What types of health information are consumers compelled to divulge under Affordable Care Act rules?

What types of health information are consumers compelled to divulge under Affordable Care Act rules?

I just selected a new health insurance plan and they’re asking me questions about my health. I thought insurance companies can’t do this anymore?

Under health care reform laws, insurance companies can’t require you to answer health questions in order to buy insurance.

However, once you are covered by a health plan, companies are allowed to ask questions to determine whether you qualify for one of their disease management programs or for case management services. Disease management programs help consumers learn how to manage chronic health conditions such as diabetes, heart disease, or depression.

Case management programs help consumers who have very serious health conditions, such as leukemia, cut through the red tape to get the insurance company to pay for their treatment. For example, to prevent misdiagnosis, some insurance companies won’t start paying for cancer treatment until consumers get a second opinion to confirm the diagnosis. The average consumer wouldn’t know this, but a case manager will tell the consumer about this requirement and, if necessary, help the consumer schedule an appointment for a second opinion. Many case managers are also licensed nurses, so they can also suggest solutions to problems, such as side effects, that consumers experience during treatment.

Both of these services are voluntary, so you don’t have to answer the questions. Even if you do answer the questions, you don’t have to participate in the programs.

I recently applied for life insurance and they made me answer questions about my health. I thought insurance companies can’t do this anymore?

Under health care reform laws, insurance companies can’t require you answer health questions in order to buy medical insurance. However, insurance companies can still require to you answer health questions to buy other types of insurance, including:

  • Life insurance 
  • Long-term care insurance 
  • Dental insurance
  • Vision insurance 
  • Disability insurance
  • Medicare Supplement plans and Medicare Advantage plans, under certain circumstances

Read more information about health care reform.

Our consumer experts can answer your questions about any type of insurance. They are available by phone at 1-800-562-6900 or by submitting an inquiry through our website.

Kreidler: Nearly 14.5 percent of Washingtonians were uninsured in 2012

Kreidler: Nearly 14.5 percent of Washingtonians were uninsured in 2012

Today, we issued our fourth report on the number of Washingtonians who have no health insurance. At the end of 2012, some 990,000 people -- approximately 14.5 percent of the state's population -- were uninsured.

From 2010 through 2012:
  • The number of uninsured people in Washington grew by more than 44,000.
  • Four out of five people with individual insurance were underinsured, meaning they had plans that only paid for 25-40 percent of their medical costs.
  • Employer-sponsored coverage grew increasingly scarce.
  • Uncompensated care ballooned to nearly $1 billion per year.
The Affordable Care Act fully took effect on Jan. 1 and the uninsured rate is expected to drop to 6 percent by 2016. Early provisions of the Affordable Care Act prevented an estimated 100,000 people from joining the ranks of the uninsured prior to 2014.

“For many families who have struggled to get or keep health coverage, health reform couldn’t come soon enough,” said Insurance Commissioner Mike Kreidler. “Regardless of how you feel about ‘Obamacare,’ it’s hard to argue that we’re not making progress in stopping the growth of uninsured or that the status quo was sustainable. Before health reform, we had hundreds of thousands of people living one bad diagnosis away from bankruptcy.”

The Test for Determining Implied Consent to Use a Motor Vehicle

The Test for Determining Implied Consent to Use a Motor Vehicle

In Myers-Gordon(Litigation guardian of) v. Martin, 2013 ONSC 5441 (S.C.J.), the defendant’s son drove his mother’s  car while impaired and was involved in an accident, killing two pedestrians and injuring two others. Claims were brought against the defendant’s mother, Karen Martin. The parties agreed that the Ms. Martin had not given her son express consent to use her vehicle. The issue before the court on this motion for summary judgement was whether Ms. Martin had given her son implied consent to take her vehicle.

Justice Kent relied on the 2008 decision in Seegmiller v. Langer [2008] O.J. No. 4060 where 8 principles were considered to determine if there was implied consent:

  1. Whether a motor vehicle is in possession of some person without the consent of the owner is a question of fact determined on the evidence.
  2. The meaning of possession is a question of law, applying this definition is not a question of law alone.
  3. Generally, possession means power, control or dominion over property
  4. Once ownership is established, the onus passes to the owner to establish that another was in possession without consent.
  5. The owner’s vicarious liability is based on possession, not operation.
  6. Consent to possession is not synonymous with consent to operate.
  7. If possession is given, the owner will be liable despite a breach of a condition attached to possession, including that the person in possession not operate the vehicle.
  8. Breach of the owner’s conditions, does not alter the fact of possession.

Justice Kent considered the above factors and found no implied consent despite the fact that the son had driven the vehicle with permission numerous times in the past, Ms. Martin left the keys at home where they were accessible to her son and Ms. Martin had not brought up the issue (with her son or the police) that her vehicle was taken without consent until a significant time after the accident. The actions were dismissed against Ms. Martin due to Justice Kent’s confidence in the son’s evidence that he never thought he had consent to possess or drive the vehicle.
Consent is fact-driven and the eight-fold test provides a useful framework in which to work. 
Food for thought when planning Super Bowl party

Food for thought when planning Super Bowl party

If your Super Bowl party gets out of hand or you find yourself with an unruly guest, our consumer advocates shared a general overview of what your homeowner insurance may cover. You should check your own policy to find out exactly what you are covered for.

If someone is injured at your home

Generally, homeowner policies have two types of coverage that could apply.

Premises medical (guest medical) is designed to cover medical expenses (each policy has its own limit) that occur from an on-premises, accidental injury. Premises medical is a more direct payment method to pay for, or reimburse, the injured guest for related medical expenses.

