Tuesday, 31 January 2012 19:02

New Year, new paperwork

With the turn of the New Year, many Ohioans with group health insurance have been inundated with information regarding new or renewal health insurance policies and may be asking, “What is this information, what does it mean, and what am I supposed to do with it?”

According to a 2009-2010 report by the Kaiser Family Foundation, 53 percent of Ohioans have health insurance through their employer and many have questions about their benefits, especially at the beginning of a calendar year. Employees may be directing these questions to you or your employee benefits managers.

“December is one of the busiest times of the year in terms of sending plan and benefit information to new and existing members, and this often results in a considerably higher call volume to customer service at the beginning of the year,” explains Nancy Markle, vice president of client services at SummaCare, Inc. “Members have a lot of questions regarding how their benefits work, even more so if they have a new benefit plan or have switched to a different carrier.”

Smart Business spoke to Markle about the information your health insurance company is required to provide its enrollees and how to be prepared should you receive these questions.

What information about a policy does your health insurance carrier have to provide?

Group health insurance information requirements are governed by individual states, and the information insurers are required to provide may vary by state. In Ohio, enrollees in a fully insured group plan receive a document called a Certificate of Insurance (COI), and the Ohio Department of Insurance (ODI) has a summary of items that must be included in this document. These items include, but are not limited to, information regarding provisions, appeals, services covered and not covered and policyholders’ rights.

In addition to a Certificate of Insurance, many enrollees will receive a Schedule or Summary of Benefits (SOB). This document details the services covered under the policy and the deductibles, copays and coinsurance amounts associated with these services. If applicable, the SOB will detail this information for both in- and out-of-network coverage.

It is important for both you and enrollees to keep these documents and any addendums to the documents so you have a current and up-to-date record of what your health insurance policy includes and excludes as services can change throughout the year.

What are some health insurance terms that frequently cause confusion?

Many calls that a health insurance company customer service department receives are benefit-related and often just require a little explanation. This often includes defining commonly used industry terms to someone who is not familiar with health insurance lingo.

Two frequently misunderstood terms that go hand-in-hand are deductible and coinsurance. A deductible is a specified dollar amount of covered medical expenses that an enrollee must pay before an insurance policy will pay for its part of the service or treatment.

Coinsurance is the amount an enrollee pays for covered service or treatment after the deductible has been met. Coinsurance is usually based on a percentage. For example, if your policy has an in-network deductible of $1,000 and an in-network coinsurance of 80 percent, the beneficiary must pay $1,000 out-of-pocket before the 80 percent coinsurance for in-network services will apply. This means that the enrollee will pay the contracted rate for any services received that have a coinsurance until the $1,000 deductible is met.

Copayment, or copay, is another term that often causes confusion. A copay is a flat fee an enrollee pays for a covered service or treatment. Common services which may require a copay include office visits and urgent care and/or emergency room visits. Out-of-pocket costs for copays do not always apply toward the deductible, so understanding your plan is important to managing health care costs.

It is important to understand what covered service copays or coinsurance amounts apply to the deductible, as some out-of-pocket costs do not apply to the deductible amount.

Other terms that can be confusing are premium and out-of-pocket maximum. Premium is the amount paid for the overall policy (usually through the employer) on a monthly, quarterly or annual basis. Out-of-pocket maximum refers to the maximum amount of coinsurance or copays an enrollee must pay before your health insurer starts paying 100 percent of covered medical bills. This amount differs from the deductible because it is the maximum dollar amount an enrollee will be required to pay during the benefit year (outside of the premium), and it may or may not include deductible or copays. For example, if your plan has an out-of-pocket maximum of $5,000 and you’ve reached your deductible and have paid eligible copays and coinsurance that total $5,000, your health insurer will pay 100 percent of covered service and treatment costs for services received in-network. This typically occurs when a person is receiving ongoing treatment for a chronic condition, has utilized many of the treatments and services covered under his or her plan or has a large medical expense during a calendar year.  Most, if not all, COI documents contain a definition section, so your COI is a good resource to help define other common insurance terms.

How can enrollees make the most of their health insurance benefits?

Enrollees in a group policy can make the most of their benefits by ensuring they understand their plan and the services and treatments that are covered or excluded. To receive benefits at a richer level, seek care from in-network providers and hospitals.

Enrollees should also familiarize themselves with any value-added services. Insurance companies will often offer additional services at little or no-cost, including resources to help you quit smoking, receive diabetic supplies and discounts on vision services and more.

Finally, if beneficiaries find anything confusing, they should contact the insurer for an explanation. Carriers realize that informed members are more satisfied members.

Some information obtained from the Shopper’s Guide to Health Insurance, Ohio Department of Insurance. For more information, visit http://www.insurance.ohio.gov.

Nancy Markle is vice president of client services with SummaCare, Inc. Reach her at marklen@summacare.com or (330) 996-8466.

Published in Akron/Canton

Did you know that tobacco use in the United States costs an estimated $197 billion a year in lost productivity and health care costs? Add to that second-hand smoke, which costs an additional $10 billion in losses. Tobacco use contributes to one of every five deaths, and smokers die an average of 13 years earlier than nonsmokers.

“While it’s not easy to quit, it is possible to do so. And employers can help,” says Julie Sich, health promotions coordinator for SummaCare Inc.

“Both the employer and employee can benefit when the employer helps the employee who wants to quit,” says Sich. “Employees who quit can significantly improve their health and quality of life. Employers benefit by spending less on tobacco-related illnesses and gaining productivity in the work place.”

Smart Business spoke with Sich about how to provide the tools to help your employees quit smoking.

Why should employers be concerned about employees who smoke?

