wlhankins@arkbluecross.com by Arkansas Blue Cross and Blue Shield

Autumn 2015 A publication for the policyholders of the Arkansas Blue Cross and Blue Shield family of companies

Catch FREE TICKETS to

“ The Gingerbread Man!” 4 p.m. Sunday, December 6

page

at the

Arkansas Arts Center’s Children’s Theatre in Little Rock. You can get free tickets starting November 1 at all ArkansasBlue stores. Hurry! Quantities are limited. MPI 4050 10/15

Enrollment information

Arkansas Blue Cross honored by American Red Cross

Bullying prevention

pages

page

4-5

A true Arkansas solution 3

- Out of the Blue

- Medicare enrollment is here

- Important information for members with individual or family policies

As members of the Arkansas Legislature consider the future of healthcare in our state, Arkansas Blue Cross and Blue Shield wants to build on the progress we’ve already made and work together to ensure a system that’s by and for Arkansans. To keep Arkansas moving in a stronger, healthier direction, we recommend that we, as a state:

- Internet safety reminder

- The ABCs of 1095 tax forms

- New and upcoming generics

- Shop, enroll, pay: Insurance just got easier

- My Application Tracker gets a new look

- UAMS medical students receive Arkansas Blue Cross and Blue Shield Primary Care Scholarships

- Your search is now simpler

- Interprofessional education team gets national recognition

- Living Fearlessly: Arkansas Blue Cross employees honored by American Red Cross

- Raising funds and awareness to “eLEMONate” cystic fibrosis

- Arkansas Blue Cross awards grant to establish nursing professorship at University of Arkansas at Pine Bluff

- You asked ... we responded

- Arkansas Blue Cross named one of the Best Places to Work in Arkansas

- Why are we encouraging our members to have primary care physicians?

- New ArkansasBlue opens in Red Wolves territory!

- Bullying prevention

- Annual notice

- Packing healthy school lunches

- Women’s health and cancer rights act - Customer service numbers

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 DIRECTOR of CORPORATE MARKETING: Kelly Whitehorn

BLUE & YOU Autumn 2015

Arkansas’ healthcare delivery system should provide cost effective, high-quality care to all residents, regardless of the source of payment for that care. Traditionally funded Medicaid fee-forservice payments artificially suppress the cost of care for one population while driving higher prices for others. A collaborative approach to engaging the healthcare delivery system to effectively manage care and costs is critical to the long-term viability of the state’s healthcare system, particularly in rural areas. By paying market established rates to doctors and hospitals, Arkansas’ response to Medicaid expansion has opened up access to care across the state, while coming in below Medicaid budget guidelines. Moving forward, we need to build on this program—as well as the value-based innovations we have achieved across the healthcare system as a whole— as we also implement more actively managed care strategies for individuals with complex health needs.

- Catch free tickets to “The Gingerbread Man”

Autumn 2015

on the cover

Adopt a holistic view of the healthcare system that makes care more affordable for everyone.

Nine-year-old Aven Emery set up her lemonade stand on the steps of the Arkansas Capitol building to help “eLEMONate” cystic fibrosis. See page 12 for more.

Give healthcare consumers the support they need to use their care wisely. More than 60% of patients say they have no idea about the cost of their care until they receive a bill.1 We need to give people the support that will help them understand (and become invested in) the cost implications of their healthcare choices. Having access to care is one thing, knowing how to

use that care is something much more significant. Comprehensive healthcare literacy education and the one-on-one support of local healthcare navigators who can help individuals choose care wisely and direct individuals to community resources should be a requirement for all health plans charged with caring for the current Private Option population.

Create incentives for greater personal responsibility. In a country where 84% of all healthcare spending is on those with one or more chronic medical conditions 2, it’s clear that we need to focus on the kinds of care and support that address the lifestyle risks and behaviors that lead to chronic illness. The newly insured present a unique opportunity to tackle the root causes of poor health through member-centered support and education. By building appropriate incentives into the program around preventive care and wellness, such as requirements to complete a health risk assessment, select a primary care doctor and complete an annual physical, we can reinforce personal responsibility and move a long way towards improving Arkansas’ overall health ranking.

1. Institute of Medicine, September 2012 2. Robert Wood Johnson Foundation. Chronic Care: Making the Case for Ongoing Care. Princeton, NJ: Robert Wood Johnson Foundation; 2010:16

“OUT OF THE BLUE”

CONTINUED ON PAGE 26

Autumn 2015 BLUE & YOU

A true Arkansas solution 3

- Out of the Blue

- Medicare enrollment is here

- Important information for members with individual or family policies

- Internet safety reminder

- The ABCs of 1095 tax forms

- New and upcoming generics

- Shop, enroll, pay: Insurance just got easier

- My Application Tracker gets a new look

- UAMS medical students receive Arkansas Blue Cross and Blue Shield Primary Care Scholarships

- Your search is now simpler

- Interprofessional education team gets national recognition

- Living Fearlessly: Arkansas Blue Cross employees honored by American Red Cross

- Raising funds and awareness to “eLEMONate” cystic fibrosis

- Arkansas Blue Cross awards grant to establish nursing professorship at University of Arkansas at Pine Bluff

- You asked ... we responded

- Arkansas Blue Cross named one of the Best Places to Work in Arkansas

- Why are we encouraging our members to have primary care physicians?

- New ArkansasBlue opens in Red Wolves territory!

- Bullying prevention

- Annual notice

- Packing healthy school lunches

- Women’s health and cancer rights act - Customer service numbers

BLUE & YOU Autumn 2015

- Catch free tickets to “The Gingerbread Man”

Autumn 2015

on the cover

Adopt a holistic view of the healthcare system that makes care more affordable for everyone.

Nine-year-old Aven Emery set up her lemonade stand on the steps of the Arkansas Capitol building to help “eLEMONate” cystic fibrosis. See page 12 for more.

1. Institute of Medicine, September 2012 2. Robert Wood Johnson Foundation. Chronic Care: Making the Case for Ongoing Care. Princeton, NJ: Robert Wood Johnson Foundation; 2010:16

“OUT OF THE BLUE”

CONTINUED ON PAGE 26

Autumn 2015 BLUE & YOU

IMPORTANT INFORMATION

MEDICARE Annual Election Period

For members with individual or family policies

October 15 through December 7

Selecting a health insurance plan is one of the most important decisions you can make to protect you and your family, so it is important to make the best choice.

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, 2016.

Your open enrollment period (OEP) begins November 1 and ends January 31*. 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 1, 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 after November 1 for more information. *For policies purchased before April 1, 2010, OEP is October 1 through December 15.

Affordable coverage and peace of mind Arkansas Blue Cross and Blue Shield’s Medicare products continue to offer members low monthly premiums. In 2016, choose from:

MEDICARE ADVANTAGE PLANS

FEATURING:

MEDICARE PRESCRIPTION DRUG PLANS

FEATURING:

MEDICARE SUPPLEMENT 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

• Competitively priced monthly premiums • Convenient home delivery with our mail-order program

• Affordable monthly premiums • Coverage for all conditions from day one, upon acceptance

Attention Medicare Advantage and Medicare Part D plan members

If you would like to learn more about our Medicare plans...