Liability would cover an injury to a guest if the homeowner was found to be negligent, and the negligence was the cause of the injury. For instance, if a homeowner failed to repair a falling-down porch and a guest was injured on it, the liability portion of the policy could cover the injury.

If a guest causes damage at your home

If an unruly guest damages your home or your belongings—such as a beer bottle launched at the TV after a bad play—it might be classified as vandalism and covered by your policy, subject to the policy deductible. The homeowner’s insurer may seek collection action against the unruly guest for reimbursement. The guest may have his or her own homeowner policy that includes liability coverage; however, it would likely not apply because intentional acts are excluded from personal liability coverage.

If you have renter insurance, check your policy for what type of damage is covered and check your lease for what type of damage you are responsible for.

Be prepared for guests

Any time you invite guests to your home, whether it be a Super Bowl party or any other gathering, it’s your responsibility to ensure your home is safe and that your guests are reasonably safe. That includes being responsible with providing alcohol to your guests, making sure there are no obvious hazards and generally taking the same precautions for your guests’ safety as you do for your own.

Before the game, talk to your insurance agent about what is and what is not covered in your policy.

You can find more information about home insurance on our website.

Enjoy the Super Bowl and go Seahawks!

What to do if you haven’t received your proof of medical insurance

What to do if you haven’t received your proof of medical insurance

Some Washington health-care enrollees have not yet received proof of their insurance coverage. As a result, many consumers are unsure if their medical treatments are covered. If you recently bought a plan, but still haven’t received proof of insurance from your insurance company, Insurance Commissioner Mike Kreidler offers these tips.

Since open enrollment began on Oct. 1, insurance companies have encountered multiple problems that have prevented them from being able to enter new members into their systems. Some companies received incomplete or incorrect information from the insurance marketplaces. Other companies were overwhelmed with the number of applications they received and were unable to process them by the time the new plans went into effect. This delay in providing proof of coverage has many consumers worrying if they really have insurance and wondering what to do next.

Contact the company
The first thing you should do is contact your insurance company to verify that you do have insurance coverage. Ask your company for proof of coverage, such as an insurance card or identification numbers. When you speak to your company, take detailed notes of the conversation. Include the date and time that the conversation took place, and the name of the representative you speak to. Keep copies of any written communication you receive, such as emails or letters. You may need these materials later.

If you are not sure how to contact your plan, our website has contact information for each of the insurance companies that sells plans through Washington Healthplanfinder.

You should also verify that you have paid your first premium on time. Some insurers have permitted late payments for coverage retroactive to Jan. 1. Find out your insurer’s deadline and keep any records that can serve as proof of payment.

If you are about to buy coverage from Washington Healthplanfinder, print any paperwork or confirmations that you receive during the enrollment process.

If you know you don’t qualify for a subsidy through Washington Healthplanfinder, you may find it easier to buy insurance directly a broker or an insurance company. Here’s a list of the plans that are available in Washington.

Remember, 2014 open enrollment for most plans ends on March 31.

Payment options
You may need to get a prescription filled or see your doctor before you receive your insurance card. Your medical provider (hospital, doctor, pharmacy) may be able to verify your coverage by contacting your insurer directly. If they cannot verify your coverage cannot be obtained, you still have options.

One option is to pay for expenses out of pocket. Once your insurance coverage is established, your insurance company should reimburse you in accordance with its established fees for services, minus any deductibles and copayments you are responsible for.

You may also be able to work with your doctor’s office, hospital or pharmacy to delay payment or set up a payment plan until they can verify that you’re insured. Keep your receipts and any bank statements that show that you’ve paid for the services.

More information
The Insurance Commissioner doesn’t administer Washington Healthplanfinder, so if you purchased insurance there, your best bet is to contact their customer service staff if you have questions about whether you are covered.
Insurance Commissioner's 2014 legislative priorities

Insurance Commissioner's 2014 legislative priorities

The 2014 legislative session started on January 13. It’s a short session, scheduled to conclude March 13.

This year, the Office of the Insurance Commissioner has two important legislative priorities.

Insurance Company Solvency (HB 2461)
We're seeking to adopt two model acts created by the National Association of Insurance Commissioners (NAIC) in response to the global financial crisis.

One, called the Holding Company Act, enhances our ability to oversee, monitor and regulate any company under a parent company or holding company system. It must be adopted by Jan. 1, 2016, or Washington state risks losing its NAIC accreditation. This model act aims to improve transparency and accountability of companies and conglomerates that own insurance companies. The legislation would also prevent firms from circumventing regulation designed to protect against financial shell games that could result in insolvency.

The other is called the Own Risk and Solvency Assessment (ORSA) Model Act and requires companies to create a plan for self-assessing and reporting their current and future financials in light of their two- to five-year business plans.

Alien Insurer State of Entry (HB 1402/SB 5489)
This bill modernizes the terms under which international insurance companies could enter the U.S. insurance market through Washington state and requires them to meet the same financial-strength standards and play by the same rules.

K-12 Data Study Funding Restoration
The Legislature passed SB 5940 in 2012, requiring our office to annually study and report on K-12 employee benefits. The original bill included an appropriation of $1.3 million, but the funding was cut last year to $300,000. Without restored funding, we cannot complete the study. This bill restores the funding to its original appropriation.

We post this information on our legislative priorities page.

