Summer 2014 A publication for the policyholders of the Arkansas Blue Cross and Blue Shield family of companies
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Insurance madE
easy
Not everyone speaks insurance. We can help. Here are some definitions of terms you may come across as you use your insurance coverage. Also, feel free to call the Customer Service number on the back of your member ID card if you have questions — we love to hear from you.
copayment – a dollar amount that you pay for a health service on the day it happens. Use it in a sentence, please? “The pharmacist charged me a copayment of $10 for my medication and my insurance paid the rest.”
coinsurance – Some health plans require
you to pay a percentage of your medical bill, which is known as coinsurance. You’ll only pay coinsurance after you’ve met your plan’s deductible. Use it in a sentence, please? “The Millers’ plan charges 20 percent coinsurance after the deductible is met. Their son’s $120 doctor visit only cost them $24 in coinsurance.”
MPI 2575 6/14
deductible – a dollar amount that you pay
for health care services before the health plan begins to pay. Use it in a sentence, please? “One more doctor’s visit and Larry will meet his deductible, and will only pay coinsurance from that point forward.”
preventive care – Your checkup each year is an example of preventive care, which means a visit to the doctor before you get sick. Preventive care is important because you’re taking steps to prevent disease and illness from happening instead of going to the doctor after you’re sick. Use it in a sentence, please? “My preventive care is covered at no cost, so even though I’m healthy, I make sure to get an annual checkup each year for free!”
Get the health care you need
Tornado recovery
Bicycle safety
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page
page
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12
2014 Financial Information Privacy Notice • PAGE 22
Do you know the proper way for your child to wear a bicycle helmet? Find out! (see story on page 12)
NEIGHBOR TO NEIGHBOR 3
- Neighbor to neighbor
4
- Get the health care you need
6
- Helping our neighbors after the storm
8
- Preventive services - What’s wrong with this picture?
9
- What’s in your genes?
10
- Living Fearlessly: A summer swim turns into a struggle for Kali Hardig’s life
12
- Bicycle safety
14
- Car seat safety
15
- Helmets in storms
16
17
- Healthy tastes great!
18
- Arkansas Blue Cross brings dentists to Arkansas
19
- Foundation awards 126 mini-grants, takes applications for major grants
20
- Helping kids at Second Chance Ranch to Live Fearless - Employees make calls for Arkansas Children’s Hospital
- Beginner’s guide to reading food labels
21 22
- Newsworthy promotions and hiring
23
- Born too early
- Arkansas Blue Cross and Blue Shield financial information privacy notice
- Customer Service numbers
24
- Insurance made easy
SUMMER 2014
EDITOR: Jennifer Gordon – bnyou-ed@arkbluecross.com • DESIGNER: Ryan Kravitz • PHOTOGRAPHER: Chip Bayer CONTRIBUTORS: Chip Bayer, Ben McVay and Alex Roberts VICE PRESIDENT of CORPORATE MARKETING: Karen Raley MANAGER of COMMUNICATIONS and eMARKETING: Kelly Whitehorn
on the cover BLUE & YOU Summer 2014
As I walked through the devastation of the April tornado that hit Mayflower and Vilonia, I was reminded once again how precious and precarious life can be. In a matter of minutes, the storm leveled homes and took several lives. And, within hours, the employees of Arkansas Blue Cross and Blue Shield rallied to reach out to everyone affected by the storm, whether they were our members, our employees or our fellow Arkansans. That kind of response is what I’ve come to expect from our Blue Team, because Arkansas Blue Cross isn’t just a health insurance company; we are your neighbors. And, whether you are right here in central Arkansas or have coverage in another state, we will give you that same dedication, because we believe in providing the best service possible to each and every member. You can learn more about our response to the tornado in this issue of Blue & You, along with many other ways we reach out to our neighbors. From special events for the Second Chance Ranch to Blue & You Foundation grants for organizations throughout the Natural State, we do our best to improve the lives of everyone around us. With that kind of dedication, it’s no wonder Arkansas Blue Cross has been trusted for more than 65 years to provide affordable, reliable health insurance plans. Many families have been with our company for generations.
That same trust has made us the most widely accepted health care coverage by medical professionals, not only in Arkansas, but nationwide as part of the Blue Cross and Blue Shield Association. The 37 independent, locally operated Blue Cross and Blue Shield Plans work together to create a vast network that allows you access to top doctors, specialists and hospitals in all 50 states. Nationwide, more doctors choose Blue Cross and Blue Shield health plans for their own families. So, whether you live right here in Little Rock, or anywhere in the country, we want to thank you for putting your trust in our family of companies. Being neighborly is a state of mind, not of geography, and we want you to know we will always be there for you.
Kali Hardig, snuggles her Yorkshire terrier puppy, Chloe, while talking about surviving a deadly amoeba.
Summer 2014 BLUE & YOU
Do you know the proper way for your child to wear a bicycle helmet? Find out! (see story on page 12)
NEIGHBOR TO NEIGHBOR 3
- Neighbor to neighbor
4
- Get the health care you need
6
- Helping our neighbors after the storm
8
- Preventive services - What’s wrong with this picture?
9
- What’s in your genes?
10
- Living Fearlessly: A summer swim turns into a struggle for Kali Hardig’s life
12
- Bicycle safety
14
- Car seat safety
15
- Helmets in storms
16
17
- Healthy tastes great!
18
- Arkansas Blue Cross brings dentists to Arkansas
19
- Foundation awards 126 mini-grants, takes applications for major grants
20
- Helping kids at Second Chance Ranch to Live Fearless - Employees make calls for Arkansas Children’s Hospital
- Beginner’s guide to reading food labels
21 22
- Newsworthy promotions and hiring
23
- Born too early
- Arkansas Blue Cross and Blue Shield financial information privacy notice
- Customer Service numbers
24
- Insurance made easy
SUMMER 2014
EDITOR: Jennifer Gordon – bnyou-ed@arkbluecross.com • DESIGNER: Ryan Kravitz • PHOTOGRAPHER: Chip Bayer CONTRIBUTORS: Chip Bayer, Ben McVay and Alex Roberts VICE PRESIDENT of CORPORATE MARKETING: Karen Raley MANAGER of COMMUNICATIONS and eMARKETING: Kelly Whitehorn
on the cover BLUE & YOU Summer 2014
As I walked through the devastation of the April tornado that hit Mayflower and Vilonia, I was reminded once again how precious and precarious life can be. In a matter of minutes, the storm leveled homes and took several lives. And, within hours, the employees of Arkansas Blue Cross and Blue Shield rallied to reach out to everyone affected by the storm, whether they were our members, our employees or our fellow Arkansans. That kind of response is what I’ve come to expect from our Blue Team, because Arkansas Blue Cross isn’t just a health insurance company; we are your neighbors. And, whether you are right here in central Arkansas or have coverage in another state, we will give you that same dedication, because we believe in providing the best service possible to each and every member. You can learn more about our response to the tornado in this issue of Blue & You, along with many other ways we reach out to our neighbors. From special events for the Second Chance Ranch to Blue & You Foundation grants for organizations throughout the Natural State, we do our best to improve the lives of everyone around us. With that kind of dedication, it’s no wonder Arkansas Blue Cross has been trusted for more than 65 years to provide affordable, reliable health insurance plans. Many families have been with our company for generations.
That same trust has made us the most widely accepted health care coverage by medical professionals, not only in Arkansas, but nationwide as part of the Blue Cross and Blue Shield Association. The 37 independent, locally operated Blue Cross and Blue Shield Plans work together to create a vast network that allows you access to top doctors, specialists and hospitals in all 50 states. Nationwide, more doctors choose Blue Cross and Blue Shield health plans for their own families. So, whether you live right here in Little Rock, or anywhere in the country, we want to thank you for putting your trust in our family of companies. Being neighborly is a state of mind, not of geography, and we want you to know we will always be there for you.
Kali Hardig, snuggles her Yorkshire terrier puppy, Chloe, while talking about surviving a deadly amoeba.
Summer 2014 BLUE & YOU
GET THE
What are alternatives?
YOU NEED
Follow the guidance of your PCP. You should have your PCP’s phone number and contact information from your first visit. If you cannot reach your PCP and he or she has a preferred urgent care center, you should obtain your care there. If not, you should be aware of alternatives near you such as urgent care centers, convenient care clinics and walk-in medical clinics.
When you neeD IT nder the federal health care law and, in Arkansas, with the “private option,” tens of thousands of Arkansans have health insurance — many for the first time. While health insurance is important for you to get the health care services you need, it also is important to understand how to get care in a health system that already is crowded.
After you have selected a PCP, you will want to get to know her/him and she/he will want to get to know you. Schedule a first appointment and bring all of your medications with you. While there, ask your PCP what you should do if you need urgent care. Your PCP may want you to call, or may direct you to a trusted urgent care center. These centers can provide a record of your visit and arrange for follow-up care with your PCP.
