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Eating for a Heart Healthier You

Heart-healthy eating doesn’t have to be complicated or restrictive, and caring for your heart isn’t about one big change, but the small, everyday choices that support your long‑term health.

You don’t have to give up the foods you love. Making simple swaps and practicing mindful eating can make a big difference in your heart health. Below, you’ll find simple ways to start building heart-healthy habits.

What is Heart-Healthy Eating?

Heart-healthy eating is a proactive approach to lowering the risk of heart disease, heart attack, and stroke. Embrace a plan that works for you! Here are some ways to start making small changes:

  • Prioritize fruits, vegetables, whole grains, beans, and high-fiber foods. 
  • Incorporate lean proteins such as seafood, lean meats, beans, nuts, and soy products. 
  • Avoid saturated and trans fats, limit sodium, and alcohol, and reduce added sugar intake. 

How to Get Started

Begin by reflecting on what truly matters to you. Your personal motivations will be the driving force behind your commitment to heart-healthy eating. Explore your feelings about change and identify both the challenges and positive aspects. Draw inspiration from past successes, times when changes were easier, and apply that wisdom to your current journey.

Celebrate every small victory, whether creating a grocery store checklist, meal prepping, or opting for a healthier substitute—each positive change contributes to your overall success.

What Does Heart-Healthy Eating Look Like?

Choosing a heart-healthy diet doesn’t mean you need to say goodbye to your favorite recipes. Small modifications can make a big difference! Opt for heart-healthy choices by making small substitutions, like choosing:

  • Avocado oil or olive oil instead of shortening or margarine
  • Fat-free milk over whole milk
  • Lean proteins, such as ground turkey or extra-lean beef
  • Low-sodium alternatives or enhance flavor by replacing salt with herbs, spices, or lemon

5 Recipes for a Day of Heart-Healthy Eating

Healthy eating starts with food choices. You don’t have to be a chef when it comes to creating nutritious and heart-healthy meals for you and your family because the Resource Center’s Chef Leslie has got you covered! Here’s a sample day of heart-healthy meals you can try:

Visit our Recipe Library for more inspiration and easy substitutions/modifications for heart-healthy eating.

The Heart of the Matter

Small changes lead to big results. Start today and make heart health part of your everyday life. Your heart health is an investment in lifelong wellness filled with flavorful possibilities!

Visit The California Schools VEBA (CalVEBA) Cooking & Nutrition Hub to help you make informed choices about your dietary and lifestyle choices, supporting your journey towards better health and well-being.

The Resource Center offers many Cooking & Nutrition Classes. Join us to learn how to blend the art of food and cooking with the science of medicine to optimize your overall health and wellness – all while having fun! Check out our calendar to sign up for an upcoming class.

Do You Feel It In Your Gut?

There’s lots of buzz about gut health and how you can improve it, but probiotics alone are not the cure-all for gastrointestinal (GI) issues, as some may believe.

Probiotics are live microorganisms, often referred to as ‘good’ bacteria, that can provide health benefits when consumed in adequate amounts. They help balance the gut microbiome, support digestion, and can help improve some gastrointestinal conditions.

Probiotics

However, probiotics are considered safe for most people — except for people who are significantly immunocompromised — and may be worth using if they help with mild to moderate GI symptoms. 

More ways to help common GI symptoms include: 

  • High-fiber foods for people with symptoms of hemorrhoids or digestive conditions. 
  • Hydration and fiber for those with constipation. 
  • Avoidance of food triggers, such as caffeinated beverages, for people with reflux symptoms. 
  • General healthy lifestyle choices, including eating well, exercising, and avoiding tobacco and alcohol can also help. 

The Power of Protein & Fiber

While probiotics can be beneficial, incorporating adequate amounts of protein and fiber into your diet is essential for maintaining a healthy gut. Together, protein and fiber contribute to a healthy digestive system, supporting overall gut health and function. Your goal should be to aim for at least 10 grams of protein and 5-8 grams of fiber for your first meal.

Start Strong: Easy Options to Begin Your Day

  • An extra egg (96 grams of protein)
  • A scoop of protein powder (15-25 grams of protein)
  • ½ cup of Greek yogurt (10-12 grams of protein)
  • 4 ounces of tempeh (22 grams of protein)

Your gut plays a key role in your overall health and vitality. Take the first step towards better gut health with our Gut Check Toolkit. From lifestyle tips to delicious, gut-friendly recipes, it has the tools you need to nurture your digestive system and thrive.

