Autumn 2014 A publication for the policyholders of the Arkansas Blue Cross and Blue Shield family of companies
page
8
Boo with
Blue!
Boo with Blue, a Halloween party at the Museum of Discovery hosted by Arkansas Blue Cross and Blue Shield, will scare up some spooky fun from 6 to 9 p.m., Friday, October 10. Join us for a “Move More� dance party, museum exploration, giveaways and prizes for the best costumes. Arkansas Blue Cross members get in FREE and non-members can stop by any ArkansasBlue location in Little Rock, Pine Bluff or Hot Springs (see page 23) to pick up free tickets.
MPI 2871 10/14
Medicare Annual Election Period
Understand your ID Card
Reading Menus
page
page
page
4
6
14
Make Halloween less scary with our safety tips – page 16
In 2000, only 25 percent of the world’s information was stored on computers. Today, 98 percent of data is digital. We have a lot of information, but what do we do with it?
3
- Why big data matters to you
4
- Medicare Annual Election Period October 15 through December 7
5
- Important information for members with individual or family policies or those moving from a group health plan - Open enrollment for Arkansas State and Public School employees
6
- Understand your health plan ID card
7
- Is your doctor in network?
8
- Living Fearlessly: Hiking toward better health
18
- Arkansas Blue Cross named one of the Best Places to Work in Arkansas - New ArkansasBlue store opens in Hot Springs
20
- Summer intern program - Fighting hunger
10
- Game day fare from the Green Leaf Grill
11
- Arkansas Blue Cross executives take the ALS Ice Bucket Challenge - UAMS medical students receive Arkansas Blue Cross and Blue Shield Primary Care Scholarships
12
- SilverSneakers lowers blood sugar, increases fun
14
- Reading menus with your health in mind
16
- Be seen on Halloween
- Celebrating Arkansas families
21
- New senior vice presidents announced - 2014 Blue & You Fitness Challenge winners announced
22
- New and upcoming generics - Annual notice
23
- Women’s Health and Cancer Rights Act - Customer service numbers
24
- Boo with Blue at the Museum of Discovery
Autumn 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 Autumn 2014
Why big data matters to you
Bern Bradley leads the Little Rock Hikers on a trek along the Arkansas River Trail – page 8
In the health insurance industry, we not only collect data, we protect it. We understand that your health is your business, and we are very careful not to share your specific information with anyone but your health care providers. I want to reassure you that we take protecting your personal information — whether it be your health information or general information — extremely seriously. We use current technologies and state-of-the-art facilities to make sure your private information is kept safe and secure. What we do share — selectively — is something we call “big data.” Arkansas Blue Cross and Blue Shield has claims information on more than 3.9 million people. We share this data (without sharing identities) with Blue Health Intelligence, the nation’s largest health information database run by the Blue Cross and Blue Shield Association. Blue Health Intelligence includes information from many Blue Cross and Blue Shield companies and all 50 states. By using this information, we can implement programs which can lead to positive changes — making it more affordable, efficient and effective for our members. Through the Arkansas Payment Improvement Initiative, we are working with Medicaid and leading specialists to address improving the patient experience and improving the health of the population while reducing costs. What we’ve found is that physicians, who are in the best position to control what medical services are offered and where, often don’t have the ability to compare prices. By providing them with the data they need, they can make informed decisions, not only on the cost of services, but also on which medical procedures may be more effective in helping patients heal faster with fewer complications.
For example, did you know that in Arkansas, the total cost of a knee replacement may range anywhere from $15,000 to $40,000? That is a huge difference in cost, and in some of those cases it includes readmission for infection or additional medical care. The total cost of an episode of care can have a huge impact on what our members pay out of pocket. And no one wants to pay more unnecessarily. In 2015, we will expand the patient-centered medical home program, which seeks to reward primary care physicians (PCPs) who transform their practices into medical homes with 24hour access and electronic medical records. At a patient-centered medical home, the staff treats you when you are sick, but also works to keep you healthy by focusing on preventing illnesses. They use evidence-based medicine, which means they use data gathered from medical facilities throughout the country to determine the best way to treat your condition. As an Arkansas Blue Cross member, you can directly access the data we have on your health claims history through your Personal Health Record and view your benefits in My Blueprint on our websites. You can even add information to help your doctors know more about your health and your family’s medical history or remove certain information you would rather be private. This allows you to be an active participant in your health care. The bottom line is, no other organization in the country has the data the Blue plans have collected. We are committed to protecting your information and using it only for your benefit. And, we want you to be an active participant in your health, and your data, so you can make informed decisions about your health care. Together, we are improving health care in Arkansas.
Autumn 2014 BLUE & YOU
Make Halloween less scary with our safety tips – page 16
In 2000, only 25 percent of the world’s information was stored on computers. Today, 98 percent of data is digital. We have a lot of information, but what do we do with it?
3
- Why big data matters to you
4
- Medicare Annual Election Period October 15 through December 7
5
- Important information for members with individual or family policies or those moving from a group health plan - Open enrollment for Arkansas State and Public School employees
6
- Understand your health plan ID card
7
- Is your doctor in network?
8
- Living Fearlessly: Hiking toward better health
18
- Arkansas Blue Cross named one of the Best Places to Work in Arkansas - New ArkansasBlue store opens in Hot Springs
20
- Summer intern program - Fighting hunger
10
- Game day fare from the Green Leaf Grill
11
- Arkansas Blue Cross executives take the ALS Ice Bucket Challenge - UAMS medical students receive Arkansas Blue Cross and Blue Shield Primary Care Scholarships
12
- SilverSneakers lowers blood sugar, increases fun
14
- Reading menus with your health in mind
16
- Be seen on Halloween
- Celebrating Arkansas families
21
- New senior vice presidents announced - 2014 Blue & You Fitness Challenge winners announced
22
- New and upcoming generics - Annual notice
23
- Women’s Health and Cancer Rights Act - Customer service numbers
24
- Boo with Blue at the Museum of Discovery
Autumn 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 Autumn 2014
Why big data matters to you
Bern Bradley leads the Little Rock Hikers on a trek along the Arkansas River Trail – page 8
In the health insurance industry, we not only collect data, we protect it. We understand that your health is your business, and we are very careful not to share your specific information with anyone but your health care providers. I want to reassure you that we take protecting your personal information — whether it be your health information or general information — extremely seriously. We use current technologies and state-of-the-art facilities to make sure your private information is kept safe and secure. What we do share — selectively — is something we call “big data.” Arkansas Blue Cross and Blue Shield has claims information on more than 3.9 million people. We share this data (without sharing identities) with Blue Health Intelligence, the nation’s largest health information database run by the Blue Cross and Blue Shield Association. Blue Health Intelligence includes information from many Blue Cross and Blue Shield companies and all 50 states. By using this information, we can implement programs which can lead to positive changes — making it more affordable, efficient and effective for our members. Through the Arkansas Payment Improvement Initiative, we are working with Medicaid and leading specialists to address improving the patient experience and improving the health of the population while reducing costs. What we’ve found is that physicians, who are in the best position to control what medical services are offered and where, often don’t have the ability to compare prices. By providing them with the data they need, they can make informed decisions, not only on the cost of services, but also on which medical procedures may be more effective in helping patients heal faster with fewer complications.
For example, did you know that in Arkansas, the total cost of a knee replacement may range anywhere from $15,000 to $40,000? That is a huge difference in cost, and in some of those cases it includes readmission for infection or additional medical care. The total cost of an episode of care can have a huge impact on what our members pay out of pocket. And no one wants to pay more unnecessarily. In 2015, we will expand the patient-centered medical home program, which seeks to reward primary care physicians (PCPs) who transform their practices into medical homes with 24hour access and electronic medical records. At a patient-centered medical home, the staff treats you when you are sick, but also works to keep you healthy by focusing on preventing illnesses. They use evidence-based medicine, which means they use data gathered from medical facilities throughout the country to determine the best way to treat your condition. As an Arkansas Blue Cross member, you can directly access the data we have on your health claims history through your Personal Health Record and view your benefits in My Blueprint on our websites. You can even add information to help your doctors know more about your health and your family’s medical history or remove certain information you would rather be private. This allows you to be an active participant in your health care. The bottom line is, no other organization in the country has the data the Blue plans have collected. We are committed to protecting your information and using it only for your benefit. And, we want you to be an active participant in your health, and your data, so you can make informed decisions about your health care. Together, we are improving health care in Arkansas.
Autumn 2014 BLUE & YOU
IMPORTANT Medicare Annual Election Period October 15 through December 7 Medicare’s Annual Election Period (AEP) begins October 15, and runs through December 7. During AEP, Medicare beneficiaries can purchase a Medicare Advantage plan and/or a Medicare Part D prescription drug plan. You also may change from your existing plan. If you join a plan during AEP, or make changes to an existing plan, your new benefits will be effective January 1, 2015.
Affordable coverage and peace of mind
Attention Medicare Advantage plan members
Arkansas Blue Cross and Blue Shield’s Medicare products continue to offer members low monthly premiums. In 2015, choose from:
If you have a Medicare Advantage or Medicare Part D plan, during October, you will receive an Annual Notice of Change (ANOC), which will explain any changes to your current plan that will become effective in January. If you are satisfied with your current plan, you are not required to change anything.
Medicare Advantage plans, featuring: • Low monthly premiums – with some plans as low as $0 a month • Option to include prescription drug coverage • Access to the state’s top doctors and hospitals • Free basic fitness center membership Medicare prescription drug plans, featuring: • Competitively priced monthly premiums • Convenient home delivery with our mail order program Medicare supplement plans, featuring: • Affordable monthly premiums • Coverage for all conditions from day one, upon acceptance
4
BLUE & YOU Autumn 2014
If you would like to learn more about our Medicare plans... Call your local Medi-Pak® Choice licensed agent or 1-800-392-2583 to learn more. You also can visit our website, arkansasbluecross.com/Medicare. We’d love to hear from you. If you have a friend or family member who will be looking for a Medicare Advantage or Part D plan this AEP, we hope you’ll recommend Arkansas Blue Cross!
INFORMATION Selecting a health insurance plan is one
For members with individual or family policies purchased on healthcare.gov, the Health Insurance Marketplace
of the most important decisions you make to protect you and your family, so it is important to make the best choice.