Worldwide, an estimated five million people will die this year as a result of smoking. In the U.S., tobacco use is responsible for an estimated one in five deaths, or about 443,000 deaths per year. This creates a huge impact on businesses and the health care system.

In addition, for every death that results from smoking, an additional 20 people suffer from at least one serious illness related to smoking, including smoking bronchitis, heart disease, stroke, cancer and lung disease. People who suffer from those diseases are not as productive and can cause substantial increases in health insurance premiums.

With an estimated 46.6 million smokers in the U.S. — 20.6 percent of the adult population — this can have a significant impact on the productivity of the country’s employers.

How do employees who smoke cost their employers money?

The first way smokers cost employers more money is obviously an increased use of health care, which can drive up premiums, but there are other ways that may not be as obvious. For example, if employees are taking four 10-minute smoking breaks each day, they are working one full month less each year than employees who aren’t taking comparable breaks. Each employee who smokes costs an employer an average of $1,897 per year in lost productivity as a result of smoking breaks and by being absent an average of two days more per year than their nonsmoking counterparts. In addition, workers’ compensation costs for nonsmokers average $176, while costs for smokers are more than 12 times that, at $2,189.

How can employers encourage employees to quit?

Many employees already want to quit smoking but don’t know where to turn. Studies show that approximately 70 percent of smokers want to quit, and, in 2008, about 45 percent of smokers attempted to do so. With that in mind, it may be easier than employers think to help people quit, as the majority of smokers already have the desire to stop.

Begin by surveying employees to identify the amount of interest in quitting, and find out what resources are available to help you decide on the approach you wish to take. Some employers choose to minimize their involvement and simply steer employees to information or community programs that could help. Others may choose to make some smoking cessation resources available themselves.

Finally, companies may choose to offer smoking cessation benefits such as therapy and individual and group counseling. When it comes to smoking cessation, one size does not fit all. People respond differently to different methods, and a program that offers both a counseling and coaching component can help a smoker develop a cessation strategy that works best for that individual.

Pairing counseling with nicotine replacement therapies and medications is even more effective, and employers who provide low- or no-cost access to medication can greatly increase their employees’ rate of success.

By providing support to help smokers quit, employers send the message that they care about their employees and want them to be healthy. Employees should also be reassured that the employer has their best interests at heart and is not trying to stigmatize them by encouraging them to quit.

How can employers provide incentives for employees to quit?

Small incentives can be effective in helping employees to quit. For example, those who succeed — or even those who complete a program but fail to quit — can be rewarded with lower health insurance and/or life insurance premiums or cash in a flexible spending account to pay for medication to aid in quitting. Also, employers can pair quitting smoking with other health and wellness programs, making it just one part of a healthy lifestyle.

Employers should encourage a supportive workplace. If smokers are stigmatized, they are less likely to succeed. Encourage your nonsmoking employees to offer support to those who are trying to quit.

Can banning smoking on company property be an effective step to helping employees quit?

Making it more difficult for employees to smoke during the workday may provide an incentive for some, although not all, employees to quit. However, banning smoking on your property can have additional benefits, including improved morale among nonsmokers, reduced liability from lawsuits for exposure to second-hand smoke, better air quality around the building, a better image for visitors and lower building maintenance fees.

Breaking an addiction to nicotine is not easy, but employers are in a great position to encourage and help their employees quit. Research shows that paying to help an employee quit smoking provides a great return on investment in lower health care costs, lower workers’ comp costs, increased productivity and fewer days of missed work.

Julie Sich is health promotions coordinator for SummaCare Inc. Reach her at (330) 996-8779 or sichj@summacare.com.

Published in Akron/Canton

Nearly 26 million Americans suffer from diabetes, costing employers billions of dollars a year in direct and indirect costs. But many employers continue to ignore the problem, hoping that employees are dealing with it on their own.

“Diabetes costs employers an estimated $174 billion a year in unemployment, absenteeism and presenteeism,” says Julie Sich, health promotions coordinator for SummaCare Inc.

“Fifteen million work days are lost each year as a result of diabetes, with 120 million days of reduced performance and another 107 million days lost to unemployment disability.”

Smart Business spoke with Sich about how employers can help employees control their diabetes and reduce costs not only for the employee but for the employer, as well.

What is diabetes, and what are its consequences?

Diabetes is a disease that causes the elevation of glucose levels in the blood. This is a result of the body failing to produce enough insulin or of cells failing to respond correctly to insulin that the pancreas produces. Because of that, glucose builds up in the blood, and the cells do not get the glucose they need.

With Type 1 diabetes, the body produces no insulin at all. With Type 2, the body fails to produce enough, or what it does produce does not work properly.

While diabetes is treatable, it is not curable. And if not properly controlled, it can lead to an increased risk of cardiovascular disease, retinal damage, chronic kidney failure, nerve damage, blindness and gangrene on the feet, which can lead to amputation.

Symptoms include frequent urination, disproportionate thirst, unexplained weight gain or loss, blurred vision, swollen gums and numbness in the extremities.

Who should be tested for diabetes?

It is recommended that adults ages 45 years and older without symptoms be screened for diabetes every three years. Diabetes can be diagnosed through a simple urine test, which can detect the presence of excess glucose. A follow-up blood test can confirm glucose levels. Early detection is critical, as the resulting treatment may reduce complications of diabetes.

Once someone has been diagnosed, what are the recommended tests?

The HbA1c test measures the amount of glycated hemoglobin in the blood. It measures blood sugar levels over several months. Abnormal results indicate that blood glucose levels have been above normal for weeks or months and are a good indication of how well the disease is being managed.

