DIRECTOR'S REPORT–Thomas H. Young, Director

"Meeting the Challenge"

For the past several years much has been made of the decreasing numbers of active letter carriers in the NALC Health Benefit Plan.

Of course, there is that solid core of active carriers who believe that belonging to the Health Benefit Plan "comes with the territory" when you belong to the union. For them, belonging to the Plan is a no-brainer and their commitment is very much appreciated.

So, as we prepared for the 2002 benefit year, President Sombrotto, the National Trustees and myself looked toward the question of how we could provide a positive change to benefit the Plan’s primary constituency ... retired letter carriers. These are the folks, some of whom have belonged to the Plan since we began, that are living on fixed incomes and really feel the pressure from increased medical costs.

The changes in the Plan for 2002 make utilization of the PPO Network even more important than ever. For those without Medicare, the in-patient cost will go up, but remember that the Plan’s structure now has to focus on retiree needs.

Before any of you jump off the deep end, take a look at our competition. See where their premiums have gone and take a look at their benefits. No plan is immune from the turbulence that is created by medical care in this country.

I firmly believe that what the Health Benefit Plan is presenting for 2002 is a very realistic and viable premium and benefit package. As in the past, we continue to be rated a top nationwide fee-for-service plan. The Plan is competitive and should draw a lot of attention during Open Season.

In the face of not having a Seminar, many of you have questioned the availability of information for Health Benefit Representatives. I can tell you that our great staff is working hard at compiling a notebook to aid you in the performance of your duties. As always, we
are available to answer your questions and help in every way we can.

"Use it or lose it" and "withered on the vine" were a couple of phrases that came to mind as we reviewed the HBR Claims Status Line. It seems the Maytag repairman was getting more calls than this aid we created just for HBRs to use as a tool in representing their members. Because of this lack of interest, effective November 1, 2001 the Plan is discontinuing access to members’ claim information. Of course, you will continue to have the valuable resource of our wonderful Customer Service Representatives.

As for your efforts during Open Season, I wish you good luck. Let us know whenever you need any assistance.

How the Plan Changes for 2002

Note:?Do not rely solely on these change descriptions; this page is not an official statement of benefits.

Program-wide Changes:

• Four states are added to the list of medically underserved areas: Georgia, Montana, North Dakota and Texas. Louisiana is no longer medically underserved.
• We changed the address for sending disputed claims to OPM.

Changes to this Plan:

• Your share of the NALC Postal premium will decrease by 15.5% for Self Only and decrease by 25.9% for Self and Family.
• Your share of the non-Postal premium will decrease by 6.4% for Self Only or 10.9% for Self and Family.
• We clarified the brochure to better explain that the non-PPO benefits are the standard benefits of this Plan, that PPO benefits apply only when you use a PPO provider, and that when no PPO provider is available, non-PPO benefits apply.
• We clarified the preventive care, adult benefits by removing the entry for blood lead level testing for adults because it is a test more typically done for children.
• We no longer limit total blood cholesterol tests to certain age groups.
• We now cover routine screening for chlamydial infection.
• We added meningococcal immunization coverage under Preventive care for children.
• Your PPO copayment for amblyopia and strabismus examinations is now $20. Previously your copayment was $15.
• Your charges for physical and occupational therapy are now covered up to a combined total of 50 visits per calendar year. Previously the Plan covered up to 90 visits for each.
• We increased speech therapy benefits by removing the requirement that services must be required to restore functional speech.
• Your charges for speech therapy are now covered up to a total of 30 visits per calendar year. Previously the Plan covered up to 90 visits.
• We now cover certain intestinal transplants.
• Your hospital inpatient coinsurance is now 10% of the Plan allowance at PPO hospitals and 30% of the Plan allowance at non-PPO hospitals. Previously you paid nothing at PPO hospitals and 20% of the Plan allowance at non-PPO hospitals.
• We changed how we determine our Plan allowance for non-PPO benefits. In geographic areas where you have adequate access to a PPO provider but do not use one, our allowance is based on the average PPO negotiated rate for that region.
• If you do not have adequate access to a PPO provider, our Plan allowance will be based on the 80th percentile of data gathered by Ingenix, Inc. Previously it was based on the 90th percentile.

HEALTH IN THE NEWS

Food of the Month

Eggplant

The eggplant has been known to human beings for thousands of years. Until the 12th century, however, its main use was as a table decoration. Before that time, it was feared that this beautiful member of the nightshade family caused insanity.

