nursing<br />

professorship in rural health.<br />

Baptist Health Foundation’s Arkansas<br />

<strong>Blue</strong> Cross and <strong>Blue</strong> Shield Endowed<br />

Nursing Scholarship will fund<br />

four scholarships a year through<br />

interest generated from the grant for<br />

Arkansans who intend to work as<br />

nurses in Arkansas.<br />

Arkansas State University’s Arkansas<br />

<strong>Blue</strong> Cross and <strong>Blue</strong> Shield Endowed<br />

Nursing Professorship in Rural Health<br />

allows A-State to provide increased<br />

focus on the particular issues related<br />

to serving rural communities,<br />

and to expand the number of<br />

opportunities for students to<br />

enter into the program.<br />

“At Arkansas <strong>Blue</strong> Cross, we have<br />

about 300 nurses on staff and we<br />

regularly hear from our members<br />

how vital our nurses are in<br />

helping them navigate the<br />

health care system,” said<br />

Mark White, president<br />

and chief executive<br />

officer at Arkansas <strong>Blue</strong><br />

Cross. “We value the<br />

role nurses play at<br />

Arkansas <strong>Blue</strong> Cross<br />

and in health care.”<br />

Arkansas Arts Center’s Children’s Theatre<br />

Arkansas <strong>Blue</strong> Cross and <strong>Blue</strong> Shield<br />

hosted a special showing of “The Cat<br />

in the Hat” at the Arkansas Arts Center’s<br />

Children’s Theatre on March 15. Free<br />

tickets were given away at most of<br />

our Arkansas<strong>Blue</strong> locations (Little Rock,<br />

Hot Springs and Pine Bluff). More than<br />

100 families from throughout<br />

Arkansas stopped by their<br />

local Arkansas<strong>Blue</strong> store to<br />

pick up tickets. Parents and<br />

children alike enjoyed the<br />

play. <strong>Blue</strong>Ann Ewe and the<br />

Cat, himself, arrived early<br />

to the play for a special<br />

photo op with the children.<br />

Arkansas <strong>Blue</strong> Cross is proud<br />

to sponsor the arts in Arkansas<br />

and provide a family friendly<br />

outing for its members.<br />

<strong>Summer</strong> <strong>2015</strong> BLUE & YOU 17


Arkansas <strong>Blue</strong> Cross and <strong>Blue</strong> Shield<br />

Financial Information Privacy Notice<br />

At Arkansas <strong>Blue</strong> Cross and <strong>Blue</strong> Shield and<br />

