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
Financial Privacy Information - P18
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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