A publication for the policyholders of the Arkansas Blue Cross and Blue Shield family of companies
Representatives of Arkansas Blue Cross and Blue Shield are
ready to help you. Call or come by one of our locations.
Arkansas Blue Cross tops
national customer survey
a customer at
3 Out of the Blue
The health care law and you
The Health Insurance Marketplace –
how it might help you
Meetings for small businesses
Arkansas’ Health Care Independence
Program: Do you qualify?
Customers rank Arkansas Blue Cross
as a top Blue Plan in the nation
Your role in health care
Will Arkansas have enough doctors?
Grants available for health programs
Live Fearless – our new advertising
New ArkansasBlue health insurance
store opens in Pine Bluff
Fast food and asthma
Binge drinking studies
Lose weight the Healthy Weigh!
The “freedom” of short-term coverage
Arkansas Blue Cross and Blue Shield –
Financial Information Privacy Notice
Is memory loss from aging
or lack of sleep? Maybe both.
Customer Service telephone numbers
Health care law timeline
Blue & You is published four times a year by Arkansas Blue Cross and
Blue Shield for the company’s members, health care professionals
and other persons interested in health care and wellness.
Health information from sources outside of Arkansas Blue Cross and Blue
Shield do not necessarily represent the official position of the company.
EDITOR: Jennifer Sullivan – email@example.com • DESIGNER: Ryan Kravitz • PHOTOGRAPHER: Chip Bayer
CONTRIBUTORS: Will Ballard, Chip Bayer, Gio Bruno, Matthew Creasman, Damona Fisher, Kristy Fleming, Lauren
Green,Trey Hankins, Heather Iacobacci-Miller, Genny Kirchner, Kathy Luzietti, Wendy McCullar, Mark Morehead,
Alex Roberts, Kelly Whitehorn and Stephen Wilson
VICE PRESIDENT, COMMUNICATIONS and PRODUCT DEVELOPMENT: Karen Raley
2 BLUE & YOU SUMMER 2013
Sara Harris, ArkansasBlue team leader,
consults with a customer about the
upcoming health care law changes.
Upcoming changes under the health care law
It has been a busy year for the health care
industry, and it is only halfway through. We
have seen remarkable progress made toward
implementing provisions of the new health care
law as they become effective, but I know many
of you still have concerns about the changes yet
to be implemented. You can rest assured that our
team at Arkansas Blue Cross and Blue Shield has
been working to determine how to best address
Arkansas Medicaid expansion
Arkansas historically has had one of the most
restrictive Medicaid programs in the country,
and I applaud the bipartisan efforts of the
Arkansas Legislature and Gov. Mike Beebe
to create the Arkansas Medicaid private
option that was signed into law in April.
Arkansas is the first state in the nation to
create a system allowing qualified low-income
Arkansans to purchase subsidized private
insurance through the state’s Health Insurance
Marketplace, but other states are watching with
interest. For the first three years, this program
will be funded entirely with federal money.
Expanding Medicaid to provide health care
coverage to low income Arkansans is the right
thing to do. It not only benefits people who are
struggling financially, it benefits their families,
the business owners who hire these workers,
our health care providers and the state’s
economy. Ultimately, we will see the benefits
of a healthier population.
Controlling health care costs
Many of you may have heard news reports
concerning increases in premium costs as a
result of new regulations under the health care
law. There are provisions of the law that will
increase costs for some, but there will be both
winners and losers under the new regulations.
a message from our President and CEO,
Why are costs increasing for some? The law
requires the insurance industry to cover more
services, offer some services at no cost to the
member, and calculate premiums according
to new guidelines. There also are a number of
new taxes and fees included within the law.
Certainly, most Americans understand that when
you provide free or reduced-cost insurance to
millions of people and cover more services,
there will be a cost associated with it.
In this issue of Blue & You, we explain some of
the new provisions within the health care law
and what we believe you can expect regarding
your coverage. Some of you will find that your
coverage will be less expensive in the future;
for others, it will be more costly. Regardless of
the impact, Arkansas Blue Cross has spent the
past two years working to find solutions that
will provide you and your family affordable
If you purchase health care coverage for
you and your family on your own, we will be
reaching out to you this summer to request
a health insurance review. During a phone
call or a visit we can cover any changes the
law will require and make you aware of the
most affordable choices available to you.
It is important that you are informed about
your options and you that maintain your
“grandfathered” status until you have the
information needed to aid in the decision
process. Our customer support teams are
CHANGES continued on page 23
SUMMER 2013 BLUE & YOU
the HEALTH CARE law
“Will it impact my coverage?”
Whether your health insurance coverage will
change as a result of new health care rules that
go into effect January 1, 2014, depends on when
you bought your health insurance and whether
you bought it at work or on your own.
If you are on a Medicare Supplement plan,
regardless of when it was purchased, you won’t
see any changes to your plan coverage in 2014
as a result of the health care law. If you have a
Medicare Advantage or Medicare Prescription
Drug Plan, the process for notifying you about
2014 changes at the end of September 2013
remains unchanged as a result of the law.
Plans purchased before March 2010
If your health plan was in place before the law
was passed in March 2010, whether purchased
through your employer or on your own, you
may have what is known as a “grandfathered”
plan. A number of changes already have
been made to these policies to meet new
legal requirements. Changes include allowing
children to stay on a parent’s health plan until
their 26th birthday and removing lifetime dollar
limits on some medical services. These plans
will not see any big changes in 2014. If you are
unsure whether your plan is grandfathered, call
the customer service number on your ID card or
contact your human resources administrator.
Employer Plans (purchased after March 2010)
If you have coverage through a company with
100 or more employees, many changes required
by the health care law already have been applied
to your health plan. These required changes
included removing any annual or lifetime dollar
limits on certain medical services and adding
preventive services if your plan did not include
them. A major change that will be implemented
relates to your total out-of-pocket cost. When
this rule is put in place for your health plan, all
deductibles, coinsurance and copayments will
count toward your out-of-pocket maximum.
4 BLUE & YOU SUMMER 2013
If your employer employs 51 to 100
employees, similar changes will become
effective in 2016.
Employers with 50 or fewer employees are
likely to see a number of changes to their
coverage if the plan is not a grandfathered plan.