High blood pressure and high glucose levels can damage the kidneys’ filters, so a yearly kidney screening is also recommended. When the kidneys are damaged, proteins leak into the urine, and the urinary albumin test can detect leakage. The second test is a blood test to measure creatinine, a waste product. The results will indicate how well the kidneys are removing wastes from the blood.

LDL C cholesterol levels should also be measured to ensure they are being kept in check. A person with diabetes who is able to lower these levels can reduce cardiovascular complications 20 to 50 percent. Blood pressure should also be checked, as increased levels increase the risk of heart attack, stroke, eye problems and kidney disease.

Finally, vision should be screened every two years — more often if vision is abnormal — as diabetes can result in the tissue being pulled away from the eye lens. This can lead to blurred vision and, in severe cases, to blindness, but can be treated if diagnosed early.

Why should employers be concerned about employees suffering from diabetes?

With the number of people suffering from diabetes expected to reach 40 million by 2015, few employers will not be impacted.

Data show that those who control the disease and keep their blood sugar levels at a healthy level cost employers an average of $24 a month, while those who do not control their levels cost their employers $115 a month. In addition, men with diabetes miss an average of 11 days more per year than their healthy counterparts, while women miss an average of 8.7 additional days.

The cost savings and the increased productivity make it worth an employer’s efforts to help employees prevent and control diabetes.

How can employers encourage employees to be screened?

Employers can start by educating employees. Diabetes doesn’t just affect older workers; employees in their 20s and 30s are suffering from diabetes, as well. However, many of them don’t realize it; of the nearly 26 million Americans with the disease, about 7 million are undiagnosed. By educating employees about the risks of diabetes and the steps they can take to stay healthy, employers can improve productivity and lower health costs.

For example, those at risk for Type 2 diabetes can prevent or delay the onset of the disease by losing weight, eating healthier and exercising for 30 minutes a day, five days a week. Through wellness programs and education, employees can learn to take these small steps that can lead to long-term rewards.

How can employers help those who have been diagnosed?

Once an employee is diagnosed, employers should encourage him or her to maintain a healthy lifestyle. Nearly 90 percent of those suffering from diabetes are also overweight. By offering wellness programs that encourage healthy diet and exercise, employers can help employees better manage their illness.

Employers can also reduce or eliminate the copay on diabetes medication, discount health care premiums in exchange for enrollment in diabetes management programs and offer free testing supplies. By helping your employees stay healthy and productive, you are helping your company do the same.

Julie Sich is health promotions coordinator for SummaCare Inc. Reach her at (330) 996-8779 or sichj@summacare.com.

Published in Akron/Canton

Each year, about 40,000 people die in the United States as a result of breast cancer, and more than 232,000 new cases are diagnosed.

But with early detection, the number of deaths could decrease and those who are newly diagnosed would have a better chance at treatment and survival, says Julie Sich, health promotions coordinator for SummaCare Inc.

“Breast cancer is highly treatable if detected in the early stages,” says Sich. “With proper screening done on a regular basis, both men and women diagnosed with breast cancer have a high rate of survival.”

Smart Business spoke with Sich about the importance of early detection and how you, as an employer, can encourage employees to be screened.

How can screening help increase the rate of survival for those with breast cancer?

Based on a person’s history, age, lifestyle and other factors, a doctor may recommend screening for cancer. Because cancer starts at the cellular level and can grow slowly, screening can identify cancers before they become large enough to be physically detected and/or symptoms appear.

What are the risk factors of breast cancer?

The chances of getting breast cancer increase with age, and the majority of women are older than age 60 when diagnosed. A woman’s personal health history can also have an impact — someone who has suffered breast cancer in one breast is more likely to be diagnosed in the other.

Family history also plays a role; if your mother, father, sister or daughter has had an occurrence, especially before age 50, you are at higher risk for the disease. Having other relatives with breast cancer, both on the maternal and paternal sides, also increases your odds. Other risk factors include having a first child later in life, never having children, having a first menstrual period before age 12 and going through menopause after age 55.

While most of these factors cannot be controlled, a person can take steps to control other risk factors by decreasing alcohol consumption, eating healthy foods, staying at a healthy weight and taking part in regular physical activity.

It’s also important to remember that while most people think of breast cancer as a female disease, men can also be diagnosed with breast cancer. Of the more than 232,000 new diagnoses expected in 2011, more than 2,000 of those will be men, so men also need to be screened as part of their routine physicals.

How often should someone be screened?

Self-exams are recommended monthly for women starting in their 20s. Women in their 30s should talk with their physician to determine when it is clinically appropriate to schedule their first mammogram and frequency. Once a woman reaches the age of 40, clinical breast examinations are recommended every one to two years.

Mammograms — which can detect early changes in the breast before they can be felt — are recommended every two years after age 40. However, some women should be screened more often, for example, if they face high risk or have had an abnormal mammogram in the past. Women should talk with their physicians to determine what interval is best for them based on their personal and family histories.

If a mammogram indicates a suspicious area, that test may be followed up with an MRI, ultrasound or biopsy.

Why should employers encourage employees to be screened?

Early detection can result in both direct and indirect benefits for an employer. Screening will give employees peace of mind, improve their health and keep them healthier, happier and more productive at work. In addition, the investment in early detection can result in a huge cost savings to the employer, employee and the insurance company. Direct medical costs are high, lost productivity can be substantial and disability can continue for long periods of time. If cancer is found in the early stages, the resulting costs and time off work will be much smaller than if it had not been detected until later.

Screening costs insurance companies a few hundred dollars and can catch the disease early, while it can still be easily treated. Without screening, the disease may not be discovered until it has advanced, when treatment is much more difficult and costly — potentially hundreds of thousands of dollars.