Download The Toolkit

When to get help 

Unlike other organ systems, the GI tract can be taboo. Few individuals like to talk about their colon and bowel issues. However, it’s important to feel comfortable enough to discuss your digestive issues with your doctor so that you can find treatments to address potentially serious concerns. 

Symptoms that may indicate more severe GI tract problems include: 

  • Chronic diarrhea 
  • Rectal bleeding 
  • Black, tarry stools 
  • Unexplained weight loss or rapid weight gain 
  • Jaundice 
  • Iron-deficiency anemia 
  • Severe abdominal pain 

Talk with your doctor if you have new or concerning symptoms. Additionally, it’s important to get GI screening tests done at the proper age, such as colon cancer screening at age 45 for those who are at average risk.

Visit The California Schools VEBA (CalVEBA) Cooking & Nutrition Hub to help you make informed choices about your dietary and lifestyle choices, supporting your journey towards better health and well-being.

Not sure what preventative screenings you should be getting at your age? Download this infographic! 

Read this blog to learn more about colon cancer prevention. 

Learn about nutrition and holistic ways you can support your gut microbiome in CalVEBA’s Cooking & Nutrition classes led by Chef Leslie and Healing through Natural Medicine classes led by Dr. Ioanna Vouloumanou (Dr. V.) DAOM, LAc. Visit the class calendar to sign up for these educational classes.

This blog includes content from Sharp Health News, a publication of Sharp HealthCare.

Sleep and Your Mental Health

Dalai Lama

“Sleep is the best meditation.”

Getting a good night’s sleep isn’t just about feeling rested—it’s central to your mental and overall well-being. The National Sleep Foundation reports that over 90% of American adults with good sleep health experience minimal depressive symptoms.*

Healthy sleep enhances mood, regulates emotions, and improves concentration for better well-being. This post offers simple strategies to prioritize sleep so you can feel and function your best, starting tonight!

Getting your zzz’s

Why Sleep Matters

Even one night of poor sleep can reduce resilience and impair cognitive function. Quality sleep reduces stress and anxiety, improves focus, and increases empathy. If you have insomnia, the risks are even greater for developing serious mental health conditions. People experiencing sleep issues — including insomnia, hypersomnia (excessive sleepiness), and nightmares — have an increased risk of depression, suicidal ideations, and death by suicide.

Dreaming of Better Sleep?

Creating good sleep habits starts at home. Your daily routine, from the moment you wake up to what you eat and how you move, all contribute to better sleep.

Six Tips for Better Sleep

Take Control of Your Nights

1. Stick to a Schedule

Go to bed and wake up at the same time every day, even on weekends, to regulate your body’s internal clock (circadian rhythm).

2. Watch Your Intake

Steer clear of nicotine, caffeine, alcohol, and heavy meals close to bedtime.

3. Soak Up the Sun

Aim for 30 minutes of natural light in the morning to help set your sleep-wake cycle.

4. Stay Active

Exercise daily, but wrap up your workout a couple of hours before bed to allow your body to cool down and prepare for sleep.

5. Create Comfort

Keep your bedroom cool, dark, and quiet. Consider using a white noise machine or fan, use room-darkening-curtains, and maintain a temperature between 60 and 67 degrees.

6. Put Down the Devices

Reduce screen time at least one hour before bed. Studies show exposure to your phone’s blue light suppresses melatonin production (the hormone that regulates sleep).

Drift into Sleep: Meditation App & Classes

Apps like Calm and Headspace offer daily mindfulness and meditations to relax, release stress, and sleep better.

Check out our calendar and sign up for an upcoming meditation class at the VEBA Resource Center (VRC) or visit the on-demand video library for classes such as Yoga Nidra (Yoga for Sleep)

Sweet dreams! Here’s to better sleep, brighter days, and restful nights that support your mental health and enhance your well-being.

Bonus tip:

Wind down by bathing, reading, or listening to this 2-minute Simple Meditation.

*Source: National Sleep Foundation (2023, March 9). The Link Between Our Sleep Health and Mental Health. Sleep in America® Poll 2023. 

How to Quiet the Mind and Calm the Body 

In today’s fast-paced world, it can be easy to feel overwhelmed by constant distractions and a noisy mind. This mental clutter can lead to stress, anxiety, and even physical health issues.

Fortunately, mindfulness practices offer a powerful way to cultivate inner peace and improve overall well-being. The American Psychological Association highlights that mindfulness can significantly reduce stress, anxiety, and depression, aid in pain management and addiction recovery, and potentially boost the immune system.

