April 2020

HealthLine
APRIL 2020
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:
• Glossary of Important Terms
GLOSSARY OF
IMPORTANT TERMS
Our members are health care consumers,
and an educated consumer can make the
best decisions for his or her own care (and
bottom line). With that in mind, the Plan
wanted to take this opportunity to provide
you with some basic health care definitions,
and how those defined terms apply to the
Plan. The definitions are courtesy of the U.S.
Department of Labor’s Uniform Glossary and
can be found online at www.cciio.cms.
gov, www.dol.gov/ebsa/healthreform,
and www.healthcare.gov. As always, please
review your Summary Plan Description,
which is the controlling document, for more
detail on the items discussed below.
Allowed Amount: This is the maximum
payment the plan will pay for a covered
health care service. For example, coverage
for holistic medicine such as acupressure,
homeopathy, and massage therapy is currently
limited to $1,000 per calendar year.
Balance Billing: When a provider bills you
for the balance remaining on the bill that
your plan doesn’t cover. This amount is the
difference between the actual billed amount
and the allowed amount. For example, if the
provider’s charge is $200 and the allowed
amount is $110, the provider may bill you for
the remaining $90. This happens most often
when you see an out-of-network provider.
Coinsurance: Your share of the costs of
a covered health care service, calculated
as a percentage of the allowed amount for
the service. Currently, you generally pay
10% coinsurance, after you’ve met your
deductible, for any in-network medical
care other than office visits. Out-ofnetwork
coinsurance is generally 30%. For
example, if you receive an in-network hospital bill
for $1,000 and you’ve met your deductible, your
coinsurance payment of 10% would be $100. The
Plan pays the rest of the allowed amount.
Copayment: A fixed amount you pay for
a covered health care service, usually when
you receive the service. The Plan’s copayment is
currently $10 for most services.
Deductible: An amount you could owe
during a coverage period (usually one year)
for covered health care services before your
plan begins to pay. An overall deductible
applies to all or almost all covered items
and services. The Plan’s current overall
calendar year in-network deductible is $200 for
individuals and $400 for families and applies to
most services (other than office visits for which you
pay a copayment). There is a separate, additional
prescription drug deductible of $250/$500 for
members on the Supplemental Plan.
Durable Medical Equipment (DME):
Equipment and supplies ordered by a
health care provider for everyday or
extended use. DME may include: oxygen
equipment, wheelchairs, and crutches.
Currently, you would be responsible for
10% coinsurance, after you’ve met your
deductible, for any in-network DME.
Emergency Medical Condition: An
illness, injury, symptom, or condition so
serious that a reasonable person would seek
care right away to avoid severe harm. The
Plan generally covers emergency room visits and
ambulance services, whether in-network or outof-network,
at 10% coinsurance after you’ve met
your deductible.
Formulary: A list of drugs your plan
covers. Your plan may put drugs in different
cost-sharing levels or tiers. For example, a
formulary may include generic drug and
brand-name drug tiers, and different costsharing
amounts will apply to each tier. The
Plan currently has four tiers of copayments for
formulary drugs, ranging from the least expensive
(generic drugs) to the most expensive (specialty drugs).
If you are taking a brand-name drug, you should
check with your provider or pharmacist to find out if
there is a less expensive generic alternative.
Home Health Care: Health care services
and supplies you get in your home under
your doctor’s orders. Services may be
provided by nurses, therapists, social
workers, or other licensed health care
providers. Home health care usually doesn’t
include help with non-medical tasks, such
as cooking, cleaning, or driving. The Plan
currently covers in-network home health care, which
must be preauthorized by Blue Cross Blue Shield
of Massachusetts (see page 8), at 10% coinsurance
after you’ve met your deductible.
Medically Necessary: Health care
services or supplies needed to prevent,
diagnose, or treat an illness, injury,
condition, disease, or its symptoms and
that meet accepted standards of medicine.
The Plan will not cover any expenses it does
not deem to be medically necessary.