The law requires that these health plans include
a core set of benefits (essential health benefits)
and cover preventive services at 100 percent
with no member out-of-pocket costs. Among
the preventive services provided with no cost
sharing are colonoscopies and contraceptives.
Also in 2014, your health plan will cover medical
conditions that previously required a waiting
period. Employers with two to 50 employees will
be invited to attend meetings with Arkansas Blue
Cross to discuss in detail how the health care
law is impacting our employer customers (see
article on page 9). After the meeting, employers
will be contacted by their agent or an Arkansas
Blue Cross representative, to determine the
most affordable option for their organization.
Those who bought coverage on their own
after March 2010
If you bought an individual or family health
plan (not a Medicare plan) on your own and it
was purchased after March 2010, you can keep
the policy you currently have until December 30,
2014, with no changes.
Some of our members will find the new health
plans to be more desirable. You may receive a
new kind of tax credit that lowers their monthly
health plan costs. If that is the case, your agent
or an Arkansas Blue Cross representative will
make you aware of a more affordable option.
New health care plans will cover preventive
health benefits at 100 percent, will have no
waiting periods for medical conditions and you
will have guaranteed approval for health care
coverage. Also, all deductibles, copayments
and coinsurance will go toward your out-ofpocket
We are here to help
This summer we are asking our members
with individual or family health plans (not
Medicare plans) to call us or their agent or
come in and let us check to see if a lower cost
plan will be available under the new law. Our
representatives are trained and ready to talk
“Will it impact what I pay?”
For many Americans who are not on
Medicare, the full implementation of the new
health care law in 2014 may mean a change in
what they pay monthly (called a premium). And
there will be winners and losers.
The extent to which the new rules will affect
your health plan depends in part on when your
coverage was purchased, and whether you
get coverage through an employer or if you
purchase coverage on your own for yourself
and/or your family. The new changes will have
the greatest impact on those who work for
companies with 50 or fewer employees and
those who buy coverage for themselves and
their families on their own or through an agent.
The amount you pay monthly (your premium)
may increase or decrease as a result of four
primary provisions contained in the new law.
• New taxes and fees
• New requirements regarding what
medical services must be covered
by insurance policies
• New rules concerning how insurance
companies must calculate members’
• The availability of tax credits or subsidies to
help pay for health insurance for individuals
and families who qualify
with you. You can call us at 1-800-310-3778 or
you can visit with us in person at one of our
offices around the state. Arkansas Blue Cross
has been providing Arkansans quality health
plans at affordable prices for 65 years, and
we look forward to working with you.
New Taxes and Fees
New taxes and fees included in the law will
have an impact on premiums. The money
collected from these fees will be used to
help pay for advance premium tax credits
(commonly called subsidies) which will be
available to Americans in low-to-middle
income ranges to help pay for health insurance.
These taxes and fees also will be used to fund
research into effective medical practices, to
help cover the cost of the Health Insurance
Marketplaces that will be established in every
state and to stabilize the insurance market in
the early reform years. Industry experts project
that the fee collected to help fund the tax credit
alone will add 2-3 percent to the cost of health
insurance. Collectively, the fees could add as
much as 3-5 percent to individual and employer
health plan premiums.
New Coverage Requirements
Health plans sold to individuals and employers
with 50 or fewer employees must cover a core
set of medical services called “essential health
benefits.” Many of these essential health
benefits were covered by Arkansas Blue Cross
health plans already, such as hospitalization and
emergency care. Others were offered, but the
buyer in some cases had the choice of whether
to purchase the coverage, such as maternity
and preventive care. Beginning in 2014, these
coverage requirements no longer will be
optional. In addition, more preventive services
have been added and the health plan must pay
100 percent of the cost of these services.
LAW continued on page 6
SUMMER 2013 BLUE & YOU
LAW continued from page 5
Because more services will be covered and the
health plan will pay more of the cost, premiums
will go up to cover the cost of these new health
New rules around determining your monthly costs
Historically, insurance companies have
considered a number of factors when
calculating premiums for employers or
individuals purchasing coverage. These factors
include the health condition of the individual
or the employees in an employer’s group plan.
Those employers or individuals who have more
health conditions are likely to use more medical
services and are, therefore, charged a higher
rate. Beginning in 2014, health insurers will
not be allowed to consider health conditions in
developing premiums. As a result, those who
are less healthy may find their costs are less
and those who are healthier will pay more in
Age also has been an important consideration
in establishing premiums. Older people generally
use more medical services and, therefore, pay
more, while younger people who are not as
likely to need expensive medical care pay less.
Although age still will play a role in setting rates,
there will not be as a great a range between the
rate charged to a 24-year-old and the rate charged
to a 60-year-old. Younger people can expect to
pay higher rates when these rules are applied in
2014, and older people will pay less.
These are two of a number of new rules
regarding setting premiums that will begin
in 2014 and will cause changes in how much
people pay for coverage.
Advance premium tax credits
Beginning in January 2014, many low- and
middle-income Americans who do not have the
opportunity to enroll in an employer’s health
plan will be eligible to receive a new kind of
tax credit that lowers monthly premiums. The
amount of tax credit a household receives is
based on their household income and family
size. The lower the household income, the
higher the tax credit.
If you think your household may be eligible
for an advance premium tax credit, please
call Arkansas Blue Cross. We will help you
determine if you meet the requirements and
provide you with an estimate of what your
premium might be after the tax credit is applied.
Arkansas Blue Cross has the information you need
The health care law is complex and difficult to
understand. Some of our members will benefit
and others will not. You can count on Arkansas
Blue Cross to provide the accurate and reliable
guidance you need to understand how the
health care law affects you and those you love.
Please don’t make any changes to your health
insurance coverage without talking to us first.
If your current plan was issued before the law
passed, keeping it may be your best option.
And if you drop it, you can’t get it back. If you
buy coverage on your own, call your agent or
Arkansas Blue Cross or come by one of our
locations for a health insurance review. We are
ready to help you evaluate your options and
select a plan that provides the coverage you want
at the lowest cost. Call 1-800-310-3778 today.
Could you receive help with
your health care costs?
We can help you find out in just a few
If you are wondering if you will get a break on
the monthly cost of your health insurance plan
in 2014, we can give you a quick answer.
Just visit our website, arkansasbluecross.com,
and select “Will I qualify for a tax credit?,” and
you can get an answer by answering two simple
questions: household income and household
size. That’s it.
