What is My Blueprint? - Arkansas Blue Cross and Blue Shield

March 2003Annual meeting spotlights underwritingguidelines, rising health care costs, new productThere was a better-than-expected agent turnout atthe Arkansas Blue Cross and Blue Shield StatewideBusiness Division’s annual holiday meeting in LittleRock. The company used the event to formallyintroduce BasicBlue ® , the newest individual healthinsurance product for Statewide Business.Ron DeBerry, vice president of Statewide Business,conveyed his appreciation to the agents for theircontinued support in 2002 and his vision for newdevelopments in 2003.DeBerry told agents of an ongoing project to reviseand update the individual underwriting guidelines. “Inparticular, we are reviewing all of the existing surchargeratings and exclusion riders used by Arkansas BlueCross. We then will compare them with otherunderwriting guidelines that are used throughout thehealth insurance industry,” he said.He added that, due to the constantly changingmedical treatments for various impairments and thedevelopment of new prescription drugs, someunderwriting guidelines that have been in place sincethe mid 90s may need to be revised or updated.Agents may direct their comments and suggestionsregarding this matter to Deborah Benafield, agentrepresentative, at (501) 396-4110 ordjbenafield@arkbluecross.com.Ray Bredfeldt, M.D., regional medical director ofthe Northwest Regional Office in Fayetteville, presented“Facing the Challenge of Higher Health Care Costs,”during which he stressed the correlation between lifestylechoices and the ever-increasing cost of health care.He pointed to the cost of developing bio-tech drugsand said that the cost of these drugs often can exceed$1,000 per month. Dr. Bredfeldt reminded agents of theimportant role they play in helping their clientsunderstand howthese costs affectrates.Finally,Benafield spokeabout BasicBlue,a midstream deductible product that is designed to fit aspecific market segment. “This product should have aspecial appeal for those individuals desiring catastrophiccoverage,” she said.BasicBlue offers optional riders for physician officevisits and prescription drugs. However, maternitycoverage is not available with this product and statemandatedbenefits do not apply. These benefits areavailable with BlueCare ® PPO and PPO Plus.According to Benafield, underwriting may besomewhat more liberal with BasicBlue since anyoptional benefits for which the client may apply canbe declined, while a policy may still be issued coveringtheir in-hospital services.For more information on this new product, pleasecontact Benafield.Introducing …BlueCare Dental.See page 4 for details.

Followingautomatic draftprocess savestime and troubleBlue NotesIndividual Coveragevs. Family Coverage3Our automatic draft processprovides a convenient way forcustomers to pay their premiums.However, the convenience is lost —and sometimes, so is the customer— if the process for establishing theservice is not followed.It is vital that you make sureyour customers understand how theautomatic draft process will workand that they know to pay anyinvoice Arkansas Blue Cross andBlue Shield sends them — even ifthey have elected to use automaticdraft. We will never bill thecustomer and collect an automaticdraft for the same month.Agents, you must submit aseparate automatic draft form andVOIDED check with eachapplication, and the form must befully completed. You also shouldmake certain it and the voided checkare securely attached (e.g. stapled)to the application. Arkansas BlueCross processes more than 4,500applications each month; therefore,if an applicant’s paperwork becomesseparated and lost, it is unlikely thatwe will be able to find it. A fewseconds of precautions on thefront end will save us all fromextra work later.If you have additional questionsabout theautomaticdraft process,please contactDeborahBenafield.Now that we are into a new year, Iwant to address a topic that continues tocause confusion for many people. Whena woman who has an individual contract(no other immediate family member is onDeborah BenafieldIndividual Services Marketingthe coverage with her) becomes