If you have a Medicare Advantage or Medicare Part D plan, this fall 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.

Call your local Medi-Pak® Choice licensed agent or 1-844-298-2444 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!

BLUE & YOU Autumn 2015

INTERNET SAFETY

REMINDER Shopping and managing personal accounts online is so simple and convenient that it’s easy to forget about the dangers of being hacked. Here are five tips when using the Internet to make sure your data stays protected:

Keep your computer’s anti-virus and anti-spyware up to date

Keep all of your passwords secure

Don’t click on links or open attachments from people you don’t recognize

Check a site for an indication that it’s secure, including a small lock icon on your web browser’s status bar or a web address that begins with “https” (the “s” stands for “secure”)

Call your bank, service provider or the institution to verify any information requests or if you have any questions

Autumn 2015 BLUE & YOU

IMPORTANT INFORMATION

MEDICARE Annual Election Period

For members with individual or family policies

October 15 through December 7

Selecting a health insurance plan is one of the most important decisions you can make to protect you and your family, so it is important to make the best choice.

Affordable coverage and peace of mind Arkansas Blue Cross and Blue Shield’s Medicare products continue to offer members low monthly premiums. In 2016, choose from:

MEDICARE ADVANTAGE PLANS

FEATURING:

MEDICARE PRESCRIPTION DRUG PLANS

FEATURING:

MEDICARE SUPPLEMENT PLANS

FEATURING:

• Competitively priced monthly premiums • Convenient home delivery with our mail-order program

• Affordable monthly premiums • Coverage for all conditions from day one, upon acceptance

Attention Medicare Advantage and Medicare Part D plan members

If you would like to learn more about our Medicare plans...

BLUE & YOU Autumn 2015

INTERNET SAFETY

Keep your computer’s anti-virus and anti-spyware up to date

Keep all of your passwords secure

Don’t click on links or open attachments from people you don’t recognize

Check a site for an indication that it’s secure, including a small lock icon on your web browser’s status bar or a web address that begins with “https” (the “s” stands for “secure”)

Call your bank, service provider or the institution to verify any information requests or if you have any questions

Autumn 2015 BLUE & YOU

ABCs TAX FORMS of

The

1095

In 2016, everyone who files a 2015 federal income tax return also will need to include at least one 1095 tax form. A 1095 tax form provides basic information about your health insurance and is proof that you had healthcare coverage. You may receive a 1095 A, B or C tax form from either the federal government, state of Arkansas, your health insurance provider or your employer. You also may receive more than one 1095 tax form if you had more than one form of healthcare coverage during the year.

1095-A

1095-B or

1095-C

If you purchased healthcare coverage through healthcare.gov and received financial assistance through an advanced premium tax credit (subsidy) to help lower the cost of your monthly health insurance premium, you should receive a 1095-A tax form from the federal government. If you received healthcare coverage through the Private Option, you should receive a 1095-A tax form from the state of Arkansas. If you purchased your health plan directly from Arkansas Blue Cross and Blue Shield, you should receive a 1095-B tax form. If you have healthcare coverage through an employer, you may receive a 1095-B or 1095-C tax form from either Arkansas Blue Cross, Health Advantage, USAble Mutual or your employer.

Exclusions

Some of our members won’t receive a 1095 tax form from us. If you have coverage such as a short-term plan, that doesn’t meet the government requirements to be a qualified health plan, you won’t receive a 1095. If you aren’t sure if you should receive a 1095 from us. you can call the Customer Service number associated with your health plan on page 27.

What you should know

• If you receive more than one form, they should show – collectively – for which months you had coverage.

• That the information on the form(s) is accurate. If you don’t agree with the information, you can contact the entity that issued it to you (federal government, state of Arkansas, Arkansas Blue Cross or your employer) to discuss it. If Arkansas Blue Cross provides you with a 1095-B, you will be able to print additional copies from My Blueprint, our member self-service website. It’s one more reason to register for My Blueprint!

Your tax preparer should be able to answer any questions you have regarding your healthcare coverage and taxes. Arkansas Blue Cross does not provide tax advice.

BLUE & YOU Autumn 2015

Life gets busy – we understand – so we’ve been working to make it a little easier. Beginning in December, if you purchase healthcare coverage directly from Arkansas Blue Cross and Blue Shield or through healthcare.gov, you will be able to set up automatic payments through your account in our secure member website, My Blueprint, at arkansasbluecross.com. If you are considering purchasing healthcare coverage from us for the first time during this year’s open enrollment, you will be able to shop, enroll and pay for the first month of your insurance coverage in one easy transaction. After you pay your first month’s premium, you will have the option of setting up automatic payments for your health or dental insurance coverage. If you prefer to set up automatic payments later, or if you want to change how you are paying — maybe from a checking account to a credit card — you can do that, too.

OPEN ENROLLMENT BEGINS

November 1

It will all be available beginning in December.

for Individual and Family plan members

We also offer several other options, including paying in person with a monthly bill. See your options below and choose what’s best for you!

Payment Options Auto Pay New Members Online or Mobile By phone

The type of 1095 tax form you receive is not that important. What is important: • If you don’t receive a 1095 tax form. If you don’t receive at least one form by early February, you should contact the entity that should have issued it to you (federal government, state or Arkansas, Arkansas Blue Cross or your employer).

Insurance just got easier

By mail

In person

Set up autopayments online at arkansasbluecross.com (beginning in December). Pay your first premium when you complete your application online at arkansasbluecross.com. Go to arkansasbluecross.com/paybill or log in to the secure member website, My Blueprint, from our home page 1-800-354-9904 Members with metallic medical plans (Gold, Silver, Bronze, Catastrophic):

All other members (including dental and non-metallic medical plans):

Enterprise Exchange Services P.O. Box 34320 Little Rock, AR 72203-4320

Arkansas Blue Cross and Blue Shield Attn: Cashiers (Drafts) P.O. Box 3590 Little Rock, AR 72203-432

Stop by one of the 250 convenient Moneygram locations, found at moneygram.com, or visit one of our offices in locations throughout the state (see page 27 for locations). For more information on your payment options, visit arkansasbluecross.com/paybill

Autumn 2015 BLUE & YOU

ABCs TAX FORMS of

The

1095

1095-A

1095-B or

1095-C

Exclusions

What you should know

• If you receive more than one form, they should show – collectively – for which months you had coverage.

Your tax preparer should be able to answer any questions you have regarding your healthcare coverage and taxes. Arkansas Blue Cross does not provide tax advice.

BLUE & YOU Autumn 2015

OPEN ENROLLMENT BEGINS

November 1

It will all be available beginning in December.

for Individual and Family plan members

We also offer several other options, including paying in person with a monthly bill. See your options below and choose what’s best for you!

