2000 - Spring by Arkansas Blue Cross and Blue Shield

~CHILDRENâ&#x20AC;&#x2122;S Health Information Inside~

Spring 2000

From playpen to prom * Keeping your child healthy *

Customer Service Numbers Category

Little Rock Toll-free Number (501) Number

State/Public School Employees

378-2437 1-800-482-8416

e-mail: publicschoolemployees@arkbluecross.com stateemployees@arkbluecross.com Medi-Pak (Medicare supplement)

378-3062 1-800-338-2312

Medicare (for beneficiaries only): Part A (hospital benefits) Part B (physician benefits)

378-2173 1-800-482-5525 378-2320 1-800-482-5525

UniqueCare, UniqueCare Blue, Blue Select® (individual products) 378-2010 1-800-238-8379 Group Services

378-5579

1-800-421-1112

BlueCard®

378-2127 1-800-880-0918

Federal Employee Program (FEP)

378-2531 1-800-482-6655

Health Advantage

221-3733 1-800-843-1329

Medi-Pak HMO (Health Advantage) 954-5200 1-800-354-9904 USAble Administrators

378-3600 1-800-522-9878

Numbers to call for information about obtaining coverage: Category

Little Rock Toll-free Number (501) Number

Medi-Pak (Medicare supplement)

378-2937 1-800-392-2583

UniqueCare Blue, Blue Select® (individual products)

378-2937 1-800-392-2583

Medi-Pak HMO (Health Advantage) 378-6987 1-800-588-5706

Regional Office locations: Central Northeast Northwest South Central Southeast Southwest West Central

Little Rock Jonesboro Fayetteville Hot Springs Pine Bluff Texarkana Fort Smith

Customers who live in these regions may contact the regional offices or call the appropriate toll-free telephone number listed above.

is published four times a year by the Arkansas Blue Cross and Blue Shield Advertising and Communications Division for the company’s members, health care professionals and other persons interested in health care and wellness. Opinions expressed herein do not necessarily reflect the views of Arkansas Blue Cross and Blue Shield or any of its publics.

INSIDE THIS ISSUE

~SPRING 2000~

Prenatal information ................................. 4-5 Special Delivery program ............................. 5 Immunize your child ..................................... 6 Signs of sinus & ear infections .................... 7 Measuring up, Sibling rivalry ....................... 8 Is your child getting enough sleep? ............. 9 Raising healthy kids ............................. 10-11 Help! My child has ADD! ............................ 12 Rules are good for children ....................... 13 Teen turmoil: Acne & Depression ............... 14 Talking to your teen ................................... 15 Focus on Children’s Health (ways to praise, the general’s plan and word scramble contest winner) .... 16 Club Update, Ageless Heroes, Olympics .... 17 Leading the Way (get to know some of Arkansas’ legislators) ....... 18-19 Who owns Arkansas Blue Cross? .......... 20-21 Survey results in a letter from the editor ... 21 Health Advantage news for members ......... 22 Blue & Your Community ............................. 23 Clearly Blue (a terminology guide) .................... 24 Vice President of Advertising and Communications Patrick O’Sullivan Editor Kelly Whitehorn Designer Gio Bruno

Contributors Mark Carter, Janice Drennan, Damona Fisher and Kathy Luzietti

Pregnant Women Guidelines* 1st Prenatal Visit

14-16 Weeks

24-28 Weeks

36 Weeks

1. Genetic and obstetric history, dietary intake, tobacco/alcohol/ drug use, risk factors for intrauterine growth retardation and low birthweight, prior genital herpetic lesions. 2. Fundal height and fetal heart tones. 3. Urine culture. 4. Blood pressure. 5. Hemoglobin and Hematocrit. 6. ABO/Rh typing. 7. Rh(D) and other antibody screen. 8. Pap smear. 9. VDRL/RR. 10. Hepatitis B surface antigen (HBsAg). 11. Urinalysis for glucose and protein. 12. Gonorrhea culture and Chlamydial testing. 13. Ultrasound cephalometry. 14. HIV counseling and testing.

Each Visit: 1. Fundal height and fetal heart tones. 2. Blood pressure. 3. Urinalysis for glucose and protein.

(Clinical discretion during 24 to 28 week period): 4. Maternal serum alpha-fetoprotein (MSAFP)(2). 5. 50g oral glucose tolerance test.

(Clinical discretion during 36-week period): 4. Beta strep.

*NOTE: These guidelines represent minimum levels of recommended care. Individual risk factors may require additional screenings and services.

Notice to all mothers-to-be I

mproving the health of mothers and infants is a national challenge. Talk to your physician today about steps you can take toward ensuring a healthy pregnancy. Adopted from national guidelines, the services listed here were reviewed by local physicians prior to release. Health Advantage has distributed this information to primary care physicians and those physicians specializing in obstetrics and gynecology (OB/GYN) within the Health Advantage network. This information is intended only as a guide. Individual treatment is a coordinated effort between you and your physician.

Planning to have a baby? 1. Take a vitamin pill that has a folic acid in it every day. Folic acid is a special vitamin that can help prevent birth defects of the brain and spine. Foods that have folic acid include orange juice, green vegetables, fortified breakfast cereals and enriched rice and whole wheat bread. 2. Have a medical checkup before getting pregnant.

All about the

Special Delivery program T

he Special Delivery program is a pregnancy program offered as an additional benefit to Arkansas Blue Cross and Blue Shield, Health Advantage and USAble Administrators members. It was created with three strategies in mind to make sure our members have healthier pregnancies — education, assessment and intervention. The Special Delivery program seeks to assist the expectant mother and her physician in the prevention of preterm births secondary to high-risk perinatal conditions. All program participants receive educational materials and coupons by mail. Services not normally offered such as skilled nursing assessments or nursing assistant care in the home for conditions including pregnancy-induced hypertension, diabetes mellitus and preterm labor are covered through the Special Delivery program. How the program works: • Expectant mothers should enroll in the program by the 14th week of pregnancy. • The expectant mother will complete a risk assessment brochure where she answers a series of basic questions. The questions are designed to identify factors that may put the mother and/or baby at risk. • If risk exists, the expectant mother is followed throughout her pregnancy to determine if home health care is appropriate. If high risk exists, the mother and baby are monitored at regular intervals throughout the pregnancy to identify needs she might have (for example, home health), provide further education and to encourage the mother-to-be to keep her appointments with her doctor. If low risk exists, the patient will be rescreened at 24 to 28 weeks via telephone contact by the Special Delivery nurse or by completing a risk assessment brochure that will be mailed to her and returned to Medical Management. If the Special Delivery program is a benefit of your health insurance and you would like more information, please call toll-free 1-800-742-6457 or 501-954-5468.

