Blue & You - Summer 2013
Get Ready for Changes Under the Health Care Law; Live Fearless; Arkansas Blue Cross tops national customer survey; Financial Information Privacy Notice
Get Ready for Changes Under the Health Care Law;
Live Fearless;
Arkansas Blue Cross tops national customer survey;
Financial Information Privacy Notice
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SUMMER<br />
<strong>2013</strong><br />
A publication for the policyholders of the Arkansas <strong>Blue</strong> Cross and <strong>Blue</strong> Shield family of companies<br />
Representatives of Arkansas <strong>Blue</strong> Cross and <strong>Blue</strong> Shield are<br />
ready to help you. Call or come by one of our locations.<br />
page<br />
4<br />
Live<br />
Fearless<br />
page<br />
10<br />
Arkansas <strong>Blue</strong> Cross tops<br />
national customer survey<br />
page<br />
15<br />
Financial Information<br />
Privacy Notice<br />
page<br />
22
of<br />
Arkansas<strong>Blue</strong><br />
employee Michael<br />
Stewart greets<br />
a customer at<br />
the Shackleford<br />
Crossings<br />
location.<br />
3 Out of the <strong>Blue</strong><br />
15<br />
4<br />
7<br />
9<br />
The health care law and you<br />
The Health Insurance Marketplace –<br />
how it might help you<br />
Meetings for small businesses<br />
Arkansas’ Health Care Independence<br />
Program: Do you qualify?<br />
16<br />
17<br />
18<br />
19<br />
Customers rank Arkansas <strong>Blue</strong> Cross<br />
as a top <strong>Blue</strong> Plan in the nation<br />
Over-the-counter medicines<br />
<strong>You</strong>r role in health care<br />
Will Arkansas have enough doctors?<br />
Member discounts<br />
Grants available for health programs<br />
10<br />
Live Fearless – our new advertising<br />
campaign<br />
20<br />
New Arkansas<strong>Blue</strong> health insurance<br />
store opens in Pine Bluff<br />
12<br />
Fast food and asthma<br />
Binge drinking studies<br />
Lose weight the Healthy Weigh!<br />
22<br />
The “freedom” of short-term coverage<br />
Arkansas <strong>Blue</strong> Cross and <strong>Blue</strong> Shield –<br />
Financial Information Privacy Notice<br />
13<br />
14<br />
Is memory loss from aging<br />
or lack of sleep? Maybe both.<br />
<strong>Blue</strong> News<br />
23<br />
24<br />
Customer Service telephone numbers<br />
Health care law timeline<br />
SUMMER<br />
<strong>2013</strong><br />
<strong>Blue</strong> & <strong>You</strong> is published four times a year by Arkansas <strong>Blue</strong> Cross and<br />
<strong>Blue</strong> Shield for the company’s members, health care professionals<br />
and other persons interested in health care and wellness.<br />
Health information from sources outside of Arkansas <strong>Blue</strong> Cross and <strong>Blue</strong><br />
Shield do not necessarily represent the official position of the company.<br />
EDITOR: Jennifer Sullivan – bnyou-ed@arkbluecross.com • DESIGNER: Ryan Kravitz • PHOTOGRAPHER: Chip Bayer<br />
CONTRIBUTORS: Will Ballard, Chip Bayer, Gio Bruno, Matthew Creasman, Damona Fisher, Kristy Fleming, Lauren<br />
Green,Trey Hankins, Heather Iacobacci-Miller, Genny Kirchner, Kathy Luzietti, Wendy McCullar, Mark Morehead,<br />
Alex Roberts, Kelly Whitehorn and Stephen Wilson<br />
VICE PRESIDENT, COMMUNICATIONS and PRODUCT DEVELOPMENT: Karen Raley<br />
2 BLUE & YOU SUMMER <strong>2013</strong><br />
on the<br />
cover<br />
Sara Harris, Arkansas<strong>Blue</strong> team leader,<br />
consults with a customer about the<br />
upcoming health care law changes.
OUT<br />
Upcoming changes under the health care law<br />
It has been a busy year for the health care<br />
industry, and it is only halfway through. We<br />
have seen remarkable progress made toward<br />
implementing provisions of the new health care<br />
law as they become effective, but I know many<br />
of you still have concerns about the changes yet<br />
to be implemented. <strong>You</strong> can rest assured that our<br />
team at Arkansas <strong>Blue</strong> Cross and <strong>Blue</strong> Shield has<br />
been working to determine how to best address<br />
these challenges.<br />
Arkansas Medicaid expansion<br />
Arkansas historically has had one of the most<br />
restrictive Medicaid programs in the country,<br />
and I applaud the bipartisan efforts of the<br />
Arkansas Legislature and Gov. Mike Beebe<br />
to create the Arkansas Medicaid private<br />
option that was signed into law in April.<br />
Arkansas is the first state in the nation to<br />
create a system allowing qualified low-income<br />
Arkansans to purchase subsidized private<br />
insurance through the state’s Health Insurance<br />
Marketplace, but other states are watching with<br />
interest. For the first three years, this program<br />
will be funded entirely with federal money.<br />
Expanding Medicaid to provide health care<br />
coverage to low income Arkansans is the right<br />
thing to do. It not only benefits people who are<br />
struggling financially, it benefits their families,<br />
the business owners who hire these workers,<br />
our health care providers and the state’s<br />
economy. Ultimately, we will see the benefits<br />
of a healthier population.<br />
Controlling health care costs<br />
Many of you may have heard news reports<br />
concerning increases in premium costs as a<br />
result of new regulations under the health care<br />
law. There are provisions of the law that will<br />
increase costs for some, but there will be both<br />
winners and losers under the new regulations.<br />
BLUE<br />
a message from our President and CEO,<br />
MARK WHITE<br />
Why are costs increasing for some? The law<br />
requires the insurance industry to cover more<br />
services, offer some services at no cost to the<br />
member, and calculate premiums according<br />
to new guidelines. There also are a number of<br />
new taxes and fees included within the law.<br />
Certainly, most Americans understand that when<br />
you provide free or reduced-cost insurance to<br />
millions of people and cover more services,<br />
there will be a cost associated with it.<br />
In this issue of <strong>Blue</strong> & <strong>You</strong>, we explain some of<br />
the new provisions within the health care law<br />
and what we believe you can expect regarding<br />
your coverage. Some of you will find that your<br />
coverage will be less expensive in the future;<br />
for others, it will be more costly. Regardless of<br />
the impact, Arkansas <strong>Blue</strong> Cross has spent the<br />
past two years working to find solutions that<br />
will provide you and your family affordable<br />
insurance options.<br />
If you purchase health care coverage for<br />
you and your family on your own, we will be<br />
reaching out to you this summer to request<br />
a health insurance review. During a phone<br />
call or a visit we can cover any changes the<br />
law will require and make you aware of the<br />
most affordable choices available to you.<br />
It is important that you are informed about<br />
your options and you that maintain your<br />
“grandfathered” status until you have the<br />
information needed to aid in the decision<br />
process. Our customer support teams are<br />
CHANGES continued on page 23<br />
SUMMER <strong>2013</strong> BLUE & YOU<br />
3
the HEALTH CARE law<br />
?<br />
“Will it impact my coverage?”<br />
Whether your health insurance coverage will<br />
change as a result of new health care rules that<br />
go into effect January 1, 2014, depends on when<br />
you bought your health insurance and whether<br />
you bought it at work or on your own.<br />
Medicare Plans<br />
If you are on a Medicare Supplement plan,<br />
regardless of when it was purchased, you won’t<br />
see any changes to your plan coverage in 2014<br />
as a result of the health care law. If you have a<br />
Medicare Advantage or Medicare Prescription<br />
Drug Plan, the process for notifying you about<br />
2014 changes at the end of September <strong>2013</strong><br />
remains unchanged as a result of the law.<br />
Plans purchased before March 2010<br />
If your health plan was in place before the law<br />
was passed in March 2010, whether purchased<br />
through your employer or on your own, you<br />
may have what is known as a “grandfathered”<br />
plan. A number of changes already have<br />
been made to these policies to meet new<br />
legal requirements. Changes include allowing<br />
children to stay on a parent’s health plan until<br />
their 26th birthday and removing lifetime dollar<br />
limits on some medical services. These plans<br />
will not see any big changes in 2014. If you are<br />
unsure whether your plan is grandfathered, call<br />
the customer service number on your ID card or<br />
contact your human resources administrator.<br />
Employer Plans (purchased after March 2010)<br />
If you have coverage through a company with<br />
100 or more employees, many changes required<br />
by the health care law already have been applied<br />
to your health plan. These required changes<br />
included removing any annual or lifetime dollar<br />
