Insurance Update
September 2017
Issue No. 84
In this issue
Sound advice for protecting your hearing

About Us 
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  A not-for-profit ministry of
Church of the Brethren Benefit Trust Inc.

Church of the Brethren Insurance Services provides the following products: dental, vision, basic life and accidental death & dismemberment, supplemental life and AD&D, dependent life and AD&D, retiree life, long-term disability, short-term disability, voluntary accident insurance, and Medicare supplement for eligible Church of the Brethren employees .
Dental, vision, retiree life, and Medicare supplement coverage may also be available for eligible retired Church of the Brethren employees.
For eligibility information, call Connie Sandman at 800-746-1505, ext. 366, or contact your human resources representative.
Medical and ancillary plans (named above) may be available to Brethren-affiliated employer groups.
Long-Term Care Insurance is available for all members of the Church of the Brethren, their family and friends, and employees of Church of the Brethren-affiliated agencies, organizations, colleges, and retirement communities. 

Contact Us 
1505 Dundee Ave., Elgin, IL 60120

September: Transitioning to Fall

Certainly autumn, like each other season, has its own feel. But there is something about fall -- days when the air is brisk and dry and clear. The hills and trees burst into color. The kids are back at school and seeing their friends again and even enjoying, at least for a while, being back in the classroom.
Then there are the sounds of fall - leaves crunching under foot, kids raking and romping in the leaves, the cheer of the crowd at football games, the song of the wood thrush and the warbler, leaf-blowers making more noise than they should.
Thus just as each season has its feel, it also has its sound. Think for a moment how good it is to be able to hear the sounds of autumn, and then consider how it would be if your ability to hear gradually diminished. This issue of Insurance Update features the remarkable qualities of the ear, what might cause hearing loss, how it can be treated, and the devices that help. We hope you will find this informative, but more than that we hope it will remind you what a remarkable thing hearing is.
And we've included some tips on how to protect yourself from hearing loss, as well as several intriguing online tests you can take to see how good your hearing is.
We also want to remind you that September is the perfect time to consider a Medicare supplement policy -- especially valuable to those who have retired. Medicare supplement insurance pays for those things Parts A and B of Medicare do not cover.
As you know, our purpose is to bring you each month something that can contribute to your overall "wellness" as well as insurance information. You may not spend much time thinking about your ears, but this month we also invite you to ponder the extraordinary human ear and all that it means for us.
Medicare Supplement Insurance

Medicare supplement insurance can help you pay for some of the health care costs that Medicare parts A and B do not cover. Even when Medicare covers a significant portion of your healthcare costs, large medical bills can remain if a procedure is very expensive or a hospital stay is very long. This is where Medicare supplement insurance will help you.
Medicare supplement insurance is available through Brethren Insurance Services. Here are some general rules for Medicare supplement insurance policies -- 
  • To purchase a Medicare supplement policy, you must have Medicare Part A and Part B.
  • If you have a Medicare Advantage Plan, you must leave the Medicare Advantage Plan before your Medicare supplement policy begins.
  • Your Medicare supplement insurance premium is in addition to the monthly Part B premium that you pay to Medicare.
  • A Medicare supplement policy only covers one person. If you and your spouse both want Medicare supplemental coverage, you'll each have to buy separate policies.
  • Your Medicare supplement policy is guaranteed renewable even if you have health problems. Brethren Insurance Services will not cancel your Medicare supplement policy as long as you pay the premiums.
  • Medicare supplement policies do not include prescription drug coverage. If you want prescription drug coverage, you can join a Medicare Prescription Drug Plan (Part D).
  • Medicare supplement policies generally do not cover long-term care, vision or dental care, hearing aids, eyeglasses, or private-duty nursing.
Brethren Insurance Services offers Medicare supplement insurance to:
  • Medicare-eligible employees who work 20 or more hours per week at a participating Church of the Brethren church, organization, or agency with fewer than 20 employees (as well as their Medicare-eligible spouses).
  • Medicare-eligible retirees of a Church of the Brethren-affiliated employer, as well as their Medicare-eligible spouses, widows, or widowers, are also eligible for this product.
  • When you become eligible for Medicare -- typically at age 65 -- you must enroll in Medicare Part A and Part B as your primary coverage; you may then enroll in Medicare supplement insurance within six months of your Medicare eligibility date.
For a complete summary of benefits, visit