Call toll-free 1-800-742-6457 or 501-954-5468.

Here are some helpful hints for having a healthy baby

3. Adopt a healthy lifestyle — eat a balanced diet, get plenty of exercise and reduce stress. 4. If you are not immune to chicken pox and rubella, check with your health care provider about getting vaccinated before you conceive. 5. Have medical problems like diabetes, epilepsy and high blood pressured treated.

6. Try to achieve your ideal weight. If you are overweight when you become pregnant, you’re more likely to develop high blood pressure and diabetes during pregnancy. If you’re underweight, you’re more likely to have a low-birthweight baby. 7. If you have had problem pregnancies or birth defects in your family, you should talk about it with your health care provider.

8. Avoid exposure to toxic substances and chemicals. 9. Don’t eat undercooked meat or handle cat litter.

Be an overprotective parent — immunize I f you have a newborn baby or are thinking

about starting a family, you have plenty to worry about. One thing you shouldn’t worry about is whether you should get your child immunized. The American Academy of Pediatrics recommends that parents protect their children from serious childhood illnesses through immunizations. Without immunizations, your child is at risk for illnesses such as measles, whooping cough, hepatitis, polio and much more. Immunizations begin at birth, and children should receive most of their immunizations during their first two years of life. Some immunizations are combined and protect against numerous diseases. The current immunization schedule is available from your pediatrician and was featured in the Winter 1999 issue of Blue & You. Your child needs the following immunizations to stay healthy: • MMR vaccine to protect against measles, mumps and rubella. • Polio vaccine to protect against polio. • DTaP or DTP vaccines to protect against diptheria, tetanus and whooping cough.

• Hib vaccines to protect infants and children against Haemophilus influenzae type B infection (this can be a cause of meningitis or blood strain infections). • HBV vaccine to protect against hepatitis B, which causes liver disease. • Varicella vaccine to protect against chicken pox. Reactions to immunizations may occur, but they are usually mild. Serious reactions are very rare but may occur. The risks from these potentially serious diseases are greater than the risk of a serious reaction from an immunization. Immunizations are an important part of keeping your child healthy. Immunize your child on time and keep your child’s records up-to-date. Also, make sure your child has regular checkups with his or her pediatrician or health clinic. Remember, the best way to make sure your child gets the immunizations he or she needs is to check with your child’s pediatrician or your local health clinic. Information for this article was obtained from the American Academy of Pediatrics.

Special thanks A special thanks to Tony Johnson, M.D., and Charles Gist, M.D., for their time and commitment to this issue of Blue & You focusing on their area of specialty — children. Dr. Johnson is a pediatrician with the Arkansas Pediatric Clinic and Dr. Gist specializes in child, adolescent and adult psychiatry with Psychiatric Associates of Arkansas, PLLC. Both practice in Little Rock, Ark.

S O M ETI M ES

A SI N US I N FECTI ON C AN MAS QU E R ADE AS A COLD

H ow can you tell if your child has an acute sinus infection rather than a case of the common cold? • Symptoms of a cold that linger more than 10 days without any improvement. • High fever. • Large amount of yellow-green discharge from the nose. • Eye swelling and eye pain or headache. • Coughing (worse at night). • Bad breath. If your child exhibits these symptoms, chances are you’ve got an acute sinus infection on your hands. Colds (viral upper respiratory infections) can last a week to 10 days and include some fever at the onset. But colds require no specific treatment from a doctor. Nasal discharge resulting from a cold will look clear

at first, turn yellow-green and then clear again before disappearing. It’s important to remember that antibiotics do not treat viral infections. Children get sinus infections for much the same reason they get colds. The sinuses are lined with the same layer of mucous-producing tissue found in the nose and upperrespiratory tract. When inflamed and swollen, the sinus’ exit passages can’t drain properly and bacteria creates an infection for which antibiotic treatment is necessary. Some children who have allergies and thus swollen and inflamed upper respiratory tracts are prone to sinus infections. Allergic children with sinus infections should be treated for the allergy as well as for the sinus infection. Information for this article was obtained from “Ask Mom M.D.,” Dr. Karen Kaplan, Pediatrician

EAR I N FECTIO N

KNOW THE SIGNS

OR NOT?

E ar infections can be serious, especially in children. Acute ear infection, or infection of the inner ear, can affect anyone but is more common in children. It results from bacterial or viral infection of the fluid in the middle ear, which causes production of fluid or pus. Chronic ear infection is the result of prolonged or repeated acute ear infection and can cause permanent damage to the ear. Chronic infections may go unnoticed and show less severe symptoms, leading to delayed treatment. Parents should always hold their babies in a sitting position when feeding to help reduce the risk of acute ear infection in infants. Symptoms parents can look out for include: • Ear pain or discomfort

(severe earache, pressure in the ear). • Pulling at the ear. • Drainage from the ear. • Hearing loss in the affected ear. • Fever. • Chills. • Irritability. • Feeling of general illness. • Nausea or vomiting. • Diarrhea. Ear drops, nasal sprays, nose drops, oral decongestants, and sometimes oral antihistamines, can be used to help promote drainage or relieve pain. But most importantly, if symptoms persist, see your doctor or health care provider.

Measuring

I f your baby or child seems small for his or

her age, the best advice for you is — don’t panic. Everyone is different, so what is normal for the child next door may not be what is normal for your child. The most important thing to watch for is a pattern of steady growth and development. Each time you visit your pediatrician’s office for your baby or child’s checkup, the nurse will weigh your child and take a height measurement. Those measurements are usually graphed on a chart so the pediatrician can watch your child’s growth. Other factors to consider: • Size at birth is a poor predictor of your child’s final adult height or weight. • Reaching developmental milestones (talking, walking, fine motor skills, etc.) does not necessarily indicate greater intelligence.

What is normal for your child? • Abnormalities in hearing or sight require early corrective action, so be especially watchful of any apparent problems. Babies normally lose weight in the first few days after birth. Breast-fed babies lose no more weight than bottle-fed babies. Within the first few months after birth, babies usually establish a growth rate that is consistent for many years. By the time your child is 2 or 3 years of age, he or she should have established a consistent growth pattern that is a fairly good indicator of final height. The measurements that your pediatrician will be taking — and watching — for a consistent pattern are weight, height, head circumference and developmental milestones.

