2006 - Summer by Arkansas Blue Cross and Blue Shield

Summer 2006

HAPPY CAMPERS Stay safe this summer

Results of member satisfaction survey, p. 27

FYI Hello

of our negotiated rates with providers and our provider networks. By using BlueCard participating providers, you will reduce your out-of-pocket expenses and will not receive “balance billing” from participating providers for covered services. After a member has received care, in most cases, the member should: 1. Not have to ﬁle any claim forms. 2. Not have to pay up front for medical services except for the usual out-of-pocket expenses (non-covered services, deductible, copayment and coinsurance). 3. Receive an Explanation of Beneﬁts (EOB) from your Arkansas Blue Cross, BlueAdvantage or Health Advantage home plan.

Arkansas Blue Cross and Blue Shield, BlueAdvantage Administrators of Arkansas and Health Advantage offer an interpretation service so you can ask questions in Spanish and several other languages. If a representative who speaks that language is not available, an interpreter may be added to the line to help with the call.

Tips for using the BlueCard program

¡Hola!

Important telephone numbers

Arkansas Blue Cross and Blue Shield, BlueAdvantage Administrators of Arkansas and Health Advantage ofrece un servicio de interpretación para que usted pueda hacer preguntas en español o en otros varios idiomas. Si el representante que habla su idioma no está disponible, un intérprete puede ser conectado a la linea para poder ayudarlo con su pregunta.

Arkansas Blue Cross BlueAdvantage Health Advantage Wal-Mart service by BlueAdvantage Alltel service by Arkansas Blue Cross

Remember the BlueCard® program when traveling this summer When you are an Arkansas Blue Cross and Blue Shield, BlueAdvantage Administrators of Arkansas or Health Advantage member, your beneﬁts travel with you wherever you go, both in the United States and around the world. BlueCard gives you access to in-network doctors and hospitals virtually everywhere you go. Locating an in-network doctor or hospital is easy. You can access this information by Web or by telephone using the following information. Visit www.BCBS.com, and click on “BlueCard Doctor and Hospital Finder.” Call 1-800-810-BLUE (2583), and follow the instructions provided. Here’s how it works. If you’re a member of Arkansas Blue Cross, BlueAdvantage or Health Advantage and traveling or living out of state, Arkansas is considered your “home” Plan. When you are traveling or living in another state, the Blue Cross Plan in the other state is your “host” Plan. Arkansas, as your home Plan, always will be responsible for the “member relationship.” The host Plan manages the “provider (doctor or hospital) relationship.” Basically, when members travel or live out-of-state, they can take advantage of the provider relationships in other states because he or she is a Blue Plan member. And, when Blue Plan members travel to Arkansas and need medical care, they can take advantage

Blue & You Summer 2006

1. Always carry your most current insurance ID card. 2. When you arrive at the doctor’s ofﬁce or hospital, present your ID card, and the doctor’s ofﬁce or hospital will verify your membership and coverage.

1-800-880-0918 1-888-872-2531 1-800-843-1329 1-866-823-3790 1-800-800-4298

is published four times a year by Arkansas Blue Cross and Blue Shield for the company’s members, health-care professionals and other persons interested in health care and wellness. Vice President, Communications and Product Development: Karen Raley Editor: Kelly Whitehorn — BNYou-Ed@arkbluecross.com Designer: Gio Bruno Contributors: Chip Bayer, Janice Drennan, Damona Fisher, Kathy Luzietti and Mark Morehead

Customer Service Numbers Category

Little Rock Number (501)

Toll-free Number

State/Public School Employees

378-2364

1-800-482-8416

Arkansas Blue Cross and Blue Shield health insurance plans for individuals and families 378-2010

1-800-238-8379

Arkansas Blue Cross Group Services 378-3070

1-800-421-1112

BlueCard®

378-2127

1-800-880-0918

Federal Employee Program (FEP)

378-2531

1-800-482-6655

Health Advantage

378-2363

1-800-843-1329

BlueAdvantage Administrators of Arkansas

378-3600

1-888-872-2531

Pharmacy Customer Service: Arkansas Blue Cross Health Advantage BlueAdvantage Specialty Rx Medi-Pak (Medicare supplement)

1-800-863-5561 1-800-863-5567 1-888-293-3748 1-866-295-2779 378-3062

1-800-338-2312

Medi-Pak Rx Membership

1-800-262-7095

Medi-Pak Rx Claims

1-800-698-8397

Medicare (for beneﬁciaries only):

Inside

this issue Summer 2006 2 4 6 7 8 9 10 11 12 13

14 16 17 18 20 21 22

1-800-MEDICARE (633-4227)

For information about obtaining coverage, call: Category

Little Rock Number (501)

Toll-free Number

Medi-Pak (Medicare supplement)

378-2937

1-800-392-2583

Medi-Pak Rx

378-2937

1-800-392-2583

Health insurance plans for individuals and families

378-2937

1-800-392-2583

23 24 25 26 27 28 29

Regional Ofﬁce locations are: Central, Little Rock; Northeast, Jonesboro; Northwest, Fayetteville; South Central, Hot Springs; Southeast, Pine Bluff; Southwest, Texarkana; and West Central, Fort Smith.

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

31 32

Web sites:

FYI Use sun sense during your summer vacation Beat the summer heat Swimming and water safety tips Avoid the bugs and the bees First-aid kits: What to include Fireworks safety tips Better to be safe than sorry Was it something I ate? Something in the air Dealing with dust, dogs and other allergens Allergy Stats Cold or allergy? Going camping? Remember these tips! Pack a little precaution The Healthy Weigh! Education Program Study indicates low-calorie diet may be linked to longevity Do you wear contact lenses? Increase in eye infections reported Contact lenses remain a safe form of vision correction Understanding how coverage decisions are made Bird Flu Update New BlueChoice policy provides “choice” to customers Health question? HealthConnect Blue has the answer What our members are saying about HealthConnect Blue My BlueLine Ask the Pharmacist Prior approval required for certain radiological services HHS Secretary promotes Medicare Rx Federal Features (for Federal Employee Program members) Surveys say members satisﬁed with health plans 2006 ﬁnalists do get the “Don’t Start” Smoking message “One Class at a Time” grants continue to help teachers Greenway promoted Arkansas Blue Cross Financial Information Privacy Notice My Blueprint Blue & Your Community Blue Online

www.ArkansasBlueCross.com www.HealthAdvantage-hmo.com www.BlueAdvantageArkansas.com www.BlueAndYouFoundationArkansas.org www.BlueAnnEwe-ark.com

Blue & You Summer 2006

Use sun sense W

hether you spend your vacation lounging on a beach or climbing a mountain, avoid skin damage by protecting yourself from the sun’s ultraviolet (UV) radiation. Sunlight causes premature aging of the skin (wrinkles, leathery appearance, age spots, freckles), skin cancer and cataracts. Its effects are cumulative, meaning that the risk of developing skin cancer increases as you age. The damage cannot be undone. Tanning beds are not a safe way to expose your skin to UV rays. A tan is a sign of skin damage. Your body produces melanin in response to injury after the sun’s rays have killed some cells and damaged others. A tan is not a sign of good health. The sun produces two types of UV rays that penetrate the earth’s atmosphere and reach skin: 1. UVA: These rays penetrate deep into the skin, causing damage to skin cells and increasing the risk of developing skin cancer. 2. UVB: These rays damage the top layer of skin and are responsible for sunburn. Tanning beds may emit UVA rays, which are the most dangerous, UVB rays or both. No tanning bed or sunlamp is safe. The exposure is more intense than the midday summer sun. The U.S. Environmental Protection Agency and National Weather Service developed the UV index to help people judge the intensity of sunlight on a daily basis. Levels range from 0 to 11+. A rating of 6 to 7 is high; 11+ is extreme.

Exposure Category

Index Number

Sun Protection Messages

Although people

Low

2 (or less)

with fair skin and

Wear sunglasses on bright days. In winter, reﬂection off of snow can nearly double UV strength. If you burn easily, cover up and use sunscreen.

Moderate

3-5

Take precautions, such as covering up and using sunscreen if you will be outside. Stay in shade near midday when the sun is strongest.

High

6-7

Protection against sunburn is needed. Reduce time in the sun between 11 a.m. and 4 p.m. Cover up, wear a hat and sunglasses, and use sunscreen.

Very High

8-10

Take extra precautions. Unprotected skin will be damaged and can burn quickly. Try to avoid the sun between 11 a.m. and 4 p.m. Otherwise, seek shade, cover up, wear a hat and sunglasses, and use sunscreen.

Extreme

11 (or more)

Take all precautions. Unprotected skin can burn in minutes. Beachgoers should know that white sand and other bright surfaces reﬂect UV and will increase UV exposure. Avoid the sun between 11 a.m. and 4 p.m. Seek shade, cover up, wear a hat and sunglasses, and use sunscreen.

blue eyes have a higher risk, even people with dark skin can develop skin cancer.

Source: U.S. Environmental Protection Agency (EPA)

Blue & You Summer 2006

during your summer vacation Your skin type, which is genetic, determines whether you will burn or tan as a result of sun exposure. Although people with fair skin and blue eyes have a higher risk, even people with dark skin can develop skin cancer. Take extra precaution in the sun if you have numerous, irregular or large moles; freckles; fair skin; or blond, red or light brown hair.

Be sun savvy • Apply sunscreen liberally 20 minutes before sun exposure. Make sure your sunscreen protects against UVA and UVB rays and has a sun protection factor (SPF) of at least 15. Don’t overlook ears, the back of your neck and the tops of your feet. Make sure the sunscreen has not expired. Reapply every two hours or after getting wet or sweating. • Avoid going outside between 10 a.m. and 4 p.m. during daylight saving time. If you do go out, wear protection and stay in the shade as much as possible. • Protect your skin with long sleeves and long pants when possible. Tightly woven fabrics are best. If it’s too hot, at least wear a dry T-shirt. A wet shirt offers less protection. • Wear a wide-brimmed hat that shades your head and neck all the way around. A tightly woven material, such as canvas, works best. A straw hat might let in too much sunlight. • Wear sunglasses that provide 100percent UV protection (both UVA and UVB). Most sunglasses made in the United States meet this standard. The wraparound kind provides the most protection.

❊

Sources: Skin Cancer Prevention Campaign, Centers for Disease Control; “Better Health Channel: Healthier Living Online,” Victorian government, Australia (www.betterhealth.vic.gov.au); and the Environmental Protection Agency

Blue & You Summer 2006

Beat the summer heat I

n Arkansas, and the South in general, the summer heat can make you feel tired and listless. With temperatures soaring into the high 90s, and the humidity hovering at stiﬂing levels, we all feel drained at times. During the heat of summer, it’s important to take precautions to avoid heat-related illnesses. The No. 1 protective factor against heat-related illness is air-conditioning. If a person’s home is not airconditioned, people can reduce their risk for heat-related illness by spending time in public facilities that are air-conditioned. And, remember the following tips: • Drink plenty of water. • Exercise in the early mornings or evenings. • Treat any pre-existing conditions. • Wear loose and light-colored clothing. • Check the heat index daily, and give yourself time to adjust to the heat before undertaking any athletic endeavors. • Dress infants and children in cool, loose clothing, and shade their heads and faces with hats or an umbrella. • Do not leave infants, children or pets in a parked car. • Provide plenty of fresh water for your pets, and leave the water in a shady area. The elderly, young children and people with mental illness and chronic disease are the most susceptible to heatstroke. One-half of all heat-related illnesses occur in people age 65 and older. In 2001, 300 deaths in the United States were caused by excessive heat exposure. Preexisting conditions that may contribute to heat-related illnesses include anorexia, cardiac disease, uncontrolled diabetes, uncontrolled high blood pressure, obesity, upper respiratory tract infection, cystic ﬁbrosis and gastroenteritis. Medications that may contribute to heat-related illnesses include alpha adrenergics, anticholinergics, antihistamines, benzodiazepines, beta blockers, calcium channel blockers, neuroleptics, phenothiazine diuretics, and tricyclic antidepressants. There are three main heat-related illnesses: heat cramps, heat exhaustion and heatstroke.

