Monday, December 31, 2012

my last day at work and a guide to finding health insurance

Today is my second to last day at work.  In just a few hours, I will be going around singing this song.

Most of you just know me as a bike racer and blogger.  But since I graduated college, I have been dedicated to the non-profit field, working in community health and on policy initiatives aimed at expanding health care access for the uninsured and underserved populations.  My last day is January 2nd.  It is a bit of bittersweet time for me.   And given that it is my second to last day at work and the office is completely empty, and I only have a few more files to sort through, I thought I'd take a little time to reflect on my time and use some of my knowledge to cover a topic that a lot of readers might find helpful: finding health insurance!

My background

For the last five years, I have worked at the Alameda Health Consortium in the program and policy department.  This is a small non-profit that is an association of community clinic in the county.  My work has mostly focused on providing support services to clinics that serve the uninsured population.  I have worked on some truly great projects over the years....creating a website, that provides comprehensive health care information for people in the county who don't have insurance, translated fully in Spanish and Chinese....organizing marches, rallies, and other advocacy events with clinic patients and staff.... creating a partnership with the community colleges to offer continuing education classes to clinic employees....working with primary care provider by offering training in specialty care....lots and lots of data with eligibility enrollment systems and programs.  And I am sure lots of other stuff.

My health insurance through my work will be ending on January 31st, and I have three options: to enrollment in my employer's COBRA program (which will cost me $380/month), purchase a private health plan, or go without insurance.

Given that I have spent my entire adult life working on issues of the uninsured, the third isn't really an option.  Although given the amount of case work I have done and my knowledge of and ability to maneuver the many bureaucracies... I probably am the most prepared to be uninsured!

Anyway, as I am going through the process of purchasing insurance, I thought there may be many readers and bike racers reading this, who were interested in some information.  So, I thought I'd provide a rare, somewhat useful blog post.

Finding health insurance, a short guide:

If you are looking to purchase health insurance, I would first direct you to the website:   I have looked as several, and I think this is the most comprehensive and best site that compares difference insurance plans.  You type in your birthdate and zipcode, and can see a variety of health insurance plans. It is easy to use and you can sort and toggle options in a variety of ways.  You can compare things like your monthly premium, deductible, coinsurance, and copays. 
If those words are greek to you... a premium is what you pay every month, whether or not you use it.  A deductible is how much you pay "out of pocket" until your insurance "kicks in."  If your deductible is $1,000, then you most spend that much money before your policy begins.  Coinsurance of 30... means that, after the deducible, you pay 30%, the plan pays 70%.  Up until your out-of-pocket maximum... meaning, that is most you will ever pay in a given year.  Lastly, copay is what you pay at the door of a visit; usually, you have either a copay or coinsurance. 
After looking at my plan options, I decided to go with a high-deductible plan, as I don't use the doctor very often, and preferred a smaller monthly premium, as I don't have a lot of income coming in right now.  I went with a plan offered by Kaiser Permanente, as that is where I have had coverage for the last 8 years.  I could have decided to go with a plan offered by Blue Shield, Blue Cross, Health Net, etc. - but I have been in the Kaiser system a long time, and didn't feel like change.  I went with the 2700/30 plan, which was a $2,700 deductible, and then a 30% coinsurance, for $149/month.  The reason I went with this plan, was because I could also purchase an HSA to cover my expenses.

A Health Savings Account, is a pre-tax account, where you can set aside money to pay for your health expenses.  It rolls over from year to year (differing from a Flexible Spending Account that many people are familiar with).  In addition to paying my premium, I can also set aside some money to my HSA, that I can use to pay down on my deductible (if needed), and also use for things like dental, optometry and eye glasses, chiropractic, and acupuncture.  I wondered if I could use my HSA to pay for my then I would be able to pay for my health insurance pre-tax.  You can only use your HSA to pay for your premium if you are received unemployment benefits. If you are doing COBRA through your employer, you can use an HSA to pay for that as well.