How can employers encourage employees to be screened?

Employers can help employees stay healthy and identify breast cancer early by making sure that their benefit plans cover cancer prevention and early screening services.  Providing adequate coverage can help encourage employees who would otherwise not be screened to get screened. Offering education and incentives can also make employees aware of these services and encourage them to take advantage of them.

Employers should encourage employees to eat well, stop smoking, exercise and drink less as part of an overall approach to health, and incorporate these concepts as part of their wellness activities. Following these guidelines will help employees not only reduce their risk of breast cancer, but other cancers and diseases as well.

Employers can also sponsor activities during Breast Cancer Awareness Month and offer matches to fundraisers for activities such as the Susan G. Komen Race for the Cure.

By providing comprehensive health insurance and creating better access to preventive services, you can not only help your employees stay healthy but reduce turnover and lost productivity, avert direct medical costs and create a reputation as an employer who cares about the health of its employees.

Julie Sich is health promotions coordinator for SummaCare Inc. Reach her at (330) 996-8779 or sichj@summacare.com.

Published in Akron/Canton

How many days of work did your employees miss last year as a result of the flu? And how many more did they cost you when they came to work sick, infecting your other employees?

There’s no getting around the fact that people are going to get sick. But as an employer, you can help your employees make smart choices to improve their odds of staying healthy, says Julie Sich, health promotions coordinator for SummaCare Inc.

“By encouraging your employees to get flu shots, you can increase the chances of maintaining a healthy work force,” says Sich. “A vaccinated employee population can also reduce the risk of lost productivity as a result of absent employees, or those who are at work but are less productive as a result of being ill.”

Smart Business spoke with Sich about how to encourage your employees to get flu shots and how doing so can benefit both your employees and your business.

What is the impact of the flu on American businesses?

Each year, an average of five to 20 percent of the American population will be infected with the flu virus. More than 200,000 people will be hospitalized annually due to complications from the flu. It’s estimated that the flu is responsible for an average of 200 million days of diminished productivity in the workplace and 75 million missed days of work. The average employer will lose $600 in work value for each employee infected with the flu virus.

Who should be vaccinated?

The Centers for Disease Control recommends that everyone over the age of six months be vaccinated against the flu, but it is especially important for those at high risk. People at high risk include pregnant women, those 50 years and older, those with chronic medical conditions, those who live or work in nursing homes, and those who live with or care for those at high risk.

Additionally, if company leaders are encouraging employees to be vaccinated, they must lead by example. As an executive, you should be the first to be vaccinated. If you show your employees that you take this seriously, they are more likely to follow your example.

What can employers do to encourage employees to get vaccinated?

Employers can encourage employees to get flu shots by offering incentives such as vouchers or gift cards and also by including flu shots as a covered benefit under your health plan. Employer-subsidized vaccines can also be an incentive, as some employees may be unable or unwilling to pay themselves.

In addition, employers can grant time off without penalty to allow employees to leave work to be vaccinated during their shifts. People are more likely to be vaccinated if  allowed to do so on company time rather than having to go after work or on a weekend. In addition, creating a competition to reward the department with the highest percentage of people immunized can be an effective strategy.

How can an onsite flu vaccine clinic increase the number of participants?

The easier you make it for employees to be vaccinated, the more likely they are to do so. And the cost of hosting the program is small when compared to the time and money that sick employees will cost you annually.

Employers may also want to consider extending the program to family members, as sick spouses and children could cause employees to lose time at work to stay home to care for them.

To arrange an on-site clinic, identify a reliable flu vaccine provider, and schedule the clinic during convenient hours for your employees. The employer needs to provide a private area, but the provider will take care of the paperwork and do the rest.

Providing vaccines is well worth the investment in the savings to the employer in work time. It is also worth the investment because employees who don’t get sick won’t be seeking treatment, which can incur costs to both the employee and to the medical plan.

Being vaccinated is quick, simple and inexpensive. By encouraging your employees to take advantage of a vaccination program, you are not only saving money but also increasing productivity and morale.

How can employers promote the benefits of being vaccinated?

Posters in high-traffic areas can provide information and also act as a reminder to employees who repeatedly pass them. Emails about upcoming clinics in the area can also be effective, as can information included in pay envelopes or through company newsletters.

Beyond encouraging vaccinations, what else can employers do in the workplace to help employees stay healthy?

Encourage employees to wash their hands often, especially after sneezing or coughing, to prevent the transmission of illness. Placing alcohol-based hand sanitizers around the workplace can also encourage employees to wash more often and minimize germs on their hands. If possible, avoid having employees share computer keyboards and telephones. If that is not possible, provide sanitizers and encourage employees to use them liberally.

Discourage employees from touching their faces, as any viruses they touch will be much more easily transmitted through the nose and mouth. And encourage people to use tissues when sneezing or coughing, as the flu virus can easily be transmitted through the air.

Finally, encourage employees who are sick to stay home. Many employees don’t want to use sick days, or feel pressured to come in to work even when they are not well. By creating an environment that encourages workers who are ill to stay home, you can minimize the impact that one sick worker can have on the productivity of an entire office.

Be prepared as we head into flu season.  By encouraging and even providing flu shots, your employees and their families have a better chance of remaining healthy — which is good news for all!

Julie Sich is health promotions coordinator for SummaCare Inc. Reach her at (330) 996-8779 or sichj@summacare.com.

Published in Akron/Canton

More than 18 percent of the U.S. population suffers from high cholesterol, and many of those people may not know it. In fact, up to two-thirds of those suffering from high cholesterol may not have their cholesterol levels under control and, as a result, this silent killer may be doing grave damage to your employees, says Julie Sich, health promotions coordinator for SummaCare, Inc.