Sibling rivalry: A normal part of the sibling relationship I t’s a scene that’s played out every day in homes throughout the country. Your children are arguing over which show to watch on television or maybe arguing over whose turn it is to set the table. If you have more than one child, you likely recognize these scenarios immediately as something you see in your own home — sibling rivalry. No matter how much it seems to distract you and take away from the harmony in your family, sibling rivalry is a natural part of growing up. Sometimes the arguments can work themselves out, but when they seem out of hand, Mom or Dad should step in and control the situation. Here are some tips for handling sibling rivalry: • When children are bickering, pointedly praise the child who

is behaving more appropriately. • Put a behavior plan into place, with a written contract that rewards certain behavior (for example, give your brother a sincere compliment each day). • Many times, children are arguing for their parent’s attention. Try to spend regular uninterrupted time with each of your children. • Parents should not quarrel or bicker with each other in front of the children. Parents also should maintain a calm demeanor with the kids. • Family rules should be clearly explained and boundaries defined. The consequences of actions should be appropriate. For example, if one child hits a sibling, denial of a favorite treat or television program would be appropriate. • If your children cannot control their bickering, separate them from each other for a period of time

Is your child getting enough sleep? W ith Mom and Dad both working and the kids involved in numerous activities, today’s family is very busy … and very tired. While adults can get by on eight hours of sleep per night, children often need more depending on their age, activity level and health status. When school is out, kids are doing their homework, going to soccer practice, taking piano lessons, working on their school science project and much more. While keeping your children involved in activities is an admirable goal, keep in mind that making sure your children get enough sleep will help them in school and with their extracurricular activities. A 1999 survey commissioned by the National Sleep Foundation found that a majority of kids say they are sleepy during the day and 15 percent admit to falling asleep in school. Teen-agers, more than any other age group, are not getting enough sleep. Researchers believe that access to the Internet, television, academic pressures, social obligations and after-school jobs all contribute to the sleep shortage among children and teen-agers. (separate parts of the house where they cannot see or speak to each other). • Don’t take sides in a sibling argument. Encourage your children to work out their differences. • Do not compare your children to each other, or to their friends. • Do not reward tattling. It will only encourage your children to tell on each other and create more friction between them. And most of all, don’t give up. Time and persistence will help you learn new ways of dealing with sibling rivalry. Some bickering or disputes are entirely normal and help the children to resolve conflict. In the long run, you are teaching your children how to get along better, and that will prepare them for important relationships in the future.

Lack of sleep contributes to problems comprehending and retaining educational information during school hours. It also contributes to behavioral problems in children. So how much sleep does your child need? Here are a few simple guidelines: • Newborn babies — Anywhere from 12 to 20 hours per day. • Toddlers and preschoolers —Approximately 12 hours per day and one afternoon nap. • School-aged children (grades K-6) — Approximately 10 hours per day. • Teen-agers — At least nine hours of sleep per day. “Sleep hygiene” is another way to view sleep patterns for your children. Try to remember: • Keep regular sleep patterns and wake-up times seven days per week. • Use the bedroom for sleeping only (keep computer, television, etc., in a separate room). • Teen-agers that have trouble sleeping may need to get up, read a boring book until they feel sleepy, then return to bed. • Significant sleep problems can be a symptom of clinical depression. Remember that good sleep habits begin early — between 2 and 4 months of age. Even at that young age, babies are learning where to sleep, how to sleep and when to sleep. By the time your baby is 4 to 6 months of age, he or she should be able to sleep eight to 12 hours per night. Establish a routine that helps you — and your baby — get a good night’s sleep.

Raising Healthy Kids Healthy Habits That Last a Lifetime

wo of the most important things that parents can do for their children are making sure they get proper nutrition and regular exercise. Teaching children healthy habits early in life can help them develop healthy attitudes and behaviors that can benefit them throughout their lives. Unfortunately, in today’s world, not only are getting proper nutrition and exercise very important to children — they can also be very challenging achievements for parents — at least without appropriate planning.

Some Surprising Facts Did you know that … • Take-out foods make up 35 percent of the average family’s meals. • Three or more cans of soda are consumed daily by two-thirds of teenage boys. • Less than 35 percent of children participate in physical education classes at school and the majority do not get recess. • By the time children reach ninth grade, 70 percent of girls and 50 percent of boys do not take part in any vigorous activity. • Obesity in children has more than doubled since the 1970s.

Nutrition Good eating habits and table manners should begin at a young age. By the time a child is eating in his high chair, parents should establish regular meal schedules and good table manners. It is important that children have their meals at the same time and avoid excessive snacking or drinking juice, which interferes with mealtime. Children also should

eat at the table — not in front of the television or anywhere else. In today’s fast-paced world, with families often going in many different directions, we often find ourselves grabbing meals on the run. Most often, microwave meals, snack foods and fast-food restaurants win out over home-cooked meals. In fact, in the average family, home-cooked meals are usually the exception rather than the rule. So the best way to ensure that your children get the nutrition they need is with careful planning. Some things you can do to help your children be healthier eaters: • Resist the tendency to let your kids “be in charge” of what they eat. • Become familiar with the Food Guide Pyramid for Young Children and keep the shelves and refrigerator stocked with items from each food group. • Spread out some of the recommended servings from the Food Guide Pyramid so you can include them, not only at mealtime, but in snacks as well. • Pack healthy lunches for school. • Offer a variety of foods and serve reasonable childsized portions that won’t overwhelm your child — he or she might even go back for seconds. • Don’t make your kids “clean their plate.” That’s asking them to ignore their body’s own natural signals that tell them when they are full and might possibly even lead to eating disorders. • Limit the amount of beverages your child may

drink between meals. Beverages may spoil their appetite for meals and snacks. • Dessert should be just another part of a healthful meal and not set up as a “reward.” Got a picky eater in the family? What family doesn’t? The first rule to remember when dealing with a picky eater is — forget the hard sell! Try to introduce new foods gradually by using a low-key approach. Most children usually resist trying new foods, but if given enough good-tasting variety to choose from, almost all children will eventually give in. Let them become familiar with the food by touching it, picking it up and slowly tasting it. They may not try it until the 10th time it’s served, but the important thing is — they will try it. If you’re concerned about your child not eating enough, put at least one food on the table that they like. Overall, most children, if given an opportunity to select from a variety of foods from all of the food groups, will select sufficient amounts of nutrients, and eating patterns will usually improve over time. If you’re seriously concerned about your child not getting the proper nutrition, check with your pediatrician.