limits on certain medical services and adding<br />
preventive services if your plan did not include<br />
them. A major change that will be implemented<br />
relates to your total out-of-pocket cost. When<br />
this rule is put in place for your health plan, all<br />
deductibles, coinsurance and copayments will<br />
count toward your out-of-pocket maximum.<br />
4 BLUE & YOU SUMMER <strong>2013</strong><br />
If your employer employs 51 to 100<br />
employees, similar changes will become<br />
effective in 2016.<br />
Employers with 50 or fewer employees are<br />
likely to see a number of changes to their<br />
coverage if the plan is not a grandfathered plan.<br />
The law requires that these health plans include<br />
a core set of benefits (essential health benefits)<br />
and cover preventive services at 100 percent<br />
with no member out-of-pocket costs. Among<br />
the preventive services provided with no cost<br />
sharing are colonoscopies and contraceptives.<br />
Also in 2014, your health plan will cover medical<br />
conditions that previously required a waiting<br />
period. Employers with two to 50 employees will<br />
be invited to attend meetings with Arkansas <strong>Blue</strong><br />
Cross to discuss in detail how the health care<br />
law is impacting our employer customers (see<br />
article on page 9). After the meeting, employers<br />
will be contacted by their agent or an Arkansas<br />
<strong>Blue</strong> Cross representative, to determine the<br />
most affordable option for their organization.<br />
Those who bought coverage on their own<br />
after March 2010<br />
If you bought an individual or family health<br />
plan (not a Medicare plan) on your own and it<br />
was purchased after March 2010, you can keep<br />
the policy you currently have until December 30,<br />
2014, with no changes.<br />
Some of our members will find the new health<br />
plans to be more desirable. <strong>You</strong> may receive a<br />
new kind of tax credit that lowers their monthly<br />
health plan costs. If that is the case, your agent<br />
or an Arkansas <strong>Blue</strong> Cross representative will<br />
make you aware of a more affordable option.<br />
New health care plans will cover preventive<br />
health benefits at 100 percent, will have no<br />
waiting periods for medical conditions and you<br />
will have guaranteed approval for health care<br />
coverage. Also, all deductibles, copayments<br />
and coinsurance will go toward your out-ofpocket<br />
maximum.
We are here to help<br />
This summer we are asking our members<br />
with individual or family health plans (not<br />
Medicare plans) to call us or their agent or<br />
come in and let us check to see if a lower cost<br />
plan will be available under the new law. Our<br />
representatives are trained and ready to talk<br />
?<br />
“Will it impact what I pay?”<br />
For many Americans who are not on<br />
Medicare, the full implementation of the new<br />
health care law in 2014 may mean a change in<br />
what they pay monthly (called a premium). And<br />
there will be winners and losers.<br />
The extent to which the new rules will affect<br />
your health plan depends in part on when your<br />
coverage was purchased, and whether you<br />
get coverage through an employer or if you<br />
purchase coverage on your own for yourself<br />
and/or your family. The new changes will have<br />
the greatest impact on those who work for<br />
companies with 50 or fewer employees and<br />
those who buy coverage for themselves and<br />
their families on their own or through an agent.<br />
The amount you pay monthly (your premium)<br />
may increase or decrease as a result of four<br />
primary provisions contained in the new law.<br />
They are:<br />
• New taxes and fees<br />
• New requirements regarding what<br />
medical services must be covered<br />
by insurance policies<br />
• New rules concerning how insurance<br />
companies must calculate members’<br />
monthly costs<br />
• The availability of tax credits or subsidies to<br />
help pay for health insurance for individuals<br />
and families who qualify<br />
with you. <strong>You</strong> can call us at 1-800-310-3778 or<br />
you can visit with us in person at one of our<br />
offices around the state. Arkansas <strong>Blue</strong> Cross<br />
has been providing Arkansans quality health<br />
plans at affordable prices for 65 years, and<br />
we look forward to working with you.<br />
New Taxes and Fees<br />
New taxes and fees included in the law will<br />
have an impact on premiums. The money<br />
collected from these fees will be used to<br />
help pay for advance premium tax credits<br />
(commonly called subsidies) which will be<br />
available to Americans in low-to-middle<br />
income ranges to help pay for health insurance.<br />
These taxes and fees also will be used to fund<br />
research into effective medical practices, to<br />
help cover the cost of the Health Insurance<br />
Marketplaces that will be established in every<br />
state and to stabilize the insurance market in<br />
the early reform years. Industry experts project<br />
that the fee collected to help fund the tax credit<br />
alone will add 2-3 percent to the cost of health<br />
insurance. Collectively, the fees could add as<br />
much as 3-5 percent to individual and employer<br />
health plan premiums.<br />
New Coverage Requirements<br />
Health plans sold to individuals and employers<br />
with 50 or fewer employees must cover a core<br />
set of medical services called “essential health<br />
benefits.” Many of these essential health<br />
benefits were covered by Arkansas <strong>Blue</strong> Cross<br />
health plans already, such as hospitalization and<br />
emergency care. Others were offered, but the<br />
buyer in some cases had the choice of whether<br />
to purchase the coverage, such as maternity<br />
and preventive care. Beginning in 2014, these<br />
coverage requirements no longer will be<br />
optional. In addition, more preventive services<br />
have been added and the health plan must pay<br />
100 percent of the cost of these services.<br />
LAW continued on page 6<br />
SUMMER <strong>2013</strong> BLUE & YOU<br />
5
LAW continued from page 5<br />
Because more services will be covered and the<br />
health plan will pay more of the cost, premiums<br />
will go up to cover the cost of these new health<br />
plan benefits.<br />
New rules around determining your monthly costs<br />
Historically, insurance companies have<br />
considered a number of factors when<br />
calculating premiums for employers or<br />
individuals purchasing coverage. These factors<br />
include the health condition of the individual<br />
or the employees in an employer’s group plan.<br />
Those employers or individuals who have more<br />
health conditions are likely to use more medical<br />
services and are, therefore, charged a higher<br />
rate. Beginning in 2014, health insurers will<br />
not be allowed to consider health conditions in<br />
developing premiums. As a result, those who<br />
are less healthy may find their costs are less<br />
and those who are healthier will pay more in<br />
monthly premiums.<br />
Age also has been an important consideration<br />
in establishing premiums. Older people generally<br />
use more medical services and, therefore, pay<br />
more, while younger people who are not as<br />
likely to need expensive medical care pay less.<br />
Although age still will play a role in setting rates,<br />
there will not be as a great a range between the<br />
rate charged to a 24-year-old and the rate charged<br />
to a 60-year-old. <strong>You</strong>nger people can expect to<br />
pay higher rates when these rules are applied in<br />
2014, and older people will pay less.<br />
These are two of a number of new rules<br />
regarding setting premiums that will begin<br />
in 2014 and will cause changes in how much<br />
people pay for coverage.<br />
Advance premium tax credits<br />
Beginning in January 2014, many low- and<br />
middle-income Americans who do not have the<br />
opportunity to enroll in an employer’s health<br />
plan will be eligible to receive a new kind of<br />
tax credit that lowers monthly premiums. The<br />
amount of tax credit a household receives is<br />
based on their household income and family<br />
size. The lower the household income, the<br />
higher the tax credit.<br />
If you think your household may be eligible<br />
for an advance premium tax credit, please<br />
call Arkansas <strong>Blue</strong> Cross. We will help you<br />
determine if you meet the requirements and<br />
provide you with an estimate of what your<br />
premium might be after the tax credit is applied.<br />
Arkansas <strong>Blue</strong> Cross has the information you need<br />
The health care law is complex and difficult to<br />
understand. Some of our members will benefit<br />
and others will not. <strong>You</strong> can count on Arkansas<br />
<strong>Blue</strong> Cross to provide the accurate and reliable<br />
guidance you need to understand how the<br />
