There are constantly changes in our benefits; our members must stay informed to receive least out-of-pocket expense. When you receive mailings from UAW, General Motors or one of the insurance carriers you should read them so you stay informed. After reading the material if you have any questions please contact the phone number listed in that letter or your Union Benefit Representative.

Prescription drug changes are extensions of the 2003 GM Health Care Program for UAW represented members’ provisions and are in keeping with items agreed to during the 2003 negotiations. They were developed by GM with input from Medco (prescription drug carrier), as well as independent outside pharmacy consultants and UAW representatives. These changes are designed to help the Program continue providing high quality, affordable prescription drug coverage. This is not related to the Memorandum of Understanding between GM and the UAW, dated October 29, 2005, which was ratified by the membership.

Effective February 1, 2006, additional medications were added to the maintenance drug list. The list is being expanded to include, for example, additional medications used to treat hypertension, osteoporosis, diabetes, Parkinson’s disease and high cholesterol. Members should have received a letter explaining the additions from Medco Health Solutions Inc. with the current list attached. If you did not receive that list and currently taking maintenance drugs you can find them by clicking the link above this article or go to www.medco.com, or call the customer service at 1-800-464-4679 plus your Union Benefit Representative will have a copy.

Coverage of specified maintenance drugs is limited to a maximum of three fills at participating retail pharmacy (each up to a 34-day supply). After three fills, you will have to pay the entire cost of the medication if you continue to fill the prescription at retail. To avoid paying more, you can choose to have your next prescription filled through the Medco mail-order pharmacy. At mail order, you will be able to receive up to a 90-day supply of medication for one co-payment. You or a covered dependent may be taking one of these medications and have already filled a prescription one or more times at a retail pharmacy. Remember that, beginning with the fourth fill at retail, you will pay the entire cost of the medication. When using Medco Mail-Order pharmacy first, ask your doctor for a new prescription for up to a 90-day supply, plus refills for one year as appropriate. Make sure you have a two-week supply on hand before starting mail order. If not, ask your doctor for a 14-day prescription that you can fill at a participating pharmacy so that you do not run out of medication waiting for your mail-order prescription to arrive. Option 1- You can mail your prescription to Medco. Mail the new prescription using order form and postage-paid envelope. Your order will be delivered within 7 to 11 days after you mail the order. See your Union Benefit Rep. for the form or call customer service (1-800-464-4679). Option 2- You can ask your doctor to fax your prescription to Medco. Provide your doctor with your member ID number (located on your medical ID card) and ask him or her to call 1-888-327-9791 for instructions on how to use the fax service. Your prescription order will be delivered within 5 to 8 days after your doctor faxes the order. You can also download a form at www.gmbenefits.com or contact your Union Benefits Rep.

Local 239 Benefit Section encourages all members to use Mail-Order Pharmacy on medications taken three or more months even if the medication is not on the "Maintenance Drug List". This will reduce your co-payments for those medications.

Step Therapy, this component encourages treatment that is consistent with evidence-based or commonly accepted medical guidelines by having patients use acceptable first-line therapies, instead of starting with more advance drugs or therapy. It will apply to prescriptions for treatment of psoriasis (skin rash) and to prescriptions for certain Rheumatoid Arthritis, but not limited to these conditions. Some medications may not be covered unless you have first tried another medication or therapy. If your doctor believes the first-line, lower cost alternatives would not be effective treatment for you; he or she can request a coverage review. To begin a coverage review, ask your doctor to call Medco at 1-800-417-1764 between 8:00 a.m. and 9:00 p.m., Eastern Time, Monday through Friday. If you are submitting a prescription at retail, your pharmacist will inform you that approval is needed before prescription can be filled. The pharmacist will give you or your doctor a toll-free number to call. If you are submitting a mail-order prescription, a Medco pharmacist will contact the doctor for you. Your doctor will receive a fax form to fill out and return. Medco will notify you and your doctor by letter of the decision, usually within 2 days of receiving all the required information.

Prior Authorization, this component is designed to help confirm diagnosis and other clinical information before medications are dispensed. It also acts as a safeguard to help ensure FDA- approved, or commonly acceptable medical guidelines are followed for the use of certain medications. Prior Authorization will be applied to certain drugs prescribed to stimulate the formation of red blood cells, Alzheimer’s Disease medications and anti-nausea medication prescribed for certain cancer patients. If you were taking a medication before the effective date of this change and it now require prior authorization, you will receive a letter explaining that you will need a coverage review. You or your doctor can initiate a review before the date indicated in the letter. This is the same process as Step-Therapy. If neither you nor your doctor initiates a review and you drop off the prescription at a retail pharmacy, the pharmacist informs you that your medications need prior authorization. If you fill the prescription without obtaining approval, you will pay the entire cost for that prescription. However, if you receive approval later, you can submit a claim for reimbursement. If you submit your prescription through mail-order, a Medco pharmacist will contact your doctor to begin the review.