For other information, contact Brethren Insurance Services at or 800-746-1505, ext. 3366.
The Amazing Ear
The nature and complexity of hearing

The ear has three main parts. First, there is the skin-covered cartilage on the side of your skull that we call the ear. This external ear plus the channel running inside the skull, called the ear canal, make up the outer ear. Next, the eardrum and three very small bones make up the middle ear. Finally, the small, spiral, shell-shaped organ called the cochlea, and the auditory nerve together compose the inner ear.
Have you ever cupped your ear with your hand and noticed that you could hear better? Your hand increased the effectiveness of this sound-gathering appendage. It is this outer ear that collects sound waves traveling through the air and directs them down the ear canal to the eardrum or tympanic membrane, causing it to vibrate. These vibrations are then conducted through three tiny bones (or ossicles) which are called the malleus (hammer), incus (anvil), and stapes (stirrup). They have been given these nicknames because they resemble these objects. The ossicles are in the tympanic cavity, which is also connected to the Eustachian tube, which runs to the nasal cavities. That third bone, the stapes, is attached to the cochlea, passing the vibrations from the ossicles into fluid inside the cochlea, causing it to move tiny hair cells, which send neural signals to the auditory nerve, which then carries them to the brain. The brain reads these signals and turns them into meaningful sounds.
If you think about it, the vibrations composing sound make an extraordinary journey -- from the air, to a vibrating membrane, through pulsating bones, to waves in liquid, to oscillating hairs, to electrical signals, and finally to the brain. What an interesting and complex process hearing is!
When problems occur in this process
There are many ways problems can develop, and the result is hearing loss. Some hearing problems are present at birth. More than 50 percent of the time this congenital hearing loss comes from genetic factors; a gene from one or both parents has an impact on the development of some part of the outer, middle, or inner ear.
There are also non-genetic pre-natal factors such as a utero infection, illness, a toxin consumed during pregnancy, or a virus. Sometimes during the birth process itself, procedures taken to save the baby's life -- such as a ventilator or a strong antibiotic -- can affect hearing. Hearing loss can also occur after birth through chronic ear infections, ototoxic drugs, diseases such as meningitis or mumps, a head injury, or a perforated eardrum.
Scientists often identify hearing loss in five categories.
  1. Conductive -- where sound waves are not able to pass through the outer and/or middle ear This can be caused by a malformation in the ear structures. Or fluid can collect in the middle ear from colds or ear infections and can interfere with the movement of the eardrum and ossicles. Other causes are allergies, poor Eustachian tube function, a perforated eardrum, benign tumors, impacted earwax, infection in the ear canal, or even a foreign body in the ear.
  2. Sensorineural -- caused when damage to the tiny hairs in the cochlea prevent vibrations from being converted into electrical signals and sent to the brain through the auditory nerve. This can be caused by exposure to loud noise, head trauma, virus or disease, auto-immune inner ear disease, aging, malformation of the inner ear, tumors, Meniere's Disease, or by otosclerosis, which is a hereditary disorder in which a bony growth forms around one of the small bones in the middle ear, preventing it from vibrating when stimulated by sound.
  3. Mixed -- a combination of conductive and sensorineural loss.
  4. Neural -- results from damage to the auditory nerve.
  5. Auditory neuropathy -- where vibrations move normally through the ear but transmission to the brain is impaired.
It goes without saying that early diagnosis is important with infants. Ideally, newborns are screened before 1 month of age. If there are problems, diagnostic tests should be completed as soon as possible (preferably before 3 months of age). When infants with hearing loss receive early diagnosis and intervention they have a better chance for positive speech, language, and listening outcomes.
Treatments and aids
There are many sophisticated treatment possibilities to correct or minimize hearing loss. For congenital conductive issues, surgery may be possible. If the problem is not amenable to surgery, a bone-conduction or surgically implanted device may be considered. If the problem is caused by infection or a tumor or Eustachian tube dysfunction, antibiotics or antifungal medications might be indicated. With hearing loss from head trauma, surgery may work.
Either medication or surgery is indicated for sensorineural hearing loss, depending on the cause. Sometimes hearing aids can help. For irreversible sensorineural loss a cochlear implant, an electronic medical device that replaces the function of the damaged inner ear, may be called for. However, the most common way of treating hearing loss is to use a hearing aid.
Aging and auditory technology
With the aging population there is a larger and larger demand for hearing devices. According to the National Institutes of Health, "Approximately one in three people in the United States between the ages of 65 and 74 has hearing loss, and nearly half of those older than 75 have difficulty hearing." Age-related hearing loss generally occurs equally in both ears. It usually happens gradually so that people may not realize at first what they have lost. The most common causes are changes in the inner ear, but problems in the middle ear and along the nerve pathways may also lead to hearing loss.
Inner ear changes come from damage to the tiny sensory hair cells. Once damaged, they never grow back, and hearing is diminished. Long-term exposure to sounds that are too loud or last too long can cause this kind of damage. High blood pressure and diabetes, which are common in older people, can contribute to hearing loss. Some chemotherapy drugs are toxic to those hair cells. More rarely, hearing loss may be caused when the eardrum no longer functions well or when the tiny bones in the middle ear become less able to carry sound vibrations.
Scientists are unable to prevent age-related hearing loss, but people can protect themselves by avoiding damaging sounds - using earphones, earplugs, or ear muffs whenever they are faced with loud music, the din of snowmobile, lawnmower, or leaf blower engines, or just making a point to bypass the constant jangle and clamor of modern life.
If you think you might have hearing loss, ask yourself the following questions:
  1. Do you sometimes feel embarrassed when you meet new people because you struggle to hear?
  2. Do you feel frustrated when talking to members of your family because you have difficulty hearing them?
  3. Do you have difficulty hearing or understanding co-workers, clients, or customers?
  4. Do you feel restricted or limited by a hearing problem?
  5. Do you have difficulty hearing when visiting friends, relatives, or neighbors?
  6. Do you have trouble hearing in the movies or in the theater?
  7. Does a hearing problem cause you to argue with family members?
  8. Do you have trouble hearing the TV or radio at levels that are loud enough for others?
  9. Do you feel that any difficulty with your hearing limits your personal or social life?
  10. Do you have trouble hearing family or friends when you are together in a restaurant?
[If you would like to test yourself, go to the links below and try one or more of the online tests.]
How can the experts help you?
There are several kinds of highly skilled people to consult if you are having hearing problems.