health care law affects you and those you love.<br />
Please don’t make any changes to your health<br />
insurance coverage without talking to us first.<br />
If your current plan was issued before the law<br />
passed, keeping it may be your best option.<br />
And if you drop it, you can’t get it back. If you<br />
buy coverage on your own, call your agent or<br />
Arkansas <strong>Blue</strong> Cross or come by one of our<br />
locations for a health insurance review. We are<br />
ready to help you evaluate your options and<br />
select a plan that provides the coverage you want<br />
at the lowest cost. Call 1-800-310-3778 today.<br />
Could you receive help with<br />
your health care costs?<br />
We can help you find out in just a few<br />
seconds. Literally.<br />
If you are wondering if you will get a break on<br />
the monthly cost of your health insurance plan<br />
in 2014, we can give you a quick answer.<br />
Just visit our website, arkansasbluecross.com,<br />
and select “Will I qualify for a tax credit?,” and<br />
you can get an answer by answering two simple<br />
questions: household income and household<br />
size. That’s it.<br />
This “estimator” is for individuals or families<br />
who purchase their health insurance on their<br />
own (in other words, you do not have coverage<br />
through your employer). Glad we can help!<br />
6 BLUE & YOU SUMMER <strong>2013</strong>
the HEALTH INSURANCE Marketplace<br />
?<br />
Qualifying for a tax credit<br />
Federal Poverty Level – <strong>2013</strong><br />
PEOPLE<br />
in family 100% 133% 200% 300% 400%<br />
1<br />
2<br />
3<br />
4<br />
5<br />
6<br />
7<br />
8<br />
Helping some Americans pay for health care<br />
If you are one of millions of Americans under<br />
age 65 who will purchase a health plan this<br />
fall through the Health Insurance Marketplace<br />
(exchange), you may be eligible for a $0<br />
premium plan or a new kind of tax credit that<br />
lowers your monthly premiums.<br />
The Health Insurance Marketplace is a website<br />
designed to determine if you are eligible for<br />
financial help to cover your health insurance<br />
costs. It also will help you and your family shop<br />
for and purchase health insurance. Americans<br />
may also contact the Health Insurance<br />
Marketplace by telephone.<br />
A Health Insurance Marketplace is being set<br />
up in each state, either by the state itself, by the<br />
federal government, or in Arkansas’ case, in<br />
partnership with the federal government. Each<br />
marketplace will be responsible for:<br />
• Creating and maintaining a consumer<br />
shopping website.<br />
• Providing access to all information necessary<br />
to determine if you are eligible for help<br />
paying for your premium or if you qualify for<br />
free coverage.<br />
• Helping consumers shop for and purchase<br />
health plans.<br />
• Making sure all health plans offered on the<br />
marketplace meet all the new regulations.<br />
The Health Insurance Marketplace will be<br />
open October 1 for people to purchase<br />
coverage that begins January 1.<br />
$11,490<br />
$15,510<br />
$19,530<br />
$23,550<br />
$27,570<br />
$31,590<br />
$35,610<br />
$39,630<br />
$15,282<br />
$20,628<br />
$25,975<br />
$31,322<br />
$36,668<br />
$42,015<br />
$47,361<br />
$52,708<br />
$22,980<br />
$31,020<br />
$39,060<br />
$47,100<br />
$55,140<br />
$63,180<br />
$71,220<br />
$79,260<br />
$34,470<br />
$46,530<br />
$58,590<br />
$70,650<br />
$82,710<br />
$94,770<br />
$106,830<br />
$118,890<br />
$45,960<br />
$62,040<br />
$78,120<br />
$94,200<br />
$110,280<br />
$126,360<br />
$142,440<br />
$158,520<br />
NOTE: Federal minimum wage employee working 50 weeks per<br />
year, 40 hours per week would earn $14,500.<br />
Why buy on the marketplace?<br />
Many Americans will be eligible to receive<br />
advance premium tax credits (subsidies) if they<br />
purchase a health plan through the marketplace.<br />
An advance premium tax credit is a new tax credit<br />
that you can use to lower your monthly premium<br />
costs beginning January 1, 2014. (see chart below<br />
to see if you might qualify.)<br />
The amount of the advance premium tax credit<br />
that each household will receive is calculated by<br />
using their income, the size of their family and<br />
other factors. This new tax credit helps lower- and<br />
middle-income families. Some households, based<br />
on their income, will receive additional financial<br />
assistance when they receive medical care.<br />
Essential health benefits<br />
Every health plan sold to small employer<br />
groups and individuals on the Health Insurance<br />
Marketplace must include a core set of benefits<br />
established by the law. Many of these services<br />
are covered today by health plans sold by<br />
Arkansas <strong>Blue</strong> Cross. Others, such as preventive<br />
care and mental health services, are available to<br />
purchase as options, but going forward, those<br />
will be required.<br />
The essential health benefits are included in<br />
the following 10 categories:<br />
1. Ambulatory patient services<br />
2. Emergency services<br />
3. Hospitalization<br />
4. Maternity and newborn care<br />
5. Mental health and substance<br />
use disorder services, including<br />
behavioral health treatment<br />
6. Prescription drugs<br />
7. Rehabilitative and habilitative<br />
services and devices<br />
8. Laboratory services<br />
9. Preventive and wellness services<br />
and chronic disease management<br />
10. Pediatric services, including oral<br />
and vision care<br />
LAW continued on page 8<br />
SUMMER <strong>2013</strong> BLUE & YOU<br />
7
LAW continued from page 7<br />
In addition, these essential health benefits<br />
must be covered with no annual or lifetime<br />
dollar limits. Preventive services, including<br />
women’s preventive care and birth control must<br />
be paid 100 percent by the health plan.<br />
Metallic plans<br />
People often found that it was difficult to<br />
compare what their total cost would be from<br />
one plan to the next. It was easy to compare<br />
the monthly payments (premiums) but it was<br />
difficult to compare how much you would pay<br />
out of pocket for medical services. In an effort to<br />
make it easier for people to determine what they<br />
will pay for medical services, the health care<br />
law standardized the health plans on and off the<br />
Health Insurance Marketplace. Because these<br />
health plans are called Bronze, Silver, Gold and<br />
Platinum, they are referred to as Metallic Plans.<br />
For instance, the lowest level of coverage,<br />
called the Bronze plan, is designed to cover<br />
60 percent of your total health care costs.<br />
A person purchasing a Bronze plan will pay<br />
more when they receive health care but less<br />
month to month (their premium). A person<br />
purchasing a Platinum plan will pay more<br />
month to month, but pay less at the doctor’s<br />
office. (See chart below.)<br />
Because the law requires that insurance<br />
companies offer plans that only fit these levels,<br />
they are no longer allowed to offer plans that<br />
don’t fit the requirements. For instance, you<br />
won’t be able to purchase a plan to cover 75<br />
percent of your medical costs. As a result of<br />
this regulation, health insurance companies<br />
will have to reduce the options available to<br />
small employers and individuals.<br />
Arkansas <strong>Blue</strong> Cross can estimate any<br />
advance premium tax credits you may be<br />
eligible to receive and can help you select<br />
a health plan. <strong>You</strong> can buy an Arkansas <strong>Blue</strong><br />
Cross plan on and off the marketplace. Call<br />
us at 1-800-310-3778 or come in for a health<br />
insurance review.<br />
Metallic<br />
Coverage<br />
LEVELS<br />
100%<br />
0%<br />
60% * 70% * 80% * 90% *<br />
BRONZE SILVER GOLD PLATINUM<br />
*NOTE: Percentage shows how much of your total health care costs this plan pays.<br />
? Have a question? Ask us!<br />
The health care law is complex and confusing,<br />
but Arkansas <strong>Blue</strong> Cross and <strong>Blue</strong> Shield is here<br />
to help. If you have questions regarding anything<br />
to do with the health care law, we want to hear<br />
from you in an email, post or tweet.<br />
Our email address designated for the health<br />
care law questions is HCRinfo@arkbluecross.com.<br />
Send us an email and we will respond directly<br />
8 BLUE & YOU SUMMER <strong>2013</strong><br />
to you. We usually can get an answer back<br />
to you in a day or two. To find our corporate<br />
Facebook page, just search for Arkansas <strong>Blue</strong><br />
Cross and <strong>Blue</strong> Shield. Our Twitter account<br />
is arkbluecross.<br />
If you are under 65 and have an individual or<br />
family health plan you purchased on your own<br />
or with the help of an agent, you can call your<br />
agent or call us for a health insurance review at<br />
1-800-310-3778.<br />
We love to hear from you!