I did a bit of research on HSAs.  They are typically offered through banks, e.g. Wells Fargo, Chase, US Bank.  Some have start-up fees, some have small monthly fees for administration, some allow you to invest money, some provide interest to contributions, etc.  All of them I found offer a debit card that you can use to pay for your expenses.  Here is one list I found of HSA administrators.  I decided to go with the OptumHealth HSA.  After the financial meltdown, I closed my bank account, and enrolled in a credit union... so there was no way I was going to open an account with Wells Fargo or Chase.  I don't know much about OptumHealth, other than they support a bike team, so I thought they should get my business!  Also, I was very impressed with their packets and information on their website. 

If you put $500-$1000 in your HSA, you can that pre-tax, and then can use that for health expenses.  (Here is a calculator you can estimate how much savings it would be to you to do this pre-tax)  If you don't use it this year, it rolls over.  I will prefer to set aside a little bit of money each month to put in the HSA, so if I ever had an accident, then I will be able to use the HSA to spend-down on my Kaiser deductible.  It is also kind of nice, because if I go to the chiropractor, accupuncture, or buy some new contacts of glasses, then I can do that all pre-tax.  I don't know how much savings that would really be, but I am counting pennies now, so every bit helps!

Getting denied


I did not get denied due to a per-existing condition, but it does happen!   Thankfully, because of the Affordable Care Act (e.g. health reform), no one will need to worry about this after this year!  But in the meantime, if you get denied, here are your options.  The most obvious option is to make an appeal, or apply to another company.  But, there is another option.

As part of the Affordable Care Act, each state is required to operate a "Pre-Existing Insurance Plan" where you cannot get denied because of your health status.  You have to show proof that you got denied from a carrier.  So, keep that letter!  The deducibles vary by state, but I believe they can be no more than $2,000.  For people age 20 - 35, the premiums are usually in the $150 - $250 range.  The above link is the federal government link.  For some states, the federal government administers the program, and for others, the states administer it,  itself.  You might need to dig around a bit. If you are having trouble finding your states info, feel free to email me... bethbikes at gmail.

Under 25

If you are under 25 years old, you can stay on your parents insurance -- if they have employer-based insurance --  and that might be the best option for you.   You should have your parents talk to their employer about this.  The amount of cost-sharing might vary.

Still uninsured?

If you didn't heed anything in this guide, and are still uninsured - a few tips.   If you need primary care, you should go to a community health center.  They typically have a "sliding fee scale" where you can pay less.  Here is a national database where you can search.  This might not be the best source for your information, but it is a start.  

If you have to go the ER, go to the public hospital.  Prices will be less expensive for you, and they are more likely to have charity care programs that deduct your costs.  If you have a bill you can't pay, know your rights and your payment options.  Here is a website to get you started.  Be sure to contact your state Ombudsman.  Each state has one and you can file disputes and they will help you negotiate the process.  These are all free services, so look into these first.

Health Reform?

This will ALL be changing next year... the affordable care act will require everyone to purchase insurance and will offer subsidies and a centralized place ("the exchange") for people to research and purchase insurance.  These things are all getting established currently, and enrollment for your new policies will occur this fall.  Insurance companies will be required to offer a minimum amount of services, and people will be able to get assistance with their policies, based on their income.  Of course, if you receive insurance through your work, not much will change... except that certain employers who offered crap policies will now be required to provide more robust options.  Anyway, as more information on the roll-out process begins, I will write a new post to help guide people through the process.  I, myself, will be enrolling in the exchange - so I can offer some first-hand knowledge.

That is a wrap

This was probably the most boring blog post I have ever written, but hopefully someone found it useful.  If you have questions - please leave them in the comments, as someone else might have the same question, and then I can answer it.

Thanks for reading!

Thursday, August 23, 2012

scrapers - i am specialized

it is no surprise that i grew up a fairly sheltered life in suburbia, ohio.  i went to college in a different (but equally) sheltered environment  at a small liberal arts school in connecticut.  after college i moved out to the bay area to near-berkeley (technically, north oakland, but berkeley pretty much just vomits into this section of town).  this too, sheltered.  the last eight years i have bounced around different parts of oakland. now, i live in east oakland, which i will say is totally legit. 

the first time i heard the word "scraper" was in the spring of 2007, when i was a juror on a murder trial.  the kinda creepy district attorney on the case attempted to give a definition of the term "scraper" to the pretty (square) jury.  i somehow knew something was lost in translation, so i consulted urban dictionary that night, probably against court protocol.

since then, i started noticing scrapers ALL the time... especially once i moved from lake merritt to allendale, and now to eastmont.