This “estimator” is for individuals or families
who purchase their health insurance on their
own (in other words, you do not have coverage
through your employer). Glad we can help!
6 BLUE & YOU SUMMER 2013
the HEALTH INSURANCE Marketplace
Qualifying for a tax credit
Federal Poverty Level – 2013
in family 100% 133% 200% 300% 400%
Helping some Americans pay for health care
If you are one of millions of Americans under
age 65 who will purchase a health plan this
fall through the Health Insurance Marketplace
(exchange), you may be eligible for a $0
premium plan or a new kind of tax credit that
lowers your monthly premiums.
The Health Insurance Marketplace is a website
designed to determine if you are eligible for
financial help to cover your health insurance
costs. It also will help you and your family shop
for and purchase health insurance. Americans
may also contact the Health Insurance
Marketplace by telephone.
A Health Insurance Marketplace is being set
up in each state, either by the state itself, by the
federal government, or in Arkansas’ case, in
partnership with the federal government. Each
marketplace will be responsible for:
• Creating and maintaining a consumer
• Providing access to all information necessary
to determine if you are eligible for help
paying for your premium or if you qualify for
• Helping consumers shop for and purchase
• Making sure all health plans offered on the
marketplace meet all the new regulations.
The Health Insurance Marketplace will be
open October 1 for people to purchase
coverage that begins January 1.
NOTE: Federal minimum wage employee working 50 weeks per
year, 40 hours per week would earn $14,500.
Why buy on the marketplace?
Many Americans will be eligible to receive
advance premium tax credits (subsidies) if they
purchase a health plan through the marketplace.
An advance premium tax credit is a new tax credit
that you can use to lower your monthly premium
costs beginning January 1, 2014. (see chart below
to see if you might qualify.)
The amount of the advance premium tax credit
that each household will receive is calculated by
using their income, the size of their family and
other factors. This new tax credit helps lower- and
middle-income families. Some households, based
on their income, will receive additional financial
assistance when they receive medical care.
Essential health benefits
Every health plan sold to small employer
groups and individuals on the Health Insurance
Marketplace must include a core set of benefits
established by the law. Many of these services
are covered today by health plans sold by
Arkansas Blue Cross. Others, such as preventive
care and mental health services, are available to
purchase as options, but going forward, those
will be required.
The essential health benefits are included in
the following 10 categories:
1. Ambulatory patient services
2. Emergency services
4. Maternity and newborn care
5. Mental health and substance
use disorder services, including
behavioral health treatment
6. Prescription drugs
7. Rehabilitative and habilitative
services and devices
8. Laboratory services
9. Preventive and wellness services
and chronic disease management
10. Pediatric services, including oral
and vision care
LAW continued on page 8
SUMMER 2013 BLUE & YOU
LAW continued from page 7
In addition, these essential health benefits
must be covered with no annual or lifetime
dollar limits. Preventive services, including
women’s preventive care and birth control must
be paid 100 percent by the health plan.
People often found that it was difficult to
compare what their total cost would be from
one plan to the next. It was easy to compare
the monthly payments (premiums) but it was
difficult to compare how much you would pay
out of pocket for medical services. In an effort to
make it easier for people to determine what they
will pay for medical services, the health care
law standardized the health plans on and off the
Health Insurance Marketplace. Because these
health plans are called Bronze, Silver, Gold and
Platinum, they are referred to as Metallic Plans.
For instance, the lowest level of coverage,
called the Bronze plan, is designed to cover
60 percent of your total health care costs.
A person purchasing a Bronze plan will pay
more when they receive health care but less
month to month (their premium). A person
purchasing a Platinum plan will pay more
month to month, but pay less at the doctor’s
office. (See chart below.)
Because the law requires that insurance
companies offer plans that only fit these levels,
they are no longer allowed to offer plans that
don’t fit the requirements. For instance, you
won’t be able to purchase a plan to cover 75
percent of your medical costs. As a result of
this regulation, health insurance companies
will have to reduce the options available to
small employers and individuals.
Arkansas Blue Cross can estimate any
advance premium tax credits you may be
eligible to receive and can help you select
a health plan. You can buy an Arkansas Blue
Cross plan on and off the marketplace. Call
us at 1-800-310-3778 or come in for a health
60% * 70% * 80% * 90% *
BRONZE SILVER GOLD PLATINUM
*NOTE: Percentage shows how much of your total health care costs this plan pays.
? Have a question? Ask us!
The health care law is complex and confusing,
but Arkansas Blue Cross and Blue Shield is here
to help. If you have questions regarding anything
to do with the health care law, we want to hear
from you in an email, post or tweet.
Our email address designated for the health
care law questions is HCRinfo@arkbluecross.com.
Send us an email and we will respond directly
8 BLUE & YOU SUMMER 2013
to you. We usually can get an answer back
to you in a day or two. To find our corporate
Facebook page, just search for Arkansas Blue
Cross and Blue Shield. Our Twitter account
If you are under 65 and have an individual or
family health plan you purchased on your own
or with the help of an agent, you can call your
agent or call us for a health insurance review at
We love to hear from you!
The Arkansas Health Care
Independence Program is a
new program for low income
Arkansans that will allow them
to shop for and enroll in Arkansas
Blue Cross and Blue Shield and
other health care plans on the
Health Insurance Marketplace.
These health plans will be
available at no cost to them.
People who choose this
program can use any of the
doctors or hospitals that other
MEETINGS for SMALL
Employers with two to 50 employees are invited to attend meetings with
Arkansas Blue Cross and Blue Shield representatives to discuss in detail
how the health care law is impacting our employer customers.
Arkansas Blue Cross will hold meetings in 10 locations throughout
the state during August and September. After the meetings,
employers will be contacted by their agent or an Arkansas Blue Cross
representative. We hope to see you at one of the following locations:
Thursday, August 8
Hot Springs Convention Center
Tuesday, August 13
Hilton Garden Inn
Wednesday, August 21
Arkansas Blue Cross members
choose and will either pay
nothing or very little when
they receive medical care.
Call us at 1-800-310-3778
to find out if you qualify.
Beginning in October, we
can help you enroll.