pregnant, the newborn dependent willNEVER be added automatically, as is required by law for familycoverage (two or more immediate family members covered together).Additionally, we will not change her policy to family coverage priorto the birth of the child. This means that no claims whatsoever will bepaid for the newborn dependent. Only the mother’s charges will becovered. There continues to be confusion with this issue as it pertainsto our individual line of business. If you have further questions on thismatter please feel free to contact me.Also, we will not underwrite a pregnant woman until after thedelivery of her child, nor will we offer family coverage to her spouse orany existing children. We will write those family members onindividual applications only, because we are not assuming the risk ofthe unborn dependent. After a pregnant woman has delivered and thechild is eight weeks old, a change form can be submitted to add allfamily members to one (the spouse’s) contract.Policyholder’s Request for an Agent Change to Existing CoverageWhen a person desires an agent change on their existing coverage,we will honor their request to change provided the coverage wasinitially agent-generated. If their policy was written without the serviceof an independent agent, then the policyholder’s request to change toan outside agent is denied.New Agent ContractsAs I addressed in an earlier edition of Agent Update, new agentcontracts have been written and will be released for signature withinthe next two months. Please review these contracts, properly executethem and return them to us for proper handling. Your promptattention to this matter is greatly appreciated.Contact Deborah at 1-800-634-6314, ext. 2-4110,or e-mail her at: djbenafield@arkbluecross.com

Agents Bruce and PhyllisHawkins share their story5Ask Bruce Hawkins for the secret to success in theinsurance business, and he’ll give you an answer as basicand steadfast as the man himself. “Pay attention to thecustomer, not just the employer in a group case, buttheir employees as well. Drop by, go through thebusiness and shake hands. People like to put a namewith a face. Don’t just go by at renewal time.”Hawkins and his wife, Phyllis, began their Morriltonlife and health agency in August 1979 and their propertyand casualty agency in March 1985. He decided to enterthe insurance field after purchasing a life insurancepolicy before getting married. “I liked the agent’slifestyle,” said Hawkins. “The freedom to choose whomyou work with, when you work, and play golf when youwant, was very appealing to a 22-year-old about to getmarried. But the people contact was the main focus.”With a background in banking, marketing andeducation, Phyllis didn’t so much choose to join thefamily business as much as it chose her. “I had no plansto be an insurance agent,” she said. “It sort of happenedby default. We had lost a secretary, who was our onlyemployee at that time. I came in after my school job andworked during the summer. Once I was here, I neverleft!” Today, she oversees the property and casualty sideof the agency.“The challenge we face is to make sure that we,as agents, give our clients every possible service,every option available, with every qualitycompany doing business in Arkansas.”In 1984, the Hawkins Insurance Agency was one ofthe first independent agencies appointed by ArkansasBlue Cross and Blue Shield. Affiliation with a nationallyrespected company opened a broader market for thelocal agency. “Arkansas Blue Cross has always been theRock of Gibraltar for our business,” said Hawkins.