Exercise Another important part of a child’s growth and development is regular exercise. In recent years, studies have shown that childhood obesity has increased at an alarming rate. According to a recent survey, kids blame homework for their lack of time for physical activity. But two out of three parents surveyed say lack of interest or competition from television is the reason their youngsters aren’t getting enough exercise. Considering the decrease in physical activity in schools in recent years and the fact that many children choose television and video games as primary sources of entertainment, it’s no wonder that there is a lack of physical activity in our children’s lives. Once again, involvement by adults or parents is critical if children are

11 to receive adequate exercise in their daily routine. Some things you can do to help your children get more exercise: • Limit your child’s time in front of the television or computer. • Encourage his or her participation in outdoor sports — soccer, baseball, swimming, etc. • Encourage fun activities that involve physical movement such as riding a bike, jumping rope, a game of chase, playing hopscotch, etc. • Ask older children to do chores that involve physical activity, like walking the dog or helping with yardwork. • If your child’s school doesn’t have a recreation program for children, encourage school officials to add it to the curriculum. • Volunteer your time at your child’s school to help with recreational activities after school or on weekends. If you want your children to live a healthy lifestyle — get involved in their lives and start the process now. It’s up to you to teach them healthy habits and behaviors that will benefit them the rest of their lives. Resources for this article include: Stephen Tucker, M.D., Little Rock; International Life Sciences Institute; NetBiochem: Nutrition; and “Arkansas Times: 2000 How-to Guide.”

he bell rings. The children sit down in their seats and the teacher gives instructions for the first assignment of the school day. However, there is one child who is looking out the window and thinking about the airplane that just flew by, or wondering what kind of bird she hears chirping. The teacher notices and redirects that child to the assignment at hand. The child pays attention for a moment, but then her pencil falls to the floor. She then is distracted by all the different tennis shoes the other children are wearing and begins thinking about when and where she might get her next pair. These are a few moments in the life of a child with Attention Deficit Disorder (ADD) or Attention Deficit Hyperactivity Disorder (ADHD). It is estimated that 3 to 10 percent of children have this disorder, which is characterized by the inability to pay attention in class or difficulty completing academic assignments.

• Often acts without thinking. • Shifts excessively from one activity to another. • Needs a lot of supervision. • Speaks out of turn in class. • Doesn’t wait for his or her turn in games or group activities. • Runs or climbs excessively. • Can’t sit still. • Excessive activity during sleep. • Always on the go, acts as if “driven.” • Experiences angry outbursts. • May be a social loner. • Blames others for problems. • Fights with others quickly. • Very sensitive to criticism. ADD or ADHD symptoms are caused by a neurological dysfunction within the brain. Studies have confirmed that there is a

My child has ADD! However, not every student who can’t sit still in class or can’t complete an assignment has ADD or ADHD. This is particularly true in the lower elementary grades when children naturally have more energy and have not reached a level of maturity to meet the demands of the classroom. If your child has had the symptoms of poor attention, concentration and/or poor impulse control for some time, you should have your child examined by a physician. In addition to a physical exam, the physician may have the parents and teachers complete questionnaires about the child’s behavior. A child with ADD or ADHD may have some of the following symptoms: • Doesn’t seem to listen. • Doesn’t complete assignments. • Easily distracted. • Difficulty in concentrating or paying attention.

definite difference in brain functioning between those with ADD/ADHD and those without it. ADD or ADHD may be acquired or inherited. Treatment of ADD or ADHD includes medications such as Ritalin®. Ritalin is used to improve the chemical imbalance in the brain that is causing the symptoms. It is considered a very effective and relatively safe form of treatment. When properly treated through medication and a psychological treatment program under the direction of a physician, children and adolescents with ADD or ADHD can lead very normal and productive lives. In fact, many traits in ADD or ADHD children lead them to very successful adult lives. Children with ADD or ADHD usually have average or above-average intelligence. They are often creative and usually have a high energy level. Remember that a loving, supportive and consistent environment is essential for positive growth and development of children, especially those with ADD or ADHD.

Rules are good for your children What is your wish for your children?

Like most parents, you probably hope your children grow up happy, healthy and well-adjusted — all admirable (and achievable) aspirations, but they may take a lot of dedication and work on your part. Just remember that rules are tools … when you are constructing a well-balanced child. Children are not little adults. They do not have the depth of experience, the knowledge or the reasoning capacity to think as adults; therefore, it is up to you to guide them, help them in decisionmaking, and most importantly, teach them the difference between right and wrong. As a parent, the best thing you can do to help your children achieve those goals is to encourage healthy habits, maintain rules and boundaries, and be a role model for your children as to what is appropriate and inappropriate behavior. Tony Johnson, M.D., a pediatrician with the Arkansas Pediatric Clinic in Little Rock, stresses that parents should begin setting rules and limits when their children are at a young age. Children also should understand the disciplinary consequences of their actions. According to Dr. Johnson, setting formal bed times, encouraging healthy eating habits and establishing household rules is not only good for the parents, it’s even better for the children. Dr. Johnson maintains that consistent, effective parenting is better for everyone in the long run. “You have to maintain your role as a parent,” said Dr. Johnson. “It is important for the parents to be the parent in the relationship with their children. In many cases, with both parents working these days and children busy with extracurricular activities, sometimes it is easier to let the children stay up later or ignore the household rules.

“Letting your child establish unhealthy eating or sleep habits or not having established rules or guidelines may lead to an unhealthy lifestyle or inappropriate behavior later,” said Dr. Johnson. “Children need rules,” said Charles Gist, M.D., a psychiatrist with Psychiatric Associates of Arkansas, PLLC, in Little Rock. “Think about those fourth-grade boys on the playground. They may have 20 minutes for recess, but they will spend 15 of those minutes making up the rules for the game. It’s normal, and it is how they understand the world.” A common diagnosis today, and one that both Dr. Johnson and Dr. Gist see among 7- to 13-year-olds, is “episodic outburst disorder” or “intermittent explosive disorder.” With this diagnosis, children under stressful situations simply fall apart, throw tantrums or “just lose it.” According to Dr. Gist, studies have been ineffective and have not ruled conclusively the cause of this disorder, but theories include depression, manic-depressive disorder or a chemical imbalance. Also, there is a possibility that the disorder could be the result of many years of parents having failed to set limits. As a result, children do not know how to react in stressful situations. A 2-year-old has a tantrum because he or she hasn’t learned appropriate behavior, but now physicians are seeing this behavior with children who are much older. Along with discipline and guidance, Dr. Johnson and Dr. Gist agree that positive reinforcement goes a long way in creating an emotionally healthy child. “It’s self-fulfillment. If you expect joy and success for your child, that is what you will get. Parents should exhibit a demeanor that concentrates on the positive and is respectful to the child. Then, the child will flourish,” said Dr. Gist.