I LOVE THEM!  i know i am a super white girl from the midwest with about zero street cred - but i think the rims and colorful cars are so damn cool!!

thus, i am beginning a new photo series...  I AM SPECIALIZED

here are the first two shots from my ride yesterday.

unfortunately i missed the picture of my bike with the AWESOME bright blue scraper with huge rims and the candy red scraper -- as we were both rolling, and i couldn't get a picture of my bike with the car.

note: the photo series is a BIKE with a scraper, not just a scraper on its own.  anybody can take a picture of a car.  join the fun if you can- get a picture of your bike with some sweet scraper.  ....and sorry if you live in the peninsula or marin....or colorado or oregon, etc, etc.... a prius or subaru doesn't count.

#oakland #scraper @IAMSPECIALIZED

Monday, August 06, 2012

NY Times - Yep, I made it!

my awesome blog - which doesn't even have a unique domain name - has been cited by the new york times as expert opinion.

when i got a random email from greg bishop, the journalist who wrote the article, i was a shocked, to be honest.  'me?  a expert opinion on quads?  AWESOME.  i hoped he found me by googling "big quads" or something like that... but i found out the U.S. national coach, Ben Sharp, referred him to my blog....which gives some street cred to the coach who also brought home a silver medal. 

don't believe me? it even made the front page of the online nytimes!  Here is a screenshot i took at 8:15am.

and here is a screenshot i took at 9:30am.  it looks like QUADS bumped lebron james as trending article.  yeah, dog!

anyway, mr. bishop emailed me a bunch of hilarious questions.  they were so awesome, i want to publish the interview in full.  enjoy!


Let's start with the genesis of the blog. How did it come about? How did quads become a sub-topic? How did you come to write the legendary quad post?

I started by blog (http://bethbikes.blogspot.
com/) when I first started cycling, back in 2007 (there’s an article about how I got into cycling in our region’s weekly:

Blogging was kind of "the thing" back then, before Facebook and Twitter ( saturated social media. Tons of people in the biking community in Northern California were blogging, and it became a fun way to communicate with people between the weekend races.  At that point in time, I was definitely blogging more than training.

I measured my quads the first time back in the summer of 2007.  It was kind of a joke, a very skinny friend of mine would kid me that my quads were bigger than her head.  I rolled with it and did a measurement and wrote a blog post about it.  A few other people tried to measure their quads on their own blogs - but they were measuring in the wrong spots.  I mean, cyclists (especially "roadies" ... aka road riders) have an obsession with being skinny - so I had to kick that mindset in the pants, and sort of became a crusader to glorify the big quad.  

How did you learn about the proper way to measure quads? Or is that your step-by-step guide, ie something you made up?
Have you ever had to correct someone?

I made it up.  I mean, I had very big quads at the time – and yeah, maybe they weren’t all muscle … but I wanted to make the rules so I would win!   What’s the saying: "you no playa da game you no maka da rules"?

Anyway, the point of measuring quads is to get the biggest number possible.  It isn't like measuring waist lines for skinny-minnies … this is about bragging about massive (sometimes) muscular quads!  So, naturally, you measure in the biggest spot.  I have to correct people all the time as they almost always measure to low, saying "oh that is just fat up there."   Sure, that may be true …. but people making those kind of comments obviously didn’t get the point of measuring quads.  Go big or go home!

This might be a dumb question, but you say in the blog that you can measure improvement by measuring the quads. What would be indicative of progress? Like how much could someone gain, ie your quad before cycling, afterward?

Quad size does not necessarily correlate with cycling speed, but that doesn't mean huge muscular quads aren't awesome.  Back when I was writing about quads all the time (and doing my first races), I was measuring in above 60cm in diameter!   Now, that’s pretty huge … but nothing in comparison to someone like Jennie Reed (world Keirin Champ and current Olympian for the US Team Pursuit) who’s quads were OFF THE CHARTS!  Nowadays, I am a measly 57cm … which is puny.  But now I am a national champion, so I guess I can't be too down on myself for losing some of my quad-tasticness.  