“We sometimes say our blood is almost blue,” hejoked. “We have a tremendous amount of respect forArkansas Blue Cross,” he added. “It is a company thatmakes us feelcomfortable,whether we’revisiting with thosein customer serviceor with Ms. SharonAllen. We know[Sharon] will listenbecause she cares.”Now in his 23 rdyear of business,Hawkins said theirstaff has been thetrue key to theirsuccess. “Eachemployee hasBruce and Phyllis Hawkinscustomer service astheir highest priority. Not one of our employeeswill back up from a challenge.” Their team includesCindy Sutton, Lorie Clary, Shirley Koontz, DonnaZimmerman, Paula Hearne, Tom Hale and Jim Sutton.Bruce and Phyllis see their biggest business challengeas expanding beyond their demographic borders. “Togrow in a small town is difficult due to limited businessesand resources,” said Hawkins. To meet that challenge,they associated their business with another insuranceagent, Ross Honea, who was in life insurance estateplanning and worksite marketing, and established H & HEmployee Benefits Specialists. “This gave us addedexpertise to offer our clients,” explained Phyllis, “and aLittle Rock metropolitan identity for our hometown agency.”Hawkins cited rising costs of health care as one ofthe greatest changes in the industry during the lastdecade. “As all of us are aware, the cost of health care is atremendous burden on employers, employees andindividuals. The challenge we face is to make sure thatwe, as agents, give our clients every possible service,every option available, with every quality company doingbusiness in Arkansas.”He said that, along with cost considerations, keepingup with rules, regulations and law changes also is atremendous challenge to doing business. A former state(See Hawkins, Page 10)

6What’s on-line for agents?Visit the “Agents” sectionof ArkansasBlueCross.com orHealthAdvantage-hmo.com to see what’s available foragents who sell Arkansas Blue Cross and HealthAdvantage products. Look for the “Agents” button at thetop of the home page of either site.You’ll find a menu page that points out sections ofthe site designed especially for agents, such as the AgentUpdate archive and the “Forms for Agents” section.Other areas that might be of interest to agents also arelinked from the “Agents” page on ArkansasBlueCross.com:• Health Plans & Services — brief descriptions ofproduct offerings and services that provide addedvalue to members;• Wellness Discounts — a list of health clubmemberships — weight-loss programs, andsporting goods and safety equipment vendorsoffering discounts to members;• About Us — information on the history,structure, financial stability and A.M. Best ratingLinks to Arkansas Blue CrossWeb sites allowedAgents who want to linkto the ArkansasBlueCross.comor HealthAdvantage-hmo.comsite from their Web site shouldfollow these guidelines:If the Arkansas Blue Cross and Blue Shield logois used on an agency Web site, the full logo,including the cross and shield symbols, the fullcompany name and the fine print disclosure line (AnIndependent Licensee of the Blue Cross and BlueShield Association), must be used. The Arkansas BlueCross logo must be no larger in size than the logos ofother companies the agency represents, and theagency logo should be larger than the Arkansas BlueCross logo (so that the agency Web site cannot bevisually construed to be an Arkansas Blue Cross Website by virtue of logo prominence).(See Web, Page 12)of Arkansas Blue Cross;• Provider Directory —searchable lists ofphysicians, dentists,hospitals, pharmaciesand other health careproviders and facilitiesparticipating in ArkansasBlue Cross and HealthAdvantage networks;• FAQ — to answer commonquestions about health plans and services;• Glossary — easy-to-understand definitions ofhealth insurance terms;• Contact Us — for information on how to get theanswers you need from Arkansas Blue Cross andHealth Advantage.“In-FORM-mation” at your fingertipsIn the “Forms for Agents” section onArkansasBlueCross.com, you’ll find the following forms inportable document format (PDF). You may print andcopy these as needed. A link is provided on the “Forms”page to Adobe Acrobat Reader, the free softwareprogram you will need to open and print the documents.• BlueCare PPO/PPO Plus application forIndependent Agents• BlueCare PPO/PPO Plus application for FarmBureau Agents• BlueCare PPO/PPO Plus Change Request Form• BasicBlue application for Independent and FarmBureau Agents• Medi-Pak application for Farm Bureau Agents• Large Group Employee Application/MedicalQuestionnaire for Late Enrollees• Small Group Quote Request Form• Small Group Employee Application• Small Group Medical QuestionnairesThe “Agents” section of HealthAdvantage-hmo.comcontains similar information. Visit our Web sites today!