Payment Options Auto Pay New Members Online or Mobile By phone

Insurance just got easier

By mail

In person

All other members (including dental and non-metallic medical plans):

Enterprise Exchange Services P.O. Box 34320 Little Rock, AR 72203-4320

Arkansas Blue Cross and Blue Shield Attn: Cashiers (Drafts) P.O. Box 3590 Little Rock, AR 72203-432

Autumn 2015 BLUE & YOU

Y O U R

WILL SOON BE

~ Hola! Habla espanol? ~ de El directorio proveedores en epanol estara disponible en Noviembre.

SIMPLER

APPLICATIONTRACKER

gets a new look

If you enroll online with Arkansas Blue Cross and Blue Shield this year, you’ll be using the redesigned My Application Tracker tool. My Application Tracker is a seamless part of the healthcare coverage shopping experience. It creates a personal, password-protected account when you submit your medical coverage application. You can log in later to:

Check the status of your application See if we need any additional documentation from you Sign up for email updates

eginning in November, our online list of in-network doctors and hospitals, or provider directory, will be updated to make finding care easier. The update looks a little like Google, with just one search bar. In it you can enter a doctor or clinic name, specialty, or a medical condition you’re experiencing, and receive a list of healthcare professionals who can treat you.

OTHER UPDATES INCLUDE: More filters to narrow your search and find exactly what you need

Added quality star ratings to compare doctors

Now accessible across devices, including your smartphone

We tested the new directory with members. They found it to be easier to use — we think you will, too!

Shop for additional coverage

To access My Application Tracker after you’ve submitted an application, go to arkansasbluecross.com and select “Applicant” under “Log in.”

BLUE & YOU Autumn 2015

Autumn 2015 BLUE & YOU

Y O U R

WILL SOON BE

~ Hola! Habla espanol? ~ de El directorio proveedores en epanol estara disponible en Noviembre.

SIMPLER

APPLICATIONTRACKER

gets a new look

Check the status of your application See if we need any additional documentation from you Sign up for email updates

OTHER UPDATES INCLUDE: More filters to narrow your search and find exactly what you need

Added quality star ratings to compare doctors

Now accessible across devices, including your smartphone

We tested the new directory with members. They found it to be easier to use — we think you will, too!

Shop for additional coverage

To access My Application Tracker after you’ve submitted an application, go to arkansasbluecross.com and select “Applicant” under “Log in.”

BLUE & YOU Autumn 2015

Autumn 2015 BLUE & YOU

In 2014 alone:

Kirstie Kelly, chairperson for the Arkansas Blue Cross Employees’ Committee accepts the American Red Cross 2015 Clara Barton Distinguished Humanitarian of the Year Award on behalf of all employees.

Arkansas Blue Cross employees honored by American Red Cross

rom cleaning up the devastation left behind by tornadoes, to giving of their own blood, Arkansas Blue Cross and Blue Shield employees have long been involved in helping their fellow Arkansans through the American Red Cross. This year, for the first time ever, the 13th American Red Cross Clara Barton Distinguished Humanitarian of the Year award went … not to one person … but to the employees of Arkansas Blue Cross. Because Blue cares.

“The enthusiasm of the employees of Arkansas Blue Cross to support the mission of the Red Cross continues to be impressive. From generous financial support from the Blue & You Foundation to expand our health and safety training infrastructure, to Arkansas Blue Cross employee and corporate support of Red Cross responses across the state, as well as national and international responses, their response has been humbling.”

The award was presented at the annual Arkansas Heroes Celebration luncheon. Candace A. Carey, American Red Cross of Greater Arkansas executive director, shared with attendees the reasons why the actions of the employees at Arkansas Blue Cross warranted the award.

Carey added, “During the response to last year’s EF-4 tornado, Arkansas Blue Cross employees, many of whom were personally impacted by the tornado, performed a variety of roles with the Red Cross from financial donors, to telethon participants, to Red Cross representatives in the community. Arkansas Blue Cross employees are always ready to take an active role in support of the Red Cross.”

‘‘

• Arkansas Blue Cross employees raised a total of $57,000 for 25 charitable organizations through $2 casual days; $23,248 of that amount was raised for the American Red Cross’ disaster relief. • More than 300 employees donated approximately 3,743 hours of their time to directly impact more than 136,233 Arkansans. • More than 60 employees joined with others to pack thousands of boxes for the Arkansas Hunger Alliance in 2014. • More than 700 employees signed up for Arkansas Blue Cross and Blue Shield teams to walk, run or bike to raise money and awareness for charitable organizations around the state. Arkansas Governor Asa Hutchinson, a former American Red Cross Humanitarian of the Year honoree, makes opening remarks at the American Red Cross award luncheon held at the Little Rock Marriott on May 27.

“Arkansas Blue Cross is honored for our employees to be named recipients of the Clara Barton Distinguished Humanitarian of the Year Award by the American Red Cross,” Mark White, president and chief executive officer of Arkansas Blue Cross, said during the presentation. “What a testament to the selfless acts of kindness they perform, the hours of volunteer time they give, the money they donate personally and the spirit in which they serve others every day. “It is my privilege to work beside them and watch them in action outside the workplace serving their fellow Arkansans. Our employees prove daily that together, we can accomplish much. And help our neighbors live a little more. Kirstie Kelly, chairperson for the Arkansas Blue Cross Employees’ Committee, said, “Our employees are the first to raise their hands to volunteer and then use their hands to pick up debris following a natural disaster like the tornadoes in Vilonia and Mayflower last year. They are the first to dig deep into their own pockets to contribute to a cause that will mean a child or a senior will have shelter or a healthy dinner tonight. They are the first to roll up their sleeves and donate blood so that an accident victim or a cancer patient will get a second chance.” Because Blue cares.

Our employees prove daily that together, we can accomplish much. And help our neighbors live a little more fearlessly.

‘‘

– Mark White, president and CEO of Arkansas Blue Cross 10

BLUE & YOU Autumn 2015

In 2014 alone:

Kirstie Kelly, chairperson for the Arkansas Blue Cross Employees’ Committee accepts the American Red Cross 2015 Clara Barton Distinguished Humanitarian of the Year Award on behalf of all employees.

Arkansas Blue Cross employees honored by American Red Cross

‘‘

Our employees prove daily that together, we can accomplish much. And help our neighbors live a little more fearlessly.