Heat Cramps Signs of heat cramps include elevated body temperature, thirst and muscle cramps. Heat cramps often occur in athletes Blue & You Summer 2006

or other physically ﬁt people, and are caused by excessive heat exposure. When you have excessive activity with profuse sweating and too little ﬂuid intake, it can result in painful muscle spasms (heat cramps) in the calf or abdominal wall muscles.

Heat Exhaustion The symptoms of heat exhaustion include elevated body temperature, thirst, muscle cramps, nausea/vomiting, headache, malaise, hypotension, lightheadedness/fainting, lack of coordination, confusion, and irritability. Heat exhaustion occurs with persons being either water-depleted or sodium-depleted, although in reality they often overlap. Heat exhaustion from water depletion occurs most often in the elderly, who are more likely to have preexisting conditions or take medications that can make them more vulnerable to dehydration, especially during the summer. Heat exhaustion from sodium depletion often occurs in those who not only have not maintained ﬂuid in their system but have not replaced the sodium lost in sweat as well.

Heatstroke Heatstroke is the deadliest of heat illnesses. The symptoms of heatstroke are the same as with heat cramps and heat exhaustion but also include delirium/seizure/coma, renal failure, hyperventilation, pulmonary edema, arrhythmia and shock. Treatment for heatstroke must begin immediately. Classic heatstroke usually occurs during the summer and usually affects those with advanced age or chronic medical conditions. Exertional heatstroke also occurs most often in the summer and primarily affects outside laborers or athletes. Symptoms are similar to those of classic heatstroke, except that those with exertional heatstroke continue to sweat. This is important because when someone continues to sweat, heatstroke may be overlooked, and treatment could be delayed. Remember, heatstroke is a medical emergency. Multiple organ systems can be affected. Heat-related illnesses can affect anyone. The best way to avoid Heat, continued on Page 10

Swimming and water safety tips O

ne of the all-time favorite ways to beat the summer heat always has been to put on the old swimsuit and ﬁnd the nearest body of water. Arkansas is ﬁlled with lakes, rivers, streams and ponds suitable for swimming, not to mention the swimming pools and water parks. Being in the water can be a wonderful hotweather pastime or, if one becomes careless, it can be deadly. By following some basic swimming and water safety tips, hitting the local swimming hole can be a refreshing and safe activity for anyone.

General Safety Tips According to the American Red Cross (www.redcross.org), there are certain safety tips that apply to all water-related activities. The most important one is this: If you intend to spend time in or around the water, learn to swim. Swimming lessons are available almost anywhere and are a good investment. Always swim in pairs. Never swim alone. Swim in areas supervised by a lifeguard and pay attention to posted rules. Inexperienced swimmers, especially children, should wear U.S. Coast Guard-approved personal flotation devices. Be aware of the environment conditions such as where there are hazards, where the deep and shallow areas are, where the entry and exit points are, and the location of any possible currents. Use feet-first entry. Headfirst entry only should be used in areas clearly marked for diving with no obstructions. If swimming outdoors, exit the water immediately upon the first sign of inclement weather. And, never mix alcohol with water-related activities.

Beach Safety Tips • Wear sunscreen, and limit the amount of exposure to the sun between 11 a.m. and 4 p.m. • Stay hydrated: Drink plenty of water even if you do not feel thirsty. • Wear eye protection: Sunglasses that block UV rays are recommended. • Wear footwear: Bare feet can get burned from the sand or cut by sharp objects on the beach.

Boating Safety Tips Whenever you plan to go out on a boat provide a “float plan” to a responsible friend or relative. Let them know where you will be and about how long you will be gone. Attend a boating course in your area. The U.S. Coast Guard Auxiliary, for example, provides free boating instruction. Have personal flotation devices for everyone in the boat. Watch the weather, and head for home at the first sign of inclement weather.

Home Pool Tips If you have a home pool (full-size or “kiddie” pool), it is important to never leave a child unobserved around the water. Your eyes must be on the child at all times. It’s a good idea to install a telephone or have a cordless telephone handy so you can call 911 in an emergency. Learn cardiopulmonary resuscitation (CPR) and insist that baby-sitters, grandparents and others who care for your children know CPR as well. Keep toys away from the pool when not in use. Toys can attract small children. Post CPR instructions and emergency telephone numbers in the pool area.

Lake and River Tips Swim in areas that have good water quality. Dark, murky water can obscure hidden objects, drop-offs and aquatic life that may be hazards. Make sure rafts and other ﬂotation devices are in good condition. Make sure water is deep enough before entering headﬁrst. By applying these safety tips you can have an enjoyable summer of water-related fun. ❊ Sources: American Red Cross and the U.S. Coast Guard Auxiliary

Blue & You Summer 2006

Avoid the bugs and the bees S

ummertime brings lots of good things — vacations, lazy days by the pool and no homework! However, it also brings out the bugs and the bees, and a little bite from one of those critters can be mildly irritating or, at the other end of the spectrum, create lifethreatening symptoms. Ticks, bees, ants, mosquitoes, hornets, wasps, yellow jackets and other insects make enjoying the outdoors in the summertime less than enjoyable. To reduce the chance that you may be bitten by a stinging, flying insect, remember to: 1. Wear light-colored, smooth-finished clothing. 2. Avoid perfume and perfumed soaps, lotions or deodorants. 3. Wear clean clothing and bathe regularly. Sweat angers bees. 4. Try to cover as much of your body as possible with clothing. 5. Avoid flowers. 6. During the months of July, August and September, be sure to check around your home for new insect nests. 7. Keep outdoor areas clean and free from food. 8. If there is a single, stinging insect flying near you, remain still or lie face down on the ground. Swatting at an insect may cause it to sting. 9. If you are surrounded by a group of stinging insects, run to get away from them. Go indoors or jump into water. A shaded area is better than an open area when trying to get away.

You’ve been stung. What do you do now? Have someone stay with you in case you have an allergic reaction. Wash the site with soap and water. The stinger can be removed by using gauze to wipe the area or by scraping a ﬁngernail over the area — never squeeze the stinger or use tweezers. (It will cause more venom to be released.) Do not scratch the sting. This will cause the site to swell and itch more, and increase the chance of infection. The severity of an insect sting varies from person to person. A normal reaction to a sting would be pain, swelling and redness conﬁned to the area around the sting site. A large local reaction would result in swelling that extends beyond the sting site. For example, a sting on the forearm might result in swelling in the entire arm. Although alarming in appearance, this type of reaction is usually treated the same as a normal reaction. If the reaction seems highly unusual or very large, you may need medical attention.

Venomous vs. Non-venomous critters Venomous insects include wasps, hornets, yellow jackets, all bees and ﬁre ants. Non-venomous insects include chiggers, ﬂeas, lice, scabies, bed bugs, ticks and mosquitoes. The differences are in relation to the nature of the bite or sting. Venomous insects attack as a defense mechanism Blue & You Summer 2006

by injecting painful, toxic venom through their stingers to punish you so you will stay away from them next time. Non-venomous insects bite and usually inject anti-coagulant saliva in order to feed on your blood.

Rocky Mountain Spotted Fever Although ticks are non-venomous, they can cause a person harm. Rocky Mountain Spotted Fever (RMSF) is an infection transmitted by ticks. The signs and symptoms usually develop within one to 14 days after a tick bite. RMSF usually begins suddenly with a high fever with chills, muscle aches and a severe headache that may center around the forehead. Eyes may become red, muscles may be tender to the touch, and there may be generalized body swelling. The rash that makes RMSF a “spotted” fever may begin anytime between one and 10 days after the fever and headache start. The rash looks like small red spots and usually begins on the wrists and spreads over the body (not usually the face). As the infection progresses, the original red spots may change in appearance to look more like bruises or bloody patches under the skin. Usually, RMSF causes moderate to severe illness and may damage the liver, kidneys and lungs. Antibiotics have helped to decrease most of the suffering and danger resulting from the infection.

Lyme Disease Like RMSF, Lyme Disease also is attributed to tick bites. In the majority of people, the ﬁrst symptom of Lyme Disease is a red rash. The telltale rash starts as a small red spot at the site of the tick bite. It expands over a period of time forming a circular rash. Sometimes it resembles a bull’s eye. A fever, headache, stiff neck, body aches and fatigue often accompany the rash. Bugs, continued on Page 16

First-aid kits: H

Fireworks safety tips

What to include

ealth-care professionals and emergency technicians all agree: an easily accessible, well-stocked first-aid kit is an absolute necessity in every home. Having emergency medical supplies gathered ahead of time plus having a familiarity with the supplies goes a long way in helping to manage an emergency. In fact, it is recommended to have a first-aid kit at home and one in each vehicle. It also is recommended that containers for first-aid supplies be roomy enough to allow easy access to everything, durable enough to protect the contents, and lightweight enough to carry. While some supplies may vary depending on location and extremes in climate, there are certain items all first-aid kits should include: • A first-aid manual • Sterile gauze • Adhesive tape • Adhesive bandages in various sizes • Elastic bandages • Antiseptic wipes • Antiseptic solution • Antibiotic cream or ointment • Hydrocortisone cream • Calamine lotion • Acetaminophen and ibuprofen • Tweezers • Scissors • Safety pins • Instant cold packs • Thermometer • Several pair of plastic gloves • Flashlight and batteries • A list of emergency telephone numbers • Blanket (stored nearby) • Extra prescription medications (for trips) After assembling a first-aid kit, it is equally important to read the first-aid manual and become familiar with the kit’s contents (this applies to everyone in the home who is old enough to understand and capable of administering first aid). Be sure to store the firstaid kit out of the reach of children. Finally, check all first-aid kits regularly to ensure the replacement of used items and expired medications. With very little effort, it is possible to properly establish a firstaid kit that could mean the difference between life and death in an emergency. ❊ Sources: American Red Cross and the U.S. Department of Labor, Occupational Safety and Health Administration.

elebrate the Fourth of July, but celebrate safely. The Consumer Products Safety Commission and the National Council on Fireworks Safety offer these safety tips: • Always read and follow label directions. • Do not let children use fireworks alone; always have an adult present. • Buy from reliable sellers. • Use fireworks outdoors only. • Always have water close by (hose or a bucket). • Never experiment or make your own fireworks. • Light only one firework at a time. • Never re-light a “dud.” Wait 15 to 20 minutes, and then soak it in a bucket of water. • Never give fireworks to small children. • If necessary, store fireworks in a cool, dry place. • Dispose of fireworks properly by soaking them in water, and then disposing of them in your trash can. • Never throw or point fireworks at other people. • Never carry fireworks in your pocket. • Never shoot fireworks in metal or glass containers. • The shooter should always wear eye protection and never have any part of the body above the firework. • Stay away from illegal explosives. In Arkansas and surrounding states (Missouri, Texas, Oklahoma, Louisiana, Mississippi and Tennessee), essentially all fireworks are allowed. However, the rules concerning fireworks often vary by city or county , so check with local authorities before you use fireworks. For information on other states, visit The National Council of ❊ Fireworks Safety Web site at www.fireworksafety.com.