Enterprise recognized as leaderin Web site performanceArkansas Blue Cross and Blue Shield’s Web site,ArkansasBlueCross.com, recently received recognition onthree fronts.The site ranked in the “top 16” foron-line services among 97 Blue Crossand Blue Shield plans and othercommercial payors in a recent studyconducted by Cap Gemini Ernst &Young Group, one of the largestmanagement and InformationTechnology consulting organizationsin the world.The site also was ranked as thestate’s “Best Insurance Site” in the 2002 Arkansas Business“Best of Arkansas” Web Awards.In a third award, the Arkansas Blue Cross Web sitereceived the PRISM Award as the best Web site inArkansas from the Public Relations Society of America(PRSA), Arkansas Chapter. This is the second year in arow that the site has won this award from PRSA.Cap Gemini Survey of “Payor” Web sitesThe Cap Gemini study evaluated Web siteperformance based on the followingattributes of Web sites typicallyexpected by customers:• Secure — Leading Web sites usepasswords and/or encryption to restrictaccess to sensitive information.• Extensive — Leading Web sitesoffer a variety of on-line services thatare valuable to their customers.• Accessible — Leading Web sitesoffer customer services, providerdirectories and log-ins for secure member/providerinformation directly to users on the home page.• Connected — Leading Web sites have links toother sites that offer health information.• Customized — Leading Web sites have tailoredtheir design and offerings to address members’individual needs.7Best of Arkansas Web Awards“Dynamic … easy to use … functional”That’s what Arkansas Business, the state’s weeklybusiness journal, looked for when it set out to find thestate’s best Internet sites. “The Web site for the state’slargest health insurance company does a great job ofconveying its myriad of information in an organizedmanner,” the judges said about the Arkansas Blue Crosssite. “A personal benefits and claims tracker, along withsections providing rate quotes and legislative updates,keeps the site user-focused. And BlueAnn’s Wild andWoolly Web siteoffers games,music videos,a weekly polland otherinteractivetools foryoungerviewers.”Farm Bureau of Arkansas was first runner-up with itsarfb.com site.Judges included Steve Asmussen, informationtechnology director, Baptist Health; J. Edward Horton,marketing and alliances leader, Acxiom Corp.; TomAllen, president, Avow Technology Solutions; RussellShain, dean of the College of Communications,Arkansas State University; Wayne Chapman, associateprofessor of theater arts and member of CyberCollege ITfaculty, University of Arkansas at Little Rock; PamelaSchmidt, associate director, Information TechnologyResearch Center, University of Arkansas; DanDelaughter, director of management of informationsystems, Arkansas Department of Parks and Tourism;Michael Preble, associate director-education, ArkansasArts Center; David Snyder, general manager-interactivedivision, Crain’s Chicago Business; and Jeff Ireland,president, virtuallythere.net, Fort Worth, Texas.

Why must I registerto use My Blueprint?You must register on-line and receive a passwordby U.S. Mail before you can enter MyBlueprint. This level of security is necessary toprotect your personal information and meetfederal privacy regulations.99Who can register to useMy Blueprint?Only the policyholder (subscriber or contractholder) can register, but the policyholder cansee information for a covered spouse ordependent.The policyholder must enter some basicinformation from his or her ID cardto complete the registration form:• Member ID number• First and last name and middle name or initial• Date of birthThe only other information the form requires is selection of two secret questions and answersto be used if you forget your password. Entering your e-mail address is optional.What do I need to log in?A log-in ID and a password are needed tolog in. When you register on-line, you receivea log-in ID on screen. Your password is mailedfive to seven business days following successfulregistration.After you receive your password by mail,you can return to the site and log in. Theaccount must be activated using thecomputer-generated ID and password.After the initial log-in, you may change thepassword to something easier to rememberbut cannot change the log-in ID. Pleaseremember to keep your log-in ID andpassword private.Welcome to My Blueprint!

