DIRECTOR'S REPORT–Thomas H. Young, Director

Open Season is Coming!!!

Now is the time to get serious about promoting the Plan to your fellow branch members. From November 8 through December 13, active and retired members will have the opportunity to join the NALC Health Benefit Plan.

As always, we are eager to have every active letter carrier make us their health plan of choice. Shortly, all letter carriers will receive an Open Season packet in the mail. All we ask is that they take the time to read the material and make some informed decisions regarding their health care needs.

The philosophy of the NALC Health Benefit Plan has always been to cater to the health coverage needs of our union brothers and sisters. So, you can see, the NALC health Benefit Plan is the place to be for letter carriers and their families.

Enclosed with this edition of the HBR Report is an advanced copy of our CD that contains the 2005 Official Plan Brochure, NALC PPO Directory, Caremark Pharmacy Network, and an educational bonus tool, the new Open Season Booklet for use during the upcoming Open Season as well as throughout the year.

I am asking each and every one of you to attend your branch meetings during this coming Open Season and do every thing you can to promote the Plan. We’ll provide you with the materials you will need, all we need is for you to provide the "TALK."

Go to the polls –

People often wonder if their one vote counts, whether it’s worth the trouble of going to the polls or filling out an absentee ballot.

It is worth the trouble. In local elections, an outcome is often decided by just a few votes. If just a few people decide it’s not worth the trouble, the best candidate could be defeated.

In presidential elections, there have been many where the popular vote is almost equal. If enough people decide their one vote doesn’t count, the candidate they prefer could be defeated.

VOTE. It’s your right and your duty.

How the Plan Changes in 2005

Do not rely on these change descriptions; this page is not an official statement of benefits. For that, go to Section 5 of the 2005 official Plan brochure. Also, we edited and clarified language throughout the brochure; any language change not shown here is a clarification that does not change benefits.

Program-wide changes

In Section 3 under Covered providers, Alaska is designated as a medically underserved area in 2005. Maine, Utah and West Virginia are no longer designated as medically underserved areas in 2005.

In Section 9, we revised the Medicare Primary Payer Chart and updated the language regarding Medicare Advantage plans (formerly called Medicare + Choice plans).

In Section 12, we revised the language regarding the Flexible Spending Account Program - FSAFEDS and the Federal Long Term Care Insurance Program - FLTCIP.

Changes to this Plan

We now require prior approval for certain specialty drugs, including biotech drugs. Failure to obtain prior approval will result in a reduced benefit. (Section 5(f))

Clarifications

We have clarified that a licensed or registered dietician/nutritionist is a covered provider for diabetic education. (Section 5(a))

We have clarified that the 50-visit physical and occupational therapies limitation applies to covered chiropractic manipulations in MUA states. (Section 5(a))

HEALTH IN THE NEWS

COPD and the Great American Smokeout
(November 18, 2004)

People worry about getting heart disease or Alzheimer’s, but not about chronic obstructive pulmonary disease (COPD).

Lung cancer is deadlier, but COPD is far more common. Some 13 million Americans have it, nearly 40 times as many as have lung cancer, according to the American Lung Association. It’s the fourth leading cause of death in the U.S. and includes chronic bronchitis and emphysema.

In 2000, for the first time, COPD killed more women than men. By 2020, it may be the third leading cause of death in the U.S.

The disease isn’t curable, but it is largely preventable. About 85 percent of all cases in the U.S. are triggered by smoking.

It’s one reason that the Nov. 18 Great American Smokeout is so important. Those who stop smoking in the early stages get increased lung function for many years.

Early diagnosis is critical. By the time shortness of breath occurs, the illness has been progressing for a decade or more.

COPD victims have treatment options. Inhaled steroids that reduce inflammation are now the most common treatment before lung-volume reduction surgery.

Exercise helps. Doctors at the University of Nebraska Medical Center say building endurance increases lung function.

Low-carb eating without the hassle

If you’re interested in cutting back on carbohydrates without following a book or a strict diet, you now have that chance.

Molly Kimbal, a nutritionist with the Ochsner Clinic in New Orleans, says eliminating some highly processed foods is an easy way to reduce carbohydrates in your diet and cut calories.

First, eliminate carbs with little or no food value, such as pastries, fruit juices, soft drinks, crackers, and pretzels.

Doctors at the American Council on Science and Health say you should be sure to get plenty of the high-fiber vegetables such as broccoli, zucchini, cauliflower, squash, and asparagus. While bananas are a high-carb food, they are also full of potassium, so don’t eliminate them.