‘‘

– Mark White, president and CEO of Arkansas Blue Cross 10

BLUE & YOU Autumn 2015

Raising funds

awareness to “eLEMONate” cystic fibrosis and

Aven Emery dreams of a day when she won’t have to wear a loud vest that shakes her lungs three times a day; when she can go play with other children without fear of getting sick; and when a cure is found for cystic fibrosis, the illness that has controlled her life since she was a tiny infant. All those dreams are still a long way off, but with the help of Arkansas Blue Cross and Blue Shield, one dream became a reality — to set up a lemonade stand to raise funds and awareness for the Cystic Fibrosis Foundation. Through Aven’s Lemonade Stand, set up on the steps of the Arkansas State Capitol, Arkansas Blue Cross raised more than $8,000 to help find a cure for children like Aven. Aven, 9, is one of an estimated 30,000 people in the United States (and 70,000 worldwide) living with cystic fibrosis (CF). In people with CF, a defective gene causes thick

mucus in the lungs, pancreas and other organs. In the lungs, the mucus clogs airways and traps bacteria, leading to infections and damage. In the pancreas, the mucus prevents the release of digestive enzymes that allow the body to break down food and absorb vital nutrients. “It would make me so happy if we had a cure for cystic fibrosis so I wouldn’t have to wear this vest every day,” Aven said of her daily treatment. She must wear the shake vest 40 hours a month and take more than 12,000 pills a year, mostly pancreatic enzymes. Only about 300 people in Arkansas have CF, but surprisingly, the disease has touched the lives of six employees at Arkansas Blue Cross. Curtis Barnett, senior vice president of Arkansas Blue Cross, became a CF champion after working closely with Brittany Emery, and by getting to know her daughter, Aven.

“Our employees are like family to us, so we were proud to get the chance to work with the CF Foundation to raise public awareness and funds. During the time that I’ve become involved with CF, I’ve been overwhelmed by the kindness and caring of the CF community, their passion for finding a cure, and how CF patients are living their lives to the fullest despite the challenges they face. CF patients and their families truly are an inspiration.

His older sister, Presley Harwood, 20, is married with a young daughter, and while she tries hard to live a normal life, she battles not only with her CF, but with diabetes caused by the illness.

Presley Harwood

“Because CF does not qualify for federal funding, bringing attention to this disease is critical to raising funds from private sources so we can find a cure. I’m proud to be part of the fight to eliminate CF, and I’m especially proud to be chosen as the Breath of Life Honoree for the Cystic Fibrosis Foundation of Arkansas gala.” Trish Jenkins, another Arkansas Blue Cross employee, has two children with CF, Dylan and Presley. “I really appreciate all that Arkansas Blue Cross is doing. Obviously a cure would be very important for me as it would let my children lead longer and healthier lives.” For Dylan, 17, a cure would mean going to public school and hanging out more with his friends. He said other kids didn’t understand his illness and he was often bullied. “People with CF, they don’t look sick. It’s all on the inside,” he said.

“When they find a cure … that would be the highlight of my life because I would be able to do activities with my daughter that I can’t do now. I could get a pedicure for once, or a manicure, go to a waterpark or a playground and not worry about getting terribly sick,” Presley said. Arkansas Blue Cross employee Jeisse Castillo, and his wife Misty, recently found out their son, Alexander, has CF.

Dylan Jenkins

Jeisse, Alexander and Misty Castillo

Aven Emery

“My wife called me when she took him to his first pediatric appointment. I was at work and she told me that our son had a deadly disease called cystic fibrosis. That was something I had never heard of in my life.” He said at first they were frightened by what they read about the disease on the Internet, but the website for the Cystic Fibrosis Foundation, CFF.org, provided them information that gave them hope. They also were immediately embraced by co-workers at Arkansas Blue Cross. “I’ve never worked for a place that is more than willing to help us with something as big as this, and now more than ever I think that their help is amazing,” Jeisse said. “It really is amazing.”

Governor Asa Hutchinson, center, declares August 26, 2015, Cystic Fibrosis Awareness Day.

BLUE & YOU Autumn 2015

Autumn 2015 BLUE & YOU

Raising funds

awareness to “eLEMONate” cystic fibrosis and

His older sister, Presley Harwood, 20, is married with a young daughter, and while she tries hard to live a normal life, she battles not only with her CF, but with diabetes caused by the illness.

Presley Harwood

Dylan Jenkins

Jeisse, Alexander and Misty Castillo

Aven Emery

Governor Asa Hutchinson, center, declares August 26, 2015, Cystic Fibrosis Awareness Day.

BLUE & YOU Autumn 2015

Autumn 2015 BLUE & YOU

You asked ... we responded Member feedback leads to coverage changes for breast pumps Social media has allowed Arkansas Blue Cross and Blue Shield to share information on upcoming events, job opportunities and even funny videos, but the best use for it has been getting feedback from our members.

“When we say at Arkansas Blue Cross that we love to hear from you, we really do,” said Karen Raley, vice president of Corporate Marketing. “While we review our policies on a regular basis, your feedback is helpful in determining if we are meeting your needs. We are pleased with the changes in the breast pump policy and benefits that have been implemented this year.”

‘‘

When we say at Arkansas Blue Cross that we love to hear from you, we really do.

‘‘

When several members asked on our Facebook page and Twitter account why electric breast pumps were not covered for mothers of new infants, our social media team went to work seeking answers for them. That led to several discussions and, ultimately, to a change in the policy.

– Karen Raley,

vice president of Corporate Marketing

All fully insured Arkansas Blue Cross and Health Advantage* members, and most BlueAdvantage Administrators of Arkansas members, may now request coverage of an electric breast pump up to $160 with no deductible, coinsurance or copayment. This is a one-time-only benefit per member; not for each pregnancy. Coverage also is *Baptist Health members should contact Customer Service for specific information about their policy.

BLUE & YOU Autumn 2015

available for members who need to rent a hospital-grade breast pump due to medical complications for either the mother or child. Rental of a hospital-grade breast pump is covered for six months and is available after each pregnancy depending on need. Contact the Customer Service number listed on the back of your member ID card or the number associated with your health plan on page 27 for more details.

Why are we encouraging our members to have primary care physicians? At Arkansas Blue Cross and Blue Shield, your health is our greatest concern. That is why we started an initiative this year to align our members with a primary care physician in their area, ensuring they will receive the right care from the right place at the right time. You may have received a letter from us asking for you to choose a primary care physician (PCP) and to let us know who you have chosen. Here’s why: HAVING A PCP HELPS:

Improve health

Lower out-ofpocket costs

Increase the quality of care

A PCP makes sure you get the care you need when you need it.

By improving health, a PCP can help you avoid costly visits to the emergency room, or inpatient hospital stays.

Having a PCP can help avoid duplicate tests and prescriptions. And by having access to test results run by specialists, PCPs have a big-picture view of your health and can often determine the cause of an illness.

HOW DOES THE PCP ALIGNMENT WORK? If you do not have a PCP selected, we first look at your claims history. If it shows you have been to a local PCP recently, we will assign you to that doctor. Letters were sent to members regarding this initiative. We hope that if you received a letter, you chose a PCP and called Customer Service to share that information. YOU CAN CHANGE YOUR PCP WHENEVER YOU LIKE If you decide you want to change your PCP, you can do so at any time. All of our members can call Customer Service to change their PCP, and many members can go into My Blueprint, our self-service website, and make the change. It only takes a few minutes and your health plan ID card to register for My Blueprint, and it gives you immediate access to all the resources in the self-service center.

