June 2015

HealthLine
June 2015
www.local4funds.org
International union of Operating Engineers local 4
health & Welfare plan
Dear Health & Welfare Participant,
This edition of HealthLine features the
following topics:
• Enhanced Benefits: Nutritional
Counseling and Speech Therapy
• What You Should Know Before You
Receive Care: Usual and Customary
Charges
• Newborns’ and Mothers’ Health
Protection Act
• Revised Eligibility Requirement for
New Members of Local 4D
• Social Security Numbers for All
Covered Members and Dependents
• Subscriber Claims
ENHANCED BENEFITS:
NUTRITIONAL COUNSELING
AND SPEECH THERAPY
The Board of Trustees is pleased to
announce, effective January 1, 2015,
nutritional counseling will be a covered
benefit in the event of illness or injury. In
addition, speech therapy will be a covered
benefit when prescribed by a physician.
To find out more about these benefits,
call Blue Cross and Blue Shield (BCBS) at
1-800-401-7690.
WHAT YOU SHOULD KNOW
BEFORE YOU RECEIVE CARE:
USUAL AND CUSTOMARY
CHARGES
For out-of-network providers who do
not have a PPO payment agreement with
BCBS, BCBS will cover the provider’s
charge up to the “usual and customary”
charge. This charge is established by BCBS
as appropriate based on its fee schedule
with in-network providers. The usual and
customary charge may be less than the
out-of-network provider’s actual charge.
If that is the case, you will be responsible
for the difference between the usual and
customary charge that BCBS pays and the
provider’s actual charge (in addition to your
deductible and/or copayment and/or coinsurance,
as applicable). Remember, usual
(health bits)
You can host a birthday party
for children that’s nutritious
with these healthy ideas suggested by the
Academy of Nutrition and Dietetics: Instead
of serving soda or another sweetened drink,
opt for fruit juice mixed with sparkling water
for a liquid refresher with less sugar. Serve
mini meatball dippers for a protein-packed
finger food. Whip up a simple trail mix made
with whole-grain cereal, nuts, and dried fruit.
and customary charges will not apply if you
visit an in-network provider.
NEWBORNS’ AND MOTHERS’
HEALTH PROTECTION ACT
This act requires group health care plans
to provide a minimum hospital stay for
the mother and newborn child of 48 hours
after a vaginal delivery and 96 hours after
a cesarean section. However, federal law
does not prohibit the mother’s or newborn’s
attending physician—in consultation
with the mother—from determining that
a shorter length of stay is appropriate. The
Plan requires admission certification of
your maternity stay only if the minimum
length of stay (48 or 96 hours, as applicable)
is exceeded. A stay exceeding the minimum
length requires authorization and is
subject to review for medical appropriateness.
Under the Plan, a pregnancy-related
hospital stay is treated like an illness, as
required by federal law.
(continued on page 8)
Indoor or outdoor cycling is
a good sport for people with
arthritis because it works all the
muscles in the lower body, even the
feet. But when you ride outside, the
Arthritis Foundation recommends
you wear padded cycling gloves that
absorb shock. Also, avoid using a bike
with handlebars that cause you to
hunch over, which puts added stress
on your hands, wrists, and elbows.

2
5
Ways to Eat Healthy
This Summer
ICE CREAM, HOT DOGS, FRIED DOUGH
AT THE FAIR—summer doesn’t always have
the best rep, nutrition-wise. With a few
simple tweaks, you can avoid extra pounds,
food poisoning, and other dietary disasters
during these lazy, hazy days. Here’s how:
1
Stay trim while you
travel.
Carrying healthy, quick meals and
snacks keeps you from braking
for fast food on summer journeys. Pack
unsalted nuts, peanut butter sandwiches on
whole-grain bread, fruit such as bananas
and apples, and tuna snack packs. Extralong
drive? Stock a cooler with hummus,
light yogurt, berries, salad greens, hardboiled
eggs, and whole-grain veggie or
turkey sandwiches.