Your open enrollment period (OEP) begins November 15 and ends February 15. During OEP you will be able to review your information and decide if you want to keep the plan you have, make changes to your current plan, or change health plans. Watch your mail for a letter from Arkansas Blue Cross that will explain your options in more detail. Because information regarding the health plans on the Health Insurance Marketplace will not be available until November 15, we can’t discuss your options with you until then. But as soon as the information is available, we will be happy to help!
If you need to choose a new health plan because you either didn’t have coverage before or are leaving a group health plan provided by your employer, call us or if you have an agent, call your agent. We can help you determine your options. Call 1-800-238-8379 for more information.
Open enrollment for Arkansas State and Public School employees Arkansas State and Public School employee open enrollment dates have been set. This year, enrollment periods will be separate for state and school employees. Arkansas state employee open enrollment was September 1-30. Public school employee open enrollment will be October 1-31. Selected changes must be completed
during this time frame for changes to be effective at the beginning of the next plan year, January 1, 2015. Rates and benefits have been approved by the State and Public School Life and Health Insurance Board. Plan options and premium information for Arkansas State and Public School employees have been posted on arbenefits.org. For questions and additional
information, contact the Employee Benefits Division at 1- 877-815-1017. You also can visit the Health Advantage website, healthadvantage-hmo. com, for featured plan information, health resources and our member self-service area, My Blueprint, which gives you access to additional tools to improve your health, like a health care cost calculator.
Autumn 2014 BLUE & YOU
5
IMPORTANT Medicare Annual Election Period October 15 through December 7 Medicare’s Annual Election Period (AEP) begins October 15, and runs through December 7. During AEP, Medicare beneficiaries can purchase a Medicare Advantage plan and/or a Medicare Part D prescription drug plan. You also may change from your existing plan. If you join a plan during AEP, or make changes to an existing plan, your new benefits will be effective January 1, 2015.
Affordable coverage and peace of mind
Attention Medicare Advantage plan members
Arkansas Blue Cross and Blue Shield’s Medicare products continue to offer members low monthly premiums. In 2015, choose from:
If you have a Medicare Advantage or Medicare Part D plan, during October, you will receive an Annual Notice of Change (ANOC), which will explain any changes to your current plan that will become effective in January. If you are satisfied with your current plan, you are not required to change anything.
Medicare Advantage plans, featuring: • Low monthly premiums – with some plans as low as $0 a month • Option to include prescription drug coverage • Access to the state’s top doctors and hospitals • Free basic fitness center membership Medicare prescription drug plans, featuring: • Competitively priced monthly premiums • Convenient home delivery with our mail order program Medicare supplement plans, featuring: • Affordable monthly premiums • Coverage for all conditions from day one, upon acceptance
4
BLUE & YOU Autumn 2014
If you would like to learn more about our Medicare plans... Call your local Medi-Pak® Choice licensed agent or 1-800-392-2583 to learn more. You also can visit our website, arkansasbluecross.com/Medicare. We’d love to hear from you. If you have a friend or family member who will be looking for a Medicare Advantage or Part D plan this AEP, we hope you’ll recommend Arkansas Blue Cross!
INFORMATION Selecting a health insurance plan is one
For members with individual or family policies purchased on healthcare.gov, the Health Insurance Marketplace
of the most important decisions you make to protect you and your family, so it is important to make the best choice.
Your open enrollment period (OEP) begins November 15 and ends February 15. During OEP you will be able to review your information and decide if you want to keep the plan you have, make changes to your current plan, or change health plans. Watch your mail for a letter from Arkansas Blue Cross that will explain your options in more detail. Because information regarding the health plans on the Health Insurance Marketplace will not be available until November 15, we can’t discuss your options with you until then. But as soon as the information is available, we will be happy to help!
If you need to choose a new health plan because you either didn’t have coverage before or are leaving a group health plan provided by your employer, call us or if you have an agent, call your agent. We can help you determine your options. Call 1-800-238-8379 for more information.
Open enrollment for Arkansas State and Public School employees Arkansas State and Public School employee open enrollment dates have been set. This year, enrollment periods will be separate for state and school employees. Arkansas state employee open enrollment was September 1-30. Public school employee open enrollment will be October 1-31. Selected changes must be completed
during this time frame for changes to be effective at the beginning of the next plan year, January 1, 2015. Rates and benefits have been approved by the State and Public School Life and Health Insurance Board. Plan options and premium information for Arkansas State and Public School employees have been posted on arbenefits.org. For questions and additional
information, contact the Employee Benefits Division at 1- 877-815-1017. You also can visit the Health Advantage website, healthadvantage-hmo. com, for featured plan information, health resources and our member self-service area, My Blueprint, which gives you access to additional tools to improve your health, like a health care cost calculator.
Autumn 2014 BLUE & YOU
5
Member Name: JOHN L DOE Arkans as Blue
Cross a P O Bo nd Blu x2 e Shield Little Ro 181 ck AR 7 2203-21 An Inde 81 penden tL
and Blu
e Shield
Member ID: ZZZ123456789
DOB 10/04/1945
pay Op en A $1 2/ cce 20% ss P 35/55 /10 OS 0%
P O Box 1525 Lantham NY 12110
PCP/PHONE# JOHN A SMITH (501)555-1234
om ecross.c ansasblu www.ark
ice: omer Serv
ust Vision C 379 800-238-8
Understand your Health Plan ID Card
icensee Associat of the Blue Cro ss ion
claims and ly : File all ect Providers quests dir re n inatio pre-determ administrator. ms to the clai
RXBIN 123456 RXPCN ADV
o
P O B POS Open Access Y 12110 Lantham N
RXGRP RX0000
Little
e Bl nsee of th ndent Lice An Indepe ciation so As ld ie and Blue Sh
GET TO KNOW YOUR HEALTH INSURANCE CARD
Member ID: ZZZ123456789
PCP/PHONE# JOHN A SMITH (501)555-1234
Group No. 9876543210
Copay $20/$35
RXBIN 123456
Coins 20%
RXPCN ADV
RX Copay $12/35/55/100%
RXGRP RX0000
Open Access POS
Rx categories:
Dependents: Your card may include your dependents.
6
True BLUE PPO Member Name: JOHN L DOE
Member DOB: 10/04/1945
Member ID: ZZZ123456789
Group #: 9876543210
Dependents 02 JANE
1/11/2011
RxBIN: 123456 RxPCN: ADV RxGRP: RX0000 Off. CoPay: $20 Rx: $100+20%
On the back: You’ll find a list of helpful telephone numbers on the back. Feel free to give us a call when you have any questions. We love to hear from you.
BLUE & YOU Autumn 2014
Tells you a little about your plan. Shows your medical copayment, coinsurance, deductible and prescription drug copayment, depending on the plan. ®
The pharmacy will use these numbers if you have pharmacy benefits to apply your discount and file your claims.
Ser vic
ww
an
eS
n Bsluas Blu 1 s and• tEmergency • Doctor e CrAorksOasroom r rPosO ox 218 72203-218 C a e r t lu isBoxo 2 P B an B in s a m s d ckdARBlunesee of o 181 R e tl Arkan n Claims ALit Lit Lice S • ioHospital ndent tionh R• oPharmacy 25 tle Vis 5 Indepe ield Associa c 1 n k A x A o 0 h R 1 72203-2and Blue S P O B m NY A12n1In 181 depen antha sas
dent L e Shield icensee of the Blue Cro Assoc ss their care, but they can choose to stay iation L
and Blu
in network, or pay a higher share of their medical costs by seeking medical care outside the network. Preferred Provider Organization (PPO): PPO plans do not require a PCP, but tend to require higher out-of-pocket payments of premiums.
Plan details:
DOB 10/04/1945
Member Name: JOHN L DOE
Arkansas Blue Cross anprint off a temporary card. (Not available for our Medicare d Blue Shield and Medicare Prescription Drug Plan members.) Vision Claims Admini Advantage strator P O Box 1525 Arkansas Blue Cross Lantham NY 12110 and Blue Shield P O BoxPLAN? WHAT’S YOUR 21
Point-Of-Service (POS): Members with a POS plan also have a PCP to coordinate
Insurer: That’s us!
Used to pull up your plan’s particular benefits.
www. arkans asblue cross Vision Custom o 800-23 ross.c e 8-837.a9rkansrasSblueercvice: e: w
Open
Health Maintenance Organization (HMO): An Independent Licens ee of the Blue Cross With an HMO,and members select a primary Blue Shield Ass ociation care physician (PCP) who is in the health plan’s network. The PCP coordinates care with other doctors and medical facilities within the HMO network.
DISCLAIMER: Your card may look slightly different or have different information.
Group number:
www.arkans
: File ITH pPCJOre01H-N)5d55AeSM -1t23 e4rmin$3a5t all claims and (5 io $20/ to Cothpaey claims n0%20r%equests dir s ad5/10 ectly Coin $12/35/5 minis trator. RX Copay S PO s es cc A
81 Little Rock AR 72203-218 1
For being a 4 x 2-inch piece of paper, your health plan ID card has a lot of important information on it. It plays a key role in providing doctors and hospitals with the information they need so you can get the care you need. It also helps them send your claims directly to us, so you can have peace of mind. We encourage you to carry your ID card in your wallet at all times. So, what’s on your ID card? Let’s look:
This unique number helps us identify who you are, the type of health plan you have and how your claims are paid.