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The Arkansas Health Care<br />
Independence Program is a<br />
new program for low income<br />
Arkansans that will allow them<br />
to shop for and enroll in Arkansas<br />
<strong>Blue</strong> Cross and <strong>Blue</strong> Shield and<br />
other health care plans on the<br />
Health Insurance Marketplace.<br />
These health plans will be<br />
available at no cost to them.<br />
People who choose this<br />
program can use any of the<br />
doctors or hospitals that other<br />
MEETINGS for SMALL<br />
businesses<br />
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Employers with two to 50 employees are invited to attend meetings with<br />
Arkansas <strong>Blue</strong> Cross and <strong>Blue</strong> Shield representatives to discuss in detail<br />
how the health care law is impacting our employer customers.<br />
Arkansas <strong>Blue</strong> Cross will hold meetings in 10 locations throughout<br />
the state during August and September. After the meetings,<br />
employers will be contacted by their agent or an Arkansas <strong>Blue</strong> Cross<br />
representative. We hope to see you at one of the following locations:<br />
HOT SPRINGS<br />
Thursday, August 8<br />
Hot Springs Convention Center<br />
JONESBORO<br />
Tuesday, August 13<br />
Hilton Garden Inn<br />
LITTLE ROCK<br />
Wednesday, August 21<br />
Embassy Suites<br />
Arkansas <strong>Blue</strong> Cross members<br />
choose and will either pay<br />
nothing or very little when<br />
they receive medical care.<br />
Call us at 1-800-310-3778<br />
to find out if you qualify.<br />
Beginning in October, we<br />
can help you enroll.<br />
FORT SMITH<br />
Tuesday, August 27<br />
Holiday Inn City Center<br />
FAYETTEVILLE<br />
Wednesday, August 28<br />
Embassy Suites<br />
MOUNTAIN HOME<br />
Thursday, August 29<br />
ASU – Vada Sheid Development Center<br />
(The Sheid)<br />
TEXARKANA<br />
Wednesday, September 4<br />
Texarkana Country Club<br />
EL DORADO<br />
Wednesday, September 11<br />
El Dorado Conference Center<br />
PINE BLUFF<br />
Thursday, September 12<br />
Pine Bluff Convention Center<br />
The Arkansas Health Care Independence Program: Do you qualify?<br />
On April 23, Arkansas Gov. Mike<br />
Beebe signed historic legislation<br />
approving a Medicaid expansion<br />
program in Arkansas, creating<br />
the Arkansas Health Care<br />
Independence Program.<br />
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Meetings will be held at 1:30-3 p.m. in all locations.<br />
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SUMMER <strong>2013</strong> BLUE & YOU<br />
9
When was the last time you felt … FREE?<br />
Free of worry? Free of fear?<br />
Free of uncertainty?<br />
It’s time to uncover that feeling again.<br />
Because you are protected …<br />
with the compassion of a CROSS<br />
that’s been trusted for 65 YEARS;<br />
the security of a SHIELD accepted<br />
by more than 90 PERCENT<br />
of doctors and specialists.<br />
And the power of a card that<br />
opens doors in IN ALL 50 STATES.<br />
Giving you the freedom to love.<br />
To dream. To dare. To believe. To laugh.<br />
To dance like no one is watching.<br />
Arkansas <strong>Blue</strong> Cross and <strong>Blue</strong> Shield.<br />
LIVE FEARLESS<br />
<strong>You</strong>’ve likely seen and heard our new<br />
messages on television and radio for<br />
several weeks now. What is it all about?<br />
Health care financing was invented<br />
during the Great Depression, and with<br />
a new health care revolution on the<br />
horizon, we know you may have concerns.<br />
Arkansans have come to rely on Arkansas<br />
<strong>Blue</strong> Cross and <strong>Blue</strong> Shield for more than<br />
six decades — and you still can.<br />
with the card that opens doors in 50 states<br />
An independent licensee of the <strong>Blue</strong> Cross and <strong>Blue</strong> Shield Association.<br />
We’ll be here to guide you through this<br />
rapidly evolving health care landscape.<br />
Giving you strength to be fearless, even<br />
in the face of change. Contact us about<br />
affordable health coverage to protect you<br />
and your family. So you can Live Fearless.<br />
10 BLUE & YOU SUMMER <strong>2013</strong>
An independent licensee of the <strong>Blue</strong> Cross and <strong>Blue</strong> Shield Association.<br />
An independent licensee of the <strong>Blue</strong> Cross and <strong>Blue</strong> Shield Association.<br />
SUMMER <strong>2013</strong> BLUE & YOU<br />
11
Fast Food and Asthma<br />
We all know fast food isn’t exactly ideal for<br />
us. But, if your child has asthma, you may have<br />
even more of a reason to cut out the fast food.<br />
A recent study published in Thorax (a respiratory<br />
medical journal, suggests that consuming fast<br />
food more than three times a week can lead to an<br />
increase in the severity of their asthma.<br />
While the findings do not show that fast food is the<br />
cause of asthma, they do suggest that children with<br />
asthma who eat fast food often have more severe<br />
asthma than children who do not eat fast food often.<br />
Why? It appears that it may be due to the high<br />
levels of saturated and trans fats and sugar found<br />
in fast food; all of which are known to affect the<br />
immune system.<br />
Sources: Healthyliving.msn.com / Usnews.com<br />
Studies tie binge drinking to future heart<br />
disease and liver damage<br />
<strong>You</strong>ng people who party too hard may regret it later<br />
in life, according to recent studies on alcohol’s lasting<br />
effects on health.<br />
In research published in the Journal of the American<br />
College of Cardiology and in Alcoholism: Clinical<br />
& Experimental Research, binge drinking has been<br />
identified as a significant risk factor for both heart<br />
disease and liver damage later in life.<br />
In the study regarding heart health, researchers looked<br />
at two groups of healthy nonsmoking students, ages 18<br />
to 25. One group had a history of binge drinking and the<br />
other group did not drink heavily. The study found that<br />
binge drinkers had impaired function in two cell types<br />
that control blood flow. These vascular changes can be<br />
a precursor to hardening of the arteries, heart attack<br />
and stroke.<br />
The study focused on liver damage in binge drinkers<br />
found that over time binge drinking can sensitize<br />
the liver and make it prone to more subsequent<br />
damage. High levels of alcohol were found to create<br />
an inflammatory response in the liver, sending out<br />
various damaging signals to systems in the body.<br />
Both studies cautioned against the notion that<br />
being young and healthy can protect people from<br />
poor lifestyle behaviors or choices.<br />
Source: Journal of the American College of Cardiology;<br />
Alcoholism: Clinical & Experimental Research<br />
12 BLUE & YOU SUMMER <strong>2013</strong><br />
SPECIAL NOTICE:<br />
*Arkansas State and Public School Employees<br />
can enroll in a weight-loss program administered<br />
by the Employee Benefits Division.<br />
Call 1-877-815-1017 for more information.<br />
**Medi-Pak ® Medicare supplement and<br />
Medi-Pak Rx insurance policyholders are<br />
not eligible for The Healthy Weigh! program.<br />
Lose weight<br />
The Healthy Weigh! Education<br />
Program is free for members of<br />
Arkansas <strong>Blue</strong> Cross and <strong>Blue</strong><br />
Shield, Health Advantage (except<br />
ARBenefits members*), <strong>Blue</strong> Cross<br />
and <strong>Blue</strong> Shield Service Benefit<br />
Plan (Federal Employee Program),<br />
Medi-Pak Advantage (PFFS), Medi-<br />
Pak Advantage PPO, and eligible<br />
members of <strong>Blue</strong>Advantage<br />
Administrators of Arkansas.**<br />
To enroll, complete the attached<br />
enrollment form and return it in<br />
the self-addressed, postage-paid<br />
envelope included in this magazine.<br />
The program starts when you enroll.<br />
After enrollment, you will begin to<br />
receive information through the mail,<br />
which you can read in the privacy<br />
of your own home and at your own<br />
pace. The program is completely<br />
voluntary, and you may leave the<br />
program at any time. If you have<br />
further questions about the program,<br />
call the Health Education Program’s<br />
toll-free number at 1-800-686-2609.<br />
Simply complete, sign and return<br />
the attached enrollment form in the<br />
self-addressed, postage-paid envelope<br />
to join The Healthy Weigh!