Acne:

If your teen-ager has acne, he or she is not alone.

Close to 100 percent of young people between the ages of 12 and 17 have at least an occasional bout with acne. Many teen-agers are able to manage their acne with over-the-counter treatments; however, approximately 40 percent of teen-agers have acne severe enough for them to seek treatment from a physician. The two things that teen-agers should remember about taking care of their skin are: 1) He or she should wash his or her face twice a day with a mild cleanser and 2) Keep their hands off of their faces as the hands can spread bacteria, which may increase the acne. So what causes acne? Acne is a disease of the sebaceous glands. There are some basic factors that work together to cause acne including hormones, the factor that usually causes acne in teen-agers. Acne usually begins when the body starts to produce hormones — usually between 11 and 14 years of age. There are many myths associated with acne and its

Good news, it’s treatable causes. Things that do not cause acne are poor hygiene, food (including pizza or chocolate) and stress. Besides physical symptoms, teen-agers usually experience some psychosocial effects of acne. Recent studies indicate that some teen-agers with acne experience social withdrawal, decreased self-esteem, reduced self-confidence, poor body image, embarrassment, depression, anger, preoccupation and frustration. If your teen-ager has acne, don’t let it get him or her down. If over-the-counter products have not produced the desired results, contact your pediatrician or family physician. With all the outlets available today for treating and preventing acne, teen-agers can hopefully avoid the scars of acne — both physical and emotional. Information for this article was obtained from the American Academy of Dermatology.

Troubled teens may be dealing with depression Approximately 7 to 10 percent of children or adolescents will experience an episode of major depression before the age of 15. Recent studies show that there is a significant clinical occurrence of depression among adolescents. Depression is not everyday ups and downs. It is when a “down” mood lasts for weeks. The condition may stem from a biological illness, a chemical imbalance or certain personality traits (low self-esteem, extreme pessimism). There may be a history of depression in the family. Clinical depression is a serious health problem that affects the whole person. It can change behavior, physical health and appearance, academic

performance, social activity and the ability to handle everyday decisions and pressures. Signs include disruptive behavior, possible academic difficulties, peer problems, irritability and aggression or suicidal threats. Approximately 3 to 5 percent of the teen population experiences clinical depression each year. With teen-agers, depression has been linked to poor school performance, truancy, alcohol and drug abuse, running away and feelings of worthlessness. Suicide is often linked to depression. There is hope. Depression is treatable. Between 80 and 90 percent of people with depression can be helped. Symptoms may be relieved with psychological therapies, medications or a combination. See your pediatrician or family physician if you suspect your adolescent is suffering from depression.

Take time for teen talk The teen-ager behind the closed doors in his upstairs bedroom used to be your clingy, cuddly toddler who screamed when you left the room. Now it seems like he wants to scream when you walk into the room. The teen-age years can be difficult — for both the teen and the parent. Despite their outward bravado, teenagers are unsure of who they are, what they want to be or whether the choices they make are the best choices. As a parent, what can you do to guide your teenager, yet give them room to help develop their own decision-making skills? 1. Keep communications open. Try to listen calmly even if you have a different opinion. Develop a courteous, respectful tone. Avoid making judgments. Keep the door open on any subject. Many times, teens avoid discussing things that make their parents feel uncomfortable. 2. Encourage positive self-worth. Encourage (but don’t force) participation in sports, music, art, dance or other hobbies or interests. 3. Supervise and guide. Set limits on their freedom and behavior. Teen-agers may want some “say” in the

decision-making, however, they do not want parents to give up authority or be wishy-washy. Parents who appear confused about discipline or who are inconsistent may be perceived as weak. 4. Respect their need for independence. Parents can accept and respect teen-agers as individuals without always agreeing with their opinions and vice-versa.

5. Try not to overreact. Many parents brace themselves for adolescence like they are preparing for battle. As a result, they may be quick to overreact the first time their teen-ager steps out of line. They punish severely, withdraw trust and lose confidence in their teen-ager. Parents must prepare to let their children make mistakes but step in when help is needed. Being a parent is never easy. With each year comes a different challenge. However, efforts to communicate and understand your teen-ager will pay off in the long run. And maybe you and your teen will look back at the teen years as a positive experience in your relationship.

Communicating about substance It is never too early to talk to your child about the dangers of substance abuse. You are the parent, and it is your responsibility to make sure your child understands the dangerous consequences of substance abuse. What can you do? 1. Talk with your child honestly and really listen when your child is talking to you. 2. Help your child develop self-confidence. Praise his or her successes. 3. Help your child develop strong values. Teach your child how to make decisions based on right and wrong. 4. Be a good example. If you smoke or drink excessively, your child is aware of your actions. 5. Help your child deal with peer pressure and acceptance. Discuss the importance of being an individual and the meaning of real friendships.

abuse — what all parents should know

6. Provide guidance and clear rules about not using drugs. 7. Encourage healthy, creative activities. 8. Spend time with your child, sharing the good and bad times. 9. Facilitate early intervention with the help of a physician when your child is having problems in school, dealing with learning disabilities, or experiencing trauma, stress or depression. Remember, prevention starts with you as the parent. There are no guarantees that your child will not choose to use drugs, but you can influence their decision by setting a good example. Information for this article was obtained from the American Academy of Pediatrics.

C H I L D R E N ’S

15 Ways to Praise Your Child I f you want to tell your child that he or she is doing a good job but can’t quite think of the right words, here are 15 ways to tell your child he or she is great! 1. 2. 3. 4. 5. 6. 7. 8. 9. 10. 11. 12. 13. 14. 15.

You’re on the right track! That’s a lot better! I knew you could do it! You’re getting better every day! Terrific! Fantastic! Good thinking! I’m very proud of you! You’re learning very fast! You’re very good at that! Outstanding! Wonderful! You certainly did well today! You are doing a good job! You’re the best!