Public comment on bills
The state Legislature’s website has a new feature that allows citizens to comment on bills. All comments are emailed to all state legislators. If you are interested in commenting on these bills or any others that are being considered, you can search for the bill and select “comment on this bill” next to the bill number.
Supreme Court Sets Out The Test for Summary Judgment

Supreme Court Sets Out The Test for Summary Judgment

The Supreme Court has overturned the "full appreciation" test used by the Ontario Court of Appeal in summary judgment.  The appeals in Hryniak v. Maudlin, 2014 SCC 7 and Bruno Appliance and Furniture v. Hryniak, 2014 SCC 8 were released January 23, 2014.

The Court emphasized that summary judgment rules must be interpreted broadly, "favouring proportionality and fair access to the affordable, timely and just adjudication of claims".  The new Rule 20 represents a significant alternative model of adjudication.

There will be no genuine issue requiring a trial when the judge is able to reach a fair and just determination on the merits on a motion for summary judgment.  This will be the case when the process:

(1)  Allows the judge to make the necessary findings of fact;
(2)  Allows the judge to apply the law to the facts, and
(3)  Is a more proportionate, more expeditious and less expensive means to achieve a just result (para. 49).

The standard for fairness is whether it gives the judge confidence s/he can find the necessary facts and apply the relevant legal principles so as to resolve the dispute. The evidence need not be equivalent to a trial.  The Court held that a documentary record, particularly when supplemented with the new fact-finding tools such as oral testimony, is often enough to resolve material issues justly and fairly (para. 57). The judge may need to compare things such as the cost and speed of a trial versus summary judgment.

At para. 66, the Court set out a roadmap for summary judgment:

There will be no genuine issue requiring a trial if the summary judgment process provides her with the evidence required to fairly and justly adjudicate the dispute and is a timely, affordable and proportionate procedure, under Rule 20.04(2)(a).  If there appears to be a genuine issue requiring a trial, she should then determine if the need for a trial can be avoided by using the new powers under Rules 20.04(2.1) and (2.2).  She may, at her discretion, use those powers, provided that their use is not against the interest of justice.  Their use will not be against the interest of justice if they will lead to a fair and just result and will serve the goals of timeliness, affordability and proportionality in light of the litigation as a whole.

The Supreme Court's interpretation of r. 20 seems to be a firm statement that summary judgment is an appropriate way to resolve cases, rather than the restrictive interpretation taken by the lower courts.  We may see an increase in the number of summary judgment motions in the future.
Does homeowner insurance pay for fixing a botched home repair job?

Does homeowner insurance pay for fixing a botched home repair job?

My contractor did poor repair work on my home, and my insurance company won’t pay for fixing the work. Doesn’t my insurance have to pay for it?

Consumers often ask us about this. Unless your insurer gave you no choice but to use its recommended contractor(s), the answer is no. If you chose the contractor, then the resolution will be between you and the contractor. If the contractor does not fix the work, then you may need to seek legal advice about your options. Generally, a contractor will try to resolve such issues, so we recommend that you first try to work it out with your contractor.

By the way, the situation is the same for auto repairs. If you chose the repair shop, then resolution needs to be between you and the shop. If you chose a shop recommended by your insurer, then we would expect your insurer to help you resolve the issue.

Learn more about understanding home insurance or auto insurance.

You can report consumer issues to our experts at 1-800-562-6900 or by viewing Talk to an Insurance Expert.
The Limitation Period in False Arrest/Imprisonment Cases

The Limitation Period in False Arrest/Imprisonment Cases

A recent decision looks at when the limitation period begins to run in a false arrest/false imprisonment case, as well as the impact of a peace bond on a negligent investigation claim.

In E.B.F. (Litigation guardian of) v. Ontario, 2013 ONSC 2581 (S.C.J.), the plaintiff sued the Crown for false arrest, false imprisonment, breach of Charter rights and negligent investigation arising out of charges laid against him by the O.P.P in 2008.  The plaintiff's daughter alleged he had sexually assaulted her.  The charges were ultimately withdrawn in 2009 after the plaintiff agreed to enter into a peace bond.  The claim was issued in 2011.  The Crown brought a motion to strike the claim.  There were two issues for the Court to consider:

1.  Whether the limitation period began when the plaintiff was arrested or when the peace bond was entered into; and
2.  Whether the peace bond represented the charges being terminated in the plaintiff's favour, a precondition to being able to pursue a negligent investigation claim.

Justice Chiappetta held there was no reasonable cause of action against the Crown.  A claim for false arrest, false imprisonment or breach of Charter rights crystallizes on the date of arrest.  Although the plaintiff alleged he was unable to determine the arrest was wrongful until after receiving legal advice and the results of a private investigation, there was no persuasive evidence that the plaintiff suffered from any mental or psychiatric disorder that would have impacted his ability to understand the arrest, the charges and his belief of innocence.

The plaintiff argued that since the only conditions imposed by the peace bond were to keep the peace and be of good behaviour (as every other citizen is required to do), the proceedings terminated in his favour.  Justice Chiappetta held that the agreement to withdraw the charges in return for a peace bond represented a negotiated compromise, and was not a termination of proceedings in the plaintiff's favour.

Since the plaintiff's claim was issued beyond the limitation period and he failed to show the proceedings were terminated in his favour, the claim was dismissed.