Network Provider: A provider who has a
contract with your health insurer or plan who
has agreed to provide services to members of
a plan. You will pay less if you see a provider
(continued on page 8)

2
(recipe)
Zucchini Potato
Pancakes
THE BIG BENEFITS OF
Eating Less Meat
1 medium zucchini, grated (about 1¼ cups)
1 medium Yukon gold potato, grated
(about 2 cups)
½ cup rolled oats
½ cup whole-grain bread crumbs
1 egg
2 tbsp. dried, minced onions
1 tsp. onion powder
1 tsp. garlic powder
½ tsp. freshly ground black pepper
½ tsp. salt
Olive oil spray
A VEGETARIAN LIFESTYLE CAN BE
GOOD FOR BOTH YOUR HEALTH
AND THE ENVIRONMENT. But what
if you appreciate a chicken enchilada
once in a while?
A flexitarian, or “flexible
vegetarian,” diet could be your
solution. Flexitarians mainly eat
plant-based foods, such as vegetables,
fruits, whole grains, beans, nuts, and
tofu, as well as eggs and low-fat or
nonfat dairy products. But unlike
vegetarians, they also eat meat,
poultry, or fish occasionally—
once a week or less.
The flexitarian diet has many health
benefits. It helps you decrease the
amount of saturated fat and cholesterol
you eat. It also helps you eat more
vegetables, fruits, and grains. Plus,
research suggests that a flexitarian
diet helps with weight control and
lowers your risk for heart disease
and diabetes.
Going flexitarian can have a
positive influence on the environment,
too. Lower beef consumption,
especially, could decrease greenhouse
gas emissions from food production
by up to 35 percent.
If you decide to go flexitarian,
you should still avoid less nutritious
choices whenever possible, such as
desserts, sugary drinks, salty snacks,
and refined grains like white bread.
Strive to eat protein-rich foods, such
as legumes and nuts. When you eat
meat, ensure it’s lean.
Remember, this diet isn’t about
excluding entire food categories. It’s
about savoring a variety of delicious,
nutritious foods—including the
occasional salmon filet or juicy
lean burger.
In a food processor fitted with a standard
blade, add zucchini, potato, and oats. Process
for about 20 to 30 seconds—just enough to
combine and chop up more finely. In a large
bowl, stir together potato-zucchini-oat
mixture with remaining ingredients. Form
into six pancakes. Heat a griddle on high for
two minutes. Spray with olive oil, then add
pancakes. Cook for about five minutes per
side or until just browned. Try topping with
applesauce or real maple syrup.
Serves six; serving size is one pancake.
Each serving provides about 148 calories,
2 g total fat (0.4 g saturated fat, 0 g trans fat),
35 mg cholesterol, 170 mg sodium,
27 g carbohydrates, 4 g fiber, 2 g sugar,
and 6 g protein.

DOES SOCIAL MEDIA
MOTIVATE OR DISCOURAGE YOU
TO WORK OUT?
3
IT’S A QUESTION WE OFTEN WONDER
ABOUT—DOES SCROLLING THROUGH
SOCIAL MEDIA have a positive or
negative effect on our well-being?
When it comes to fitness-related posts,
there isn’t a clear answer.
In a new study, researchers found that
for some people, seeing exercise-related
social media posts, such as images of
friends exercising or wearing workout
clothes, checking into gyms, or posting
about fitness-related accomplishments,
made them feel motivated to work out.
For others, however, viewing fitness
posts had a negative effect on their body
image. Such posts actually made them
feel badly about their weight.
But that doesn’t mean you have to
shun all social media for fear of negative
effects. Here’s how to handle the feelings
you may experience when scrolling
through fitness posts on your feed.
IF YOU FEEL MOTIVATED
If seeing your friends work out inspires
you to do the same, act on those feelings.
Don’t wait for the perfect time or until
you find the best plan—get started today.
If you’re not sure where to start, find
an exercise buddy. Reach out to your
friends posting about their exercise
routines or fitness achievements. After
all, research shows that working out with
a friend who’s more advanced than you
can help you push harder and longer.
IF YOU FEEL DISCOURAGED
If you find yourself feeling down about
your body after surfing social media sites,
you don’t have to unfollow your friends.
Instead, try practicing self-compassion—
research shows that it can act as a buffer
against comparing your body with others’
or harshly judging your own figure.
The next time social media posts
get you down, follow these
self-compassion tips:
• Remember that no one is perfect.