“People can’t feel their cholesterol levels rising and often don’t know their levels are high until a stroke or heart attack has occurred,” says Sich. “It is imperative to have regular screenings so that you can take action before irreversible damage has occurred.”

Smart Business spoke with Sich about the risks of high cholesterol and how to control cholesterol levels.

What is cholesterol, and what are the risks if levels are too high?

Cholesterol is a soft, waxy fat substance created by your body, and it is an essential part of the function of every part of your body. However, if you are producing too much of it, either as a result of the food you eat or heredity, the resulting plaque can accumulate on your blood vessel walls. That plaque can lead to a thickening of the walls of the blood vessels and can break off into clots, which can then result in stroke or heart attack.

Because the condition is often symptomless, it is important to be screened regularly.

How often should someone be screened?

Screening is simple — a blood test can establish cholesterol levels and should be done as a routine part of preventive care. In healthy adults, screening is recommended every five years, and more often — up to several times a year — for those whose levels are high and who are taking steps to lower them.

Screening should also be done more often for those who face one or more risk factors for heart disease. Risk factors include smoking, hypertension with blood pressure of 140/90 or higher, taking medication for high blood pressure, a family history of premature heart disease (before age 55 for male relatives and before age 65 for female relatives), pre-existing heart disease or a previous heart attack or diabetes mellitus. Men are also at greater risk after age 45, while the risk rises after age 55 for women.

What are the recommended cholesterol levels?

There are two types of cholesterol — LDL cholesterol and HDL cholesterol. In the past, the total cholesterol number was targeted. However, more recently, it is not the total number that matters as much as the levels of ‘good’ (HDL) and ‘bad’ (LDL) cholesterol.

Cholesterol levels are measured in terms of milligrams per deciliter of blood. For LDL, those at high risk of heart disease should aim for levels below 70 mg/dL; those at lower risk of heart disease should aim for below 100 mg/dL. For those without risk factors, 100-129 mg/dL is near ideal, while 130-159 mg/dL is borderline high, 160-189 mg/dL is considered high and anything over 190 mg/dL is considered very high. Higher levels of this cholesterol clog the arteries, making it harder for the blood to get through. That, in turn, makes the heart work harder, putting stress on the organ.

In addition, if the plaque on the walls of the arteries breaks loose, a clot can form. If that gets lodged in an artery it can choke off the blood supply and cells are deprived of oxygen and die. If a clot makes its way into the brain, blocking blood flow, a stroke can result. And if it moves to the coronary arteries, a heart attack may result.

HDL cholesterol, on the other hand, is often referred to as the ‘good’ cholesterol. This type attaches itself to bad cholesterol and routes it to the liver, which filters it out of the body, reducing the amount of bad cholesterol in your system. Levels of 60 mg/dL and above are recommended, while levels between 50 and 59 mg/dL are considered acceptable. Anything below 40 mg/dL for men and 50 mg/dL for women are considered poor levels.

In addition, triglyceride levels of 100 mg/dL or lower are considered optimal for heart health.

How can someone lower his or her cholesterol levels?

Increasing your levels of HDLs might be a better protector against heart disease than lowering your levels of LDLs, or bad cholesterol. Diet and exercise can play a big part in lowering cholesterol. For example, foods such as oatmeal, nuts and fish should be a regular part of your diet to help maintain healthy cholesterol levels. Vegetables, fruits and whole grains can also help increase dietary fiber and help lower bad LDL cholesterol. Reduce the amount of proteins in your diet, often consumed in meat and dairy products, and limit the amount of saturated fats and trans-fatty acids. When you must add fat, use those high in monounsaturated fats such as olive and peanut oil.

Also, limit the consumption of alcohol, as it can increase cholesterol levels. If you are taking cholesterol-lowering medication, it is important to continue taking it as directed by your physician. Because people on these types of medications don’t notice any difference in the way they feel as a result of taking them, it can be difficult to convince them that those drugs could be saving their lives.

So, how can employers help?

Encourage your employees to get their cholesterol checked regularly. Share information about the importance of diet and exercise. Consider offering healthy alternatives in vending machines and at company gatherings. Offer friendly ‘challenges’ with prizes for those who lower their levels — and maintain! Be creative — your employees will thank you for it!

JULIE SICH is the health promotions coordinator for SummaCare, Inc. Reach her at (330) 996-8779 or sichj@summacare.com. SummaCare offers a full line of health plans and ancillary products. Through its extensive network of more than 7,000 providers and more than 50 hospitals, SummaCare offers coverage to more than 115,000 members throughout northern Ohio.

Published in Akron/Canton

Executives and employees are often so involved in their jobs and so busy with their lives that they overlook one very important factor — their health. This can be especially true with men, who often feel more pressure to “tough it out” and may dismiss their symptoms as just the result of the stress of the job.

“Employers can take steps to help ensure their male employees acknowledge symptoms and get the care that they need,” says Julie Sich, health promotions coordinator for SummaCare, Inc.

“Employers can’t ignore the health of their male employees. Nearly two-thirds of working-age men are overweight, which increases the risk of high blood pressure, heart disease, diabetes and cancer. But through workplace health checks and strategies to educate male employees about the special risks they face, employers can help them to lead happier, longer and more productive lives.”

Smart Business spoke with Sich about how employers can have a positive impact on both their own health and the health of their male employees.

Why should employers be concerned about men’s health?

Although there are factors beyond our control that can affect our health, the greatest risks stem from things that we can control. Lifestyle choices such as poor dietary habits, drinking and smoking and risky behaviors such as driving dangerously have an enormous impact on long-term health.