Tuesday, August 27
Holiday Inn City Center
Wednesday, August 28
Thursday, August 29
ASU – Vada Sheid Development Center
Wednesday, September 4
Texarkana Country Club
Wednesday, September 11
El Dorado Conference Center
Thursday, September 12
Pine Bluff Convention Center
The Arkansas Health Care Independence Program: Do you qualify?
On April 23, Arkansas Gov. Mike
Beebe signed historic legislation
approving a Medicaid expansion
program in Arkansas, creating
the Arkansas Health Care
Meetings will be held at 1:30-3 p.m. in all locations.
SUMMER 2013 BLUE & YOU
When was the last time you felt … FREE?
Free of worry? Free of fear?
Free of uncertainty?
It’s time to uncover that feeling again.
Because you are protected …
with the compassion of a CROSS
that’s been trusted for 65 YEARS;
the security of a SHIELD accepted
by more than 90 PERCENT
of doctors and specialists.
And the power of a card that
opens doors in IN ALL 50 STATES.
Giving you the freedom to love.
To dream. To dare. To believe. To laugh.
To dance like no one is watching.
Arkansas Blue Cross and Blue Shield.
You’ve likely seen and heard our new
messages on television and radio for
several weeks now. What is it all about?
Health care financing was invented
during the Great Depression, and with
a new health care revolution on the
horizon, we know you may have concerns.
Arkansans have come to rely on Arkansas
Blue Cross and Blue Shield for more than
six decades — and you still can.
with the card that opens doors in 50 states
An independent licensee of the Blue Cross and Blue Shield Association.
We’ll be here to guide you through this
rapidly evolving health care landscape.
Giving you strength to be fearless, even
in the face of change. Contact us about
affordable health coverage to protect you
and your family. So you can Live Fearless.
10 BLUE & YOU SUMMER 2013
An independent licensee of the Blue Cross and Blue Shield Association.
An independent licensee of the Blue Cross and Blue Shield Association.
SUMMER 2013 BLUE & YOU
Fast Food and Asthma
We all know fast food isn’t exactly ideal for
us. But, if your child has asthma, you may have
even more of a reason to cut out the fast food.
A recent study published in Thorax (a respiratory
medical journal, suggests that consuming fast
food more than three times a week can lead to an
increase in the severity of their asthma.
While the findings do not show that fast food is the
cause of asthma, they do suggest that children with
asthma who eat fast food often have more severe
asthma than children who do not eat fast food often.
Why? It appears that it may be due to the high
levels of saturated and trans fats and sugar found
in fast food; all of which are known to affect the
Sources: Healthyliving.msn.com / Usnews.com
Studies tie binge drinking to future heart
disease and liver damage
Young people who party too hard may regret it later
in life, according to recent studies on alcohol’s lasting
effects on health.
In research published in the Journal of the American
College of Cardiology and in Alcoholism: Clinical
& Experimental Research, binge drinking has been
identified as a significant risk factor for both heart
disease and liver damage later in life.
In the study regarding heart health, researchers looked
at two groups of healthy nonsmoking students, ages 18
to 25. One group had a history of binge drinking and the
other group did not drink heavily. The study found that
binge drinkers had impaired function in two cell types
that control blood flow. These vascular changes can be
a precursor to hardening of the arteries, heart attack
The study focused on liver damage in binge drinkers
found that over time binge drinking can sensitize
the liver and make it prone to more subsequent
damage. High levels of alcohol were found to create
an inflammatory response in the liver, sending out
various damaging signals to systems in the body.
Both studies cautioned against the notion that
being young and healthy can protect people from
poor lifestyle behaviors or choices.
Source: Journal of the American College of Cardiology;
Alcoholism: Clinical & Experimental Research
12 BLUE & YOU SUMMER 2013
*Arkansas State and Public School Employees
can enroll in a weight-loss program administered
by the Employee Benefits Division.
Call 1-877-815-1017 for more information.
**Medi-Pak ® Medicare supplement and
Medi-Pak Rx insurance policyholders are
not eligible for The Healthy Weigh! program.
The Healthy Weigh! Education
Program is free for members of
Arkansas Blue Cross and Blue
Shield, Health Advantage (except
ARBenefits members*), Blue Cross
and Blue Shield Service Benefit
Plan (Federal Employee Program),
Medi-Pak Advantage (PFFS), Medi-
Pak Advantage PPO, and eligible
members of BlueAdvantage
Administrators of Arkansas.**
To enroll, complete the attached
enrollment form and return it in
the self-addressed, postage-paid
envelope included in this magazine.
The program starts when you enroll.
After enrollment, you will begin to
receive information through the mail,
which you can read in the privacy
of your own home and at your own
pace. The program is completely
voluntary, and you may leave the
program at any time. If you have
further questions about the program,
call the Health Education Program’s
toll-free number at 1-800-686-2609.
Simply complete, sign and return
the attached enrollment form in the
self-addressed, postage-paid envelope
to join The Healthy Weigh!
Is memory loss
from aging or
lack of sleep?
The benefits of a good night’s sleep on the body are well known, but did you know it is
also beneficial for your brain? New findings are making strong correlations between sleep
and memory, and are shedding light on why older people may have trouble with both.
A study by the National Institutes of Health’s National Institute on Aging found a marked
difference in the brain-wave activity of younger people and older people while they sleep.
Looking deeper into the difference, they found that the lack of deep sleep in seniors
prevents their brains from storing memories in the location of the brain used for recalling
them over the long term. Instead their brains leave memories stored in the portion of the
brain that is used for short-term memory.
So, if you find yourself struggling to recall facts, or having more frequent “it’s-just-onthe-tip-of-my-tongue”
moments, make sleep a priority.
How can you get better sleep?
• Turn off electronics a couple of
hours before bedtime.
• Avoid nicotine, caffeine and alcohol in
• Stick to a schedule; don’t sleep late
• Exercise in the late afternoon.
• Keep your room cool and dark.
Place black tape over electronic
lights if necessary.
• Keep pets and children out of the bed.
• Take a hot shower or bath before
going to bed.
• When you wake up in the morning,
open the blinds or step outside as
soon as possible. Sunlight helps
regulate your biological clock.
• Seek medical help if you have a
sleep problem, especially if it
SUMMER 2013 BLUE & YOU
Arkansas Blue Cross provides
family fun for members
Arkansas Blue Cross and Blue Shield members enjoyed a
variety of family-friendly activities earlier this year. We appreciate
our members and always are looking for opportunities to add
value to our relationship. And, there is more to come!