An Independent Licensee of the Blue Cross and Blue Shield Association
ProvidE# P/PHON ers
D
Name: Member OE D JOHN L ID: Member 6789 ZZZ12345 3210 o. 987654 Group N 123456 N BI RX ADV RXPCN 0000 RX RP RXG
NEED A NEW ONE? asbluecross.coAmrkansas Blu DON’T LEAVE Vision Cus3to7m9 er Providers: File all Copay $20/$35 8 e V claims and Cross a ision C Vision Customer Se -238800IT HOME WITHOUT rvice n la :cards d pre-determination requeDid you know you im d B n a s lu can order new ID online? Visit s P O Box Adminis e Shielde all claim directly 800-238-8379 sts directly Coins 20% ieldthe cla il trator You’ll 1525member s Shto im rs: Fbe asked s lue Shield ad and Blue quest to show B m ss arkansasbluecross.com and log in to the self-service ini d L str ro an ato C a e r. ss ovide ination re ator. lu n ro B r C t s P h e sa lu a an B r rk m t m A r is e t N in e Arkansas ims Administrator RX Copay $12/35/55/100% Y m -d d 81 e 1 r a 21 your ID card at the: p 2 s site. Once you’re in, you’ll be able to order an ID card and ox la B 110 and PO claim Vision C 25 203-2181 Cross Ark to the hield Rock AR 72 x 15 Blue ue Cross
Group No. 9876543210
Member ID number:
Arkansas Blue Cross and Blue Shield
P O Box 2181 Little Rock AR 72203-2181
Type of plan: The type of health plan you have. (see “What’s Your Plan?” on page 7)
Suitcase: Do you have a suitcase? If so, you’re a member of the national BlueCard® ® network and can receive certain levels of health care benefits when you live or travel across the country.
Is your doctor in network? Before you see a new doctor, or even go for lab work, it’s a good idea to verify that those medical professionals or facilities are in network. What does that mean? Arkansas Blue Cross and Blue Shield, Health Advantage and BlueAdvantage Administrators of Arkansas all set up networks with doctors, hospitals, laboratories and other health care providers. (Medicare prescription drug plans do not have a network.) Providers in a network agree to deliver their services at agreed-upon prices for our members. While Arkansas Blue Cross and our family of companies have more health care providers in network than any other insurance company, it is important to recognize that not all providers participate in all our networks. Please check to make sure any doctor, hospital or laboratory your primary care physician (PCP) refers you to is a networkparticipating provider before your visit. You can find out if a provider is in network by searching for them in our doctor and
hospital directory on our websites, or by calling the Customer Service telephone number on the back of your health insurance ID card. If you go to a provider that is not in your health plan’s network, you could be charged for services that are not covered, or you could end up paying higher out-of-pocket costs. Even if you have a current listing that identifies a particular provider as a participating provider on your plan, it is a good idea to verify this with us before you go to your appointment. If your doctor refers you to a provider that is not part of your plan’s network, you can print out a list of in-network providers from our websites and ask him or her to recommend one from that group. This includes laboratories. When in doubt, please ask. If you have questions, call the Customer Service number on your ID card or go to our websites, listed on page 23. We are here to assist you! Autumn 2014 BLUE & YOU
7
Member Name: JOHN L DOE Arkans as Blue
Cross a P O Bo nd Blu x2 e Shield Little Ro 181 ck AR 7 2203-21 An Inde 81 penden tL
and Blu
e Shield
Member ID: ZZZ123456789
DOB 10/04/1945
pay Op en A $1 2/ cce 20% ss P 35/55 /10 OS 0%
P O Box 1525 Lantham NY 12110
PCP/PHONE# JOHN A SMITH (501)555-1234
om ecross.c ansasblu www.ark
ice: omer Serv
ust Vision C 379 800-238-8
Understand your Health Plan ID Card
icensee Associat of the Blue Cro ss ion
claims and ly : File all ect Providers quests dir re n inatio pre-determ administrator. ms to the clai
RXBIN 123456 RXPCN ADV
o
P O B POS Open Access Y 12110 Lantham N
RXGRP RX0000
Little
e Bl nsee of th ndent Lice An Indepe ciation so As ld ie and Blue Sh
GET TO KNOW YOUR HEALTH INSURANCE CARD
Member ID: ZZZ123456789
PCP/PHONE# JOHN A SMITH (501)555-1234
Group No. 9876543210
Copay $20/$35
RXBIN 123456
Coins 20%
RXPCN ADV
RX Copay $12/35/55/100%
RXGRP RX0000
Open Access POS
Rx categories:
Dependents: Your card may include your dependents.
6
True BLUE PPO Member Name: JOHN L DOE
Member DOB: 10/04/1945
Member ID: ZZZ123456789
Group #: 9876543210
Dependents 02 JANE
1/11/2011
RxBIN: 123456 RxPCN: ADV RxGRP: RX0000 Off. CoPay: $20 Rx: $100+20%
On the back: You’ll find a list of helpful telephone numbers on the back. Feel free to give us a call when you have any questions. We love to hear from you.
BLUE & YOU Autumn 2014
Tells you a little about your plan. Shows your medical copayment, coinsurance, deductible and prescription drug copayment, depending on the plan. ®
The pharmacy will use these numbers if you have pharmacy benefits to apply your discount and file your claims.
Ser vic
ww
an
eS
n Bsluas Blu 1 s and• tEmergency • Doctor e CrAorksOasroom r rPosO ox 218 72203-218 C a e r t lu isBoxo 2 P B an B in s a m s d ckdARBlunesee of o 181 R e tl Arkan n Claims ALit Lit Lice S • ioHospital ndent tionh R• oPharmacy 25 tle Vis 5 Indepe ield Associa c 1 n k A x A o 0 h R 1 72203-2and Blue S P O B m NY A12n1In 181 depen antha sas
dent L e Shield icensee of the Blue Cro Assoc ss their care, but they can choose to stay iation L
and Blu
in network, or pay a higher share of their medical costs by seeking medical care outside the network. Preferred Provider Organization (PPO): PPO plans do not require a PCP, but tend to require higher out-of-pocket payments of premiums.
Plan details:
DOB 10/04/1945
Member Name: JOHN L DOE
Arkansas Blue Cross anprint off a temporary card. (Not available for our Medicare d Blue Shield and Medicare Prescription Drug Plan members.) Vision Claims Admini Advantage strator P O Box 1525 Arkansas Blue Cross Lantham NY 12110 and Blue Shield P O BoxPLAN? WHAT’S YOUR 21
Point-Of-Service (POS): Members with a POS plan also have a PCP to coordinate
Insurer: That’s us!
Used to pull up your plan’s particular benefits.
www. arkans asblue cross Vision Custom o 800-23 ross.c e 8-837.a9rkansrasSblueercvice: e: w
Open
Health Maintenance Organization (HMO): An Independent Licens ee of the Blue Cross With an HMO,and members select a primary Blue Shield Ass ociation care physician (PCP) who is in the health plan’s network. The PCP coordinates care with other doctors and medical facilities within the HMO network.
DISCLAIMER: Your card may look slightly different or have different information.
Group number:
www.arkans
: File ITH pPCJOre01H-N)5d55AeSM -1t23 e4rmin$3a5t all claims and (5 io $20/ to Cothpaey claims n0%20r%equests dir s ad5/10 ectly Coin $12/35/5 minis trator. RX Copay S PO s es cc A
81 Little Rock AR 72203-218 1
For being a 4 x 2-inch piece of paper, your health plan ID card has a lot of important information on it. It plays a key role in providing doctors and hospitals with the information they need so you can get the care you need. It also helps them send your claims directly to us, so you can have peace of mind. We encourage you to carry your ID card in your wallet at all times. So, what’s on your ID card? Let’s look:
This unique number helps us identify who you are, the type of health plan you have and how your claims are paid.
An Independent Licensee of the Blue Cross and Blue Shield Association
ProvidE# P/PHON ers
D
Name: Member OE D JOHN L ID: Member 6789 ZZZ12345 3210 o. 987654 Group N 123456 N BI RX ADV RXPCN 0000 RX RP RXG
NEED A NEW ONE? asbluecross.coAmrkansas Blu DON’T LEAVE Vision Cus3to7m9 er Providers: File all Copay $20/$35 8 e V claims and Cross a ision C Vision Customer Se -238800IT HOME WITHOUT rvice n la :cards d pre-determination requeDid you know you im d B n a s lu can order new ID online? Visit s P O Box Adminis e Shielde all claim directly 800-238-8379 sts directly Coins 20% ieldthe cla il trator You’ll 1525member s Shto im rs: Fbe asked s lue Shield ad and Blue quest to show B m ss arkansasbluecross.com and log in to the self-service ini d L str ro an ato C a e r. ss ovide ination re ator. lu n ro B r C t s P h e sa lu a an B r rk m t m A r is e t N in e Arkansas ims Administrator RX Copay $12/35/55/100% Y m -d d 81 e 1 r a 21 your ID card at the: p 2 s site. Once you’re in, you’ll be able to order an ID card and ox la B 110 and PO claim Vision C 25 203-2181 Cross Ark to the hield Rock AR 72 x 15 Blue ue Cross
Group No. 9876543210
Member ID number:
Arkansas Blue Cross and Blue Shield
P O Box 2181 Little Rock AR 72203-2181
Type of plan: The type of health plan you have. (see “What’s Your Plan?” on page 7)
Suitcase: Do you have a suitcase? If so, you’re a member of the national BlueCard® ® network and can receive certain levels of health care benefits when you live or travel across the country.
Is your doctor in network? Before you see a new doctor, or even go for lab work, it’s a good idea to verify that those medical professionals or facilities are in network. What does that mean? Arkansas Blue Cross and Blue Shield, Health Advantage and BlueAdvantage Administrators of Arkansas all set up networks with doctors, hospitals, laboratories and other health care providers. (Medicare prescription drug plans do not have a network.) Providers in a network agree to deliver their services at agreed-upon prices for our members. While Arkansas Blue Cross and our family of companies have more health care providers in network than any other insurance company, it is important to recognize that not all providers participate in all our networks. Please check to make sure any doctor, hospital or laboratory your primary care physician (PCP) refers you to is a networkparticipating provider before your visit. You can find out if a provider is in network by searching for them in our doctor and
hospital directory on our websites, or by calling the Customer Service telephone number on the back of your health insurance ID card. If you go to a provider that is not in your health plan’s network, you could be charged for services that are not covered, or you could end up paying higher out-of-pocket costs. Even if you have a current listing that identifies a particular provider as a participating provider on your plan, it is a good idea to verify this with us before you go to your appointment. If your doctor refers you to a provider that is not part of your plan’s network, you can print out a list of in-network providers from our websites and ask him or her to recommend one from that group. This includes laboratories. When in doubt, please ask. If you have questions, call the Customer Service number on your ID card or go to our websites, listed on page 23. We are here to assist you! Autumn 2014 BLUE & YOU
7
With his health care coverage, Bern has the confidence that he can go to the doctor when he is sick and have his blood sugar tested every three months to make sure his diabetes is in check.