Although regular check-ups are recommended for both men and women, men may often forgo those appointments, whether out of fear of finding something wrong, a lack of motivation or an ‘I don’t have time’ mentality. As a result, for many men, a trip to the doctor comes only when they finally can’t ignore that something is wrong. This often leads to longer, more difficult and expensive treatment than if a condition had been caught earlier.

What can employers do to help men improve their health?

Well-targeted workplace initiatives can help identify potentially serious conditions earlier in their development and improve outcomes.

Employers can hold wellness information programs, which help men become aware of how their behaviors and lifestyle choices may be affecting their health. For example, although an employee may recognize that heavy drinking isn’t a recommended behavior, he may not fully understand the significant impact it can have on his health.

Employers can also offer age-specific health assessments targeting risk areas for men in each age group. If any red flags are raised, the employee can then be referred to a general practitioner or specialist for a more in-depth assessment. The physician can then recommend precautionary actions on the part of the patient or treat the malady before it progresses further. Even if no underlying problems are detected at the time of the assessment, the program can make recommendations specific to each person, such as lifestyle changes or actions to help reduce the risk of developing an illness.

In many cases, offering an online assessment may be a more effective route. Men may be reluctant to discuss any symptoms they are experiencing with a physician, but would be more open in an anonymous, online setting. In this setting, they can be more comfortable answering questions about things such as prostate symptoms or exercise habits.

What kinds of regular checkups should all men be having?

Men under the age of 60 should undergo an eye exam every two to three years, not only to test for vision, but also to screen for underlying issues such as glaucoma, macular degeneration and cataracts. Annual dental exams are also recommended, although those who smoke or chew tobacco may want to see their dentist more regularly.

Men should also have their blood pressure checked every one to two years.  This allows a physician to potentially detect problems long before any symptoms develop. Cholesterol testing can help detect the potential risk of heart disease; men should be tested every five years after the age of 35, earlier if risk factors such as obesity, smoking or diabetes exist. A full-body screening for skin cancer every five years is also recommended.

What other screenings should men have that they may be reluctant to address?

Though the colonoscopy is, understandably, a test that is often avoided, it can detect polyps or cancerous growths. Screening is recommended every 10 years for men over the age of 50, earlier for those with a family history of colon cancer. A yearly stool test can also help to detect early signs of cancer.

Testicular cancer is the most common cancer among men under age 35, but also affects older men. Because it is considered highly curable in its early stages, it is important to detect it before it progresses so that it can be successfully treated. Screening should be part of any physical exam, and men should also examine themselves monthly for anything unusual, including lumps. Also, prostate cancer screenings are generally recommended beginning at age 50 and should begin earlier if there is a family history of the disease.

Finally, many men are often reluctant to address mental health issues. It’s common for men to go undiagnosed for depression or other mental illnesses because they fear that exhibiting sadness or anxiety can impact an image of strength in the workplace.

Seeking treatment from a qualified professional can significantly benefit the patient’s home and work life, alleviating even the physical symptoms the person didn’t realize were associated with this type of illness. Employers should make information regarding mental health available to employees to help diminish a negative stigma and encourage them to address potential emotional health issues with a physician as quickly as possible.

Julie Sich is health promotions coordinator for SummaCare, Inc. Reach her at (330) 996-8779 or sichj@summacare.com.

SummaCare offers a full line of health plans and ancillary products. Through its extensive network of more than 7,000 providers and more than 50 hospitals, SummaCare offers coverage to more than 115,000 members throughout northern Ohio.

Published in Akron/Canton

Studies estimate that approximately 15 percent of Americans will suffer from depression at some time in their lives.  Given this number, it’s likely that some of your employees are suffering from depression.

As an employer, this prevalent condition could be a burden on your business as mood disorders cost companies an estimated $11.5 billion per year in lost productivity.

“Fortunately, depression is one of the most treatable conditions,” says Julie Sich, health promotions coordinator for SummaCare, Inc.  “There are things you can do as an employer to make sure employees are correctly diagnosed and are effectively managing any prescribed antidepressant medication. A referral to an Employee Assistance Program (EAP), if available to employees, may be the first step to helping employees with their symptoms.”

Smart Business spoke with Sich about the signs of depression, the barriers to treatment and how to manage the condition.

What are the signs of depression, and when should someone seek help?

While everyone feels sad at times, someone with depression has feelings of sadness over a period of several weeks or more. Other symptoms of depression may include a decrease in energy levels, difficulty concentrating and making decisions, feelings of helplessness, hopelessness and pessimism, loss of interest in activities once enjoyed, changes in sleeping patterns and changes in eating patterns.

Someone suffering from treatable depression may also become irritable, act differently than usual, have emotional outbursts or be preoccupied. These conditions can have an impact on performance in the workplace as the person may be unfocused while at work, arrive late for work or have frequent absences, resulting in a loss of productivity.

When these feelings or behaviors last for long periods of time or become overwhelming, they can keep someone from leading a satisfying life and can also interfere with relationships and family. By seeking help, someone suffering from depression may be able to see improvement in several weeks.

Why is it important to manage depression?

Depression is a progressive, chronic condition, and it’s one of the most costly conditions to treat. In addition, recent studies report that depression is the one disorder that causes the most amount of lost work time in America. As a result, it is predicted that depression will soon become the leading cause of disability in today’s work force.

If left untreated or undertreated, depression can have a significant impact on a person’s ability to work, resulting in a decrease in a company’s overall productivity. Some studies estimate that employees who suffer from depression work at about 70 percent of their optimal productivity, decreasing output and affecting their time management ability. And that can lead to stress for other employees who see an increased workload as they work harder to make up that productivity.