Choosing a primary care provider
The primary care provider is your main health care provider in non-emergency or non-urgent situations. Your primary care provider will:
The most important first step when you have health insurance is to select and build a relationship with a primary care provider (PCP). Your PCP is the best friend your family’s health will ever have. A PCP is a doctor who specializes in primary care, either working individually or leading a team where a nurse practitioner or physician assistant may assume the role of PCP as part of the team looking after you. Most PCPs are family practice physicians or internists. However, some PCPs specialize in children (pediatrics) and some in the care of senior citizens (geriatrics).
• Be the first point of contact for almost any health problem (except clear-cut emergencies) and identify and treat common medical conditions • Assess the urgency of your medical problems and direct you to the best place for that care • Coordinate your care including arranging for any needed referrals to other medical specialists • Provide preventive care and teach healthy lifestyle choices See your primary care provider for: • Existing conditions like asthma, diabetes, hypertension, etc. • Follow-up health checks • Preventive care — tests, immunizations, flu shots, etc. • Regular exams
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BLUE & YOU Summer 2014
• Undiagnosed problems
To find a primary care provider near you, go to arkansasbluecross.com, or the website for your health plan, and select “Find a Doctor.”
When should you go to the emergency room? What will you do if you or a loved one needs immediate medical care? Most of us answer, “go to the nearest emergency room.” Emergency care is meant for serious medical conditions when delaying care could cause permanent harm or even death. If you or a family member encounters something like this, it’s important to seek immediate care at an emergency room or by calling 911. Emergency responders are trained to react quickly and transport you to the facility that best meets your needs.
Visit an ER for: • Chest pain • Difficulty breathing • Loss of consciousness • Severe burns • Severe head pain or injury, including loss of vision • Suspected poisoning • Attempted suicide Remember the emergency room is just for that — emergencies. Unless it’s a true emergency, you likely can get quicker, quality medical care somewhere else.
Urgent care centers Urgent care centers are being developed around the state. These centers treat conditions that should be looked at right away, but are not emergencies. You may need to go to an urgent care center if your PCP is not available. Urgent care centers are sameday, walk-in clinics that are open for extended times during the week and on Saturdays and Sundays. Some symptoms that can be treated at an urgent care center include: • Fever without rash • Minor trauma, such as a common sprain • Headache • Severe sore throat • Minor broken bones, such as the wrist, hand, ankle or foot Your out-of-pocket cost for an urgent care visit may be less than half the cost of an emergency room visit. Again, you should be proactive by discussing your options for after-hours care with your primary care provider.
Summer 2014 BLUE & YOU
5
GET THE
What are alternatives?
YOU NEED
Follow the guidance of your PCP. You should have your PCP’s phone number and contact information from your first visit. If you cannot reach your PCP and he or she has a preferred urgent care center, you should obtain your care there. If not, you should be aware of alternatives near you such as urgent care centers, convenient care clinics and walk-in medical clinics.
When you neeD IT nder the federal health care law and, in Arkansas, with the “private option,” tens of thousands of Arkansans have health insurance — many for the first time. While health insurance is important for you to get the health care services you need, it also is important to understand how to get care in a health system that already is crowded.
After you have selected a PCP, you will want to get to know her/him and she/he will want to get to know you. Schedule a first appointment and bring all of your medications with you. While there, ask your PCP what you should do if you need urgent care. Your PCP may want you to call, or may direct you to a trusted urgent care center. These centers can provide a record of your visit and arrange for follow-up care with your PCP.
Choosing a primary care provider
The primary care provider is your main health care provider in non-emergency or non-urgent situations. Your primary care provider will:
The most important first step when you have health insurance is to select and build a relationship with a primary care provider (PCP). Your PCP is the best friend your family’s health will ever have. A PCP is a doctor who specializes in primary care, either working individually or leading a team where a nurse practitioner or physician assistant may assume the role of PCP as part of the team looking after you. Most PCPs are family practice physicians or internists. However, some PCPs specialize in children (pediatrics) and some in the care of senior citizens (geriatrics).
• Be the first point of contact for almost any health problem (except clear-cut emergencies) and identify and treat common medical conditions • Assess the urgency of your medical problems and direct you to the best place for that care • Coordinate your care including arranging for any needed referrals to other medical specialists • Provide preventive care and teach healthy lifestyle choices See your primary care provider for: • Existing conditions like asthma, diabetes, hypertension, etc. • Follow-up health checks • Preventive care — tests, immunizations, flu shots, etc. • Regular exams
4
BLUE & YOU Summer 2014
• Undiagnosed problems
To find a primary care provider near you, go to arkansasbluecross.com, or the website for your health plan, and select “Find a Doctor.”
When should you go to the emergency room? What will you do if you or a loved one needs immediate medical care? Most of us answer, “go to the nearest emergency room.” Emergency care is meant for serious medical conditions when delaying care could cause permanent harm or even death. If you or a family member encounters something like this, it’s important to seek immediate care at an emergency room or by calling 911. Emergency responders are trained to react quickly and transport you to the facility that best meets your needs.
Visit an ER for: • Chest pain • Difficulty breathing • Loss of consciousness • Severe burns • Severe head pain or injury, including loss of vision • Suspected poisoning • Attempted suicide Remember the emergency room is just for that — emergencies. Unless it’s a true emergency, you likely can get quicker, quality medical care somewhere else.
Urgent care centers Urgent care centers are being developed around the state. These centers treat conditions that should be looked at right away, but are not emergencies. You may need to go to an urgent care center if your PCP is not available. Urgent care centers are sameday, walk-in clinics that are open for extended times during the week and on Saturdays and Sundays. Some symptoms that can be treated at an urgent care center include: • Fever without rash • Minor trauma, such as a common sprain • Headache • Severe sore throat • Minor broken bones, such as the wrist, hand, ankle or foot Your out-of-pocket cost for an urgent care visit may be less than half the cost of an emergency room visit. Again, you should be proactive by discussing your options for after-hours care with your primary care provider.
Summer 2014 BLUE & YOU
5
Helping our neighbors AFTer
the On the evening of April 27, a tornado stretching more than a half-mile wide plowed through central Arkansas, carving a path from Ferndale through Mayflower and on to Vilonia. By morning, employees of Arkansas Blue Cross and Blue Shield were doing whatever they could to help their neighbors, and in some cases co-workers, to pick up the pieces. The response began at the Green Leaf Grill, Arkansas Blue Cross’ new restaurant, where the staff prepared 400 hot and healthy meals for the American Red Cross to distribute to families and workers in the disaster area. The company’s prescription refill program also was immediately activated. Members with fully insured pharmacy benefits living in areas identified as disaster areas by the American Red Cross were able to work with their pharmacists and Arkansas Blue Cross customer service to get copayments/coinsurance waived for prescription medications destroyed by the storm. More than 40 Arkansas Blue Cross employees took calls for donations during the KATV Spirit of Arkansas
6
BLUE & YOU Summer 2014
Telethon benefitting the American Red Cross tornado relief fund. Jim Bailey, chief marketing officer for Arkansas Blue Cross, presented a $10,000 gift from the company and challenged other corporations to do the same. Fundraisers held throughout the company raised more than $23,000 from employees for the American Red Cross. On weekends after the storm, employees in their blue “Live Fearless” T-shirts helped to restore the disaster area. In Mayflower, they helped one of eight employees who lost their homes in the tornado. In Vilonia, they collected debris and belongings in nearby fields. For many, it has been a labor of love as they find any way they can to reach out to help friends, neighbors and fellow Arkansans. “Our hearts go out to our fellow Arkansans who lost so much in these storms,” said Mark White, president and chief executive officer of Arkansas Blue Cross. “We know that recovery following a natural disaster will take months. Our commitment, and that of our employees, to central Arkansas recovery efforts is that we will be there and will be ready to serve.”
Summer 2014 BLUE & YOU
7
Helping our neighbors AFTer
the On the evening of April 27, a tornado stretching more than a half-mile wide plowed through central Arkansas, carving a path from Ferndale through Mayflower and on to Vilonia. By morning, employees of Arkansas Blue Cross and Blue Shield were doing whatever they could to help their neighbors, and in some cases co-workers, to pick up the pieces. The response began at the Green Leaf Grill, Arkansas Blue Cross’ new restaurant, where the staff prepared 400 hot and healthy meals for the American Red Cross to distribute to families and workers in the disaster area. The company’s prescription refill program also was immediately activated. Members with fully insured pharmacy benefits living in areas identified as disaster areas by the American Red Cross were able to work with their pharmacists and Arkansas Blue Cross customer service to get copayments/coinsurance waived for prescription medications destroyed by the storm. More than 40 Arkansas Blue Cross employees took calls for donations during the KATV Spirit of Arkansas
6
BLUE & YOU Summer 2014
Telethon benefitting the American Red Cross tornado relief fund. Jim Bailey, chief marketing officer for Arkansas Blue Cross, presented a $10,000 gift from the company and challenged other corporations to do the same. Fundraisers held throughout the company raised more than $23,000 from employees for the American Red Cross. On weekends after the storm, employees in their blue “Live Fearless” T-shirts helped to restore the disaster area. In Mayflower, they helped one of eight employees who lost their homes in the tornado. In Vilonia, they collected debris and belongings in nearby fields. For many, it has been a labor of love as they find any way they can to reach out to help friends, neighbors and fellow Arkansans. “Our hearts go out to our fellow Arkansans who lost so much in these storms,” said Mark White, president and chief executive officer of Arkansas Blue Cross. “We know that recovery following a natural disaster will take months. Our commitment, and that of our employees, to central Arkansas recovery efforts is that we will be there and will be ready to serve.”
