Labor
CONNECTION
WINTER 2015
DNoA Dental Network Expands
to One of Largest in Country
T
here has never been a time more
important than now to be an engaged
health care consumer. Being one can help
stretch your dental benefits – such as checking
to make sure you are seeing a dentist that is in
your network. Dental plans typically have an
annual dollar maximum ranging from $1,000
to $3,000 per year for covered services, so it’s
important to know that not all networks are
alike. All Dental Network of America (DNoA)
contracted dentist’s offer discounted rates.
2015 National Dental PPO Metro Network
DNoA has recently expanded the PPO Dental Network adding the Advantage Plus network of
United Concordia Dental. This has increased our national dental access points (any location
that a dentist practices) to over 330,000 — 13,000 in Illinois alone. Finding a dentist has never
been easier. Just log in to dnoa.com and search for a dentist near you. If your current dentist
is not in this network, you are likely paying more than you need to for dental care. Obtaining a
discounted rate makes your annual dental dollars go farther.
Strong Discounts
IN THIS ISSUE
When seeing a network dentist, Fund members are eligible for average discounted fees between
28 percent and 40 percent below what dentists usually charge for services. Our network dentists
agree to accept the allowable amount as payment in full for eligible dental expenses. This
agreement means Fund members save money each time they use a network dentist.
Below is an example showing the cost savings of seeing a DNoA preferred network dentist
versus a non-network dentist.
BCBSIL Keeps in Touch with
Labor Change – Page 2
Labor Career Builders – Page 2
This and That – Page 3
Savings Example In-­‐network Dentist *
Out-­‐of-­‐network Dentist *
Billed Charge for Crown (D2752) Allowable Amount Dental Plan pays 80% Member's Responsibility $ 1,026 $ 1,026 BCBS Leads in
Value-based Care – Page 3
$ 749 $ 599 $ 150 $ 1,026 $ 821 $ 205 Someone You Should Know – Page 4
*The dollar amount shown is for illustrative purposes only; check your benefit booklet for
deductible,
and dollar
that may
apply.
*The dollar amount shown is for coinsurance
illustrative purposes only; maximums
check your benefit booklet for deductible, coinsurance and dollar maximums that may apply. Please contact your BCBSIL Account Executive to see how the enhanced dental network can help
Please contact your BCBSIL Account Executive to see how the enhanced dental network can help you you start saving today.
start saving today. A Division of Health Care Service Corporation, a Mutual Legal Reserve Company, an Independent Licensee of the Blue Cross and Blue Shield
Association. Dental Network of America (“DNoA”) is a separate company and acts as the administrator of Blue Cross and Blue Shield of Illinois
dental programs.
Add on right side of cover in margin with holiday graphic: Top 15 States with Highest
Union Membership – Page 4
Health and Wellness – Page 5
Good Health, Good Golf – Page 5
BCBSIL Keeps in Touch with Labor Change
D
ick Quigley, Blue Cross and Blue Shield of Illinois (BCBSIL)
Labor Accounts Divisional Vice President, firmly believes
that in order for his Labor Account Executive staff to be highly
successful and consultative to BCBSIL’s Labor Funds, it is
important for his staff to continue to understand the dynamics of
a labor union. Over the years, many of his account management
team has attended a week-long intensive study program at the
National Labor College, which was founded by George Meany,
former AFL-CIO president, in 1969. For the last four years,
Rutgers School of Management and Labor Relations has offered
an advanced labor studies program in conjunction with the Blue
Cross and Blue Shield Association’s National Labor Office.
This year, three BCBSIL Labor Account Executives, Pam Bland,
Derek Serbe and Matt Gibson, attended the Rutgers certification
program in New Brunswick, NJ. Pam Bland described the
program as, “Three and a half days of intensive class room
learning and a collective bargaining case study — all preceded by
three weeks of pre-course reading.”
valuable oversight provided by the Federal Mediation and
Conciliation Service (FMCS). The FMCS members participated
in the collective bargaining sessions to ensure the bargaining
guidelines were followed throughout the process.
Presentations covered an array of topics all tied to labor, including
interest-based bargaining, Labor Management Cooperation
Committees (LMCC), the collective bargaining process and
current labor union strategies involving the Affordable Care Act.
“I gained a greater understanding of the benefits of the LMCC
format and how advance training on the process will greatly
benefit all that are at the table,” Derek Serbe said.