Tech gadgets for the healthy traveler

It's hard to stay healthy in the best conditions. Traveling makes it even harder. Whether you're taking the great American road trip or venturing to foreign parts unknown, you want to make sure your body is ready for the quest. Common sense applies, of course. Wash your hands. Don't drink the water. Think twice about eating meat on a stick.
There are also some cool tech gadgets you can bring with you to make sure your body can keep up with your adventurous ambitions. Here are a few of our favorites.
Misfit likes to call their device "the world's most elegant physical activity monitor." They might be right. In a market flooded with digital activity trackers that aim to keep you honest about your body in motion, the Misfit Shine stands out as a beautiful piece of tech you can wear on your wrist or clothing. Travelers to sunny climes with glistening oceans will appreciate its waterproof design. It works much like other trackers on the market, syncing wirelessly with your phone and using LEDs that light up to show your daily progress.

Satechi USB Portable HumidifierSatechi Portable HumidifierSatechi USB Portable Humidifier
It looks like something Peter Parker might have whipped up as a science project, but this portable humidifier is the real deal. All you do is screw the device onto nearly any water bottle and plug it into a USB outlet.
It creates a soothing environment - complete with a dim blue mood light – that can provide relief from cold, cough and flu symptoms, as well as itchy skin, congested sinuses and cracked lips. Add some scented oils and wait for the on-staff massage therapist (or your spouse) to complete the experience. When used with cold water the humidifier also acts as a refreshing mister.

Shiatsu Heated Foot MassagerShiatsu Heated Foot MassagerShiatsu Heated Foot Massager
After a day of urban - or jungle - hiking this foot massager will become a welcome addition to your travel gadget collection. It combines Japanese acupressure techniques with heat therapy to soothe and relax sore and tired feet. It's also soft and highly transportable, encased in fleece that is as comfortable as slippers. The unit has two customizable rotating nodes that target pressure points on the soles, simulating the fingertip motions used in Shiatsu to relax the muscles and facilitate blood flow.
You can also adjust the heat settings to enhances blood circulation to soothe sore, tired muscles in the feet.
This wand purports to kill 99.9% of targeted bacteria – E.Coli, Salmonella, and the H1N1 virus – in 10 seconds. It's also effective in killing dust mite eggs in pillows, bedding, and carpet. This thing will likely find use in your home as well as your hotel room. Use it to reduce dust mite populations and flea and bed bug eggs in mattresses, pillows and carpets. Just pass the wand over any area for 10 seconds and it's done.

Your hotel probably offers a wake up call, but they can't compete with this cool watch. The SleepTracker actually gives you insight into your personal sleeping habits. It has an internal accelerometer to detect movements associated with periods of restlessness that indicate when you are in a light sleep stage.
The unit then keeps a record of your moments of restlessness when you are almost awake and gives you the ability to upload your sleep data via USB to your computer and review it by day, week or month. Best of all, the SleepTracker can help you wake up at your optimum time by analyzing your sleep patterns. You'll be refreshed and ready for your next travel adventure.

SteriPen Freedom Solar Bundle Portable Water PurifierSteriPen Freedom Solar Bundle Portable Water PurifierSteriPen Portable Water Purifier
The SteriPen Freedom is the worlds smallest, lightest UV water purifier. If you want to stay healthy abroad, you need to stay hydrated.
This purifier lets you do it in a lightweight, easy to use package that pus the power of the sun to work for you. The unit features an internal, USB-rechargeable battery that allows you to power up just about anywhere: from a wall outlet, a computer or the portable solar panel.

Acupressure Wrist BandsAcupressure Wrist BandsAcupressure Wrist Bands
If you're the type of traveler who gets queasy going to and fro, these acupressure wrist bands are the next best thing to having your acupressure therapist actually with you on the plane, boat or car. They're obviously drug free, inexpensive, and wrap around your wrists like a watch.
Once on, the bands apply gentle pressure to the acupressure points that relieve nausea.
'Ignore the hype' about health care reform is good advice

'Ignore the hype' about health care reform is good advice

While the rollout of the Affordable Care Act has not gone as smoothly as hoped for, the doomsday talk is something that should be considered with a good helping of skepticism.

That’s the word from insurers. "Don’t believe the hype: Health insurers think Obamacare is going to be fine" is the recent headline from the Washington Post. Bosses at some of the big-name companies said they expected the initial stages of health-care reform to be rocky. They stress patience.

That’s the same message that Commissioner Kreidler delivered to Congress about five weeks ago when invited to testify before a House health-care subcommittee.

And when asked Jan. 17 by the host of Northwest Now about any concern in our state about the enrollment of the "young invincibles" – people under 30 – Kreidler, the nation’s longest-serving elected insurance commissioner, again urged patience. Two to three years of experience are needed to make informed judgments, he noted.

Learn more about what the commissioner had to say during his interview about health-care reform at KBTC’s Northwest Now website..
Motion to Add Party Must be Served but not Heard Before Limitation Period Expires

Motion to Add Party Must be Served but not Heard Before Limitation Period Expires

When a plaintiff seeks to add a party defendant, must the motion be heard prior to the expiry of the limitation period?

According to Justice Edwards in Computer Enhancement Corporation v. J.C. Options, 2013 ONSC 4548 (S.C.J.), the motion must be served, but not necessarily heard, prior to the expiry of the limitation period.  Justice Edward held that the suggestion that a motion to add a party must be served, argued and a court order obtained prior to the expiry of the limitation period was "lacking in common sense".  There are lengthy delays in obtaining motion dates and the moving party is therefore "very much in the hands of the court" as to whether the motion can be argued and disposed of within the limitation period.