Blue & You Summer 2006

Better to be safe than sorry T

he break is over. Winter has come and gone and, it’s time to ﬁll up the gas can, dust off the mower and begin your weekly battle with the weeds and grass on your front lawn. However, before you get in a rush or hand off the project to your spouse or child, make sure all family members are ready to operate the lawn equipment in a safe and responsible manner. 1. Dress appropriately. Close ﬁtting clothes, sturdy shoes, heavy gloves and ear plugs will not earn you any fashion accolades, but they will give you an edge in safety. 2. Never let a child ride or operate a garden tractor or mower, even if the child is supervised. Even teenagers should be supervised, and should possess adequate strength and maturity. 3. Young children should simply stay indoors when outdoor lawn

and power equipment is being used. Adults should turn off the mower or power equipment if young children enter the area. 4. Unplug electrical tools and disconnect spark plug wires on gasoline-powered tools before making adjustments or clearing jams near moving parts. 5. Handle gasoline carefully. Never ﬁll tanks while machinery is on or when equipment is hot. Wipe up spills. Store gas in an appropriate container away from the house, cars and hot-water heater. Do not smoke around the gasoline. 6. Watch out for sharp blades, loose belts or worn-out extension cords. Remember, think safety when working with outdoor equipment. It’s good for your health. ❊

Heat, continued from Page 6 them is to avoid overexerting yourself in the summer heat. Take note of the following table to help you remember when to stay out of the heat.

Heat Index 130 degrees or higher

105 to 130 degrees

80 to 90 degrees

Extreme danger — Heatstroke highly likely with continued exposure. Dangerous — Heat cramps or heat exhaustion possible with prolonged exposure and/or physical activity. Caution — Fatigue possible with prolonged exposure or physical activity.

The Heat Index combines humidity and temperature measurements to create a scale to describe how warm the air feels when humidity is high. Remember, the summer heat and humidity can be a dangerous combination. Take care to keep yourself healthy during those uncomfortable summer days. ❊ Source: Centers for Disease Control and Prevention Blue & You Summer 2006

Was it something I ate? W

hen planning that barbecue in the backyard or cookout at the campsite, be sure the shindig you and your family are enjoying doesn’t end up with everyone vying for time in the bathroom. Although America’s food supply is the safest in the world, the facts tell us that the foods we eat may be the vehicle to transport a variety of unpleasant symptoms that can either cause a bad bellyache or perhaps be life-threatening to the weaker among us (including children and the elderly). These unwelcome dinner guests cause 76 million cases of foodborne illnesses in the United States each year. The main causes of foodborne illnesses are bacteria, viruses and parasites. They can be found in a variety of foods including meat, milk and other dairy products, spices, chocolate, seafood and even water. Specific foods that have been implicated in foodborne illnesses are unpasteurized fruit and vegetable juices and ciders; raw or undercooked eggs or foods containing undercooked eggs; chicken, tuna, and potato and macaroni salads; creamfilled pastries; and fresh produce. Common symptoms of foodborne illnesses include diarrhea, abdominal cramping, fever, headache, vomiting, severe exhaustion, and sometimes blood or pus in the stools. However, symptoms may vary according to the type of bacteria and amount eaten. There are health conditions that may cause a bout of foodborne illness to be more severe. Those health conditions include: liver disease, hemochromatosis (iron disorder), diabetes, stomach problems, cancer, immune disorders, and long-term steroid use (as with asthma and arthritis). When symptoms are severe, the ill person should visit a doctor or seek emergency help. For mild cases of foodborne illnesses, the individual should drink plenty of liquids to replace fluids lost through vomiting and diarrhea.

If you can’t remember anything else, remember this The No. 1 thing to remember to avoid foodborne illnesses is: keep it clean. Practice these four steps for food safety. 1. Wash your hands and surfaces often. With hot soapy water, wash your hands, cutting boards, dishes, utensils and

countertops before, during and after food preparation. 2. Separate the food. Always keep raw meat, poultry, seafood and their juices away from other foods. 3. Cook to proper temperatures. Use a food thermometer to make sure foods are cooked to a safe internal temperature. 4. Refrigerate promptly. Be sure to refrigerate foods within two hours. Set your refrigerator no higher than 40 F and the freezer at 0 F.

Take preventive measures The thought that the food you are consuming may make you sick is unappetizing, at the least. There are, however, steps to take to make sure your food is protected. When you are grocery shopping: • Pick up your packaged and canned goods first. • Don’t buy packages or cans that are torn or dented. • Don’t eat raw shellfish and use only pasteurized milk products and pasteurized or otherwise treated juices and ciders, if you have a health problem, especially one that has impaired your immune system. • Choose eggs that are refrigerated in the store, and open the carton and make sure the eggs are clean and are not cracked. • Don’t buy frozen seafood if the package is torn, or if there are signs of frost or ice crystals on the package. • Check for cleanliness at the meat or fish counter and salad bar. • When shopping for shellfish, buy from markets that get their supplies from state-approved sources; stay clear from vendors who sell from roadside stands or the back of a truck. • Take an ice chest along to keep frozen and perishable foods stored if you will be away from home for more than an hour.

Keep hot foods hot and cold foods cold Hot or cold foods left standing at room temperature for an extended amount of time provide an ideal climate for bacteria to grow. Improper cooking also plays a significant role in foodborne illnesses. Beef, lamb and veal should be cooked to temperatures of 145 F; pork and ground beef to 160 F; whole poultry and thighs to 180 F; poultry breasts to 170 F; and ground chicken or turkey to 165 F. Eggs should be cooked until the whites and yolk are firm. Seafood should be cooked thoroughly to an internal temperature of 145 F; fish that is ground or flaked should be cooked to 155 F; and stuffed Food safety, continued on Page 15

Blue & You Summer 2006

Something in the I

f there is something in the air that makes you sneeze and snifﬂe, you may prefer a shopping trip to the mall rather than a picnic in the park. And, it’s the pollen that may keep some people indoors. Pollen is microspores that usually appear on plants as a ﬁne dust. Contrary to popular belief, spring isn’t the only time that pollen is in the air. Pollen grains may be dispersed into the air in summer and fall, also, depending on the type of tree, grass or weed. Ragweed is a common cause of pollen allergies in the fall. Although most allergic pollen comes from plants that produce it in large quantities, it’s the chemical make-up of the pollen that determines whether it is likely to cause allergies. Besides avoidance, other allergy treatments include oral overthe-counter antihistamine medications, oral and nasal over-thecounter decongestants, and nose drops or nose sprays. Consult your physician for more treatment options.

air

If you are allergic to pollen, you should minimize your symptoms by avoiding exposure to pollen. 1. Remain indoors in the morning when outdoor pollen levels are the highest. 2. Wear a face mask designed to ﬁlter air if you must be outdoors. 3. Keep windows closed, and use the air conditioner in the house or car if possible. 4. Do not dry your clothes by hanging them outdoors. 5. Avoid contact with other irritants such as insect sprays, tobacco smoke, fresh tar or paint. 6. Avoid doing yard work such as mowing the lawn, if possible. If you would like information on the pollen count where you live, contact the National Allergy Bureau, which monitors pollen counts in many locations throughout the U.S. The telephone number for pollen counts is 1-800-9-POLLEN. ❊

Dealing with dust, dogs and other allergens A

person could be allergic to one or several things. The most common include pollens, molds, dust mites, animal dander (dead skin ﬂakes from animals with fur), foods, medications and insect stings.

Common types of allergies 1. Seasonal allergic rhinitis (sometimes called hay fever) is caused by an allergy to the pollen of trees, grasses, weeds or mold. The person with a reaction has spells of sneezing, itching, watery eyes, runny nose, burning palate and throat. 2. Allergic rhinitis is a general term used for anyone who has allergy symptoms (as with seasonal allergies), and it may be seasonal or a year-round problem caused by dust mites, dander, mold, etc. 3. Eczema or atopic dermatitis is a noncontagious itchy rash that often occurs on hands, arms, legs and neck. 4. Contact dermatitis is a reaction affecting areas of the skin. The skin may become red, itchy and inﬂamed after contact with irritants such as plants, cosmetics, medications, metals and chemicals.

Blue & You Summer 2006

5. Urticaria or hives are red, itchy, swollen areas of the skin that may appear on any part of the body. Approximately 25 percent of U.S. citizens will experience hives sometime in their lives. Most acute cases of hives are easily identiﬁable as reactions to such things as food, viruses, latex or medications. Chronic cases of hives may occur regularly for years with no identiﬁable triggers. In some cases, it may be inappropriate to ignore symptoms. Severe hay fever may lead to asthma, sinusitis and other conditions. Allergic dermatitis or hives may lead to secondary infections if they are not treated properly. Early detection and treatment of allergies is important. The tendency to suffer from allergies is genetically inherited. Instead of looking for a cure, those with allergies should work with their physician to keep their allergies under control. Successful treatment of allergies includes early detection, proper use of medications and simple allergen-avoidance techniques.

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Going camping? Remember these tips!

Allergy Stats • More than 50 million Americans suffer from allergic diseases. • Allergies are the leading cause of chronic disease in the United States, costing the health-care system $18 billion annually. • During 2002, approximately 14 million ofﬁce visits to health-care providers were attributed to allergic rhinitis.

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Cold or allergy? Symptoms General aches, pains Itchy eyes Sneezing Runny Nose Stuffy Nose Fever Duration Treatment

Cold Slight Rare or never Usual Common Common Rare 3-14 days Antihistamines Decongestants Nonsteroidal antiinﬂammatory medicines

Allergy Never Common Usual Common Common Never Weeks Antihistamines Nasal steroids Decongestants

Sources: U.S. Department of Health and Human Services, National Institutes of Health, National Institute of Allergy and Infectious Diseases

um ba yah, my Lord, Kum ba yah … if you have ever been at summer camp, those lyrics are probably familiar to you. Singing around the campfire almost is an American tradition, and something most parents have done with their parents, or children, at some point. Camping is fun, and it’s even better when you remember the following safety tips. 1. Bring proper clothing. The weather changes so be prepared with long pants and a jacket as well as shorts and T-shirts. 2. Be prepared for excessive heat. During the day, spend time in shaded areas. Hike in the morning or early evening. Wear skin protection including hats and sunscreen. 3. Don’t drink the water. Assume all water in creeks and rivers is contaminated so bring your own drinking water. 4. Stay together. A common problem in unfamiliar wooded areas is getting lost. Teach your children to recognize landmarks, and give them a whistle. Carry a compass and your cell phone (make sure it is charged). 5. Do not approach wild animals. Do not feed wild animals. Animals in the wild are strong and agile; even small animals may try to defend themselves if they feel threatened. Keep your campsite free of food odors and do not bring food into tents. Pack food in your cars overnight. What should you pack? Essentials include map of the area, compass, flashlight with extra batteries, extra food and water, extra clothing, first-aid kit, sunglasses and sunscreen, insect repellent, and matches in a waterproof container. Planning a safe family camping trip can be an enjoyable experience if you follow the motto of the Boy Scouts — Be Prepared!