2Try good-for-you
grilling.
Move over, cheeseburgers—transform
your barbecue into a health
food haven. Choose fish like salmon, trout,
and herring for heart-healthy omega-3 fatty
acids. Serve salads or grilled veggies on the
side. And try searing fruit such as peaches
or pineapple slices over the flames for a
naturally sweet dessert.
(test your savvy on … the Mediterranean diet)
3Take caution with
contamination.
Don’t let a stomach bug spoil your
good times. Fight foodborne illness
by washing your hands frequently. Rinse all
fresh fruits and veggies carefully. Keep raw
and cooked foods separate and use a food
thermometer to check that grilled foods
are done (between 145 and 165 degrees,
depending on the cut). And don’t let picnic
dishes linger—refrigerate or toss perishables
after an hour in the summer heat.
4Pick up seasonal
superfoods.
Summer harvests and markets
abound with nutritious produce.
Healthy, farm-fresh options include summer
squash, such as zucchini or pattypan,
and fruits, such as watermelon and berries.
5Make these smart
restaurant swaps.
Eating out? Even beachside bistros
now offer more nutritious options.
Order veggie dogs instead of hot dogs,
grilled corn on the cob over french fries,
grilled chicken instead of greasy burgers,
and low-fat fruit smoothies or popsicles
instead of ice cream. To stay hydrated without
the sugar of soda, wash your meal down
with sparkling water spritzed with lemon
or mint.
1. The Mediterranean diet consists of red meat, dairy products, and
lots of bread.
True False
2. This diet contains less saturated fat than the typical American diet.
True False
3. Following the Mediterranean diet seems to improve several of the
factors of metabolic syndrome, including high blood pressure,
elevated blood sugar, obesity, and unhealthy cholesterol.
True False
4. One study found that pregnant women who ate a Mediterranean
diet produced children who were less likely to have allergies and
wheezing.
True False
ANSWERS
1. False. People following this diet eat plenty of fruits and
veggies, whole grains, nuts, and fish.
2. True. The amount of saturated fat also falls within the
American Heart Association’s dietary recommendations.
3. True. The diet can also lower your risk for heart disease
and stroke, and it may help prevent and manage
diabetes. Other studies show that the Mediterranean diet
could ward off Alzheimer’s disease and some cancers.
4. True. The high levels of disease-fighting compounds in
the Mediterranean diet foods helped protect these children
against allergies and wheezing.

3
What’s Your Sun
Safety IQ?
www.cancer.org, then search for
“summer safety quiz”
When you exercise outside
during the summer months,
it’s important to keep yourself
protected from the sun’s damaging
ultraviolet rays. Unsure of
how to keep your skin safe? Test
your knowledge with this ninequestion
quiz from the American
Cancer Society. Every question
will provide you with details
about sun cancer risk, when and
where to apply sunscreen, how
often to reapply it, and more.
For Better Health,
Prescribe Yourself Some Exercise
WANT A PRESCRIPTION FOR BETTER
HEALTH? GET A MOVE ON. As you may
know, regular physical activity can reduce
your risk for heart disease, type 2 diabetes,
and bone-weakening osteoporosis.
But the list doesn’t end there. Here are
other powerful ways exercise is proving
to be the best medicine.
Cancer Prevention
Physical activity in any form may lower
cancer risk, according to the American
Institute for Cancer Research (AICR).
It helps you maintain a healthy weight,
which can reduce your risk for cancer.
But exercise may also strengthen your
immune system, help keep your digestive
system healthy, and allow you to consume
more food with cancer-protective
nutrients without gaining weight. Fruits,
vegetables, and beans, for example, contain
fiber and phytochemicals, which may
help prevent cancer-causing cell damage.
A Healthier Nervous System
Running may help prevent Parkinson’s
disease, a neurological disease that’s
caused by the death of neurons that produce
dopamine, a chemical in the brain
that controls movement. A study in Brain,
Behavior, and Immunity found that running
may protect against inflammation that
can lead to the death of these neurons.