Bern was born with a heart defect, and at 6 months and 16 months had surgeries to try to correct the condition. Bern Bradley
Hiking toward better health he freedom of hiking in the great outdoors has energized Bern Bradley to make it a part of his everyday life, and he encourages others to do it as well. On January 1, he experienced a different kind of freedom — having health insurance for the first time in years. Bern is one of Arkansas Blue Cross and Blue Shield’s members who purchased coverage through the Health Insurance Marketplace last fall. Because of a pre-existing condition, he couldn’t afford health insurance in the past, but through health care reform, he now is able to see his doctors regularly. Having health insurance allows Bern to
8
BLUE & YOU Autumn 2014
live fearlessly as an organizer for the Little Rock Hikers. After work every weekday, and early in the mornings on Saturdays and Sundays, Bern and any number of other hikers can be seen hitting the trails around central Arkansas. The hikers may do an urban hike downtown, follow the Arkansas River Trail across the Big Dam Bridge or go deep into the woods. Wherever and whenever the hikes are, Bern is there encouraging new hikers to not give up and chatting about any number of things going on in the world. One topic that eventually comes up is how he shouldn’t be there at all.
“Several folks, including some doctors, tried to discourage my parents from taking me for surgery,” Bern said. His parents were told he would not live past age 4. Now, at 56, he is part of the first generation of babies to have survived such heart surgeries. He also is part of the population with a lifelong pre-existing condition. At different times in his life, Bern has been able to get insurance through an employer, but he enjoys the flexibility of being selfemployed. Health insurance, however, had always been a problem for him since he has a pre-existing condition. Without insurance, Bern tried to stay healthy on his own because he knew he had a heart valve that eventually will need to be replaced. Six years ago, however, he had a small stroke and then found out he had diabetes. He immediately was put on two medications for it and sent to diabetes education classes. It was there he learned that if he could exercise at least 30 minutes most days, he might be able to control the diabetes and get off the medications. In 2012, Bern read the book “Wild” by Cheryl Strayed. The story, about a woman
It took a few months of working with my doctors to get the right balance OF medications. I would not be able to PAY FOR that without health insurance.
– Bern Bradley who hiked the Pacific Coast Trail from the Mojave Desert to the state border between Oregon and Washington, resonated with him. “Her book made me see that taking a hike can be more than just a long walk. The idea of taking on a challenge that big, and winning, really appeals to me. I wanted to experience that as well.” Bern started searching for a local hiking club, and in February 2013, joined the Little Rock Hikers through their website, littlerockhikers.com. “At first I was walking with the group to train for long trail hikes in the woods, but it became apparent that I needed it for health reasons.” It wasn’t long before Bern became an assistant organizer for the group and then, as founder Charles
Lucas became busy working on his thesis, Bern stepped up as an organizer. Last fall, through health insurance reform, Bern and others with pre-existing conditions were able to sign up for health insurance. He chose a Silver health plan through Arkansas Blue Cross. “My parents had Arkansas Blue Cross. Sometimes I had to call Customer Service for them as they got older and I always had good experiences with them.” It also helped that Arkansas Blue Cross has the largest network of doctors and hospitals in the state, so Bern didn’t have to change any of his doctors. “I asked my sister (who works for a cardiologist) if it was a health insurance they take and she said, ‘Everybody takes Blue Cross.’”
“Without insurance, I could get an A1c test (for blood sugar) for $50. What I couldn’t do is prescribe medicine and know how it would affect me. It took a few months of working with my doctors to get the right balance of medications for my blood pressure and diabetes. I would not be able to pay for that without health insurance. “I credit a lot of my current health status to the fact that my doctors communicate,” Bern said. “My cardiologist sent a letter to my PCP (primary care doctor) saying what needed to happen to keep me healthy. Their cooperation is key to this.” Midway through a hike recently, Bern’s cell phone rang. He burst into a wide grin as the nurse from his doctor’s office told him his blood sugar, which had been critically high months before, was now down to nearnormal levels. His hard work is paying off, and with his health insurance coverage, he now has the freedom to hike not only in Arkansas, but anywhere his boots may take him.
Autumn 2014 BLUE & YOU
9
With his health care coverage, Bern has the confidence that he can go to the doctor when he is sick and have his blood sugar tested every three months to make sure his diabetes is in check.
Bern was born with a heart defect, and at 6 months and 16 months had surgeries to try to correct the condition. Bern Bradley
Hiking toward better health he freedom of hiking in the great outdoors has energized Bern Bradley to make it a part of his everyday life, and he encourages others to do it as well. On January 1, he experienced a different kind of freedom — having health insurance for the first time in years. Bern is one of Arkansas Blue Cross and Blue Shield’s members who purchased coverage through the Health Insurance Marketplace last fall. Because of a pre-existing condition, he couldn’t afford health insurance in the past, but through health care reform, he now is able to see his doctors regularly. Having health insurance allows Bern to
8
BLUE & YOU Autumn 2014
live fearlessly as an organizer for the Little Rock Hikers. After work every weekday, and early in the mornings on Saturdays and Sundays, Bern and any number of other hikers can be seen hitting the trails around central Arkansas. The hikers may do an urban hike downtown, follow the Arkansas River Trail across the Big Dam Bridge or go deep into the woods. Wherever and whenever the hikes are, Bern is there encouraging new hikers to not give up and chatting about any number of things going on in the world. One topic that eventually comes up is how he shouldn’t be there at all.
“Several folks, including some doctors, tried to discourage my parents from taking me for surgery,” Bern said. His parents were told he would not live past age 4. Now, at 56, he is part of the first generation of babies to have survived such heart surgeries. He also is part of the population with a lifelong pre-existing condition. At different times in his life, Bern has been able to get insurance through an employer, but he enjoys the flexibility of being selfemployed. Health insurance, however, had always been a problem for him since he has a pre-existing condition. Without insurance, Bern tried to stay healthy on his own because he knew he had a heart valve that eventually will need to be replaced. Six years ago, however, he had a small stroke and then found out he had diabetes. He immediately was put on two medications for it and sent to diabetes education classes. It was there he learned that if he could exercise at least 30 minutes most days, he might be able to control the diabetes and get off the medications. In 2012, Bern read the book “Wild” by Cheryl Strayed. The story, about a woman
It took a few months of working with my doctors to get the right balance OF medications. I would not be able to PAY FOR that without health insurance.
– Bern Bradley who hiked the Pacific Coast Trail from the Mojave Desert to the state border between Oregon and Washington, resonated with him. “Her book made me see that taking a hike can be more than just a long walk. The idea of taking on a challenge that big, and winning, really appeals to me. I wanted to experience that as well.” Bern started searching for a local hiking club, and in February 2013, joined the Little Rock Hikers through their website, littlerockhikers.com. “At first I was walking with the group to train for long trail hikes in the woods, but it became apparent that I needed it for health reasons.” It wasn’t long before Bern became an assistant organizer for the group and then, as founder Charles
Lucas became busy working on his thesis, Bern stepped up as an organizer. Last fall, through health insurance reform, Bern and others with pre-existing conditions were able to sign up for health insurance. He chose a Silver health plan through Arkansas Blue Cross. “My parents had Arkansas Blue Cross. Sometimes I had to call Customer Service for them as they got older and I always had good experiences with them.” It also helped that Arkansas Blue Cross has the largest network of doctors and hospitals in the state, so Bern didn’t have to change any of his doctors. “I asked my sister (who works for a cardiologist) if it was a health insurance they take and she said, ‘Everybody takes Blue Cross.’”
“Without insurance, I could get an A1c test (for blood sugar) for $50. What I couldn’t do is prescribe medicine and know how it would affect me. It took a few months of working with my doctors to get the right balance of medications for my blood pressure and diabetes. I would not be able to pay for that without health insurance. “I credit a lot of my current health status to the fact that my doctors communicate,” Bern said. “My cardiologist sent a letter to my PCP (primary care doctor) saying what needed to happen to keep me healthy. Their cooperation is key to this.” Midway through a hike recently, Bern’s cell phone rang. He burst into a wide grin as the nurse from his doctor’s office told him his blood sugar, which had been critically high months before, was now down to nearnormal levels. His hard work is paying off, and with his health insurance coverage, he now has the freedom to hike not only in Arkansas, but anywhere his boots may take him.
Autumn 2014 BLUE & YOU
9
Game Day Fare FROM THE
Ron DeBerry douses David Bridges.
Whether you are preparing for the big game with a tailgate party at the stadium or a gathering around the television at home, you can make fun foods that are big on taste but still nutritious. Try these easy-to-prepare healthy recipes for game day, approved by our dietician and the executive chef at the Green Leaf Grill!
Yields: 16 kabobs • Serving: two skewers Directions: Thread ingredients evenly onto each skewer. Cover and chill Ingredients: 30 minutes or up to one day. Serve kabobs with fruit dip. - 1 (8-oz.) package cheddar cheese cubes Nutrition Information per serving: - 32 red grapes (2 skewers) 159 calories, 9.2 g. fat, 5 g. saturated fat, - 16 strawberries, halved 186 mg. sodium, 13.5 g. carbohydrate, 1.5 g. fiber, 7.7 g. protein - 32 pineapple cubes - 32 honeydew melon cubes
Cinnamon Yogurt Fruit Dip Ingredients: - 4 cups plain yogurt - 8 tablespoons honey - 2 teaspoons cinnamon - 2 teaspoons vanilla
Sandwich Wrap
Directions: Mix ingredients together and serve immediately. Store in the refrigerator up to three days. Nutrition Information per serving (1/2 cup): 137 calories, 0.2 g. fat, 0 g. saturated fat, 95 mg. sodium, 27 g. carbohydrate, 0.4 g. fiber, 7.1 g. protein
with
Garlic
and
Herb Cream Cheese Spread
Yields: 12 servings • Serving: one wrap with 2 tablespoons of herb cream cheese Ingredients: - 1 12 oz container of reduced-fat whipped cream cheese spread - 1 garlic clove, finely minced - 1/2 teaspoon Italian seasoning - 1/4 teaspoon onion powder - 1/2 teaspoon salt - 1 tablespoon finely chopped fresh chives, optional - 12 8-inch whole-wheat tortilla wraps - 1.5 pounds sliced deli turkey (or other desired deli meat) - Veggies of choice
Skinny Greek Yogurt Ranch Dip Yields: About 4 cups • ServES: 8
Directions: In a small bowl, combine garlic, Italian seasoning, onion powder and salt. Add cream cheese and gently fold in the seasoning. Be careful not to over mix or cream cheese will lose fluff. If using the chives, fold them in now. Cover and let chill in fridge for an hour. Stir before serving. Spread 2 tablespoons of cream cheese spread on each whole wheat tortilla followed by veggies of choice. Place 2 oz. of deli meat in each wrap. Wrap them like a burrito and cut in half. Nutrition Information per serving (1 WRAP): 250 calories, 9.1 g. fat, 4.8 g. saturated fat, 970 mg. sodium, 29 g. carbohydrate, 14.7 g. protein
Ingredients: - 4 tablespoons store-bought ranch seasoning mix - 4 cups fat-free plain Greek yogurt Directions: Whisk together ingredients in a small bowl until combined. Serve immediately with veggies. Store in refrigerator in an airtight container for up to three days.