An otolaryngologist is a doctor who specializes in diagnosing and treating diseases of the ear, nose, throat, and neck. This physician will try to find out why you're having trouble hearing and offer treatment options. He or she may also refer you to an audiologist.
An audiologist has specialized training in identifying and measuring the type and degree of hearing loss. Some audiologists may be licensed to fit hearing aids.
A hearing aid specialist is someone who is licensed by your state to conduct and evaluate basic hearing tests, offer counseling, and fit and test hearing aids.
Many styles of hearing aids
With the aging population, more and more people are wearing hearing aids, and there are many different kinds available. One of the distinguishing factors is the position of the device. There are tiny custom-fitted devices that are worn completely inside the ear and are invisible. Popular for cosmetic reasons, these are appropriate for mild-to-moderate hearing loss. There are also custom-made hearing aids that fit completely in the ear canal with only the tip of a small plastic handle showing. These are also for mild-to-moderate hearing loss. For mild-to-severe hearing loss, a device can be fitted into the ear canal with a portion of the hearing aid showing in the outer ear. Also for moderate-to-severe loss, a device can be fitted in plain sight into the outer ear. Then there are the hearing aids housed in a casing that rests behind the ear. A clear plastic tube directs amplified sound into an earbud fitted in the ear canal. This is for moderate-to-severe hearing loss. Click here to see some of the styles.
Though there have been great strides in technology, hearing aids have always had four basic components: (1) a microphone to pick up the sounds, (2) a processor to enhance the signal and deliver it to the (3) receiver, which then delivers it to the ear canal. A power source (4) drives the whole system.

