2015_Member Newsletter_web banner

Member Newsletter, Winter 2016

Print-friendly PDF | Annual Notices | Privacy Policy

2016-01_Form 1095_web

Watch for Your 1095 Form

As part of the Affordable Care Act (ACA), you may soon receive one or more new forms providing you with information about the health coverage you had or were offered in 2015. These forms provide information to help you complete your Federal tax return:

  • Form 1095-A:  The Health Insurance Marketplace sends this form to individuals who enrolled through the marketplace and includes information about the coverage, who was covered, and when.
  • Form 1095-B: Insurance carriers provide this form to their subscribers. If you are a PacificSource subscriber (not a dependent) on your plan, you should receive this form from us in the mail around the last week of January.
  • Form 1095-C: If you have group coverage and your employer has more than 50 full-time employees in the prior calendar year, you will also receive a Form 1095-C from your employer.

What You Need to Do

This year, the deadline for individuals to file their 2015 tax return is Monday, April 18. Because the IRS extended the deadline for employers and carriers to send the 1095-B and 1095-C forms to individuals, you may not receive all your forms until as late as March 31, 2016. However, you may not need to wait to receive all your 1095 forms to file your tax return. You also do not need to send the forms to the IRS; simply save them for your records.

No matter which 1095 forms you receive, please verify the information on the form as soon as you get them. If any information is incorrect, you'll need to correct the information right away. Here's who to contact if you need to make corrections or if you have questions:

  • Form 1095-A: Contact the Marketplace directly.
  • Form 1095-B: Contact PacificSource at (844) 594-6275. This number will also be on your form. Call us right away so we can generate and send you a corrected form.
  • Form 1095-C: Contact your HR department.

For more information, including frequently asked questions, visit the IRS website at: IRS.gov/Affordable-Care-Act/Questions-and-Answers-about-Health-Care-Information-Forms-for-Individuals.

If you have tax-related questions, please talk with a tax advisor or IRS representative.



CaféWell and Your Healthy Life New Year's Resolutions

2016-01_CafeWell_webDid you set a New Year's resolution to lose weight, eat better, get fit, or take better care of your health? For many, the new year means new opportunities to make better health choices. CaféWell, our online health engagement portal, can help you achieve your goals!

Participate in Activities

When you log into CaféWell, you are given a variety of activities geared toward helping you live a healthier life. These can be found right on your homepage. Are you looking for more "me time" in 2016? Maybe you want to spend more time with friends and loved ones. Or maybe you're on a mission to save money by packing a lunch for work. Whatever your New Year's goals are, let CaféWell help you start off strong in 2016.

If you're looking for a good place to start, try CaféWell's Eleven Ways to Keep New Year's Resolutions.

You can also visit the More Activities section to filter activities by category, or browse all that are available. If you don't see an activity that speaks to you or your goals, you can create your own activity. Invite your friends, family, or coworkers to join you, or fly solo - you choose!

Get Help from a Health Coach

Health coaches are great resources for your health and wellness questions, and help you stick to your New Year's resolutions. If you have questions about nutrition, fitness, stress management, or general wellness, these pros are here for you. You can use the messaging system in CaféWell to send your questions directly and securely to the health coaches. In return, you'll get expert advice specific to your needs.

The CaféWell health coaches also offer online video sessions covering a variety of health and wellness topics. Check out the Video Coaching section for more information about upcoming sessions, and to reserve your spot.

Earn Rewards

[Ed. 12/19/17: My Choice Rewards will be discontinued begining January 1, 2018.] In CaféWell, you'll earn coins for reading articles, participating in activities, joining wellness challenges, and more. For every 100 coins you earn, you're entered into a monthly sweepstakes. You can learn more about the sweepstakes in the CaféWell About Rewards section.

Many members also have access to My Choice Rewards. With this program, you can earn savings credits. These credits reflect the dollar amount you can apply toward merchandise and travel discounts in the CaféWell rewards store. Though items have discount limits, you'll experience great savings toward a variety of items.

Please note: My Choice Rewards program exclusions may apply if you are enrolled in a PacificSource health plan through an employer who has implemented a company-specific rewards program within CaféWell.

New to CaféWell? Get Started Today

To get started with CaféWell, log into or register for InTouch, and then select the CaféWell icon from your InTouch homepage. For more information, including additional login details, visit PacificSource.com/cafewell.