The program was developed under the direction of Dr. Susan
J. Shurman, Distinguished Professor of Labor Studies and
Employment Relations at Rutgers, and former Founding
President of the National Labor College. Facilitators in the
program include professors from the Rutgers University
Management and Labor Relations team and labor leaders with
Labor Career Builders
Local 798 Training Center – National Pipeline Welding School
T
he National Pipeline Welding School was jointly established
by the United Association of Journeymen and Apprentices
of the Plumbing and Pipefitting Industry of the United States
and the Pipeline Contractors Association (United Association).
The Fund was organized to provide education and training to
individuals employed in the pipeline industry throughout the
United States. In 1974, the school became part of the Pipeline
Industry Benefit Fund (PIBF). Almost 30 years later, the Local
798 training center was created to continue the educational
benefits previously carried out by the Fund.
Courses taught include downhill welding, uphill stick-rod
welding, heliarc welding, automatic welding techniques and
other courses relating to the industry. From time to time, a
certified welding inspector prep course is also offered. The
training center’s highly qualified, full-time staff works to create
training for any special needs so graduates work safely on all
types of projects.
The training center in Tulsa receives its funding through
pipeline employer contributions and provides the training at
no cost to students. Pipeline employers recommend workers to
the training center for additional levels of training to help keep
continued employment in the pipeline industry. Those who
attend the training are normally between jobs — some of whom
even come from out of state.
WINTER 2015
2
This and That
G
eneral President James T. Callahan of the International Union of Operating Engineers was presented the Rerum Novarum
Award at the St. Joseph’s Seminary event in September. The award was presented by Archbishop Blase J. Supich.
Congratulations to Don Finn, Business Manager, IBEW Local 134, on being presented the 2015 Charlie Hayes Award by the
Chicago Jobs with Justice program. The award was presented at the IBEW Local 134 office and presented by Robert G. Reiter,
Secretary Treasurer of the Chicago Federation of Labor.
The Chicago Federation of Labor hosted another successful Labor Day Luncheon at the International Union of Operating
Engineers Local 399 hall on Sept. 2, 2015.
Welcome Mark Sartell — our new Labor Account Executive. Mark comes to BCBSIL with over 25 years
of experience in the health care industry. His wide variety of experience includes selling and servicing
regional and national PPOs, as well as care management and claims cost-containment programs.
Throughout his career, he has worked with third-party administrators, carriers, health plans, fully
insured and self-insured employer groups, as well as Taft-Hartley trust funds.
Mark earned a Bachelor of Arts degree from Wheaton College. He and his wife, Sue, have four grown
sons and enjoy spending time with their extended family.
BCBS Leads in Value-based Care
F
or decades, fee-for-service reimbursement has been the dominant payment model between payers and providers. Providers were
paid and rewarded on the volume of care, not its quality.
“The current reimbursement system is not sustainable. We must find better ways to align the interests of patients, payers and providers,”
says Dr. Stephen Ondra, M.D., senior vice president and enterprise chief medical officer for Blue Cross and Blue Shield Plans in Illinois,
Montana, New Mexico, Oklahoma and Texas. “As an industry, we have arrived at a moment when even fee-for-service stalwarts see the
handwriting on the wall: We must all work together to make health care more equitable, accessible and sustainable.”
The U.S. pours more resources – about 17 percent of the GDP in 2013 – into health care than any other country in the world, yet does
not achieve the best outcomes for patients.
Putting the ‘Value’ in Value-based Care
We believe the answer to rewarding value is value-based care (VBC). This reimbursement approach incentivizes doctors and hospitals to
achieve the best possible outcomes at the lowest cost, thus maximizing the value of the care they provide. These models are changing the
way that care is delivered. By requiring increased collaboration and coordination among providers, payers and patients, we expect results
to yield better outcomes, higher patient satisfaction and lower health spending.
Our five state Plans have long been committed to helping our members have access to quality care at the right time, resulting in the
best possible outcomes. We have been a driving force in establishing industry standards for VBC initiatives and measurement.
This role is evidenced through:
• Our Plans’ leadership with the federal government’s VBC initiatives
• More than 30 years of experience implementing successful HMOs in Illinois
• The creation of one of the industry’s oldest and largest ACOs
We believe the future of health care will depend on increasing collaboration and coordination among all parties in the health care
industry. Through sharing perspectives and common objectives, we can dramatically improve the value and quality of health care
for our members.