Anyway, the measuring is a fun thing to do, like after races - it is a good way to bond with competitors (keep things friendly – after all, it is just a bike race!), and to check out their goods up close when you put a tape measure around their leg and give a little squeeze.  But, you probably should get permission before grabbing folks thighs.  Otherwise, you could get a knee somewhere you don’t want.

Regardless of measurement size, quads are a major intimidating factor across all cycling disciplines.  For real - we bike racers ALWAYS check out our competitors’ legs.  Bike racing is totally mental, so the more you can psych out your competitors with intimidating legs, the better.  And there are a few things you can do make your quads look better.  Rub on some of that warming oil before a race - the shine makes the muscles look way bigger and if you’re lucky (or dehydrated), you might even get a little bit of that freaky ‘cut’ look that bodybuilder types get.  Or, you can make sure that your team’s clothing has a design that creates a bulging (not slimming) effect in the quads.  Thinning stripes are a serious no-no.  Some cycling kit designers totally don’t get it! Oh, and when standing around before a race or at a podium presentation, be sure to flex and stand in a way that makes your quads look their biggest.  It’s all about the presentation.  

Speaking of, is there a range of acceptable quad size in cycling?

I am sure that height has something to do with it, but if you are over 60cm you are pretty badass.  And we always measure metric.  It's international friendly.

Who has the biggest quads?

Jennie Reed's quads are pretty big.  I saw them up close and got to measure them once.  It was awesome!  What is most impressive about her quads is that the lower quad muscles by her knees are almost as big as the muscles up by her hip bone.  Dude - that is why she is a world champion!  I know that German guy, Robert Förstemann, could be the Quadzilla of the cycling world … but, Jennie Reed’s are legit.  And she doesn’t use a tanning salon.

Inline image 1
Jennie Reed’s quads and mine

Inline image 2 
Me measuring Jennie Reed’s quads.  World Champ Stripes – FTW!

The skinniest? And do they get made fun of for how small their quads are?

Amber Neben's quads are pretty small, but she can pretty much kick anyone's butt whenever she wants, so I doubt she gets made fun of for it.  She’s a world champion in the time trial and rides more miles in a month than most trackies do in a year … I mean, she probably does five hill repeats while a track sprinter is still resting between their first and second 8 second sprint.  But if Amber ever came out to the velodrome, I’d totally make fun of her quads and make her leg wrestle me.

Any urban legends from the past? (Like this dude had quads the size of oak trees in 1912.)

Those German track sprinters are pretty much legendary.  I don't think any of them have names, even - they just get referred to by their quad size … “Herr Achtzig to the line”

Love this line: Friends and strangers love touching your strong legs.  ... How often has that happened? Unprompted? Any strange stories in that regard?

Well … I force my fiancé (and coach) to massage my legs all the time … so that’s not really unprompted … but, I can say that he loves touching strong legs.  But at this point in our relationship, it’s only my legs he’s going to ever touch again!!  I don’t care if some 61cm chick goes waltzing down the street!

Perhaps another dumb question. But what exercises are best to make quads bigger? How often do you lift? Reps? Most cyclists say they don't do a lot of upper body. I think that plays into this. Do you agree?

Weight lifting can definitely bulk up the quads.  The one year I did Olympic lifting at this awesome Tongan gym in Oakland, I got up over 60cm.  But I also ate a crap-ton of ice cream that year, too - so, I’m not sure if that’s causation or correlation.  Anyway, that was back when I thought I was a track sprinter ... and now that I have conceded to my fate of being an track enduro and (gasp) a roadie - I really don't lift much anymore.  Well, my coach does make me do core work and some weights for my arms to keep my biceps from being laughable.  Biceps can be intimidating, too …so, I think weight lifting is important if you want to intimidate other racers and aren’t interested in getting a bunch of tattoos or body piercings.

Have you ever participated in a quad-off? 

Not really.  Most of my competitions were virtual via the internet.  And we know how much lying goes on over the webs … but I did do some leg wrestling a few times.  That was awesome.  But I think I pulled a muscle in my butt … so, haven’t done that in awhile.

Is there a legendary one (ie the walk-off in Zoolander)?