its affiliates (including HMO Partners, Inc. doing<br />

business as Health Advantage), we understand<br />

how important it is to keep your private<br />

information just that — private. Because of the<br />

nature of our business, we must collect some<br />

personal information from our members, but we<br />

also are committed to maintaining, securing and<br />

protecting that information.<br />

Customer Information<br />

Arkansas <strong>Blue</strong> Cross and its affiliates only<br />

compile information necessary for us to provide<br />

the services that you, our member, request from<br />

us and to administer your business. We collect<br />

non-public personal financial information (defined<br />

as any information that can be tied back to a<br />

specific person and is gathered by any source that<br />

is not publicly available) about our members from:<br />

• Applications for insurance coverage. The<br />

application includes information such as name,<br />

address, personal identifiers such as Social<br />

Security number, and medical information that<br />

you authorize us to collect.<br />

• Payment history and related financial<br />

transactions from the purchase and use<br />

of our products.<br />

• Information related to the fact that you<br />

have been or currently are a member.<br />

Arkansas <strong>Blue</strong> Cross<br />

1-800-238-8379<br />

Health Advantage<br />

1-800-843-1329<br />

Self-funded group members<br />

should call Customer Service<br />

using the toll-free telephone<br />

number on their ID card.<br />

Sharing of Information<br />

Arkansas <strong>Blue</strong> Cross and its affiliates do not<br />

disclose, and do not wish to reserve the right<br />

to disclose, non-public personal information<br />

about you to other parties except as permitted<br />

or required by law. Examples of instances in<br />

which Arkansas <strong>Blue</strong> Cross and its affiliates will<br />

provide information to one another or other<br />

third parties are:<br />

• To service or process products that<br />

you have requested.<br />

• To provide information as permitted and<br />

required by law to accrediting agencies.<br />

• To provide information to comply<br />

with federal, state or local laws in<br />

an administrative or judicial process.<br />

How We Protect <strong>You</strong>r Information<br />

Arkansas <strong>Blue</strong> Cross and its affiliates use<br />

various security mechanisms to protect your<br />

personal data including electronic and physical<br />

measures as well as company policies that<br />

limit employee access to non-public personal<br />

financial information. Improper access and use<br />

of confidential information by an employee can<br />

result in disciplinary action up to and including<br />

termination of employment.<br />

Disclosure of Privacy Notice<br />

Arkansas <strong>Blue</strong> Cross and its affiliates recognize<br />

and respect the privacy concerns of potential,<br />

current and former customers. Arkansas<br />

<strong>Blue</strong> Cross and its affiliates are committed to<br />

safeguarding this information. This Financial<br />

Information Privacy Notice is provided to our<br />

members as required by state regulation to<br />

explain how we handle their non-public financial<br />

information. It is also available on our website<br />

at arkansasbluecross.com or from our Customer<br />

Service call centers. Our Customer Service areas<br />

are open from 8 a.m. to 4:30 p.m., Central time,<br />

Monday through Friday.<br />

18 BLUE & YOU <strong>Summer</strong> <strong>2015</strong>


“OUT OF THE BLUE”<br />

Continued FROM page 3<br />

insured patients in order to cover the costs of<br />

those who cannot pay, and government programs<br />

that pay too little to cover costs. A free market<br />

solution will ensure that doctors and hospitals can<br />

cover their costs and that those with commercial<br />

insurance no longer pay a “hidden tax.”<br />

3. It’s also important that we approach this in<br />

a way that is best for Arkansas. Our state<br />

has been a laboratory of sorts for innovation<br />

designed to improve both the cost and the<br />

quality of health care. Working in partnership<br />

with state government, doctors and hospitals,<br />

Arkansas <strong>Blue</strong> Cross has been working to lay<br />

the foundation for a better health care system.<br />

Together, we are protecting access to primary<br />

care by creating new, team-based approaches<br />

that give patients the additional support they<br />

need to be healthy. We are making care more<br />

affordable by changing the way we pay for<br />

the high cost of specialty care, by “bundling”<br />

payments to specialists, hospitals and other<br />

medical service providers through a program<br />

called the Arkansas Payment Improvement<br />

Initiative. These efforts are beginning to show<br />

promise toward meeting the objectives of<br />

improved cost and quality, and they are the<br />

foundation on which a more effective health<br />

care system must be built. In considering how<br />

health care should be provided to Arkansans<br />

going forward, it is important that we build on<br />

the innovations already in place. It is important<br />

that we do it Arkansas’ way.<br />

We have the opportunity to create a better health<br />

system by and for Arkansans. At Arkansas <strong>Blue</strong><br />

Cross, we welcome the opportunity to work with<br />

the Health Care Reform Task Force in building a<br />

new health care system built on existing Arkansas<br />

innovation, free enterprise, personal responsibility<br />

and common sense.<br />

CUSTOMER SERVICE NUMBERS<br />

May we help?<br />

For customer service, please call:<br />

TOLL FREE Number<br />

Medi-Pak ® members 1-800-338-2312<br />

Medi-Pak ® Advantage members 1-877-233-7022<br />

Medi-Pak ® Rx members 1-866-390-3369<br />

Arkansas <strong>Blue</strong> Cross members 1-800-238-8379<br />

• Pharmacy questions 1-800-863-5561<br />

• Specialty Rx pharmacy questions 1-866-295-2779<br />

Arkansas <strong>Blue</strong> Cross Metallic members<br />

(Gold, Silver, Bronze, Catastrophic) 1-800-800-4298<br />

• Pharmacy questions 1-800-969-3983<br />

Health Advantage members 1-800-843-1329<br />

• Pharmacy questions 1-800-863-5567<br />

<strong>Blue</strong>Advantage members 1-888-872-2531<br />

• Pharmacy questions 1-888-293-3748<br />

Federal Employee members 1-800-482-6655<br />

Looking for health or dental insurance? We can help!<br />

For individuals, families 1-800-392-2583<br />

For employer groups* 1-800-421-1112<br />

*Arkansas <strong>Blue</strong> Cross, Health Advantage and <strong>Blue</strong>Advantage Administrators of Arkansas<br />

PAY YOUR *<br />

B I L L<br />

To pay by phone*, please call 1-800-354-9904<br />

Prefer to speak with someone close to home?<br />

Call or visit one of our offices near you:<br />

• Arkansas<strong>Blue</strong> — Little Rock<br />

2612 S. Shackleford Rd., Suite J 1-501-378-2222<br />

• Fayetteville<br />

516 East Millsap Rd., Suite 103 1-800-817-7726<br />

• Fort Smith<br />

3501 Old Greenwood Rd., Suite 5 1-866-254-9117<br />

• Arkansas<strong>Blue</strong> — Hot Springs<br />

1635 Higdon Ferry Rd. – Suite J 1-800-588-5733<br />

• Jonesboro<br />

707 East Matthews Ave. 1-800-299-4124<br />

• Little Rock<br />

601 S. Gaines Street 1-800-421-1112<br />

• Arkansas<strong>Blue</strong> — Lowell<br />

507 W. Monroe Ave. – Suite B 1-888-872-2539<br />

• Arkansas<strong>Blue</strong> — Pine Bluff<br />

509 Mallard Loop Drive 1-800-236-0369<br />

• Texarkana<br />

1710 Arkansas Boulevard 1-800-470-9621<br />

Visit our websites for more information:<br />

arkansasbluecross.com • healthadvantage-hmo.com<br />

blueadvantagearkansas.com<br />

blueandyoufoundationarkansas.org<br />

Medicare Advantage and Prescription Drug plan product members must call<br />

Customer Service to discuss available payment options. Health Advantage<br />

conversion plans are not eligible for online, mobile or pay-by-phone payment option.<br />

<strong>Summer</strong> <strong>2015</strong> BLUE & YOU<br />

19


BOO<br />

W I T H<br />

BLUE!<br />

Friday, October 2<br />

6-9 p.m.<br />

Our second annual “Boo with <strong>Blue</strong>”<br />

will be held at the Museum of Discovery<br />

in Little Rock, Friday, October 2,<br />

from 6-9 p.m. “Boo with <strong>Blue</strong>”<br />

is free to Arkansas <strong>Blue</strong> Cross<br />

and <strong>Blue</strong> Shield members.<br />

Just show your health insurance ID card<br />

for admission. Non-members<br />

are invited to stop by any<br />

local Arkansas<strong>Blue</strong> store<br />

to pick up free tickets to the<br />

event starting in September.<br />

MPI 3576 7/15

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