Summer 2014 BLUE & YOU
7
Preventive S e r v i c e s If you are going to the doctor for preventive services, make sure you aren’t getting more than you intended. Many of our members have policies that cover preventive services at no additional cost to them, but knowing what is covered is key. What is a preventive service? Each health plan may have different health services covered under “preventive services,” but in general they include certain immunizations and screenings for certain cancers or other illnesses. The preventive services covered by your plan are listed in your coverage policy. When you go for preventive services like an annual checkup with covered blood work, it is possible that your doctor may order additional lab work that is not covered as a preventive service. This is understandable if you are at risk for certain conditions, but be aware that it also may add costs.
What’s wrong with this
picture?
Did you know that motor vehicle crashes are the number one killer of kids? This is largely due to the improper use, or lack of, child safety seats. Can you spot all of the improper things in the car seat photo? Hint: There’s more than one! Turn to page 14 for answers and tips on how to keep your little ones safe while traveling.
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BLUE & YOU Summer 2014
Some health plans offered by employers cover more preventive services than others. The same is true with health plans for individuals and families purchased directly. The amount you pay for preventive services or the doctors who provide the services depends on your policy. Under the health care law, health plans that are considered new (created after March 2010) must offer preventive services at no cost sharing to the member. One way to know what preventive services are covered by your health plan is to visit with your physician before your checkup. We have provided this information to doctors and hospitals in our networks. Also, you can go to our websites and look at your coverage policy. You also can review other wellness and preventive information by logging in on the home page of our website.
What’s in your genes? Ever since an Austrian friar in 1866 noticed that the pea plants in his garden had changing traits from one generation to the next, genetics has fascinated the scientific world. Today, we have new medical tests that can determine if your genes carry traits that may put you at higher risk for illnesses like certain cancers. Some of these tests have real clinical value and can help your doctor determine which treatment might be most effective, and some may provide you with information regarding your possible risk for certain future health concerns. So should everyone get tested for every possible genetic health problem? The best answer, at least for now, would be “no.” These tests are very expensive, and in some cases are not as reliable as we would hope. On occasion, different labs may report different findings on the same member’s specimen.
Arkansas Blue Cross and Blue Shield also does not cover many genetic tests because they have no real clinical benefit. They may be able to tell you if you carry a “bad gene” (a mutation) but in many circumstances they can’t predict if the “bad gene” will cause a problem, or if the problem will be severe or mild. In these cases it often is better to look for the specific medical problem caused by the gene than to get a genetic test. For these reasons, Arkansas Blue Cross only covers certain genetic tests and only does so in specific circumstances where there is a benefit. You may need to have a family history of an illness or specific symptoms to determine if the testing would be of value to you and your doctor. If your doctor or a genetic counselor suggests genetic testing, find out first if the test is covered under your health plan. You can log in on the home page of our website to find your coverage benefits, or you can call a customer service representative to help you.
Summer 2014 BLUE & YOU
9
Preventive S e r v i c e s If you are going to the doctor for preventive services, make sure you aren’t getting more than you intended. Many of our members have policies that cover preventive services at no additional cost to them, but knowing what is covered is key. What is a preventive service? Each health plan may have different health services covered under “preventive services,” but in general they include certain immunizations and screenings for certain cancers or other illnesses. The preventive services covered by your plan are listed in your coverage policy. When you go for preventive services like an annual checkup with covered blood work, it is possible that your doctor may order additional lab work that is not covered as a preventive service. This is understandable if you are at risk for certain conditions, but be aware that it also may add costs.
What’s wrong with this
picture?
Did you know that motor vehicle crashes are the number one killer of kids? This is largely due to the improper use, or lack of, child safety seats. Can you spot all of the improper things in the car seat photo? Hint: There’s more than one! Turn to page 14 for answers and tips on how to keep your little ones safe while traveling.
8
BLUE & YOU Summer 2014
Some health plans offered by employers cover more preventive services than others. The same is true with health plans for individuals and families purchased directly. The amount you pay for preventive services or the doctors who provide the services depends on your policy. Under the health care law, health plans that are considered new (created after March 2010) must offer preventive services at no cost sharing to the member. One way to know what preventive services are covered by your health plan is to visit with your physician before your checkup. We have provided this information to doctors and hospitals in our networks. Also, you can go to our websites and look at your coverage policy. You also can review other wellness and preventive information by logging in on the home page of our website.
What’s in your genes? Ever since an Austrian friar in 1866 noticed that the pea plants in his garden had changing traits from one generation to the next, genetics has fascinated the scientific world. Today, we have new medical tests that can determine if your genes carry traits that may put you at higher risk for illnesses like certain cancers. Some of these tests have real clinical value and can help your doctor determine which treatment might be most effective, and some may provide you with information regarding your possible risk for certain future health concerns. So should everyone get tested for every possible genetic health problem? The best answer, at least for now, would be “no.” These tests are very expensive, and in some cases are not as reliable as we would hope. On occasion, different labs may report different findings on the same member’s specimen.
Arkansas Blue Cross and Blue Shield also does not cover many genetic tests because they have no real clinical benefit. They may be able to tell you if you carry a “bad gene” (a mutation) but in many circumstances they can’t predict if the “bad gene” will cause a problem, or if the problem will be severe or mild. In these cases it often is better to look for the specific medical problem caused by the gene than to get a genetic test. For these reasons, Arkansas Blue Cross only covers certain genetic tests and only does so in specific circumstances where there is a benefit. You may need to have a family history of an illness or specific symptoms to determine if the testing would be of value to you and your doctor. If your doctor or a genetic counselor suggests genetic testing, find out first if the test is covered under your health plan. You can log in on the home page of our website to find your coverage benefits, or you can call a customer service representative to help you.
Summer 2014 BLUE & YOU
9
While the doctors were always keeping the Hardigs informed, “It was such uncharted territory,” Traci said. “They couldn’t tell us what was going to happen because they didn’t know.”
A summer swim turns into a struggle for Kali Hardig‘s life
O
n a sweltering summer day last year, Kali Hardig splashed down into the slightly cooler water of a local swimming lake. Water went up her nose as she dove toward the sandy bottom. In that brief moment, a microscopic monster began its mission to take Kali’s life. Today the bright and happy 13-year-old is a testament to the staff at Arkansas Children’s Hospital and a multitude of family, friends and strangers.The Hardig’s health plan through Arkansas Blue Cross and Blue Shield provided the security they needed to focus on their daughter. But for 55 days, Kali’s future was far from certain. About a week after Kali’s swim, Traci Hardig could tell her daughter was dangerously ill. She had a high fever that wouldn’t break, a bad headache and had vomited violently. Kali didn’t even want her new puppy, Chloe, to sit with her. Traci rushed her daughter from Benton to Arkansas Children’s Hospital (ACH) where Joe, Kali’s dad, met them. A flurry of tests led to a grim discovery. Kali had primary amebic meningoencephalitis (PAM), a long name for a rare condition caused by Naegleria fowleri, an amoeba (one-celled parasite) that lives in warm water.
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BLUE & YOU Summer 2014
If an amoeba gets into a person’s sinuses, it can move to the brain and rapidly cause damage, swelling, seizures, and in most cases, death. Of the 128 cases of PAM reported by the Centers for Disease Control and Prevention in the United States from 1962 to 2012, only two people had survived. Traci was told that the odds of contracting PAM are higher than winning the lottery; and the odds of surviving it — astronomical. As the doctors’ words sank in, Traci told Joe, “I can’t think about planning a funeral.” Joe quickly said, “We aren’t going to.” In that moment, they chose to live fearlessly and focus their attention on keeping their daughter alive. “Everything else just faded away,” Joe said. “I didn’t think of anything else.” For 22 days, Kali struggled for life in the pediatric intensive care unit (PICU).