A Longer Life
Exercise helps you live healthier for
longer. In fact, people who are physically
active for about seven hours a week have
a 40 percent lower risk of dying early
compared to those who are active for less
than 30 minutes each week, according
to the Centers for Disease Control and
Prevention.
Exercise Rx
For better health, try to log in 150
minutes each week of moderately intense
activity, such as brisk walking, or 75
minutes per week of vigorous exercise,
such as jogging or running, and at least
two weekly sessions of strength training.
For greater disease protection, however,
feel free to do even more. For cancer prevention,
the AICR recommends aiming
for 60 minutes or more of daily moderate
activity, such as brisk walking, or 30
minutes or more of vigorous activity.
Similarly, to prevent Parkinson’s disease,
a recent study in Brain found that getting
more than six hours per week of physical
activity reduced the risk of contracting
the neurological disorder by 43 percent.
Need a push?
For exercise email tips, sign up at www.exerciseyourlife.org.

4
Expecting Parents:
Should You Get a Keepsake Ultrasound?
HER FIRST PAIR OF SHOES. HIS
FAVORITE STUFFED ANIMAL. Most
parents keep mementos from their baby’s
early days—and government officials
usually don’t have much to say about it.
However, the U.S. Food and Drug
Administration (FDA) has issued a warning
on one keepsake: nonmedical ultrasounds.
Doctors safely use these imaging
tests during prenatal visits. But the FDA
advises families to steer clear of retail
outlets offering photos and even videos of
their impending arrivals.
A Valuable Medical Tool
When you go for an ultrasound, a doctor
or technician rubs a thin layer of gel
on your stomach. He or she then uses
a device called a transducer to transmit
sound waves through your insides.
As the sound waves bounce off your
uterus and baby, they form a black-andwhite
image you and your doctor can
see. Three- or four-dimensional versions
provide added detail and even motion.
Unlike X-rays, ultrasounds use no
ionizing radiation. That’s one reason
they’re used during pregnancy. Routine
ultrasounds can help your doctor check
that your baby is developing properly. As
a side perk, they help you bond with your
baby and capture images you can share
with family and friends.
Safe—But Use Sparingly
Ultrasounds have few risks. No evidence
links them to any health problems for
mothers or babies. But they do slightly
heat some tissues.
FDA experts say the long-term effects
of these processes aren’t known. So, it’s
best to get ultrasounds only when medically
necessary. Your doctor can tell you
how often he or she recommends the test.
What’s more, keepsake ultrasounds are
offered outside a medical office. There’s
no guarantee the machines are used
safely. The staff may not have received
proper training in operating the equipment
and might not know what to do
if they detect a complication with your
baby. Plus, some videos require exposure
to ultrasound waves for up to an hour.
That’s far longer than the procedure
takes in a medical facility—usually about
20 minutes.

5
Making the Choice:
Family Medicine Practitioner or Internal Medicine Physician?
Q& A
WHEN YOU’RE ILL, you have a
choice of what kind of doctor
to see. And unless you need a specialist,
such as for a heart condition, your choice
will typically be between a family medicine
doctor or an internist.
Learn more about the differences and
similarities between these two providers
to help you make informed choices for
your health care needs.
QWho do family medicine
doctors treat?
Family medicine specialists
focus on health care for men and women
of every age—from newborns to seniors.
Because of this, they are the only medical
specialists trained to treat most medical
conditions.
During their residencies, family medicine
specialists are trained in pediatrics,
obstetrics and gynecology, emergency
medicine, ophthalmology, radiology,
orthopedics, otolaryngology (ear, nose,
and throat conditions), and urology.
Family physicians diagnose, treat,
and manage most chronic illnesses in
addition to providing preventive health
care, including checkups, immunizations,
screening tests, and counseling on how to
maintain a healthy lifestyle.
QWhat is the focus of
internal medicine
physicians?
