Winter 2009 SPECIAL EDITION

A quarterly newsletter for members of

Healthy Lifestyles

2

Healthy LifestylesA quarterly newsletter for members of Mountain State Blue Cross Blue Shield, Inc.

Visit our website:www.msbcbs.com

Phone: (304) 347-7663 Fax: (304) 347-7684 E-mail: debbie.starks@msbcbs.com

Editor - Debbie Starks

Healthy Lifestyles is published quarterly for Mountain State Blue Cross Blue Shield members to provide general information. It is not intended to provide personal medical advice, which should be obtained directly from a physician.

It is the policy of Mountain State Blue Cross Blue Shield to not discriminate against any employee or applicant for employment on the basis of the person’s gender, race, color, age, religion, creed, ethnicity, national origin, disability, veteran status, marital status, sexual orientation, or any other category protected by applicable federal, state, or local law. This policy applies to all terms, conditions, and privileges of employment, including recruitment, hiring, training, orientation, placement and employee development, promotion, transfer, compensation, benefi ts, educational assistance, layoff and recall, social and recreational programs, employee facilities, and termination.

2009 - All rights reserved. Printed in the U.S.A.

Liquid Does Not Mean Low in CaloriesWhen people think about cutting calories, they usually focus on the food they eat. They might not think a lot about what they drink. That’s too bad, because these liquids can be quite fattening. If you’re trying to cut calories, start paying attention to what’s in your glass—as well as what’s on your plate.

Juices and SodasSodas and other sweetened drinks tend to have more calories than most people realize. A 12-ounce can of soda, for example, can have more than 150 calories. A 16-ounce glass of punch or lemonade can have more than 200. And fruit juice is not necessarily a good choice, seeing as an 8-ounce glass of orange juice might have 110 calories. To put these numbers in perspective, consider that a serving of potato chips has about 150 calories.

Beware of the SmoothieMany smoothies are made with ice cream or whole-milk yogurt, both of which are high in calories. A single smoothie could have as many as 800 calories—two hot-dogs’ worth!Try snacking on a piece of fruit instead, which might have 50 to 100 calories.

AlcoholAnother major source of calories that people often overlook is alcohol. A single shot of whiskey— just 2 ounces of liquid—has nearly 125 calories. A 5-ounce glass of wine or a 12-ounce glass of beer has about 160. Mixed drinks can have even more calories. An 8-ounce margarita, for instance, has 240 calories.

A Blues On Call Health Coach Can Help

To learn more about eating well, call a Health Coach. Health Coaches are specially trained healthcare professionals such as nurses, dietitians, and respiratory therapists. They are available by phone, anytime, 24 hours a day, 7 days a week, at no charge to you.

To talk to a Health Coach, call 1-888-BLUE-428. You can also get information online at www.mybenefi tshome.com.

3

Start healthy habits -

The problem with going on a diet is that someday you’ll go off of it and return to the eating habits that caused your weight gain. At that point, you’ll go on another diet, and the cycle will begin again.

If you’re hoping there’s a better way, there is. The logical and long-lasting solution is to change the way you eat — gradually and permanently — until you’re eating in a way that helps you achieve a healthy weight. Often eating healthy requires a life change, but in time your new way of eating won’t feel so new — it will be a new normal.

Change for goodThink of your new way of eating in positive instead of negative terms by concentrating on what you can eat, not what you shouldn’t. In fact, nothing needs to be off-limits — you can even feel OK about having dessert if you have a reasonable portion.

Here are some additional strategies:

Watch your portions. If you’ve been loading your plate morning, noon and night, you could be eating perfectly healthy foods — just too much of them. To realign portion sizes, read food labels and measure portions onto your plate for a week or so until you can eyeball what a

half-cup of mashed potatoes or 3 ounces of chicken looks like. Consider proportion. Eating too much protein or starchy foods such as pasta and bread can

lead to weight gain. To better balance your plate, consider that one-quarter should be a lean protein such as chicken or fi sh, one-quarter a healthy starch, such as brown rice or

whole-wheat pasta and the remaining half a healthy vegetable or salad. Keep a food journal. Chances are you think you’re eating a healthy diet when you’re not.

That’s because it’s easy to forget about those two sodas you have between meals that add 310 calories or the nightly 400-calorie bowl of ice cream. Most of us are not as self-aware as

we think we are. That’s why it’s a great reality check to keep a food journal in which you write what, when and how much you eat.