The general’s plan for the future T he surgeon general has unveiled a 10-year health plan for the United States that focuses on getting our nation’s children into better shape, helping people quit smoking, eliminating drug abuse and encouraging teens to either abstain from sex or use condoms. Surgeon General David Satcher’s plan aims for 30 percent of Americans to exercise 30 minutes each day and reduce by half the number of overweight or obese children, which currently stands at about 11 percent of our children. To reach his goal, the surgeon general will begin measuring 10 areas called the “leading health indicators” which address a broad range of health and social concerns. Health goals include an increase in the number of children getting vaccinated, encouraging people to exercise more, combating depression, increasing access to health insurance, and discouraging substance abuse. The new program is the first to establish a set of measurements. The surgeon general’s office will collect data from state and local agencies and from federal agencies that compile health statistics that track whether Americans are annually reaching goals set by the program in the 10 areas.

The kid with the code Corey Felts, 9, of Jonesboro, out-scrambled more than 530 other entrants from

throughout the state to win the Healthy Habits Word Scramble contest that appeared in the Summer 1999 issue of Blue & You. Kids of all ages decoded nine hidden health messages, and Corey’s correctly completed entry was pulled from among them in a drawing for a $25 Wal-Mart gift certificate and a fun assortment of Arkansas Blue Cross and Blue Shield novelty items (many of which feature health-and-wellness ambassador BlueAnn Ewe).

Blue sheep could be parents’ best friend Parents and teachers in Arkansas have tapped into a new resource which is encouraging kids to eat their veggies, brush their teeth, exercise and be safe ... and have fun in the process. Since September 1999, more than 5,000 elementary school-aged children have joined the BlueAnn Health Club or BlueAnn Class Club through their homes or classrooms. The central figure of the clubs is BlueAnn Ewe — Arkansas Blue Cross and Blue Shield’s ambassador of health and wellness — a blue sheep. The clubs give parents and teachers a new set of fun tools to help teach children about healthy habits and encourage them to participate in positive behaviors that could last a lifetime.

BlueAnn Club members receive packets of fun, educational health information and activities in the mail. Plus, they may have a chance to win some really cool prizes when they practice doing healthy things. So, if you need a little assistance motivating your little ones to practice healthy habits, join lots of other parents and teachers and let a big, blue sheep help out. Sign up today! BlueAnn wants ewe! Just call 1-800-515-BLUE, toll-free, and ask for the BlueAnn Club. The BlueAnn Health Club is recommended for elementary school-aged children (5 to 10 years old). The BlueAnn Class Club is recommended for kindergarten and first-grade classrooms.

Ageless Heroes 2000 For the third year, Arkansas Blue Cross and Blue Shield will be searching for seniors whose achievements prove that the golden years can be a time of health, vitality and accomplishments. Ageless Heroes TM, a national and state awards program, was created as a cornerstone of the Blue Cross and Blue Shield Association’s commitment to healthy aging and is designed to honor inspirational mature individuals who set examples of how to live life fully, with vigor and health. The Ageless Heroes Awards Program encourages people in communities throughout the state to nominate senior heroes — colleagues, family, friends and

neighbors — who are age 65 and older and who continue to achieve and inspire. Nominations will be accepted beginning in May. Watch for more information in the next issue of Blue & You as well as your local newspapers.

Olympic village by the river side To help bring the spirit of the Olympics to the Natural State, Arkansas Blue Cross and Blue Shield is bringing the “Caring for the Human Spirit” tour to Arkansas during Riverfest 2000 May 27-28 in Little Rock. The tour is part of the Blue Cross and Blue Shield Association’s sponsorship of the United States Olympic team in the 2000 Summer Games in Sydney, Australia, and the 2002 Olympic Winter Games in Salt Lake City, Utah. Arkansans will have an opportunity to visit a miniOlympic Village at our own River Market during the weekend festival. There will be Olympic memorabilia

displays and three exhibits for visitors to enjoy, including an Olympic mini-decathlon, health fair and nutrition center. Visitors can get a body fat evaluation and blood pressure, heart rate and vision screenings. Plus, sports fans can shoot hoops, have the speed of their baseball pitch checked by radar, shoot a fast and accurate hockey puck, put on a bungee vest and sprint against resistance, or ride a virtual cycle against a computer program and clock. Look for the Olympic Village at the corner of Markham and Rock Street, just north of the main library. It’s fun. It’s free. And it’s only here this year!

Leading T

his issue of Blue & You continues our mission to introduce our state senators and representatives of the Arkansas General Assembly to our customers.

Rep. Sarah Agee (R) (Dist.9) Prairie Grove City, County & Local Affairs; Joint Performance Review; Public Transportation (O) 501-846-4606 (H) 501-846-4177 Rep. Jerry Allison (D) (Dist. 86) Jonesboro Vice-Chairman; Agriculture & Economic Development; Education; Joint Performance Review (0) 870-932-7765 (H) 870-932-7960 Rep. Denny Altes (R) (Dist. 14) Fort Smith Public Health, Welfare and Labor; State Agencies & Governmental Affairs (O) 501-646-8922 (H) 501-484-5494 Rep. Russ Bennett (R) (Dist. 22) Lewisville Public Transportation; State Agencies & Governmental Affairs O/H 870-921-4866

Rep. Bill Bevis (D) (Dist. 70) Scott Agriculture & Economic Development; Energy; Public Transportation (O) 501-945-5630 (H) 501-676-5630

Rep. Pat Bond (D) (Dist. 64) Jacksonville Vice-Chairman, City, County & Local Affairs; Education; Joint Retirement & Social Security (O) 501-982-1538 (H) 501-982-8872

Rep. Mike Hathorn (D) (Dist. 24) Huntsville Agriculture & Economic Development; Judiciary; Rules (O/H) 501-665-2448

Rep. Russ Hunt (R) (Dist. 68) Searcy City, County & Local Affairs; Revenue & Taxation (O) 501-268-3055 (H) 501-279-2928

Rep. Jimmy Jeffress (D) (Dist. 83) Crossett City, County & Local Affairs; Education; Energy; Joint Budget (H/O) 870-364-8291

Rep. Jim Milum (R) (Dist. 29) Harrison Agriculture & Economic Development; Joint Retirement & Social Security; Revenue & Taxation (O) 870-365-0042 (H) 870-741-7532

the Way These elected officials spend numerous hours working on health care issues that affect you. (Upcoming issues of Blue & You will feature additional profiles of our legislators.) Rep. Mark Smith (R) (Dist. 49) El Dorado City, County & Local Affairs; Judiciary (O) 870-862-7965 (H) 870-862-7929