In making his decision, Justice Edwards followed the Divisional Court in Philippine v. Portugal, 2010 ONSC 956 (Div. Ct.), where the plaintiff was permitted to add a claim for conspiracy, and declined to follow Marks v. Ottawa, 2013 ONSC 1089 (S.C.J.) where the Court refused to permit the addition of a party where the motion had not been heard prior to the expiry of the limitation period.
Enrolled in the federal High Risk Pool? You've got two extra months to find coverage

Enrolled in the federal High Risk Pool? You've got two extra months to find coverage

The federal government announced today that it was extending the deadline for people enrolled in the federally-run Pre-existing Condition Insurance Plan (PCIP) to find new coverage. Consumers in this program now have until March 31, 2014 to find new insurance.

If you're enrolled in this plan, expect to get a letter in the mail explaining the new deadline and details on cost-sharing.

Get more information about PCIP.

The Truth About Common Nutrition Myths

If the last time you ate fried anything was at the state fair three years ago, we have news for you. No, funnel cake hasn't become the diet food du jour. But fried foods -- as well as burgers and beer -- can have a place in a healthy diet. Surprised? No wonder. "With all the misinformation and exaggerated health headlines out there, it's easy to get fooled," says Robert J. Davis, PhD, an adjunct professor at Emory University's Rollins School of Public Health and the author of Coffee Is Good for You. To help you figure out which truths to swallow, we asked the experts to debunk the top 10 food myths. Read on to find out what's standing between you and better health, not to mention that basket of chicken fingers.

Myth: Red wine is tops for your ticker. The real deal: When it comes to heart health, red wine gets all the glory. But that glass of Syrah may not be so superior: University of Texas researchers found that although moderate drinkers lived longer than those who abstained, wine drinkers weren't better off than those who preferred beer or liquor.
"Reports of red wine's antioxidant powers were probably overblown," says Arthur Klatsky, MD, the senior cardiology consultant for Kaiser Permanente, a nonprofit health plan based in Oakland, California. The alcohol itself is what boosts levels of HDL, or "good," cholesterol. "The molecules act like Drano in your blood vessels, sweeping away plaque," Dr. Klatsky says. "This lowers your risk of developing blood clots, which can lead to strokes and heart attacks." Whether you prefer Pinot or pilsner, raise a glass to your health -- and then switch to water. Tossing back more than two drinks a day does your heart more harm than good, Dr. Klatsky says.
Myth: Organic produce packs more nutrients than the conventional kind. The real deal: Although buying organic fruits and veggies helps protect the environment, research published in theAmerican Journal of Clinical Nutrition found that they have no nutritional advantage over their conventionally grown counterparts. And while the latter contain more chemical residue, no studies have definitively proven that the amount of chemicals we ingest causes any harm: Much of the research linking pesticides with disease was done on farmers who had been exposed to huge quantities, Davis says. Still prefer organic? Spend the extra money on produce that has a peel you eat, such as apples and peaches.
Myth: A grilled-chicken sandwich beats a burger. The real deal: This seemingly healthy favorite not only contains more calories -- roughly 350 versus 250 -- than a plain hamburger, but it can also be a sodium bomb. "Many restaurants use chicken that has been injected with a saltwater solution to keep it moist," says Stephen Sinatra, MD, a cardiologist in Saint Petersburg, Florida, and a coauthor of The Fast Food Diet. Even a no-frills chicken sandwich with just lettuce, tomato, and mayo can pack more than 1,300 milligrams of sodium. That's more than double the amount in a burger and more than half of your daily quota.
Worried about a burger's toll on your heart? Don't be. A recent study in the American Journal of Clinical Nutrition found that people who ate about five ounces of lean beef daily as part of a healthy diet lowered their cholesterol level by the same amount as those who ate less beef.
Myth: Wheat is wicked. The real deal: With celebrities such as Gwyneth Paltrow and Lady Gaga praising gluten-free diets, it comes as no surprise that sales of products made without gluten -- a protein found in wheat, barley, and rye -- have nearly tripled since 2006. But unless you're one of the estimated 7 percent of people in the United States with celiac disease or a gluten sensitivity, there's no need to avoid the stuff.
"Wheat is packed with important nutrients, including folate," says Jessica Crandall, RD, a dietitian in Denver and a spokeswoman for the Academy of Nutrition and Dietetics. Few gluten-free breads, cereals, or pastas, meanwhile, are a good source of folate, a B vitamin. "Shun whole grains completely and you may even wind up gaining weight," says Bonnie Taub-Dix, RD, the author ofRead It Before You Eat It. That's because they boost the level of the feel-good chemical serotonin in your brain, so if you skip them, chances are you'll feel unsatisfied and wind up snacking unnecessarily.
Myth: Sprinkling on less salt keeps sodium in check. The real deal: Nine in 10 Americans consume more than 2,300 milligrams of sodium, the recommended daily threshold, according to the Centers for Disease Control and Prevention. Laying off the shaker can help a little, but 90 percent of the sodium in our diets comes from processed and restaurant foods. "Manufacturers use it as a preservative, so it's found in items that don't even taste salty, like bread," says CDC epidemiologist Elena Kuklina, MD, PhD. The first step toward cutting back: reading labels. Go for breads with fewer than 100 milligrams a slice and soups with no more than 140 milligrams per serving.
Myth: Raw veggies rule. The real deal: There's no need to crunch through another plate of crudités in the name of nutrition. "Besides making vegetables more palatable, cooking can also increase their nutritional value," says Tammy Roberts, RD, a nutrition and health-education specialist at the University of Missouri Extension. In fact, Cornell University scientists found that stewing tomatoes for a half hour increased their cancer-fighting lycopene content by 35 percent. Cooking also unlocks another nutrient, beta-carotene, in corn and carrots. "Heat breaks down the fibrous cell walls, releasing more of these antioxidants," Roberts explains.
On the other hand, water-soluble vitamins, including vitamin C, are usually destroyed by heat. "To cover all your bases, eat a variety of vegetables," Roberts says. If you dig into a salad at lunch, consider serving roasted broccoli or carrots as a side dish at dinner.
Myth: Brown eggs are better than white. The real deal: Despite their higher price tag (they can cost up to 20 percent more), brown eggs aren't all they're cracked up to be. "Although they look more wholesome, they have the same nutritional breakdown as the white kind," Crandall says. "They simply come from a different breed of hen."
Instead, put your extra dollars toward omega-3-enriched eggs, which can deliver more than 600 milligrams of these heart-healthy fats, compared with the 30 milligrams provided by the regular kind. Researchers found that people who ate fortified eggs daily experienced a 32 percent decrease in their triglyceride level. For the biggest benefit, look for brands that contain both EPA and DHA, two easy-to-absorb omega-3s.
Myth: High-fructose corn syrup is worse for you than sugar. The real deal: It's been blamed for America's obesity crisis, but experts say that high-fructose corn syrup doesn't pave the way for weight gain any more than other sweeteners do. "From a biochemical standpoint, it's no different from sucrose, or table sugar," says Marion Nestle, PhD, a professor of nutrition, food studies, and public health at New York University and a coauthor of Why Calories Count: From Science to Politics. "It has the same number of calories, and the body processes both of them the same way."
The problem is that high-fructose corn syrup is extremely cheap, so manufacturers add it to countless products. As a result, Americans are consuming more of the sweet stuff than ever before. The bottom line: Limit your consumption of all added sugar, which can appear on labels as "dextrose," "maltose," "beet sugar," and "fruit juice concentrate."
Myth: Fried food makes you fat. The real deal: "Deep-frying can be just as healthy as sautéing," says Harold McGee, a food-science writer and the author of On Food and Cooking: The Science and Lore of the Kitchen. "When properly deep-fried, food soaks up minimal oil." Case in point: A chicken leg contains only 16 calories more when fried than it does when roasted. That's because the intense heat causes moisture inside the food to evaporate, creating steam pressure that blocks oil -- and calories -- from entering. To create this effect, the oil needs to be between 325 and 350 degrees for larger pieces of food, like chicken, and 375 to 400 degrees for smaller items, such as potato wedges. To know when the proper temperature has been hit, use a deep-frying or candy thermometer.
Myth: Loading up on fruit helps you slim down. The real deal: Some weight-loss plans consider fruit a freebie that dieters don't have to factor into their daily tally. But just because grapes are loaded with nutrients doesn't mean you should graze on them all day. "Fruit is high in vitamins and fiber," Taub-Dix says. "But it still contains calories and sugar." A banana, for instance, has roughly the same number of calories -- around 100 -- as two chocolate-chip cookies.
If you're trying to slim down, Taub-Dix recommends that you stick with four servings (a half cup or a piece of fruit counts as one) a day and pair each serving with some protein. "A handful of nuts or a cup of Greek yogurt will slow down digestion and keep your blood sugar levels steady," she says.