Is memory loss<br />
from aging or<br />
lack of sleep?<br />
maybe both<br />
The benefits of a good night’s sleep on the body are well known, but did you know it is<br />
also beneficial for your brain? New findings are making strong correlations between sleep<br />
and memory, and are shedding light on why older people may have trouble with both.<br />
A study by the National Institutes of Health’s National Institute on Aging found a marked<br />
difference in the brain-wave activity of younger people and older people while they sleep.<br />
Looking deeper into the difference, they found that the lack of deep sleep in seniors<br />
prevents their brains from storing memories in the location of the brain used for recalling<br />
them over the long term. Instead their brains leave memories stored in the portion of the<br />
brain that is used for short-term memory.<br />
So, if you find yourself struggling to recall facts, or having more frequent “it’s-just-onthe-tip-of-my-tongue”<br />
moments, make sleep a priority.<br />
How can you get better sleep?<br />
• Turn off electronics a couple of<br />
hours before bedtime.<br />
• Avoid nicotine, caffeine and alcohol in<br />
the evening.<br />
• Stick to a schedule; don’t sleep late<br />
on weekends.<br />
• Exercise in the late afternoon.<br />
• Keep your room cool and dark.<br />
Place black tape over electronic<br />
lights if necessary.<br />
• Keep pets and children out of the bed.<br />
• Take a hot shower or bath before<br />
going to bed.<br />
• When you wake up in the morning,<br />
open the blinds or step outside as<br />
soon as possible. Sunlight helps<br />
regulate your biological clock.<br />
• Seek medical help if you have a<br />
sleep problem, especially if it<br />
includes snoring.<br />
SUMMER <strong>2013</strong> BLUE & YOU<br />
13
NEWS<br />
Arkansas <strong>Blue</strong> Cross provides<br />
family fun for members<br />
Arkansas <strong>Blue</strong> Cross and <strong>Blue</strong> Shield members enjoyed a<br />
variety of family-friendly activities earlier this year. We appreciate<br />
our members and always are looking for opportunities to add<br />
value to our relationship. And, there is more to come!<br />
Families at the Hop on Over Easter Party at Arkansas<strong>Blue</strong><br />
enjoyed dancing and playing games with Radio Disney. And,<br />
two lucky families won season passes to the Museum of<br />
Discovery and the Little Rock Zoo along with beach towels,<br />
insect repellent, sunscreen, first-aid kits, bubbles and more.<br />
Arkansas<strong>Blue</strong> is Arkansas’ first health insurance store, located<br />
in the Shackleford Crossings shopping center in Little Rock.<br />
The Easter Bunny and<br />
<strong>Blue</strong>Ann Ewe interact with<br />
a young admirer at the<br />
Arkansas<strong>Blue</strong> Easter party.<br />
During the Night at the Museum Pajama Party in June at the<br />
Museum of Discovery in Little Rock, parents and children went on a scavenger hunt in the<br />
Arkansas <strong>Blue</strong> Cross and <strong>Blue</strong> Shield Amazing <strong>You</strong> Gallery for a chance to win prizes, and<br />
shared healthy snacks in the Gigabyte room. <strong>Blue</strong>Ann Ewe was on hand to dance with the kids<br />
and point out clues in the gallery. While all of our members could get in free to the event, we<br />
also gave away 300 tickets to non-members at Arkansas<strong>Blue</strong>.<br />
As part of our title sponsorship of the Arkansas <strong>Blue</strong> Cross and <strong>Blue</strong> Shield Amazing <strong>You</strong><br />
Gallery inside the Museum of Discovery (designed to teach youth and families about the<br />
body and how to keep it healthy), we have two member-appreciation days each year.<br />
Mark your calendar — the next member-appreciation day at the Museum of Discovery<br />
will be on Grandparent’s Day, Sunday, September 8.<br />
Walk at Lunch<br />
April 24 was National Walk @ Lunch Day (NW@LD), and Arkansas <strong>Blue</strong> Cross and<br />
<strong>Blue</strong> Shield; Arkansas Center for Health Improvement; Me, Myself and I Workout;<br />
Arkansas Department of Human Services; Arkansas Workers’ Compensation; and the<br />
Arkansas Plant Board employees walked together to the Little Rock River Market.<br />
NW@LD is an event designed to encourage employees to spend part of their lunch<br />
break on this day walking in an effort to promote fitness and encourage regular<br />
worksite wellness activities. NW@LD is part of the <strong>Blue</strong> Cross and <strong>Blue</strong> Shield<br />
Association’s Walking Works program.<br />
14 BLUE & YOU SUMMER <strong>2013</strong>
Customers Rank Arkansas <strong>Blue</strong> Cross<br />
as a top <strong>Blue</strong> Plan in the Nation<br />
Arkansas <strong>Blue</strong> Cross and <strong>Blue</strong> Shield is one of the best <strong>Blue</strong> Plans in the nation in providing<br />
valuable products, excellent customer service and gaining the trust of members, according to a<br />
national survey of <strong>Blue</strong> Plan members.<br />
A recent consumer brand index (CBI), a tool for understanding consumers’ perceptions of a brand or<br />
company, was developed for the <strong>Blue</strong> Cross and <strong>Blue</strong> Shield Association to determine how all the <strong>Blue</strong><br />
Plan markets rank with their members. There are 38 <strong>Blue</strong> Plans across the United States, but the survey<br />
was more in-depth and actually involved 61 individual markets. The survey focused on three primary areas:<br />
Did the Plan meet expectations? Is the Plan a company you can trust?<br />
3. How do you feel and think about the Plan?<br />
1. 2.<br />
Out of a possible 100 points, Arkansas <strong>Blue</strong> Cross received an overall score of 82, tying two other<br />
<strong>Blue</strong> Plan markets for the top score in the nation. The median score nationwide was 76. Members<br />
were asked, based on everything they have seen, heard, read or experienced, how they think about<br />
their Plan on a scale of 1 to 10. A score with a plus sign indicates that the score was significantly<br />
different than the system-wide results. So how did Arkansas <strong>Blue</strong> Cross do, question-by-question?<br />
Did your Plan meet expectations?<br />
Arkansas <strong>Blue</strong> Cross: 8.3 +<br />
<strong>Blue</strong> Plan national average: 7.7<br />
Is your Plan a company you can trust?<br />
Arkansas <strong>Blue</strong> Cross: 8.6 +<br />
<strong>Blue</strong> Plan national average: 8.0<br />
How do you feel and think about your Plan?<br />
Arkansas <strong>Blue</strong> Cross: 8.2 +<br />
<strong>Blue</strong> Plan national average: 7.8<br />
“We are pleased that our members think so highly of us,” said Karen Raley, vice president of<br />
Communications and Product Development at Arkansas <strong>Blue</strong> Cross. “We put our members first in<br />
everything we do and these survey results let us know that our members recognize that.”<br />
It is that “member first” attitude permeating every division within Arkansas <strong>Blue</strong> Cross that makes<br />
it difficult to pinpoint who should get the most credit for the glowing CBI results. Customer Service<br />
and other employees who interact directly with members leave a lasting impression of the company<br />
as a whole. The Communications team provides a Web presence that is user-friendly and informative.<br />
New member welcome kits provide vital information right up front that help members more<br />
completely understand their benefits.<br />
“It takes all of us to deliver the kind of service our members deserve, and all of our employees<br />
should be pleased with these excellent ratings,” said Karen. “However, we have no intention of<br />
relaxing now. Our industry as a whole is facing unprecedented challenges, and we need to raise<br />
the bar — for ourselves and for Arkansas <strong>Blue</strong> Cross. Our customers deserve that.”<br />
Heart Walk <strong>2013</strong><br />
Arkansas <strong>Blue</strong> Cross had a great team showing at the Heart Walk held April 20<br />
at Burns Park in North Little Rock. Employees and their family members walked<br />
together to show their support for heart disease research. <strong>Blue</strong> definitely cares!<br />
SUMMER <strong>2013</strong> BLUE & YOU<br />
15
FROM the PHARMACIST<br />
Over-the-counter medicines<br />
Access + Knowledge = Power<br />
More and more, Americans can go to their<br />
favorite grocery store instead of to the doctor<br />
when they need medicine. This immediate<br />
access to medicine to treat an ailment gives us<br />
immense power over our health, but it must be<br />
balanced by the knowledge to use the medicine<br />
correctly. The following information from the<br />
U.S. Food and Drug Administration (FDA)<br />
provides some great advice for using over-thecounter<br />
(OTC) medicines responsibly.<br />
The FDA determines whether medicines are<br />
prescription (Rx) or OTC. The FDA also decides<br />
when a prescription medicine is safe enough<br />
to be sold directly to consumers, a regulatory<br />
process known as Rx-to-OTC switch. More than<br />
700 products sold over the counter today use<br />
ingredients or dosage strengths available only<br />
by prescription 30 years ago.<br />
With new opportunities in self-medication come<br />
new responsibilities and an increased need for<br />
knowledge. The FDA and the Consumer Healthcare<br />
Products Association (CHPA) have prepared the<br />
following information to help Americans take<br />
advantage of self-care opportunities.<br />
by TREY GARDNER, Pharm D.,<br />