Is there someone no one else would challenge?

Well … I’d love to see a quad-off between someone like Jennie Reed and Robert Forstemann, but every time I see that picture of Forstemann in his underwear I kind of get the heebie-jeebies … so, maybe not.  

Anyway, I wouldn't challenge someone like Jimmy Watkins because his quads are massive and he’s super intimidating with his scowls and facial hair (note: he’s actually a TOTAL teddy bear).  Oh, and Jimmy is a firefighter, so if Forstemann ever needs the jaws-of-life to pry those undies out of Forstemann’s thighs … he’s your man.

Some US guys told me they had to get specially made jeans. Is that true? If so, where? How do they label the sizes or whatever?
I also heard there used to be some Brazilian jeans store in Philadelphia that cyclists liked to flock to for custom fits. Ever heard of this?

I am SO happy you brought up jeans!  In addition to quad measuring, jeans have been another big campaign on my blog.  Finding jeans - especially for a woman - that fit an athletic body type is next to impossible.  All the jeans we have access to are way too tight in the quads and just overflowing in the waist.  Jean companies are missing a huge market in their designs … athletic women!

In 2008, I began a campaign on my blog for "keirin cut" jeans.  Doesn’t that have an awesome ring to it … keirin cut!  The keirin is the coolest track sprinting event and that’s why jeans designed for athletic women should have that name.  These jeans would be designed to have room for big quads, but also have a smaller waist.  Back then, there was a US domestic professional road racing team, Rock Racing, with Rock & Republic jeans as the title sponsor.  Michael Ball was the CEO, and I sent him a number of emails - all chronicled on my blog  (http://bethbikes.blogspot.
com/2008/08/r-and-quads.html ) - trying to get him to make a new jean design based on this ‘keirin cut’ technology.  He ignored me, because he sucks.  But, I am still hopeful that someone will make some keirin cut jeans and give me 10% of all profits for the genius idea and name.

Lastly, I guess, on the more serious side.
Have you met cyclists who were self-conscious about their thighs? Or is it a sport in which everyone can truly embrace that?

I hope that all cyclists - from track to road to BMX to mountain bike - are proud of their quads and bodies on the whole.  I mean, we pedal hours and hours every week - it’s a full-time job – so often, our bodies are seen as a measurement of our ability.  And that can lead to some crazy concepts of self-worth.  So, I’m a big advocate of embracing quad pride.  And hell, we are always checking out each other's legs anyways … that’s why we cyclists shave our legs … to make the muscles look ripped!  Don't let anyone tell you differently.  

Also, is there a way to quantify quad size relative to performance?
Are there any elite sprinters with small quads? Any folks with huge quads who aren't that great?
Vicky Pendleton's quads don't look that big - and she is amazingly fast.  And she gives the best interviews in the world.  Maybe you can get her to measure them for you?  That would be awesome.  Be sure to send them to me!  And I wonder how big Marianne Vos' quads are – she’s the best cyclist in the world, man or woman.  So, that would be a huge get.  I have always wanted to measure Sarah Hammer’s quads, but I think she might be a germaphobe, so I have never dared to get close enough.  She did take a picture with me once, however, and put her hand on my back, so maybe the germaphobe thing is just hearsay.  As for folks with huge quads that aren’t that great?  … I’m sure there are some sumo wrestlers who could go off the charts – but thinking about those boys on bicycles just makes me giggle.

Wednesday, January 11, 2012

the bermuda triangle and other waxing endeavors

today is the eve of my team camp excursion.  if you haven't heard yet (which i am sure you have, as the few people who read this blog know me personally...) next year i will be racing with the NOW and Novartis for MS team.

when they told me team camp was going to be in bermuda my first thought was.... yeah right!  but then i got sent a flight itinerary and realized it wasn't a joke: 1) i really was on on this team for next year - it wasn't a practical joke! and 2) team camp was in bermuda.  score!

knowing absolutely nothing about bermuda, i channeled my one reference point: the beach boys song, "kokomo" and immediately started humming: "aruba, jamaica ooo i wanna take you to bermuda, bahama come on pretty mama..." 