10
Nutrition Information per serving (1/2 cup): 55 calories, 0.3 g. fat, 0 g. saturated fat, 98 mg. sodium, 3.5 g. carbohydrate, 0 g. fiber, 8.5 g. protein
BLUE & YOU Autumn 2014
Karen Raley gets her splash on.
ARKANSAS BLUE CROSS
Fruit and Cheese Kabobs with Cinnamon Yogurt Dip
Yields: 4 cups • Serving: ½ cup
Bridges and Carolyn Henry (right) freeze out Mark White.
The Green Leaf Grill is located on the first floor of the Arkansas Blue Cross and Blue Shield building at Sixth and Gaines in downtown Little Rock. The full-service restaurant is open to the general public for breakfast and lunch. Executive chef Jason Knapp and dietician Kristen Rowe focus on healthy foods that taste great.
The water was ice cold, the day was hot, but hearts were warm as Arkansas Blue Cross and Blue Shield raised $20,000 and doused three executives during the Ice Bucket Challenge for ALS (amyotrophic lateral sclerosis).
Tommy May (with check, above left), a member of the Arkansas Blue Cross board of directors, and Kip Jackson (with check, above right), of Sherwood (brother of employee Julie Nichols), who are both battling the debilitating disease.
Mark White, president and chief executive officer; David Bridges, executive vice president and chief administrative officer; and Karen Raley, vice president of Corporate Marketing, all accepted the icy dunking as employees cheered them on. The challenge was held in honor of
ALS (also known as Lou Gehrig’s disease) progressively kills nerve cells in the brain and spinal cord, causing the brain to lose the ability to initiate and control muscle movement. Patients in the later stages of the disease may become totally paralyzed.
UAMS medical students receive Arkansas Blue Cross and Blue Shield Primary Care Scholarships Medical students who want to work as primary care doctors in rural Arkansas aren’t as plentiful as those who want to work in the cities and suburbs. It’s a troubling trend. The Arkansas Blue Cross and Blue Shield Primary Care Scholarship, awarded each year to two students at the University of Arkansas for Medical Sciences (UAMS), not only helps deserving students, it helps hundreds of people in the communities where these future physicians will set up their medical practices. Seniors Andrew Briggler, from Hattieville, and Nathan Schandevel, from Paragould, are the recipients of the 2014 scholarship. They each will receive $20,000 toward their educations. They graduate in May 2015. The scholarships are possible through a $1 million endowment grant from Arkansas Blue Cross in partnership with UAMS. The first scholarships were given in 2012. “On behalf of our members, Arkansas Blue Cross and Blue Shield is focused on the issue
Nathan Schandevel (left) and Andrew Briggler are this year’s recipients of the 2014 Arkansas Blue Cross and Blue Shield Primary Care Scholarship.
of access to quality health care and believes that this scholarship award partially addresses that concern,” said Mark White, president and chief executive officer of Arkansas Blue Cross. “If we consider the future and the additional Arkansans who will be receiving necessary care as a result of the Affordable Care Act, our investment is going to make an incremental difference as we seek solutions to improving the health status of all of our citizens.” Autumn 2014 BLUE & YOU
7 11
Game Day Fare FROM THE
Ron DeBerry douses David Bridges.
Whether you are preparing for the big game with a tailgate party at the stadium or a gathering around the television at home, you can make fun foods that are big on taste but still nutritious. Try these easy-to-prepare healthy recipes for game day, approved by our dietician and the executive chef at the Green Leaf Grill!
Yields: 16 kabobs • Serving: two skewers Directions: Thread ingredients evenly onto each skewer. Cover and chill Ingredients: 30 minutes or up to one day. Serve kabobs with fruit dip. - 1 (8-oz.) package cheddar cheese cubes Nutrition Information per serving: - 32 red grapes (2 skewers) 159 calories, 9.2 g. fat, 5 g. saturated fat, - 16 strawberries, halved 186 mg. sodium, 13.5 g. carbohydrate, 1.5 g. fiber, 7.7 g. protein - 32 pineapple cubes - 32 honeydew melon cubes
Cinnamon Yogurt Fruit Dip Ingredients: - 4 cups plain yogurt - 8 tablespoons honey - 2 teaspoons cinnamon - 2 teaspoons vanilla
Sandwich Wrap
Directions: Mix ingredients together and serve immediately. Store in the refrigerator up to three days. Nutrition Information per serving (1/2 cup): 137 calories, 0.2 g. fat, 0 g. saturated fat, 95 mg. sodium, 27 g. carbohydrate, 0.4 g. fiber, 7.1 g. protein
with
Garlic
and
Herb Cream Cheese Spread
Yields: 12 servings • Serving: one wrap with 2 tablespoons of herb cream cheese Ingredients: - 1 12 oz container of reduced-fat whipped cream cheese spread - 1 garlic clove, finely minced - 1/2 teaspoon Italian seasoning - 1/4 teaspoon onion powder - 1/2 teaspoon salt - 1 tablespoon finely chopped fresh chives, optional - 12 8-inch whole-wheat tortilla wraps - 1.5 pounds sliced deli turkey (or other desired deli meat) - Veggies of choice
Skinny Greek Yogurt Ranch Dip Yields: About 4 cups • ServES: 8
Directions: In a small bowl, combine garlic, Italian seasoning, onion powder and salt. Add cream cheese and gently fold in the seasoning. Be careful not to over mix or cream cheese will lose fluff. If using the chives, fold them in now. Cover and let chill in fridge for an hour. Stir before serving. Spread 2 tablespoons of cream cheese spread on each whole wheat tortilla followed by veggies of choice. Place 2 oz. of deli meat in each wrap. Wrap them like a burrito and cut in half. Nutrition Information per serving (1 WRAP): 250 calories, 9.1 g. fat, 4.8 g. saturated fat, 970 mg. sodium, 29 g. carbohydrate, 14.7 g. protein
Ingredients: - 4 tablespoons store-bought ranch seasoning mix - 4 cups fat-free plain Greek yogurt Directions: Whisk together ingredients in a small bowl until combined. Serve immediately with veggies. Store in refrigerator in an airtight container for up to three days.
10
Nutrition Information per serving (1/2 cup): 55 calories, 0.3 g. fat, 0 g. saturated fat, 98 mg. sodium, 3.5 g. carbohydrate, 0 g. fiber, 8.5 g. protein
BLUE & YOU Autumn 2014
Karen Raley gets her splash on.
ARKANSAS BLUE CROSS
Fruit and Cheese Kabobs with Cinnamon Yogurt Dip
Yields: 4 cups • Serving: ½ cup
Bridges and Carolyn Henry (right) freeze out Mark White.
The Green Leaf Grill is located on the first floor of the Arkansas Blue Cross and Blue Shield building at Sixth and Gaines in downtown Little Rock. The full-service restaurant is open to the general public for breakfast and lunch. Executive chef Jason Knapp and dietician Kristen Rowe focus on healthy foods that taste great.
The water was ice cold, the day was hot, but hearts were warm as Arkansas Blue Cross and Blue Shield raised $20,000 and doused three executives during the Ice Bucket Challenge for ALS (amyotrophic lateral sclerosis).
Tommy May (with check, above left), a member of the Arkansas Blue Cross board of directors, and Kip Jackson (with check, above right), of Sherwood (brother of employee Julie Nichols), who are both battling the debilitating disease.
Mark White, president and chief executive officer; David Bridges, executive vice president and chief administrative officer; and Karen Raley, vice president of Corporate Marketing, all accepted the icy dunking as employees cheered them on. The challenge was held in honor of
ALS (also known as Lou Gehrig’s disease) progressively kills nerve cells in the brain and spinal cord, causing the brain to lose the ability to initiate and control muscle movement. Patients in the later stages of the disease may become totally paralyzed.
UAMS medical students receive Arkansas Blue Cross and Blue Shield Primary Care Scholarships Medical students who want to work as primary care doctors in rural Arkansas aren’t as plentiful as those who want to work in the cities and suburbs. It’s a troubling trend. The Arkansas Blue Cross and Blue Shield Primary Care Scholarship, awarded each year to two students at the University of Arkansas for Medical Sciences (UAMS), not only helps deserving students, it helps hundreds of people in the communities where these future physicians will set up their medical practices. Seniors Andrew Briggler, from Hattieville, and Nathan Schandevel, from Paragould, are the recipients of the 2014 scholarship. They each will receive $20,000 toward their educations. They graduate in May 2015. The scholarships are possible through a $1 million endowment grant from Arkansas Blue Cross in partnership with UAMS. The first scholarships were given in 2012. “On behalf of our members, Arkansas Blue Cross and Blue Shield is focused on the issue
Nathan Schandevel (left) and Andrew Briggler are this year’s recipients of the 2014 Arkansas Blue Cross and Blue Shield Primary Care Scholarship.
of access to quality health care and believes that this scholarship award partially addresses that concern,” said Mark White, president and chief executive officer of Arkansas Blue Cross. “If we consider the future and the additional Arkansans who will be receiving necessary care as a result of the Affordable Care Act, our investment is going to make an incremental difference as we seek solutions to improving the health status of all of our citizens.” Autumn 2014 BLUE & YOU
7 11
PERSISTENCE PAYS OFF Janis struggled at first. But she stuck with it, kept going and really built up her endurance. She’s done a great job. – Sonya Vanlandingham, instructor
SilverSneakers lowers blood sugar, increases fun ®
Janis Creasey
That was Janis Creasey’s philosophy in 2012. Creasey had recently retired after a 40-year career that kept her tied to a desk, and in retirement she wanted to do something for herself — something for her health.
first, sometimes out of breath before class even started, walking from her parking spot to the room on the second floor of The Center at Bishop Park in Bryant, Ark. Progress was slow, but steady.