The Best Fat-Burning Workout for a Packed Gym

The best fat-burning workout for a packed gymIt's January, and you're ready to ramp up your results this year…but the gym is so packed that you can't even get to your favorite equipment. No worries-we've got your back. When it comes to getting in amazing shape in the shortest amount of time, you can't beat metabolic resistance training (MRT), a type of workout that maximizes caloric expenditure while also increasing your metabolic rate. The basic principles of MRT involve working in a circuit with little to no rest in between moves.
Studies have shown that MRT can help boost your calorie burn both during and up to 38 hours after your workout is over! Do this simple, small-space friendly routine at the gym or at home up to four non-consecutive days per week for best results.

How it works: Perform each set of moves in a circuit (back to back with little to no rest in between). Rest 60 to 90 seconds in between in each circuit, repeating the circuit 3 times total.
You will need: Free weights
Side lunge pressSide lunge press1. Side lunge front v-raise: Stand with feet together, holding dumbbell in right hand. Step right foot out and lower into a side lunge, reaching hands to the floor on either side of right foot [A].
Push off right leg and bring feet together as right arm presses dumbbell overhead with palm facing in. Repeat, lowering right arm down as right foot steps back out into side lunge [B]. Repeat on opposite side.

Single-leg squat rowSingle-leg squat row2. Single-leg squat row: Stand on left leg, holding dumbbell with left hand, right leg bent and right foot lifted slightly off the floor behind body. Bend left knee and squat down, hinging forward at hips and reaching arms down towards the floor, keeping spine straight [A].
Bend left elbow behind body and pull dumbbell into side of torso [B]. Extend left arm and return to starting position. Do 12 reps; repeat on opposite side. If you have trouble balancing, try this move in a split stance instead, with the back foot lightly tapped on the floor for stability.
Diamond pushupDiamond pushup3. Diamond pushup: Begin in plank position with feet slightly wider than hip width and hands together directly under chest, forming a diamond shape [shown]. Keeping abs drawn into spine, bend elbows and lower chest as close to the floor as possible without sagging through hips (elbows stay close to sides). Return to start. Modify on knees if needed.
Cross chopCross chop4. Cross chop: Stand with feet wider than hip width, holding dumbbell. Bend elbows and raise dumbbell to right shoulder (as if winding up to hit a baseball with a bat), rotating torso to the right, lifting left heel off the floor in preparation for the chop [A].
Engage abs and quickly lower dumbbell down and across to left knee, rotating torso to the left and lifting right heel to lower into a left lunge [B]. Immediately return to start. Do 12 reps; repeat on opposite side.