InTouch Offers 2015 Recaps and Information About Your Plan

2016-01_InTouch_webTax time is right around the corner, and now is a great time to reflect on your 2015 expenses and set your budget for 2016. We have some tools to help you with that. Using InTouch, our secure online site for members, you can view summaries of your healthcare spending and claims for 2015.

When looking at these summaries, it's a good idea to pay attention to your out-of-pocket costs and your claim history. The information in these summaries show what your plan paid, what you paid, how it applied to your deductibles, and more. This information offers insight to help you plan ahead.

To access the reports, visit PacificSource.com and log into InTouch, then from the Explanation of Benefits section, click "Year End Claim History Report" or "Year End Out-of-Pocket Costs Summary."

Other InTouch Features

All members have access to InTouch, which offers many helpful tools and resources to help you make the most of your health plan. Here are a few things you'll find when you use InTouch:

  • Health plan snapshot: View a summary of information for your family members covered under your plan.
  • Your benefits: Access information about your plan's benefits, including out-of-pocket expenses, co-pay, and deductibles.
  • Provider directory: Locate a doctor, specialist, or facility in your network that meets your healthcare needs.
  • Your ID card: You can print a temporary ID card, or order a replacement ID card.
  • Access to CaféWell: CaféWell is our health engagement portal that gives you personalized guidance to live a healthier life.

InTouch on the Go

You can get information when you want it using the free myPacificSource mobile app on your iPhone® or Android™ device. When you use the myPacificSource app, you have quick and easy access to our provider directory, your ID card, benefit information (such as deductibles and out-of-pocket totals), and more. Visit PacificSource.com/mobile to learn more.



Getting Non-urgent and Urgent Healthcare

Has there ever been a time when you were sick or hurt, but you didn't know if you really needed to see a doctor? Who do you call? What do you do?

In situations like this, many people go to urgent care or the emergency room because they don't know what options they have. You can save money-and get fast, professional medical advice-by knowing when to call a nurse line, go to urgent care, or go to the ER.

Use the following information as your resource guide, and use the How to Plan Ahead tips to help you prepare.

Nurse Line: Not Urgent or Life-threatening

  • You know something is wrong, but it's not urgent. Nurse lines are a great go-to resource to help you figure out what's wrong and whether or not you need to seek medical care.
  • You want to talk to a medical professional, but you don't think you need a doctor visit, or it's after your doctor's regular clinic hours.
  • You have an illness or injury and you need advice, but you don't need (or don't know if you need) treatment.

Urgent Care: Urgent, but Not Life-threatening

  • You have an illness that needs treatment-such as flu, bronchitis, strep throat, or ear infections-and your primary care doctor is unavailable to see you right away.
  • You have an injury that needs treatment-such as sports injuries, minor burns, cuts, and dislocations-and your primary care doctor is unavailable to see you right away.

Emergency Room: Urgent and Life-threatening

  • You have a serious medical problem, such as inability to breathe, severe head injuries, seizures, severe burns, ingesting poisonous substance, heavy bleeding, and other life-threatening problems.

How to Plan Ahead

  • Keep this handy infographic on your fridge or common area in your home. It will help you remember when to use a nurse line, urgent care center, or emergency room.
  • Make an emergency phone list. The list should include a nurse line, local urgent care centers, and other relevant emergency numbers. Keep this list on your fridge and in your mobile phone. The 24-Hour NurseLine for PacificSource members is (855) 834-6150.
  • Research local urgent care centers. Find out what health conditions they treat, if they take walk-ins, what the clinic hours are, and if they accept your insurance plan. You can use the PacificSource Provider Directory to find urgent care centers and emergency rooms that are participating facilities with your plan.
  • Talk to your family and emergency contact. For emergency plans to work, everyone needs to know what the plan actually is. Take the time to talk to your family members and emergency contact person to make sure everyone knows what to do and who to call.
  • Work with your primary care doctor and clinic. Find out if your doctor is available to take same-day walk-ins, or after-hours options. The more your doctor is involved in all health and medical situations, the better care he or she can provide you.



Dental Health: Beyond the Basics

DentalProperly caring for your teeth not only keeps your smile looking its best; it can help you avoid a variety of dental and other health problems. You probably know the basics-visit your dentist at least twice a year, and brush and floss your teeth at least twice a day-but what else can you do? Here are some tips for taking great care of your oral health.