Quiet Your Mind

Try these seven simple mindfulness practices to quiet your mind and calm your body:  

1. Stop To Rest

Notice what you see, hear, and feel in the moment you pause in stillness. Listen to this mindful moment meditation to soak in the beauty around you.

2. Relax with Your Breath

Take a deep breath and focus on your exhalation, feeling yourself letting go as you breathe out. Follow along with this 7-11 breathing practice.

3. Visual Awareness

Focus on something interesting or beautiful you see nearby and take a moment to notice its details. Follow along with this grounding meditation that engages your 5 senses.

4. Listen to Your Surroundings

Bring your attention to the sounds you hear and pause to listen carefully, focusing on each sound separately. Watch this guided meditation to tune into your surroundings and notice the sounds around you.

5. Check-In with Your Body

Bring your attention into your body and feel the sensations in each area. Release any tension or tightness and let relaxation spread. Watch this 10-minute guided chair yoga sequence to invigorate energy into the body.

6. Keep the Good Things in Mind

Imagine someone or something you love and feel the joy and serenity it brings to your life. Check out this journal prompt to help you reflect on moments of joy.

7. Focus on Gratitude

Think about someone or something you’re grateful for and reflect on how it enriches your life. Start your mornings with a virtual Gratitude Meditation class.

Calm Your Body

Incorporating these mindfulness practices into your daily routine can significantly enhance your ability to navigate life’s challenges with clarity and resilience. Embrace mindfulness and experience the transformative power of inner peace.

Thank you to our content partners at Sharp HealthCare.

California Schools VEBA (CalVEBA) Mindfulness Resources

Explore a variety of mindfulness classes, both virtual and in-person, by visiting our calendar. Access on-demand mindfulness and meditation videos anytime in our video library.

To watch more videos on mindfulness and ways to manage stress, check out our YouTube Channel.

Invest in Your Future Self: Proactive Mental Wellness Strategies

I am strong and resilient, capable of overcoming any challenge.

Yes, you are, and we are here to help! 

Mental well-being matters. We all experience stress, but you don’t have to feel overwhelmed. This post provides practical strategies and resources to help you proactively manage your mental wellness and build resilience for a happier, healthier future. 

The Power of Proactive Mental Wellness 

According to data from the Centers for Disease Control and Prevention, 12.5% of adults 18 and over experience regular feelings of worry, nervousness, or anxiety. 

When you’re stressed, your energy, emotions, and behaviors can feel off balance or scattered, leading to a state of dysregulation. Self-regulation, a cornerstone of mental well-being, lays the foundation for healthy behaviors and relationships. Self-regulation can help alleviate these symptoms, as well as help improve your sleep, self-esteem, relationships, and reduce your risk of medical issues like heart disease and high blood pressure. 

Ignoring your mental well-being can negatively impact your health, relationships, and overall quality of life. Being proactive, on the other hand, equips you to navigate challenges, build stronger relationships, and live a more fulfilling life. It’s all about investing in your future self. 

Let’s explore easy things you can do to re-regulate your brain, which in turn will help improve your mental health and well-being. 

Your Mental Well-being Toolkit: 5 Minutes to a Calmer You 

Ready to take charge? Even small steps can make a big difference. Our Mental Well-being Toolkit offers practical tools you can use in just five minutes a day to regulate your emotions and manage stress: 

  • Daily Self-Regulation Calendar: Filled with daily ideas to help you cultivate mental wellness. We’ve included a blank one so you can personalize your own.  
  • Affirmation List: Positive affirmations to boost self-confidence and maintain a positive mindset.  
  • Journal Prompts: Thought-provoking prompts to guide your self-reflection and integrate self-regulation into your routine.  
Download your free Mental Well-being Toolkit today!

Strategies for Stress Management & Mindfulness

Stress can disrupt your balance, affecting your energy, emotions, and behaviors. Self-regulation is key to navigating these challenges. Here are some additional strategies: 

Investing in Your Well-being

Mental and physical health are interconnected, which is why it’s so important to get your recommended screenings and health care visits. Screenings can vary by age, so we’ve put together an Infographic to help you keep track of what you need done and when. In addition, use the Doctor’s Visit Prep Guide to make the most of your appointment with your health care provider.

  • Yearly Screenings for All Ages: Stay on top of your health screenings with regular check-ins. Download Infographic. 
  • Doctor’s Visit Prep Guide: Be prepared before, during and after your visit with this helpful guide. Download the Prep Guide.

Professional Support: We’re Here to Help 

Feeling overwhelmed and looking for someone to talk to? We have programs to provide you with caring support and guidance for everything from how to handle emotional challenges to setting and achieving balanced goals aligned with your strengths, values, and identity. These resources are available to California Schools VEBA (CalVEBA) members and their dependents (aged 18+).

