4J Licensed Newsletter #221

NINE GREAT YEARS!
INSURANCE COVERAGE AND QUALIFYING EVENTS
A BOOST FOR THE AGING BRAIN
AN APPARENT PARADOX?
EXERCISE, KNEES AND OSTEOARTHRITIS
A FOND FAREWELL FROM MR. BENEFITS ANSWER MAN

NINE GREAT YEARS! (back to top)
With this article, I am about to conclude nine years as Licensed-staff Benefits Coordinator. Over the course of those years I have written 110 of these newsletters; I have, along with a number of our colleagues done my best to represent your interests on the Joint Benefits Committee, and have been here to answer your benefits, retirement, and Sick Leave Bank questions. My time occupying the office at the top of the stairs above the Ed Center’s Tower Room has been a most satisfying conclusion to a great career in 4J. I have enjoyed the opportunity to assist you in understanding your benefits package through the tenures of three different insurance carriers (PacifiCare, ODS, and OSBA/Regence). There have been some good years, some not-so-good years, and a couple of painful years as we have navigated the choppy waters of the medical/dental insurance world together. For some individuals, there have been times that I have had to deliver information that they didn’t want to hear, but it was always the information that was accurate and correct to the best of my knowledge. I have assisted a relative few of you in appeals of insurance carrier coverage decisions and we have prevailed on some.

Through all these years, we, your colleagues on the JBC, have worked diligently to do the most good for the most members. I believe that in this effort we have succeeded.

Now as I enter retirement, let me thank you for letting me represent and work with and for you. It has been a pleasure!

INSURANCE COVERAGE AND QUALIFYING EVENTS (back to top)
Jackie McLaughlin, 4J Benefits Manager has informed me that recently there have been a number of instances of members failing to notify the 4J Employee Benefits Office when an event has occurred that would allow additional dependents to be added to the member's coverage, or would render a dependent ineligible and require they be dropped from the member’s coverage. In both cases, serious consequences could result!

Our OSBA/Regence BCBSO coverage specifies that any qualifying event (marriage, birth, or adoption of a child) must be documented and enrollment-change forms filed within 31 days of the event or the new dependent will be ineligible for enrollment until the next open enrollment period.

In cases where a qualifying event eliminates eligibility of a previously covered dependent (divorce or dissolution of a domestic partnership, marriage of a dependent child, a child no longer being 50% financially dependent), failure to report the event makes the member financially liable for any claims paid for services provided to the person who was ineligible for coverage at the time the service was provided.

In the case of a retired member, missing this “qualifying event window” eliminates any future enrollment for the new dependent in question and carries the same financial responsibility for services provided an ineligible dependent. It is your responsibility to attend to this matter. It is not a problem that the Employee Benefits Office can fix after the fact. This is a policy of the insurance carrier over which we have no control. Please take care of this important matter so you face neither large out-of-pocket expense for services provided past date of dependent eligibility nor a new dependent is not either temporarily, in the case of active employees, or permanently, in the case of retirees, disqualified for coverage.

A BOOST FOR THE AGING BRAIN (back to top)
An article in the May 2007 issue of the Mayo Clinic Health Letter caught my eye. According to the editors, “A recent study demonstrates for the first time that the inevitable shrinkage of the aging brain can actually be reversed with regular aerobic exercise.” It is important to note that the findings are specific to older healthy adults. More study needs to be done to determine whether or not aerobic exercise might have a positive impact on progressive dementia or perhaps help prevent it.

But it would seem, this finding represents yet another reason for practicing a healthy active lifestyle that includes regular moderate to high-intensity aerobic exercise.

AN APPARENT PARADOX? (back to top)
The Minnesota Heart Survey, a long-term study of heart health has concluded that, “Over the past 25 years, Americans have been eating an increasingly heart-healthy diet.” According to researchers they have been consuming more fruits, vegetables, whole grains, etc. and less fat (saturated and trans fats) and cholesterol. They speculate that this may be at least a strong factor in the decrease in death rates from heart disease. But, unfortunately, the energy balance (more calories in than out) and sodium intake have taken a turn for the worse. A direct result of the American pattern of eating out and “Super-Size” portions perhaps?

EXERCISE, KNEES AND OSTEOARTHRITIS (back to top)
As a runner and marathoner for many years I have heard variations of the following comment/question more times than I can count, “It’s amazing that your knees are holding up.” Or, “Doesn’t all that pounding eventually cause arthritis in your knees?” I’ve always responded that to my knowledge it is better to run (even at the obsessive level required of marathoning) as a preventative measure than not to do so. It turns out that neither the comments/questions nor my response is entirely on point. A number of studies have concluded that regular weight bearing exercise such as walking, running/jogging does not lead to the development of knee osteoarthritis nor, to my disappointment, does it prevent it. But the upside to this debate and these conclusions is that beyond the concern over knee osteoarthritis, exercise has so many other benefits for general health. Also, many physicians recommend moderate exercise to reduce/relieve the joint pain and stiffness in their patients who have arthritis.

A FOND FAREWELL FROM MR. BENEFITS ANSWER MAN (back to top)
Mr. BAM has decided to join me in retirement. During the last 9 years he has offered “lighter-side” insights into the world of benefits and life. He asked me to say goodbye for him – he’s far too emotional to do it himself. He will say farewell with a couple of “pearls” from his favorite cowboy philosopher, Chuck Pyle, The Zen Cowboy.

• When you come to a fork in the road, take it.
• Always ride the horse in the direction it’s going.
• Nobody rises to low expectations.

Michael Caley
Licensed-Staff Benefits Coordinator
Eugene School District 4J
200 North Monroe
Eugene, OR 97402-4295
Phone: W: 541-687-3244 H: 541-485-1493
fax: 541-687-3687 e-mail: caley@4j.lane.edu

4J Benefits and Wellness Newsletter