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Blue & You Summer 2006

Pack a little precaution H

undreds of thousands of Arkansans will be traveling the Natural State this summer taking in its beautiful sites, camping in its parks, hiking its scenic trails, ﬂoating its many rivers. When planning your getaway, be sure you’ve taken the necessary steps so that you and your family have a safe and healthy trip.

Auto Maintenance

Several days before you pull out of the driveway, be sure you’ve checked your automobile for best performance — is there any scheduled maintenance needed (oil, other ﬂuids, ﬁlters, belts, tire rotation)? Are your tires in good condition (correct air pressure, cuts, bulges, tread wear, balance)? Is your spare tire aired and ready? Is the battery in good condition? Are your wiper blades in good shape? Do you have an emergency road kit?

Proper Attire Be sure you pack appropriate clothing for your planned activities and the weather conditions. If you might get wet, be sure to bring along dry clothes to change into. Do you need shirts with sleeves for warmth or to guard against the sun? If you are planning to walk a lot, are sneakers or hiking boots more appropriate? If the season is unusual, consider layering to go from cool to warm (or vice versa) temps. What about a hat?

People who suffer from allergies should take the same precautions on vacation as they do at home. Bring any medications used on a regular basis. It’s also a good idea to bring an antihistamine in case of accidental exposure to a substance that triggers an allergic reaction. It also may be helpful to pack your own pillowcase for use in hotels, and to request a non-smoking room. The inflammation of the joints that occurs with arthritis may be especially troubling during long trips that restrict movement. Taking frequent breaks to walk around and relieve stiff joints and muscles can make car trips more enjoyable. Remember to pack aspirin, anti-inflammatory drugs, or any prescription medications you normally use for arthritis. There’s nothing more miserable than getting sick while on vacation. For most destinations, the major health risk to travelers is diarrhea, which may be easily avoided. In general, common sense prevails. When in doubt, steer clear of uncooked meat, raw fruits and vegetables and unpasteurized milk products, and drink only bottled water. If you begin to feel sick or develop a fever, rest and drink tea or purified water. Most cases of traveler’s diarrhea clear up within a few days. In the wild, there’s always the possibility of bites. If a wild animal bites you, it’s important to see a doctor as soon as possible. Many animal bites require a tetanus shot and, in certain cases, a rabies shot. If bitten by a snake, lie as still as possible so not to spread the venom that may be present; then send others to get help immediately. Check your body for ticks. Remove any

Health Hints Don’t forget, motion sickness is an unpleasant problem for many travelers. However, there are some over-the-counter and prescription medications available. If you wish to combat motion sickness on your own, try the following: • When traveling by car, try to sit in the front seat and, if you can, avoid reading as it only heightens the feeling of motion sickness. • When traveling by boat, sit as close to the middle of the vessel as possible and look straight ahead at the horizon, a ﬁxed point that will not move. To avoid heatstroke, stay out of the sun for prolonged periods of time. Avoid outdoor activity during the hottest part of the day. It’s very easy to get caught up in the excitement of a vacation and get dehydrated. Be sure to drink plenty of ﬂuids to avoid dehydration, and don’t wait until you feel thirsty. Avoid caffeinated drinks, which can dehydrate you even more.

Blue & You Summer 2006

with tweezers and watch the area for rash over the course of the next few weeks. See your doctor if you develop abdominal pain, diarrhea, fever, rash, cough or weight loss. Pack insect repellents for your trip.

article on Page 9), a map, compass, flashlight, knife, waterproof firestarter, personal shelter, whistle, warm clothing, sturdy hiking boots, rain wear, high-energy food and water. Ask your doctor about necessary immunizations. Take a first-aid course before you leave and learn the ABCs of treating emergencies. Learn to recognize medical emergencies and respond to them immediately and appropriately, comforting the victim until help arrives. As common sense would dictate, avoid areas of natural hazards such as rock falls, floods, and hazardous plants and animals, and check for potential hazards of terrain, sanitation (including infectious disease) and climate. When it comes to traveling, plan well so that the little bumps in the road just make the trip more colorful and not catastrophic. Packing a little precaution will help make the memories of your trip the kind you want to put in a scrapbook and not ones you want to forget. ❊ Sources: TravelSense.org; Arkansas.com; Centers for Disease Control and Prevention

15 Valuables Keep your valuables in a money belt concealed under your clothes. Or, use the hotel safe to store valuables. Whenever you use your credit card, keep an eye on it until it is returned to you. Always verify that it is your credit card before storing it again. Check credit cards when they are returned. Be careful when out on the town at night. Watch your drinks being poured and never accept a drink from a stranger. Get information about reputable restaurants and other entertainment from trusted sources. Avoid being out on the streets late at night.

Blazing Your Own Trail If you’re charting unknown territory, you’re going to want to take extra precautions to avoid putting yourself in harm’s way. Plan for the worst. Pack a survival kit that includes your ﬁrst-aid kit (see Food safety, continued from Page 11 ﬁsh should be cooked to 165 F. Don’t thaw meat or other frozen food at room temperature; instead put them in the refrigerator for a day or two, or defrost submerged in cold water. Cooked foods should not be left standing on the table or counter for more than two hours. Hot dishes should be served immediately, and if the food has been reheated, it should be reheated to 160 F. Keep cold food in the refrigerator until it is ready to be served.

Although there is a lot to remember when it comes to keeping your food free from bacteria, viruses and parasites — it’s worth the work to avoid foodborne illnesses.

❊ Sources: U.S. Food and Drug Administration and the U.S. Department of Agriculture

Blue & You Summer 2006

The Healthy Weigh! Education Program

t’s no secret that being overweight is bad for your health. People who are overweight or obese are more likely to have heart disease, high blood pressure, diabetes, stroke, liver disease, gallbladder disease and certain cancers. Because of the increased incidence of these illnesses, a person who is 30 or more pounds overweight at age 40 can expect to live six-and-one-half years less that someone the same age who is at a normal weight. These risks can be quickly reversed with weight loss. Being very overweight also can make some ailments worse. When you take a step, you put twice your body weight on the joints of your back, hips and knees. If you have arthritis, the extra weight can make the pain worse. So, are you ready to make a change in your weight? Arkansas Blue Cross and Blue Shield can help! If you are an Arkansas Blue Cross, Health Advantage, Blue Cross and Blue Shield Service Beneﬁt Plan (Federal Employee Program), or BlueAdvantage Administrators of Arkansas member,

you are eligible to participate in The Healthy Weigh! Education Program. The information available through this program is based on guidelines set forth by the National Institute of Health Obesity Education Initiative. As a participant in this program, you will receive educational information in the mail including tips, a BMI chart, a list of wellness discounts that are available to you as an Arkansas Blue Cross, Health Advantage, Federal Employee Program or BlueAdvantage member and much more. The free program starts when you enroll. To enroll, simply complete, sign and return the enclosed enrollment form in the self-addressed postage-paid envelope included in Blue & You. You will begin to receive information through the mail, which you can read in the privacy of your own home, and at your own pace. The program is completely voluntary, and you may leave the program at any time. If you have further questions about the program, call the Health Education Program’s toll-free number at 1-800-686-2609.

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Study indicates low-calorie diet may be linked to longevity

o news is good news? Not necessarily. Sometimes, the news is good. Recently, a clinical trial being conducted by the National Institute on Aging, a division of the National Institutes of Health of the U.S. Department of Health and Human Services, indicated that overweight people who cut their calories by 25 percent during a six-month period reduced fasting insulin levels and core body temperature — and both of these are indicators for which lower levels have been associated with longer life. Beyond its effects on fasting insulin levels and core body temperatures, the low-calorie diet also resulted in changes in some,

but not all, of the metabolic factors that have been related to aging. The ﬁndings were reported in the April 5, 2006, issue of the Journal of the American Medical Association. ❊

Bugs, continued from Page 8 After several months of infection, more than half of those with Lyme Disease, who were not treated with antibiotics, develop recurrent attacks of arthritis. Less often, people with untreated Lyme Disease may develop heart abnormalities, eye problems and chronic skin disorders. Nearly all Lyme Disease patients can be effectively treated with antibiotics. The sooner such therapy begins the quicker and more complete the recovery.

Blue & You Summer 2006

The best way to avoid those irritating stings and bites is to protect yourself when outdoors. And, remember if you have had an allergic reaction to an insect sting, it’s important to see your doctor. ❊ Sources: American College of Allergy, Asthma & Immunology, National Institutes of Health, and The Nemours Foundation

Do you wear contact lenses? Increase in eye infections reported

n early March 2006, the Centers for Disease Control and Prevention (CDC) released a report stating that corneal disease specialty centers in the United States were seeing increases in Fusarium keratitis (a severe infection of the cornea), and that the CDC is encouraging those wearing contact lenses to take preventative measures. Fusarium keratitis is a serious and painful corneal disease caused by a fungal organism. Until now, it rarely has been reported in the healthy contact lens-wearing population. It typically occurs after trauma associated with plant matter or in immuno-compromised individuals. The higher incidence of Fusarium keratitis among normal contact lens wearers is a new ﬁnding. This disease is not transmitted from person to person. As of April 2006, there were more than 100 cases of patients with Fusarium keratitis under investigation in the United States. The CDC is working with public health authorities in numerous states to encourage preventative measures. Of those patients with the infection, 98 percent wore soft contact lenses. There is an ongoing investigation by the CDC, state and local health departments and the U.S. Food and Drug Administration to determine whether this cluster represents an increase in the infections and to determine

the cause of the infections. On May 15, 2006, Bausch & Lomb, Inc., permanently removed from the market a contact-lens solution called ReNu with MoistureLoc MultiPurpose Solution. However, the CDC has not found a definite connection between the product and Fusarium keratitis. Symptoms of Fusarium keratitis include blurred vision, a red and painful eye that does not improve when the contact lens is removed, increased sensitivity to light, and excessive tearing or discharge. If you experience any of these symptoms, you should contact your physician. Sometimes it is difficult to differentiate between fungal and bacterial infections. Confirmation may be obtained by your doctor through corneal culture, corneal tissue biopsy or confocal microscopy. Laboratory results take time to get back, so your doctor may place you on antibiotics pending results. Should fungal treatment be warranted, topical or oral anti-fungal agents may be used. In some cases, surgical intervention is necessary, including corneal transplantation. ❊

Contact lenses remain a safe form of vision correction

s with any medical device, hygiene plays a key role in the safety of a product. Be sure to keep your hands, contact lens case and the contact lens itself clean. Bacteria (or other contaminants) found on these items may get into the eye upon insertion of the lens. After removal, lenses should be cleaned immediately. The lens should be rinsed thoroughly before placing in the lens case. Contact lens solution should be discarded upon opening the case and fresh solution should be used each time the lens is placed in the case. The case should be stored dry between disinfection cycles. The lens case should be replaced every three months to avoid infection.