Families at the Hop on Over Easter Party at ArkansasBlue
enjoyed dancing and playing games with Radio Disney. And,
two lucky families won season passes to the Museum of
Discovery and the Little Rock Zoo along with beach towels,
insect repellent, sunscreen, first-aid kits, bubbles and more.
ArkansasBlue is Arkansas’ first health insurance store, located
in the Shackleford Crossings shopping center in Little Rock.
The Easter Bunny and
BlueAnn Ewe interact with
a young admirer at the
ArkansasBlue Easter party.
During the Night at the Museum Pajama Party in June at the
Museum of Discovery in Little Rock, parents and children went on a scavenger hunt in the
Arkansas Blue Cross and Blue Shield Amazing You Gallery for a chance to win prizes, and
shared healthy snacks in the Gigabyte room. BlueAnn Ewe was on hand to dance with the kids
and point out clues in the gallery. While all of our members could get in free to the event, we
also gave away 300 tickets to non-members at ArkansasBlue.
As part of our title sponsorship of the Arkansas Blue Cross and Blue Shield Amazing You
Gallery inside the Museum of Discovery (designed to teach youth and families about the
body and how to keep it healthy), we have two member-appreciation days each year.
Mark your calendar — the next member-appreciation day at the Museum of Discovery
will be on Grandparent’s Day, Sunday, September 8.
Walk at Lunch
April 24 was National Walk @ Lunch Day (NW@LD), and Arkansas Blue Cross and
Blue Shield; Arkansas Center for Health Improvement; Me, Myself and I Workout;
Arkansas Department of Human Services; Arkansas Workers’ Compensation; and the
Arkansas Plant Board employees walked together to the Little Rock River Market.
NW@LD is an event designed to encourage employees to spend part of their lunch
break on this day walking in an effort to promote fitness and encourage regular
worksite wellness activities. NW@LD is part of the Blue Cross and Blue Shield
Association’s Walking Works program.
14 BLUE & YOU SUMMER 2013
Customers Rank Arkansas Blue Cross
as a top Blue Plan in the Nation
Arkansas Blue Cross and Blue Shield is one of the best Blue Plans in the nation in providing
valuable products, excellent customer service and gaining the trust of members, according to a
national survey of Blue Plan members.
A recent consumer brand index (CBI), a tool for understanding consumers’ perceptions of a brand or
company, was developed for the Blue Cross and Blue Shield Association to determine how all the Blue
Plan markets rank with their members. There are 38 Blue Plans across the United States, but the survey
was more in-depth and actually involved 61 individual markets. The survey focused on three primary areas:
Did the Plan meet expectations? Is the Plan a company you can trust?
3. How do you feel and think about the Plan?
Out of a possible 100 points, Arkansas Blue Cross received an overall score of 82, tying two other
Blue Plan markets for the top score in the nation. The median score nationwide was 76. Members
were asked, based on everything they have seen, heard, read or experienced, how they think about
their Plan on a scale of 1 to 10. A score with a plus sign indicates that the score was significantly
different than the system-wide results. So how did Arkansas Blue Cross do, question-by-question?
Did your Plan meet expectations?
Arkansas Blue Cross: 8.3 +
Blue Plan national average: 7.7
Is your Plan a company you can trust?
Arkansas Blue Cross: 8.6 +
Blue Plan national average: 8.0
How do you feel and think about your Plan?
Arkansas Blue Cross: 8.2 +
Blue Plan national average: 7.8
“We are pleased that our members think so highly of us,” said Karen Raley, vice president of
Communications and Product Development at Arkansas Blue Cross. “We put our members first in
everything we do and these survey results let us know that our members recognize that.”
It is that “member first” attitude permeating every division within Arkansas Blue Cross that makes
it difficult to pinpoint who should get the most credit for the glowing CBI results. Customer Service
and other employees who interact directly with members leave a lasting impression of the company
as a whole. The Communications team provides a Web presence that is user-friendly and informative.
New member welcome kits provide vital information right up front that help members more
completely understand their benefits.
“It takes all of us to deliver the kind of service our members deserve, and all of our employees
should be pleased with these excellent ratings,” said Karen. “However, we have no intention of
relaxing now. Our industry as a whole is facing unprecedented challenges, and we need to raise
the bar — for ourselves and for Arkansas Blue Cross. Our customers deserve that.”
Heart Walk 2013
Arkansas Blue Cross had a great team showing at the Heart Walk held April 20
at Burns Park in North Little Rock. Employees and their family members walked
together to show their support for heart disease research. Blue definitely cares!
SUMMER 2013 BLUE & YOU
FROM the PHARMACIST
Access + Knowledge = Power
More and more, Americans can go to their
favorite grocery store instead of to the doctor
when they need medicine. This immediate
access to medicine to treat an ailment gives us
immense power over our health, but it must be
balanced by the knowledge to use the medicine
correctly. The following information from the
U.S. Food and Drug Administration (FDA)
provides some great advice for using over-thecounter
(OTC) medicines responsibly.
The FDA determines whether medicines are
prescription (Rx) or OTC. The FDA also decides
when a prescription medicine is safe enough
to be sold directly to consumers, a regulatory
process known as Rx-to-OTC switch. More than
700 products sold over the counter today use
ingredients or dosage strengths available only
by prescription 30 years ago.
With new opportunities in self-medication come
new responsibilities and an increased need for
knowledge. The FDA and the Consumer Healthcare
Products Association (CHPA) have prepared the
following information to help Americans take
advantage of self-care opportunities.
by TREY GARDNER, Pharm D.,
Arkansas Blue Cross and Blue Shield
OTC know-how: It’s on the label
You wouldn’t ignore your doctor’s instructions
for using a prescription medicine; so don’t
ignore the label when taking an OTC medicine.
Here’s what to look for:
• Product name
• Active ingredients — therapeutic substances
• Purpose — product category (such as
antihistamine, antacid or cough suppressant)
• Uses — symptoms or diseases the product
will treat or prevent
• Warnings — when not to use the product,
when to stop taking it, when to see a
doctor and possible side effects
• Directions — how much to take,
how to take it, and how long to take it
• Other information — such as storage
• Inactive ingredients — substances
such as binders, colors or flavoring
Make sure you are reading the label correctly.