10CHIP administration reminderAs a reminder, the administration of theArkansas Comprehensive Health Insurance Pool(CHIP) now is handled by BlueAdvantageAdministrators of Arkansas (formerly USAbleAdministrators), not Arkansas Blue Cross andBlue Shield.BlueAdvantage signed a three-year contract toadminister the program. There are different telephonenumbers and addresses to use with the newadministration and new applications to be utilizedfor new business.For CHIP customer service assistance, membersshould call, toll-free: 1-800-285-6477. This is thesame number to call for eligibility/application issuesand information, and to order supplies.To submit CHIP claims, members should mailthem to: CHIP, c/o BlueAdvantage, P.O. Box 1460,Little Rock, AR 72203-1460. Electronic claimssubmitted by providers will be submitted as usualthrough AHIN.Last year, all CHIP insureds were notified by letterof the change and received new ID cards, policyforms, benefits summaries, and rate increaseinformation.CHIP was created by legislation passed by theArkansas General Assembly in 1995 as a healthinsurance plan for individuals who have been turneddown for insurance or who can’t afford healthinsurance. CHIP was created to pay claims for highriskhealth insurance consumers. Funded 60 percent bypremiums collected from policyholders and 40 percentfrom assessments to insurance carriers, the plan will notdeny any applicant simply because of their health status.The state began issuing policies from this pool inJuly 1996. Arkansas Blue Cross served as administratorof the CHIP fund until the middle of 2002.CHIP is an individual, comprehensive majormedical policy with deductibles of $1,000, $5,000 and$10,000, which may be elected. Correspondingcalendar year coinsurance maximums are $5,000,$25,000 and $50,000. After the deductible is met,claims are paid at 80 percent of the allowed amountin-network or 60 percent of allowed amount out-ofnetwork(hospital, physician, drug). Once the calendaryear coinsurance maximum has been met, claims thenare paid at 100 percent the of allowed amount. Thereare no copayments on CHIP. Claims are filed by theprovider, with the exception of pharmacy claims,which are not networked. Individuals must filepharmacy claims.If you’re looking for an alternative health insurancebenefits program for a client who’s hard to cover, don’tforget the CHIP.If you have questions, contact BlueAdvantage at1-800-285-6477 or visit the Web site atBlueAdvantageArkansas.com.(Hawkins, continued from Page 5)representative, Hawkins has been alobbyist since 1995. Currently, hehas the Central Arkansas HealthUnderwriters Association (CAHUA)as one of his clients.“The CAHUA goal is to helpagents by making it easier to dobusiness in our state,” he said.“Many issues facing an agent intoday’s marketplace can be addressedin a number of ways, if not on acompany level, then usually on alegislative level. I would highlyencourage every agent in the state toget to know his or her representativeand senator. It is important becausewhat they do in the GeneralAssembly affects all our lives.”Hawkins said the CAHUAfavors repealing the “grandfatherclause” in the continuing educationlaw for agents that passed in the 90s.“They believe, as many organizationsdo, that everyone involved ininsurance should continually striveto educate themselves regardless ofage or number of years in theinsurance business.”You may contact Hawkinsregarding lobbyist matters atdbhawkins@cox-internet.com.They said they enjoy workingside by side. “It’s funny sometimes,because we are a true ‘mom and pop’organization. We have beenfortunate to have a business that welove where we can truly help others,”said Phyllis. “It’s what insurance is allabout.”Lifelong residents of Morrilton,they have one son, Clayton, 15, whoPhyllis calls “the joy of our lives.”

Meet new status rep Stephen Phaup11If you call Arkansas Blue Crossand Blue Shield with questions aboutunderwriting or applications, you mayhave the opportunity to work withStephen Phaup, our newest statusrepresentative.Phaup, who joined the companyin 2002, said he also works withapplicants and agents to explain thestatus of applications during theunderwriting process.“We are able to let them knowwhether their application has beenapproved or not,” he said. “Also, we can explain whywe might need additional information before we canreach a decision for them.”(Link, continued from Page 2)Action ItemsThis section gives you information about thoseissues on which Arkansas Blue Cross would encourageyou to take action.BlueLink TeamLet us help you become active in the legislativeprocess. Arkansas Blue Cross invites you to join ourBlueLink Team. As a member of the team, youwill receive updates on Congress and the ArkansasLegislature. You also will receive information onkey issues so that you can be better informed incommunications with legislators. Membershipapplications are available on-line.Arkansas General AssemblyFrom here we’ll link you to the state Legislature’sWeb site for complete bill information and otherlegislative events.(Agenda, continued from Page 2)state-mandated benefits.• House Bill 2192 by, Rep. Roger Smith of HotSprings, amending the insurance trade practice lawsand the Insurance Sales Consumer Protection Act.• House Bill 2390, by Rep. Kevin Penix of FortSmith, allowing insurers to adopt an approved courseof study for prelicensing of agents and to allowBrad Welshans, manager ofIndividual Marketing, said that to alarge degree the status representativehandles “problem cases.” He said agentswill find Phaup does his best to resolveproblems in as timely and positive amanner as possible. “And, our agentswho are golfers will be impressed tolearn that Stephen played golf for theUniversityof Arkansas, and he can still get in theoccasional subpar round.”Phaup and his wife, Courtney, residein North Little Rock and have two dogs. Away fromthe office he enjoys picking on the guitar, taking thedogs to the park and, of course, golfing.Contact Your LegislatorsClick this link for helpful tips on how tocommunicate with your legislators. Since the stateLegislature meets for only three months every other year,you may want to reach members while they are out ofsession and back at home.Arkansas Insurance DepartmentVisit the Arkansas Insurance Department’s Web sitefor consumer help and information.Blue Cross Blue Shield Health IssuesVisit the Blue Cross and Blue Shield Association’sextensive health issues Web site for a comprehensive lookat current health care issues. This site also links you toyour state and federal senators and representatives. Allyou have to do is type in your ZIP code to obtaininformation, including e-mail addresses and telephonenumbers, about your legislators. From that page, youalso can access information about Arkansas’congressional delegation.insurers to conduct prelicensing training for agents.• House Bill 2769, by Rep. Paul Bookout ofJonesboro, imposing continuing educationrequirements on insurance producers.