Don’t fi nish everything on your plate. Many of our eating habits come from our upbringing. Were you encouraged to be a member of the “clean-plate club” even if you were full? Looking at the habits you inherited and seeing if they are helping or hindering your weight can help you adopt healthier behaviors.

Be patient. It took years for you to get to the weight you are now; it’s going to take some time for the weight to come off. Plus, an overnight diet overhaul can set you up for failure and make it easy to become discouraged.

To successfully lose weight, you have to look at how you eat now, analyze it and make necessary, gradual changes that reduce your calorie intake. To keep pounds off permanently, you must incorporate these new, healthy behaviors into your daily routine so that they become a natural part of your life.

4

Mountain State Blue Cross Blue Shield (MSBCBS) is pleased to inform you that Dependent Maternity Care is a covered benefi t for all of our insured members, including our Direct Pay members who have elected the maternity rider.

This new benefi t is effective February 1, 2010, and includes both maternity benefi ts for any dependent who becomes pregnant, in addition to the post-delivery care for a dependent mother and her newly born child. This includes:

Inpatient Newborn Care – Routine care of a newborn, including circumcision while the mother remains an inpatient for the maternity admission. Maternity Services – Hospital, medical and surgical services for a normal pregnancy, complications of pregnancy, and miscarriage.

As defi ned by your policy, an eligible dependent is classifi ed as the following:

Unmarried child under age 19 for whom you provide primary fi nancial supportUnmarried child between ages 19 and 25 who is a full-time student at an accredited college or university (or other qualifi ed technical or specialized school) for whom you provide primary fi nancial support

Unmarried child between ages 19 and 25 regardless of student status who remains dependent upon you for primary fi nancial support

If you have questions regarding this information, please contact the Customer Service number listed on the back of your MSBCBS ID Card.

Healthy Lifestyles

Important Information for Mountain State

Mountain State Blue Cross Blue Shield (MSBCBS) will pay for physician services for the administration of the H1N1 vaccine.

All insured groups will be provided with full coverage. MSBCBS is encouraging physicians to especially immunize MSBCBS patients who belong to one of the following high-risk groups identifi ed by the Centers for Disease Control and Prevention (CDC):

Pregnant womenPeople who live with or care for children

younger than 6 months of age Healthcare and emergency medical services

personnelPersons between the ages of 6 months

through 24 yearsPeople ages 25 through 64 years who have

chronic health disorders or compromised immune systems

For the latest information on the H1N1 virus, including details about high-risk groups, recommended immunization guidelines, and vaccine availability, visit www.cdc.gov/h1n1fl u.

For questions regarding benefi ts eligibility for MSBCBS members, please contact the appropriate customer service area located on the back of the member’s identifi cation card.

Members and Group Administrators

5

The Mental Health Parity and Addiction Equity Act of 2008

The Paul Wellstone and Pete Domenici Mental Health Parity and Addiction Equity Act of 2008 was passed in October 2008 as part of the Emergency Economic Stabilization Act. It requires true parity between medical benefi ts and benefi ts that cover mental health and substance abuse services. Your employee health care benefi ts are affected by the Mental Health Parity law as follows:

If you are an employee of a group with less than 50 employees covered by Mountain State Blue Cross Blue Shield (MSBCBS), your Mental Health Parity benefi ts will change effective 2/1/10.

If you are an employee of a group with more than 50 employees covered by MSBCBS, your Mental Health Parity benefi ts will change at your renewal date.

If your health care benefi ts are provided as part of a collective bargaining agreement, you need to comply by the later of 1/1/10, or upon the expiration of your last bargaining agreement that was ratifi ed before 10/3/08.

The Mental Health Parity law considers three aspects of health care coverage for groups that offer both medical/surgical and mental health or substance abuse disorder benefi ts:

Financial requirements or what employers think of as cost-sharing provisions such as deductibles, co-payments, coinsurance, and out-of-pocket expenses.

Treatment limitations such as the maximum number of services covered, limits on the frequency of treatment, number of visits, days of coverage, or other similar limits on the scope or duration of treatment .

Network limitations, such as what is or is not covered out of network in a network-based benefi t plan.