Fortunately, while the Hardig’s attention was focused solely on Kali, they didn’t have to be concerned about how they would pay for her care. Having a Federal Employee Program health plan through Arkansas Blue Cross gave them comfort knowing they wouldn’t have a huge pile of medical bills afterward. “It was a relief knowing our health care coverage was in good hands,” Traci said.
them she was out of the woods. Kali had two nurses assigned to her at all times, Joe said, “and trust me, they weren’t sitting around.” In the midst of Kali’s stay at ACH, Traci received a call she did not expect from Brenda Strange, R.N., C.C.M., a nurse case manager for Arkansas Blue Cross. “Is there anything we can do for you?” Traci couldn’t think of anything, but Brenda continued to check in on the family.
The 449th National Guard Unit in Kuwait sent a picture of support to Kali’s Facebook page during her struggle.
‘‘
“She called me all the time,” Traci said, adding that it was nice to hear so much concern from her health insurance company. Brenda even visited Kali and her family just to be sure they had everything they needed.
‘‘
:
FROM LEFT: Joe, Kali and Traci Hardig
The Hardigs stayed by Kali’s side, with Traci only leaving for about 24 hours to go to an appointment at M.D. Anderson in Houston for her own battle with cancer.
It was a relief knowing our health care coverage was in good hands. – Traci Hardig, Kali’s mother
required her to get on her hands and knees and stretch out her arms and legs. The position of the painful movements reminded Kali of her Yorkshire terrier puppy. Doing her “Chloe exercises” helped Kali stay focused on her goal of returning home to her canine buddy, whom she hadn’t seen in more than a month.
Amazing coincidences (some Small miracles happened After Kali was moved out of would say small miracles), outside the hospital as well. PICU, she couldn’t walk or combined with the extreme Joe recently had returned talk. She could understand dedication of the staff at from Kuwait as part of the what was being said to her, ACH, always seemed to 77th Aviation Brigade with but she couldn’t form the happen just when they were the Arkansas National Guard. words to respond. needed the most. Specialized Through support from the One of Kali’s least favorite equipment and items new to Guard, family and friends, physical therapy exercises ACH were brought the Hardigs in to help save Kali. didn’t have to Kali visits with case manager Brenda Strange by the Other necessary worry about their pool donated to her family by Martin’s Pools in Benton. medical equipment utilities and house payment for a just happened to month. Strangers be on loan at came to mow the right time. the family’s yard. “It was a rollercoaster,” Joe said. At no time CONTINUED ON PAGE 15 did the doctors tell
KALI
Summer 2014 BLUE & YOU
7 11
While the doctors were always keeping the Hardigs informed, “It was such uncharted territory,” Traci said. “They couldn’t tell us what was going to happen because they didn’t know.”
A summer swim turns into a struggle for Kali Hardig‘s life
O
n a sweltering summer day last year, Kali Hardig splashed down into the slightly cooler water of a local swimming lake. Water went up her nose as she dove toward the sandy bottom. In that brief moment, a microscopic monster began its mission to take Kali’s life. Today the bright and happy 13-year-old is a testament to the staff at Arkansas Children’s Hospital and a multitude of family, friends and strangers.The Hardig’s health plan through Arkansas Blue Cross and Blue Shield provided the security they needed to focus on their daughter. But for 55 days, Kali’s future was far from certain. About a week after Kali’s swim, Traci Hardig could tell her daughter was dangerously ill. She had a high fever that wouldn’t break, a bad headache and had vomited violently. Kali didn’t even want her new puppy, Chloe, to sit with her. Traci rushed her daughter from Benton to Arkansas Children’s Hospital (ACH) where Joe, Kali’s dad, met them. A flurry of tests led to a grim discovery. Kali had primary amebic meningoencephalitis (PAM), a long name for a rare condition caused by Naegleria fowleri, an amoeba (one-celled parasite) that lives in warm water.
10
BLUE & YOU Summer 2014
If an amoeba gets into a person’s sinuses, it can move to the brain and rapidly cause damage, swelling, seizures, and in most cases, death. Of the 128 cases of PAM reported by the Centers for Disease Control and Prevention in the United States from 1962 to 2012, only two people had survived. Traci was told that the odds of contracting PAM are higher than winning the lottery; and the odds of surviving it — astronomical. As the doctors’ words sank in, Traci told Joe, “I can’t think about planning a funeral.” Joe quickly said, “We aren’t going to.” In that moment, they chose to live fearlessly and focus their attention on keeping their daughter alive. “Everything else just faded away,” Joe said. “I didn’t think of anything else.” For 22 days, Kali struggled for life in the pediatric intensive care unit (PICU).
Fortunately, while the Hardig’s attention was focused solely on Kali, they didn’t have to be concerned about how they would pay for her care. Having a Federal Employee Program health plan through Arkansas Blue Cross gave them comfort knowing they wouldn’t have a huge pile of medical bills afterward. “It was a relief knowing our health care coverage was in good hands,” Traci said.
them she was out of the woods. Kali had two nurses assigned to her at all times, Joe said, “and trust me, they weren’t sitting around.” In the midst of Kali’s stay at ACH, Traci received a call she did not expect from Brenda Strange, R.N., C.C.M., a nurse case manager for Arkansas Blue Cross. “Is there anything we can do for you?” Traci couldn’t think of anything, but Brenda continued to check in on the family.
The 449th National Guard Unit in Kuwait sent a picture of support to Kali’s Facebook page during her struggle.
‘‘
“She called me all the time,” Traci said, adding that it was nice to hear so much concern from her health insurance company. Brenda even visited Kali and her family just to be sure they had everything they needed.
‘‘
:
FROM LEFT: Joe, Kali and Traci Hardig
The Hardigs stayed by Kali’s side, with Traci only leaving for about 24 hours to go to an appointment at M.D. Anderson in Houston for her own battle with cancer.
It was a relief knowing our health care coverage was in good hands. – Traci Hardig, Kali’s mother
required her to get on her hands and knees and stretch out her arms and legs. The position of the painful movements reminded Kali of her Yorkshire terrier puppy. Doing her “Chloe exercises” helped Kali stay focused on her goal of returning home to her canine buddy, whom she hadn’t seen in more than a month.
Amazing coincidences (some Small miracles happened After Kali was moved out of would say small miracles), outside the hospital as well. PICU, she couldn’t walk or combined with the extreme Joe recently had returned talk. She could understand dedication of the staff at from Kuwait as part of the what was being said to her, ACH, always seemed to 77th Aviation Brigade with but she couldn’t form the happen just when they were the Arkansas National Guard. words to respond. needed the most. Specialized Through support from the One of Kali’s least favorite equipment and items new to Guard, family and friends, physical therapy exercises ACH were brought the Hardigs in to help save Kali. didn’t have to Kali visits with case manager Brenda Strange by the Other necessary worry about their pool donated to her family by Martin’s Pools in Benton. medical equipment utilities and house payment for a just happened to month. Strangers be on loan at came to mow the right time. the family’s yard. “It was a rollercoaster,” Joe said. At no time CONTINUED ON PAGE 15 did the doctors tell
KALI
Summer 2014 BLUE & YOU
7 11
GET IN GEAR!
5.
Dress riders in fitted clothes so they don’t get caught in chains or wheel spokes. Reflective clothing is ideal and shoes are a must!
4.
Check brakes and gears so stops and starts are smooth.
3.
Make sure they are visible with secure reflectors.
In addition to a good helmet, riders should ride a bike that fits their bodies. Their clothes should fit, too!
1.
Just about everyone loves the wind in their hair and sun on their face—and kids are no exception!
2.
Unfortunately, children are more likely to be seen in an emergency room for biking injuries than for any other sport. As kids saddle up on their two-wheelers this summer, make sure they’re cycling safely with these tips.
PROTECT THE HEAD! A properly fitted helmet is a rider’s number one protection. Have your rider put on his or her helmet and ask the following questions:
1. Look up. Can you see the bottom of the helmet’s rim? The rim should be one to two fingerwidths above the eyebrows.
Children should be able to comfortably touch the ground when seated on a bike.
Make sure tires are properly inflated.
SHOW THEM HOW! 2. Check the straps by your ears. Do they make a V? The straps should be a little tight but comfortable.
3. Open your mouth. Does the helmet hug your head? If not, tighten the straps.
Kids learn from watching others, so make sure to set a good example by wearing your helmet, too.
Riders under age 10 have difficulty estimating the speed and distance of traffic, so it’s best to supervise them whenever they’re on their bikes. Also, teach your kids how to interact with traffic by: • Paying attention to and making eye contact with drivers
Riders are more likely to wear helmets if… • They get to pick out their own • Other riders are wearing helmets, too
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BLUE & YOU Summer 2014
• Riding as far to the right side of the road as possible • Looking left, right and left again at an intersection Following these tips should help you and your riders enjoy the wind in your hair all summer long!
Summer 2014 BLUE & YOU
13
GET IN GEAR!
5.
Dress riders in fitted clothes so they don’t get caught in chains or wheel spokes. Reflective clothing is ideal and shoes are a must!
4.
Check brakes and gears so stops and starts are smooth.
3.