Even doctors want to know what health plans they are in

Striking a balance of price and reasonable access to quality medical care is an evolving issue nationwide, Insurance Commissioner Mike Kreidler told a leadership gathering of the American Medical Association on Jan. 10.

The key topic for the panel on Jan. 10: How insurance regulators, medical providers and insurance companies can guarantee patients access to quality care.

Several of the larger health insurers kept their rates down by limiting their provider networks,” Kreidler said during a panel discussion at the AMA’s 2014 State Legislative Strategy Conference in Tucson, AZ.  “This has upset both consumers and providers.”

Kreidler said that he noticed a trend by insurance companies last summer to develop “narrower networks” of doctors and hospitals in the new health plans they offered for the first time on Washington’s Health Benefits Exchange, which manages the Washington Healthplanfinder.

That’s the online site where consumers can shop for 46 health plans and, in many cases, get subsidies to help pay for premiums.

Consumers can also choose from 51 plans in the outside market, where subsidies are not available. Although narrower networks are found in these plans as well, the concern is more prominent in the Exchange.

In some cases, insurers did not contract with doctors and hospitals that had traditionally been part of their networks. The new business model emerged as a way for insurers to keep premiums as inexpensive as possible for consumers.

This development has raised a red flag for consumers and doctors alike. Kreidler recognized the issue when insurers began filing new plans last year. His office is now developing further guidelines to make sure that consumers have reasonable access to services.

More transparency about which doctors and facilities are included in the plans is another key aspect – for both consumers and the medical community. 

His office has already received many comments from consumer groups, doctors, insurers, Indian tribes, legislators and more. Draft rules will be ready in February and will be open for more public scrutiny.

Kreidler noted that this is just a first step.

 “We want to make sure that we have up-to-date information so that consumers know which networks their doctors are in,” Kreidler said. “Doctors also want to know the networks they’re in. What we want to do is establish a common frame of reference for everyone.”


Kreidler to speak on health reform at American Medical Assn event

Kreidler to speak on health reform at American Medical Assn event

Insurance Commissioner Mike Kreidler will offer his views at the American Medical Association's State Legislative Strategy event Jan. 10 on how the Affordable Care Act is changing the way insurance companies and medical providers offer services to consumers.

He'll be joined by a panel of experts, including:

·         Dr. Barbara L. McAneny, AMA Board of Trustees (moderator)

·         Margaret E. O’Kane, president, National Committee for Quality Assurance

·         David L. Cusano, senior research fellow, the Center on Health Insurance Reforms, Georgetown University Health Policy Institute

·         Dr. Donald Liss, vice president, clinical programs and policy, Independence Blue Cross and member of the AMA Innovators Committee
Key topic for the group: How insurance regulators, medical providers and insurance companies can guarantee patients access to high-qualify care.
Settlement Implies Release Will be Furnished

Settlement Implies Release Will be Furnished

In most cases, parties are able to agree on the form of release when a settlement has been reached.  A recent case confirmed that there is an implied agreement to furnish a release, unless there is an express agreement to the contrary.

In OZ Optics Limited v. Timbercon Inc., 2013 ONSC 6439 (S.C.J.), the parties agreed on a settlement, but were unable to agree on the wording of a release.  Justice McNamara held that the case law is clear that where a settlement is reached, it is normally implied that an executed final released will be provided, unless there is an agreement otherwise.  In the circumstances, there was no express agreement not to furnish a release.  Justice McNamara held that the draft release prepared by the plaintiff was fair, reasonable and reflective of the agreement reached by the parties.

10 Things Your Feet Say About Your Health

What can your toes tell you? The nurse just took your temperature, checked your blood pressure, and even made you step on the scale (with that heavy sweater on, no less). And as she hands you the paper gown, she gives her final directive: "You can leave your socks on."
When it comes to your health, that could be a big mistake. A change in your feet--whether on the skin, nails, or even how they feel--can be the first sign of a potentially serious problem that, if caught early, could save your life. "Our feet are the first parts to be affected by nerve issues because they're the farthest from our hearts and spine," explains Carolyn McAloon, DPM, a Bay Area podiatrist and president of the California Podiatric Medication Association. Even more reason to never ignore feet: They're easily compromised when our bodies feel threatened, since we send blood to the internal organs and the brain before the extremities.
Here, we reveal what could be lurking behind your most common foot concerns. If you see something familiar on the list, it's best to get it checked by your doc or podiatrist before attempting any treatment. 
Hairless feet and toes
What it might mean: Serious circulation problems

Sure, it's a pain during sandal season, but hair on your toes is a good thing. Sudden baldness can be a sign that your feet aren't getting enough blood flow to sustain hair growth. Expect your doctor to check for a pulse in your feet, which is another indication that your heart may not be able to pump enough blood to your feet, says Dr. McAloon. (Feet aren't your only cue to poor circulation. Read 8 Weird Health Tricks From Your Hands for more tips.)