What are the barriers to managing depression and anti-depression medication, and how can they be overcome?

Those suffering from depression often avoid diagnosis and treatment because of the stigma that is sometimes associated with the illness. They are reluctant to seek treatment from a mental health professional or even talk about their symptoms with their primary care physician. As a result of that stigma, even if someone takes the step of seeking help and being diagnosed with depression, that person may fail to take the medication as prescribed.

An additional challenge comes with convincing patients to continue taking antidepressants. Anti-depression medication can sometimes have unpleasant, short-term, temporary side effects without the patient showing much improvement for the first several weeks. Another challenge is that those who are able to overcome all of the initial hurdles may stop taking their medication after a few months when they are feeling better and begin to think that they no longer need to continue.

If a person diagnosed with depression is hospitalized, additional barriers can result following hospitalization. These include failure of the provider to communicate scheduled follow-up visits, systems that don’t adequately help patients keep appointments, poor coordination of care between primary physicians and mental health professionals and a lack of transportation or childcare to be able to keep appointments.

Overall, the biggest barrier to treating depression is a patient failing to follow the instructions of the health care provider.

How can employers help employees combat these problems?

Employers can start by talking openly about depression and by guiding employees to the right resources for diagnosis and treatment through their health insurance plan. Employers can also work with their health insurer to provide member education through newsletters, encouraging those who may be suffering from it to seek treatment. Also, your health insurer should monitor follow-up contact and work with physicians to educate them on the issues and reinforce the need to continue taking medication if prescribed.

Your health insurer can also develop a medication management program to work with members who may find it difficult to take their medication consistently.  Some carriers can even develop a program to follow up with health care providers who are not following clinical practice guidelines. In addition, partnering with a behavioral health medication management program can help identify those who are not adhering to their prescriptions and intervene early. Such a program can increase the probability that employees receive effective care to manage their depression.

By working with your health insurer, you can help your employees lead a happier, more productive life, improving not only the quality of their lives but also the quality of their work and their impact on your bottom line.

JULIE SICH is the health promotions coordinator for SummaCare, Inc. Reach her at (330) 996-8779 or sichj@summacare.com. SummaCare offers a full line of health plans and ancillary products. Through its extensive network of more than 7,000 providers and more than 50 hospitals, SummaCare offers coverage to more than 115,000 members throughout northern Ohio.

Published in Akron/Canton

Colorectal cancer is a topic that no one wants to think about, much less talk about, but failing to address the need for colorectal cancer screenings could be costly to you and your employees. And since March is National Colorectal Cancer Awareness Month, it’s a good idea to educate your people about this deadly disease.

“Diagnosing the problem in the early stages allows for more successful treatment and gives the patient a higher chance of becoming cancer-free,” says Julie Sich, health promotions coordinator for SummaCare, Inc. “Despite the availability of several methods of testing, too many people fail to be screened because the thought of having it done makes them uncomfortable. However, that temporary discomfort is a small price to pay for a potentially life-saving procedure.”

Smart Business spoke with Sich about how individuals can lessen their risk of developing colorectal cancer and how regular screenings could save lives.

What is colorectal cancer?

Colorectal cancer is a slow-growing cancer that occurs when cells in the colon or rectum become abnormal and divide out of control, creating a tumor. If the abnormal cells are not caught and treated early, the cancer can also invade surrounding tissue or break away to form tumors in other parts of the body, ultimately leading to death.

Although the rates of colorectal cancer are on the decline, the disease is still diagnosed in about 145,000 people a year in the United States, making it the third-most-common type of cancer (not including skin cancer) in both men and women. Additionally, the disease kills about 49,000 people in the U.S. each year, making it the second-most-lethal cancer behind lung cancer, according to the National Cancer Institute.

The exact causes of the disease are not known, but those older than age 50, who have polyps, who have a family history of the disease, who smoke or have inflammatory bowel diseases (such as ulcerative colitis or Crohn’s disease), have a higher risk of developing colorectal cancer.

What steps can people take to lower their risk of colorectal cancer?

Diet and exercise are believed to play a role in prevention. Some research suggests that high consumption of red meat could contribute to the development of colorectal cancer, as can failing to consume the recommended amount of whole grains, fruits and vegetables. There is also evidence to suggest that a sedentary lifestyle may contribute to the disease, as can smoking. However, 75 percent of colorectal cancer occurs in those with no known risk factors, according to the Centers for Disease Control.

But while lifestyle components are important, the most critical thing you can do to prevent the cancer from developing is to catch it in its early stages of development. Regular colorectal cancer screenings are very important. Although some symptoms such as a change in bowel habits, diarrhea, constipation, abdominal discomfort, weight loss, vomiting and constant tiredness could be indications of the presence of the disease, colorectal cancer is generally symptomless in its early stages and, in most cases, the only way to detect it is through screenings.

Simply put, screenings save lives. Nearly all colorectal cancers develop from pre-cancerous polyps in the colon and rectum, and detecting them early in their growth allows for removal of the polyps before they become cancerous, creating an excellent prognosis. But even if the presence of cancer is detected, early treatment before it has spread into neighboring tissues increases the chances of long-term survival.

What are the screening options?

There are several screening options, and patients should consult with their doctor to determine which test is right for them. Screening options include a fecal occult blood test or fecal DNA test, both of which involve screening for hidden blood; sigmoidoscopy, which gives the physician a direct view of the lower third of the colon; colonoscopy, which provides a direct view of the entire colon through a tube administered by the physician and which also allows the physician to remove any polyps at the time of the procedure; and various other tests and screenings.