  • Optum Emotional Wellbeing Solutions (EWS): Available 24/7, experienced guides offer strategies and confidential support at no cost to you. Receive assistance (via phone or virtual appointments) for issues like stress management for you and your dependents. Call 888-625-4809 or visit www.liveandworkwell.com to get started. 
  • Whole Health Coaching: Get help identifying goals, strengths, and values to create a tailored health and wellness plan just for you. For more information on this six-session program, visit: Whole Health Coaching.

Explore More Resources

  • Classes: From meditation to sound healing, find classes to help you relax and refocus.  
  • Mental Health Blog: Practical strategies and insights for supporting your mental well-being. 
  • Videos: Guided meditations and self-regulation activities.  
  • Book & App Recommendations: Explore our curated list of resources for relaxation, stress management, and focus.

New Health Plan: Here’s What to Do Next

Selecting a new health plan that is right for your health and budget is an important part of healthy living. Now that you’ve made your selection, there are things you need to do to ensure the transition to the new plan goes smoothly. These steps can prevent disruption to your care, limit out-of-pocket expenses, and help you ​maximize your​ benefits.

Revisit Your Benefits

Refreshing your understanding of what’s covered by your plan is a good idea throughout the year, especially at the start of a plan year. Your best source of information is your health plan’s Summary of Benefits and Coverage (SBC). It’s an easy-to-understand overview of benefits and coverage provided by a health plan. Health insurance companies are required to provide this document for all plan types. We know this document can be intimidating, so we put together a guide defining terms, sections, and key information. You can view the guide here. Familiarize yourself with your plan’s coverage and benefits for the most value and cost savings.

Additionally, you’ll want to check to see if there are any pre-existing condition rules. The Affordable Care Act (ACA) prevents insurers from denying coverage or charging more for pre-existing conditions. But there are exceptions. Grandfathered health plans — plans in place on or before March 23, 2010 — aren’t required to have the same ACA protections. Check to see if your new plan falls in this category and what that might mean for you.

Take Advantage of Online Resources

You don’t have to worry about bringing your plan materials on the go with you. CalVEBA members can access their plan information online through the MyVEBA Member Portal. Register and sign in to:

  • View Your current health plan.
  • Access digital ID cards for yourself or your dependents.
  • Review your Summary of Benefits and Coverage (SBC).
  • Access plan documents and benefit resources.

Transfer Medical Records

Under the Health Insurance Portability and Accountability Act of 1996 (HIPAA), only you or your representative has a right to access your medical records. Providers and health plans can send your information to another provider or plan if it’s needed for care or payment — otherwise, you’ll need to permit them. If you’re changing PCPs, you’ll want to submit a Medical Records Transfer form or Medical Records Release form. Call your PCP’s office, and they can get one to you. 

Choosing the Right Primary Care Provider

Health happens beyond the doctor’s office, but meeting with your Primary Care Provider (PCP) can make all the difference in managing your overall well-being. Your PCP is your go-to resource for preventive care, specialist referrals, and personalized support, ensuring your care is consistent, coordinated, and aligned with your goals.

If your plan is a Health Maintenance Organization (HMO), your PCP will also help manage referrals, ensuring you only receive medically necessary care.

Here’s how to pick your PCP:

  • Contact The CalVEBA Advocacy Team at 888-276-0250 or through an online form. Be sure to have the following information ready:  
    • Name  
    • Date of Birth or Social Security Number  
    • Medical Group 
  • Use our new provider search tool, coming soon!

Is your new plan a Health Maintenance Organization (HMO)? HMOs typically require that you get referrals from your PCP to see specialists. That way, they can coordinate your care and make sure you’re getting what’s medically necessary.

Note: If you don’t select a PCP, one will automatically be assigned to you. You can change your PCP and medical group anytime during the year, but you cannot change your benefits plan.

Update Your Contact Information

Making sure your new plan has the right contact information for you is important. The goal is not to enable the insurance company to contact you unnecessarily. Rather, it’s to make sure that you receive plan information, claims are processed smoothly, and you get timely notifications.

Here When You Need Us

The Advocacy Team is here to help you navigate the healthcare system—whether it’s accessing care, dealing with referrals and prior authorizations, or making the most of your CalVEBA benefits for you and your family. 

If you have any questions, contact The Advocacy Team at 888-276-0250 or submit a contact form. For urgent requests, use the “Urgent” box on the contact form.