Autumn 2015 BLUE & YOU

‘‘

When we say at Arkansas Blue Cross that we love to hear from you, we really do.

‘‘

– Karen Raley,

vice president of Corporate Marketing

BLUE & YOU Autumn 2015

Improve health

Lower out-ofpocket costs

Increase the quality of care

A PCP makes sure you get the care you need when you need it.

By improving health, a PCP can help you avoid costly visits to the emergency room, or inpatient hospital stays.

Autumn 2015 BLUE & YOU

Bullying is defined as

unwanted, aggressive behavior

among school-aged children that involves real or perceived power imbalance. The behavior is repeated, or has the potential to be repeated, over time. Studies show bullying causes depression in children and youth. Bullying impacts the body’s stress response system and these changes can be risk factors for poorer health. Being bullied “gets under the skin.”

Bullying is one of the prominent causes of distress and ongoing turmoil in our students’ lives. It is common, one out of four children report being bullied at least once each year. It can take the form of physical violence, social isolation, spreading rumors or cyber bullying.

they kept their distance.

As a 6’4” awkward sophomore, I was never “agile, mobile and hostile” enough for my coaches, who let me know they resented having to special-order a pair of size 16 football cleats for me. After off-season football practice at Jonesboro High, we filed into the locker room. Larry, a short, tough cocky junior had it in for me. He jumped on my back and wouldn’t get off. His face up by my ear, running his mouth, I staggered for a couple of steps trying to get him off. Then I pitched forward and flipped him off my back. He came up swinging. My next memory has me on my knees looking up trying to keep him from punching me in the head. They pulled him off and I dressed out in silence feeling ashamed, shaken and alone. No one in the locker room said anything and

“ He beat me up,” I said, not wanting to get back to the memory.

BLUE & YOU Autumn 2015

Forty years later at my high school reunion, Danny, our place kicker, came up to me. “ Herbert I never forgot that time when you stood up to Larry. We all thought that was something.”

“ Yeah, but you really got some good licks in, and he never messed with any of us after that.” Danny had a totally different view of the incident than I had. What I remembered with shame and humiliation as a beating, he had a totally different memory. It never registered to me that I connected with any of my swings. As in my story, the victim’s perception is quite different from the perceptions of others. There may be distortion of what really happened. The person feels like they are alone in experiencing bullying. This experience of feeling alone after bullying is common. There is a power imbalance that

defines bullying that gets reflected in classroom relations. Those who witness bullying play a key role in reinforcing and maintaining the social imbalance. In studies, while most students report that they disapprove of bullying, they are unlikely to stand up for the bullied, even if they feel sorry for them. Like the other sophomores in that locker room, they may be reluctant to get involved because they feel anxious about their own safety or social status. Our society has normalized bullying as a part of growing up. Pediatricians recognize that bullying is not a developmental milestone, nor should it be addressed as such. They have a long-standing history of preventing violence among youth. In 1999, the American Academy of Pediatrics released a policy statement outlining the important role pediatricians play in preventing violence among children and youth. Harmful biological changes associated with bullying are revealed in genetics research, neuroimaging studies and studies of the stress response system.

The community can prevent bullying. Schools can create a sense of belonging. They can support norms against bullying. Students can show respect for one another. Parents can set an example by being kind. They also can talk with their children and work with schools to address bullying.

Bullying is preventable. Consistent discipline can reduce bullying.

Having just one friend makes it less likely that a child will be bullied.

Signs a student may be bullied Students who are being bullied often exhibit some warning signs. These students may: • Have torn, damaged or missing pieces of clothing, books, or other belongings • Have unexplained cuts, bruises and scratches from fighting • Have few, if any, friends with whom he or she spends time • Seem afraid of going to school, walking to and from school, riding the school bus, or taking part in organized activities (such as clubs or sports) with peers • Take a long “illogical” route when walking to or from school • Lose interest in doing school work, or suddenly begin to do poorly in school • Appear sad, moody, teary or depressed when he or she comes home • Complain frequently of headaches, stomachaches or other physical problems • Have frequent bad dreams or trouble sleeping • Experience a loss of appetite • Appear anxious and suffer from low self-esteem

Characteristics of a bully It’s important to recognize the characteristics of students who bully, which may help prevent bullying and allow for early intervention. These students may: • Have a positive attitude toward violence and the use of violent means • Have a strong need to dominate and subdue other students and get their own way • Be impulsive, aggressive or easily angered • Lack empathy toward students who are bullied • Have defiance and aggression toward adults, including teachers and parents • Be involved in other anti-social or rule-breaking activities such as vandalism, delinquency and substance abuse • Have greater physical strength than others in general and the students they bully in particular (especially in boys) • Be more likely to report owning a gun for risky reasons, such as to gain respect or to frighten others

Autumn 2015 BLUE & YOU

Bullying is defined as

unwanted, aggressive behavior

they kept their distance.

“ He beat me up,” I said, not wanting to get back to the memory.

BLUE & YOU Autumn 2015

Forty years later at my high school reunion, Danny, our place kicker, came up to me. “ Herbert I never forgot that time when you stood up to Larry. We all thought that was something.”

Bullying is preventable. Consistent discipline can reduce bullying.

Having just one friend makes it less likely that a child will be bullied.

Autumn 2015 BLUE & YOU

PACKING What’s missing in their diet? Keep your kids healthy and happy by thinking outside the lunchbox Feeding your children healthy and nutritious food is an important part of parenting. But healthy eating means much more than making them eat their broccoli at the dinner table— it’s a well-rounded approach to diet. Packing healthy school lunches is one way to make a big difference in your children’s health. A balanced lunch provides the essential vitamins, minerals and other nutrients your kids needs for healthy growth and development. Take a few extra minutes each morning to pack a healthy, balanced lunch.

PACK A

BALANCED LUNCHBOX:

A balanced lunch includes fruits and vegetables (apples, bananas, carrots, grapes, strawberries), whole grains (bread, crackers, cold wholewheat pasta salad), lean proteins (sliced chicken breast, peanut and almond butter, beans) and low-fat dairy products (carton of milk, Take your kids to the yogurt). Try supermarket and let not to load the them pick fruit that lunchbox with they want. processed food.

BLUE & YOU Autumn 2015

SIMPLIFY

LUNCH: Kids love finger foods— make lunch easy to eat. Cut up larger fresh fruit, like apples or watermelon, into bite-sized chunks. Pack baby carrots or celery with a small container of black bean dip, hummus or another dipping sauce.

REINVENT

THE CLASSICS:

You don’t have to pack the same PB&J sandwich every day. Consider replacing the jelly or jam with banana slices, honey or apple butter. Use all-natural peanut butter and whole-grain or whole-wheat bread.

Give sandwiches a completely different spin – serve ham, turkey or chicken sandwiches in a whole-wheat tortilla wrap, with lettuce, tomato and a drizzle of low-fat ranch dressing.

Research shows American children aren’t getting enough of four essential nutrients: vitamin D, calcium, fiber and potassium. Here are some foods that are rich in each missing nutrient.