Internists, or internal medicine physicians,
provide health care for adults only.
They are trained extensively in a variety
of subspecialities, such as in acute and
chronic care, mental health care (including
substance abuse), malfunction of
the nervous system and reproductive
organs, and general women’s health care
and gynecology, but not maternity care.
Internal medicine physicians can also
address disease prevention with patients.
QWhen should you
choose one over the
other?
The kind of doctor you choose depends
on your gender and age. For example, if
you are a woman of childbearing age, you
can get ongoing care from a family doctor
before, during, and after a pregnancy.
Likewise, if you have children, you
can receive care for yourself and your kids
from a family doctor but not an internist.
Your decision may also be influenced
by your heath care plan. For example,
your health insurance company’s in-network
doctors may include a family doctor
you are interested in, but not the internist
you’d like to see or vice versa.
(health bits)
Don’t be afraid to
approach a boss who’s
sitting alone at lunch or
a social occasion, advises
Richard Templar in The Rules of
Work. Go up and make small talk,
but just don’t ask about a pay raise
or time off for vacation. Bosses
usually appreciate workers talking
with them because they can feel
isolated and ignored.
With strength training,
lifting lighter weights for
more repetitions doesn’t
usually lead to significant
strength gains, notes
the American Council on
Exercise. To increase muscle
size and your strength, it’s
more effective to turn up the
intensity. That means it’s
better to work your muscles
harder by lifting heavier
weights for fewer reps.
YOUR FOOT TYPE
dictates the best shoe
option for your athletic
endeavors. If you have high-arched feet,
the American Council on Exercise advises that you
buy shoes with greater shock absorption. You’re
also susceptible to ankle injuries because you could
have poor lateral stability, so you need shoes that
provide good ankle support. If you have low-arched
(flat) feet, look for shoes with less cushioning but
greater support in the mid-foot region and heel.

6
Binge Drinking
Can Boost Blood Pressure in Young Men
YOU MIGHT HAVE AN ALCOHOLIC
BEVERAGE ON CERTAIN OCCASIONS,
such as enjoying a beer at a ball game or
raising a toast in celebration. Drinking
in moderation is not a problem for most
individuals.
But drinking way too much at one
time, known as binge drinking, can have
serious consequences, including alcohol
poisoning, heart and liver disease, brain
damage and sexual dysfunction, and
more.
Additionally, a recent study of about
8,600 young men and women found
that men who binge drank in early adulthood
increased their risk of developing
high blood pressure.
How Much Is Too Much?
Binge drinking is as a drinking pattern
that brings a person’s blood alcohol concentration
to 0.08 percent or higher. Men
are likely to reach this level when they
have five or more drinks in two hours,
and women when they have four or more
in the same time frame.
A standard drink contains
about 14 g (0.6 fluid oz.) of
pure alcohol. A standard drink
is equivalent to 12 fluid oz. of
beer, 8 to 9 fluid oz. of malt
liquor, 5 fluid oz. of wine, or
1.5 fluid oz. of hard liquor.
Control Binge Drinking
These strategies can help you
reduce binge drinking. If you are
unable to cut back on your own,
seek assistance from your doctor or
a substance abuse professional.
• Decide ahead of time how much
you will drink during a night out.
• Track how much you drink by recording
your intake on your smartphone,
or by writing it down in a
notebook. Keeping tabs
A Standard
Drink
12 oz. Beer
8-9 oz. Malt Liquor
5 oz. Wine
1.5 oz. Hard Alcohol
on your drinking can
help you stick to a limit.
• Pace your drinks by
having sparkling water
or juice in between each
alcoholic beverage.
• Avoid places that, or
people who, are likely
to trigger your desire to
excessively drink.
• Ask friends and family
to support your efforts to
cut back.
• Join a support group, such
as Alcoholics Anonymous.
See for yourself
Visit www.rethinkingdrinking.niaaa.nih.gov to assess your drinking
pattern. Search for “what’s your pattern?”
