The NALC Health Benefit. Vol Fredric V. Rolando, President Brian Hellman, Director Waverly Court Ashburn, VA

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1 The NALC Health Benefit HBR Report Vol Fredric V. Rolando, President Brian Hellman, Director February Waverly Court Ashburn, VA American Heart Month Board of Trustees Michael J. Gill Lawrence D. Brown, Jr., Chairman Randall L. Keller

2 Director s Report Open Season Figures The new enrollment figures as of February 2, 2014 show a total gain of 2,625 members: NALC HBP High Option - a gain of 1,714 members NALC HBP CDHP - a gain of 225 members NALC HBP Value Option - a gain of 686 members We will update you as we continue to receive additional enrollments in the Plan options. I want to personally thank each of you for your hard work during this Open Season. We appreciate your help spreading the word about all the benefits that the NALC Health Benefit Plan has to offer. As a Health Benefit Representative, you are able to continuously reach out to new co-workers and current Plan members to help them understand the benefits and take advantage of any new wellness programs that we offer. With your help, we can encourage our members to live a healthy lifestyle. Use our website and Customer Service representatives as resources to aid you. New Stroke Prevention Guidelines for Women Women face a higher risk of stroke. New guidelines offer ways to lower your risk. The new stroke prevention recommendations for women are based on the most current scientific research and include: All women with a history of preeclampsia should be regularly evaluated and treated for cardiovascular risk factors such as high blood pressure, obesity, smoking and high cholesterol. Screening for risk factors should start within one year after delivery. Pregnant women with high blood pressure or who experienced high blood pressure during a previous pregnancy should talk to their healthcare providers about whether they should take low-dose aspirin starting the second trimester until delivery to lower preeclampsia risk. Expecting mothers with severe high blood pressure (160/110 mmhg or above) should be treated with blood pressure medications that are safe during pregnancy. Pregnant women with moderately high blood pressure ( mmhg/ mmhg) should be considered for safe blood pressure medications. Women should be screened for high blood pressure before starting birth control pills because the combination increases stroke risk. Women should not smoke, and they should be aware that smoking while taking birth control pills increases the risk of stroke. Women smokers who have migraines with aura (visual impairments) should stop smoking to avoid a higher stroke risk. Women over age 75 should be screened for atrial fibrillation. Women in this age group are more likely than men to develop the heart rhythm disorder, which increases stroke risk five-fold. For more information go to: 2

3 American Heart Month A statement by Kathleen Sebelius - US Dept of Health and Human Services ( Heart disease is responsible for 1 of every 4 deaths in the United States, making it the leading cause of death in our nation. As we observe American Heart Month, there are some key steps you and your loved ones can take to protect against heart disease. By maintaining a healthy diet, getting regular exercise and not smoking, you can dramatically reduce the risk of premature death or disability due to heart disease. Awareness of risk factors is also critical to preventing heart disease. Far too many people who are at high risk for heart disease don t know it. That is why it is so important to get your blood pressure and cholesterol checked regularly and to speak with your doctor about your health history. The Affordable Care Act is making it easier than ever before to take care of your heart. Most health plans now must cover a set of preventive services, such as cholesterol and blood pressure checks, at no out-ofpocket costs to the consumer. The security that comes with quality, affordable health insurance is vital to the fight against heart disease. Thanks to the Affordable Care Act, millions of Americans are gaining access to health coverage, many for the first time. Under the health care law, patients can no longer be discriminated against because of a pre-existing condition, such as cardiovascular disease, high blood pressure or diabetes. In addition to expanding access to care, we are working to coordinate and strengthen heart disease prevention efforts across the nation through initiatives like Million Hearts, Healthy People 2020 and The Heart Truth. Million Hearts and partners recently urged practices and health systems to improve blood pressure control through the adoption of standardized treatment protocols. Widespread adoption of simple, evidence-based treatment protocols can have a major impact on blood pressure control among patients, saving lives and preventing disability. The Healthy People 2020 Heart Disease and Stroke objectives track the heart and stroke health of our Nation and set targets for improvements. The Heart Truth s nine 2014 community action program grantees are initiating year-long education programs for reaching women of color and low income with heart disease risk factor screenings and tailored interventions that encourage the adoption of heart healthy lifestyle behavior changes. This American Heart Month, please consider what steps you and your family can take to promote a heart healthy lifestyle. There s no better Valentine than a healthy heart! 3

4 You Can Quit Smoking! Quitting is hard. Many people try several times before they quit for good. But they do succeed. Get Ready Get Help + Get Medicine Stay Quit! Good Reasons for Quitting You will feel better. You will have more energy and breathe easier. Your chances of getting sick will go down. Smoking is dangerous. More than 435,000 Americans die each year from smoking. Smoking causes illnesses such as cancer, heart disease, stroke, problems with pregnancy, and lung disease. More Good Reasons for Quitting If you are pregnant, your baby will be healthier. Your baby will get more oxygen. The people around you, especially children, will be healthier. Breathing in other people s smoke can cause asthma and other health problems. Savings Per Month You will have more money. If you smoke one pack per day, quitting smoking could save you up to $150 a month. If you smoke (packs per day) You pay (per day) Quitting saves (per month) 1 $5.00 $150 2 $10.00 $300 3 $15.00 $450 There Has Never Been A Better Time to Quit A combination works best. Set a quit date. Get support. Take medicine. Get Ready Set a quit date. No smoking after: Change the things around you. Get rid of all cigarettes and ashtrays in your home, car, and place of work. Do not let people smoke in your home. After you quit, don t smoke not even a puff! Don t use any tobacco! 4