Today, more than one-third of our five state Plans’ members are impacted by our value-based arrangements that reward doctors
and hospitals for lowering costs and improving quality. Because of our successes and commitment to VBC, we anticipate that
number to dramatically accelerate in the near future.
WINTER 2015
3
Someone You Should Know
also a certified lobbyist further expanding his knowledge of the
legislative process. In 2002, Tony was the First Deputy Corporation
Counsel serving as cabinet advisor to the mayor of Honolulu.
Antonio J. Saguibo Jr., JD
Executive Director, West Coast
BCBSA National Labor Office
After concluding his time with LIUNA and the mayor’s office,
in 2006, Tony began working at the Hawaii Medical Service
Association (HMSA) — better known as BCBS of Hawaii —
managing state and Taft-Hartley health plans. He quickly
moved up the ladder to vice president, eventually having
responsibility for all commercial and individual business.
Before departing HMSA, Tony oversaw the management of
the Hawaii Medicaid program.
W
hy would any man in his right
mind pick up and move from
the lush tropical island of Hawaii to
Portland, Ore? As you read more
about Antonio “Tony” J. Saguibo Jr.,
you’ll understand.
Tony recently accepted the position of Executive Director, West
Coast, of the National Labor Office with the Blue Cross and Blue
Shield Association. In his new role, he will continue to champion
the initiatives of the National Labor Office in the west coast
region. No stranger to labor, Tony comes from the state of Hawaii,
which trails only New York and Alaska on the highest number of
unionized workers per state. As previous vice president of account
management and sales at Blue Cross and Blue Shield of Hawaii, he
also served as past chairman of the National Labor Office Board.
Committed to organized labor and the Blues, Tony uses his vast
knowledge and experience to bridge the unique needs of both
entities. “We are in the middle of a watershed moment where the
landscape of health care is considered a major shift in history as
significant as Medicare was,” Tony says.
“Regardless of the changing landscape, the NLO’s objectives
and mission are the same: to support organized labor’s core
values in its endeavor to maintain good working conditions
and mutual respect.”
Born in California and spending most of his childhood in Hawaii,
Tony earned a bachelor’s degree in political science from California
State University and a J.D. from the University of San Diego School
of Law. He was soon defending homeowners’ rights and moved to
defending the rights of workers.
Tony strongly believes in the collective bargaining process.
“Collective bargaining works very well, but we, as Americans, must
re-evaluate our sense of entitlement. If we work together through
the collective bargaining process collectively, we can keep our
industries healthy and our jobs here rather than overseas.”
Recognizing Tony’s passion for defending workers’ rights, an uncle
who was a business manager for the Hawaii Laborers, recruited
Tony as general counsel for LIUNA’s local union in Hawaii. This
position gave Tony invaluable experience in collective bargaining,
mediation, arbitration and politics of the labor movement. From
1997 to 2006 while serving as a trustee for the Laborers, Tony was
Oregon may not sound as attractive as Hawaii, but it’s known for its
beautiful vistas, mountains of snow, vineyards and even deserts. But
Tony and his wife were most motivated to move to Oregon so they
could live closer to their oldest daughter.
Top 15 States with
Highest Union Membership
State Name
Percent of Union Members
New York
24.6
Alaska22.8
Hawaii21.7
Washington16.8
New Jersey
16.5
California16.3
Illinois15.1
Rhode Island
15.1
Connecticut14.8
Michigan14.5
Nevada14.4
Minnesota14.2
Massachusetts13.7
Montana12.7
Pennsylvania12.7
This chart shows the states with the highest
union membership as of 2014.
Source: Unionstats.com
WINTER 2015
4
Health and Wellness
Tips to Simplify Diabetic Food Choices
C
hoosing what to eat for diabetes prevention and management
doesn’t have to be complicated or expensive. The best basic
meal plan is a well-rounded diet full of nutritious foods. If you
have diabetes, a healthy eating plan for you is not that different
than a healthy eating plan for people without diabetes.
Eating to Manage Your Health
Consider these three tips for managing your weight and
your diabetes.
1.Make your grains whole grains. Foods with carbohydrates,
such as bread, can raise your blood sugar levels as your body
breaks down the food. In general, the less processed a food is,
the less impact it will have on your blood sugar. Whole grains
are a great example of a less-processed source of carbs.