Always use enough light. It usually takes three
times more light to read the same line at age 60
than at age 30. If necessary, use your glasses or
contact lenses when reading labels.
Always remember to look for the statement
describing the tamper-evident feature(s) before
you buy the product and when you use it.
When it comes to medicines, more does
not necessarily mean better. You should never
misuse OTC medicines by taking them longer
or in higher doses than the label recommends.
Symptoms that persist are a clear signal it’s time
to see a doctor.
16 BLUE & YOU SUMMER 2013
PHARMACY continued on page 21
the DOCTOR’S corner
Your role in health care
Health care is changing in many ways to
provide the highest quality of care while
keeping costs down. Doctors and their care
teams, hospitals, insurance companies,
employers and many others are learning their
roles as part of this new approach. What you
may not realize, however, is that you are a vital
part of that change. On its most basic level,
health care is between the person who delivers
care and the person who receives it. To achieve
better health outcomes, patients must make
good decisions based on complete information.
If you’ve been in your doctor’s office recently,
you may have noticed some changes. The clinic
may be using an electronic medical record.
Computerized records make it easier to keep
up with current and past problems, medication
lists, recommended screening tests, lab results
and needed immunizations. Some doctors and
facilities have developed systems to securely
share your information so those who need
to know a test result will have access to it
rather than delaying care or repeating the test.
There may be someone in the clinic who is
coordinating care between specialists or the
emergency room and your doctor. To improve
the clinic’s efficiency, you may be asked for
feedback about clinic services. Specialists and
primary care doctors are communicating more
in order to monitor costs and improve your care.
To achieve the highest quality of care,
both underuse and overuse of health care
resources must be avoided. With some of the
new payment methods, your doctor may be
eligible for higher payments if his patients
receive appropriate tests that have proven
beneficial. The health maintenance your doctor
recommends is to prevent or delay more
serious illness, and you should benefit from
following his advice and changing behaviors.
You may be asked to participate in an education
program for a condition like diabetes or
by CONNIE MEEKS, M.D. – Corporate Medical Director
Arkansas Blue Cross and Blue Shield
low back pain. If your doctor recommends
a screening or a behavior change, consider
his advice. Take personal responsibility and
recognize that routine care is an investment in
better health for the long term.
In contrast, there are some overused
procedures that have not proven effective.
Leading medical specialty societies have
teamed up with Consumer Reports to spread
the word that doctors and patients should
have important conversations to decrease the
practice of ordering unnecessary tests and
procedures. The Choosing Wisely campaign
focuses on lists of “Five Things Physicians and
Patients Should Question,” created by each
participating specialty group. For instance, the
specialty group for family doctors recommends
that electrocardiograms or other cardiac
screenings for low-risk patients without
symptoms should not be ordered.
Pediatricians recommend against cough and
cold medicines for respiratory illnesses in children
under four years of age. Doctors will be spending
more time discussing with patients why certain
tests may or may not be needed. Your part in this
is to be open to discussions with your doctor and
to understand that there are new expectations
for him to provide advice supported by evidence,
discuss options and gain your cooperation in a
plan of care. This is shared decision making, so
there is an expectation that you will participate
and follow through with decided plans.
The goal of improved personal health is
not only that it is good for patients, but that
it will contribute to the improved financial
health of our country. The effort begins with
you taking responsibility.
Source: Choosing Wisely campaign,
SUMMER 2013 BLUE & YOU
The Blue & You Foundation for a Healthier
Arkansas recently collaborated with the Arkansas
Center for Health Improvement (ACHI) to fund a
study examining the current and future numbers
of physicians and specialists statewide.
The report, Arkansas Health Care
Workforce: A Guide for Policy Action,
provides a unique, multi-dimensional
look at how and where health care
is provided in Arkansas. This includes
location, office capacity, acceptance
of patients covered by Medicare and
Medicaid and the patient experience. Previous
studies either have been national in scope and based
on raw population-to-physician ratios or have relied
solely on survey information.
According to Patrick O’Sullivan, executive director
of the Blue & You Foundation, the report provides
a much-needed resource for informing policy
decisions that will result in meaningful solutions
for improving the health care system in Arkansas.
“Much discussion has centered on the idea that
we have a serious statewide shortage of doctors
and that this shortage will worsen due to an
aging health care workforce,” Patrick said. “At the
same time, there has been a lack of consistent
data to demonstrate the real picture in Arkansas.
ACHI has proven expertise for using information
from various sources to pull together a big picture
and identify policy implications. The Blue & You
Foundation is pleased to have partnered with
ACHI to provide policymakers and stakeholders a
guide for important decisions.”
The information in the report shows not only
the number of medical professionals needed, but
where they will be needed. The report describes a
severe shortage in the southeast and southwest
regions, but points to an excess supply in
central Arkansas. On a positive note, many clinic
managers surveyed said they expect to keep their
present staff and in many cases have plans to add
18 BLUE & YOU SUMMER 2013
The Blue & You Foundation funds a study to find out
Health Care Workforce
A Guide for
The following are a few highlights
from the report:
• While there is a shortage of primary care
physicians, the presence in Arkansas of
physician extenders, like advanced
practice nurses and physician assistants,
make up all but 4 percent of the shortfall
in the supply of primary care clinicians.
• There are critical shortages of primary
care physicians and physician extenders
in some rural areas and a potential
oversupply in urban areas.
• Primary care clinicians may approach
the needed number statewide by 2020,
but shortages will remain in rural parts of
the state unless incentives are put in place.
• Creative solutions may involve policies
regarding expanded insurance coverage,
transportation resources and use of
Demand greater than supply
Demand 20% or more
Demand 10% to 19%
Little or no supply shortage
Demand = Supply (+ 9%)
Supply 10% or more
Adequacy of Supply and Demand of Primary Care Providers
by County (2012)
To learn more about the report, go to the
ACHI website, achi.net.
Metabolic Research Centers
Enjoy a 10 percent discount on all new program enrollment
fees at the Metabolic Research Center, a weight management
company with locations in Bentonville, Fort Smith, Fayetteville,
Conway and Little Rock.
