a publication of
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It’s all about getting into
right mindset. the
How determination and Network Health’s Millennium program sparked Rose Suomi to get back into shape
from the president
Dear Readers
N
etwork Health recently celebrated our 30th anniversary. When our doors first opened in November 1982, our name was Nicolet Health Plan as we were started by the physicians of Nicolet Clinic, and Nicolet Clinic was our sole customer. Fast-forward to today. I’m proud to say we are the area’s leading health plan, serving more than 130,000 members in 17 counties in northeast Wisconsin. While the growth we’ve seen since we first opened Sheila Jenkins is astounding, the growth President we’ve had in just this past Network Health year is equally impressive. You may remember, we started the year off by launching our new brand and advertising campaign, We Speak Your Language. We pledged to end the use of confusing insurance jargon and to make health insurance easy to understand. We’ve seen great success with the award-winning campaign, and feedback from you, our members, has been very positive.
C
O
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E DITORIAL STAFF President Sheila Jenkins Vice President, Penny Ransom Strategic Planning and Brand Management
We expanded our offices to accommodate our growth in staff. About 100 of our employees are now working from our beautifully renovated downtown Appleton office. Most recently, we began offering individual and family health plans, and membership has exceeded our initial expectations. In August, our Board of Directors adopted a new mission statement for Network Health. It reads: Our mission at Network Health is to enhance the life, health and wellness of the people we serve. This new mission statement was crafted by a group of employees and truly guides what every Network Health employee does each day. You’ll see that commitment reflected in the pages of Balance as well as in your interactions with our staff. We’ve come a very long way since 1982 and even the past year. We’re eager to have another successful year in 2013. On behalf of everyone at Network Health, we wish you good health and success as 2012 comes to an end, and we’re looking very forward to being your partners in health in the New Year.
S
life 3 Giving Back Network Health helps local families enjoy the holidays through the Adopt-A-Family program
4 Your Right to Request an Independent Review
Your right to have certain Network Health decisions independently reviewed
4 How Do Health Plans Make Their Decisions?
Publications Sam Darcy Coordinator
E ditorial Board P eggy Huss, David Weiss, Dawn Rady, Deborah Anderson, Renee Corral, Barb Gore, Chuck Rynearson Balance is published quarterly by Network Health. The health information contained in Balance is meant to supplement, not replace, the advice of health care professionals. © 2012 Network Health. No portion of this newsletter may be reproduced without written permission from Network Health.
Tell Us What You Think I f you have questions or suggestions or would like to tell us how Network Health improved your life, send us an email at balance@networkhealth.com. You can also write to us at: Network Health Attention: Sam Darcy 1570 Midway Pl. Menasha, WI 54952
6
Steps to keep you healthy this winter
7
understanding or following your treatment plan
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08
health
5
Is it a Cold or the Flu?
Prediabetes
Take action now to avoid diabetes in the future
FEATURE 8 Putting Her Best Foot Forward
How ambition, perseverance and the Millennium program helped Rose Suomi get into the best shape of her life
Information about Network Health’s decision-making process
4 Here to Help Where to turn if you have obstacles keeping you from
imple Tips to Boost Your S Immune System
wellness 12 ‘ Tis the Season to Eat
Steps to avoid holiday weight gain this year
13 Safely Preparing Your Holiday Meal
Simple guidelines when entertaining this holiday season
14 Beating the Holiday Blues
Know the differences between cold and flu symptoms
How to enjoy the holidays without the anxiety, stress and depression that can come with the season
professional
Network Health is teaming up with CVS Caremark for your pharmacy benefits
6 Good Questions for Your Good Health Three questions you should ask your health care
15 Network Health’s New Partnership
networkhealth.com
life
Information to help you get the most out of your coverage
Giving Back Network Health helps local families enjoy the holidays
A