Arkansas <strong>Blue</strong> Cross and <strong>Blue</strong> Shield<br />
OTC know-how: It’s on the label<br />
<strong>You</strong> wouldn’t ignore your doctor’s instructions<br />
for using a prescription medicine; so don’t<br />
ignore the label when taking an OTC medicine.<br />
Here’s what to look for:<br />
• Product name<br />
• Active ingredients — therapeutic substances<br />
in medicine<br />
• Purpose — product category (such as<br />
antihistamine, antacid or cough suppressant)<br />
• Uses — symptoms or diseases the product<br />
will treat or prevent<br />
• Warnings — when not to use the product,<br />
when to stop taking it, when to see a<br />
doctor and possible side effects<br />
• Directions — how much to take,<br />
how to take it, and how long to take it<br />
• Other information — such as storage<br />
information<br />
• Inactive ingredients — substances<br />
such as binders, colors or flavoring<br />
Make sure you are reading the label correctly.<br />
Always use enough light. It usually takes three<br />
times more light to read the same line at age 60<br />
than at age 30. If necessary, use your glasses or<br />
contact lenses when reading labels.<br />
Always remember to look for the statement<br />
describing the tamper-evident feature(s) before<br />
you buy the product and when you use it.<br />
When it comes to medicines, more does<br />
not necessarily mean better. <strong>You</strong> should never<br />
misuse OTC medicines by taking them longer<br />
or in higher doses than the label recommends.<br />
Symptoms that persist are a clear signal it’s time<br />
to see a doctor.<br />
16 BLUE & YOU SUMMER <strong>2013</strong><br />
PHARMACY continued on page 21
the DOCTOR’S corner<br />
<strong>You</strong>r role in health care<br />
Health care is changing in many ways to<br />
provide the highest quality of care while<br />
keeping costs down. Doctors and their care<br />
teams, hospitals, insurance companies,<br />
employers and many others are learning their<br />
roles as part of this new approach. What you<br />
may not realize, however, is that you are a vital<br />
part of that change. On its most basic level,<br />
health care is between the person who delivers<br />
care and the person who receives it. To achieve<br />
better health outcomes, patients must make<br />
good decisions based on complete information.<br />
If you’ve been in your doctor’s office recently,<br />
you may have noticed some changes. The clinic<br />
may be using an electronic medical record.<br />
Computerized records make it easier to keep<br />
up with current and past problems, medication<br />
lists, recommended screening tests, lab results<br />
and needed immunizations. Some doctors and<br />
facilities have developed systems to securely<br />
share your information so those who need<br />
to know a test result will have access to it<br />
rather than delaying care or repeating the test.<br />
There may be someone in the clinic who is<br />
coordinating care between specialists or the<br />
emergency room and your doctor. To improve<br />
the clinic’s efficiency, you may be asked for<br />
feedback about clinic services. Specialists and<br />
primary care doctors are communicating more<br />
in order to monitor costs and improve your care.<br />
To achieve the highest quality of care,<br />
both underuse and overuse of health care<br />
resources must be avoided. With some of the<br />
new payment methods, your doctor may be<br />
eligible for higher payments if his patients<br />
receive appropriate tests that have proven<br />
beneficial. The health maintenance your doctor<br />
recommends is to prevent or delay more<br />
serious illness, and you should benefit from<br />
following his advice and changing behaviors.<br />
<strong>You</strong> may be asked to participate in an education<br />
program for a condition like diabetes or<br />
by CONNIE MEEKS, M.D. – Corporate Medical Director<br />
Arkansas <strong>Blue</strong> Cross and <strong>Blue</strong> Shield<br />
low back pain. If your doctor recommends<br />
a screening or a behavior change, consider<br />
his advice. Take personal responsibility and<br />
recognize that routine care is an investment in<br />
better health for the long term.<br />
In contrast, there are some overused<br />
procedures that have not proven effective.<br />
Leading medical specialty societies have<br />
teamed up with Consumer Reports to spread<br />
the word that doctors and patients should<br />
have important conversations to decrease the<br />
practice of ordering unnecessary tests and<br />
procedures. The Choosing Wisely campaign<br />
focuses on lists of “Five Things Physicians and<br />
Patients Should Question,” created by each<br />
participating specialty group. For instance, the<br />
specialty group for family doctors recommends<br />
that electrocardiograms or other cardiac<br />
screenings for low-risk patients without<br />
symptoms should not be ordered.<br />
Pediatricians recommend against cough and<br />
cold medicines for respiratory illnesses in children<br />
under four years of age. Doctors will be spending<br />
more time discussing with patients why certain<br />
tests may or may not be needed. <strong>You</strong>r part in this<br />
is to be open to discussions with your doctor and<br />
to understand that there are new expectations<br />
for him to provide advice supported by evidence,<br />
discuss options and gain your cooperation in a<br />
plan of care. This is shared decision making, so<br />
there is an expectation that you will participate<br />
and follow through with decided plans.<br />
The goal of improved personal health is<br />
not only that it is good for patients, but that<br />
it will contribute to the improved financial<br />
health of our country. The effort begins with<br />
you taking responsibility.<br />
Source: Choosing Wisely campaign,<br />
choosingwisely.org<br />
SUMMER <strong>2013</strong> BLUE & YOU<br />
17
WILL ARKANSAS<br />
The <strong>Blue</strong> & <strong>You</strong> Foundation for a Healthier<br />
Arkansas recently collaborated with the Arkansas<br />
Center for Health Improvement (ACHI) to fund a<br />
study examining the current and future numbers<br />
of physicians and specialists statewide.<br />
The report, Arkansas Health Care<br />
Workforce: A Guide for Policy Action,<br />
provides a unique, multi-dimensional<br />
look at how and where health care<br />
is provided in Arkansas. This includes<br />
location, office capacity, acceptance<br />
of patients covered by Medicare and<br />
Medicaid and the patient experience. Previous<br />
studies either have been national in scope and based<br />
on raw population-to-physician ratios or have relied<br />
solely on survey information.<br />
According to Patrick O’Sullivan, executive director<br />
of the <strong>Blue</strong> & <strong>You</strong> Foundation, the report provides<br />
a much-needed resource for informing policy<br />
decisions that will result in meaningful solutions<br />
for improving the health care system in Arkansas.<br />
“Much discussion has centered on the idea that<br />
we have a serious statewide shortage of doctors<br />
and that this shortage will worsen due to an<br />
aging health care workforce,” Patrick said. “At the<br />
same time, there has been a lack of consistent<br />
data to demonstrate the real picture in Arkansas.<br />
ACHI has proven expertise for using information<br />
from various sources to pull together a big picture<br />
and identify policy implications. The <strong>Blue</strong> & <strong>You</strong><br />
Foundation is pleased to have partnered with<br />
ACHI to provide policymakers and stakeholders a<br />
guide for important decisions.”<br />
The information in the report shows not only<br />
the number of medical professionals needed, but<br />
where they will be needed. The report describes a<br />
severe shortage in the southeast and southwest<br />
regions, but points to an excess supply in<br />
central Arkansas. On a positive note, many clinic<br />
managers surveyed said they expect to keep their<br />
present staff and in many cases have plans to add<br />
new clinicians.<br />
18 BLUE & YOU SUMMER <strong>2013</strong><br />
have<br />
enough<br />
DOCTORS?<br />
The <strong>Blue</strong> & <strong>You</strong> Foundation funds a study to find out<br />
Arkansas<br />
Health Care Workforce<br />
A Guide for<br />
Policy Action<br />
March <strong>2013</strong><br />
Funded by:<br />
The following are a few highlights<br />
from the report:<br />
• While there is a shortage of primary care<br />
physicians, the presence in Arkansas of<br />
physician extenders, like advanced<br />
practice nurses and physician assistants,<br />
make up all but 4 percent of the shortfall<br />
in the supply of primary care clinicians.<br />
• There are critical shortages of primary<br />
care physicians and physician extenders<br />
in some rural areas and a potential<br />
oversupply in urban areas.<br />
• Primary care clinicians may approach<br />
the needed number statewide by 2020,<br />
but shortages will remain in rural parts of<br />
the state unless incentives are put in place.<br />
• Creative solutions may involve policies<br />
regarding expanded insurance coverage,<br />
transportation resources and use of<br />
information technology.<br />
Demand greater than supply<br />
Demand 20% or more<br />
Demand 10% to 19%<br />
Little or no supply shortage<br />
Demand = Supply (+ 9%)<br />
Supply 10% or more<br />
Adequacy of Supply and Demand of Primary Care Providers<br />
by County (2012)<br />
To learn more about the report, go to the<br />
ACHI website, achi.net.