Restricted Coverage of Certain Gastro-Intestinal Drugs, there is a class of drugs often prescribed for stomach problems and known as Proton Pump Inhibitors or PPIs. In the future, Program coverage will be limited to the generic omeprazole and brand Nexium. Generic omeprazole is the preferred medication; however, if your physician indicates a brand is necessary, then Nexium is the preferred medication. Because of the high cost of brand name PPIs, the Program will no longer cover Aciphex, Prevacid, Prilosec 40mg, and Protonix. This will help in the effort to continue providing high quality, affordable prescription drug coverage. If your doctor believes that the generic or Nexium are not effective treatment options, he or she can request a coverage review. If the coverage is approved, you will pay the brand name co-payment under your plan. If coverage is denied, you will be responsible for the entire cost of the brand-name drug if you decide to purchase it.

Restricted Coverage of Certain Anti-depressant Medications, there is a class of drugs often prescribed for treatment of depression and known as Selective Serotonin Reuptake Inhibitors or SSRIs. Two brands SSRIs are Celexa (citalopram generic) and Lexapro. For first time patients who have not used either product, coverage will be restricted to generic citalopram. If you are already taking Lexapro, you will still receive coverage at the appropriate co-payment. If you have not previously been prescribed Lexapro but started taking it after March 1, you will be responsible for the entire cost unless you agree to take the preferred drug, citalopram. Because of the high cost of this medication, the Program will not cover Lexapro in the future. Ask your doctor whether the generic citalopram would be right for you. Other alternatives may also be available. If your doctor believes that the alternatives would not be effective treatment for you, he or she can request a coverage review. As before if approved, you will pay the co-payment for brand-name drug. If coverage is denied, you will be responsible for the entire cost if you still decide to purchase it.

Dose Optimization, basically it is preferable to take medications once a day, whenever appropriate and possible. Sometimes doctors prescribe medications to be taken in lower strengths but multiple times a day, when there is no clinical reason for not taking a larger dose once a day. This can add unnecessary cost to the Program and the patient will not achieve therapeutic results. If you or your doctor believe that multiple doses is needed you or your doctor can request a coverage review.

Prescriptions for Certain Cholesterol-lowering Medications, there is a class of cholesterol-lowering drugs known as Statins. These medications will be subject to Dose Optimization. The Program will not cover certain brand-name drugs. The preferred alternatives are Lipitor, Zocor and Pravachol, and generic lovastatin, which have been proven to be effective treatments for people with the same condition, but at a lower cost. If your doctor believes that the alternatives would not be effective treatment for you, he or she can request a coverage review. As stated above if approved you will pay the brand-name co-payment. If denied and you still want to purchase the drug you will pay the entire cost.

Future Applications of "Rx Tools", other forms are Length of Therapy (for example, limiting treatment of finger/toe nail fungus to 3 months as approved in FDA labeling) and Appropriate Quantity (for example, allowing 8 estrogen patches per retail and 24 per mail-order script, since appropriate dosing is twice a week). 34-day and 90-day Provision edits, designed to identify quantities that appear to be in excess of the amount considered usual for a 34- or 90-day supply, also may be used. Identified inconsistencies would initiate a discussion between the dispensing pharmacy/pharmacist and the prescribing physician prior to the quantity being dispensed.

Over the past several months the International Union have been discussing the issue of covering needles for BD pens for drugs Byetta and Fortio. The company has agreed to start covering them as of February 10, 2006.Recognizing that there were cases pending in the system; they also agreed to cover them.

When using a participating hospital and you receive a balance bill for anesthesia, radiology or pathology please contact your Union Benefit Plans Rep. so they can submit a Hold Harmless Appeal to United Healthcare. IF you make any type of payment to the provider you are accepting financial responsibility and will owe the balance.

UAW/GM Legal Services (410-633-5600) can assist you and your spouse with updating your will. This is recommended when you have a life event, such as a birth/adoption of a child, death of a spouse, divorcee etc. They also can help with estate planning for your parents, and your spouse’s parents.

You can update your beneficiaries on your Basic, Optional, Personal Accidental Life Insurance plus your Personal Savings Plan online at www.gmbenefits.com or contact Fidelity Investments at 1-800-489-4646 to request a form. On your PSP account your spouse is automatically your beneficiary unless she signs the waiver and has it notarized which has to be returned to Fidelity Investments with your beneficiary elections.

We are still having problems with Fidelity and their administration of the Pension Plan it has only been 15 months since they taken the contract over from the Pension Administration Center and they still don’t understand how our plan works. When you receive your Medicare card you have to call Fidelity (1-800-489-4646) to update that information so you will be reimbursed $76.20 into your Pension check. This is only reimbursed to the retiree or surviving spouse. If you are experiencing problems with your pension check contact your Union Benefit Representative.

Jim Streets: 443-425-1584

FAX: 443-425-1468

10301 Philadelphia Road

White Marsh, MD 21162

Child Care/Elder Care Resource and Referral Service vender has changed all active members should of received their brochure in the mail. The new phone number is 1-888-733-3702 website www.workfamilyprogram.com When accessing the website the Company Name: uawgm, Password: helpnow. This program has been enhanced with new online classroom an interactive whiteboard provides a suite of robust tools. The Convenience and Concierge Service also has improvements convenience of purchasing tickets, gifts, flowers etc. online.

Fraternally

Local 239 Benefit Section