She joined a nearby SilverSneakers class after reading about the program in Blue & You magazine. Her class was close, convenient and free as a qualifying Arkansas Blue Cross and Blue Shield member. There was a catch, though. Creasey wasn’t sure she enjoyed exercise. After attending several classes, her husband asked if it was fun.
A few weeks into SilverSneakers, strange things started happening. Creasey’s stamina improved and the exercises became easier. The more she worked out, the healthier she felt. And the healthier she felt, the more energy she had in her everyday life outside of the gym. Creasey noticed something else, too — something completely unexpected. She was really starting to enjoy herself.
“I told him, ‘No it’s not fun. It’s not supposed to be fun,’ ” Creasey said. She struggled at
“It started becoming fun,” she said. “You leave feeling better and you like yourself better, too.”
BLUE & YOU Autumn 2014
There’s another health perk, too. A decade earlier, Creasey was diagnosed with type 2 diabetes. The exercise has helped her manage her condition. Since joining, her blood sugar has been in check, she said. And the time and energy spent exercising encourages her to eat better, too.
And her old philosophy that exercising isn’t meant to be fun? As a proud and vocal ambassador for SilverSneakers, Janis has done a 180-degree turn — and for good reason, too. “I didn’t think I was going to like it, but I love it,” Creasey said, with a smile. “This class has given me my life back.”
ABOUT SILVERSNEAKERS
SilverSneakers is the leading exercise program for older adults. It helps older Arkansans stay young by leading an active, healthy lifestyle. The best part is SilverSneakers is free for qualifying Arkansas Blue Cross and Blue Shield members. Benefits of regular exercise can include:
Exercise isn’t supposed to be fun. IT’S EXERCISE.
12
“This class is an investment in my future health. Hopefully, it will keep me healthy longer and give me a better quality of life,” Creasey said.
Now the 67-year-old from Alexander, Ark., is hooked. She’s a regular three days a week. She’s also 40 pounds lighter.
• Lose or maintain weight • More energy each day • Increased strength/stamina Sign up and use your membership to exercise at any participating fitness center. Call today at 1-888-423-4632 or visit online at silversneakers.com.
For more information on SilverSneakers, call 1-888-423-4632, or visit silversneakers.com. SilverSneakers® is a registered mark of Healthways, Inc. The SilverSneakers® Fitness Program is provided by Healthways, Inc., an independent company that operates separately from Arkansas Blue Cross and Blue Shield.
Autumn 2014 BLUE & YOU
13
PERSISTENCE PAYS OFF Janis struggled at first. But she stuck with it, kept going and really built up her endurance. She’s done a great job. – Sonya Vanlandingham, instructor
SilverSneakers lowers blood sugar, increases fun ®
Janis Creasey
That was Janis Creasey’s philosophy in 2012. Creasey had recently retired after a 40-year career that kept her tied to a desk, and in retirement she wanted to do something for herself — something for her health.
first, sometimes out of breath before class even started, walking from her parking spot to the room on the second floor of The Center at Bishop Park in Bryant, Ark. Progress was slow, but steady.
She joined a nearby SilverSneakers class after reading about the program in Blue & You magazine. Her class was close, convenient and free as a qualifying Arkansas Blue Cross and Blue Shield member. There was a catch, though. Creasey wasn’t sure she enjoyed exercise. After attending several classes, her husband asked if it was fun.
A few weeks into SilverSneakers, strange things started happening. Creasey’s stamina improved and the exercises became easier. The more she worked out, the healthier she felt. And the healthier she felt, the more energy she had in her everyday life outside of the gym. Creasey noticed something else, too — something completely unexpected. She was really starting to enjoy herself.
“I told him, ‘No it’s not fun. It’s not supposed to be fun,’ ” Creasey said. She struggled at
“It started becoming fun,” she said. “You leave feeling better and you like yourself better, too.”
BLUE & YOU Autumn 2014
There’s another health perk, too. A decade earlier, Creasey was diagnosed with type 2 diabetes. The exercise has helped her manage her condition. Since joining, her blood sugar has been in check, she said. And the time and energy spent exercising encourages her to eat better, too.
And her old philosophy that exercising isn’t meant to be fun? As a proud and vocal ambassador for SilverSneakers, Janis has done a 180-degree turn — and for good reason, too. “I didn’t think I was going to like it, but I love it,” Creasey said, with a smile. “This class has given me my life back.”
ABOUT SILVERSNEAKERS
SilverSneakers is the leading exercise program for older adults. It helps older Arkansans stay young by leading an active, healthy lifestyle. The best part is SilverSneakers is free for qualifying Arkansas Blue Cross and Blue Shield members. Benefits of regular exercise can include:
Exercise isn’t supposed to be fun. IT’S EXERCISE.
12
“This class is an investment in my future health. Hopefully, it will keep me healthy longer and give me a better quality of life,” Creasey said.
Now the 67-year-old from Alexander, Ark., is hooked. She’s a regular three days a week. She’s also 40 pounds lighter.
• Lose or maintain weight • More energy each day • Increased strength/stamina Sign up and use your membership to exercise at any participating fitness center. Call today at 1-888-423-4632 or visit online at silversneakers.com.
For more information on SilverSneakers, call 1-888-423-4632, or visit silversneakers.com. SilverSneakers® is a registered mark of Healthways, Inc. The SilverSneakers® Fitness Program is provided by Healthways, Inc., an independent company that operates separately from Arkansas Blue Cross and Blue Shield.
Autumn 2014 BLUE & YOU
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14
BLUE & YOU Autumn 2014
Autumn 2014 BLUE & YOU
15
14
BLUE & YOU Autumn 2014
Autumn 2014 BLUE & YOU
15
Be Seen on
Never cross in the middle of the street. Not only may drivers not see you, but you may not see the car!
If there’s no sidewalk to walk on, walk facing traffic and as far to the side of the road as possible.
Tips for drivers Slow down! The most popular time for trick or treating is from 5:30 to 9:30 p.m. There’s no doubt that goblins and vampires will cause delays, so go ahead and budget extra time into your drive. Also remove distractions from inside your car (cell phone, radio, etc.) and keep an eye out for children in the crosswalks and beyond.
Costume Tips • If possible, choose light colored costumes that reflect light. • Put reflective tape or stickers on costumes, or have children carry a flashlight or glow stick. • Select costumes that fit well. Costumes that are too long can cause tripping, making it that much harder for a driver to see a child. • Masks can obstruct a child’s view of traffic, so if possible, opt for face paint or have your child wear the mask on top of the head instead of the face.
Follow traffic signals and cross in the crosswalk or path where drivers expect to see you.
Children age 12 and under should be accompanied by an adult.
hether it’s Elsa, a cowgirl, Superman or Darth Vader—one thing kids probably haven’t considered this Halloween is pedestrian safety. With their eyes on the prize (often it’s delicious candy), they forget that being visible to cars should be their No. 1 priority. Here are some tips to help them stay safe so their worst case scenario of the night may only be a belly ache.
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BLUE & YOU Autumn 2014
The sidewalk is the safest place to be, so use it when it’s available.
Children are twice as likely to be hit by a car on Halloween than on any other day.
Autumn 2014 BLUE & YOU
17
Be Seen on
Never cross in the middle of the street. Not only may drivers not see you, but you may not see the car!
If there’s no sidewalk to walk on, walk facing traffic and as far to the side of the road as possible.
Tips for drivers Slow down! The most popular time for trick or treating is from 5:30 to 9:30 p.m. There’s no doubt that goblins and vampires will cause delays, so go ahead and budget extra time into your drive. Also remove distractions from inside your car (cell phone, radio, etc.) and keep an eye out for children in the crosswalks and beyond.
Costume Tips • If possible, choose light colored costumes that reflect light. • Put reflective tape or stickers on costumes, or have children carry a flashlight or glow stick. • Select costumes that fit well. Costumes that are too long can cause tripping, making it that much harder for a driver to see a child. • Masks can obstruct a child’s view of traffic, so if possible, opt for face paint or have your child wear the mask on top of the head instead of the face.
Follow traffic signals and cross in the crosswalk or path where drivers expect to see you.
Children age 12 and under should be accompanied by an adult.
hether it’s Elsa, a cowgirl, Superman or Darth Vader—one thing kids probably haven’t considered this Halloween is pedestrian safety. With their eyes on the prize (often it’s delicious candy), they forget that being visible to cars should be their No. 1 priority. Here are some tips to help them stay safe so their worst case scenario of the night may only be a belly ache.
16
BLUE & YOU Autumn 2014
The sidewalk is the safest place to be, so use it when it’s available.
Children are twice as likely to be hit by a car on Halloween than on any other day.
Autumn 2014 BLUE & YOU
17
Arkansas Blue Cross named one of the Best Places to Work in Arkansas Is Arkansas Blue Cross and Blue Shield a great place to work? Our employees think so! For the second time, Arkansas Blue Cross has been named by Arkansas Business and Best Companies Group as one of the Best Places to Work in Arkansas. The second annual award was designed to identify, recognize and honor the best employers in Arkansas, benefiting the state’s economy, workforce and businesses.
Arkansas Blue Cross is one of 12 companies in this year’s Best Places to Work in Arkansas. “Our employees are truly dedicated to the work they do and to our members, so we take great pride in providing them with a positive work environment,” said
Mark White, president and chief executive officer for Arkansas Blue Cross. “Having our employees rank us so favorably in the Best Places to Work survey is an honor and it tells us that they appreciate the programs we have put in place to encourage better health, to further their education and to cultivate our family atmosphere.” Arkansas Blue Cross offers employees tuition reimbursement, free onsite gyms, a cafeteria
focused on healthy foods and an employee health clinic. The average tenure at Arkansas Blue Cross is 10 years, and hundreds of employees have been with the company 15 years or longer. If you’d like to know more about career opportunities at Arkansas Blue Cross, visit our website, arkansasbluecross.com or like our Facebook page. We’d love to have you on the Blue Team!