t Network Health, we’re thankful for our members and we’re glad to be part of the community. That’s why every holiday season we adopt local families in need. Network Health first began adopting families back in 1999, and the company involvement continues to grow every year. In December of 2011, five local families were adopted—a total of 30 people. Network Health employees worked together to contribute items like coats, snow pants, gloves and other clothing. Some families also requested basic items like cleaning supplies, towels and blankets. Of course, there were plenty of toys donated, too, so children could have the kind of Christmas they’d been hoping for. We really enjoy this opportunity to give back to the community. Network Health event organizer and senior business intelligence analyst, Jennifer Resch, says, “I could talk all day about the Adopt-A-Family Program. It is one of my absolute favorite parts of the holiday.” It’s easy to see why. Jennifer has been part of the program since the very beginning, and she’s touched by the difference she makes in family members’ lives. In fact, after thirteen years, Jennifer still has one of the crafts a thankful family member made for her. “That year was very special; we had a great time. It was very personal,” she says. Network Health’s experience with the Adopt-A-Family program has been very rewarding and we’re proud to be a part of it. n e t w o r k h e a l t h . c o m
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life { YOUR CARE }
Your Right to Request an Independent Review
Y
ou have the right to have an independent review organization examine certain final decisions made by Network Health. Network Health has contracted with three nationally-accredited independent review organizations to conduct the reviews. The decision is binding for both Network Health and the member. Decisions made by Network Health that are eligible for review are those where we determined the requested care or services do not meet our requirements for medical necessity, appropriateness, health care setting, level of care, effectiveness, experimental treatment, rescission of a policy or certificate or coverage denial determination based on pre-existing condition exclusion. Requests for services that are not included in your
benefits package are ineligible for independent review (including, but not limited to, benefits limitations and direct exclusions). Typically, you must complete Network Health’s internal complaint process (called a grievance) before you can initiate an independent review. However, you do not need to complete the process if you need immediate medical treatment and a delay could jeopardize your life or health or we agree with you that it is in everyone’s best interest to proceed with your concern directly to independent review. For more information on the independent review organization process, please refer to your certificate of coverage or contact Network Health Customer Service at 800-826-0940 or 920-720-1300.
Here to Help W
e understand that there may be religious, financial or cultural obstacles that keep you from following or understanding a treatment plan prescribed by your primary care practitioner. These obstacles may include: > Beliefs and concerns about the condition and treatment > Perceived barriers to meeting treatment requirements > Access, transportation and financial barriers to obtaining treatment > Cultural, religious and ethnic beliefs All of these factors play into a person’s ability to follow their doctor’s treatment plan. If you are unable to follow your treatment plan because of one or more of these barriers, and need additional support, call Network Health’s Care Management Department at 920-720-1600 or 800-236-0208. A nurse in care management will assist you with finding ways to work through these barriers. 4 | balance • F a l l
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How Do Health Plans Make Their Decisions?
D
id you know that utilization decisions made about your care by Network Health are based on the appropriateness of care and service? Care and service include medical procedures, behavioral health procedures, pharmaceuticals and devices. Decisions are based on written criteria founded on sound clinical evidence and on the benefits outlined in your certificate of coverage Network Health does not reward practitioners—or other individuals conducting utilization review—for denying coverage for care or service. Network Health also does not prohibit providers from advocating on behalf of members within the utilization management program. In addition, the medical director, associates (or designees), care management staff and supervisors of this staff receive no financial incentive to encourage decisions that result in underutilization. If you have questions about the utilization process at Network Health or a utilization management decision or would like a copy of specific utilization criteria, call the care management department Monday through Friday, 8 a.m. to 5 p.m., at 920-720-1600 or 800-236-0208. For questions specific to behavioral health utilization, call 920-720-1340 or 800-555-3616. Callers may leave a message 24 hours a day, seven days a week. networkhealth.com
health
News and tips to help you maintain a healthy and happy life
Is It a Cold or the Flu?