Health Happens Every Day 

Your wellness journey goes beyond routine doctor’s visits—good health is about daily choices to nourish and care for your body and mind. Whether you’re cooking a nutritious meal, practicing mindfulness, or getting active, every step counts toward building a balanced, healthy life. 

To help you on this journey, CalVEBA offers resources designed to support your daily health efforts. Explore tips and tools for maintaining a healthy lifestyle and staying on top of your wellness goals.  

Gut Check: The Link Between Gut Health and Mental Health

You may have heard sayings like “trust your gut,” “go with your gut,” or “a gut instinct.” These phrases all refer to an innate knowing or consciousness that comes from ​within us — specifically,​ our gut.

Interestingly, a growing body of scientific research reveals how our gut affects the rest of our bodies and even our mental well-being. This interconnectedness between our mind and gut health is becoming increasingly evident. In this article, we’ll review this connection and explore ways you can support your mental health by supporting your gut health.

What is the Gut-Brain Connection? 

You may not know but your gastrointestinal (GI) tract and your brain are constantly communicating with each other. This two-way conversation happens along what is called the gut-brain axis. It plays a crucial role in regulating both digestive function and mental function. This communication occurs through several pathways including: 

  • Enteric Nervous System (ENS) – two thin layers of more than 100 million nerve cells that line your GI tract, running from the esophagus to the rectum, and is often referred to as the second brain 
  • Vagus Nerve – one of the 12 cranial nerves that runs down and throughout your body 
  • Gut microbiome – the community of (friendly) bacteria and other microorganisms in your gut that produce or help produce chemical neurotransmitters 

Your Gut Health, Your Mental Health 

The gut-brain axis sends and receives information from your brain. The health of one can have a big impact on the health of the other. 

Stress Resilience

Recent studies shows that your gut health has a significant connection to how well you respond to and bounce back from stress. More specifically, people who are more resilient to stress have a microbiome that supports a reduction in inflammation and a strong gut barrier. This research suggests that a strong barrier enables the body to absorb nutrients better and blocks toxins that would create inflammation. If you have a weak barrier and lack the microbiome that prevents inflammation, a signal will make its way to the brain in the form of stress, priming your mind and body to be unable to let go of stress mode. 

Depression

The link between gut health and depression is becoming increasingly clear. One study discovered that people with depression and anxiety had less of a certain kind of bacteria related to the production of these short-chain fatty acids than others. Another study found gut microbiomes that lacked bacteria diversity often correlated with people living with depression.  

Mood Changes 

If you or someone you know is living with irritable bowel syndrome (IBS), constipation, diarrhea, and other stomach issues, you may notice mood shifts. That’s because your gut-brain axis communicates this irritation to the central nervous system — resulting in mood changes. A high percentage of people with these stomach issues often develop depression and anxiety, too. 

Taking Care of Your Health

Now you know the impact your gut health has on your mental health. How can you use this knowledge to support your mental health?  

Gut Healthy Diet 

What you eat plays a key role in maintaining a healthy gut. Certain foods can either promote or disrupt gut health. Try incorporating more: 

  • Probiotic foods and beverages like yogurt, sauerkraut, kefir, miso, tempeh, kombucha, and kimchi. 
  • Prebiotic foods like asparagus, apples, artichokes, bananas, oats, onion, garlic and prebiotic beverages.  
  • Soluble and insoluble fiber through fruits, ​vegetables​, beans, oats, legumes, barley, whole wheat, berries, and nuts. 
  • Antioxidants through ​vitamins ​C and E, beta carotene, and ​selenium-rich​ foods and drinks. 

In addition to what you add, it’s a good idea to consider what you need to take away. To reduce inflammation, consider saying no to foods with a high ​added sugar​ content, fried foods, packaged foods, and more. Studies suggest a link between eating highly processed foods and depression and anxiety. Don’t worry. There is room for most things in a healthy diet. So, you don’t have to go overboard in saying goodbye to a sweet treat or fast food forever. Let it be a ​“​nice to have sometimes​”​ rather than a ​“​have all the time.​”​   

Download “Gut Check: Your Essential Starter Kit” for guidance and recipes to support your journey toward better gut health. This starter kit provides practical tips and delicious recipes to help you incorporate gut-friendly foods into your diet and make informed choices about what to avoid.

The VEBA Resource Center offers members virtual cooking classes. You can learn how to cook deliciously and nutritiously for your gut. We also have a library ​of ​cooking videos featuring recipes you’ll love. Learn more here. 