All that was changed by Thomas Jefferson, who planted imported eggplants at Monticello. Soon the word was out. The eggplant was nutritious and could be used in many ways.

Today, we know that this substantial vegetable is high in fiber and a good source of potassium. Unlike most foods used in vegetarian fare, it’s a stick-to-your-ribs addition to any meal. You won’t feel hungry in an hour or two when your main dish features eggplant.

The big purple American is the most popular in the U.S. Chinese eggplant looks more like a purple cucumber; Italian and white varieties are smaller.

October is National Breast Cancer Awareness Month

In its second decade of educational programs, 17 major nonprofit cancer groups sponsor Breast Cancer Awareness Month in 2001. They ask that women of all ages consider their personal roles in breast cancer prevention.

While genetics plays a part in 10 percent of cases, individuals are asked to remember the factors they can control. These include not smoking, reducing dietary fat, and eating a healthy diet rich in fruits, vegetables and grains.

According to The New England Journal of Medicine, research shows reduced cancer rates in people who eat diets high in fruits and vegetables. Some studies show up to a 25 percent reduction in breast cancer risk among fruit and vegetable eaters.

Although a recent, well-publicized study concluded that this diet makes no difference, the American Cancer Society disagrees. It says the studies in this project were so dissimilar that no real conclusions should be drawn.

Breast tumors take seven years to grow to a detectable size. Study subjects must be followed 8 to 10 years to see a benefit from a particular diet. This was not the case in the flawed study.

One thing is certain. A diet including many fruits and vegetables is proven to lower your risk of heart disease, diabetes, and other health problems, and possibly cancer as well. And there is no evidence whatever to show that such a diet is harmful.

New devices offer hope to heart patients

By August, doctors were cautiously hopeful. The first totally internal artificial heart was humming along just fine several weeks after being implanted into the chest of a man who would have died without it.

The bionic device called AbioCor raises hope for thousands of patients who are too old or otherwise ineligible for heart transplants. While experts say it will be a miracle if the device lasts for the long term in the first patient, the manufacturer, Abiomed of Boston, says that it would consider it a success if recipients live even six months. Abiomed has invested 40 years of research and development leading up to testing of the new heart.

Ventricular assist devices.

Heart patients have recently been blessed with another advance in treatment. "Ventricular-assist devices" allow patients to keep their natural hearts while they take over part of the pumping function. A number of these devices are approved by the U.S. Food and Drug Administration to tide patients over until they can get one of the scarce transplantable hearts that come from donors. Several models include small portable controllers and batteries which allow the patient to live at home. At least one in development is totally implantable.

Some doctors, including Robert Jarvik, developer of one of the first artificial hearts, think heart-assisting devices may be better than an artificial heart. One advantage: if they fail, the patient’s own heart works as a backup. In addition, several patients’ hearts have recovered once given a chance to rest on the device.

Those who are gravely ill with heart disease have new choices. None is easy, but all give the patient a chance to live and possibly to recover.

Salmonella from cantaloupes

Raw eggs and undercooked chicken are widely known to be responsible for Salmonella poisoning. Salmonella bacterium sometimes is found on fruits and vegetables, especially those that touch the soil.

Earlier this year, 30 people fell ill with salmonellosis after eating cantaloupe tainted with the bacterium.

The bacterium can be found on the skin of some cantaloupes. When they are cut, it is spread onto the slices. To prevent the problem, scrub cantaloupes and other melons under running water before cutting. Wash your hands before handling the fruit. Refrigerate any leftovers immediately.

SAFETY ISSUES

FEMA pushes safe rooms for stormy areas:

The Federal Emergency Management Agency (FEMA) says a safe room can be a lifesaver when a tornado or hurricane crashes into your house.

The safe room may resemble a large walk-in closet like the one shown to builders at the National Association of Home Builders convention in Atlanta. It’s built with enough concrete to survive any kind of storm.

The Federal Housing Administration approves — it will let you borrow up to $5,000 extra on a new home mortgage to cover the price of a safe room. Anyone who is seriously considering a safe room should get the FEMA booklet ("Protecting Yourself from the Storm"). This booklet is based on 30 years of wind research done at Texas Tech University in Lubbock, Texas, an area that experiences severe winds and tornados and has few basements. It says common spots are a large closet, a small bedroom, a bathroom, or even a wine cellar.