I
t’s hard to avoid getting sick this time of year. It almost seems inevitable. But, do you have a cold or the flu? Telling the difference between the two can sometimes be even harder. The common cold and the flu are both respiratory illnesses, but they are caused by different viruses. The two illnesses have many similar symptoms, making it difficult to tell them apart. In general, the flu is worse than the common cold. People with the flu will usually have more severe symptoms of body aches, fever, tiredness and dry cough. With a cold, you’re more likely to have a runny or stuffy nose. Most flu symptoms gradually improve over two to five days, but it’s not uncommon to feel down for a week or more. Both cold and flu viruses enter your body through the membranes of your nose, eyes or mouth. Every time you touch your hand to one of these areas, you could infect yourself with a virus. That’s why it’s so important to keep your hands germ-free with frequent washing. net workhealth.com
Know the Difference Symptoms
Cold
Flu
Fever
Sometimes, usually mild
Usual; higher (100-102 F; occasionally higher); lasts 3 to 4 days
Headache
Occasionally
Common
General Aches and Pains
Slight
Usual; often severe
Fatigue and Weakness
Sometimes
Usual; can last 2 to 3 weeks
Extreme Exhaustion Never
Usual; at the beginning of the illness
Stuffy Nose
Common
Sometimes
Sneezing
Usual
Sometimes
Sore Throat
Common
Sometimes
Chest Discomfort and Cough
Mild to moderate; hacking cough
Common; can become severe F a l l 2 01 2
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health
Network Health offers TTY services for deaf, hard of hearing or speech-impaired members. Members who need these services should call 800-947-3529.
Good Questions for Your Good Health
D
id you know studies show that people who understand health instructions make fewer mistakes when they take their medicine or prepare for a medical procedure? It’s true. Informed patients can even manage a chronic health condition more effectively. Communication with your practitioner is important. And, many health care professionals recommend Ask Me 3™, a patient education program designed to promote communication and improve health outcomes. The program encourages patients to understand the answers to three questions. 1. What is my main problem? 2. What do I need to do? 3. Why is it important for me to do this? You can ask questions when: > You see a doctor, nurse or pharmacist. > You prepare for a medical test or procedure. > You get your medicine. Make sure to ask these three questions next time you discuss your care with your practitioner. It can help you be better informed and understand what you need to do to take care of your health.
Simple Tips to Boost Sleep Your Immune System
week will help you maintain a healthy immune system.
Y
our body’s immune system is more powerful than you probably think. During cold and flu season, there are millions of viruses your body has to fight off. But, every winter it seems that your immune system eventually loses the battle to the sniffles. Fortunately, there are steps you can take each day to strengthen your immune system and fight off sickness.
Exercise – One of the best
ways to improve your immune system is to work out. Studies show that even relatively low levels of aerobic exercise can protect your immune system. Taking a short 20 to 30 minute walk five days per
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– Getting a good night’s sleep is key to keeping your immune system working properly. In simple terms, lack of sleep hurts the immune system’s ability to function. Not getting enough sleep has been linked to a list of mental and physical health issues, including those that stem from an impaired immune system. If you have trouble getting enough sleep, try to create a routine where you are going to bed at the same time every night and getting up at the same time each morning.
Diet – Eating appropriate portions of
a well-balanced diet, high in nutrients and low in saturated and trans fats, can help keep you healthy. Nutrition is critical not only for your immune system, but also for your overall health. Food and drink rich in vitamins and antioxidants will help you recover when you do happen to catch a virus. networkhealth.com
For a complete list of recent changes to our provider network, go to networkhealth.com/providerchanges.
According to the Centers for Disease Control and Prevention,
just 7 percent of people with prediabetes are aware of their condition.
Prediabetes A
ccording to the American Diabetes Association, almost 80 million Americans have prediabetes. But because prediabetes doesn’t always have symptoms, millions of people don’t know they have it. That’s why it’s so important to know your risk factors, and what you can do to prevent yourself from developing type 2 diabetes.
What is prediabetes? Prediabetes is when your blood sugar is higher than normal, but not yet high enough to be classified as type 2 diabetes. Without a lifestyle change, 15-30 percent of people with prediabetes will develop type 2 diabetes within five years. S ay W h at ?
Type 2 Diabetes – The most common form of diabetes, where the body does not produce enough insulin or the cells ignore the insulin. net workhealth.com
Take action now to avoid diabetes in the future
If you have prediabetes, the long-term effects of diabetes may already be starting. People with prediabetes are also 50 percent more likely to develop heart disease and stroke.
Control and Prevention, modest weight loss and regular exercise can prevent or delay type 2 diabetes in 58 percent of people with prediabetes.