Pending applications – Call 1-800-634-6314. The Application Status Unit handlespending applications that are in the Underwriting division.Policy services – Questions regarding an in-force policy should be directed to1-800-238-8379. This area will be able to assist with billing problems, addresschanges, etc.Marketing or products – Call Deborah Benafield at 1-800-634-6314 or(501) 396-4110.Section 125 plans – Call Deborah Benafield at 1-800-634-6314 or (501) 396-4110.Arkansas Blue Cross and Blue ShieldMember Information Lines Little Rock Toll FreeCustomer Service (main line) 501-378-2010 1-800-238-8379BlueCare PPO or BlueCare PPO Plus 501-378-2010 1-800-238-8379Blue Select® 501-378-2010 1-800-238-8379BlueCard® 501-378-2127 1-800-880-0918Customer Service E-Mail AddressesArkansas Blue Cross and Blue Shield: customerservice@arkbluecross.comArkansas Blue Cross Web siteswww.ArkansasBlueCross.comwww.HealthAdvantage-hmo.comwww.BlueAdvantageArkansas.comHow to Contact UsTo get the information you needwww.BlueAndYouFoundationArkansas.orgwww.BlueAnnEwe-ark.comClip & Save(Web, continued from Page 6)Any content on the agency site that refers toArkansas Blue Cross (or Health Advantage) shouldinclude the following “Blue Cross ReferenceStatement:”“(Name of Agent or Agency) is anindependent soliciting agent of Arkansas BlueCross and Blue Shield [and Health Advantage]and is authorized to provide information andtake applications for Arkansas Blue Cross [andHealth Advantage] products. (Name of Agent orAgency) is not authorized to state policies orissue contracts but can connect you withauthorized personnel at Arkansas Blue Cross [andHealth Advantage], which maintain separateoffices and retain sole authority over coverageeligibility, terms or conditions. The service areafor Arkansas Blue Cross [and Health Advantage]is the state of Arkansas. Residents outsideof Arkansas may visit www.bcbs.com forreferral to the Blue Cross BlueShield Plans licensed in othergeographic areas.”Arkansas Blue Cross and Blue ShieldAdvertising and Communications320 W. Capitol Ave., Suite 200P.O. Box 2181Little Rock, AR 72203-2181PRSRT STDU.S. PostagePAIDLittle Rock, ARPermit No. 1913Agent Update is published four times a year forindependent agents and brokers by the Advertisingand Communications Division of Arkansas Blue Crossand Blue Shield.March 2003EditorTammi Williamson Bradley501-378-5869501-378-2969 (FAX)twbradley@arkbluecross.comContributorsGio Bruno, Janice Drennan, Damona Fisher,Kathy Luzietti and Kelly WhitehornVice President,Advertising & CommunicationsPatrick O’Sullivanwww.ArkansasBlueCross.com