Make sure they are visible with secure reflectors.
In addition to a good helmet, riders should ride a bike that fits their bodies. Their clothes should fit, too!
1.
Just about everyone loves the wind in their hair and sun on their face—and kids are no exception!
2.
Unfortunately, children are more likely to be seen in an emergency room for biking injuries than for any other sport. As kids saddle up on their two-wheelers this summer, make sure they’re cycling safely with these tips.
PROTECT THE HEAD! A properly fitted helmet is a rider’s number one protection. Have your rider put on his or her helmet and ask the following questions:
1. Look up. Can you see the bottom of the helmet’s rim? The rim should be one to two fingerwidths above the eyebrows.
Children should be able to comfortably touch the ground when seated on a bike.
Make sure tires are properly inflated.
SHOW THEM HOW! 2. Check the straps by your ears. Do they make a V? The straps should be a little tight but comfortable.
3. Open your mouth. Does the helmet hug your head? If not, tighten the straps.
Kids learn from watching others, so make sure to set a good example by wearing your helmet, too.
Riders under age 10 have difficulty estimating the speed and distance of traffic, so it’s best to supervise them whenever they’re on their bikes. Also, teach your kids how to interact with traffic by: • Paying attention to and making eye contact with drivers
Riders are more likely to wear helmets if… • They get to pick out their own • Other riders are wearing helmets, too
12
BLUE & YOU Summer 2014
• Riding as far to the right side of the road as possible • Looking left, right and left again at an intersection Following these tips should help you and your riders enjoy the wind in your hair all summer long!
Summer 2014 BLUE & YOU
13
CAR SEAT
SAFETY What’s wrong with this
A properly fitted and fastened car seat can be a lifesaver. That’s why child safety seats are required by law. Below are some good reminders on how to fasten your child in his or her forwardfacing car seat. You can find information for other types of restraint systems, as well as technicians to help you pick the right one, at:
picture?
SafeCar.gov/therightseat NHTSA.gov seatcheck.org / 1-866-SEAT-CHECK
INCORRECT 1.
1. 2.
2. 3.
3.
CORRECT
The loose, twisted straps are not at the shoulder. The bulky coat prevents a snug fit.Always make sure your child is buckled in snugly. This requires straight straps at the shoulder that meet the harness chest clip at armpit level. Avoid bulky layers of clothing by using a jacket or blanket as a cover over the restraints. The harness chest clip is unfastened and below the chest.
ADDITIONAL SAFETY TIPS: • Follow the manufacturer’s recommendations for weight limits, use and installation. • Secure the child safety seat in your vehicle so it can’t move more than one inch from side to side or front to back. • Replace seats that are more than six years old. • Register safety seats with the manufacturer in case of a recall.
And remember: the safest place for your child is in the back seat! 14
BLUE & YOU Summer 2014
Helmets in storms Not only do bicycle helmets work for sunny days outside, they can be valuable for severe weather as well. While getting to shelter quickly is most important when a tornado is on the way, the U.S. Centers for Disease Control and Prevention (CDC) now recommend families consider adding helmets to their storm survival kits.
KALI
CONTINUED FROM PAGE 11
Cards, letters and stuffed toys poured in from around the world as Kali’s struggle to survive made international news. “There are so many wonderful people out there and we just want to thank them all for their prayers and support,” Joe said. Another blessing — Traci’s cancer went into remission. She fearlessly delayed chemotherapy treatment to stay by Kali’s side. “God couldn’t take me … I have to be here for Kali now,” Traci said. Nearly two months after Traci rushed Kali to the hospital, she finally was released to go home. Kali said Chloe was so excited to see her she couldn’t contain herself. “When I came home she about licked my face off!”
The CDC issued a position statement on helmets and tornadoes in response to inquiries from safety groups and media outlets that had reported incidents of children surviving tornadoes while wearing bicycle, football or baseball helmets. “We don’t have research on the effectiveness of helmet use to prevent head injuries during a tornado, but we have long made the recommendation that people try to protect their heads,” the CDC said.
The Hardigs have been chosen as the 2014 Children’s Miracle Network Hospitals Champion Family for Arkansas. As part of their role, Traci and Kali have given talks to several groups about the need for people to wear nose clips while swimming, especially in unchlorinated water. The lake where Kali contracted her illness is closed to swimming and has been stocked with catfish. It reopened as a campground and the Hardigs attended the rededication. “It wasn’t their fault,” Traci said. “They are a family, just like us.” Brenda, the nurse case manager, was able to visit with the Hardigs again at their home in Benton and to give Kali and Traci plenty of hugs. “Faith was the biggest role in Kali being here with us today,” Brenda said. “There are definitely reasons she is here with us, and knowing this beautiful little girl and her family, they will continue to show us those reasons every day!”
Summer 2014 BLUE & YOU
15
CAR SEAT
SAFETY What’s wrong with this
A properly fitted and fastened car seat can be a lifesaver. That’s why child safety seats are required by law. Below are some good reminders on how to fasten your child in his or her forwardfacing car seat. You can find information for other types of restraint systems, as well as technicians to help you pick the right one, at:
picture?
SafeCar.gov/therightseat NHTSA.gov seatcheck.org / 1-866-SEAT-CHECK
INCORRECT 1.
1. 2.
2. 3.
3.
CORRECT
The loose, twisted straps are not at the shoulder. The bulky coat prevents a snug fit.Always make sure your child is buckled in snugly. This requires straight straps at the shoulder that meet the harness chest clip at armpit level. Avoid bulky layers of clothing by using a jacket or blanket as a cover over the restraints. The harness chest clip is unfastened and below the chest.
ADDITIONAL SAFETY TIPS: • Follow the manufacturer’s recommendations for weight limits, use and installation. • Secure the child safety seat in your vehicle so it can’t move more than one inch from side to side or front to back. • Replace seats that are more than six years old. • Register safety seats with the manufacturer in case of a recall.
And remember: the safest place for your child is in the back seat! 14
BLUE & YOU Summer 2014
Helmets in storms Not only do bicycle helmets work for sunny days outside, they can be valuable for severe weather as well. While getting to shelter quickly is most important when a tornado is on the way, the U.S. Centers for Disease Control and Prevention (CDC) now recommend families consider adding helmets to their storm survival kits.
KALI
CONTINUED FROM PAGE 11
Cards, letters and stuffed toys poured in from around the world as Kali’s struggle to survive made international news. “There are so many wonderful people out there and we just want to thank them all for their prayers and support,” Joe said. Another blessing — Traci’s cancer went into remission. She fearlessly delayed chemotherapy treatment to stay by Kali’s side. “God couldn’t take me … I have to be here for Kali now,” Traci said. Nearly two months after Traci rushed Kali to the hospital, she finally was released to go home. Kali said Chloe was so excited to see her she couldn’t contain herself. “When I came home she about licked my face off!”
The CDC issued a position statement on helmets and tornadoes in response to inquiries from safety groups and media outlets that had reported incidents of children surviving tornadoes while wearing bicycle, football or baseball helmets. “We don’t have research on the effectiveness of helmet use to prevent head injuries during a tornado, but we have long made the recommendation that people try to protect their heads,” the CDC said.
The Hardigs have been chosen as the 2014 Children’s Miracle Network Hospitals Champion Family for Arkansas. As part of their role, Traci and Kali have given talks to several groups about the need for people to wear nose clips while swimming, especially in unchlorinated water. The lake where Kali contracted her illness is closed to swimming and has been stocked with catfish. It reopened as a campground and the Hardigs attended the rededication. “It wasn’t their fault,” Traci said. “They are a family, just like us.” Brenda, the nurse case manager, was able to visit with the Hardigs again at their home in Benton and to give Kali and Traci plenty of hugs. “Faith was the biggest role in Kali being here with us today,” Brenda said. “There are definitely reasons she is here with us, and knowing this beautiful little girl and her family, they will continue to show us those reasons every day!”
Summer 2014 BLUE & YOU
15
Do the food labels on your groceries look like they are in a different language? We can help translate them for you. Go grab a box of cereal or can of soup and use this handy guide to make sense of it all.
TIPS FROM THE
% Daily Value More than HALF of ALL AMERICANS struggle to understand food labels
You’ll find “percent daily value” as a column on the right side of the nutrition facts label. It’s based on a 2,000-calorie diet and shows you the recommended daily amount you should eat.
located in the Arkansas Blue Cross building in Little Rock
LOW: 5% or less percent daily value HIGH: 20% or more percent daily value Serving Size This is your starting point. Find out the size of a single serving and how many servings are in the entire package. The nutrition facts will relate to the serving size, not the entire package.
No Calories ...
Calories
(Almost)
Calories are the measure of energy you get from a serving. Eat two Food must have servings and you eat twice the less than 5 calories calories. Four servings? Four times to be calorie free the calories. You get the point. LOW: 40 calories • HIGH: 400 calories Sodium Salt (sodium) can raise blood pressure, which increases your risk of heart disease. LOW: 140 mg or less • HIGH: 400 mg or more
HOW TO BE SUGAR FREE Must have less than .5 grams of sugar
Did You
Know?