Everyone makes mistakes and
everyone experiences failure.
• Be kind to yourself. Instead of
judging, understand and accept
where you are in your fitness journey.
• Recognize that all bodies are
different—and almost all fall
short of our ideals.
Above all, remember that exercise is
about much more than losing weight.
Increasing your physical activity can
reduce your risk for disease, improve
your sleep, and help you feel better
in your own skin.

4
Could Your Child Have a
Learning Disability?
IT’S NORMAL FOR KIDS TO FIND SOME
SCHOOL SUBJECTS HARDER THAN
OTHERS. And it’s common for them to
struggle a bit when learning something
new. But if learning troubles become a
lasting pattern, you might start to suspect
a learning disability.
Reading, writing, and doing math
are the basic building blocks of school
success. Learning disabilities affect how
your child performs these essential
skills. Learning issues aren’t tied
to intelligence—even bright kids can
have learning disabilities. Instead,
they’re caused by problems with how
the brain handles information.
WHAT TO WATCH FOR
There are various types of learning
disabilities. Here are typical signs of
three common ones.
DYSLEXIA
Difficulties with reading and spelling
• Trouble recognizing and spelling
words that are known
• Difficulty reading with accuracy
and ease
• Often finding it hard to understand
what other people say
DYSCALCULIA
Difficulties with arithmetic
• Trouble grasping arithmetic concepts,
such as fractions and negative numbers
• Difficulty understanding math
word problems
• Mistakes when making change for cash
• Often struggling with the time
sequence of events
DYSGRAPHIA
Difficulties with handwriting
• Tension and an awkward position
when writing by hand
• Trouble forming letters or writing
within a designated space
• Often having a hard time getting
ideas down on paper
Not every child with these signs has a
learning disability. Developmental delays,
vision or hearing problems, emotional
disorders, and medical illnesses can also
affect learning. Your child’s doctor and
school can help you determine what’s
going on.
CONSULT YOUR PEDIATRICIAN
Talk with your child’s pediatrician about
your concerns. The pediatrician can look
for health problems that might be playing
a role. For example, let’s say your child has
a chronic health condition, such as asthma
or type 1 diabetes. If the condition isn’t
well-controlled, that could lead to
frequent absences and falling grades.
At times, the pediatrician may refer
your child to other specialists for further
evaluation. For instance, your child
might see a neurologist, psychologist,
or speech pathologist.
CONTACT YOUR CHILD’S SCHOOL
Share what you discover with your
child’s school. If you think your child
may have a learning disability, ask for
an educational assessment. This type of
assessment can determine whether your
child qualifies for special education
services. Such services help your child
learn to build on strengths and
compensate for weaknesses.
A learning disability is a lifelong
challenge. It can’t be cured, but its
impact can be lessened. With support
from family, health care providers,
and teachers, your child with a
learning disability can thrive
at school and beyond.

5
HPV VACCINE
AND
:
KNOW THE FACTS
THE HUMAN PAPILLOMAVIRUS (HPV)
VACCINE IS KNOWN FOR PREVENTING
CERVICAL CANCER—and for good
reason. Health care providers began
recommending the shot for females more
than 10 years ago. Since then, the rate of
cervical precancers linked to common
HPV types has dropped 40 percent.
But HPV eventually infects nearly
every sexually active person, male or
female. Boys and men also face
consequences. The virus can cause
cancers of the mouth, back of the
throat, penis, and anus, along with
genital warts.
That’s why vaccination matters for
boys as well as girls. In 2011, providers
began suggesting the shots for all young
people. Ideally, all children should get
two doses, six to 12 months apart,
beginning at age 11 or 12.
THE COST OF SKIPPING SHOTS
Despite this guidance, only 28 percent
of boys in the recommended age group
have received the HPV vaccine. That’s
compared with almost 42 percent of girls.
This low rate is worrying. In a recent
study, about 45 percent of adult men had
a genital HPV infection. One-fourth had
a high-risk strain of the virus.
Parents of boys may not realize:
• The most common cancer caused
by HPV is mouth and throat cancer,
which affects more males than females
• Nearly four out of 10 HPV-related
cancers strike men
• Each year, more than 14,000 American
men develop HPV-related cancers
Males who get vaccinated will also protect
their future partners, including women
who are at risk for cervical cancer.