In each of these areas, employers cannot impose any requirements that are more restrictive than the “predominant” requirement or limitation that applies to “substantially all” medical/surgical benefi ts. In addition, separate treatment limitations cannot apply only to mental health or substance abuse disorderbenefi ts.

Also, the law includes two requirements regarding disclosure of information. Health Plans must disclose the criteria for medical necessity determinations with respect to mental health/substance abuse benefi ts to participants, benefi ciaries or contracting providers if requested. Health Plans must also disclose the reason for any denial of reimbursement or payment for mental health/substance abuse benefi ts.

Employers are permitted to fi le for an exemption from the law if they meet certain criteria. The employer must comply with all requirements of the law for the fi rst plan year. After six months, the group needs to look at the total cost of its benefi ts. If that cost has increased by more than two percent,the group can apply for an exemption from the law’s requirements for the following plan year. The cost increase must be attributable to the application of the parity requirements and certifi ed by a qualifi ed actuary. The documentation of the cost increase must be retained for six years.

If it is necessary to make changes to bring your plan into compliance, please contact your MSBCBS Account Representative to discuss the details of your plan changes.

MSBCBS does not provide legal advice and this article should not be construed as such. The contents areintended only for general information purposes.

Important Information for Mountain State Members

Healthy Lifestyles

6

Women’s Health and Cancer Rights Act of 1998 and Related West Virginia Law

The Federal Women’s Health and Cancer Rights Act of 1998 mandates that if your Plan provides mastectomy benefi ts, it will cover the following procedures:

All stages of reconstruction of the breast on which the mastectomy was performed

Surgery and reconstruction of the other breast to present a symmetrical appearance

Prostheses and treatment of physical complications of the mastectomy, including lymphedema

Coverage for the above will be provided in a manner determined in consultation with the attending physician and the patient and subject to the terms and conditions of your Plan including any applicable deductible and coinsurance limitations consistent with those established for other benefi ts under this plan*.

Additional mandated coverage for insured policies:

Coverage shall be provided for a minimum stay in the hospital of not less than forty-eight hours for a patient following a radical or modifi ed mastectomy and not less than 24 hours of inpatient care following a total mastectomy or partial mastectomy with lymph node dissection for the treatment of breast cancer. This law does not require inpatient coverage when not medically necessary or when the attending physician and the patient determine that a shorter hospital stay is appropriate.

This notice only affects a participant or benefi ciary that has a policy that provides medical and surgical benefi ts with respect to a mastectomy and who elects breast reconstruction in connection with a mastectomy. Reconstructive surgery rights apply to any individual involved with a mastectomy, not just cancer patients.

If you have any questions about this or other health care benefi ts,please call the Customer Service number located on the back of your I.D. card.

Important Notice About Your Rights Under Your Health Plan

If you receive paper Explanations of Benefi ts (EOBs), you may soon notice a change in how many you receive.

In the coming months, for most members, Mountain State Blue Cross Blue Shield (MSBCBS) will no longer mail paper EOBs, if your services arecovered in full or if all you owe is a copayment. For some claims, you’ll continue to receive a paper EOB. These include claims for which you owe additional money, other than a copayment, and claims you fi led yourself. (Today, most claims are fi led by providers.) If you do not have access to a computer or prefer to continue receiving paper EOBs, please notify Member Service by calling the number on the back of your MSBCBS ID card.

What does this change mean for you? Less clutter in your mailbox! While you won’t receive a paper version, you will be able to view EOBs for all types of claims on the member website. While you’re there, please support our efforts to manage administrative expenses further by opting to “Go Green” entirely by signing up for e-Delivery of all EOBs.Simply log ontowww.mybenefi tshome.com and click the Member tab. Log in using your ID and password. Under Quick Resources,click on Go paperless and click eEOB. Make sure the box is checked. Click Submit.

is Going Green

*See your Certifi cate Book for details of any applicable

deductibles, coinsurance or co-payments.

If you have any questions about thischange, please call the Member Service number on the back of your ID card.