What are the risk factors for prediabetes? > Overweight > Physically active less than three times a week > Older than 45 > Family history of type 2 diabetes > Developing diabetes while pregnant > Family heritage is African American, Hispanic/Latino, American Indian, Asian American or Pacific Islander > Giving birth to a baby weighing 9 pounds or more
Modest weight loss - Losing 5-7 percent of your body weight. This would be 10-14 pounds for a 200-pound person. Don’t worry about drastically changing your total weight, losing just 10-15 pounds can make a difference.
How can I lower my risk for developing type 2 diabetes? Just because you have prediabetes doesn’t mean that developing type 2 diabetes is inevitable. Healthy lifestyle changes can bring your blood sugar levels back to normal. According to the Centers for Disease
Regular exercise - Exercising moderately for 150 minutes a week. This could be as simple as going for a brisk 30-minute walk five days a week. You can control your prediabetes with a healthier lifestyle. The same lifestyle changes that treat or reverse prediabetes help prevent it too. Prediabetes can also serve as a wakeup call for you to improve your health. But, you’ll never be able to make the right changes if you don’t have the knowledge. Know the risk factors and make the lifestyle changes now. It will improve your life dramatically. F a l l 2 01 2
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S T O C O V E R Y
Putting her
best foot
forward How ambition, perseverance and the Millennium program helped Rose Suomi get into the best shape of her life
W H at moti vates a person to get into shape? Better health, a vacation, a new pair of jeans? For Rose Suomi of Greenville, it was the chance to feel better each and every day. Rose was never lazy. She was just a normal person busy with the day-to-day duties of a family and career. But until about two years ago, finding the time and making the commitment to exercise regularly never quite fit into her schedule. It was then she decided it was time to make exercise and nutrition a priority in her life. “I was never a sports person. I never played anything in high school,” she said. “But, I realized that I needed to take exercise seriously and push myself to get into better shape.”
By Sam Darcy
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Photographs by Shane Van Boxtel, Image Studios
>>>
net workhealth.com
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S T C O V E R R Y
Rose soon found an ally in her quest to get fit and feel better. In 2011, her employer, Primary Care Associates, initiated a wellness program for its employees with the help of Network Health. The wellness program, Millennium, offers employees rewards for meeting health and fitness goals, while providing tools to make better health decisions. Some of these tools include onsite health screenings, health coaching, presentations, a Fitbit® pedometer and online nutrition programs. Launched in 2008, Millennium has grown to around 10,000 participants this year, and looks to expand to 30,000 in 2013. “Millennium is a big hit here at Primary Care Associates and people are excited to use it,” said Rose. “The support from Network Health has been great for employees.” Network Health wellness coordinator, Mark Geiger, said Primary Care Associates has the highest percentage of participation and rewards achievement of all employer groups in the Millennium program.
S ay W h at ?
Jones Fracture – A foot fracture at the base of the small toe. BodyPump™ – A weight-based group fitness program that uses music and choreography to target different muscle groups in the body. 10 | balance • F a l l
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“Millennium is a big hit here at Primary Care Associates and people are excited to use it. The support from Network Health has been great for employees.” networkhealth.com
“Once I got into the right mindset, I found I had
more energy and I felt great, both mentally and physically.” According to Rose, the introduction of the Fitbit has been very popular among employees, and it has really encouraged her to reach her goals. “The Millennium program—especially the Fitbit—has inspired me to get moving,” she said. “It pushes me every day to get my steps and motivates me to stay on track.” Rose also used the Millennium program to track her nutrition. The accessibility of the online program made it a convenient tool for her. “The nutrition program served as a reminder,” she said. “It reinforced and really put me back into perspective of what was going in my body.” Rose joined a gym where she participates in many different exercise classes. The encouragement she received through Millennium, coupled with her ambition, led to great results for Rose. Soon, she was walking over 15,000 steps each day, in addition to working out at the gym. Before she knew it, she had lost well over 20 pounds and felt better than she had in years. “When you keep your weight down, everything is better,” she said. “Once I got into the right mindset, I found I had more energy and I felt great, both mentally and physically.” Soon, she was keeping up with her husband, an avid bicyclist, on their bike rides. He no longer had to wait for her to climb each hill and catch her breath. Unfortunately for Rose, she sustained a Jones fracture in her foot this summer. The break required surgery to put pins in her foot, making it nearly impossible to run, let alone put any weight on the foot. While this would be an easy excuse to kick back for the summer, Rose did not let it derail her active lifestyle. net workhealth.com
What’s a Fitbit?