Without proper care, contact lenses have been associated with eye infection. It is important to replace lenses as prescribed by your doctor, even if proper hygiene measures are being followed. Always use the solution prescribed by your doctor, switching solutions could result in lens/solution incompatibility, lens discomfort or infection. By following your optometrist’s instructions, you can ensure contact lenses remain a safe and effective form of vision correction. ❊ Sources: Centers for Disease Control and Prevention and the American Optometric Association Blue & You Summer 2006

Understanding health insurance: A

t some point during your lifetime, your doctor has recommended a treatment for a medical condition, and you have asked yourself the age-old health insurance question, “Is it covered?” It’s a good question, and in most situations, the answer is “yes.” As a member — you can rest assured that Arkansas Blue Cross and Blue Shield always has your health in mind when evaluating which medical services and procedures will be covered by your health plan. There are four criteria, called the “Primary Coverage Criteria,” that a treatment must satisfy in order to be considered for coverage. • First, the treatment must be a health intervention intended to treat a medical condition. • Second, the intervention must be safe and effective. • Third, the treatment must provide an appropriate level of service, considering its potential benefits and harms. For example, an intervention would not be covered if it involves hospitalization or other intensive treatment setting when the intervention could be administered safely and effectively in an outpatient or other less-intensive setting, such as at home. • Finally, if more than one intervention meets the first three criteria, we only may cover the most cost-effective intervention. “Cost-effective” means a health intervention where the benefits and harms relative to the costs represent an economically efficient use of resources for patients with the medical condition being treated through the health intervention. For example, if the benefits and risks to the patient of two alternative interventions are comparably equal, a health intervention costing $1,000 will be more cost-effective than a health intervention costing $10,000. “Cost-effective” shall not necessarily mean the lowest price. “We spend a lot of time determining whether it is effective before we would say it is not effective,” said James Adamson, M.D., vice president and chief medical officer of Arkansas Blue Cross. According to Dr. Adamson, coverage decisions are not based on cost except in situations where an established, proven treatment is known to be as effective or more effective than a new technology.

What is a coverage policy? Creating a “coverage policy” — which determines what treatments are or are not covered — is not an easy process; it takes many hours of research to make sure the treatments satisfy the Primary Coverage Criteria. The purpose of a coverage policy is to inform members and their physicians why certain medical procedures may or may not be covered under Arkansas Blue Cross or Health Advantage health plans. Arkansas Blue Cross adds approximately 40 to 60 new coverage policies each year. Our medical directors review Blue & You Summer 2006

How coverage decisions are made hundreds of new medical services, procedures, devices and drugs to determine if they should be covered or not covered under the Arkansas Blue Cross coverage policy. Local physicians also provide input in their area of specialty. Each coverage policy is reviewed for accuracy every year to determine if it restricts coverage of a service, procedure, device or drug. According to Dr. Adamson, Arkansas Blue Cross is made aware of the need for new coverage policies from various sources including: reviews of medical literature; request for coverage of a new technology from a customer, physician or hospital, or drug/ device manufacturer; problems with current coverage identiﬁed through concerns from customers or physicians; review of new services submitted on claim forms; and request for “off-label use” of drugs or devices (off-label use means the use of a drug or device for a different medical condition than the condition for which the drug or device was developed originally). Coverage policy decisions are reached after a review of information including: 1. U.S. Food and Drug Administration status. 2. Assessment by independent assessment organizations designated by the Agency for Healthcare Research and Quality as an Evidence-Based Practice Center such as the Duke University Evidence-Based Practice Center, the New England Medical Center Evidence-Based Practice Center, and the Johns Hopkins Evidence-Based Practice Center. 3. Independent technology assessment organizations such as Hayes, Inc. 4. Guidelines published by recognized multi-center physician organizations such as the National Comprehensive Cancer Network. 5. Results of clinical trials. 6. Position papers of major medical organizations. 7. Consultation with national medical experts. 8. Consultation with practicing Arkansas physicians from appropriate specialties. Prior to implementation, any revisions to our coverage policy, any new coverage policies, and assessments of new technologies are reviewed by Arkansas Blue Cross’ clinical staff. And, by law, there is a mechanism in place that allows doctors or other healthcare providers who participate in our provider networks to have input into coverage policy decisions.

Why are some services not covered? Your health insurance contract or plan does not provide coverage for every medical service, procedure, device or drug that a health-care professional may decide to use to prevent, diagnose or treat a particular medical problem. “Medical professional groups agree that coverage policies are appropriate and necessary. It is understandable that a member has difﬁculty understanding why what a physician has recommended

is not covered. Unfortunately, the effectiveness of many new techniques and procedures is unproven. However, if we covered unproven services, the premium would be so expensive that it would be unaffordable,” said Dr. Adamson.

What about investigational or experimental treatments? As an insurer, Arkansas Blue Cross has a dual obligation to pay all valid claims and to deny those claims not covered under a member’s health plan or that do not meet Primary Coverage Criteria. In actuality, less that two percent of claims are denied because the claim was considered investigational or experimental. Arkansas Blue Cross always is being asked by organizations, physicians and others to pay for some procedures that may be unproven but that some people may feel are “cutting edge.” In the early 1990s, many health insurance companies were being asked to cover bone marrow transplants for breast cancer. Many female patients and doctors were demanding the treatment despite the lack of evidence to support this form of treatment. When insurers refused to provide coverage, they usually lost in court. When clinical trials were actually done, they showed that this painful and risky treatment did not work. “In some instances, where the health beneﬁt is unproven, the treatment can do more harm than good,” said Dr. Adamson.

What’s best for you No matter what, Arkansas Blue Cross always is looking out for the health of our members with continuous updates of coverage policies and by being vigilant in making sure all approved treatment options for our members are safe and effective. That is why we have coverage policies.

For more information For more information or to review our coverage policies, visit our Web sites at www.ArkanasasBlueCross.com or www.HealthAdvantage-hmo.com. ❊ Blue & You Summer 2006

Bird Flu Update

he current outbreak of avian (bird) flu, a strain known as H5N1, is highly contagious among birds and rapidly fatal. It can infect domesticated birds, including chickens, ducks and turkeys. And, unlike other strains of bird flu, it can be transmitted to humans causing severe illness and death. According to current statistics, the fatality rate is 50 percent among humans who contract the disease. The good news is that there is no reason to panic. As of May 1, 2006, the current bird flu has not been found in the United States. And, among those humans in foreign countries who have contracted the disease — most of the cases have occurred from direct or close contact with infected poultry or contaminated surfaces. However, rare cases of human-to-human spread of H5N1 virus may have occurred. There is no evidence of transmission beyond one person. Nonetheless, because all influenza viruses have the ability to change, scientists are concerned that H5N1 virus one day could be able to infect humans and spread easily from one person to another. Because these viruses do not commonly infect humans, there is little or no immune protection against them in the human population and an influenza pandemic (worldwide outbreak of disease) could begin. Experts from around the world are watching the H5N1 situation in Asia and Europe very closely and are preparing for the possibility that the virus may begin to spread more easily from person to person. Here’s the problem. Flu viruses are unstable and can mutate rapidly jumping from one animal species to another fairly easily. Scientists fear the bird flu virus could mutate into a form that spreads easily to humans and become an extremely lethal disease. This could happen if someone already infected with a flu virus catches the bird flu virus. The two viruses could combine into a “new” virus that is spread from person to person. The resulting virus would be something no one has seen or been exposed to before. There is little pre-existing natural immunity to a bird flu infection in the human population. If these viruses gain the ability to transmit easily between humans, an influenza pandemic could result.

Bird flu in humans Symptoms of bird flu in humans have ranged from typical flulike symptoms (fever, cough, sore throat and muscle aches) to eye infections, pneumonia, severe respiratory diseases (such as acute respiratory distress), and other severe and life-threatening complications. It is believed that most cases of bird flu infection in humans have resulted from contact with infected poultry or contaminated surfaces. Studies done in laboratories suggest that the prescription Blue & You Summer 2006

medicines approved for human flu viruses should work in preventing bird flu infection in humans. However, flu viruses can become resistant to these drugs, so these medications may not always work. Additional studies are needed to prove the effectiveness of these medicines.

The risk The risk from bird ﬂu is generally low for most people because the viruses occur mainly among birds and do not usually infect humans. However, during an outbreak of bird ﬂu among poultry (domesticated chicken, ducks, turkeys), there is a possible risk to people who have contact with infected birds or surfaces that have been contaminated with excretions from infected birds. Currently, there is a ban on the importation of birds and bird products from H5N1-affected countries.

National response The Centers for Disease Control and Prevention has joined a new, inter-agency task force organized by the U.S. Secretary of Health and Human Services. Additionally, the CDC has developed a test for the detection of the H5 viruses, and the CDC is working with partners to assist states with pandemic planning efforts and on antiviral stockpile issues.

Statewide response Arkansas is collaborating with other states and federal agencies to develop a response to pandemic inﬂuenza and to maintain important health-care and community services if an outbreak should occur.

Arkansas Blue Cross response Arkansas Blue Cross will be working with the Arkansas Department of Health and Human Services as well as our providers, employer groups, agents and members to collaborate on a communications and response plan should an outbreak occur. Arkansas Blue Cross will continue to keep our members informed about planned responses, how to be prepared should an outbreak occur, and the status of the bird ﬂu worldwide.

Antiviral drugs and vaccines Although the federal government is stockpiling medical supplies and antiviral drugs, no country in the world has enough antiviral drugs to protect all its citizens. Antiviral drugs can be used to treat severe cases as long as there is a reasonable chance that the drugs might help save lives. Antiviral drugs might also be prioritized for people who work in essential occupations, such as health-care workers. Other strategies for slowing the spread of a severe inﬂuenza outbreak could include temporarily closing public places and facilities. There currently is no vaccine to protect humans against a Bird Flu, continued on Page 21

New BlueChoice policy provides “choice” to customer

f you have friends or family members who may have been putting off the purchase of health insurance, Arkansas Blue Cross and Blue Shield now offers a new health insurance plan for individuals and families that allows policyholders to select benefit features that fit their unique needs and budget. “BlueChoice is all about choice,” said Ron DeBerry, senior vice president of Statewide Business. “We believe this new insurance plan will appeal especially to individuals or families who need insurance coverage but may not need all the bells and whistles. BlueChoice also is a great plan for early retirees, those without group health insurance, or students looking for their first job.” BlueChoice provides an array of deductible, coinsurance and copayment options from which to choose. BlueChoice accesses the True Blue PPO network and policyholders have “open access” to health-care providers, which means they are not required to receive a referral to see a physician but will save more money by staying in-network. BlueChoice provides up to $2 million in lifetime benefits for each covered family member. What sets BlueChoice apart from many other health insurance products is that coverage may be customized. Wellness benefits, children’s preventive care and hospitalization are standard coverage with a BlueChoice policy. However, in addition to deductible, coinsurance and copayment options, purchasers may choose from two prescription drug benefit options and may select maternity coverage. They may enhance their benefits by adding critical illness coverage or term life insurance. Whatever their needs and budget require, BlueChoice provides the options to tailor their insurance plan. “Unlike most policies, which provide a set list of benefits, BlueChoice gives policyholders an opportunity to design the plan they need,” said DeBerry. BlueChoice is for individuals under the age of 65 and not on Medicare who do not have employer-sponsored health coverage. Medical underwriting is required for this new insurance policy; however, it is a bit more flexible because of the higher deductibles associated with the plan structure. Considered a “limited benefit” policy, BlueChoice doesn’t cover

all types of illness, such as treatment for alcoholism, drug addiction and psychiatric conditions; and there are limits on home health care, outpatient therapy, occupational therapy, respiratory therapy and speech therapy. “For those who currently do not have health insurance and may think they cannot afford it, we believe BlueChoice can provide options to meet people’s needs both with price and benefits,” said DeBerry. “We believe BlueChoice might even be the perfect option for those purchasing health insurance for the first time.” Those interested in finding out more about BlueChoice — including a FREE rate quote — may call, tollfree 1-800-392-2583 (Monday through Friday, 8 a.m. to 5 p.m.).