LOW RISK, LONG-TERM REWARD
The shots work best when preteens and
teens receive them before becoming
sexually active, when they haven’t yet been
exposed to the virus. And preadolescents
produce more antibodies than older teens.
That’s why health care providers
recommend starting young—as early as
age 9. But even if your son is older, it’s not
too late. The government recommends
young adults who aren’t already vaccinated
receive HPV shots through age 26.
If you have questions about the
HPV vaccine, talk with your child’s
pediatrician. Overall, the shots are very
safe. Minor side effects include pain,
dizziness, nausea, or headaches.
Because of how it’s made, the vaccine
can’t transmit the virus. And it provides
protection against HPV for years to come
—there’s no evidence the protection
decreases over time.

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6
7 Ways to
Weed Plastıcs
Out of Your Life
Swap this for that to protect your health, your family, and the environment.
SKIP THIS
CHOOSE THAT
Plastic cups
for hot drinks
Porcelain, glass, or
stainless steel mugs
Disposable plastic
eating utensils
Reusable stainless
steel utensils
Plastic food containers
(especially for holding and
heating hot foods)
Porcelain, glass, or stainless steel
food containers
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Plastic water bottles
Stainless steel water bottles
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Plastic
baby bottles
(especially older
hand-me-downs)
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Glass baby bottles
(slip them inside a
silicone sleeve to
prevent breaking)
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Disposable plastic
shopping bags
Reusable cloth bags (wash
them frequently)
Plastic straws
No straw
FOR YOUR HEALTH
Bisphenol A (BPA) and phthalates, chemicals found in
some plastics, have been linked to potential health risks.
More than 90 percent of Americans ages 6 and older
have detectable levels of BPA in their bodies.
FOR YOUR WORLD
More than 26 million tons of U.S.-made plastics
end up in landfills every year.
Up to 90 percent of the trash littering our o ceans
and coastlines is plastic.

GROW AN
Allergy-Friendly GARDEN
THEY SAY YOU REAP WHAT YOU
SOW—AND WHEN IT COMES TO
GARDENING WITH ALLERGIES, that old
saying couldn’t be more true. If you’re
one of the 40 to 60 million Americans
with hay fever, your symptoms can be
aggravated by pollen from grasses, trees,
and weeds in your neighborhood. But
planting certain seeds, shrubs, and
saplings this spring can help you have
fewer symptoms all season long.
UPROOT THESE GRASSES AND TREES
Seasonal allergies occur when your body
treats pollen in the air as an unwelcome
invader. This overreaction can cause
congestion, sneezing, a runny nose, a
scratchy throat, and itchy, watery eyes.
Some greenery can make allergy
symptoms worse than others. Aim
to keep these irritating offenders off
your property:
• Grasses: johnsongrass, rye,
timothy, Bermuda, orchard,
sweet vernal, bluegrass, fescue
• Allergy-triggering trees: maple,
oak, ash, birch, hickory, juniper,
cedar, cottonwood
RAISE THESE FRUITS AND
FLOWERS INSTEAD
Having allergies doesn’t mean
you’re stuck landscaping with gravel
and concrete. These buds and blooms
will beautify your yard with less chance
of giving you the sniffles:
• Flowers: lilac, daisy, geranium,
dahlia, hibiscus, iris, roses,
snapdragon, tulips
• Low-allergen trees: cherry, crepe
myrtle, redwood, apple, dogwood,
pear, plum
Another option? If you’re in a
warm, dry climate, consider succulents,
such as cactus plants.
HEDGE YOUR BETS WITH
THESE HABITS
Gardening is good exercise,
produces nutritious fruits and
vegetables, and helps beautify
your community. In short, it’s
worth the effort, even with
allergies. To increase your
comfort, follow these tips:
• Take your allergy medications
before you head outside. And if
you have asthma, keep your
quick-relief drugs on hand.
• No matter what type of grass
you have, keep it short. If you
can, ask someone else to mow.
• Don’t touch your eyes or face while
you’re working. Try wearing a mask
and gloves.
This Spring
• Wash your hands often and rinse
your eyes when you come back
inside. Shower right away to help
ease your symptoms.