T
he Fitbit is a wireless device that measures data like number of steps walked, number of calories burned and other personal metrics. The Fitbit is available for free to any Millennium participant who registers online. It allows you to wirelessly sync the device with your computer to see detailed graphs of how active you are during each part of the day. You can also log and track your weight, what you eat and when you sleep. According to Network Health wellness coordinator, Mark Geiger, the Fitbit serves as a constant reminder for a person to monitor his or her goals. “In today’s society, it’s hard to set aside time for exercise,” said Geiger. “The Fitbit provides a visible reminder to see how active you’re being on a day-to-day basis, and it encourages you to get up and moving.”
“When I first broke my foot, I couldn’t stand lying around,” she said. “I wanted to get my steps in.” Determined to stay active, Rose wore her Fitbit everyday and remained motivated to register her daily steps. “People laughed at me trying to exercise with a broken foot,” she said. “But I still had my Fitbit on, because it motivates me.” Rose and her coworkers track each other’s progress with the Fitbit on the online leaderboard. And, despite her broken foot, Rose still managed to beat some of her coworkers for steps recorded. In September, Rose’s cast was removed and her foot was put in a boot. Still unable to put weight on her foot, she was also given a scooter to help her move around. Rose instantly returned to the gym where she and her scooter enrolled in a BodyPump™ class. “I can do everything but the lunges,” she said. “I just needed to get back to the gym and get my heart rate up.” According to Geiger, Rose always remained eager to learn more about improving her health, always seeking to know what else she could achieve. “What blew me away with Rose is that she never let her injury affect her day-to-day exercise,” Geiger said. “She didn’t use her injury as an excuse, and whether she realized it or not, her efforts to stay active made her a great role model for her coworkers.” Rose didn’t have to be a marathon runner or an elite athlete to dedicate herself to get in better shape. She’s the perfect example of the results a regular person can have with the right attitude and ambition. “Everyone can exercise some. It’s all about getting in that mindset,” says Rose. “Even when you have a broken foot.” F a l l 2 01 2
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wellness
Tools to empower your personal health
Avoid holiday weight gain this year
‘Tis the Season to Eat C ookies, eggnog and pies. It seems like your waistline is in danger everywhere you turn during the holidays. But if you’re careful of what you eat, you can make it through without having to loosen your belt. These tips will help keep dieting off your list of New Year’s resolutions.
Save the calories for meal time ~ Don’t waste calories mindlessly
eating snack foods. Save them for the main course and dessert.
Avoid sauces ~ Watch out for sauces made from cream, half-and-half or meat drippings. Be selective ~ Portion control. Just
because it’s a buffet, doesn’t mean you have to eat everything that’s put out. Focus on the foods you enjoy, not on trying everything.
The Naughty List
Consider portion control when enjoying these traditional holiday foods. Food
Serving Size
Calories
Fat Grams
Baked Ham
3 slices
345
21
Beef Brisket
3 slices
291
15
Eat a healthy snack before going to a party. This may help you avoid gorging on snacks and appetizers.
Bread Stuffing
1 cup
355
17
Sweet Potato Casserole
1 cup
276
6
Green Bean Casserole
1 cup
143
8
Make a trade ~ If you plan on
Eggnog
1 cup
439
19
Cheesecake
1/8 slice of 9 inch pie
412
25
Never go to a party hungry ~
indulging in dessert, sacrifice something at lunch or dinner.
Avoid temptation ~ Don’t
congregate next to the buffet table at parties. Focus on socializing rather than eating. It’s also important to try to maintain your daily routine of eating healthy and exercising throughout the holidays. Exercise is usually the first thing eliminated from a busy schedule, which is unfortunate because it provides a psychological boost and helps stabilize your weight.