  1. Be thorough-set a timer and brush your teeth for a full two minutes. Less than that, and you may be leaving behind bacteria.
  2. When brushing, include your gums along with your teeth. This will help stimulate blood flow and improve your gum health.
  3. When flossing, wrap the floss around the tooth in a C shape before moving it up and down; this will cover more of the tooth surface. And don't forget to floss along the back of the teeth in the very back of your mouth.
  4. Try a plastic floss holder, sold next to toothbrushes in most grocery and drug stores. These two-pronged plastic tools allow you to clean between teeth with one hand.
  5. Use a mouth rinse to help reduce plaque.
  6. Avoid soft drinks, fruit juices, and sugary foods.
  7. Some medications can affect oral health. Talk with your doctor if your oral health has suddenly changed after starting a new medication.
  8. Avoid smoking tobacco or using smokeless tobacco products.

Signs That You May Have Periodontal Disease 

  • Gums that bleed during and after brushing or flossing
  • Red, swollen, or tender gums
  • Receding gums or deep pockets between teeth and gums
  • Persistent bad breath or bad taste in your mouth
  • Loose or shifting teeth
  • Changes in your bite or how your dentures fit



Upcoming Survey: Let Your Voice Be Heard

2015-02_Satisfaction survey facesThe last time you went to your doctor, what was your experience like? Did you get all your questions answered? Did your doctor clearly explain your medication instructions?

Every year, a survey is conducted to learn more about our members' healthcare experience. The information from the survey helps us identify areas where we can work with doctors to help provide a better experience for you as a patient and our member. This survey is called the Consumer Assessment of Healthcare Providers and Systems (CAHPS), and all health insurance companies participate.

You could be chosen at random to participate, but not all our members will be contacted. Here's what you need to know if you are asked to participate in the survey:

  • PacificSource does not directly conduct the survey. If you are contacted, you will be contacted by the survey company, called Morpace.
  • The survey is not a scam. Your participation and input is important to us and helps us to serve you better.
  • Surveys will be mailed in January and February, and follow-up phone calls may continue through May.
  • The survey questions are multiple choice and ask about your healthcare experience and your satisfaction with your care. You may be asked about your communication with your doctors, the coordination of your healthcare needs, and other experience-related questions.
  • The Centers for Medicare and Medicaid Services (CMS) will publicly report survey results, but your individual responses are completely confidential.

For more information about the CAHPS survey, visit CMS.gov/Research-Statistics-Data-and-Systems/Research/CAHPS/index.html.



Tips to Be Medication Savvy

Med SavvyWhether you occasionally wake up with a headache or you're managing a chronic condition, prescription drugs and over-the-counter medications play a big role in our day-to-day health and wellness. Use the following tips to safely stay on top of your medications and make the most of your prescription drug benefits.

  • Organize your medications in a pill box - By keeping your medications organized, it's easy to keep track of what you're taking and when.
  • Set refill reminders - Use a calendar, electronic reminders, or set up auto-refill for your medications to help you keep track of when you're due for a refill. You can also take it one step further and set up regular reminders for when to take your medications.
  • Save money with generic drugs - Generics are tested to make sure the active ingredients are the same as the brand. You'll get the same treatment quality at a more affordable price.
  • Take advantage of prescription mail-order opportunities - Having your maintenance medications delivered directly to your home will save you time-and often, money.
  • Check formularies for preferred medications - Preferred medications can be pretty spendy, but formularies can help you keep the cost in check. Share the information with your provider for an opportunity to pay lower co-pays. You can find complete drug lists and prior authorization criteria on our website at PacificSource.com/drug-list.
  • Use caution when choosing a new over-the-counter medication - Read the drug facts label, and ask your provider or pharmacist if the medication is right-and safe-for you.
  • Tell your doctor about all medications you're taking - It's important to provide this information every time you see your doctor. Remember to include over-the-counter medications and herbal supplements. 
  • Talk to your pharmacist - Your pharmacist is the expert and can answer questions you may have about side effects, drug interactions, and more.
  • Take advantage of health services provided by your healthcare plan - Pharmacies offer flu shots and other immunizations, some of which may be covered by your plan at no cost to you.
  • Read your explanation of benefits (EOB) - Your prescription medications are included on your EOB statements, which can help you understand your healthcare coverage and get the most value from your plan.






Facebook  PinterestIcon  YouTube



This Member Newsletter is provided for general information only, and is not to be used to determine benefits. Your benefits are determined only by your policy. Please refer to your plan materials or our Customer Service Department for specific benefit information.