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Everything You Wanted to Know About Regulating Your Thyroid to Improve Your Quality of Life

Posted by on Dec 8, 2013 in Blog, Happy Together

Ed-Mulvey1208Have you been excessively tired lately? Are you a male or female over the age of 30 who has thinning hair, dry skin, and unexplained weight gain? If you answered yes to all of these questions, you may need to have your thyroid checked. Most people see these symptoms as obvious signs of aging, which is why nearly 30 million Americans have a thyroid disorder and half of those people remain undiagnosed, according to the American Association of Clinical Endocrinologists.

The thyroid is a small, butterfly-shaped gland just below the Adam’s apple. Its main purpose is to produce 2 hormones: T3 (triiodothyronine) and T4 (thyroxine). These hormones are secreted by the thyroid to meet the metabolic needs of the body. T3 and T4 hormones control every cell, tissue, and organ in the body. As a part of the endocrine system, the thyroid’s duty is to regulate how much or how little of these hormones go into the bloodstream.

When there is too much T3 and T4 secreted into the bloodstream, the thyroid disorder is called hyperthyroidism. Symptoms include:

• Hair loss
• Bulging eyes
• Rapid heartbeat
• Muscle weakness
• Irritability

The most common cause of hyperthyroidism is Graves’ disease. This is when the body’s immune system overstimulates the thyroid. The thyroid then attacks it back by overproducing T3 and T4. Treatment of hyperthyroidism can be either a pill known as a beta blocker or radioactive iodine treatments which destroy all or part of the thyroid.

When there is too little T3 and T4 secreted into the bloodstream, the thyroid disorder is called hypothyroidism. Symptoms include:

• Fatigue
• Forgetfulness
• Puffy face
• Sore muscles
• Weight gain or fluid retention

The most common cause of hypothyroidism is Hashimoto’s disease. This is when the body’s immune system destroys the thyroid. This causes the thyroid to slow down and, in some cases, stop any production of T3 and T4. Treatment of hypothyroidism comes in the form of a hormone replacement pill called levothyroxine.

Thyroid disease is not easily diagnosed. Most symptoms go unnoticed or are attributed to getting older. If symptoms go untreated, they become more severe. Constant stimulation of your thyroid gland in either disorder can cause an enlarged thyroid or goiter. You may become more forgetful, have slower thought processes, or feel depressed. Thyroid disease can be complicated, so it is recommended that you be checked by a doctor who specializes in metabolic disorders. The physician will conduct a series of tests to see if your thyroid is functioning correctly.

Earlier this year, I visited an endocrinologist because I was worried about my increasing fatigue. I was diagnosed with hypothyroidism and have been taking levothyroxine ever since. Hormone replacement has, among other changes, given me more energy, improved my strength, and aided in a 20-pound weight loss. My decision to get my thyroid checked has definitely changed my life for the better. If you think you may have a thyroid disorder, please visit for more information.

Stephanie Behrends
Customer Service Representative

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What Is Celiac Disease?

Posted by on Dec 2, 2013 in Blog, Happy Together

DanielleBanks2November is Celiac Awareness Month. Celiac disease is an autoimmune disorder triggered by the ingestion of gluten, a protein found in wheat, barley, and rye. It is estimated that 1 out of every 141 Americans have celiac disease, but 83% of those individuals who have it are either undiagnosed or misdiagnosed. Although some individuals with celiac disease may show no symptoms, some of the most common symptoms include:

• Bloating or Gas
• Diarrhea
• Constipation
• Fatigue
• Pale Mouth Sores
• Headaches
• Discolored Teeth

Because these are very common symptoms for a variety of diseases, celiac disease tends to be misdiagnosed. The only treatment available for celiac disease is a lifelong gluten-free diet. Continuing to eat gluten can damage the intestine. A gluten-free diet consists of avoiding foods that contain wheat, rye, and barley. This disease is becoming more common; therefore, many products are also made gluten-free.