The Metabolic program is unique because it addresses the
root cause of disorder eating and recurring weight gain. Their
personalized approach helps clients by identifying why as well as what they eat. They recognize and
affirm the unique and intrinsic worth of each individual by this one-on-one approach. The programs
at Metabolic were designed by the nation’s foremost experts in the field of disorder eating and are
administered nationally through Metabolic Research Centers. Metabolic Research Center offers to
deliver high-quality, cost-effective services and products to the clients they serve.
Save on Jenny Craig
As our member, you can choose a FREE 30-Day Program*
or 25 percent off a Premium Program* from Jenny Craig. ® Just
print the coupon on the national and statewide discounts page
on any of our websites.
Pick a program that works with you, not against you! MyDays
is a flexible, new weigh-loss choice that gives you the structure you need to stay on track and the
freedom to live your life. Eat five days of Jenny and two days of your own healthy choices. Your
consultant will help you find the program that fits your real life.
It’s about progress, not perfection. Your personal consultant will help you stay on track every step
of the way. Jenny has two options for consultations:
• Get weekly, face-to-face support and
motivation at one of more than 600 locations.
* Plus the cost of food and shipping, if applicable.
At participating centers. Restrictions apply.
Grants available for health programs
• Enjoy the convenience and privacy of getting
your support and motivation on the phone
Programs to improve the health of Arkansans, whether in a small town or throughout the state, have
until July 15 to submit applications for grants from the Blue & You Foundation for a Healthier Arkansas.
The grants of $5,000 to $150,000 may be used for general operational or specific program support
for an existing or new program. Any public charity, public school, government agency or non-profit
hospital in Arkansas is eligible to apply; however, grants are not made to individuals. Funds must be
used to produce positive health outcomes for Arkansans.
The grants will be awarded in November to fund health improvement programs during 2014.
Information about the grants and the online application submission process can be found at
SUMMER 2013 BLUE & YOU
health insurance store
OPENS INPINE BLUFF
Residents of Pine Bluff and southeast
Arkansas can speak face to face with health
insurance experts at the new ArkansasBlue
office at 509 Mallard Loop Drive in Pine Bluff.
Health insurance experts at the new location
will provide 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 assistance with
questions or concerns they may have about
purchasing or choosing health insurance.
ArkansasBlue also will provide visitors with
information on dental and other insurance plans.
And, with the full implementation of the health
care law approaching in 2014, visitors who have
purchased individual or family health insurance
plans can come in for health insurance reviews
to see how new regulations will impact their
health insurance coverage and cost.
“Arkansas Blue Cross has operated a fullservice
office in Pine Bluff since 1994, serving
members in a 13-county area with customer
service, individual and group product sales
and marketing, medical management and
provider services,” said Dwayne Pierce, regional
executive. “Our new location will allow us to
expand our services and provide more oneon-one
counseling about health and dental
insurance for individuals and families, especially
with the implementation of the new health
insurance law approaching.”
Walk-in members and shoppers also can
pick up informational brochures or digitally
walkthrough an online shopping experience
with an Arkansas Blue Cross representative.
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. The flagship store
has proven to be a resource for people needing
health insurance answers, and a gathering place
for fun and informative events.
The “freedom” of
With the changes in the health insurance industry, some
people will find they need a health insurance policy to
fill a gap in coverage, or they may be looking for a more
affordable solution with comprehensive coverage.
Whether you need coverage
for one month or a longer
period, Arkansas Blue Cross and
Blue Shield has a solution for
you. We have affordable plans
designed to provide coverage for
the length of time you need it.
Essential Blue Freedom is a
comprehensive health insurance
policy that lasts 364 days,
with the freedom to reapply
for coverage. It is available to
Arkansas residents age 64 and
younger who are not eligible
for Medicaid or Medicare.
20 BLUE & YOU SUMMER 2013
It offers affordable copayments
for doctor visits as well as
prescription drug coverage.
Your application is subject
to a medical review, and a
waiting period for pre-existing
conditions may apply, but
if you have no major health
problems and you are looking
for comprehensive coverage
at a great rate, it may be the
solution you need.
What happens after day 364?
You have the opportunity to
reapply for another Essential
Blue Freedom policy issued after
answering a few simple healthrelated
questions and by meeting
certain medical criteria. If you
fall outside the ranges, don’t
worry — you still may qualify for
reissue; however, your application
will be subject to review.
If you think Essential Blue
Freedom is an option for you,
call us at 1-800-392-2583!
We’d love to talk with you.
PHARMACY continued from page 16
Be sure to read the label for each product you
purchase. Just because two or more products
are from the same brand family doesn’t mean
they are meant to treat the same conditions or
contain the same ingredients.
Remember, if you read the label and still have
questions, talk to a doctor, nurse or pharmacist.
Although mild and relatively uncommon,
interactions involving OTC medicines can
produce unwanted results or make medicines
less effective. It’s especially important to know
about medicine interactions if you’re taking Rx
and OTC medicines at the same time.
Some medicines also can interact with foods
and beverages, as well as with health conditions
such as diabetes, kidney disease and high
Here are a few medicine interaction cautions
for some common OTC ingredients:
• Avoid alcohol if you are taking
antihistamines, cough/cold products
with the ingredient dextromethorphan, or
medicines that treat sleeplessness.
• Do not use medicines that treat
sleeplessness if you are taking prescription
sedatives or tranquilizers.
• Check with your doctor before taking
products containing aspirin if you’re taking
a prescription blood thinner or if you have
diabetes or gout.
• Do not use laxatives when you have
stomach pain, nausea or vomiting.
• Unless directed by a doctor, do not use
a nasal decongestant if you are taking
a prescription medicine for high blood
pressure or depression, or if you have
heart or thyroid disease, diabetes,
or prostate problems.
This is not a complete list. Read the label!
Medicine labels change as new information
becomes available. That’s why it’s important to
read the label each time you take medicine.
Time for a Medicine Cabinet Checkup?
• Be sure to look through your medicine
supply at least once a year.
• Always store medicines in a cool, dry place
or as stated on the label.
• Throw away any medicines that are past
the expiration date.
• To make sure no one takes the wrong
medicine, keep all medicines in their
Protect Yourself Against Tampering
Makers of OTC medicines seal most products
in tamper-evident packaging (TEP) to help
protect against criminal tampering. TEP works
by providing visible evidence if the package has
been disturbed. But OTC packaging cannot be
100 percent tamper-proof. Here’s how to help
• Be alert to the tamper-evident features
on the package before you open it. These
features are described on the label.