Plan your meals and snacks so you don’t shop too often or just eat whatever is available. Ask yourself if you’re really hungry or if the food just looks good.

Eat early and eat often. Eat small amounts frequently, and drink plenty of water.

Don’t deprive yourself of your favorite stuff, or you could quit watching your carbs and your weight. Go ahead and have a glass of wine. If you love chocolate cake, eat a small piece occasionally.

There are hundreds of low-carb products in the supermarket. Before buying one, check the calorie count.

If your diet doesn’t include whole grains, you will benefit from a B-vitamin supplement in addition to a daily multivitamin.

October is Liver Awareness Month

Liver disease is a little-known risk of obesity.

Experts say that people watching their weight should also be watching their liver.

Most people know that losing weight lowers the risk of heart disease and type 2 diabetes. The risk of a lesser-known, but highly important obesity-related disorder, can also be lowered through weight loss.

It is known as nonalcoholic fatty liver disease (NAFLD). A surprising 25 percent of American adults have it. It is the most common liver problem in the U.S.

The disorder is marked by elevated liver enzymes and fatty deposits in the liver in the absence of excessive alcohol consumption. About 15 to 20 percent of these people ultimately develop inflammation and scarring of the liver. Advanced scarring (cirrhosis) is irreversible, according to Johns Hopkins Medical Centers.

A body mass index greater than 30 is strongly associated with NAFLD. Overweight people who tend to store fat around the abdomen, rather than around the hips, are at greater risk. Type 2 diabetes also increases the risk of NAFLD.

A diagnosis of NAFLD is generally easy. Doctors check the blood during routine blood work for elevated liver enzymes, which may be the first indication.

The American Gastroenterological Association (AGA) recommends gradual weight loss of one to two pounds per week through calorie restriction and increased exercise. A loss of about 10 percent of body weight has proved beneficial in lowering elevated liver enzymes and fatty deposits.

Veterans Day: The 11th hour of the 11th day of the 11th month.

Nov. 11, 1918, is recognized as the end of the world’s first global conflict, World War I. In 1938, November 11 was named Armistice Day in recognition of those who served.

Then came World War II and the greatest mobilization of armed forces in history. After that, American forces fought in Korea. So in 1954, the 83rd Congress changed Armistice Day to Veterans Day to honor all who served.

Veterans Day National Committee services are held at Arlington Memorial Amphitheater. It is built around the Tomb of the Unknown Soldier at Arlington National Cemetery, property that once belonged to General Robert E. Lee.

At 11 a.m., a color guard representing all military services honors the Unknown Soldier with "Present Arms," the laying of a Presidential wreath, and the playing of "Taps."

Though these services are held at Arlington, the primary focus of Veterans Day is on veterans who are alive and with us today. They are honored with parades and speeches.

To all veterans working among us, and especially those who have recently served in Iraq, we sincerely say, "Thank you. We will not forget."

Exercise boosts immunity

You know that exercise strengthens your heart, tones your muscles, and helps you maintain an ideal weight, among its other benefits.

Now research at Acadia University in Nova Scotia and elsewhere shows that people who lifted weights for 30 minutes three times a week have significantly stronger immune systems than a group that didn’t lift weights.

With the cold season coming on, it’s a good time to get the multiple benefits of exercise.

Nuts, fiber, and cholesterol

Researchers at the University of Toronto find that this diet lowers cholesterol almost as much as taking a statin:

A fiber-rich vegetarian diet consists of foods that lower cholesterol such as oats, barley, soy protein, and almonds. Add a type of margarine that includes cholesterol-lowering compounds.

In their study, the cholesterol-lowering drug lovastatin reduced cholesterol by 31 percent. The diet reduced cholesterol by 29 percent.

Five Grains of Corn

The Pilgrims and their benefactors from Massasoit’s tribe feasted for several days at the first Thanksgiving. It was a time of plenty, but the days before that harvest were far different. Five grains of corn was the daily ration during that desperate time.

Legend says that the Pilgrims placed five grains of corn beside each plate on Thanksgiving Day so they wouldn’t forget.

The corn also reminded them of difficult days on the tiny Mayflower and of a time when there were only seven healthy colonists to care for the sick.

Some people follow that custom today. They say each grain of corn has a special significance. The first reminds us to be thankful because the earth is good and our land is free.

The second acknowledges Indians who befriended the Pilgrims and helped them survive their first winter.

The third stands for our own courage and how it helps us to do great things for others and for ourselves.