In new-home construction one common construction method uses ICFs, insulated concrete forms. In an existing home, one method is to double up the wall studs, cover them with reconstituted wood called oriented strand board, and cover this with steel plates.

FEMA reports that they receive many inquiries each day about safe rooms, mainly from tornado-prone areas.

Gasoline was made to EXPLODE!

It is important to remember that gasoline has only one proper use: to power vehicles or machinery. It is so volatile that one gallon of gasoline is equivalent to 14 sticks of dynamite in explosive force.

Vapors from gasoline are very dangerous. They are heavier than air and will flow invisibly along the ground. They will ignite from a flame, spark, or static electricity, casing an explosion.

• Never use gasoline around a flame source such as matches, cigarettes or pilot lights on stoves and water heaters.
• Only use gasoline outdoors or in a well-ventilated area.
• Fill the tanks of gasoline-powered equipment when engines are turned OFF and COLD.
• Don’t carry gasoline in your car. A fiery explosion may result if there is a collision or if vapors escape.
• If gasoline is spilled on clothing, remove it immediately. Place clothing outdoors for several days before washing and drying so that gasoline vapors can evaporate. (Clothes dryers can catch fire if vapors are not allowed to evaporate first, even if the clothing has been washed.)
• Never store gas inside a building.
• Use only approved safety cans, which have flame arresters and pressure-release valves.
• Keep gasoline locked up and away from kids when not in use.

Halloween safety for kids

Hospital statistics show that a child is more likely to be involved in an injury-producing accident on Halloween than on any other day of the year.

To protect children, Prevent Blindness America offers these safety guidelines.

1. Wear makeup instead of masks.
2. Don’t wear wigs, floppy hats, eye patches or anything that blocks vision.
3. Wear bright, reflective clothing or have reflective patches on the costume.
4. Avoid pointed props such a spears, swords, or wands that can endanger other children’s eyes.
5. Carry a flashlight to illuminate dark walks, steps and paths.
6. Obey all traffic and pedestrian rules.
7. Younger kids should be accompanied by an adult. Older kids should go out in group.
8. Inspect trick-or-treat items before kids eat them.
9. Light the path and steps at your front door.

THE PHARMACY CORNER

The newspapers, magazines and other media are full of stories of rising costs of healthcare in the United States, especially the soaring prices of the medications we take to keep us in good health. Your NALC Health Benefit Plan has not only lowered its premiums for the 2002 benefit year but was able to keep your pharmacy benefits intact. Below is a quick summary of the 2002 prescription drug program:

You Pay

• Network Retail: 25% of the cost
• Network Retail (Medicare): 15% of the cost
• Non-Network Retail: $25 deductible and 40% of our allowance
• Non-Network Retail (Medicare): 40% of our allowance (no deductible)
• Mail Order: 60-day supply, $8 generic/$17 name brand
• Mail Order: 90-day supply, $12 generic/$25 name brand
• Mail Order (Medicare): 60-day supply, $5 generic/$13 name brand
• Mail Order (Medicare): 90-day supply, $7.50 generic/$19.50 name brand

PPO Booklets

Along with the new 2002 NALC Health Benefit Plan brochure, all members will receive a new PPO Booklet. However, I find it necessary to put forth this admonition — DO NOT RELY ON THE PPO DIRECTORY as a final word on which providers participate in the network.

To put it bluntly, by the time you receive the directory, some of the providers listed may no longer be participants in the network or there may have been additions that were too late for the printing deadline. Therefore, to avoid a nasty surprise that some of your claims are being paid at the non-PPO benefit level, it is important to do one of two things. Call the 1-800-622-6252 PPO locator number to verify the provider’s participation or go to the First Health website. The website can be accessed by going to www.NALC.org hitting the department bar and clicking on Health Benefit Plan.

Check Out Our Updated Web Page For Open Season!!!

The NALC Health Benefit Plan has updated its web page to bring you the latest information on the new benefits for the upcoming Open Season. The site will provide our members with copies of our Open Season materials and the official brochure. These are all provided in PDF format so you can download them. The brochure is set up in a way that you can navigate through the brochure by clicking on sections on the table of contents. As in the past, the website also provides copies of the HBR Report and other important notices as they become available.

Members can access the website by going to www.nalc.org and clicking on Departments and Health Benefit Plan.