16
SUGAR Sugar can be named many things in the list of ingredients on a food label, but it can’t hide in the nutrition facts! There are 4 grams of sugar in a teaspoon, so this example has more than 2 teaspoons of sugar per serving.
Trans fats were banned in New York City in 2006. Trans fats are considered harmful contributors to heart disease because they’re suspected to lower your good cholesterol and raise your bad cholesterol — a dangerous combination.
BLUE & YOU Summer 2014
*Institute of Medicine Dietary Reference Intakes report, 2002
1,800*
2,200*
The average daily intake of calories for women (age 31-50)
The average daily intake of calories for men (age 31-50)
Fats There is total fat, then there are different types of fat: saturated, polyunsaturated, monounsaturated and trans fats. • Unsaturated Fat: Generally OK (look for the words monounsaturated or polyunsaturated). • Saturated: Try to reduce or limit the amount of saturated fats you eat.
Healthy tastes great! Try these ingredient swaps and cooking techniques to enjoy your favorite comfort foods guilt free!
1.
Use cooking spray or a nonstick cooking pan. Even healthy oils like olive oil are around 120 calories per tablespoon. Put your cooking oil in a spray bottle to reduce your use.
2.
Cook in liquids like stock, wine, lemon juice, fruit juice, vinegar or water instead of oil.
3.
Use herbs and spices instead of salt.
• Trans Fats: These are unsaturated fats, which are created in a lab (the worst of the fats). Cholesterol This actually is a type of fat found in your blood. It is an essential part of your diet, but too much can increase your risk of heart disease. LOW: 20 mg or less • HIGH: 200 mg or more The Good Nutrients • Fiber: Suggest a minimum of 20 grams a day. • Protein: Ten to 35 percent of your daily calories will come from protein. • Vitamins and minerals: They might be listed under normal names like vitamin A, vitamin C, calcium and iron. Sometimes vitamins have strange names, for example, riboflavin (vitamin B2), cobalamin (vitamin B12) and niacin (B3). But all vitamins are good for your health.
Refrigerate soups, stews and gravy. Skim the fat off the surface before serving.
4.
Remove skin from poultry and trim excess fat and marbling from meat.
5.
6.
Choose leaner cuts of meat, like tenderloin or top sirloin. USDA** “Choice” meats have less fat and marbling than USDA “Prime.”
**U.S. Department of Agriculture
Summer 2014 BLUE & YOU
17
Do the food labels on your groceries look like they are in a different language? We can help translate them for you. Go grab a box of cereal or can of soup and use this handy guide to make sense of it all.
TIPS FROM THE
% Daily Value More than HALF of ALL AMERICANS struggle to understand food labels
You’ll find “percent daily value” as a column on the right side of the nutrition facts label. It’s based on a 2,000-calorie diet and shows you the recommended daily amount you should eat.
located in the Arkansas Blue Cross building in Little Rock
LOW: 5% or less percent daily value HIGH: 20% or more percent daily value Serving Size This is your starting point. Find out the size of a single serving and how many servings are in the entire package. The nutrition facts will relate to the serving size, not the entire package.
No Calories ...
Calories
(Almost)
Calories are the measure of energy you get from a serving. Eat two Food must have servings and you eat twice the less than 5 calories calories. Four servings? Four times to be calorie free the calories. You get the point. LOW: 40 calories • HIGH: 400 calories Sodium Salt (sodium) can raise blood pressure, which increases your risk of heart disease. LOW: 140 mg or less • HIGH: 400 mg or more
HOW TO BE SUGAR FREE Must have less than .5 grams of sugar
Did You
Know?
16
SUGAR Sugar can be named many things in the list of ingredients on a food label, but it can’t hide in the nutrition facts! There are 4 grams of sugar in a teaspoon, so this example has more than 2 teaspoons of sugar per serving.
Trans fats were banned in New York City in 2006. Trans fats are considered harmful contributors to heart disease because they’re suspected to lower your good cholesterol and raise your bad cholesterol — a dangerous combination.
BLUE & YOU Summer 2014
*Institute of Medicine Dietary Reference Intakes report, 2002
1,800*
2,200*
The average daily intake of calories for women (age 31-50)
The average daily intake of calories for men (age 31-50)
Fats There is total fat, then there are different types of fat: saturated, polyunsaturated, monounsaturated and trans fats. • Unsaturated Fat: Generally OK (look for the words monounsaturated or polyunsaturated). • Saturated: Try to reduce or limit the amount of saturated fats you eat.
Healthy tastes great! Try these ingredient swaps and cooking techniques to enjoy your favorite comfort foods guilt free!
1.
Use cooking spray or a nonstick cooking pan. Even healthy oils like olive oil are around 120 calories per tablespoon. Put your cooking oil in a spray bottle to reduce your use.
2.
Cook in liquids like stock, wine, lemon juice, fruit juice, vinegar or water instead of oil.
3.
Use herbs and spices instead of salt.
• Trans Fats: These are unsaturated fats, which are created in a lab (the worst of the fats). Cholesterol This actually is a type of fat found in your blood. It is an essential part of your diet, but too much can increase your risk of heart disease. LOW: 20 mg or less • HIGH: 200 mg or more The Good Nutrients • Fiber: Suggest a minimum of 20 grams a day. • Protein: Ten to 35 percent of your daily calories will come from protein. • Vitamins and minerals: They might be listed under normal names like vitamin A, vitamin C, calcium and iron. Sometimes vitamins have strange names, for example, riboflavin (vitamin B2), cobalamin (vitamin B12) and niacin (B3). But all vitamins are good for your health.
Refrigerate soups, stews and gravy. Skim the fat off the surface before serving.
4.
Remove skin from poultry and trim excess fat and marbling from meat.
5.
6.
Choose leaner cuts of meat, like tenderloin or top sirloin. USDA** “Choice” meats have less fat and marbling than USDA “Prime.”
**U.S. Department of Agriculture
Summer 2014 BLUE & YOU
17
Foundation awards 126 mini-grants, takes applications for major grants Without a college of dentistry, Arkansas faces a shortage of dentists. To keep smiles happy and healthy, Arkansas Blue Cross and Blue Shield is collaborating with the University of Arkansas for Medical Sciences (UAMS) to introduce dentists-to-be to the Natural State. A $150,000 grant from the Blue & You Foundation is supporting an externship program to bring fourthyear dental students from the University of Tennessee (UT) College of Dentistry for a two-week rotation. The students provide dental care to patients under the supervision of adjunct faculty in the UAMS Center for Dental Education and at Arkansas Children’s Hospital. “I think this rotation has exposed dental students to the abundance of opportunities in dentistry available here,” said Ashley Jones McMillan, 27, a fourth-year student
18
BLUE & YOU Summer 2014
Arkansas Blue Cross brings dentISTS
to Arkansas doctor at UT and an Arkansas native. “We are getting to experience dentistry on a different level through these hospital-based rotations and at two top-of-theline facilities.” For Ashley, the choice to come back to Arkansas was clear. About a third of the students in the UT program are Arkansans. But for many UT dental students, the rotation will be their first time to visit the state, and Little Rock. The students have already expressed excitement at the opportunities in the central Arkansas area, according to the faculty. UAMS also has plans for a one-year, hospital-based residency program for dental college graduates. These students will learn to work as hospitalbased dentists and will rotate through various hospital departments, like anesthesiology and the emergency room.
“Thanks to the support of Arkansas Blue Cross and the Blue & You Foundation, the UAMS Center for Dental Education is able to provide a stateof-the-art dental clinic where students can come to gain valuable experience,” said Dr. Gene Jines, associate director of the UAMS Center for Dental Education. “The comments from students who have rotated through our facility this year have been very positive.” “Expanding the medical provider workforce in Arkansas, especially in rural areas, is an important element in improving the health of all Arkansans. Supporting this UAMS dental program is one way that the Blue & You Foundation and Arkansas Blue Cross can help achieve that goal,” said Patrick O’Sullivan, executive director of the Blue & You Foundation.
20
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13
8
F
rom exercise equipment for Alma High School, a heart defibrillator for the Caldwell Fire Department, to an employee health fair in Stuttgart, the Blue & You Foundation’s mini-grant program gives community organizations $1,000 at a time to help improve the lives and health of Arkansans throughout the state. This year the Foundation awarded $1,000 mini-grants to 126 organizations in Arkansas. (See a breakdown of the grant locations in the map.) The Foundation is accepting online applications for major grants of $5,000 to $150,000 to fund yearlong health improvement programs in 2015. Any 501(c)(3) public charity, public school, governmental agency or nonprofit hospital in Arkansas is eligible to apply by the July 15 deadline. A list of the grant recipients and guidelines for applying can be found at BlueAndYouFoundationArkansas.org.