5 Get Medicine You can buy nicotine gum, the nicotine patch, or the nicotine lozenge at a drug store. You can ask your pharmacist for more information. Ask your doctor about other medicines that can help you. Nicotine nasal spray Nicotine inhaler Bupropion SR (pill) Varenicline (pill) Why not? - These tobacco deterrants are available at no cost under the NALC Health Benefit Plan. Get Help - At No Cost to you with the NALC HBP Quit for Life Program For those of you that have a plan of attack to fight that tobacco habit, look at our great benefits! Quitting tobacco may be the best thing you can do for your health. Make 2014 the year you stop using tobacco. Enroll today in our FREE Quit for Life Program. Call QUIT-4-LIFE ( ), or log on to for details to enroll. Expert Quit Coaches will help you create and follow a tailored Quitting Plan. You ll have their support via unlimited one-on-one coaching by phone, 24 hours-a-day, 7 days-a-week. By joining the Quit for Life Program, you will also receive (at no cost): A printed Quit Guide to track your custom-developed Quitting Plan and help you through any difficult situations. Advice on which type, dose, and duration of nicotine substitute or medication is right for you. Free nicotine replacement therapy products, like the patches, gum, or lozenges. Membership to Web Coach, a private, online community where you can complete activities, watch videos, track your progress, and join discussions with other participants and coaches. Stay Quit If you slip and smoke or chew tobacco, don t give up. Try again soon. Set a new quit date to get back on track. Avoid alcohol. Avoid being around smoking. Eat healthy food and get exercise. Keep a positive attitude. You can do it! You Can Quit Most people try several times before they quit for good. Quitting is hard, but You Can Quit! 5

6 Get On the Path 6

7 Tools for You Our Personal Health Record and Electronic Health Record Looking for a better way to keep track of your medical records? If you re like most people, you have a number of health concerns and visit multiple doctors and pharmacies. Keeping track of it all can be a challenge. With a personal health record you can gather and manage all that information in one easily accessible location. Our Personal Health Record (PHR) and Electronic Health Record (EHR) allow you to carry your health information with you or access it through a secure location 24 hours-a-day, 7 days-a-week. Through our website you can create a personal health record for each member of your family! The PHR allows you to keep a record of information such as: Current prescriptions Allergies Emergency contacts Primary physicians Medical conditions Immunization record You can also access your own claims history through our EHR. Our Electronic Health Record includes the following information: Patient s name Charged amount Plan allowance Paid amount Copay Deductible Coinsurance amount Provider s name Date of service Type of service Comments Take charge of your health today by taking the time to use these valuable tools. Health Risk Assessment The Health Risk Assessment is a valuable tool for you. Go to under the Health Center tab, click on Cigna Resources, click on mycareallies.com website, click the My Health Assessment tab. Here s where you find out if you are really as healthy as you think. The Health Risk Assessment is an online tool that analyzes your responses to health-related questions and gives you a personalized plan to achieve your specific health goals. The online profile provides you with the information you need to help put you on a path to good physical and mental health. Here s another reason to complete the Health Risk Assessment. When you complete the Health Risk Assessment, you are automatically enrolled in the Cigna Plus Savings SM discount dental program. The Cigna Plus Savings SM is a discount dental program that provides members access to discounted fees with participating dental providers. If you have Self Only coverage with our Plan, when you complete the HRA, we will enroll you in the Cigna Plus Savings SM discount dental program and pay the Self only Cigna Plus Savings SM discount dental premium for the remainder of the calendar year in which you completed the HRA provided you remain enrolled in our Plan. If you have Self and Family coverage with our Plan, when at least two family members complete the HRA, we will enroll you and your covered family members in the Cigna Plus Savings SM discount dental program and pay the family Cigna Plus Savings SM discount dental premium for the remainder of the calendar year in which both HRAs were completed provided you remain enrolled in our Plan. 7

8 Branch Reimbursement Certificate & Branch Printout Request Enclosed in this issue of the HBR Report you will find the Branch Reimbursement Certificate and the Branch Printout Request please follow the instructions carefully. In order for you to receive your reimbursement, you must complete the Branch Printout Request or call the Plan at NALC (6252) and ask for the Executive Office to obtain a copy of your Branch membership list. The deadline date is April 30, NOTE: Please remember to complete the Branch Printout Request below to receive a copy of your branch roster that needs to be included when submitting your Branch Reimbursement Certificate. NALC Health Benefit Plan Branch Printout Request Branch # Name: Title: Address: I request a Branch printout for the Branch Reimbursement Certificate (January 2014). 8