Regular Exercise

Exercising regularly can improve the health of your gut and, therefore, mental health. Exercising increases gut mobility, improves circulation, strengthens digestive muscles, boosts your metabolism, and improves your sleep — all things good for your gut. You don’t have to run a marathon or take up extreme weightlifting. Any movement sustained for at least 30 minutes that elevates your heart rate and brings a sweat but allows you to ​breathe enough​ to talk is your goal.  

You and your doctor know your health needs best. It’s important to check with them before trying any new exercise. If you get the ok, try to exercise five days a week. But don’t let the idea of perfection get in the way of the good. Some weeks five days may be doable, and some weeks it may not. One day is better than no days. Also, you can break up the 30 minutes into two 15-minute increments or three 10-minute increments.  

Approach exercise with realistic expectations of self and consider reaching out for support. Joining a gym, hiring a trainer, or asking a friend to be an accountability buddy can be a huge help. The VEBA Resource Center has a library of on-demand videos for members that lets you exercise wherever and whenever works for you. Take a look at what we have to offer. 

Meditation

Meditation and mindfulness practices are recognized as having many health benefits. We know it intuitively from the general feeling of wellness after a few moments of mindful breathing or listening to a guided meditation. A study confirmed that deep meditation regulates your gut microbiome, therefore, supporting your mental health. You can use tools like a ​meditation​ app, go for ​a ​walk in nature, ​do ​yoga, and more. The VEBA Resource Center also offers virtual meditation classes so you can practice when and where it works for you. 

Here for Your Whole Health

We’re ​here​ to help you live your healthiest life. ​California ​​Schools ​VEBA offers resources, information, and support in a way that works for you. In-person or virtually, we’re here for your whole health.  

Discover Your Personalized Path to Wellness 

Whether you’re navigating a health challenge or striving to enhance your overall well-being, our Whole Health Coaching Program is designed to support you every step of the way. 

Partner with a dedicated Whole Health Coach to create a personalized wellness plan that addresses your physical well-being, emotional/mental health, and daily life. 

This program is ideal for you if: 

  • You have a specific health goal or challenge you want to tackle. 
  • You value professional guidance and support. 
  • You are ready to commit to making positive changes in your life. 

Take the first step towards a healthier, happier you. For more details, visit calveba.org/whole-health-coaching. 

Understanding Your Health Plan Coverage 

If you find health insurance confusing, rest assured, you are not alone. From uncommon terms to complex grids of benefits to cost share percentages, many people have trouble fully understanding their health plan coverage. In fact, one study shows that over half of the adults surveyed felt at least one part of their health insurance was difficult to understand. Let’s demystify your health plan by walking through where to find your benefits information and how to decode it. 

Summary of Benefits and Coverage

Your best source of information is your health plan’s Summary of Benefits and Coverage (SBC). It’s an easy-to-understand overview of benefits and coverage provided by a health plan. Health insurance companies are required to provide this document for all plan types so that prospective and current members know their benefits and are also able to compare plans more easily. With that said, there’s still a lot of to unpack in this document. Below you’ll find an explanation of each section. 

Plan Information

The SBC starts with general information about a plan. This includes the type of plan it is, dates the coverage is active, and who is covered. In addition, the introduction directs you to where you can find term definitions that will be used in the document.  

Important Questions

Following the general plan introduction is a section called Important Questions. It clarifies your share of costs for care like your deductible and out-of-pocket maximums. Additionally, this section explains the plan’s use of in-network and out-of-network providers and your access to each. 

Common Medical Events

Next is a grid of common medical scenarios, what you’ll pay for each, and any rules or limitations associated. You can use this section to really get into the nuts and bolts of a plan and determine if its coverage is right for your current health needs and budget.  

Exclusions

Some medical services are not covered by your plan such as cosmetic surgery, long-term care, coverage when you travel, and routine eye care. The SBC will outline what those are and what that means for you. Sometimes what’s not covered is just as important for you as what is so make sure to review this section, too. 

Coverage Examples

People learn differently. To ensure that everyone fully understands a plan, the SBC includes examples of coverage for specific medical conditions or events. One coverage and cost share example may be living with type 2 diabetes and another may be having a baby. 

Prescription Drug Coverage

If a plan includes prescription drug coverage, the SBC will direct you to a formulary or list of covered drugs and cost-sharing to review. Take the time to review that document even if you don’t have any prescriptions as that could change.  

Rights to Continued Coverage

This section lets you know that you have a right to continued coverage unless you move out of the coverage area, don’t pay your premiums, or fraud the insurer. A carrier cannot take away your coverage because of any health issues.  