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The Nice List
Want to save some calories? Try the following lighter versions of holiday classics. Food
Serving Size
Calories
Fat Grams
Roasted Turkey (No Skin)
4 slices
190
6
Whole Wheat Biscuit
1 biscuit
44
1.62
Baked Sweet Potato
1 small potato
103
0
Boiled Green Beans
1 cup
44
0.35
Pumpkin Pie
1/8 slice of 9 inch pie
323
15 Source: Calorie Control Council networkhealth.com
The typical holiday meal averages
4,500
calories and
220
grams of fat. — The Calorie Control Council
Safely Preparing Your Holiday Meal T
he Centers for Disease Control and Prevention estimates that one in six Americans (48 million people) get sick from foodborne illnesses each year. When Wisconsin families gather for holiday meals this season, food safety may be the most important ingredient. If you are preparing a meal for the family this year, take the proper precautions to prevent your guests from getting sick. Food poisoning isn’t a very pleasant way to spend the holidays. Follow these five simple guidelines when entertaining this holiday season.
1
Thaw Thawing turkeys must be kept at a safe temperature. Foodborne bacteria will multiply between 40 and 140 F, so safely thaw frozen food in the refrigerator, under cold running water or in the microwave. Food thawed in cold water or in the microwave should be cooked immediately.
2
Clean Start with clean hands, utensils and cutting boards. Wash hands with soap for 20 seconds before and after handling food. Wash surfaces that come into contact with food after preparing each item. Do not rinse raw meat and poultry before cooking to avoid spreading bacteria to areas around the sink and countertops.
3
Separate Using the same cutting board for all your foods can spread bacteria. Keep raw meat and poultry away from raw vegetables
net workhealth.com
and other foods that won’t be cooked. Don’t put cooked food on platters that held raw meat or juices, as juices may contain harmful bacteria.
4
Cook Cooking to the safe temperature kills the bacteria. You can’t tell if it’s done by how it looks. Use a food thermometer to make sure meat, poultry and fish are cooked to a safe internal temperature. To check the cooked temperature of a turkey, insert the thermometer into the innermost part
of the thigh and wing and the thickest part of the breast. The turkey is safe when the temperature reaches 165 F. If the turkey is stuffed, the temperature of the stuffing should be 165 F.
5
Chill Refrigerate leftovers within two hours of the meal, including pie. Keep your fridge at 40 F or below and the freezer at 0 F. Remember to use or freeze leftovers within three to four days. F a l l 2 01 2
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wellness
Beating the Holiday Blues
T
he holidays are a time that most people look forward to. It’s a time for families and friends to gather for meals, memories and laughter. But for some, the holidays can bring stress, anxiety and sadness into their lives. According to Mental Health America (formerly known as the National Mental Health Association), depression peaks over the holidays with feelings ranging from mild sadness to extreme depression. Things like missing loved ones, financial pressures and unrealistic expectations can take the joy out of the holidays. The holiday blues can be a normal part of a person’s reactions to the emotions of the season. It’s also common to feel a letdown after the holidays, as it’s a hectic time that can leave you feeling exhausted both mentally and physically. It’s important to keep the right perspective during the holidays as you juggle shopping, cooking and entertaining. The following tips will help.
Don’t dwell on the past ~ Let
go of the past. Don’t be disappointed if your holidays aren’t like they used to be. As families grow, traditions and rituals often change, too.
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Don’t overindulge ~ Excessive
drinking and overeating can be common at holiday parties, but they will only make you feel more depressed.
Bury the hatchet ~ Set aside old
family grievances until a more appropriate time for discussion. Try to accept family and friends as they are. Understand that if others get agitated, they could be dealing with holiday stress and depression, too.
Take a break ~
If you find holiday parties to be taxing, take a breather. Find a quiet spot to refresh yourself, even if it’s only for a few minutes.
Get active
~ If you feel lonely, seek out community or social events. Volunteering can also lift your spirits and create friendships.