not feeling a need to fact check the beach boys, i began day dreaming about 80 degree weather bike rides, followed by sitting on the beach.  (although, the sitting on the beach part made me a bit nervous, as i knew i would have to deal with me being a bit out-of-control down there, if you get my gist....)

i finally decided to check the weather last week and saw this:

which made me realize, the beach boys' sense of geography is probably just about as good as the beach boys' sense of women (as indicated in the great song "california girls.")  so, i decided to look at google maps, and  learned some interesting thing about Caribbean geography, the first being that: no, bermuda is not in the Caribbean. 

i kindly circled or labeled all of the key reference point in the beach boys song.  and, as you can see by the map... although 'bermuda' does kind of near-rhyme with 'jamacia'... it is not close to it.


my other reference point for bermuda is, the bermuda triangle.

the bermuda triangle - that place where things get lost and are never found - has recently actualized itself a lot closer to home.

yes, down there.

while talking about the team camp trip the other week to my old teammate susannah, i lamented about being out-of-control, my eastern european heritage, and how i desperately needed to shave before even being seen in boy-cut swim shorts. hey, some people get fat in winter...other people get hairy.

susannah breen, being my trusted source on all things female, replies: "Shave? WTF - you should be waxing.  Maybe you could even right if off as a "work expense"".

this, of course, got me thinking...she's genius! however, the thought of putting hot wax on a bunch of hair down there, then ripping it off, really just didn't seem like a good idea.

so i did what i normally do: put it off and tried not to think about it.

and the same thing happened what normally happens when i ignore got more wild, wild west... i mean seriously.  totally out of control.  the jungle became pretty laughable.  "can it get any worse?"  "let's see!"  it got to the point where i think my boyfriend needed a road-map to maneuver all the detour signs down there. (hi mom!) get the seriousness of the situation.

team camp was getting closer and closer and something had to be done.  i decided i was going to make the waxing plunge, but i wanted some more information.  what is an appointment like?  what kind of wax do i get?  where do i go?  what do i wear? do i need to trim up?  how long does it last?  how much further ahead of time should i get it done?  i had lots of questions.

so, being an excellent researcher, i did what i normally do when i wanted information: i sat down at my computer, and began typing into google.  as i started to get answers, i had more questions.... i learned there were different types of waxes...  bikini wax, brazilian wax, french wax, hollywood wax.  (predictably enough i did not see hungarian wax, as that is a bit of an oxymoron) ....  i sat there contemplating what i wanted, and decided i needed some pictures, and went to and started typing  but stopped myself just before i hit enter... what the hell was i thinking?!?!   i was totally going to give myself a computer virus and open some porno!

i stopped myself, but still needed some answers... so i emailed susannah.  who, of course, provided me sufficient detail.  susannah gave me some good suggestions.  some of which i unfortunately forgot about.  "First of all, the hair should be at least 1/4" you can "trim" if you want, but no shaving of course.... hey, if I'm going to have another woman messing around my lady parts - I want them to get it over with asap."  that was sound advice.  unfortunately, i forgot it...

so i had to find a place to make my waxing appointment, and instead of basing it off recommendations or yelp reviews, i picked the place closest to my work.  this technique typically works well for me, and this one was no different.  Serenity Skincare by Nicole - she looked pretty cool on her website. 

and cool she was.  i gave a call and had my appointment yesterday.  she is located in the back of a hair salon.  i walk in and immediately say: "i have never done this before. and i am kind of out of control."  hey, no use beating around the bush. 

so, i am not sure how waxings normally go, but i could have stayed in there for hours.  she trimmed, she waxed, we chatted, laughed -- this was a blast!  i heard her life story.  i left feeling like she was my new bff.  as i walked out i gave her a hug. 

what? it seemed normal!

anyway, it wasn't until i got back into work and went into the bathroom that i really looked down and was like: holy shit i am bald!  i look like i am eleven. 

this of course resulted in a freakout for a few minutes.  i composed myself, left the bathroom stall, went back to my desk, looked around with shifty eyes...and no one was giving me creepy looks.  i know, why would they?  it's not like my co-workers have x-ray vision.  but for some reason it felt like they should. 

so there we have it.  i am bald and heading off to team camp.  looks like rain.... guess it was all for naught.