Your Rights to Continue Coverage: There are agencies that can help if you want to continue your coverage after it ends. The contact information for those agencies is: [insert State, HHS, DOL, and/or other applicable agency contact information]. Other coverage options may be available to you, too, including buying individual insurance coverage through the Health Insurance Marketplace. For more information about the Marketplace, visit www.HealthCare.gov or call 1-800-318- 2596. 

Where and When to Review Your SBC

Now that you know the basics of a SBC, you can review it when you want to confirm your current coverage or compare coverage options. You can access your current plan’s SBC on MyVEBA. With Open Enrollment starting, you should be provided a new one soon. Under the Affordable Care Act, the SBC must be distributed with enrollment forms. If there is an auto-renew of a plan, employers must provide the SBC within 30 days of the plan beginning. Sometimes plans change coverage during the year. You’ll receive a new SBC with those changes at least 60 days in advance. So make sure to review any important plan inform 

Working Together for Your Healthiest Life

If you find this blog helpful in understanding health insurance and the open enrollment period, be sure to check out the other blogs in this series for more in-depth information here. 

Get Support: The VEBA Advocacy Team can help you review your health plan and discuss it with you in depth. Call 888-276-0250 or visit calveba.org/contact for assistance. For urgent requests, use the “Urgent” box on the contact form. 

MyVEBA Portal: Easily view your current health plan information through the online portal.

Benefit Contacts: For assistance with specific carrier benefits or issues, such as claims or coverage details, visit calveba.org/benefit-contacts to contact them directly.    

Keeping Your Health and Budget Covered 

Did you know?

Supporting your health while meeting your budget needs is uniquely challenging in today’s world. With the costs of healthcare projected to rise to a 13 year high, what you’ll pay for care is an essential factor in evaluating a health plan.

Whether it’s your current plan or plans you’re considering, taking the time to understand the total costs of your care can keep both your health and budget covered. 

Itemizing Health Plan Costs 

When you think of costs associated with a health plan, you likely think of what comes out of each paycheck for the monthly premium. Monthly premiums are an important consideration, however, there are other costs to note. These costs include: 

Monthly Premiums

The monthly payment made for an insurance policy.

Deductible

What you pay each year before your health plan shares costs. Review your Summary of Benefits and Coverage (SBC) to see what payments are counted towards your deductible.

Coinsurance

The percentage of costs for care you are responsible to pay and is billed to you after the service is performed by the provider or facility.

Copayment or Copay

The fixed amount you pay for medical services, such as office visits or prescription medicines. It is usually paid at the time of your appointment.

Out-of-Pocket Costs

What you pay for healthcare expenses, including things like deductibles, coinsurance, or copays.

Out-of-Pocket Maximum

The most you will pay for healthcare expenses in a year.

Prescription drug costs

Costs for prescribed drugs depend on what tier the drug is in, whether it’s brand or generic, what pharmacy you go to, and more. 

Consider Cost Balance 

The costs of a health plan need to be considered in relation to each other. Some plan, like High Deductible Health Plans (HDHP), offer a lower monthly premium, meaning you’ll pay less per paycheck. However, you may pay more for care overall if you have significant health needs. Conversely, a plan with higher premiums will usually have lower deductibles, lowering the total amount you’d pay for care over time.

They typically work best for those who use health coverage often and those living with chronic conditions. As you consider the different costs of a health plan, balance the costs with your current health needs to, ultimately, protect your budget.  

Where to Find Cost Information 

Your best source of information is your health plan’s Summary of Benefits and Coverage SBC. It’s an easy-to-understand overview of benefits and coverage provided by a health plan. The SBC gives you a snapshot of what costs you can expect to pay throughout the year for care under your health plan. You can use this document to compare the total costs of care you can expect with each plan you’re considering – if you decide your current plan isn’t right for you or simply want to see your options.  

Questions? We Can Help.  

As you review your plan and maybe other plan options during Open Enrollment, we’re here to help make the process as easy and simple as we can. Reach out to The California Schools VEBA Advocacy Team at 888-276-0250 (Monday-Friday from 8 am – 5 pm).

What is Open Enrollment?

In the United States, most people sign up for health care plans during the annual Open Enrollment. Navigating health care plans can be confusing, so it’s important to be well-informed about your options – whether or not you intend to switch your plan. 

Open Enrollment is a critical window that can affect you, and your family’s health care options for years to come. Looking at health care plans can bring up questions, especially before Open Enrollment. Going in prepared helps to ensure that you make the best choice for you and your family. 

Here’s a comprehensive list of questions and answers to help you easily navigate Open Enrollment.  

What exactly is Open Enrollment?