Summer 2014 BLUE & YOU
19
Foundation awards 126 mini-grants, takes applications for major grants Without a college of dentistry, Arkansas faces a shortage of dentists. To keep smiles happy and healthy, Arkansas Blue Cross and Blue Shield is collaborating with the University of Arkansas for Medical Sciences (UAMS) to introduce dentists-to-be to the Natural State. A $150,000 grant from the Blue & You Foundation is supporting an externship program to bring fourthyear dental students from the University of Tennessee (UT) College of Dentistry for a two-week rotation. The students provide dental care to patients under the supervision of adjunct faculty in the UAMS Center for Dental Education and at Arkansas Children’s Hospital. “I think this rotation has exposed dental students to the abundance of opportunities in dentistry available here,” said Ashley Jones McMillan, 27, a fourth-year student
18
BLUE & YOU Summer 2014
Arkansas Blue Cross brings dentISTS
to Arkansas doctor at UT and an Arkansas native. “We are getting to experience dentistry on a different level through these hospital-based rotations and at two top-of-theline facilities.” For Ashley, the choice to come back to Arkansas was clear. About a third of the students in the UT program are Arkansans. But for many UT dental students, the rotation will be their first time to visit the state, and Little Rock. The students have already expressed excitement at the opportunities in the central Arkansas area, according to the faculty. UAMS also has plans for a one-year, hospital-based residency program for dental college graduates. These students will learn to work as hospitalbased dentists and will rotate through various hospital departments, like anesthesiology and the emergency room.
“Thanks to the support of Arkansas Blue Cross and the Blue & You Foundation, the UAMS Center for Dental Education is able to provide a stateof-the-art dental clinic where students can come to gain valuable experience,” said Dr. Gene Jines, associate director of the UAMS Center for Dental Education. “The comments from students who have rotated through our facility this year have been very positive.” “Expanding the medical provider workforce in Arkansas, especially in rural areas, is an important element in improving the health of all Arkansans. Supporting this UAMS dental program is one way that the Blue & You Foundation and Arkansas Blue Cross can help achieve that goal,” said Patrick O’Sullivan, executive director of the Blue & You Foundation.
20
32 53
13
8
F
rom exercise equipment for Alma High School, a heart defibrillator for the Caldwell Fire Department, to an employee health fair in Stuttgart, the Blue & You Foundation’s mini-grant program gives community organizations $1,000 at a time to help improve the lives and health of Arkansans throughout the state. This year the Foundation awarded $1,000 mini-grants to 126 organizations in Arkansas. (See a breakdown of the grant locations in the map.) The Foundation is accepting online applications for major grants of $5,000 to $150,000 to fund yearlong health improvement programs in 2015. Any 501(c)(3) public charity, public school, governmental agency or nonprofit hospital in Arkansas is eligible to apply by the July 15 deadline. A list of the grant recipients and guidelines for applying can be found at BlueAndYouFoundationArkansas.org.
Summer 2014 BLUE & YOU
19
NEWS
Newsworthy Promotions and Hiring
Helping Kids at Second Chance Ranch to Live Fearless Arkansas Blue Cross and Blue Shield invited families to celebrate Live Fearless Day at the Museum of Discovery on May 3, by making a donation to benefit the Second Chance Ranch residents and receiving free admission.
Arkansas Blue Cross and Blue Shield employees and BlueAnn Ewe accepted donations to Second Hand Ranch and spent Live Fearless Day in May enjoying the Museum of Discovery with children from the Ranch and many supportive members and families.
The Second Chance Ranch is a nonprofit program that provides a caring home to abused, neglected and at-risk youth. The Ranch helps children work to resolve the crises in their lives and returns them home or places them in a new home through adoption. The children at Second Chance Ranch face daily challenges that most people do not experience in their lifetimes. Yet, the simplest gesture makes a huge difference in the lives of these children. Ten employees of Arkansas Blue Cross planned a special pizza party for the kids and volunteered their time at the museum to collect donations for the Ranch while the kids enjoyed a play day at the museum.
Employees make calls for Arkansas Children’s Hospital A team of Arkansas Blue Cross and Blue Shield employees raised almost $9,000 during the 2014 Arkansas Children’s Hospital Phone-a-thon. The April 8 event raised money to support programs and services at Arkansas Children’s Hospital and helped continue their mission of bringing care, love and hope to all children who walk through the hospital’s doors.
20 18
BLUE & YOU Summer 2014
david BRIDGES
David Bridges has been promoted to executive vice president and chief administrative officer. Bridges served as president and CEO for HMO Partners, Inc. (doing business as Health Advantage) for 17 years. Health Advantage is the state’s largest health maintenance organization. He also directed the internal operations of Arkansas Blue Cross, including claims, customer service and membership.
martha CARLSON
Martha Carlson has been promoted to vice president of National Accounts and Federal Employee Program (FEP) Marketing. Carlson is responsible for the development and servicing of national business for Arkansas Blue Cross. Since 2007, she has been responsible for leading the regional sales and service team in the West Central region in Fort Smith.
The board of directors for HMO Partners, Inc. (doing business as Health Advantage) elected John Glassford as the company’s new president and chief executive officer in March. john GLASSFORD
dwayne PIERCE
Dwayne Pierce has been named lead executive for sales competence. Pierce is responsible for identifying competencies necessary for best-in-class sales performance and for managing the development and implementation of training programs necessary to build those skill sets in sales staff throughout Arkansas Blue Cross. His responsibilities also will include ensuring external agents have the resources needed for maximum productivity.
Glassford replaces David Bridges, who served as president and CEO for 17 years. Glassford will continue his role as regional executive for Arkansas Blue Cross’ Central office, overseeing group products sales and marketing, medical management, risk management and provider services.
odell NICKELBERRY
Odell Nickelberry has joined Arkansas Blue Cross as the director of Human Resources. Nickelberry is responsible for the overall administration, coordination and evaluation of human resources policy and procedures for Arkansas Blue Cross. He also offers strategic oversight for improvement of the company’s policies, procedures and practices on personnel matters.
Summer 2014 BLUE & YOU
19 21
NEWS
Newsworthy Promotions and Hiring
Helping Kids at Second Chance Ranch to Live Fearless Arkansas Blue Cross and Blue Shield invited families to celebrate Live Fearless Day at the Museum of Discovery on May 3, by making a donation to benefit the Second Chance Ranch residents and receiving free admission.
Arkansas Blue Cross and Blue Shield employees and BlueAnn Ewe accepted donations to Second Hand Ranch and spent Live Fearless Day in May enjoying the Museum of Discovery with children from the Ranch and many supportive members and families.
The Second Chance Ranch is a nonprofit program that provides a caring home to abused, neglected and at-risk youth. The Ranch helps children work to resolve the crises in their lives and returns them home or places them in a new home through adoption. The children at Second Chance Ranch face daily challenges that most people do not experience in their lifetimes. Yet, the simplest gesture makes a huge difference in the lives of these children. Ten employees of Arkansas Blue Cross planned a special pizza party for the kids and volunteered their time at the museum to collect donations for the Ranch while the kids enjoyed a play day at the museum.
Employees make calls for Arkansas Children’s Hospital A team of Arkansas Blue Cross and Blue Shield employees raised almost $9,000 during the 2014 Arkansas Children’s Hospital Phone-a-thon. The April 8 event raised money to support programs and services at Arkansas Children’s Hospital and helped continue their mission of bringing care, love and hope to all children who walk through the hospital’s doors.
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BLUE & YOU Summer 2014
david BRIDGES
David Bridges has been promoted to executive vice president and chief administrative officer. Bridges served as president and CEO for HMO Partners, Inc. (doing business as Health Advantage) for 17 years. Health Advantage is the state’s largest health maintenance organization. He also directed the internal operations of Arkansas Blue Cross, including claims, customer service and membership.
martha CARLSON
Martha Carlson has been promoted to vice president of National Accounts and Federal Employee Program (FEP) Marketing. Carlson is responsible for the development and servicing of national business for Arkansas Blue Cross. Since 2007, she has been responsible for leading the regional sales and service team in the West Central region in Fort Smith.
The board of directors for HMO Partners, Inc. (doing business as Health Advantage) elected John Glassford as the company’s new president and chief executive officer in March. john GLASSFORD
dwayne PIERCE
Dwayne Pierce has been named lead executive for sales competence. Pierce is responsible for identifying competencies necessary for best-in-class sales performance and for managing the development and implementation of training programs necessary to build those skill sets in sales staff throughout Arkansas Blue Cross. His responsibilities also will include ensuring external agents have the resources needed for maximum productivity.