To add more
whole grains
to your diet, start
partnering them with
your meals, suggests the
Academy of Nutrition and Dietetics. For
example, complement a vegetable
stir-fry with brown rice or eat
a whole wheat pita stuffed
with salad. You can also add
high-fiber ingredients to
mixed dishes. For example,
put bran or oatmeal in your
meat loaf.
(health bits)
Half of all people with
high blood pressure take
at least two medications
to control the condition,
according to the U.S. Food
and Drug Administration. The
medications begin to work within
days. But once you start using
them, you shouldn’t stop taking
them until your doctor says so.
Over time, not treating high
blood pressure can cause kidney
failure, stroke, blindness, and
heart attack.
When you’re dealing with
a difficult situation, the
American Psychological Association
recommends you avoid seeing it as
something impossible to overcome.
Try to look ahead and acknowledge
how the present circumstances
could get better. Also, start noticing
the subtle ways in which you’re
already doing better as you continue
dealing with the situation.

(recipe)
7
Pick the Right Foods from
South of the Border
YOU MAY CRAVE MEXICAN FOOD, but those chips, queso dip, and many other items
on Mexican restaurant menus add a lot of fat and calories to your diet. And that’s no
bueno. Fortunately, smart choices allow you to get your Mexican food fix without
sacrificing healthy dining habits.
Decode the Menu
Most Mexican restaurants have choices that will keep your meal healthy and low in fat.
Try these suggestions:
• Order fresh seafood or lean poultry. Items such as chicken or shrimp fajitas or fish
tacos are preferable to beef tacos or cheese enchiladas.
• Request for sauces and toppings to come on the side or substitute salsa for sour
cream, cheese sauce, and guacamole. While avocados contain healthy fats, guacamole
is higher in fat than salsa.
• Ask for your taco salad on the plate instead of in a fried taco shell.
• Choose soft versus fried (hard shell) tortillas for tacos, and corn instead of flour
tortillas for enchiladas and quesadillas. Corn tortillas are fat free and provide more
nutrients.
• Ask for a small portion of Mexican rice.
• Go for black or pinto beans rather than refried beans made with lard or other fat.
• Key menu words to help you order lighter are asada (grilled) and Veracruz-style
(with tomato sauce). Choose items that are broiled, baked, or grilled vs. fried.
• Steer clear of food with cheese, which is high in fat and sodium.
• If you want to have a drink, opt for a light Mexican beer over a margarita, which is
higher in calories and carbohydrates. The salt on the side of the glass doesn’t help, either.
One more table tip: Get those complimentary fried tortilla chips off the table.
Ask the server to take them away to avoid temptation.
Substitute salsa for sour cream, cheese sauce, and guacamole.
Table tip: Order fresh seafood or lean poultry.
Mexican Pozole
No need to
travel—get your
Mexican food fix
right at home!
2 lb. lean beef (eye round roast),
cubed
1 tbsp. olive oil
1 large onion, chopped
1 clove garlic, finely chopped
¼ tsp. salt
¹⁄8 tsp. ground black pepper
¼ cup cilantro
1 can (15 oz.) stewed tomatoes
¹⁄ ³ can (2 oz.) no salt added tomato
paste
1 can (1 lb., 13 oz.) hominy
Heat olive oil in a large pot. Gently
blot beef cubes dry with paper
towels, carefully place them in the
pot, and sauté. Mix in onion, garlic,
salt, pepper, cilantro, and enough
water to cover the meat.
Cover pot and cook over low heat
until meat is tender. Add tomatoes
and tomato paste. Continue cooking
for about 20 minutes. Add hominy
and continue cooking for another 15
minutes, stirring occasionally, over
low heat. If too thick, add water for
desired consistency.
Tip: As a variation, boneless,
skinless chicken breasts may be
used instead of beef cubes.