• Inspect the outer packaging before you
buy it. When you get home, inspect the
• Don’t buy an OTC product if the packaging
• Don’t use any medicine that looks
discolored or different in any way.
• If anything looks suspicious, be suspicious.
Contact the store where you bought the
product. Take it back!
• Never take medicines in the dark.
Source: The U.S. Food and Drug Administration
and the Consumer Healthcare Products
SUMMER 2013 BLUE & YOU
Arkansas Blue Cross and Blue Shield –
Financial Information Privacy Notice
At Arkansas Blue Cross and Blue Shield
and its affiliates (including HMO Partners, Inc.
d/b/a Health Advantage), we understand how
important it is to keep your private information
just that — private. Because of the nature of
our business, we must collect some personal
information from our members, but we also
are committed to maintaining, securing and
protecting that information.
Arkansas Blue Cross and its affiliates only
compile information necessary for us to provide
the services that you, our member, request
from us and to administer your business. We
collect non-public personal financial information
(defined as any information that can be tied
back to a specific person and is gathered by any
source that is not publicly available) about our
• Applications for insurance coverage. The
application includes information such as
name, address, personal identifiers such
as Social Security number, and medical
information that you authorize us to collect.
• Payment history and related financial
transactions from the purchase and use
of our products.
• Information related to the fact that you
have been or currently are a member.
Arkansas Blue Cross
Self-funded group members
should call Customer Service
using the toll-free telephone
number on their ID card.
Sharing of Information
Arkansas Blue Cross and its affiliates do not
disclose, and do not wish to reserve the right to
disclose, non-public personal information about
you to one another or to other parties except
as permitted or required by law. Examples of
instances in which Arkansas Blue Cross and its
affiliates will provide information to one another
or other third parties are:
• To service or process products that
you have requested.
• To provide information as permitted and
required by law to accrediting agencies.
• To provide information to comply
with federal, state or local laws in
an administrative or judicial process.
How We Protect Your Information
Arkansas Blue Cross and its affiliates use
various security mechanisms to protect your
personal data including electronic and physical
measures as well as company policies that
limit employee access to non-public personal
financial information. Improper access and use
of confidential information by an employee can
result in disciplinary action up to and including
termination of employment.
Disclosure of Privacy Notice
Arkansas Blue Cross and its affiliates recognize
and respect the privacy concerns of potential,
current and former customers. Arkansas
Blue Cross and its affiliates are committed to
safeguarding this information. This Financial
Information Privacy Notice is provided to our
members as required by state regulation to
explain how we handle their non-public financial
information. It is also available on our website
at arkansasbluecross.com or from our Customer
Service Call Centers. Our customer service areas
are open from 8 a.m. to 4:30 p.m., Central time,
Monday through Friday.
BLUE & YOU SUMMER 2013
CHANGES continued from page 3
ready to provide you with the information you
need to make a good decision for you and your
family. You also can request a review with an
agent if you have one, or you can go to one of
our locations throughout the state.
If you are age 65 or older and have coverage
through one of our Medicare products, there
should be no changes to your health plan until
2016 as a result of the health care law. We will
discuss those changes in future issues.
If you are an employer with two to 50
employees, you will be receiving information
regarding Arkansas Blue Cross meetings being
held throughout the state to help our employer
customers learn how the new regulations may
impact their businesses. Afterward, you will be
contacted by an agent or an Arkansas Blue Cross
representative to discuss your situation in more
detail. Until then, our advice is that you not make
any changes to your health plan.
If you are an employer with 51 or more
employees, you likely already have been
discussing options with an agent or Arkansas
Blue Cross representative. If not, I encourage
you to do so in the coming months.
At Arkansas Blue Cross, we are concerned with
making health care affordable for everyone. We
applaud the efforts of our state for coming up
with a unique solution to take care of the many
Arkansans who can’t afford health care. And, we
will continue to provide our members with the
most affordable health care coverage available
by finding solutions that work within health care
reform regulations and giving our members the
protection they deserve.
CUSTOMER SERVICE NUMBERS
May we help? For customer
service, please call:
Medi-Pak ® members 378-3062 1-800-338-2312
Medi-Pak ® Advantage members 1-877-233-7022
Medi-Pak ® Rx members 1-866-390-3369
Arkansas Blue Cross members 378-2010 1-800-238-8379
• Pharmacy questions 1-800-863-5561
• Specialty Rx pharmacy questions 1-866-295-2779
Health Advantage members 378-2363 1-800-843-1329
• Pharmacy questions 1-800-863-5567
BlueAdvantage members 378-3600 1-888-872-2531
• Pharmacy questions 1-888-293-3748
Federal Employee members 378-2531 1-800-482-6655
Looking for health or dental insurance? We can help!
For individuals, families 378-2937 1-800-392-2583
For employer groups* 378-3070 1-800-421-1112
*Arkansas Blue Cross, Health Advantage and BlueAdvantage Administrators of Arkansas
Prefer to speak with someone close to home?
Call or visit one of our offices near you:
• ArkansasBlue — Little Rock
2612 S. Shackleford Rd., Suite J 1-501-378-2222
516 East Millsap Rd., Suite 103 1-800-817-7726
• Fort Smith
3501 Old Greenwood Rd., Suite 5 1-866-254-9117
• Hot Springs
100 Greenwood Ave., Suite C 1-800-588-5733
707 East Matthews Ave. 1-800-299-4124
• Little Rock
601 Gaines Street 1-800-421-1112
• Pine Bluff
509 Mallard Loop 1-800-236-0369
1710 Arkansas Boulevard 1-800-470-9621
Visit our websites for more information:
arkansasbluecross.com • healthadvantage-hmo.com • blueadvantagearkansas.com • blueandyoufoundationarkansas.org
SUMMER 2013 BLUE & YOU 23
the HEALTH CARE LAW timeline
A new tool to help determine if you
qualify for cost breaks launches on
our website, arkansasbluecross.com
2014 health care plans become
available for review on our website
Online marketplace opens
Final day to buy health insurance for a
January 1, 2014 effective date
New health insurance plans begin
Last day to sign up for health insurance
MPI 1624 6/13