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Bird Flu, continued from Page 20 pandemic influenza virus because the pandemic virus has not yet fully developed. However, vaccine development efforts are under way to protect humans against a pandemic influenza virus that might develop from the current bird flu virus. ❊ Sources: Arkansas Department of Health, Centers for Disease Control and Prevention, MSNBC.com, CNN.com, Reuters UK, World Health Organization, MedlinePlus, and the National Institute of Allergy and Infectious Disease

Blue & You Summer 2006

Health question? HealthConnect Blue W

orried about your child’s allergies? Have a question about an upcoming surgery? Need some tips on weight loss? HealthConnect Blue can help you with these questions and many more. HealthConnect Blue is a complimentary, conﬁdential health information service that puts members in touch with Health Coaches by telephone and offers health information online — to help members make more informed decisions about their health care.

Easy Internet Access Members may access HealthConnect Blue online, by going to the HealthConnect Blue link at www.HealthAdvantage-hmo.com or www.ArkansasBlueCross.com. Easy-to-understand articles on thousands of health topics are easy to access.

Personal Health Coaches — Call 1-800-318-2384

A Health Coach is available anytime to discuss immediate or everyday concerns. Health Coaches are specially trained health professionals such as nurses, respiratory therapists and dietitians. Members may call as often as they like at no cost. A Health Coach can offer information and support, and help you work with your doctor to make conﬁdent health decisions that are right for you.

Health Coaches do not provide medical advice. Members with urgent needs that require immediate medical attention are (as always) urged to call their physician, contact their local 911 or emergency service, or go to a nearby emergency room, as the need requires. Health Coaches can provide members with relevant health information when they need it the most. • Call or e-mail your Health Coach 24 hours a day, 7 days per week.

What our members are saying about HealthConnect Blue

he results of a recent member satisfaction survey are in, and members are pleased with HealthConnect Blue. According to the survey results: 92 percent of members surveyed indicated they were satisﬁed or very satisﬁed with HealthConnect Blue; 96 percent said their Health Coach was helpful and understood their condition; and 82 percent said they would recommend the program to others. And, customer comments have been positive. Following are excerpts of actual comments from members:

wonderful! She empowered me with the language to help me talk to my doctors to let them know that I am very concerned — these are my symptoms, what are you going to do, let’s do some lab work, and how to go over everything with them so I understand what is going on. I can’t say enough about my Health Coach. I kept her overtime, and she graciously said that she didn’t care because I was her patient. It was so wonderful to hear that from a medical professional. Please keep this service going, and I will use it again — believe me … So, thank you very much for this service. It was needed and appreciated.”

“I just really wanted to say how much I appreciate the services of the Health Coach. It has been immensely helpful to me, and the Health Coaches have been very helpful in providing valuable information concerning the speciﬁc matters that I spoke with them about. So, I just want to say thank you so much for the service. I greatly appreciate it.”

“I have called several times about hip replacement, and I have been very happy with the response I’ve had from the people I’ve talked to. I received a wonderful booklet and video. I wanted to tell you this is a very good service.”

“I have Health Advantage insurance and I got the video on back surgery, and I thought it was an excellent video, and it showed all the different options and what to expect for those different outcomes … I thought it was a great video.” “I’ve got high blood pressure; the numbers are alarming. Everything that I have read through or seen tells me that my symptoms are not good. I wanted to call, and I spoke with a Health Coach. Absolutely

Blue & You Summer 2006

“A year ago, I found out that I had heart disease and since then it’s been congestive heart failure. You all have really been a rock. If it weren’t for you, I don’t think I would have made it through sometimes without your help, and my Health Coach has been great. She has given me that little nudge that pushed me along to do so much better, and now I am doing great. I appreciate you all. I appreciate what you have done, and it’s such a blessing to know that I can call the Health Coach 24 hours a day and they are right there. Thank you so much.”

has the answer • Call if you need help making a decision about surgery or another serious health event. • Call if you or a loved one needs help managing a chronic health condition, or the sudden onset of an illness. A Health Coach can help provide a better understanding of how to manage members’ conditions and other topics that are important to them, as well as how they might prepare for the next visit with their health-care provider. Regardless of the health topic, Health Coaches with HealthConnect Blue can send members information from nationally recognized sources. Videotapes are available on speciﬁc topics such as breast cancer, prostate cancer and low back pain. All materials are for members to keep at no cost.

As an automatic member of this program, you can: • Speak one-on-one with a Health Coach 24 hours a day, 7 days a week. • Receive personalized follow-up calls with a Health Coach about a chronic condition or other health concerns. • Have educational materials mailed to your home, at no charge. • Visit the Health Advantage Web site (www.HealthAdvantagehmo.com) or the Arkansas Blue Cross Web site (www. ArkansasBlueCross.com) to review a health encyclopedia containing in-depth health information on more than 1,900 clinical topics. ❊

Note: Currently, all Health Advantage members, Arkansas Blue Cross and Blue Shield members (excluding Medi-Pak) and eligible BlueAdvantage Administrators of Arkansas groups have access to HealthConnect Blue. This includes all Service Beneﬁt Plan (Federal Employee Program) members, Health Advantage HMO members and all public school and state employees covered by Arkansas Blue Cross or Health Advantage.

My BlueLine

ith My BlueLine, you have access to customer service 24 hours a day, 7 days a week. If you are a customer of Arkansas Blue Cross and Blue Shield, Health Advantage or BlueAdvantage Administrators of Arkansas, you can get answers to your claims or beneﬁts questions anytime, day or night. Call the telephone number on your ID card, or refer to Page 3 for Customer Service telephone numbers. My BlueLine is an interactive voice response (IVR) system that recognizes speech patterns to help answer questions when you call current customer service telephone lines. When you call a

customer service line and select My BlueLine, it will prompt you with a question, and all you have to do is simply respond to the question. When you call, remember to have your ID card on hand. For privacy purposes, the system will ask you questions to verify your identity as the caller — such as your member ID number as it is listed on your membership card. If you prefer, you immediately may choose the option of speaking to a customer service representative (during regular business hours). ❊

Blue & You Summer 2006

Ask the Pharmacist W

hen planning your summer vacation, there are many “must haves” you’ll need when packing your suitcase … beach towel, sunscreen, swimsuit and, most importantly, prescription medications for you and your family. When planning your vacation, remember the following when it comes to your prescription medication: • Take it with you! Also, think about how much medication you will need based on how long you will be gone. It’s a good idea to keep a list of your medications, their dosages, your doctor’s telephone number and your health insurance ID card handy. In additional to prescription medication, it is a good idea to take your over-the-counter medication with you, too.

• Keep a schedule of when you are supposed to take your medication. It is helpful if you are traveling to a different time zone. Consult your pharmacist about how to create an appropriate schedule to ﬁt your needs. • However, if you have diabetes you need to remember the following while you are traveling. Think about your regular daily schedule, and try to stick to it as closely as possible. For example, if you usually test your blood sugar at noon and then eat lunch, plan to do this on your trip. Don’t change your watch while you are traveling to your destination, so it will correspond to your normal schedule. That will make it easier to determine

Blue & You Summer 2006

if there are undue delays between meals, doses, etc. Do change your watch to local time after you have arrived. • Keep your medication with you while traveling, not packed in checked luggage. Checked luggage could be delayed or lost. • You can take your medications on airline flights. All medications (such as pills, injectables or homeopathic remedies) and associated supplies (such as syringes, pens, infusers, etc.) are allowed through the airport security checkpoint once they have been screened. • Because many pills look similar, keep your medication in its original container. If they are not in their original container, make sure they are clearly labeled. • Protect your medication from direct sunlight, extreme heat and water. Car trunks, glove compartments and swimsuit pockets are not good places to store your medication. • Keep your medications away from small children. • If you plan an excursion or a day away from your hotel, carry enough medication to last the full day. • If you are traveling to another country, be extra careful with your medication. Lost or stolen luggage or purses is a possibility and replacing prescription medication overseas could be difficult. Some countries have regulations about taking medication into their country so check before you go. • Ask your pharmacist if there are any foods or beverages that conflict with your medications. You may be more inclined to eat unfamiliar foods while traveling. Avoid drinking alcohol as it conflicts with many prescription and over-the-counter medications. Your pharmacist can help you with questions about mixing alcohol and medications. • If you forget to take your prescription medication with you, just go to the nearest pharmacy and have them contact your local pharmacist. The pharmacy can then fill your prescription. • Think about the climate during your vacation. A change in climate could cause you to have medication-related side effects. In hot climates, for example, diuretics may cause dizziness at first. Also, antihistamines, cold preparations and tranquilizers can decrease your ability to perspire. When you are traveling, you take your illnesses and ailments with you. So, remember to take your prescription medications with you, too. ❊

Prior approval required for high-tech outpatient radiology services

ost Arkansans are very aware of the rising cost of health care. The National Manufacturing Association has concluded that America’s standard of living will decrease in the coming years due to the transfer of jobs overseas. One major reason for this job loss is the cost of health care borne by American employees. Arkansans might not be aware that the fastest growing area of health care is medical imaging (radiological tests such as CT, PET, MRI/MRA and nuclear cardiology scans). Arkansas Blue Cross and Blue Shield currently pays approximately the same amount in claims for imaging as for prescription medications, and imaging costs are increasing at a much faster rate. In addition to the increased ﬁnancial burden this places on those paying health insurance premiums, the rapid acceleration in radiological imaging is exposing patients to worrisome doses of radiation. For example, each CT of the head delivers the radiation equivalent of 200 chest X-rays. For these reasons, Arkansas Blue Cross and Health Advantage have entered into an agreement with National Imaging Associates, Inc., (NIA) for outpatient imaging management services. Physicians who order high-tech outpatient radiology services including PET, CT, MRI/MRA (magnetic resonance angiography) or nuclear cardiology on an outpatient basis for any Arkansas Blue Cross or Health Advantage member will have to obtain prior

approval before the service can be performed. BlueAdvantage Administrators of Arkansas groups can elect to add this service on a group-by-group basis, which would be indicated on the member’s ID card. These services will not apply to members of the Federal Employee Program (FEP) or USAble Group Life at this time. Prior approval will not be required for emergency, observation department of a hospital or inpatient services. Members are not required to gain prior authorization and will not be held liable for costs associated with unapproved radiology services if a participating provider provides the service. It is your physician’s responsibility to obtain prior approval. The entire prior approval process should take only a few minutes, so members should not have to wait for necessary radiology services. For more information about the prior approval program, visit our Web sites at www.HealthAdvantage-hmo.com or www.ArkansasBlueCross.com. ❊ Special Notice: You always should try to use an in-network provider when receiving one of these diagnostic imaging services. In the event that you use an out-of-network/non-participating provider, the provider can “balance bill” you for the difference between billed and allowed charges, which could result in thousands of dollars in additional expense to you, the member.