If you have family members or friends with celiac disease, remember to be sensitive to their gluten-free diet. During the upcoming holiday season, we will tend to have a variety of meals and desserts. Consider using some of these common gluten-free alternatives:

• Brown Rice
• Corn Flour
• Corn Starch
• Lentils
• Soy Flour

To learn more about this disease, visit

Happy Thanksgiving!!

Danielle Banks
Claim Analyst

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Navigating Health Care Reform as a Small Business

Posted by on Dec 2, 2013 in Blog, Happy Together

JocelynDuncan2The Patient Protection and Affordable Care Act (ACA for short) includes a very broad array of changes that impact the small business owner. Some changes require immediate action on the part of small business owners, while others will affect the health insurance products available to small businesses beginning in 2014. It’s important to understand these changes and anticipate changes in your processes that will need to occur so that you can remain compliant with new regulations.

Health Insurance Plan Changes
While it is true that if you like your insurance coverage today, you will likely be able to keep similar coverage, there are new requirements for health insurance plans beginning in 2014. Some or all of these requirements may require changes to your current coverage, whether it be a change of the specific services covered or a change of how much money an individual will have to pay for those services.

Waiting Period
Employers cannot require their eligible employees to wait any longer than 90 days from the date they become eligible under the plan for their health insurance coverage to begin.

Essential Health Benefits
One of the objectives of the ACA is to ensure that consumers have the health insurance coverage they believe they have when they purchase a policy or enroll in a group plan. One of the ways the law accomplishes this is by requiring that all plans cover some basic benefits, called Essential Health Benefits. Under federal law, these include ambulatory services, emergency services, hospitalization, maternity and newborn services, mental health and substance use disorder services, behavioral health services, prescription drug coverage, rehabilitative services, habilitative services, laboratory services, preventive care and wellness services, chronic disease management services, and pediatric vision and dental services. There may be additional services that are required to be covered in some states based on individual state laws.

Metal Tiers
I’m sure many of you have heard of the metal tiers and how each tier covers a higher percentage of expected health care costs, but let’s look at an example to see what that looks like in terms of coverage. A very simple health insurance plan covers all required essential health benefits and nothing additional and covers physician office visits and prescription drugs under the deductible and coinsurance provisions. So what would the metal tiers look like for this plan? Here are some examples:

Bronze (60% of expected cost) – $2,000 deductible, 50%
coinsurance, and $6,350 out-of-pocket maximum per individual.

Silver (70% of expected cost) – $1,500 deductible, 70%
coinsurance, and $4,850 out-of-pocket maximum per individual.

Gold (80% of expected cost) – $1,000 deductible, 80% coinsurance,
and $2,000 out-of-pocket maximum per individual.

Platinum (90% of expected cost) – $500 deductible, 90%
coinsurance, and $1,500 out-of-pocket maximum per individual.

Plan designs can vary widely from carrier to carrier and even between different plans offered by the same carrier, so these metal tier designations can be achieved by a wide variety of plan design combinations.

Reinsurance Fees
The ACA includes a reinsurance program that begins in 2014 and continues through 2016. Each individual covered for health insurance will incur a fee, which is $5.25 in 2014 and is expected to decrease the following two years. Your health insurance carrier will be responsible for paying these fees.

Taxes, Notifications, and More
There are additional requirements beyond the health insurance plan changes that small business owners need to be aware of. These include the availability of tax credits, notification of the availability of the Marketplace requirements, Flexible Spending Account (FSA) limits, Medicare withholding and tax assessment changes, new incentives for workplace wellness programs, and new health insurance coverage reporting requirements. You can head over to the U.S. Small Business Administration (SBA) website for more information on these items.

In addition, the SBA is hosting a free one-hour webinar where small business owners can learn more about the Affordable Care Act. There are a number of time slots available from November through mid-December. You can visit to learn more and to register for a session.