Frequent foot cramping
What it might mean: Dehydration and nutritional deficiencies

Randomly occurring cramps are about as generic as foot problems get. They can be as serious as circulation and nerve issues, or as harmless as a nutritional deficiency. If you're exercising, be sure to drink plenty of water, since dehydration often leads to muscle cramping. You might also try upping your intake of potassium, magnesium, and calcium (with your doctor's go-ahead, of course), since their deficiencies make cramps more common. "For relief, soak feet in a warm foot bath and stretch your toes toward your nose, not pointing down," says Dr. McAloon. If the cramps don't let up, see your doctor for testing to rule out circulation issues or nerve damage.
A sore that won't heal
What it might mean: Diabetes or skin cancer

Stubborn sores are red flags for diabetes. Uncontrolled glucose levels in the blood can lead to nerve damage all the way down in your feet, which means any cut, sore, or scrape can come and go without you ever feeling it. And if it gets infected, the most serious cases may call for amputation.
A non-healing wound can also be a sign of skin cancer, says Dr. McAloon. Melanoma can pop up anywhere on your body--even in between your toes--so be sure to include your feet in your regular skin checks. (Brush up on your mole-detecting skills here.)
Perpetually cold feet
What it might mean: Hypothyroidism

Hypothyroidism is the most common cause of feet that just can't get warm. And if you're over 40, you could be living with a sluggish thyroid without even knowing it. Unfortunately, cold feet are the least of your problems--hypothyroidism can also cause hair loss, fatigue, unexplained weight gain, and depression. Get your feet feeling toasty again by heading to your doc for a simple blood test, and you'll start warming up shortly after starting the daily medication.
Suddenly enlarged big toe
What it might mean: Gout or other inflammatory issue

"The sudden onset of a red, hot, swollen, and painful joint requires immediate medical attention," says Dr. McAloon. Typical causes include gout, inflammatory arthritis, infection, or trauma.

What it might mean: Peripheral neuropathy or a pinched nerve

Numbness in both feet is known as peripheral neuropathy, caused most commonly by diabetes, chronic alcoholism, or a side effect of chemotherapy. If you're experiencing neuroma, or numbness in only one foot, it could be due to a pinched nerve in the foot, ankle or back. That's most likely caused by years of wearing tight shoes (we mean you, stiletto devotees.)
What it might mean: Inherited faulty foot structure

If you thought your bunions were caused exclusively by a closet full of gorgeous (yet restrictive and often painful) shoes, you can stop blaming the boutique. Bunions are actually a sign of a flawed foot structure that's often inherited and merely aggravated by inappropriate shoes. "The first foot bone drives toward the middle of the body, and you see the bump," explains Dr. McAloon. It can be painful and unsightly, but the only way to really correct it is with surgery.
Heel pain
What it might mean: Plantar fasciitis

You can't mistake it--that sharp pain in the bottom of the heel when you get out of bed or stand up from a chair. It's a strain of the ligament that supports you arch. And whether you did it by wearing too-tight shoes, walking in flip-flops, or wearing worn-out workout sneakers, the longer you let it go, the longer it takes to heal. Your podiatrist will probably tell you to ease up on your workout at first, rethink your footwear, and adopt a good stretching routine. 
Flaky, itchy, or peeling skin
What it might mean: Fungal infection

Even if you're never donned an athletic jersey in your life, you could still be walking around with athlete's foot--the euphemistic term for a fungal infection. The most common cause of itchiness and peeling, it can be treated by applying anti-fungal cream and keeping your feet as cool and dry as possible during the day. If you're fungus-free, you might be dealing with eczema or psoriasis--both to be determined by your podiatrist through a skin sample.

Yellow toenails
What it might mean: Fungus or pedicure overload

Seeing yellow when you look down? Don't freak out--especially if you've been wearing nail polish for months on end without a break. "Yellowness can also happen naturally with age," says Dr. McAloon. If it's accompanied by brittleness or flaking, it's most likely you have a fungal infection like athlete's foot. 

I’m confused--do I have health insurance or not?

I’m confused--do I have health insurance or not?

December was a very busy – and confusing – month for consumers who tried to sign up for health insurance through the Washington Healthplanfinder.

Ultimately, consumers had a deadline of 11:59 p.m. on Dec. 23 to, at a minimum, create an account in the Healtplanfinder. If you are one of those people, you have until Jan. 15 to complete an application, select a plan and pay the first month’s premium for coverage that will back-date to Jan. 1. For more information, refer to the Healthplanfinder’s frequently asked questions about retroactive enrollment.

If you did not meet the Dec. 23 deadline and you still need insurance, you have until Jan. 23 to select a plan and pay for it to have coverage effective Feb. 1.

Open enrollment for 2014 coverage ends on March 31. People eligible for Medicaid will be able to enroll through the Washington Healthplanfinder all year.

You can read more guidance from Washington’s Health Benefit Exchange in its Dec. 30 news release.

I paid my first health insurance premium, but I don’t have an ID card. What do I do?

I paid my first health insurance premium, but I don’t have an ID card. What do I do?

Yesterday, consumers were able to start using their insurance under the Affordable Care Act. Washington consumers can sign up using Washington Healthplanfinder.

While the Insurance Commissioner doesn’t administer the Washington Healthplanfinder, our consumer advocates are hearing from a lot of people who have completed their application and paid their first month’s insurance premium, but haven’t yet received their new insurance card or plan information. People want to know what will happen if they need to use their insurance before they get their insurance card.

Medical providers need your insurance ID number to bill them for your care; they don’t need the actual card. If you paid but do not yet have an ID number, you should contact your insurance plan and ask for that information. Your plan can also tell you when your card will likely arrive. If you feel more comfortable having a card, you can ask your company to tell you how to print a temporary ID card.

If you are not sure how to contact your plan, our website has contact information for each of the insurance companies that sells plans through Washington Healthplanfinder.

If you pay out-of-pocket for medical care because you don’t have ID number, you can submit a reimbursement request to your insurance company.