Member Discounts<br />
Metabolic Research Centers<br />
Enjoy a 10 percent discount on all new program enrollment<br />
fees at the Metabolic Research Center, a weight management<br />
company with locations in Bentonville, Fort Smith, Fayetteville,<br />
Conway and Little Rock.<br />
The Metabolic program is unique because it addresses the<br />
root cause of disorder eating and recurring weight gain. Their<br />
personalized approach helps clients by identifying why as well as what they eat. They recognize and<br />
affirm the unique and intrinsic worth of each individual by this one-on-one approach. The programs<br />
at Metabolic were designed by the nation’s foremost experts in the field of disorder eating and are<br />
administered nationally through Metabolic Research Centers. Metabolic Research Center offers to<br />
deliver high-quality, cost-effective services and products to the clients they serve.<br />
Save on Jenny Craig<br />
As our member, you can choose a FREE 30-Day Program*<br />
or 25 percent off a Premium Program* from Jenny Craig. ® Just<br />
print the coupon on the national and statewide discounts page<br />
on any of our websites.<br />
Pick a program that works with you, not against you! MyDays<br />
is a flexible, new weigh-loss choice that gives you the structure you need to stay on track and the<br />
freedom to live your life. Eat five days of Jenny and two days of your own healthy choices. <strong>You</strong>r<br />
consultant will help you find the program that fits your real life.<br />
It’s about progress, not perfection. <strong>You</strong>r personal consultant will help you stay on track every step<br />
of the way. Jenny has two options for consultations:<br />
• Get weekly, face-to-face support and<br />
motivation at one of more than 600 locations.<br />
* Plus the cost of food and shipping, if applicable.<br />
At participating centers. Restrictions apply.<br />
Grants available for health programs<br />
• Enjoy the convenience and privacy of getting<br />
your support and motivation on the phone<br />
each week.<br />
JULY15<br />
deadline<br />
Programs to improve the health of Arkansans, whether in a small town or throughout the state, have<br />
until July 15 to submit applications for grants from the <strong>Blue</strong> & <strong>You</strong> Foundation for a Healthier Arkansas.<br />
The grants of $5,000 to $150,000 may be used for general operational or specific program support<br />
for an existing or new program. Any public charity, public school, government agency or non-profit<br />
hospital in Arkansas is eligible to apply; however, grants are not made to individuals. Funds must be<br />
used to produce positive health outcomes for Arkansans.<br />
The grants will be awarded in November to fund health improvement programs during 2014.<br />
Information about the grants and the online application submission process can be found at<br />
blueandyoufoundationarkansas.org.<br />
SUMMER <strong>2013</strong> BLUE & YOU<br />
19
new<br />
Arkansas<strong>Blue</strong><br />
health insurance store<br />
OPENS INPINE BLUFF<br />
Residents of Pine Bluff and southeast<br />
Arkansas can speak face to face with health<br />
insurance experts at the new Arkansas<strong>Blue</strong><br />
office at 509 Mallard Loop Drive in Pine Bluff.<br />
Health insurance experts at the new location<br />
will provide Arkansas <strong>Blue</strong> Cross and <strong>Blue</strong><br />
Shield members and insurance shoppers with<br />
information about Arkansas <strong>Blue</strong> Cross insurance<br />
plans, advice on which plan best covers them<br />
and fits their budget, as well as assistance with<br />
questions or concerns they may have about<br />
purchasing or choosing health insurance.<br />
Arkansas<strong>Blue</strong> also will provide visitors with<br />
information on dental and other insurance plans.<br />
And, with the full implementation of the health<br />
care law approaching in 2014, visitors who have<br />
purchased individual or family health insurance<br />
plans can come in for health insurance reviews<br />
to see how new regulations will impact their<br />
health insurance coverage and cost.<br />
“Arkansas <strong>Blue</strong> Cross has operated a fullservice<br />
office in Pine Bluff since 1994, serving<br />
members in a 13-county area with customer<br />
service, individual and group product sales<br />
and marketing, medical management and<br />
provider services,” said Dwayne Pierce, regional<br />
executive. “Our new location will allow us to<br />
expand our services and provide more oneon-one<br />
counseling about health and dental<br />
insurance for individuals and families, especially<br />
with the implementation of the new health<br />
insurance law approaching.”<br />
Walk-in members and shoppers also can<br />
pick up informational brochures or digitally<br />
walkthrough an online shopping experience<br />
with an Arkansas <strong>Blue</strong> Cross representative.<br />
Arkansas <strong>Blue</strong> Cross opened Arkansas’ first<br />
health insurance store in 2011 in Little Rock to help<br />
Arkansans better understand health insurance<br />
products and how they work. The flagship store<br />
has proven to be a resource for people needing<br />
health insurance answers, and a gathering place<br />
for fun and informative events.<br />
The “freedom” of<br />
short-term coverage<br />
With the changes in the health insurance industry, some<br />
people will find they need a health insurance policy to<br />
fill a gap in coverage, or they may be looking for a more<br />
affordable solution with comprehensive coverage.<br />
Whether you need coverage<br />
for one month or a longer<br />
period, Arkansas <strong>Blue</strong> Cross and<br />
<strong>Blue</strong> Shield has a solution for<br />
you. We have affordable plans<br />
designed to provide coverage for<br />
the length of time you need it.<br />
Essential <strong>Blue</strong> Freedom is a<br />
comprehensive health insurance<br />
policy that lasts 364 days,<br />
with the freedom to reapply<br />
for coverage. It is available to<br />
Arkansas residents age 64 and<br />
younger who are not eligible<br />
for Medicaid or Medicare.<br />
20 BLUE & YOU SUMMER <strong>2013</strong><br />
It offers affordable copayments<br />
for doctor visits as well as<br />
prescription drug coverage.<br />
<strong>You</strong>r application is subject<br />
to a medical review, and a<br />
waiting period for pre-existing<br />
conditions may apply, but<br />
if you have no major health<br />
problems and you are looking<br />
for comprehensive coverage<br />
at a great rate, it may be the<br />
solution you need.<br />
What happens after day 364?<br />
<strong>You</strong> have the opportunity to<br />
reapply for another Essential<br />
<strong>Blue</strong> Freedom policy issued after<br />
answering a few simple healthrelated<br />
questions and by meeting<br />
certain medical criteria. If you<br />
fall outside the ranges, don’t<br />
worry — you still may qualify for<br />
reissue; however, your application<br />
will be subject to review.<br />
If you think Essential <strong>Blue</strong><br />
Freedom is an option for you,<br />
call us at 1-800-392-2583!<br />
We’d love to talk with you.