Rep. Larry Teague (D) (Dist. 19) Nashville Vice-Chairman; Revenue & Taxation; Insurance & Commerce; Rules (O) 870-845-5303 (H) 870-845-3708 Rep. Lindbergh Thomas (D) (Dist. 74) Grady Aging, Children & Youth; Legislative & Military Affairs; Judiciary (H/O) 870-479-3969

Rep. Jim Wood (D) (Dist. 80) Tupelo Vice-Chairman, Public Transportation; Agriculture & Economic Development; Rules (O/H) 870-744-2266 Senator John Brown (R) (Dist. 34) Siloam Springs Children & Youth; Education; Rules, Resolutions & Memorials; State Agencies & Governmental Affairs (O) 501-549-3290 (H) 501-524-4667

19 Senator Bill Gwatney (D) (Dist. 19) Jacksonville Vice-Chairman, State Agencies & Governmental Affairs; Children & Youth; Joint Budget; Joint Retirement & Social Security; Revenue & Taxation; Rules, Resolutions & Memorials (O) 501-982- 2102 (H) 501-982-4817 Senator Jodie Mahony ( D) (Dist. 2) El Dorado Vice-Chairman, Education; City, County & Local Affairs; Joint Advanced Communications & Information Technology; Joint Retirement & Social Security; Rules, Resolutions & Memorials (O) 870-862-6464 (H) 870-862-5950 Senator Doyle Webb (R) (Dist. 14) Benton Children & Youth; City, County & Local Affairs; Judiciary; Rules, Resolutions & Memorials (O) 501-315-9322 (H) 501- 315-4266

Guess who owns Arkansas Blue Cross and Blue Shield? You do.

For more than 50 years, Arkansas Blue Cross and Blue Shield has been covering the lives of Arkansas residents,

growing and changing to meet your health care needs. Sometimes we are considered a big business or corporate entity in our state, but Arkansas Blue Cross differs from commercial insurers in several ways. Arkansas Blue Cross is a not-for-profit organization. That means that nearly all the money collected as premium is paid out in benefits for customers — on the average about 85 cents of every dollar. The remainder — about 15 cents of every dollar — is used for operating expenses and reserve funds, which we are required by law to maintain. However, as a mutual not-for-profit company, Arkansas Blue Cross does pay state premium taxes and federal corporate income taxes. As a non-profit, mutual insurance company, Arkansas Blue Cross is owned by its policyholders, not by stockholders. This means that premium dollars are used solely to pay claims and administrative costs, not to pay stock dividends. Any excess funds are held in reserve for payment of future claims and expenses. Arkansas Blue Cross must maintain a fiscal balance between premium income and benefits paid to ensure that we have the ability to continue to offer insurance products and to pay policyholder claims in the future. Blue Cross and Blue Shield Association Affiliation Arkansas Blue Cross is a member of the Blue Cross and Blue Shield Association. This means Arkansas Blue Cross has licenses from the Blue Cross and Blue Shield Association to offer health insurance benefits and related services under the Blue Cross and Blue Shield names and service marks in the state of Arkansas. The Blue Cross and Blue Shield system is not a single company. Rather, it is a coordinated group of 49 individual and autonomous Blue Cross and Blue Shield Association Plans located throughout the United States and Puerto Rico. Each Plan is an independent corporation committed to providing affordable health care financing. One of the unique aspects of the Blue Cross and Blue Shield Association is that each member Plan is managed and controlled by its own community-based board of directors, which must contain a majority of “public members.” Public members are people from the community who are not employed in the health care industry. As a result, the Blue Cross and Blue Shield Plans have a strong commitment to their local communities and customers, which is not necessarily shared by commercial insurance companies. Neither the Blue Cross and Blue Shield Association nor the other member Plans of the Blue Cross and Blue Shield Association act as guarantors of the financial obligations of Arkansas Blue Cross and Blue Shield. However, Arkansas Blue Cross and Blue Shield and the other member Plans in the Blue Cross and Blue Shield Association are subject to uniform financial standards established by the Blue Cross and Blue Shield Association which are intended to foster a system in which each member Plan maintains adequate financial resources to meet its obligations to its customers. National Institute for Health Care Management (NIHCM) Affiliation In 1993, Arkansas Blue Cross joined with 11 of the nation’s leading health care companies to form the NIHCM. The NIHCM is a non-profit organization based in Washington, D.C., that was established to: 1) sponsor high-quality, non-

partisan research of health care issues; 2) act as a clearinghouse for research on health care management and state managed care data; and 3) promote innovation to continuously improve the health care system.

Here to serve you A staff of almost 2,000 Arkansas Blue Cross employees continues to meet the health insurance needs of you, our policyholder. Our employees are your neighbors, your family and your friends.

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ge Health Advanta members â&#x20AC;&#x201D;

take note!

MEMBER RIGHTS AND

RESPONSIBILITIES

A member should: 1. Become familiar with the requirements and procedures of Health Advantage. 2. Present Member ID Card to the health care provider when seeking care. 3. Select a primary care physician. 4. Maintain health levels by living a healthy lifestyle. 5. Coordinate all health care through the primary care physician. 6. Provide information to health care providers to assist them in the care needed to achieve health outcomes. 7. Follow all instructions given by health care providers to achieve maximum benefits of the care. 8. Meet all co-payment and co-insurance obligations and any billed charges in excess of allowable charges. 9. Notify Health Advantage of any status change. 10. Obtain all care through Plan providers. 11. Communicate any complaint or grievance immediately to Health Advantage. 12. Ensure all claims for services provided by nonPlan providers are filed within 60 days. A member has a right to: 1. Information about Health Advantage, its services and

2. 3. 4.

5. 6.

8. 9.

10.

providers, and members rights and responsibilities. Access to a Plan physician. An explanation of benefits. Be treated with respect with recognition of their dignity and right to privacy. Confidential treatment of medical information. Participate with practitioners in decision-making regarding their health care. A candid discussion of appropriate or medically necessary treatment options for their conditions, regardless of cost or benefit coverage. Change primary care physicians. Voice complaints or appeals about Health Advantage or the care provided. Provide, to the extent possible, information that Health Advantage and its practitioners and providers need in order to care for them.