Self-Management Workshops Winter Schedule For more information or to sign up for a workshop, call us at 920-720-1655 or 800-769-3186, extension 01655. Or, visit us online at networkhealth.com/register and search for Living Well. Living Well with Chronic Conditions This workshop meets once a week for six weeks. St. Elizabeth Hospital, Fowler Conference Room Three 1506 S. Oneida St., Appleton, WI 54915 Meets Wednesdays starting January 30 5:30 p.m. - 8 p.m. Living Well with Diabetes This workshop meets once a week for six weeks. St. Elizabeth Hospital, Fowler Conference Room One 1506 S. Oneida St., Appleton, WI 54915 Meets Wednesdays starting January 30 5:30 p.m. - 8 p.m. C.O.P.E with COPD Education and support to help with chronic lung disease. Oshkosh Senior Center 234 N. Campbell Rd., Oshkosh, WI 54902 Second Tuesday of every month, 1 p.m. - 3 p.m. Better Breathers A community-wide support group for people with COPD and other chronic lung diseases. Families and caregivers are welcome to attend. St. Elizabeth Hospital, Fowler Conference Rooms 1506 S. Oneida St., Appleton, WI 54915 Meets the fourth Wednesday of every month starting January 23. 1 p.m. - 2 p.m. program, 2 p.m. - 3 p.m. social hour
Understand your feelings ~ If
you have recently lost a loved one, it’s normal to grieve and feel sad. You can’t always force yourself to be happy just because it’s the holidays. The holidays can cause people to feel generally anxious and depressed, but for some, holiday tensions can lead to full-blown clinical depression. If you feel persistently sad or anxious for a long period of time, talk to your doctor or a mental health professional.
Wellness Pathways Participants All rewards activity documents are due the 15th day of the month prior to your renewal date.
networkhealth.com
Network Health’s New Partnership Network Health is teaming up with CVS Caremark for your pharmacy benefits.
S
tarting January 1, 2013, Network Health will switch our pharmacy benefits manager from Express Scripts to CVS Caremark. This change will be effective for all of Network Health’s non-Medicare members with Network Health prescription drug coverage. By teaming with CVS Caremark, Network Health is able to help you manage your medicines so you can save time and money on refills.
What’s Changing
With the switch to CVS Caremark, you will receive new prescription ID cards and will have a new customer service number to contact. The new prescription ID cards will be mailed to you. You’ll need to present your card at the pharmacy when you refill your prescriptions beginning January 1, 2013. The current pharmacies will still be available for you to use, with the exception of Target Pharmacies. By offering a smaller number of participating pharmacies, Network Health is able to keep prescription costs competitive. You will be able to create an account through CVS Caremark’s website, Caremark.com, where you will have access to enhanced tools that allow you to: net workhealth.com
> > > > >
Order new prescriptions online with FastStart ® Find a local pharmacy Receive alerts by email, phone or text message Access online tools to track and manage your prescriptions Sign up for mail order service, request refills and renewals
Beyond the website, CVS Caremark also uses technology to improve your experience. You will be able to manage prescriptions from your iPhone or Android device. You can download the free CVS Caremark App from the App Store or Android Market.
What’s Not Changing
Network Health will not be using CVS Caremark’s formulary. Network Health’s Pharmacy and Therapeutics Committee develops and maintains the Preferred Drug List (formulary). The Preferred Drug List will be updated periodically and can be found at networkhealth.com. Also, Walgreens will remain out-of-network and you will not be able to fill your prescriptions there. Once again, all of the changes are not effective until January 1, 2013. Until then, you should continue to use your Express Scripts ID card, customer service number and mail order service. F a l l 2 01 2
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1570 Midway Pl. Menasha, WI 54952
THEY SAY LIFE BEGINS AT 30
MEET NETWORK HEALTH, SERVING OUR NEIGHBORS FOR 30 YEARS. If they are right, we can’t wait to get started. In 1982, a group of Fox Valley doctors had the vision to start a health plan based in northeast Wisconsin. This month, that plan, Network Health, celebrates its 30th anniversary. Over the years, we have earned a strong reputation for personal service and quality. Today, we provide health insurance coverage to thousands in northeast Wisconsin. While the world has changed dramatically in 30 years, one thing hasn’t. Network Health still has the vision to be a pioneer.
Networkhealth.com/EndTheJargon
800-826-0940
HMO plans underwritten by Network Health Plan. POS plans underwritten by Network Health Insurance Corporation, or Network Health Insurance Corporation and Network Health Plan. Self-funded HMO and POS plans administered by Network Health Plan.