Again, not every option is right for every person, and there is no singular ‘best’ test. Patients should talk with their physician to determine which method of screening is best for their circumstances, depending on personal preference, the method the patient is most likely to follow through on, medical condition, family history and the resources available for follow-up. Discussing the benefits and potential harm of each method, their accuracy and the different method of preparation for each can also help you assess which screening option is the best choice for you.

How often should a person be screened?

How often you should be screened depends on the type of screening you undergo and your risk for cancer, and that is something that a patient should consult with his or her health care provider about. For those who are at average risk and choose colonoscopy as the screening method, screening is recommended every 10 years, starting at age 50. For higher-risk patients, and those choosing other methods, screening should be done more often.

Share this information with your employees — it could save their lives!

Julie Sich is the health promotions coordinator for SummaCare, Inc. Reach her at (330) 996-8779 or sichj@summacare.com.

SummaCare offers a full line of health plans and ancillary products. Through its extensive network of more than 7,000 providers and more than 50 hospitals, SummaCare offers coverage to more than 115,000 members throughout northern Ohio.

Published in Akron/Canton

As a business leader, it’s hard to avoid the stress and strains of the job that can lead to high blood pressure. If you’re suffering from high blood pressure, medication can help control the disease, but there are many things you can do to help control your blood pressure before resorting to taking drugs, says Julie Sich, the health promotions coordinator for SummaCare, Inc.

“Lifestyle changes can play an important part in lowering high blood pressure, reducing or delaying the need for medication,” says Sich. “It may be difficult for busy executives to find the time to eat right and exercise, but the consequences of not doing so could be fatal.”

Smart Business spoke with Sich about how changing the way you live can help change your blood pressure for the better.

What is high blood pressure, and what steps can someone with high blood pressure take to lower it?

High blood pressure, also called hypertension, occurs when blood moves through the arteries at a higher-than-normal pressure. A normal blood pressure is 120/80 or lower, while anything up to 140/90 is considered prehypertension, which develops into hypertension when numbers top 140/90. Failure to act to treat it can damage your blood vessels, increasing your risk of stroke, kidney failure, heart disease and heart attack. According to the American Heart Association, cardiovascular disease is the No. 1 killer in the United States — more than 2,600 die each day as a result of it. Many people who are suffering from it are unaware that they have the disease.

Being overweight plays a large role in contributing to causing high blood pressure. Losing just 10 pounds could both help reduce your blood pressure and, if you are taking medication for the condition, help improve the effectiveness of the drugs.

But it’s not just the number on the scale that’s important — it’s also where you’re carrying the weight. Those who tend to store weight around their waists are at higher risk of high blood pressure and should take steps to lose the excess weight.

Regular exercise will not only help you lose weight but can also help lower your blood pressure. Although 30 to 60 minutes a day of physical activity is recommended, even short amounts of activities such as walking, taking the stairs and parking your car farther away from your destination can have an impact.

Some studies have found that those who own a dog react less to the stressors in their lives and get the added benefits that come from walking the dog.

How can diet impact blood pressure?

One of the biggest dangers in diet is high salt content. Most adults should consume less than 2,300 milligrams of sodium a day, the equivalent of about one teaspoon. Most Americans consume nearly twice that at 4,000 milligrams a day. By switching to a low-salt diet of 1,500 milligrams a day or less, adults can begin to lower their blood pressure. To make up for the lack of salt that many people crave in their diets, spices can be used as a seasoning substitute to add flavor to food.

Many prepared foods are very high in sodium, so stay away from packaged foods such as frozen dinners, pizza and soup. Instead, prepare fresh foods with a focus on fruits and vegetables, which are high in vitamins, minerals and fiber, and low in calories, in addition to whole grains and low-fat dairy items.

The American Heart Association recommends at least 4.5 cups per day of fruits and vegetables, at least two 3.5 ounce servings of oily fish per week, at least three 1-ounce equivalent servings of fiber-rich whole grains each day and no more than 36 ounces of sugar-sweetened beverages per week. Also, limit intake of food that is high in dietary cholesterol, transfats and added sugar. Instead, choose items such as skinless lean meats and poultry prepared without added fat and salt, and unrefined whole-grain foods that contain fiber.

Although studies have shown that alcohol consumption can have a positive impact on heart health, it can also have the opposite effect if consumed in excess. Aim for no more than one drink per day for women and no more than two per day for men.

Finally, limit caffeine consumption, and if you smoke, take steps to quit, as inhaling smoke — either directly or second hand — increases the risk of high blood pressure.

What role does stress play in high blood pressure?

Stress can increase blood pressure, and the longer the stress continues, the bigger impact it can have on heart health. Identify what your stressors are and try to find ways to lessen or eliminate them. Absent that, identify coping strategies such as meditation that can help you better manage your stress.

How can employers help employees take steps to be healthy?

Employers should identify trends in the workplace and work to address health issues among employees. Changing unhealthy behaviors before they lead to chronic disease can help a company control its health insurance costs, as 75 percent of an employer’s health care costs and productivity losses can, in some form, be traced back to lifestyle choices made by employees.

An outside provider can help you find out what ails your work force and determine which triggers are issues among employees. By targeting existing issues, you can ensure that your employees stay happy, healthy and on the job.

Julie Sich is the health promotions coordinator for SummaCare, Inc. Reach her at (330) 996-8779 or sichj@summacare.com. SummaCare offers a full line of health plans and ancillary products. Through its extensive network of more than 7,000 providers and more than 50 hospitals, SummaCare offers coverage to more than 115,000 members throughout northern Ohio.

Published in Akron/Canton
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