The processor can separate incoming signals into two or more channels and process each channel separately. For example, a basic two-channel instrument may be programmed to give more amplification for high-frequency sounds than it gives for low-frequency sounds, in order to accommodate the kind of hearing loss you have. The more channels in a hearing aid, the greater the flexibility in programming, as the hearing aid prescription can be customized across the different frequencies, or pitches.

Here is what the new technology makes possible
Directional microphones boost sounds coming from the front of the wearer and reduce sounds from the back or sides, improving the ability to hear speech while dealing with background noise. Digital noise reduction analyzes the sound coming to the hearing aid and reduces unwanted noise. Impulse noise reduction detects and softens sudden and irregular loud noises like rattling car keys, the clicking of a keyboard, or rattling dishes. There are feedback management systems that combat the feedback whistling that often occurs in a hearing aid. Telecoil is a wireless feature that receives electromagnetic signals directly from special phones or sound systems in auditoriums and churches. Some hearing aids have Bluetooth connectivity features. Wind noise reduction detects the impact of wind and reduces its amplification. Some hearing aids have data logging, which means they store data about your listening environments and allow your hearing specialist to further customize your device. Some hearing aids can actually "learn" and adapt to your listening preferences. Finally binaural processing allows a pair of hearing aids to communicate wirelessly, thus mimicking the brain's ability to handle information coming from both ears. It keeps the hearing aids operating together. If the wearer makes an adjustment in one, the other adjusts automatically. Not only is the ear a complex and remarkable instrument, but the technology developed to aid it rises to match that sophistication.
Think about hearing
Think about the fact that you might get up early on a summer morning and walk outside and hear the birds singing; or sit in a concert hall while the music washes over you and lifts you; or listen to the inspiring sounds of the organ and the people singing in church, or the voices of those you love as they fill you with joy; or that you might be shocked by news you hear on the radio while driving to work; or that a car horn and screeching tires help you avoid an accident; or how you can sit in a movie theater literally surrounded by sound, or that you can watch TV late at night and hear every word of a rapid-fire dialog. These are moments we should not take for granted - they are moments in which we should feel grateful for the gift of hearing.  Especially now that we have learned of the amazing journey of sound going forward in roughly two-inches of space on each side of your skull, proceeding over and over at great speed, hour after hour, day after day. Be thankful for your amazing ears!
Online hearing tests

Here are four online tests. Each is different. Of course they cannot give you conclusive evidence on the state of your hearing, but they might convince you of the need to see a hearing specialist. Beyond that they are interesting, and you may simply enjoy them.

Brain Puzzle
We hope you are enjoying our  monthly BRAIN PUZZLES -- just for fun! This month's puzzle follows our theme of hearing and sound. 

LTCIIs it time to think about Long-Term Care Insurance?
Brethren Insurance Services offers Long-Term Care Insurance
Eligibility for long-term care insurance benefits is determined by the inability to meet at least two of these six activities of daily living -- bathing, eating, dressing, toileting, continence, or transferring. Cognitive impairment can also trigger benefits.
It's difficult to think about the fact that a debilitating condition or a disabling injury might leave you unable to care for yourself, or that when you reach your twilight years, the time will come when you will need some extra care. Long-term care insurance makes sure that you will get the care you need. It helps assure that the cost of your custodial care will not eat up your savings. Finally, and this is one of the best things about LTCI, it can help protect your children and other relatives from having to use their resources to care for you.
Brethren Insurance Services offers Long-Term Care Insurance for all members and employees of the Church of the Brethren and their family and friends; and also for employees of Church of the Brethren-affiliated agencies, organizations, colleges, and retirement communities and their families and friends.
If you are interested in obtaining this coverage, contact Brethren Insurance Services at or 800-746-1505 for a free, no-obligation proposal or  click here to request more information.