Glassford replaces David Bridges, who served as president and CEO for 17 years. Glassford will continue his role as regional executive for Arkansas Blue Cross’ Central office, overseeing group products sales and marketing, medical management, risk management and provider services.
odell NICKELBERRY
Odell Nickelberry has joined Arkansas Blue Cross as the director of Human Resources. Nickelberry is responsible for the overall administration, coordination and evaluation of human resources policy and procedures for Arkansas Blue Cross. He also offers strategic oversight for improvement of the company’s policies, procedures and practices on personnel matters.
Summer 2014 BLUE & YOU
19 21
Arkansas Blue Cross and Blue Shield Financial Information Privacy Notice At Arkansas Blue Cross and Blue Shield and its affiliates (including HMO Partners, Inc. doing business as Health Advantage), 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 non-public 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.
Arkansas Blue Cross 1-800-238-8379 Health Advantage 1-800-843-1329 Self-funded group members should call Customer Service using the toll-free telephone number on their ID card.
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 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. This Financial Information Privacy Notice is provided to our members as required by state regulation to explain how we handle their non-public financial information. It is also available on our website at arkansasbluecross.com or from our Customer Service call centers. Our Customer Service areas are open from 8 a.m. to 4:30 p.m., Central time, Monday through Friday.
Born Too Early Every parent wants a healthy baby, but did you know that up to 10 percent of babies in the United States are delivered before the
39th week of pregnancy without a medical reason? Many parents are unaware of the possible dangers of delivering their babies early.
Infants born before the 39th week risk:
Mothers face an increased risk of:
• Lower brain mass • Low birth weight
• Postpartum depression
• Feeding problems
• Cesarean delivery
• Respiratory distress syndrome
• Complications requiring long hospital stays
• Longer hospital stays
CUSTOMER SERVICE NUMBERS May we help? For customer service, please call:
LITTLE ROCK Number (501)
TOLL FREE Number
Medi-Pak® members 378-3062 1-800-338-2312 ® Medi-Pak Advantage members 1-877-233-7022 ® Medi-Pak Rx members 1-866-390-3369 Arkansas Blue Cross members 378-2010 1-800-238-8379 • Pharmacy questions 1-800-863-5561 • Specialty Rx pharmacy questions 1-866-295-2779 Arkansas Blue Cross Metallic members (Gold, Silver, Bronze, Catastrophic) 1-800-800-4298 • Pharmacy questions 1-800-969-3983 Health Advantage members 378-2363 1-800-843-1329 • Pharmacy questions 1-800-863-5567 BlueAdvantage members 378-3600 1-888-872-2531 • Pharmacy questions 1-888-293-3748 Federal Employee members 378-2531 1-800-482-6655
Looking for health or dental insurance? We can help! For individuals, families For employer groups*
378-2937 1-800-392-2583 378-3070 1-800-421-1112
*Arkansas Blue Cross, Health Advantage and BlueAdvantage Administrators of Arkansas
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BLUE & YOU Summer 2014
Source: NIHCM Foundation Issue Brief, March 2014, “Born Too Early: Improving Maternal and Child Health by Reducing Early Elective Deliveries.”
Prefer to speak with someone close to home? Call or visit one of our offices near you: • ArkansasBlue
— Little Rock 2612 S. Shackleford Rd., Suite J 1-501-378-2222
• Fayetteville
516 East Millsap Rd., Suite 103
1-800-817-7726
• Fort
Smith 3501 Old Greenwood Rd., Suite 5 1-866-254-9117
• Hot
Springs 100 Greenwood Ave., Suite C
• Jonesboro
707 East Matthews Ave.
• Little
Rock 601 S. Gaines Street
• ArkansasBlue
— Pine Bluff 509 Mallard Loop Drive
• Texarkana
1710 Arkansas Boulevard
1-800-588-5733 1-800-299-4124 1-800-421-1112 1-800-236-0369 1-800-470-9621
Visit our websites for more information:
arkansasbluecross.com • healthadvantage-hmo.com blueadvantagearkansas.com blueandyoufoundationarkansas.org
Summer 2014 BLUE & YOU
23
Arkansas Blue Cross and Blue Shield Financial Information Privacy Notice At Arkansas Blue Cross and Blue Shield and its affiliates (including HMO Partners, Inc. doing business as Health Advantage), 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 non-public 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.
Arkansas Blue Cross 1-800-238-8379 Health Advantage 1-800-843-1329 Self-funded group members should call Customer Service using the toll-free telephone number on their ID card.
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 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. This Financial Information Privacy Notice is provided to our members as required by state regulation to explain how we handle their non-public financial information. It is also available on our website at arkansasbluecross.com or from our Customer Service call centers. Our Customer Service areas are open from 8 a.m. to 4:30 p.m., Central time, Monday through Friday.
Born Too Early Every parent wants a healthy baby, but did you know that up to 10 percent of babies in the United States are delivered before the
39th week of pregnancy without a medical reason? Many parents are unaware of the possible dangers of delivering their babies early.
Infants born before the 39th week risk:
Mothers face an increased risk of:
• Lower brain mass • Low birth weight
• Postpartum depression
• Feeding problems
• Cesarean delivery
• Respiratory distress syndrome
• Complications requiring long hospital stays
• Longer hospital stays
CUSTOMER SERVICE NUMBERS May we help? For customer service, please call:
LITTLE ROCK Number (501)
TOLL FREE Number
Medi-Pak® members 378-3062 1-800-338-2312 ® Medi-Pak Advantage members 1-877-233-7022 ® Medi-Pak Rx members 1-866-390-3369 Arkansas Blue Cross members 378-2010 1-800-238-8379 • Pharmacy questions 1-800-863-5561 • Specialty Rx pharmacy questions 1-866-295-2779 Arkansas Blue Cross Metallic members (Gold, Silver, Bronze, Catastrophic) 1-800-800-4298 • Pharmacy questions 1-800-969-3983 Health Advantage members 378-2363 1-800-843-1329 • Pharmacy questions 1-800-863-5567 BlueAdvantage members 378-3600 1-888-872-2531 • Pharmacy questions 1-888-293-3748 Federal Employee members 378-2531 1-800-482-6655
Looking for health or dental insurance? We can help! For individuals, families For employer groups*
378-2937 1-800-392-2583 378-3070 1-800-421-1112
*Arkansas Blue Cross, Health Advantage and BlueAdvantage Administrators of Arkansas
22
BLUE & YOU Summer 2014
Source: NIHCM Foundation Issue Brief, March 2014, “Born Too Early: Improving Maternal and Child Health by Reducing Early Elective Deliveries.”
Prefer to speak with someone close to home? Call or visit one of our offices near you: • ArkansasBlue
— Little Rock 2612 S. Shackleford Rd., Suite J 1-501-378-2222
• Fayetteville
516 East Millsap Rd., Suite 103
1-800-817-7726
• Fort
Smith 3501 Old Greenwood Rd., Suite 5 1-866-254-9117
• Hot
Springs 100 Greenwood Ave., Suite C
• Jonesboro
707 East Matthews Ave.
• Little
Rock 601 S. Gaines Street
• ArkansasBlue
— Pine Bluff 509 Mallard Loop Drive
• Texarkana
1710 Arkansas Boulevard
1-800-588-5733 1-800-299-4124 1-800-421-1112 1-800-236-0369 1-800-470-9621
Visit our websites for more information:
arkansasbluecross.com • healthadvantage-hmo.com blueadvantagearkansas.com blueandyoufoundationarkansas.org
Summer 2014 BLUE & YOU
23
Summer 2014 A publication for the policyholders of the Arkansas Blue Cross and Blue Shield family of companies
page
10
Insurance madE
easy
Not everyone speaks insurance. We can help. Here are some definitions of terms you may come across as you use your insurance coverage. Also, feel free to call the Customer Service number on the back of your member ID card if you have questions — we love to hear from you.
copayment – a dollar amount that you pay for a health service on the day it happens. Use it in a sentence, please? “The pharmacist charged me a copayment of $10 for my medication and my insurance paid the rest.”
coinsurance – Some health plans require
you to pay a percentage of your medical bill, which is known as coinsurance. You’ll only pay coinsurance after you’ve met your plan’s deductible. Use it in a sentence, please? “The Millers’ plan charges 20 percent coinsurance after the deductible is met. Their son’s $120 doctor visit only cost them $24 in coinsurance.”
MPI 2575 6/14
deductible – a dollar amount that you pay
for health care services before the health plan begins to pay. Use it in a sentence, please? “One more doctor’s visit and Larry will meet his deductible, and will only pay coinsurance from that point forward.”
preventive care – Your checkup each year is an example of preventive care, which means a visit to the doctor before you get sick. Preventive care is important because you’re taking steps to prevent disease and illness from happening instead of going to the doctor after you’re sick. Use it in a sentence, please? “My preventive care is covered at no cost, so even though I’m healthy, I make sure to get an annual checkup each year for free!”
Get the health care you need
Tornado recovery
Bicycle safety
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2014 Financial Information Privacy Notice • PAGE 22