HHS Secretary promotes Medicare Rx U.S. Health and Human Services Secretary Mike Leavitt (far right) visited Little Rock on April 24 to raise awareness about Medicare Prescription Drug Coverage and the May 15 deadline to sign up without penalty. While in the Capitol City, he made a stop at the Pinnacle Business Solutions, Inc. (PBSI) Medicare Support Call Center. The PBSI Medicare Support Call Center answered 1-800-Medicare calls that addressed beneficiary questions about the new prescription drug program since October 2005. On his nationwide tour, this was the only call center (out of 10 total) the secretary visited. He spent time speaking with the staff about the nature of the calls they were receiving and even listened in on a couple of beneficiary telephone calls. Outside the call center, he addressed the media, Medicare beneficiaries, government agency officials, and PBSI and other employees. Emma Petty, (center) a representative for the American Association of Retired Persons (AARP) and a Medicare beneficiary, also spoke to the crowd, sharing her personal story of her satisfaction with the enrollment process and how the Medicare Prescription Drug Coverage program had helped save her a tremendous amount of money on her medications. ❊

Blue & You Summer 2006

Federal Features S

(Federal Employee Program)

Wellness and disease education offered to federal employees and retirees

everal new, free programs will be offered in the coming months to Blue Cross and Blue Shield Service Beneﬁt Plan enrolled members. Identiﬁed members will be receiving information in the mail as these programs are rolled out.

Disease Education Programs 1-800-318-2384 A welcome letter will be sent to identiﬁed members. This will be followed with periodical information designed to help members manage diabetes, asthma, congestive heart failure, chronic obstructive pulmonary disease and coronary artery disease.

Wellness Education Programs 1-800-686-2609

for Blue Cross and Blue Shield Service Beneﬁt Plan Members

New Respiratory, Low Back Pain and The Healthy Weigh! Wellness Education Programs will be available to members in the next few months. Identiﬁed members will receive a welcome letter introducing them to the Respiratory and Low Back Pain programs. An article and enrollment form about The Healthy Weigh! program is included in this and every issue of Blue & You.

Blue & You Summer 2006

The Respiratory program assists members who have chronic conditions such as bronchitis, pneumonia and sinusitis. The Low Back Pain program provides information to help members manage back conditions and prevent complications. This program is only for members who have never had back surgery. The Healthy Weigh! program offers information about nutrition and exercise, and provides weight loss tips and tools to help members with weight management. For enrollment information, please call 1-800-686-2609. Special Delivery is designed to help our members have healthier pregnancies by employing three strategies — education, assessment and coverage options – to educate the expectant mother in the prevention of preterm births. For more information, please call 1-800-742-6457. ❊ Special Note: Be sure to visit www.fepblue.org often. This URAC Accredited Health Web site has the most up-to-date beneﬁt and health information available 24 hours a day.

Surveys say members satisfied with health plans A rkansas Blue Cross and Blue Shield, Health Advantage and BlueAdvantage Administrators of Arkansas operational performance and member surveys conducted in 2005 by the Blue Cross and Blue Shield Association and Arkansas Blue Cross showed that our members are satisfied with their health plans. The summary results include the Member Touchpoint Direct Measures (MTM) program (measures operational and service performance), the Blue Cross Blue Shield Association member satisfaction survey, the Arkansas Blue Cross Product Survey (survey of member satisfaction with eight major product lines), and the Customer Service Member Contact Survey (survey of randomly selected callers). During 2005, Arkansas Blue Cross (which includes Health Advantage and BlueAdvantage) received the following scores on the MTM Performance Report: • In the category of claims timeliness (percentage of claims processed within 30 calendar days), Arkansas Blue Cross received 99.7 percent overall performance rating. • In the category of claims accuracy (frequency), Arkansas Blue Cross received a 98.7 percent overall performance rating. For claims accuracy (dollar amount), Arkansas Blue Cross received a 99.2 percent overall performance rating. • In the category of inquiry timeliness (response within seven days to inquiries including telephone calls, written correspondence, walk-ins, faxed items, e-mails, etc.), Arkansas Blue Cross received a 97.3 percent overall performance rating, which exceeds the MTM standard (90 percent). • In the category of inquiry accuracy, Arkansas Blue Cross received a 97.9 percent overall performance rating. • In the category of membership timeliness, Arkansas Blue Cross received a 99.7 percent overall performance rating. • In the category of membership accuracy (group level), Arkansas Blue Cross received a 98.4 percent overall performance rating. • In the category of telephone call blockage, the MTM performance guideline is 5 percent or less of all calls placed in a queue that are abandoned (the caller hangs up or disconnects the call) prior to reaching the final destination. Arkansas Blue Cross had a 2.4 percent overall abandonment rate. In the Arkansas Blue Cross Product Survey, approximately 80 percent of all members (all lines of business) reported overall satisfaction with their health plan (on a scale of 1-10 responding with a 8, 9 or 10 highly satisfied rating), with Medi-Pak members reporting a 95 percent satisfaction rate. These results compare favorably and are higher than the National Averages for Blue Plans and other health insurers.

Additionally, Arkansas Blue Cross conducts a random survey twice a year with members who have called Customer Service. Members then are selected randomly to receive a Customer Service survey, and the survey is mailed to their home address. If you have called Customer Service, you may receive a survey in the future. The recent survey results included the following: • When asked if the customer service representative maintained a professional, courteous and polite manner, 91 percent of respondents responded favorably. • When asked about the overall satisfaction of their health plan, 84 percent of respondents reported overall satisfaction. • When asked if their issue was resolved during the first telephone call, 80 percent responded that it had been. According to the results of the surveys, the primary drivers of member satisfaction are: amount of out-of-pocket expenses, getting claims paid correctly and quickly, getting correct information from Customer Service, getting problem resolved on the first contact, follow-up from Customer Service, receiving health-and-wellness information, and getting enrollment help to make the right choices. “We have a commitment to our members to provide excellent customer service every day, and the survey results are a reflection of our dedication. There always is room for improvement, and our future goals include continuously improving internal processes to meet every member’s expectations and needs,” said David Bridges, executive vice president of Internal Operations, Arkansas Blue Cross, and chief executive officer of Health Advantage. ❊

Blue & You Summer 2006

2006 ﬁnalists do get the “Don’t Start” Smoking message

atalie DeLone, 10, a fifth-grade student at Baker Elementary School in Little Rock was named the grand-prize winner in the fifth annual “Don’t Start” Smoking Coloring Contest. The contest was sponsored by Arkansas Blue Cross and Blue Shield, KASN-TV/UPN Channel 38 and KLRT-TV/FOX Channel 16, in partnership with the American Lung Association of Arkansas and the Arkansas Department of Education. Seventeen other student finalists (see list of names below) were from elementary schools in Bentonville, Bryant, Eudora, Fayetteville, Gosnell, Harrisburg, Harrison, Jonesboro, Little Rock, Star City and Van Buren. More than 17,000 entries were received statewide. All 18 finalists gathered together on April 28 along with their family members, parents, teachers, counselors and principals at the “Don’t Start” celebration party. DeLone’s winning storyboard has been turned into a 30second public service announcement (PSA) and will be shown on television stations statewide in the fall of 2006. The “Don’t Start” Smoking Coloring Contest gave students in public, private and home schools in kindergarten through fifth grade an opportunity to write and illustrate a story about why it’s important to never begin the dangerous habit of smoking. The contest gave students an opportunity to have their story transformed into a PSA while also “drawing their way” to prizes. The object of the program was to get kids thinking about why they should not use tobacco products and what they can

do because they aren’t sick from smoking. Kids used storyboard sheets to write a story and draw pictures depicting their story. They were encouraged to draw animals, people, cartoon characters or anything their creative minds could think of to tell their story. In addition to the storyboards, teachers received a seven-minute educational video and Teacher’s Packet to help build a curriculum around the “Don’t Start” Contest. “Learning at an early age about how the choices they make now can affect their health in the future is part of what our mission is all

Blue & You Summer 2006

about,” said Sharon Allen, president and chief operating officer of Arkansas Blue Cross. “We want these students to be healthy. As they all have shown in their storyboards, there is nothing healthy about smoking. We hope the ‘Don’t Start’ Smoking Contest was a fun learning opportunity for these students. We’re proud to have been a sponsor of this worthwhile project for the fifth year and I’m proud of the commitment these young people all have made to stay smoke-free.” A panel of judges picked three finalists in each grade level. From those 18 finalists, judges selected the overall winner who received a $100 savings bond and a Nintendo Game Boy® Advance, in addition to having her story turned into a PSA. All finalists received fun prizes including bicycles, portable CD players, Wal-Mart gift cards and prize packs from BlueAnn Ewe and FOX16/UPN38. Students could enter the contest as individuals, or teachers could have their students participate in the contest as a class project. ❊

2006 “Don’t Start” Smoking Contest Finalists Kindergarten First-Place Finalist — Izzy Gibbany, 6, Skyline Heights Elementary School in Harrison Second-Place Finalist — Katie Buchanan, 6, Gosnell Elementary School Third-Place Finalist — Sophie Johnson, 5, Skyline Heights Elementary School First Grade First-Place Finalist — Dexter Neal, 7, G.C. Johns Elementary School in Eudora Second-Place Finalist — Madison Brown, 7, Jimmy Brown Elementary School in Star City Third-Place Finalist — Leah Donckers, 7, Elm Tree Elementary School in Bentonville Second Grade First-Place Finalist — Charlie Jo Mallett, 7, Skyline Heights Elementary School Second-Place Finalist — Taylor Tilmon, 8, Elm Tree Elementary School Third-Place Finalist — Elizabeth Leonard, 8, Harrisburg Elementary School Finalists, continued on Page 29

“One Class at a Time” grants continue to help teachers

rkansas Blue Cross and Blue Shield and Fox 16 News at Nine have awarded $500 grants monthly to deserving teachers in Arkansas since September 2005. The newest winners are: Barbara Manning, Morrilton High School — to build a hovercraft that students can ride to observe and experience the effects of Isaac Newton’s laws of motion including frictionless surfaces and inertia. The students will learn during both the building and use of the craft. One goal is for the students to learn safely the importance of wearing seat belts in collisions to save lives.

“One Class at a Time” grants are awarded to teachers around the state of Arkansas to help supplement class needs. Teachers have gone online to www.FOX16.com to apply for the grants to use to purchase supplies, classroom tools, field trips, books, computers or other educational necessities that otherwise may not be funded. BlueAnn and FOX 16 news personalities have traveled monthly to schools to award a grant to winning teachers. Award presentations have been filmed and shown on FOX 16 News at Nine. The winners also are posted on the Web site. ❊ Principal Darin Beckwith poses with Teacher Kathey Roberts as she receives a grant check from Gray Dillard of the South Central Regional Office, shown with BlueAnn, Troy Bridges and Lakeside High School students.