9 Fredric V. Rolando, President Brian Hellman, Director Board of Trustees Michael J. Gill Lawrence D. Brown, Jr., Chairman Randall L. Keller Branch Reimbursement CERTIFICATE REIMBURSEMENT WILL NOT BE CONSIDERED UNLESS THIS CERTIFICATE IS COMPLETED IN FULL. EVERY BLANK MUST BE FILLED IN. PLEASE PRINT. DEADLINE: April 30, 2014 Branch Number Branch Secretary Branch Address City State Zip Branch Phone# Branch I certify that for the calendar year 2013, the above-referenced Branch incurred expenses for and on behalf of the NALC Health Benefit Plan. I further certify that expenses were incurred for the following reasons: (a) contacting hospital authorities and physicians to familiarize them with our Plan and to distribute claim forms and similar material relating to the Plan; and (b) assisting enrollees in filing claims properly, and distributing necessary forms to them for submission to the Plan. I further certify that the number of members shown below includes only employees and annuitants enrolled under the group plan on December 31, 2013, and does not include any enrollment terminated before December 31, 2013, any type of converted members, or any annuitant who retired prior to July 1, As reimbursement, the Branch is willing to accept (1) seventy-five cents ($0.75) for each member enrolled in the NALC Health Benefit Plan on December 31, 2013, OR (2) the amount of expenses incurred, whichever amount is less. PLEASE OBTAIN YOUR BRANCH ROSTER BY CONTACTING THE PLAN AT NALC (6252) (ASK TO SPEAK TO SOMEONE IN THE EXECUTIVE OFFICE) FOR YOUR BRANCH MEMBERSHIP ENROLLED UNDER THE GROUP PLAN ON DECEMBER 31, Number of $0.75 = $ 2. Amount of expenses incurred for the calendar year 2013 = $ Date Submitted Name Title (must be Branch President or Secretary)

10 NALC HEALTH BENEFIT PLAN BRANCH REIMBURSEMENT By approval of the Board of Trustees, the Plan will accept requests for branch reimbursement BEARING A POSTMARK NO LATER THAN APRIL 30, Each request must be accompanied by a branch reimbursement certificate (PRINTED ON THE REVERSE SIDE) and a roster of branch members enrolled on December 31, Copies of branch rosters must be ordered by completing the Branch Printout Request, or by calling the Health Benefit Plan NALC (6252), ask to speak to someone in the Executive Office. Reimbursement will be either the amount of the expenses attested to on the certificate, or the amount computed at seventy-five (75) cents per eligible member, whichever total is lower. All requests must include (a) the specific amount of expenses incurred; and (b) the number of members for whom reimbursement is requested. Reimbursement will be made only for the employees and annuitants enrolled on December 31, 2013, under Chapter 89, Title 5, United States Code-Health Insurance, effective July 9, The request should NOT include: Enrollees terminated in our plan prior to December 31, 2013 Any type of converted member or dependent nongroup plan, or Policyholders under our old program (those who retired before July 1, 1960). Reimbursement will made payable only to the Branch Secretary of record, and only if the certificate for reimbursement is signed by either the Branch President or Branch Secretary. The signature of the Branch Health Benefit Representative or Treasurer will NOT be acceptable. NALC Health Benefit Plan Waverly Court Ashburn, VA NALC (6252) 10

11 NALC Health Benefit Plan - Who is Your HBR? We would like to update our Health Benefit Representative (HBR) files. Please report any information that has changed for your branch to the: NALC Health Benefit Plan Waverly Ct Ashburn, VA Branch # Date Form Completed: Branch Address: Branch City: Branch State: Branch Zip: Branch Phone: Branch Fax: Branch Branch website: NALC Region: Work Status (Active/Retired): Name: Member ID #*: Title: (*The member ID # is required to verify coverage in the NALC Health Benefit Plan. See Article 4, Section 3 of the Constitution of the NALC Health Benefit Plan.) Home Address: Home City: Home State: Home Zip: Home Phone #: Cell Phone #: Home Date you filled the position as HBR: Are you replacing the current HBR? If yes, provide the name of the former HBR: Are there additional HBR s in your branch? If yes, provide the name(s): (A separate registration form needs to be completed for each HBR.) Would you like information mailed to your branch or your home?

12 NALC Health Benefit Plan Waverly Court Ashburn, VA The NALC Health Benefit Plan HBR Report February 2014 NALC National Convention Don t forget about the 69th Biennial Convention in Philadelphia, Pennsylvania. The convention will take place at the Philadelphia Convention Center from July 21-25, The convention will mark the 125th Anniversary of the the NALC and will honor the memory of President Emeritus Vincent Sombrotto. NALC Health Benefit Plan NALC Recorded Benefit Information NALC Prescription Drug Program NALC Caremark SPS OAP Network Providers NALC Precertification NALC Fraud Hot Line NALC Mental Health / Substance Abuse