VITAMIN D: Milk products, most breakfast cereals, orange juice, salmon and tuna CALCIUM: Milk products, hard

cheese and some orange juice

FIBER: Fruits and vegetables, chickpeas,

lentils, whole-grain products

POTASSIUM: Fruit and vegetables,

dairy, meat and seafood

NO-BAKE ENERGY

BITES No-bake energy bites are a lunchtime dessert or afternoon snack. They’re healthy, tasty and will give your kids the energy to finish the school day satisfied.

PREP: 10 MIN. TOTAL: 40 MIN.

INGREDIENTS:

PLAN AHEAD : You’re more likely to succeed when you plan lunch in advance. Have the ingredients on hand, and lunch will come together more quickly with a game plan.

Use a calendar or paper to map out the week’s meals, and take that list to the grocery store.

FEED YOUR CHILD ENOUGH CALORIES: As adults, we’re often looking to cut calories. Your child, on the other hand, needs to eat enough so he/she is not hungry in class that afternoon. Talk to your pediatrician to learn how many calories your child should eat for lunch.

• 1 cup (dry) oatmeal • 2/3 cup toasted coconut flakes • 1/2 cup all-natural peanut butter • 1/2 cup ground flax seed • 1/2 cup chocolate chips (optional) • 1/3 cup honey or agave nectar • 1 tsp vanilla extract

DIRECTIONS: Stir ingredients together in medium bowl until mixed. Cover bowl and let chill in refrigerator for half an hour. Once chilled, roll mixture into balls. Store in an airtight container and keep refrigerated for up to 1 week.

MAKES 20-25 BALLS

Autumn 2015 BLUE & YOU

PACK A

BALANCED LUNCHBOX:

BLUE & YOU Autumn 2015

SIMPLIFY

REINVENT

THE CLASSICS:

Give sandwiches a completely different spin – serve ham, turkey or chicken sandwiches in a whole-wheat tortilla wrap, with lettuce, tomato and a drizzle of low-fat ranch dressing.

Research shows American children aren’t getting enough of four essential nutrients: vitamin D, calcium, fiber and potassium. Here are some foods that are rich in each missing nutrient.

VITAMIN D: Milk products, most breakfast cereals, orange juice, salmon and tuna CALCIUM: Milk products, hard

cheese and some orange juice

FIBER: Fruits and vegetables, chickpeas,

lentils, whole-grain products

POTASSIUM: Fruit and vegetables,

dairy, meat and seafood

NO-BAKE ENERGY

BITES No-bake energy bites are a lunchtime dessert or afternoon snack. They’re healthy, tasty and will give your kids the energy to finish the school day satisfied.

PREP: 10 MIN. TOTAL: 40 MIN.

INGREDIENTS:

PLAN AHEAD : You’re more likely to succeed when you plan lunch in advance. Have the ingredients on hand, and lunch will come together more quickly with a game plan.

Use a calendar or paper to map out the week’s meals, and take that list to the grocery store.

MAKES 20-25 BALLS

Autumn 2015 BLUE & YOU

NEW and UPCOMING GENERICS 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.

UAMS medical students receive Arkansas Blue Cross and Blue Shield Primary Care Scholarships Rural Arkansas is known for its scenic beauty and country charm, but it’s also known for its lack of doctors. Arkansas Blue Cross and Blue Shield recognized this troubling trend, and in 2012 came up with a plan to help place young, eager primary care doctors back into the Natural State’s smaller communities.

BRAND NAME GENERIC USE GENERIC RELEASE Aloxi Palonosetron Nausea 2015 Avodart

Dutasteride

Benign prostatic hyperplasia 2015

Axert Almotriptan Migraines 2015 Doribax Doripenem Antibiotic 2015 Emend Caps Aprepitant Nausea 2015 Fenoglide Fenofibrate High cholesterol 2015 Ortho Tri-Cyclen Lo Norgestimate/ Birth control 2015 ethinyl estradiol Patanol Olopatadine Opthalmic antihistamine 2015 Argatroban Argatroban Anticoagulant 2015 Mirapex ER Pramipexole Parkinson’s Disease/ 2015 (not 0.375, 0.75, 1.5mg) Dihydrochloride Restless leg syndrome Renagel

Sevelamer

Tazorac Gel & Cream Tazarotene

Elevated phosphate levels

2015

Psoriasis/acne

2015

Lauren Lavender

Cenestin Estrogens, Osteoporosis 2016 conjugated synthetic

Carvedilol

High blood pressure

“I have always wondered what it would be like to live in a small town, and soon I will know,” said Lauren. She explained that she and her fiancé, both medical students, are planning to “locate to a rural town in Arkansas to practice primary care and serve the underserved. We are both very passionate and excited about our future!”

The scholarships are possible through a $1 million endowment grant from Arkansas Blue Cross in partnership with UAMS. Nora and Lauren each will receive $20,000 toward their educations. They graduate in May 2016.

Glumetza ER Metformin Diabetes 2016 Coreg CR

Seniors Nora Gibbons of Stuttgart, and Lauren Lavender of Little Rock, are the 2015 recipients of 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) who plan to set up practice in the more rural parts of the state. These scholarships not only help deserving students, they help hundreds of people in the communities where these future physicians will practice.

“My grandfather (and his father before him) practiced as a family physician in the small community of Ozark for more than 50 years,” said Nora. “I, myself, have lived in Ozark for seven years and Stuttgart for 10, thus I have certainly experienced living in an underserved area and understand how important it is for passionate primary care physicians to be in those areas.”

2016

Enablex Darifenacin Overactive bladder 2016 Frova Frovatriptan Migraines 2016 Jalyn Dutasteride/ Benign prostatic hyperplasia 2016 Tamsulosin Nuvigil Armodafinil Narcolepsy 2016

BLUE & YOU Autumn 2015

Nora Gibbons

Autumn 2015 BLUE & YOU

BRAND NAME GENERIC USE GENERIC RELEASE Aloxi Palonosetron Nausea 2015 Avodart

Dutasteride

Benign prostatic hyperplasia 2015

Sevelamer

Tazorac Gel & Cream Tazarotene

Elevated phosphate levels

2015

Psoriasis/acne

2015

Lauren Lavender

Cenestin Estrogens, Osteoporosis 2016 conjugated synthetic

Carvedilol

High blood pressure

Glumetza ER Metformin Diabetes 2016 Coreg CR

2016

Enablex Darifenacin Overactive bladder 2016 Frova Frovatriptan Migraines 2016 Jalyn Dutasteride/ Benign prostatic hyperplasia 2016 Tamsulosin Nuvigil Armodafinil Narcolepsy 2016

BLUE & YOU Autumn 2015

Nora Gibbons

Autumn 2015 BLUE & YOU

NEWS

Arkansas Blue Cross and Blue Shield awards grant to establish nursing professorship at University of Arkansas at Pine Bluff

Interprofessional Education team gets national recognition

As part of its continued commitment to improve the health of all Arkansans, Arkansas Blue Cross and Blue Shield in August announced a grant of $250,000 to the University of Arkansas at Pine Bluff’s (UAPB) Department of Nursing to fund the Arkansas Blue Cross and Blue Shield Endowed Nursing Professorship in Rural Health. The endowment will help the university attract and retain top faculty. Better-educated nurses will be able to identify and solve the unique health issues that face Arkansans in the majority of the state.