Kathey Roberts, Lakeside High School, Hot Springs — to support her environmental science class project “Bird Fest 2006.” The school has invited grades K-7 to attend the festival, which will take place in the schoolyard habitat classroom, and teach awareness of bird populations in Arkansas, the importance of sound land management to protect habitats and to observe speciﬁc bird adaptations to environments.

BlueAnn poses with Principal Blain Alexander, Troy Bridges with Fox16 News at Nine, Teacher Jamie Oitker and the Easter Bunny at Magness Creek Elementary School in Cabot following the grant award presentation.

Jamie Oitker, Magness Creek Elementary, Cabot — to purchase supplies for and construct a climbing wall for the students. The project will integrate science class (by teaching about landforms and rocks) and physical education class (by working on muscular strength and endurance). Character education also will be a focus to teach goal-setting, motivation and achievement.

Finalists, continued from Page 28 Third Grade First-Place Finalist — John Brust, 9, Skyline Heights Elementary School Second-Place Finalist — Cierra Finley, 9, Bale Elementary School in Little Rock Third-Place Finalist — Bailie Edwards, 9, Rena Elementary School in Van Buren Fourth Grade First-Place Finalist — Sydney McConnell, 9, Grimes Elementary School in Fayetteville Second-Place Finalist — Lauren Frederick, 10, Rena Elementary School

Third-Place Finalist — Jennifer Tackett, 9, Williams Magnet Elementary School in Little Rock Fifth Grade First-Place Finalist & Grand-Prize Winner — Natalie DeLone, 10, Baker Elementary School in Little Rock Second-Place Finalist — Emily Dabbs, 10, Collegeville Elementary School in Bryant Third-Place Finalist — Weston McDaniel, 10, Blessed Sacrament School in Jonesboro ❊

Greenway promoted

ark Greenway, a member of the Arkansas Blue Cross and Blue Shield board of directors, recently was promoted to senior vice president with J.B. Hunt. He is responsible for health and welfare beneﬁt plan design and strategy at J.B. Hunt Transportation Services, Inc., as well as the hiring, training

and development of a workforce of more than 15,000 employees. During the past 18 years, Greenway has held various management and operations positions with the company, including risk management, customer services and strategic planning. Greenway joined the Arkansas Blue Cross board in 2005. ❊

Blue & You Summer 2006

Arkansas Blue Cross and Blue Shield Financial Information Privacy Notice

t Arkansas Blue Cross and Blue Shield and its afﬁliates (HMO Partners, Inc. d/b/a Health Advantage, and BlueAdvantage Administrators of Arkansas), we understand how important it is to keep your private information just that — private. Because of the nature of our business, we must collect some personal information from our members, but we also are committed to maintaining, securing and protecting that information.

Customer Information

Arkansas Blue Cross and its affiliates only compile information necessary for us to provide the services that you, our member, request from us and to administer your business. We collect nonpublic personal financial information (defined as any information that can be tied back to a specific person, and is gathered by any source that is not publicly available) about our members from: • Applications for insurance coverage. The application includes information such as name, address, personal identifiers such as social security number and medical information that you authorize us to collect. • Payment history and related financial transactions from the purchase and use of our products. • Information related to the fact that you have been or currently are a member.

Sharing of Information Arkansas Blue Cross and its afﬁliates do not disclose, and do not wish to reserve the right to disclose, non-public personal information about you to one another or to other parties except as permitted or required by law. Examples of instances in which Arkansas Blue Cross and its afﬁliates will provide information to one another or other third parties are: • To service or process products that you have requested. • To provide information as permitted and required by law to accrediting agencies.

• To provide information to comply with federal, state or local laws in an administrative or judicial process.

How we protect your information Arkansas Blue Cross and its affiliates use various security mechanisms to protect your personal data including electronic and physical measures as well as company policies that limit employee access to non-public personal financial information. Improper access and use of confidential information by an employee can result in disciplinary action up to and including termination of employment.

Disclosure of Privacy Notice Arkansas Blue Cross and its affiliates recognize and respect the privacy concerns of potential, current and former customers. Arkansas Blue Cross and its affiliates are committed to safeguarding this information. As required by state regulation, we must notify our members about how we handle non-public financial information of our members. Nothing has changed in the way we conduct our business. If you would like to review the Financial Information Privacy Notices for all Arkansas Blue Cross members, you can visit our Web site at www.ArkansasBlueCross.com or call the appropriate Arkansas Blue Cross company to receive the Privacy Notice. Our customer service areas are open from 8 a.m. – 4:30 p.m., Central Time, Monday through Friday. To receive a copy of the Privacy Notice, members should call one of the following numbers. Arkansas Blue Cross — 1-800-238-8379 BlueAdvantage Administrators of Arkansas — (members should call Customer Service using the toll-free telephone number on their ID card) Health Advantage — 1-800-843-1329 ❊

My Blueprint

t’s easy to register to use My Blueprint, the online customer selfservice center for Arkansas Blue Cross and Blue Shield, Health Advantage and BlueAdvantage Administrators of Arkansas members. Visit our Web sites to use My Blueprint. Members can enter their health plan ID number, name and date of birth for immediate access to the health tools. Members will receive an activation code via the U.S. Postal Service that will allow access to personal data, such as medical and pharmacy claims.

Blue & You Summer 2006

Remember that any covered person, not just the policyholder or group employee, can register. The Arkansas Blue Cross family of companies is working to make our Web sites more user-friendly while continuing to protect the privacy of your personal health information. For more about My Blueprint, see Page 32. ❊

Blue & Your Community A

rkansas Blue Cross and Blue Shield strives to be a good corporate citizen. Our employees raise money and spend many hours helping those causes near and dear to the hearts of Arkansans.

Good Health for Scallywags Members of Arkansas Blue Cross and Blue Shield’s Southeast Regional Office staff in Pine Bluff recently set sail for good health aboard a ship full of swashbucklers at Drew Central Elementary School in Monticello. The fun health fair, sponsored by the school’s Parent Teacher Organization, was held to get elementary and middle school students thinking about health and safety, which rules out walking the plank and sword fighting. BlueAnn Ewe made an appearance to encourage eating right, exercising, wearing your seat belt and getting good sleep. It was a pirate’s life for one night but with fairly fit buccaneers.

Hearty Support Arkansas Blue Cross and Blue Shield again has supported the American Heart Association’s (AHA) Heart Walks throughout Arkansas with both sponsorships and employee teams to help raise awareness and funds for the work of the AHA. Recently in Central Arkansas, Arkansas Blue Cross employees purchased paper sneakers to raise money, participated in the Heart Walk at Riverfront Park in North Little Rock, and manned the “survivor booth” at the Walk to recognize those who were working hard to beat heart disease. In addition, Arkansas Blue Cross sponsored the Red Cap Rally, a celebration for survivors of heart attack, heart disease and congenital heart defects.

Lonoke Elementary School students get on their feet for a Radio Disney “Rockin’ Recess” with BlueAnn Ewe.

Rockin’ Recess energizes kids BlueAnn Ewe recently appeared with the local Radio Disney team for a “Rockin’ Recess” at Lonoke Elementary School to get kids moving and making good choices. Arkansas Blue Cross and Blue Shield sponsors the “Get 5” program through Radio Disney in the Central Arkansas area. “Get 5” is a creative educational entertainment program which reaches out to elementary-aged school kids to challenge them to be personally responsible for a healthy lifestyle and gives them fun, creative tools to get fit. “Get 5” is a Radio Disney national program that airs in Arkansas on FM 99.5 and encourages kids to eat five fruits and vegetables, and accomplish five five-minute bursts of physical activity a day. The Arkansas affiliate of Radio Disney features “BlueAnn Rocks” musical health messages and promotes energy bursts — times when kids are encouraged to get up and dance or move around to the next song. BlueAnn makes special “Rockin’ Recess” appearances with the Radio Disney team to promote health and fitness. ❊

Blue team employees gather for the Central Arkansas Heart Walk.

Blue Online, continued from Page 32 A pharmacy network search also is available in these sections. Maps and driving directions will help you locate the pharmacy of your choice. To keep a record of your medications, use the HealthConnect

Blue “Health Tools” section. This personal information is secure. You must log into My Blueprint to track your medications. Watch for more health tools as My Blueprint continues to grow.

❊

Blue & You Summer 2006

Blue M

aking decisions about your health care can be difﬁcult. Register for My Blueprint to gain access to several online tools that can help you understand your choices and use your health-plan beneﬁts more effectively.

Health-Plan Tools My Blueprint is a secure, self-service center that allows you to access information about your health-beneﬁt plan. You can: • Check eligibility for all covered members; • Check status of claims and review claims history; • Review primary care physician history (if applicable); • Order a replacement ID card. • Access several health tools described below. If you are a Health Advantage or BlueAdvantage Administrators of Arkansas member, you also may access a summary of your health-plan beneﬁts. Arkansas Blue Cross and Blue Shield members will have this capability soon.

Drug Savings Calculator The Drug Savings Calculator enables you to compare the cost of brand-name drugs to generic drugs. After you enter a drug name and dosage, the calculator will calculate the cost for you and show the cost of the generic alternative. If you are already taking a generic drug, the calculator will tell you that the drug you are taking is a generic and show you its cost. If a generic alternative is not available, the calculator will show you the cost of the brandname drug. The most prescribed brand-name drugs and their most commonly prescribed dosages are used to calculate costs. You’ll ﬁnd this tool in the “Pharmacy Beneﬁts” section.

Healthwise® Knowledgebase The Healthwise® Knowledgebase is a consumer healthinformation database. Its features include: • More than 1,900 clinical topics maintained by Healthwise, Inc.; • The National Organization for Rare Disorders database; • The National Cancer Institute database; • The Multum Pharmacy database.

Hospital Quality Comparison You may access the “Select Quality Care” link by logging into My Blueprint. This link will direct you to a site that provides an independent comparison of hospitals by procedure or diagnosis. You may choose to view rankings based on your health-plan data or Medicare claims data.

Online Select Quality Care reports on four hospital measures, taking into account the importance placed on each measure: • How many patients a hospital has treated for the procedure selected; • How many patients died; • How many complications the patients experienced; • How long the patients remained hospitalized. Select Quality Care is provided at no additional cost as a value-added service and is available online 24 hours a day, seven days a week to Arkansas Blue Cross, Health Advantage and BlueAdvantage members.

Pharmacy Information By logging into My Blueprint, you may access your pharmacy claims history, including the prescription number, date filled, pharmacy, prescribing physician and cost. This information is secure; only the member logged into My Blueprint can access it. To obtain the price of a drug before you go to the pharmacy to fill your prescription, go to the “Drug Pricing” link. If you need to look up a drug to check its use, side effects and interactions with other drugs or food, you can use the “Drug Search” and “Drug Cabinet” sections accessible through My Blueprint or the “Pharmacy Benefits” section. Blue Online, continued on Page 31

www.ArkansasBlueCross.com www.HealthAdvantage-hmo.com www.BlueAdvantageArkansas.com www.BlueAndYouFoundationArkansas.org www.BlueAnnEwe-ark.com Arkansas Blue Cross and Blue Shield P.O. Box 2181 Little Rock, AR 72203-2181

PRSRT STD U.S. POSTAGE

PAID Arkansas Blue Cross and Blue Shield