The fourth is to give thanks to the Pilgrims who came to the New World and established a land of religious freedom.

The fifth stands for our gratitude, which leads to joy. That joy leads us to a renewed commitment to family and country.

THE PHARMACY CORNER

Let Caremark Help You Manage Your Treatment

When you enroll with Caremark Specialty Pharmacy Services we assign a team of professionals to help manage your daily needs.

Benefit from the industry’s most comprehensive solution:

• Delivery of time-sensitive, temperaturecontrolled pharmaceuticals* and any necessary ancillary supplies to your home
• Access to emergency pharmacist consultation 24 hours a day, 365 days per year
• Specialty Pharmacy Services through a network of 17 nationwide pharmacies accredited by the Joint Commission on Accreditation of Healthcare Organizations
• Pharmacist-led clinical services including education, monitoring of your medications and proactive calls to offer counseling
• Assistance in coordinating injection training when insurance allows
• Refill order convenience 24-hours a day, 365 days a year

Caremark Specialty Pharmacy Services provide 24-hour access to emergency pharmacist consultation at no additional cost to you. We deliver treatments directly to your home or office.

Call 1-800-237-2767 or visit www.caremark.com to verify your coverage for:

Growth Hormone Disorders

Protropin®, Nutropin®, Nutropin AQ®, Nutropin, Depot®, Humatrope®, Genotropin®, Norditropin®, Saizen®, Serostim®

Multiple Sclerosis

Avonex®, Betaseron®, Copaxone®, Novantrone®, Rebif®

Hemophilia, von Willebrand Disease and related bleeding disorders

Recombinant and Monoclonal Factors VII, VIII and IX, Stimate® and others

Hepatitis C

Rebetol®, Intron A®, Rebetron®, Roferon®-A, Infergen®, Pegasys®, Peg-Intron®, CopegusTM, Referon®

Immune Disorders

Cytogam®, Gammagard® SD, Gamimune®N-SD, Gammar® P-IV, Polygam® SD, Panglobulin®, Iveegam® Sandoglobulin®, VenoglobulinTM, WinRho® SDF

Osteo/Rheumatoid Arthritis

Enbrel®, Remicade®, Synvisc®, Hyalgan®, Kineret®

Respiratory Syncytial Virus (RSV)

Synagis®

Pulmonary

TOBI®, Pulmozyme®, Respigam®

Pulmonary Hypertension

Tracleer®

Crohn’s Disease

Remicade®

Gaucher’s Disease

Cerezyme®

Blood Modifiers

Epogen®, Procrit®, Neupogen®, Neumega®, Neulasta®, Leukine®, AranespTM

Oncology

Thalomid®, Temodar®, Xeloda®, Lupron®, Zoladex®, Gleevec®, Novantron

*Products distributed by Caremark may change from time to time.

Note to Our Health Benefit Representatives

Notices of Open Season Health Fairs

We are in the process of responding to the ever-increasing number of requests for attendance at Open Season health fairs. Because the Health Benefit Plan is unable to participate in each and every fair, we are seeking your help. You may have already received a letter (or letters) from the Plan forwarding you a health fair notice.

As we mentioned in our letter to you, it is extremely important that you notify the contact person indicated in the request letter as soon as possible as to whether or not you will be able to attend. Also, please complete and mail the Open Season material request form included with your letter in the postage paid envelope. It is important that we receive your request for Open Season fair materials at least 2-3 weeks prior to the health fair in order to assure delivery in a timely manner. Remember when ordering supplies that every active letter carrier will receive a 2005 NALC HBP Brochure.

Please remember, attendance at health fairs for federal agencies is entirely your choice, however, we would encourage you to attend all Postal health fairs. Also, please note that notification of a health fair is NOT an assignment.

These health fairs are an excellent opportunity to get the word out about the benefits of your union-owned, union-operated health plan. I cannot emphasize it enough that the members of the NALC benefit enormously by having their own health plan. We are part of the system and are "on the inside" when it comes to input as to the direction of the FEHBP. Please don’t take this fact lightly, for the NALC Health Benefit Plan is often the first to ask question and challenge decisions made regarding your health benefits by the Office of Personnel Management.

Return to HBR Reports, NALC Health Benefit Plan HomePage or NALC Headquarters HomePage.

This page was last updated on November 18, 2004.

If you have any questions or comments about our health benefit plan, please write to the National Association of Letter Carriers Health Benefit Plan at 20547 Waverly Court, Ashburn, VA 20149 or call 1-703-729-4677. For automated general benefit information, call 1-888-636-NALC.