What if medical doctors, nurses, dentists, pharmacists and public health officials all learned to work together to address patients’ needs? That may sound like a futuristic goal, but at the University of Arkansas for Medical Sciences, it is happening, and the program is receiving support from Arkansas Blue Cross and Blue Shield. A team representing the UAMS Interprofessional Education program presented a poster this spring at the Interprofessional Education Collaborative Conference in Virginia.

Alicia Berkemeyer (far left), Vice President of Enterprise Primary Care Initiatives and Pharmacy Programs for Arkansas Blue Cross and Blue Shield joined Lee Wilbur, M.D., director of Interprofessional Education at UAMS; Kevin W. Ryan JD, MA, associate professor, co-director DrPH Program associate dean for Professional Programs at the Fay W. Boozman College of Public Health; and Kat Neill, PharmD, assistant dean for Experiential Education and associate professor; to present the poster, which was well received.

New look, same us! If the envelope looks a little different than what you are used to seeing when you get your Personal Health Statement or other member mail, please note that Arkansas Blue Cross and Blue Shield and its family of companies are using a new envelope and printing process.

The professorship allows UAPB to provide increased focus on the particular issues related to serving rural communities, and to expand the number of opportunities for students to enter into the program. “Arkansas Blue Cross is committed to helping Arkansans have access to quality healthcare where and when they need it — at the hospital bedside, in the clinic setting or in the community,” said Mark White, president and chief executive officer of Arkansas Blue Cross.“ And with a large percentage of Arkansans living in rural areas with special health and economic needs, we know that having skilled, knowledgeable nurses is critical to the care of our residents. The Arkansas Blue Cross Endowed Professorship in Rural Health will be used to help secure top faculty who

OF FITNESS

While you are shopping online for holiday gifts, why not give the gift of fitness for free! Register yourself, along with a group of your friends or co-workers in the Blue & You Fitness Challenge.

While you are shopping online for Christmas gifts, get something extra

If you register your group by Cyber Monday (November 30), your name will be entered into a drawing to win a Jawbone wristband, awarded on March 1. Visit blueandyoufitnesschallenge-ark.com to find out more information and register.

The Challenge starts March 1 and runs through May 30.

If you register your group by Cyber Monday

The Blue & You Fitness Challenge is a three-month contest designed to encourage good exercise habits. Groups and individuals compete to earn points by completing a variety of cardiovascular exercises.

And don’t forget, you can sign up to receive an email when your Personal Health Statement is available (November 30), your name will be entered into a drawing and securely review it online. Check it out on My Blueprint, our member self-service center awarded – and go to win a Jawbone wristband on green! March 1.

BLUE & YOU Autumn 2015

Visit blueandyoufitnesschallenge-ark.com to find out more information and register.

“We are grateful to Arkansas Blue Cross for recognizing our university’s role in producing qualified nurses for the state,” said Dr. Laurence B. Alexander, chancellor of the University of Arkansas at Pine Bluff. “Through this gift, we are able to attract highly sought after faculty to add to our already strong roster of instructors.”

GIVE THE GIFT OF FITNESS

GIVE THE GIFT

special for yourself, your friends or co-workers. Give the gift of fitness The new process is designed to help reduce and register your group or team for the Blue & You Fitness Challenge. cost and improve efficiency without sacrificing The Challenge starts March 1 and runs through May 30. The Blue & You member quality. You still will recognize our Fitness Challenge is a three-month contest designed to encourage good exercise habits. Groups and individuals compete to earn points by company logos; the envelope sizes may be a slight bit different completing a variety of cardiovascular exercises. and the ink may look a little different, but it is important mail from us — your health plan provider.

22 18

are forward thinkers — the kind of faculty that will educate, engage and inspire nursing students to work toward ways to meet the needs of Arkansans through innovative care and access options.”

A program of Arkansas Blue Cross and Blue Shield, Arkansas Department of Human Services and the Arkansas Department of Health

Autumn 2015 BLUE & YOU

NEWS

Arkansas Blue Cross and Blue Shield awards grant to establish nursing professorship at University of Arkansas at Pine Bluff

Interprofessional Education team gets national recognition

OF FITNESS

While you are shopping online for holiday gifts, why not give the gift of fitness for free! Register yourself, along with a group of your friends or co-workers in the Blue & You Fitness Challenge.

While you are shopping online for Christmas gifts, get something extra

The Challenge starts March 1 and runs through May 30.

If you register your group by Cyber Monday

BLUE & YOU Autumn 2015

Visit blueandyoufitnesschallenge-ark.com to find out more information and register.

GIVE THE GIFT OF FITNESS

GIVE THE GIFT

22 18

are forward thinkers — the kind of faculty that will educate, engage and inspire nursing students to work toward ways to meet the needs of Arkansans through innovative care and access options.”

A program of Arkansas Blue Cross and Blue Shield, Arkansas Department of Human Services and the Arkansas Department of Health

Autumn 2015 BLUE & YOU

in a ROW!

Arkansas Blue Cross named one of the Best Places to Work in Arkansas For the third 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 annual award is 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 continually go above and beyond for 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. “Being ranked so high in the Best Places to Work survey for a third time tells us that our programs to encourage better health, to further their education and to cultivate our family atmosphere are appreciated by our employees.” Arkansas Blue Cross offers employees tuition reimbursement, 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.

New ArkansasBlue opens in

Red Wolves territory! Residents of Jonesboro and northeast Arkansas are able to speak face to face with health insurance experts who can advise them about affordable health plans and more at the new ArkansasBlue office located at 2110 Fair Park Boulevard, Suite I, in Jonesboro (across from Lowe’s). The store opened for business September 14. The new ArkansasBlue provides Arkansas Blue Cross and Blue Shield members and insurance shoppers with information about Arkansas Blue Cross insurance plans, advice on which plan best covers them and fits their budget, as well as helping determine if they may qualify for free or low-cost healthcare coverage through healthcare.gov. ArkansasBlue also will provide visitors with information on dental and other insurance plans. “Arkansas Blue Cross has operated a full-service office in Jonesboro since 1995, serving members in a 17-county area with customer service, individual and group product sales and service, medical management, provider services and care management for members,” said Bill Brown, regional executive. “Our new location will allow us to expand our services and provide more one-on-one counseling about health and dental insurance for individuals and families.” Walk-in members and shoppers also can pick up informational brochures or digitally walk through an online shopping experience with an Arkansas Blue Cross representative. Telephone numbers for the new ArkansasBlue store will be the same as the numbers for the previous regional office location (see page 27). Arkansas Blue Cross opened Arkansas’ first health insurance store in 2011 in Little Rock to help Arkansans better understand health insurance products and how they work. Other ArkansasBlue locations include Pine Bluff, Hot Springs and Lowell.