3. Load up on fresh or frozen fruits and vegetables. Vegetables,
fruits and whole grains also provide more nutrition per calorie
than refined carbohydrates, and they tend to be rich in fiber.
Soluble fiber, which dissolves in water, can help lower glucose
levels and help lower blood cholesterol. Many vegetables and
fruits have soluble fiber, including apples and blueberries.
Watch your starchy vegetables, though. These include potatoes,
squash and corn. They’re high in vitamins and minerals, but
they can also be high in carbohydrates.
2.Swap salt for herbs and spices. People with diabetes have a
higher risk for stroke and heart disease. One of the simplest
ways to lower your risk is limiting how much salt you eat. Try
flavoring your foods with spices or fresh herbs instead of salt.
Good Health, Good Golf
My Five Pet Peeves in Golf
T
here isn’t much I’ve missed in my 50 years of playing and coaching golf. I have
made most of these mistakes myself, but I am still peeved every time I see or hear
these actions:
1.Slow play: If the group in front of you has put the flagstick in the hole, your group is
out of position. It has nothing to do with the group behind you.
2.Poor etiquette: Raking bunkers, repairing ball marks and replacing divots are signs
of respect for the course and the game itself. Leave it better than you found it.
3.Improper score keeping: Posting a score lower or higher than what you actually
shot (I have seen both) is a breach of the ethics of the game. Remember: Your score
is not a reflection of you.
4.Fish stories: “He hit it how far?” Show me! I am excited to watch someone who can
hit it that far! Fish tales are great in a bar, not at the club — 300 yards is a long way.
5:Just putt them all out: Men are far too free with the “gimme.” If you are going to
post your score or tell someone what you shot, putt them all out. Elite players miss
very short putts occasionally. For the record, putting is 43 percent of your golf score.
These are not in any particular order. They are all common to all golfers. It is, after all, a gentlemen’s (and ladies’) game.
J. Anderson has been a PGA golf professional since 1979 and is TPI Certified. He is an Assistant in the Golf Digest Instructional Schools and can be found in a video blog called
“Full Speed Golf” in the Northwest Herald online newspaper.
WINTER 2015
5
Celebrating 50
Years in Labor
Welcome New
Labor Clients
T
SHEET METAL
WORKERS #1
he Blue Cross and Blue
Shield of Illinois building
recently helped celebrate the 50th
anniversary of the Blue Cross
and Blue Shield Association’s
National Labor Office by
lighting up the Chicago skyline.
Morton, IL (Dental)
Blue Cross and Blue Shield of Illinois
300 East Randolph Street
Chicago, IL 60601
PRSRTD
FIRST CLASS
U.S. POSTAGE
PAID
CHICAGO, IL
PERMIT NO. 581
Labor
CONTACTS
Richard “Dick” Quigley
Divisional Vice President
Labor Accounts
(312) 653-8436
[email protected]
Dave Gieselman
Director
(312) 653-7299
[email protected]
Kevin Davis
Lead Account Executive
(713) 663-1290
[email protected]
Mark Sartell
Lead Account Executive
(312) 653-5288
[email protected]
Nadia Blan
Labor Account Executive
(312) 653-2203
[email protected]
Violet Kowalski
Labor Account Executive
(312) 653-7463
[email protected]
Derek Serbe
Labor Account Executive
(312) 653-2212
[email protected]
Pam Bland
Labor Account Executive
(312) 653-5750
[email protected]
Daniel MacKenzie
Senior Manager
(312) 653-7517
[email protected]
Andy Seymour
Labor Account Executive
(312) 653-7199
[email protected]
Jennie Tatooles
Lead Account Executive
(312) 653-2780
[email protected]
Labor Connection is a publication for those who work in and with organized labor. To receive this newsletter or to inform us of address changes, new union officers and other updates, please
e-mail [email protected]. Labor Connection is issued from Blue Cross and Blue Shield of Illinois, 300 E. Randolph Street, Chicago, IL 60601. Views expressed by our writers are their
own and do not necessarily reflect views of Labor Connection or the Health Care Service Corporation. The information contained in Labor Connection is not intended to substitute for the sound
medical advice of your doctor. If you have any questions or concerns regarding your medical condition you should discuss them with your doctor.
Editor: Kari Fortelka - [email protected]
© 2015 Blue Cross and Blue Shield of Illinois. All rights reserved.
20549.1115
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