New ArkansasBlue store opens in Hot Springs
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BLUE & YOU Autumn 2014
ArkansasBlue, Arkansas Blue Cross and Blue Shield’s health insurance store, opened in Hot Springs on September 8.
individuals and families and can answer any questions you may have about health and dental coverage.
The Hot Springs ArkansasBlue is located at 1635 Higdon Ferry Rd., Suite J, across the street from CHI St. Vincent. Our insurance representatives at the store sell health and dental insurance to
“Finding the right health insurance plan should be convenient for our customers,” said Karen Raley, vice president of Corporate Marketing for
Arkansas Blue Cross. “With the new health care law in effect, Arkansans have lots of choices and making the right decision can be confusing. Our staff at ArkansasBlue is prepared to help customers understand the new law and choose the most affordable health plan available.”
The Hot Springs ArkansasBlue is the third store operated by Arkansas Blue Cross. Other ArkansasBlue locations: • West Little Rock in the Shackleford Crossings Shopping Center • Pine Bluff, across the street from Walmart on Highway 63
Autumn 2014 BLUE & YOU
19
Arkansas Blue Cross named one of the Best Places to Work in Arkansas Is Arkansas Blue Cross and Blue Shield a great place to work? Our employees think so! For the second time, Arkansas Blue Cross has been named by Arkansas Business and Best Companies Group as one of the Best Places to Work in Arkansas. The second annual award was designed to identify, recognize and honor the best employers in Arkansas, benefiting the state’s economy, workforce and businesses.
Arkansas Blue Cross is one of 12 companies in this year’s Best Places to Work in Arkansas. “Our employees are truly dedicated to the work they do and to our members, so we take great pride in providing them with a positive work environment,” said
Mark White, president and chief executive officer for Arkansas Blue Cross. “Having our employees rank us so favorably in the Best Places to Work survey is an honor and it tells us that they appreciate the programs we have put in place to encourage better health, to further their education and to cultivate our family atmosphere.” Arkansas Blue Cross offers employees tuition reimbursement, free onsite gyms, a cafeteria
focused on healthy foods and an employee health clinic. The average tenure at Arkansas Blue Cross is 10 years, and hundreds of employees have been with the company 15 years or longer. If you’d like to know more about career opportunities at Arkansas Blue Cross, visit our website, arkansasbluecross.com or like our Facebook page. We’d love to have you on the Blue Team!
New ArkansasBlue store opens in Hot Springs
18
BLUE & YOU Autumn 2014
ArkansasBlue, Arkansas Blue Cross and Blue Shield’s health insurance store, opened in Hot Springs on September 8.
individuals and families and can answer any questions you may have about health and dental coverage.
The Hot Springs ArkansasBlue is located at 1635 Higdon Ferry Rd., Suite J, across the street from CHI St. Vincent. Our insurance representatives at the store sell health and dental insurance to
“Finding the right health insurance plan should be convenient for our customers,” said Karen Raley, vice president of Corporate Marketing for
Arkansas Blue Cross. “With the new health care law in effect, Arkansans have lots of choices and making the right decision can be confusing. Our staff at ArkansasBlue is prepared to help customers understand the new law and choose the most affordable health plan available.”
The Hot Springs ArkansasBlue is the third store operated by Arkansas Blue Cross. Other ArkansasBlue locations: • West Little Rock in the Shackleford Crossings Shopping Center • Pine Bluff, across the street from Walmart on Highway 63
Autumn 2014 BLUE & YOU
19
NEWS
New senior vice presidents announced Arkansas Blue Cross and Blue Shield is restructuring to meet the changing needs of the health care industry. Several employees have accepted new roles in the company, including Kathy Ryan and Curtis Barnett.
Summer Intern Program
Twenty college students joined the Blue Team for 10 weeks during the Arkansas Blue Cross and Blue Shield Summer Internship Program. The new internship program is a full-time, paid summer learning experience designed to provide meaningful work in a real-world environment. Interns participate in team-building activities; learn from professional coaching; receive hands on, relevant work experience; complete special projects and participate in an assigned community service project.
Fighting Hunger More than 100 Arkansas Blue Cross and Blue Shield employees volunteered their time on July 27 at the Statehouse Convention Center to pack meals for the Arkansas Hunger Alliance. The goal of the event was to pack 50,000 meals to be distributed to hunger agencies across the state.
kathy RYAN
Kathy Ryan has been promoted to senior vice president for Enterprise Information Systems and Technology. A native of Tallahassee, Fla., she received her bachelor’s degrees in biochemistry and math at Queens College in Charlotte, N.C. She joined Arkansas Blue Cross in 1982 as a senior programmer for Medicare Part B systems.
2014 Blue & You Fitness Challenge Winners Announced Groups from around Arkansas gathered at the Statehouse Convention Center in downtown Little Rock on June 30 for the closing ceremony of the 2014 Blue & You Fitness Challenge in which the winners of this year’s contest were announced.
Celebrating Arkansas Families In a celebration of families spending time together and enjoying healthy activities, Arkansas Blue Cross and Blue Shield sponsored a bronze sculpture entitled “Family” which now greets visitors to Two Rivers Park in Little Rock. The larger-than-life piece of art is the creation of Arkansas artist Kevin Kresse.
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BLUE & YOU Autumn 2014
curtis BARNETT
Curtis Barnett has been promoted to senior vice president of Enterprise Internal Operations. Curtis holds a bachelor’s degree from the University of Central Arkansas, a master’s degree from the University of Arkansas, and is a graduate of the Northwestern University Kellogg School of Management’s Advanced Executive Program. He joined Arkansas Blue Cross in 1993 as a Primary Care Network representative.
“Thousands of Americans decided to perfect their healthy self and boost their fitness routine in the Challenge this year,” said Richard Cooper, vice president of Human Resources for Arkansas Blue Cross and Blue Shield. “The 7,569 individuals participating in those groups logged 473,165 checkpoints during the contest.” A total of 151 groups representing large and small companies, banks, schools and universities, physician offices, churches, hospitals and state agencies participated in this year’s event.
2014 Winners Group Category 1 (Two Participants) – Shirley’s Praise Team, Alexander, AR Group Category 2 (Three Participants) – Arkansas Career Education, Little Rock, AR Group Category 3 (4-5 Participants) – Oregon Trail Blazers, Salem, OR Group Category 4 (6-7 Participants) – The Burnovators, Little Rock, AR Group Category 5 (8-10 Participants) – The Ten Wonders, Clinton, AR Group Category 6 (11-12 Participants) – SFLIC, Hot Springs, AR Group Category 7 (13-14 Participants) – Arkansas State Plant Board, Little Rock, AR Group Category 8 (15-17 Participants) – Arkansas Workers’ Compensation, Little Rock, AR Group Category 9 (18-22 Participants) – Johnson Dermatology, Fort Smith, AR Group Category 10 (23-33 Participants) – TDK-Lambda Americas SD, San Diego, CA Group Category 11 (34-64 Participants) – Central Arkansas Water, Little Rock, AR Group Category 12 (65-100 Participants) – Transportation Security Agency, Little Rock, AR Group Category 13 (101-299 Participants (TIE) – Bost, Inc., Fort Smith, AR and UAFS, Fort Smith, AR Group Category 14 (300+ Participants) – Simmons First National Corporation, Pine Bluff, AR
Autumn 2014 BLUE & YOU
21
NEWS
New senior vice presidents announced Arkansas Blue Cross and Blue Shield is restructuring to meet the changing needs of the health care industry. Several employees have accepted new roles in the company, including Kathy Ryan and Curtis Barnett.
Summer Intern Program
Twenty college students joined the Blue Team for 10 weeks during the Arkansas Blue Cross and Blue Shield Summer Internship Program. The new internship program is a full-time, paid summer learning experience designed to provide meaningful work in a real-world environment. Interns participate in team-building activities; learn from professional coaching; receive hands on, relevant work experience; complete special projects and participate in an assigned community service project.
Fighting Hunger More than 100 Arkansas Blue Cross and Blue Shield employees volunteered their time on July 27 at the Statehouse Convention Center to pack meals for the Arkansas Hunger Alliance. The goal of the event was to pack 50,000 meals to be distributed to hunger agencies across the state.
kathy RYAN
Kathy Ryan has been promoted to senior vice president for Enterprise Information Systems and Technology. A native of Tallahassee, Fla., she received her bachelor’s degrees in biochemistry and math at Queens College in Charlotte, N.C. She joined Arkansas Blue Cross in 1982 as a senior programmer for Medicare Part B systems.
2014 Blue & You Fitness Challenge Winners Announced Groups from around Arkansas gathered at the Statehouse Convention Center in downtown Little Rock on June 30 for the closing ceremony of the 2014 Blue & You Fitness Challenge in which the winners of this year’s contest were announced.
Celebrating Arkansas Families In a celebration of families spending time together and enjoying healthy activities, Arkansas Blue Cross and Blue Shield sponsored a bronze sculpture entitled “Family” which now greets visitors to Two Rivers Park in Little Rock. The larger-than-life piece of art is the creation of Arkansas artist Kevin Kresse.
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BLUE & YOU Autumn 2014
curtis BARNETT
Curtis Barnett has been promoted to senior vice president of Enterprise Internal Operations. Curtis holds a bachelor’s degree from the University of Central Arkansas, a master’s degree from the University of Arkansas, and is a graduate of the Northwestern University Kellogg School of Management’s Advanced Executive Program. He joined Arkansas Blue Cross in 1993 as a Primary Care Network representative.
“Thousands of Americans decided to perfect their healthy self and boost their fitness routine in the Challenge this year,” said Richard Cooper, vice president of Human Resources for Arkansas Blue Cross and Blue Shield. “The 7,569 individuals participating in those groups logged 473,165 checkpoints during the contest.” A total of 151 groups representing large and small companies, banks, schools and universities, physician offices, churches, hospitals and state agencies participated in this year’s event.