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!

BLUE & YOU Autumn 2015

Autumn 2015 BLUE & YOU

in a ROW!

New ArkansasBlue opens in

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!

BLUE & YOU Autumn 2015

Autumn 2015 BLUE & YOU

“OUT OF THE BLUE”

CONTINUED FROM PAGE 3

Support benefit design strategies that encourage smarter healthcare usage. We must continue to look for opportunities to refine the benefits design for the Private Option in ways that have been proven in the private sector, while removing those plan features that do not directly encourage smarter usage of care. Essential to improving health in our state is ensuring broad access to primary care, and finding ways to incentivize the use of that care rather than more costly emergency care. At Arkansas Blue Cross, we work in partnership with employers across the state to create a benefit model that rewards personal responsibility and better decision-making, and need that same flexibility to better serve those in the Private Option.

Acknowledge that investments in the healthcare system are investments in a stronger economy. A physically healthier Arkansas and a financially healthier Arkansas are inextricably linked. Currently, Arkansas is ranked the 49th-healthiest state.

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

BLUE & YOU Autumn 2015

Businesses are very aware of the cost of healthcare and the far-reaching effects of costly health conditions for employees and their family members. They understand that a healthier workforce, one with better access to preventive care and timely treatment, is a more present, productive workforce. As we improve our state’s healthcare system and the health of Arkansans, our state will be seen as an attractive home for businesses that currently see rapidly escalating health care. Our state will be seen as leading innovation, not just copying less effective solutions from other states. Our new approach to healthcare represents a long-term competitive advantage for our state. An investment in educating Arkansans in how to find and use care is an investment in a healthier state, and an investment in a healthier state is an investment in a larger, healthier workforce. That’s just common sense. This is the time for Arkansas to build a more sustainable approach to healthcare. By taking advantage of this unique opportunity, we can have a system that works better for all Arkansans. It’s time for a stronger Arkansas. We can build it together.

2016 Summary of Benefits and Coverage – available November 15 for individual/family policyholders

• Online in the “Benefits” section of the Arkansas Blue Cross secure member selfservice center, My Blueprint, at arkansasbluecross.com

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.

• By calling Arkansas Blue Cross Customer Service at 1-800-800-4298 to receive a printed version

* These are members who do not have health insurance through an employer, a Medicare health plan, or short-term, limited-duration Blue policies, to include Essential Blue Freedom.

upcoming year. Beginning November 15, 2015, you may access this information:

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.

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:

TOLL FREE Number

Medi-Pak® members ® Medi-Pak Advantage members Medi-Pak® Rx members Arkansas Blue Cross members • Pharmacy questions • Specialty Rx pharmacy questions Arkansas Blue Cross Metallic members (Gold, Silver, Bronze, Catastrophic) • Pharmacy questions Health Advantage members • Pharmacy questions BlueAdvantage members • Pharmacy questions Federal Employee members

1-800-338-2312 1-877-233-7022 1-866-390-3369 1-800-238-8379 1-800-863-5561 1-866-295-2779 1-800-800-4298 1-800-969-3983 1-800-843-1329 1-800-863-5567 1-888-872-2531 1-888-293-3748 1-800-482-6655

Looking for health or dental insurance? We can help! For individuals, families For employer groups*

1-800-392-2583 1-800-421-1112

*Arkansas Blue Cross, Health Advantage and BlueAdvantage Administrators of Arkansas

PAY YOUR

BILL

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 • Fayetteville 516 East Millsap Rd., Suite 103 • Fort Smith 3501 Old Greenwood Rd., Suite 5 • ArkansasBlue — Hot Springs 1635 Higdon Ferry Rd. – Suite J • ArkansasBlue — Jonesboro 2110 Fair Park Boulevard – Suite I • Little Rock 601 S. Gaines Street • ArkansasBlue — Lowell 507 W. Monroe Ave. – Suite B • ArkansasBlue — Pine Bluff 509 Mallard Loop Drive • Texarkana 1710 Arkansas Boulevard

1-501-378-2222 1-800-817-7726 1-866-254-9117 1-800-588-5733 1-800-299-4124 1-800-421-1112 1-888-872-2539 1-800-236-0369 1-800-470-9621

Visit our websites for more information:

arkansasbluecross.com • healthadvantage-hmo.com blueadvantagearkansas.com blueandyoufoundationarkansas.org

To pay by phone*, please call 1-800-354-9904 * Medicare Advantage and Prescription Drug plan product members must call Customer Service to discuss available payment options. Health Advantage conversion plans are not eligible for online, mobile or pay-by-phone payment option.

Autumn 2015 BLUE & YOU

“OUT OF THE BLUE”

CONTINUED FROM PAGE 3

BLUE & YOU Autumn 2015

2016 Summary of Benefits and Coverage – available November 15 for individual/family policyholders

• 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 1-800-800-4298 to receive a printed version

* These are members who do not have health insurance through an employer, a Medicare health plan, or short-term, limited-duration Blue policies, to include Essential Blue Freedom.

upcoming year. Beginning November 15, 2015, you may access this information:

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.

CUSTOMER SERVICE NUMBERS May we help?

For customer service, please call:

TOLL FREE Number

1-800-338-2312 1-877-233-7022 1-866-390-3369 1-800-238-8379 1-800-863-5561 1-866-295-2779 1-800-800-4298 1-800-969-3983 1-800-843-1329 1-800-863-5567 1-888-872-2531 1-888-293-3748 1-800-482-6655

Looking for health or dental insurance? We can help! For individuals, families For employer groups*

1-800-392-2583 1-800-421-1112

*Arkansas Blue Cross, Health Advantage and BlueAdvantage Administrators of Arkansas

PAY YOUR

BILL

Prefer to speak with someone close to home? Call or visit one of our offices near you: • ArkansasBlue

1-501-378-2222 1-800-817-7726 1-866-254-9117 1-800-588-5733 1-800-299-4124 1-800-421-1112 1-888-872-2539 1-800-236-0369 1-800-470-9621

Visit our websites for more information:

arkansasbluecross.com • healthadvantage-hmo.com blueadvantagearkansas.com blueandyoufoundationarkansas.org

Autumn 2015 BLUE & YOU

Autumn 2015 A publication for the policyholders of the Arkansas Blue Cross and Blue Shield family of companies

Catch FREE TICKETS to

“ The Gingerbread Man!” 4 p.m. Sunday, December 6

page

at the

Arkansas Arts Center’s Children’s Theatre in Little Rock. You can get free tickets starting November 1 at all ArkansasBlue stores. Hurry! Quantities are limited. MPI 4050 10/15

Enrollment information

Arkansas Blue Cross honored by American Red Cross

Bullying prevention

pages

page

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