CHANGE TO HEALTH ADVANTAGE MEDICAL BENEFITS Health Advantage has amended the Evidence of Coverage and Schedule of Benefits for all lines of business. Coverage for the added benefit was effective Feb. 1, 2000, for all Health Advantage members. The change shown in bold print to the right will be added to the Evidence of Coverage, Attachment B, Schedule of Benefits, Section P. with the next revision. If

you have questions, please contact your group marketing representative or Customer Service at 501-2213733 or toll-free 1-800-843-1329. P. Dental Care Services General dental services are not covered under this evidence of coverage; however, the following services may be provided in an inpatient or outpatient setting and covered when authorized by the primary care physician subject to the co-insurance specified in Attachment C, Benefit Summary. 1. Services for treatment and X-rays necessary to correct damage to non-diseased teeth or surrounding tissue caused by an accident occurring on or after effective date of coverage are covered subject to a $2,000 maximum per member per accident. Member must seek treatment within 72 hours of injury for services to be covered. 2. Treatment or correction of a non-dental physiological condition which has resulted in severe functional impairment. 3. Treatment for tumors and cysts requiring pathological examination of the jaw, cheeks, lips, tongue, roof and floor of the mouth. 4. Pre-treatment dental services in connection with the treatment of cancer of the head or neck. Injury to teeth while eating is not considered an accidental injury.

23 rkansas Blue Cross and Blue Shield strives to be a A good corporate citizen. Our employees raise money and spend many hours helping those causes near and dear to the hearts of Arkansans. Hansel and Gretel More than 100 performances of the fairy tale classic “Hansel and Gretel” have been scheduled for the Wildwood Park for the Performing Arts Spring Tour 2000, sponsored by Arkansas Blue Cross and Blue Shield. This is the fourth year Arkansas Blue Cross has teamed up with Wildwood in an effort to entertain and teach elementary schoolaged children through a live theater experience. Through the centuries, fairy tales have taught children and adults important lessons in character, conquering fears and overcoming problems. BlueAnn Ewe and cast members of the “Hansel and Gretel” production Students today still pose with young fans. can learn these life lessons as they experience this enchanting story, based on the Grimm Brothers fairy tale, in a musical theater setting — complete with a tasty gingerbread house and the delightful tunes of composer Engelbert Humperdinck. A question-and-answer session with the cast and students immediately following the performance focuses on dealing with emotions and fears. The tour will continue statewide through April. High School Heroes High School Heroes, a unique student-to-student teaching program with a strong anti-smoking message targeting fifth-graders, finished a successful year in 1999. Developed by the American Lung Association and sponsored statewide by Arkansas Blue Cross and Blue Shield, more than 990 high school students across the state were trained by the ALA to teach the program in elementary and middle

schools. These specially trained high school students — High School Heroes — presented a message on the importance of never starting to smoke to 12,081 fifthgraders in Arkansas BlueAnn Ewe and High School last year. Using Heroes teach fifth-graders about brainstorming, rolethe dangers of smoking. play, discussion and question-and-answer sessions, Heroes teach and serve as role models for the kids. The goal is to reach kids at an age when peer pressure and advertising might entice them to start smoking. The message includes information about effects of smoking to the body as well as the deceptive appeals of tobacco advertising. High School Heroes now is active in 28 counties in Arkansas. With more than 3,000 youths starting to smoke each day, it is more important than ever to reach them early in an effort to avert this dangerous and damaging habit. If you are interested in bringing the program to your school, please contact the American Lung Association/Arkansas Chapter at 1-800-880-5864. Healthy Me & Ewe As part of St. Bernards Regional Medical Center’s annual kindergarten education program in Jonesboro, BlueAnn Ewe and Dwayne Pierce of the Arkansas Blue Cross Northeast Regional Office brought “Wild and Woolly Health Tips for Kids” to more than 800 students in local schools. BlueAnn and Pierce presented a 20-minute wellness lesson to students, teaching them about such things as healthy eating, exercise, bike safety, good sleep and dental health. All students were presented with a coloring book and an opportunity to meet BlueAnn following the program.

— a guide to health insurance terminology

f health care terminology (including abbreviations and acronyms) leaves your head spinning … Arkansas Blue Cross and Blue Shield would like to help you make sense out of all the jargon. We want you to be an informed customer, so in each issue of Blue & You we will explain the meaning behind those health insurance words, acronyms and abbreviations that you may encounter when reading health care-related materials. Case Management — A process where covered persons with specific health care needs are identified. It typically combines the care from all involved including the physician, the hospital, the patient and the family — all in an effort to find the most appropriate treatment for that patient. Disease Management — A coordinated system of preventive, diagnostic and therapeutic measures for a specific chronic illness or medical condition. Exclusions — Specifically listed conditions or situations which, under an insurance policy (or health insurance contract), are not considered covered expenses. Common exclusions include cosmetic surgery, custodial care, services covered by Workers’ Compensation, treatment which is experimental or investigational, etc.

Outpatient — A person who is receiving ambulatory care at a hospital or other health care facility for diagnostic or other treatment services without being admitted as an inpatient. Provider — Either an individual or an institution licensed by the state to provide health care services or supplies to those in need of such, including but not limited to a physician, osteopathic physician, dentist, optometrist, podiatrist, psychologist or pharmacist, as well as facilities such as a hospital, clinic, ambulatory surgery center or skilled nursing facility. Utilization — The use of health care services and supplies. Usually measured in terms of average length of stay, admissions and days of care per 100 or 1,000 population or enrollees of designated group. Utilization rates are often compared by geographic location, peer group, facility or by physician and are used in comprehensive health planning. Wellness — A type of preventive medicine associated with an individual’s lifestyle which, through a combination of exercise and diet, may have the effect of a reduction in health care utilization and costs.

Gatekeeper — A primary care physician (PCP) who serves as the patient’s initial contact for medical care, and who makes referrals to specialists. Group Insurance — Any insurance policy or health services contract by which groups of employees (and often their dependents) are covered under a single policy or contract issued to their employer or other group entity. Inpatient — A patient who has been admitted, at least overnight, to a hospital or other health facility and occupies a hospital bed, crib or bassinet while under observation, care and diagnosis. Member — The individual actually eligible for health care services due to employment or purchase of nongroup coverage. While the coverage also may pay benefits to a dependent, the dependent is not the member.

Arkansas Blue Cross and Blue Shield P.O. Box 2181 Little Rock, AR 72203-2181

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