PHARMACY continued from page 16<br />
Be sure to read the label for each product you<br />
purchase. Just because two or more products<br />
are from the same brand family doesn’t mean<br />
they are meant to treat the same conditions or<br />
contain the same ingredients.<br />
Remember, if you read the label and still have<br />
questions, talk to a doctor, nurse or pharmacist.<br />
Medicine Interactions<br />
Although mild and relatively uncommon,<br />
interactions involving OTC medicines can<br />
produce unwanted results or make medicines<br />
less effective. It’s especially important to know<br />
about medicine interactions if you’re taking Rx<br />
and OTC medicines at the same time.<br />
Some medicines also can interact with foods<br />
and beverages, as well as with health conditions<br />
such as diabetes, kidney disease and high<br />
blood pressure.<br />
Here are a few medicine interaction cautions<br />
for some common OTC ingredients:<br />
• Avoid alcohol if you are taking<br />
antihistamines, cough/cold products<br />
with the ingredient dextromethorphan, or<br />
medicines that treat sleeplessness.<br />
• Do not use medicines that treat<br />
sleeplessness if you are taking prescription<br />
sedatives or tranquilizers.<br />
• Check with your doctor before taking<br />
products containing aspirin if you’re taking<br />
a prescription blood thinner or if you have<br />
diabetes or gout.<br />
• Do not use laxatives when you have<br />
stomach pain, nausea or vomiting.<br />
• Unless directed by a doctor, do not use<br />
a nasal decongestant if you are taking<br />
a prescription medicine for high blood<br />
pressure or depression, or if you have<br />
heart or thyroid disease, diabetes,<br />
or prostate problems.<br />
This is not a complete list. Read the label!<br />
Medicine labels change as new information<br />
becomes available. That’s why it’s important to<br />
read the label each time you take medicine.<br />
Time for a Medicine Cabinet Checkup?<br />
• Be sure to look through your medicine<br />
supply at least once a year.<br />
• Always store medicines in a cool, dry place<br />
or as stated on the label.<br />
• Throw away any medicines that are past<br />
the expiration date.<br />
• To make sure no one takes the wrong<br />
medicine, keep all medicines in their<br />
original containers.<br />
Protect <strong>You</strong>rself Against Tampering<br />
Makers of OTC medicines seal most products<br />
in tamper-evident packaging (TEP) to help<br />
protect against criminal tampering. TEP works<br />
by providing visible evidence if the package has<br />
been disturbed. But OTC packaging cannot be<br />
100 percent tamper-proof. Here’s how to help<br />
protect yourself:<br />
• Be alert to the tamper-evident features<br />
on the package before you open it. These<br />
features are described on the label.<br />
• Inspect the outer packaging before you<br />
buy it. When you get home, inspect the<br />
medicine inside.<br />
• Don’t buy an OTC product if the packaging<br />
is damaged.<br />
• Don’t use any medicine that looks<br />
discolored or different in any way.<br />
• If anything looks suspicious, be suspicious.<br />
Contact the store where you bought the<br />
product. Take it back!<br />
• Never take medicines in the dark.<br />
Source: The U.S. Food and Drug Administration<br />
and the Consumer Healthcare Products<br />
Association (CHPA)<br />
SUMMER <strong>2013</strong> BLUE & YOU<br />
21
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<br />
and its affiliates (including HMO Partners, Inc.<br />
d/b/a Health Advantage), we understand how<br />
important it is to keep your private information<br />
just that — private. Because of the nature of<br />
our business, we must collect some personal<br />
information from our members, but we also<br />
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<br />
from us and to administer your business. We<br />
collect non-public personal financial information<br />
(defined as any information that can be tied<br />
back to a specific person and is gathered by any<br />
source that is not publicly available) about our<br />
members from:<br />
• Applications for insurance coverage. The<br />
application includes information such as<br />
name, address, personal identifiers such<br />
as Social Security number, and medical<br />
information that 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 to<br />
disclose, non-public personal information about<br />
you to one another or to other parties except<br />
as permitted or required by law. Examples of<br />
instances in which Arkansas <strong>Blue</strong> Cross and its<br />
affiliates will provide information to one another<br />
or other 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 />
22<br />
BLUE & YOU SUMMER <strong>2013</strong>
CHANGES continued from page 3<br />
ready to provide you with the information you<br />
need to make a good decision for you and your<br />
family. <strong>You</strong> also can request a review with an<br />
agent if you have one, or you can go to one of<br />
our locations throughout the state.<br />
If you are age 65 or older and have coverage<br />
through one of our Medicare products, there<br />
should be no changes to your health plan until<br />
2016 as a result of the health care law. We will<br />
discuss those changes in future issues.<br />
If you are an employer with two to 50<br />
employees, you will be receiving information<br />
regarding Arkansas <strong>Blue</strong> Cross meetings being<br />
held throughout the state to help our employer<br />
customers learn how the new regulations may<br />
impact their businesses. Afterward, you will be<br />
contacted by an agent or an Arkansas <strong>Blue</strong> Cross<br />
representative to discuss your situation in more<br />
detail. Until then, our advice is that you not make<br />
any changes to your health plan.<br />
If you are an employer with 51 or more<br />
employees, you likely already have been<br />
discussing options with an agent or Arkansas<br />
<strong>Blue</strong> Cross representative. If not, I encourage<br />
you to do so in the coming months.<br />
At Arkansas <strong>Blue</strong> Cross, we are concerned with<br />
making health care affordable for everyone. We<br />
applaud the efforts of our state for coming up<br />
with a unique solution to take care of the many<br />
Arkansans who can’t afford health care. And, we<br />
will continue to provide our members with the<br />
most affordable health care coverage available<br />
by finding solutions that work within health care<br />
reform regulations and giving our members the<br />
protection they deserve.<br />
CUSTOMER SERVICE NUMBERS<br />
May we help? For customer<br />
service, please call:<br />
LITTLE ROCK<br />
TOLL FREE<br />
Number (501)<br />
Number<br />
Medi-Pak ® members 378-3062 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 378-2010 1-800-238-8379<br />
• Pharmacy questions 1-800-863-5561<br />
• Specialty Rx pharmacy questions 1-866-295-2779<br />
Health Advantage members 378-2363 1-800-843-1329<br />
• Pharmacy questions 1-800-863-5567<br />
<strong>Blue</strong>Advantage members 378-3600 1-888-872-2531<br />
• Pharmacy questions 1-888-293-3748<br />
Federal Employee members 378-2531 1-800-482-6655<br />
Looking for health or dental insurance? We can help!<br />
For individuals, families 378-2937 1-800-392-2583<br />
For employer groups* 378-3070 1-800-421-1112<br />
*Arkansas <strong>Blue</strong> Cross, Health Advantage and <strong>Blue</strong>Advantage Administrators of Arkansas<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 />
• Hot Springs<br />
100 Greenwood Ave., Suite C 1-800-588-5733<br />
• Jonesboro<br />
707 East Matthews Ave. 1-800-299-4124<br />
• Little Rock<br />
601 Gaines Street 1-800-421-1112<br />
• Pine Bluff<br />
509 Mallard Loop 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 • blueadvantagearkansas.com • blueandyoufoundationarkansas.org<br />
SUMMER <strong>2013</strong> BLUE & YOU 23
the HEALTH CARE LAW timeline<br />
JULY1<br />
<strong>2013</strong><br />
SEPT.3<br />
<strong>2013</strong><br />
OCT.1<br />
<strong>2013</strong><br />
DEC.15<br />
<strong>2013</strong><br />
JAN.1<br />
2014<br />
A new tool to help determine if you<br />
qualify for cost breaks launches on<br />
our website, arkansasbluecross.com<br />
2014 health care plans become<br />
available for review on our website<br />
Online marketplace opens<br />
Final day to buy health insurance for a<br />
January 1, 2014 effective date<br />
New health insurance plans begin<br />
MAR.31<br />
2014<br />
Last day to sign up for health insurance<br />
MPI 1624 6/13