Don’t get blindsided by health care reform changes. You can find a list of key principles of the ACA, including a complete timeline of past and future implementation dates, here.

At Pekin Insurance,® we understand the unique concerns and constraints of small business owners and will strive to go Beyond the expected® in assisting you with navigating through these changes. We offer a wide variety of ACA-compliant group health insurance products to meet your needs. Contact your Pekin Insurance agent today to find the right plan for you and your employees.

Jocelyn Duncan
Actuarial and Model Office Manager

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Managing Your Medical Claims is Good for Your Health

Posted by on Nov 4, 2013 in Blog, Happy Together

AmyDarlingInsurance can be confusing. The more medical care you have, the more there is to keep track of. No one plans to be sick, but preparing and having a system in place will help if you do have claims. If you or your family member becomes ill, the number of bills can be extensive. A simple outpatient surgery could easily generate several bills. You can expect bills, at minimum, from the hospital or surgery center, surgeon, pathologist, and anesthesiologist. Organization will allow you to take care of yourself or your family member and not stress about the paperwork. Managing your medical claims can be easy if you do the following:

  • Start a file at the beginning of each year to keep all of your health insurance documents in one place.
  • As bills come in, avoid paying the bill until you have your Explanation of Benefits (EOB) from your insurance carrier. Many times a doctor or hospital will bill you before the insurance discount is applied. They also do not usually know the exact benefit and will estimate the insurance payment. This oftentimes creates an overpayment on the account. You should never ignore a bill, but be cautious of paying before your insurance which could create more work for you later to recover the overpayment.
  • Once you have both the bill and the EOB, you should be able to match them up to figure out exactly what amount is a discount, how much the insurance paid, and any amount that is not covered and why it was not covered.
  • If you get a bill and do not get an EOB within 30 days, it is a good idea to contact the doctor or hospital to be sure they properly billed your insurance company. Have a copy of your insurance ID card handy to provide them any information they may need to bill your insurance.

Pekin Insurance® constantly strives to provide our insureds with Beyond the expected® claim service. We want you and your family focused on being healthy. Let us help make the claim process as easy as possible. If you ever have questions on your Pekin Insurance medical insurance, we are just a phone call away! Call 800-371-9622 for assistance on managing your medical claims.

Amy Darling, FLMI, FLHC, ACS, ARA
Director of Life Claims

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Think Pink

Posted by on Oct 8, 2013 in Blog, Happy Together

NikkiSayles October is Breast Cancer Awareness Month, which is an annual campaign to increase awareness of the disease. While most people are aware of breast cancer, many forget to take the steps to have a plan to detect the disease in its early stages.

By being alert to any breast changes and having exams and tests according to American Cancer Society guidelines for early detection, breast cancer can be found at the earliest possible stage, when it is most treatable. In addition, these exams and tests sometimes find certain benign breast conditions.

American Cancer Society recommendations for early breast cancer detection:

    • • Women age 40 and older should have a screening mammogram every year and should continue to do so for as long as they are in good health.
    • • Women in their 20s and 30s should have a clinical breast examination by a health professional as part of a regular health exam, at least every 3 years. Starting at age 40, women should have a breast exam by a health professional every year.
    • • Breast self-examination is an option for women starting in their 20s. Women should be told about the benefits and limitations of BSE. Women should know how their breasts normally look and feel and should report any breast changes to their health professional right away.
    • Women at high risk for breast cancer should get a magnetic resonance imaging (MRI) scan of the breast and a mammogram every year. Women at moderately increased risk should talk with their doctors about the benefits and limitations of adding MRI screening to their yearly mammogram. Yearly MRI screening is not recommended for women whose lifetime risk of breast cancer is less than 15%.

We have made a lot of progress but still have a long way to go!

If you would like more information please go to:
Early Detection – National Breast Cancer Foundation

Nikki Sayles, AAPA, ACS, ALMI
Senior Customer Service Representative

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