2014 Winners Group Category 1 (Two Participants) – Shirley’s Praise Team, Alexander, AR Group Category 2 (Three Participants) – Arkansas Career Education, Little Rock, AR Group Category 3 (4-5 Participants) – Oregon Trail Blazers, Salem, OR Group Category 4 (6-7 Participants) – The Burnovators, Little Rock, AR Group Category 5 (8-10 Participants) – The Ten Wonders, Clinton, AR Group Category 6 (11-12 Participants) – SFLIC, Hot Springs, AR Group Category 7 (13-14 Participants) – Arkansas State Plant Board, Little Rock, AR Group Category 8 (15-17 Participants) – Arkansas Workers’ Compensation, Little Rock, AR Group Category 9 (18-22 Participants) – Johnson Dermatology, Fort Smith, AR Group Category 10 (23-33 Participants) – TDK-Lambda Americas SD, San Diego, CA Group Category 11 (34-64 Participants) – Central Arkansas Water, Little Rock, AR Group Category 12 (65-100 Participants) – Transportation Security Agency, Little Rock, AR Group Category 13 (101-299 Participants (TIE) – Bost, Inc., Fort Smith, AR and UAFS, Fort Smith, AR Group Category 14 (300+ Participants) – Simmons First National Corporation, Pine Bluff, AR
Autumn 2014 BLUE & YOU
21
New and
Brand name
The following medications may be available soon (or now!) in generic form. Ask your pharmacist if there is a generic available for your prescription. Generic medications are the same as their brand-name counterparts in dosage form, safety, strength, route of administration, quality, performance characteristics and intended use. You can learn more about generics on the U.S. Food and Drug Administration’s website, fda.gov. Generic Release GENERIC USE
Actonel tabs (5, 30, 35mg) Copaxone Rapamune solution and tabs (1, 2mg) Viracept Renagel Argatroban Intuniv Naprelan Tazorac gel Namenda Protopic Teveten HCT Abilify ODT, tabs Oxytrol Relenza Welchol tabs & suspension Zyvox tabs, suspension, injection Nexium*
risedronate sodium glatiramer acetate sirolimus nelfinavir mesylate sevelamer argatroban guanfacine hydrochloride naproxen sodium tazarotene topical memantine tacrolimus topical eprosartan/hydrochlorothiazide aripiprazole oxybutynin zanamivir colesevelam linezolid esomeprazole magnesium
upcoming
generics
Strengthens bone Manages symptoms of multiple sclerosis Suppresses immune system Antiviral Lowers blood phosphate levels Blood thinner Treats attention deficit disorder Anti-inflammatory Treats facial acne Antidementia Treats eczema Manages high blood pressure Treats mental disorders Prevents bladder spasms Treats and prevents influenza Manages cholesterol Treats drug-resistant bacterial infections Reduces stomach acid
2014 2014 2014 2014 2014 2014 2014 2014 2014 2015 2015 2015 2015 2015 2015 2015 2015 2014-2015
*FDA approval of a generic medication does not mean it will be covered by your insurance plan. Call us if you have questions.
Annual Notice As required by the Patient Protection and Affordable Care Act (PPACA), the Summary of Benefits and Coverage (SBC) (OMB Control Numbers 15452229, 1210-0147 and 0938-1146) provides information regarding coverage specifications and limitations that apply to the health insurance plan you have selected. Before the end of each year, Arkansas Blue Cross and Blue Shield provides members who are under age 65 and have individual/family health insurance policies* with an SBC. This official communication includes information about the coverage provided by your health insurance plan in a summary format for the
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BLUE & YOU Autumn 2014
2015 Summary of Benefits and Coverage – available November 15 for individual/family policyholders upcoming year. Beginning November 15, 2014, you may access this information: • Online in the “Benefits” section of the Arkansas Blue Cross secure member selfservice center, My Blueprint, at arkansasbluecross.com • By calling Arkansas Blue Cross Customer Service at 1-800-238-8379 to receive a printed version After that date, you also may log on to arkansasbluecross. com/sbc and enter your member number (found on your member ID card) into the SBC locator tool to review the document online and print it.
If you make changes to your Arkansas Blue Cross health plan benefits that differ from your current coverage, a new SBC will be created for you within seven work days of our receipt of your change request. It will be available to you in the same manner described above. *These are members who do not have health insurance through an employer, a Medicare health plan, or short-term Blue product.
Arkansas Blue Cross, Health Advantage and BlueAdvantage Administrators of Arkansas members who receive health coverage through an employer group will get their SBC from their employer group plan administrator at the appropriate time.
Women’s Health and Cancer Rights Act The Women’s Health and Cancer Rights Act of 1998 introduced changes in insurance coverage for mastectomy. In accordance with the law, all group and individual health plans that provide medical and surgical benefits for mastectomy will cover reconstructive breast surgery, including: • Reconstructive surgery on the breast on which the mastectomy was performed. • Reconstructive surgery on the unaffected breast needed to “produce a symmetrical appearance.” • Prostheses and treatment of complications of any stage of a mastectomy, including lymphedema (post-surgical fluid buildup). These provisions apply to all policies issued by Arkansas Blue Cross and Blue Shield, Health Advantage and BlueAdvantage Administrators of Arkansas and are subject to the applicable copayments, coinsurance, benefit limitations, exclusions and benefit maximums. If you have questions about your insurance coverage, contact your group benefits administrator or a customer service representative at your local Arkansas Blue Cross office.
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
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
• ArkansasBlue
— Hot Springs 1635 Higdon Ferry Rd. – Suite J
• 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
Autumn 2014 BLUE & YOU
23
New and
Brand name
The following medications may be available soon (or now!) in generic form. Ask your pharmacist if there is a generic available for your prescription. Generic medications are the same as their brand-name counterparts in dosage form, safety, strength, route of administration, quality, performance characteristics and intended use. You can learn more about generics on the U.S. Food and Drug Administration’s website, fda.gov. Generic Release GENERIC USE
Actonel tabs (5, 30, 35mg) Copaxone Rapamune solution and tabs (1, 2mg) Viracept Renagel Argatroban Intuniv Naprelan Tazorac gel Namenda Protopic Teveten HCT Abilify ODT, tabs Oxytrol Relenza Welchol tabs & suspension Zyvox tabs, suspension, injection Nexium*
risedronate sodium glatiramer acetate sirolimus nelfinavir mesylate sevelamer argatroban guanfacine hydrochloride naproxen sodium tazarotene topical memantine tacrolimus topical eprosartan/hydrochlorothiazide aripiprazole oxybutynin zanamivir colesevelam linezolid esomeprazole magnesium
upcoming
generics
Strengthens bone Manages symptoms of multiple sclerosis Suppresses immune system Antiviral Lowers blood phosphate levels Blood thinner Treats attention deficit disorder Anti-inflammatory Treats facial acne Antidementia Treats eczema Manages high blood pressure Treats mental disorders Prevents bladder spasms Treats and prevents influenza Manages cholesterol Treats drug-resistant bacterial infections Reduces stomach acid
2014 2014 2014 2014 2014 2014 2014 2014 2014 2015 2015 2015 2015 2015 2015 2015 2015 2014-2015
*FDA approval of a generic medication does not mean it will be covered by your insurance plan. Call us if you have questions.
Annual Notice As required by the Patient Protection and Affordable Care Act (PPACA), the Summary of Benefits and Coverage (SBC) (OMB Control Numbers 15452229, 1210-0147 and 0938-1146) provides information regarding coverage specifications and limitations that apply to the health insurance plan you have selected. Before the end of each year, Arkansas Blue Cross and Blue Shield provides members who are under age 65 and have individual/family health insurance policies* with an SBC. This official communication includes information about the coverage provided by your health insurance plan in a summary format for the
22
BLUE & YOU Autumn 2014
2015 Summary of Benefits and Coverage – available November 15 for individual/family policyholders upcoming year. Beginning November 15, 2014, you may access this information: • Online in the “Benefits” section of the Arkansas Blue Cross secure member selfservice center, My Blueprint, at arkansasbluecross.com • By calling Arkansas Blue Cross Customer Service at 1-800-238-8379 to receive a printed version After that date, you also may log on to arkansasbluecross. com/sbc and enter your member number (found on your member ID card) into the SBC locator tool to review the document online and print it.
If you make changes to your Arkansas Blue Cross health plan benefits that differ from your current coverage, a new SBC will be created for you within seven work days of our receipt of your change request. It will be available to you in the same manner described above. *These are members who do not have health insurance through an employer, a Medicare health plan, or short-term Blue product.
Arkansas Blue Cross, Health Advantage and BlueAdvantage Administrators of Arkansas members who receive health coverage through an employer group will get their SBC from their employer group plan administrator at the appropriate time.
Women’s Health and Cancer Rights Act The Women’s Health and Cancer Rights Act of 1998 introduced changes in insurance coverage for mastectomy. In accordance with the law, all group and individual health plans that provide medical and surgical benefits for mastectomy will cover reconstructive breast surgery, including: • Reconstructive surgery on the breast on which the mastectomy was performed. • Reconstructive surgery on the unaffected breast needed to “produce a symmetrical appearance.” • Prostheses and treatment of complications of any stage of a mastectomy, including lymphedema (post-surgical fluid buildup). These provisions apply to all policies issued by Arkansas Blue Cross and Blue Shield, Health Advantage and BlueAdvantage Administrators of Arkansas and are subject to the applicable copayments, coinsurance, benefit limitations, exclusions and benefit maximums. If you have questions about your insurance coverage, contact your group benefits administrator or a customer service representative at your local Arkansas Blue Cross office.
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
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
• ArkansasBlue
— Hot Springs 1635 Higdon Ferry Rd. – Suite J
• 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
Autumn 2014 BLUE & YOU
23
Autumn 2014 A publication for the policyholders of the Arkansas Blue Cross and Blue Shield family of companies
page
8
Boo with
Blue!
Boo with Blue, a Halloween party at the Museum of Discovery hosted by Arkansas Blue Cross and Blue Shield, will scare up some spooky fun from 6 to 9 p.m., Friday, October 10. Join us for a “Move More� dance party, museum exploration, giveaways and prizes for the best costumes. Arkansas Blue Cross members get in FREE and non-members can stop by any ArkansasBlue location in Little Rock, Pine Bluff or Hot Springs (see page 23) to pick up free tickets.
MPI 2871 10/14
Medicare Annual Election Period
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