Serves 10. Each serving contains
about 253 calories, 10 g total fat, 3 g
saturated fat, 52 mg cholesterol, 425
mg sodium, 19 g carbohydrates, 4 g
fiber, and 22 g protein.
Source: National Heart, Lung, and Blood Institute/National
Institutes of Health

IUOE Local 4 Health & Welfare Plan
PO Box 660
Medway, MA 02053-0660
PRSRT Std
U.S. Postage
Paid
Long Prairie, MN
Permit No. 372
www.local4funds.org
(health bits)
When you’re writing a
report, Bryan A. Garner stresses
in the HBR Guide to Better Business
Writing that you must do enough research
to grasp the problem and then
state it so people who see the report
understand why the issue needs
resolving. If you’re making a recommendation,
Garner says you need to
remember the five w’s and an h: You
should spell out what needs to done,
identify who should do it, and specify
when, where, why, and how it should
be done.
If you suspect you have
a gallbladder problem,
the National Institutes of Health
recommends you talk with your
doctor. The symptoms include
sudden, severe pain in the upper
right side of your abdomen that
lasts between 30 minutes to several
hours; pain under your right shoulder
or in your right shoulder blade; and
indigestion after eating foods high in
fat or protein, including desserts and
fried foods.
Learn to put positive spins
on any negatives, stresses
Lois P. Frankel, Ph.D., in Nice Girls
Still Don’t Get the Corner Office. For
example, don’t say you could’ve
done a better job of keeping your
department under budget. A better
way to express the message is
“Although we didn’t come in under
budget, we did complete the project
ahead of schedule.”
(continued from page 1)
REVISED ELIGIBILITY
REQUIREMENT FOR
NEW MEMBERS OF
LOCAL 4D
If you are a participant in
Local 4D covered by an
Equipment House Contract,
in the calendar year in which
you receive your first credited
hour, you will become
eligible for coverage under
the Basic Eligibility Rule for
the 12-month period beginning
the following March 1,
if you have worked 1,000
or more credited hours and
remain employed working
under an Equipment House
Contract as of December 31
of that same year. This Plan
amendment is retroactive
to January 1, 2014. In other
words, if you are in Local 4D,
received your first credited
hour in 2014, worked
through December 31, 2014
under an Equipment House
Contract, and worked in
excess of 1,000 hours in 2014,
you will be covered under
the Basic Plan commencing
March 1, 2015. However, in
all calendar years after you
receive your first credited
hour as a participant in
Local 4D, you will need to
work 1,500 or more hours to
remain eligible for coverage
under the Basic Plan.
SOCIAL SECURITY
NUMBERS REQUIRED
FOR ALL MEMBERS
AND DEPENDENTS
Members must submit their
Social Security number as
well as the Social Security
numbers of all dependents
who will be covered under
the Plan, as required by federal
law. The Benefit Funds
Office will be sending out a
mailing in the near future to
gather any numbers not currently
on file.
SUBSCRIBER CLAIMS
All Department of Transportation
(DOT) physical
exams, massage therapy,
acupuncture, acupressure,
and homeopathic medicine
claims must be submitted by
the subscriber (the member)
to BCBS. A reimbursement
form is available on
the Benefit Funds website,
www.local4funds.org,
under the Participant Forms
tab. Your BCBS identification
number must be printed
on the form, and an itemized
statement and receipt of payment
must accompany the
form. Any forms submitted
to the Benefit Funds Office
will be mailed back to the
member for proper submission
to BCBS.
Sincerely,
Your Board of Trustees
Louis G. Rasetta, Chairman
Nino Catalano
Paul C. DiMinico
David F. Fantini
James Reger
John J. Shaughnessy, Jr.
IUOE Local 4
Louis G. Rasetta,
Business Manager
Administrator
Gina M. Alongi
Information in the publication is the opinion of the authors. Personal decisions regarding health, finance, exercise, and other matters should be made
after consultation with the reader’s professional advisors. All models used for illustrative purposes only. All editorial rights reserved. (6272M)