• Visit an allergist. He or she can help
you identify the plants that aggravate
your symptoms. You might benefit
from treatments such as allergy shots.
Now get growing!
77
CHECK POLLEN
COUNTS IN YOUR AREA
Visit www.aaaai.org/global/
nab-pollen-counts. Skip
gardening on days when
pollen counts are high.

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
6272M
(continued from page 1)
in the network. Also called “preferred
provider” or “participating provider.” If you
see an out-of-network provider, you will currently
be responsible for 30% coinsurance after you’ve
met your deductible. This higher coinsurance
applies to almost all out-of-network service,
including office visits.
Out-of-Pocket Limit: The most you
could pay during a coverage period
(usually one year) for your share of the
costs of covered services. After you
meet this limit, the plan will usually
pay 100% of the allowed amount. This
limit helps you plan for health care costs.
This limit never includes your premium,
balance-billed charges, or health care
your plan doesn’t cover. Some plans don’t
count all of your copayments, deductibles,
coinsurance payments, out-of-network
payments, or other expenses toward
this limit. The Plan’s current out-of-pocket
limit is $7,350 (individual) and $14,700
(family) for your medical and prescription drug
expenses combined. The limit does not include
prescription copayments or services with separate
benefit maximums (such as holistic benefits).
Preauthorization: A decision by your
health insurer or plan that a health care
service, treatment plan, prescription drug,
or durable medical equipment (DME) is
medically necessary. Sometimes called
“prior authorization,” “prior approval,” or
“precertification.” Your health insurance
or plan may require preauthorization for
certain services before you receive them,
except in an emergency. Preauthorization
isn’t a promise your health insurance or
plan will cover the cost. The Plan requires
preauthorization for all non-emergency and
non-maternity inpatient admissions, partial
hospitalizations/intensive outpatient substance
use treatment programs, home infusion therapy,
and home health care. Blue Cross Blue Shield of
Massachusetts provides preauthorization review for
medical care; Modern Assistance Programs (MAP)
provides preauthorization review for psych/substance
abuse services. There are also prescription drugs
that require prior authorization review, which is
performed by CVS.
Premium: The amount that must be paid
for your health insurance or plan. You do not
pay any premiums for your health care. The Plan
is funded by your employer’s collectively bargained
fringe benefit contributions.
Preventive Care: Routine health care,
including screenings, checkups, and
patient counseling, to prevent or discover
illness, disease, or other health problems.
The Plan has a $0 copayment for preventive
care, including routine physicals, gynecological
exams, mammograms, colonoscopies, and certain
screenings. Preventive prescription drugs are also
covered at a $0 copayment, including contraceptives
and certain statins and smoking cessation drugs.
Provider: An individual or facility
that provides health care services. Some
examples of a provider include a doctor,
nurse, chiropractor, physician assistant,
hospital, surgical center, skilled nursing
facility, and rehabilitation center. The
plan may require the provider to be
licensed, certified, or accredited as
required by state law.
Rehabilitation Services: Health care
services that help a person keep, get back,
or improve skills and functioning for daily
living that have been lost or impaired
because a person was sick, hurt, or
disabled. The Plan currently covers in-network
cardiac rehabilitation at 10% coinsurance after
you pay your deductible, and in-network physical
therapy and occupational therapy at a $10
copayment. Short-term rehabilitation for PT and
OT is limited to 100 visits per calendar year.
Specialty Drug: A type of prescription
drug that, in general, requires special
handling or ongoing monitoring and
assessment by a health care professional, or
is relatively difficult to dispense. Generally,
specialty drugs are the most expensive
drugs on a formulary. The current copayment
for specialty drugs is $200 for a 30-day supply.
Urgent Care: Care for an illness, injury,
or condition serious enough that a
reasonable person would seek care right
away, but not so severe as to require
emergency room care. The Plan covers office
visits at a freestanding urgent care facility, or a
CVS MinuteClinic, at a $0 copayment.
Sincerely,
Your Board of Trustees
William D. McLaughlin, Chairman
Angelo Colasante
Paul C. DiMinico
David F. Fantini
David B. Marr, Jr.
James Reger
IUOE Local 4
William D. McLaughlin, 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. Developed by StayWell.