Open Enrollment is when individuals and families in the U.S. can sign up for insurance plans each year. During this period, you can look at and purchase a plan typically through the Health Insurance Marketplace or your employer.  

When is the Open Enrollment period? 

The Open Enrollment period can vary slightly depending on your employer. Your employer’s Open Enrollment dates are unique. Please contact your Benefits Administrator for more information on your enrollment period to ensure you sign up for coverage within your window. 

Pro Tip: Mark these dates on your calendar so you don’t miss this critical window. 

What changes can I make during Open Enrollment?

Open Enrollment is the time to evaluate your current and future health care needs and make any necessary changes. During this period, you can choose a new insurance company and plan to find one that best suits your changing health care needs. 

You can also renew your health insurance, as well as add or remove dependents or spouses, and adjust your adult vision and dental coverage.  

Do I always need to review my options?

It can be tempting to just stick with the plan you already have. It’s important to review your options each year, even if your budget or health care needs haven’t changed. 

This is because many factors can affect the price and service offered by your insurance provider that are out of your control. Other factors that may impact your health care plan include states changing the prices of certain premiums or having new insurers enter the marketplace.  

Reviewing your options is an important part of being proactive about your health and well-being. 

Who needs to enroll during Open Enrollment?

Every person who is not a dependent should take part in Open Enrollment. That includes whether or not you want to make changes to your existing plan. Open Enrollment applies to you whether you’re purchasing insurance through the marketplace, Medicare, or your employer. 

What terms do I need to know before Open Enrollment?

There are a lot of confusing terms in the world of health care. Here are some of the top ones you should know before Open Enrollment: 

  • Deductible: How much you must spend for covered health services before your insurance company pays anything (except free preventive services). 
  • Copay: A fixed amount of money that an individual is required to pay out-of-pocket for a specific health care service or medication, typically at the time of service.  
  • Coinsurance: A cost-sharing arrangement in health care where the insured individual is responsible for paying a percentage of the covered medical expenses, typically after meeting their deductible.  
  • Premium: Premium refers to the amount of money an individual or entity pays to an insurance company in exchange for insurance coverage. This is usually paid monthly or annually. 
  • Out-of-pocket maximum: The maximum amount an individual is required to pay for covered health care services during a specific period, usually a calendar year.  

What happens if I miss the Open Enrollment period?

If you miss the Open Enrollment, your plan typically automatically renews for the next year. If your current plan is no longer available, you may be enrolled in a similar plan instead. If you don’t currently have a health care plan, you may miss your opportunity to enroll unless you meet certain requirements. 

The restrictions around Open Enrollment can vary depending on the state, income level, and whether you are eligible for Medicare. Native Americans can enroll in a health plan at any time, without needing a qualifying event. 

How do I compare the costs of different plans?

One of the most important factors to consider when choosing a plan is the cost compared to the benefits received. People often just look at the monthly premium, however, there’s much more that goes into the cost of your insurance. 

Besides the premium, some other costs to consider are your deductible, copayments and coinsurance, out-of-pocket maximum, and your estimated health care needs for the year. 

Will I receive new ID cards this year? 

As technology evolves so will your health insurance! No, you will not be receiving your new insurance ID cards in the mail like you typically do. In 2025, all carrier ID cards will be digital.  

You receive more information about your new digital ID cards during Open Enrollment. If you’d prefer a physical ID card, you can still request one from your plan carrier.

How should I prepare for Open Enrollment?

It’s almost Open Enrollment, and being prepared will make this process that much easier. Here a few more things to keep in mind as you prepare for Open Enrollment: 

  • Know how much health care you may need next year, including wiggle room for emergencies or the unexpected. 
  • See if your preferred providers and hospitals are within the network of the plans you’re looking at. 
  • Are you or your family expecting any changing medical needs in the next year such as pregnancy or surgery? 

Once you have a good idea of your budget and health care needs, ask your employee benefits contact for more information on where and when to enroll. With all this information at your fingertips, you’ll be able to easily pick out the best plan for you and your family. 

If you find this blog helpful in understanding health insurance and the open enrollment period, be sure to check out the other blogs in this series for more in-depth information here. 

VEBA Resources  

MyVEBA Portal: Easily view your current health plan information through the .   

Benefit Contacts: For assistance with specific carrier benefits or issues, such as claims or coverage details, visit calveba.org/benefit-contacts to contact them directly.    

Get Support: The VEBA Advocacy Team can help you review your health plan and discuss it with you in depth. Call 888-276-0250 or visit calveba.org/contact for assistance. For urgent requests, use the “Urgent” box on the contact form.