7

Mountain State Blue Cross Blue Shield is pleased to announce the launch of our new Preventive Health Alliance Network. The Preventive Health Alliance offers the following free educational programs at a location near you. PARS Brain and

Spine Institute1212 Garfi eld Avenue

Parkersburg(304) 865-3600Cynthia Smith

WVU HospitalsHealth Sciences

Campus The Wellness Program

Morgantown(304) 293-2520

David Harshbarger or Diane Richardson

City Hospital, WVU Hospitals – East

Dry Run RoadMartinsburg

(304) 264-1287 Ext. 1814

Dana DeJarnett

Jefferson Memorial Hospital

300 South Preston Ranson

(304) 264-1287 Ext. 1814

Dana DeJarnett

St. Mary’s Medical Center

2900 First AvenueHuntington

(304) 526-1253Mona Wilson or

Jeff Hefl in

Thomas Memorial Hospital

4650 MacCorkle Avenue

Charleston(304) 766-5983

Richard McGinnis

Saint Francis Hospital333 Laidley Street

Charleston(304) 347-6615Carrie Mallory

Wetzel Community Hospital

3 East Benjamin Dr. New Martinsville (304) 455-8005

Jeff Eggleston or Heather Leonard

LOCATIONS

PERSONAL NUTRITION COACHINGPersonal Nutrition Coaching is individual

nutrition coaching by a registered dietitian to address weight management, heart health or diabetes. An individualized plan is created that can be easily integrated into the individual’s lifestyle.

EAT WELL FOR LIFEEat Well for Life I is a lifestyle improvement

program promoting wellness and long-term weight management through increasing physical activity and healthy eating. Participants learn to make healthful food choices and are encouraged to adopt the nutrition practices needed to achieve a balanced lifestyle and long-term weight management.

Eat Well for Life II is a lifestyle improvement program that focuses on planning well-balanced meals, adopting mindful eating practices, increasing physical activity and making healthful eating choices when dining out. This class follows Eat Well for Life I.

DISCOVER RELAXATION WITHIN Discover Relaxation Within I is a lifestyle

improvement program to help identify and reduce individual stressors through specifi c relaxation techniques. This program is both educational and experiential.

Discover Relaxation Within II is a lifestyle improvement program that expands, through practice, the specifi c relaxation techniques learned in Discover Relaxation Within I and teaches participants to employ the techniques in everyday life.

CLEAR THE AIR Clear the Air is a group-based tobacco cessation

preparation program that provides the tools needed to get prepared, take action and quit tobacco for good. Participants receive a quit kit that includes coupons for over-the-counter nicotine replacement therapy.

HOPE (OSTEOPOROSIS PREVENTION) HOPE is a lifestyle improvement program that

focuses on health choices to prevent or manage osteoporosis. Program components include an overview of osteoporosis, nutrition education and cooking demonstration, strength training exercises, medication options and stress management.

Programs may vary by location - please contact your local site for more information.

Post Offi ce Box 1948Parkersburg WV 26102

PRESORTED STANDARD

U.S. POSTAGEPAID

PERMIT #2784CHARLESTON, WV

Healthy Lifestyles

People with pets probably appreciate the comfort animals can provide. However, they may not realize just how benefi cial such companionship might be to their well-being.

There appears to be an association between owning a pet and better psychological and mental health. While it’s still unclear whether there’s a defi nite cause-and-effect relationship, various studies have explored the correlation between pet ownership and health:

Women with pets tended to have lower blood pressure, triglycerides, and LDL, (“bad cholesterol”) levels than those without pets

Animal owners generally lived longer than non-owners

Heart attack patients who owned pets were less likely than non-owners to die during the year following the attack

Older women who had pets reported themselves generally happier and healthier than those without pets

Pet owners were more likely to see themselves as healthy — even when they made just as many doctor visits and took just as many medicines as othersOlder adults were more likely to remain independent by continuing to walk, shop, prepare meals

and do laundry for themselves if they owned a petOwning a pet was linked with a lower risk for depression among people recently widowed

Discovering exactly why interacting with animals may boost health is diffi cult. Scientists have found some clues, though. One possible explanation appears to be related to stress. When performing arithmetic problems, pet owners physically reacted less to the stress and recovered from it more quickly than those without pets. This was especially true if their pets were present during the test.

Just the presence of a pet, even if it’s not yours, might reduce heart rate and blood pressure — a key to controlling stress and its negative effects on your body. Also, stroking an animal releases chemicals in the brain that help people cope with pain and distress.

Finally, while owning a dog can encourage exercise, owners of cats and other pets that don’t require walking also seems to reap physical and emotional benefi ts.

Your Pet Might Keep You Healthy