December 2005
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December 2005 Benefits Report

 

 

As most of you are aware there have been some changes in our Healthcare. These changes, subject to court approval, are expected to begin in April 2006. It is important that each of you know and understand these changes. Below are summaries for both hourly employees and retirees.

UAW Hourly Employees

 

UAW hourly employees will forego six (.06c) cents of any COLA in March 2006, six (.06c) cents of any COLA in June 2006, five (.05c) cents of any COLA in September 2006, 3% raise in September 2006, and two (.02c) of any COLA starting in December 2006. In addition prescription Drug co-payment at retail pharmacy will remain the same (up to 34 day supply) except Erectile Dysfunction medications will be $15. Prescription Drug co-payment for mail order will change to $10 for Generic, $15 for Brand name and $18 for Erectile Dysfunction medications (up to a 90 day supply).There will be additions to maintenance drug list. (Mail order)

 

UAW Retirees

 

The Benefit Section of this Local strongly encourages every retired member, and surviving spouse who qualifies for the changes to elect to have the monthly contributions to come out of their pension check. If you opt out of this plan you will automatically be enrolled into the Group Catastrophic Plan which could cost you far more money. The catastrophic plan will be explained later in this article.

No effect on retirees with a Pension income lower than $8000 per year and a $33.33 Class Code Rate or less.

Monthly Contribution of $10 for a single member or $21 for a family (2 or more enrolled on policy). There will be a $150 deductible for single member or $300 deductible for a family. This is the amount that is paid by the member on covered benefits before the insurance starts paying, excludes Office Visits, Durable Medical Equipment, Prosthetic & Orthotic, Mental Health & Substance Abuse, Dental, Vision, Prescription Co-payments and Emergency Room Co-payments. Also there is a 10% co-insurance (in-network) up to $100 for a single member or $200 for family (same exclusions as deductible), 30% co-insurance (out-of-network) up to $1,000 single member $2,000 family (including deductible with same exclusions as deductible). This will create annual out-of-pocket maximums of $370 single member, $752 family ( includes monthly contribution, deductible, and co-insurance when using a participating provider) Prescription Drug co-payment at retail pharmacies will change to $5 Generic, $10 Brand name, and $15 Erectile Dysfunction medications for retirees except those who are below $8,000 annual pension income as stated above.(up to a 34 day supply) Prescription Drug co-payments for mail order will change to $10 for Generic, $15 for Brand name and $18 for Erectile Dysfunction medications (up to 90 day supply) we will have an Emergency Room Co-Payment of $50 per visit which will be waived if admitted to hospital.

Monthly Contributions, Annual Deductible, Co-insurance, Out-of-Pocket Maximum, Prescription Drug Co-payments, Emergency Room Co-payments amounts can increase up to 3% per year. If increased 3% each year it would take 24 years to double. There have been no changes made to our Durable Medical Equipment, Prosthetic & Orthotic, Mental Health & Substance Abuse, Dental or Vision.

Group Catastrophic Plan

There will be no monthly contributions which don't mean that this is better plan. The deductibles and co-insurances are greatly increased which makes this plan more costly to our members. The deductibles are $1,250 for a single member or $2,500 family (2 or more on policy). After the deductible is met, the co-insurance will be 10% for in-network providers, until you reached $1,250 single member $2,500 family for a total annual Out-of-Pocket Maximum of $2,500 single member $5,000 family. If you use an out-of-network provider the co-insurance is 30% plus the annual maximum out-of pocket cost doubles to $5,000 single member, $10,000 family. With this plan co-payments for Emergency Room will be $100 per visit which will be waived if admitted to hospital. Prescription co-payments at a retail pharmacy will be $15 Generic, $35 Brand Name, $50 Erectile Dysfunction medications (up to a 34 day supply). Prescription co-payments for mail order will be $30 Generic, $70 Brand Name, $100 Erectile Dysfunction medications (up to 90 day supply). All dollar-denominated plan design items such as drug co-payments, deductibles, and out-of-pocket maximums will increase annually at a rate not to exceed 3%. Even though that there is no monthly contributions the deductibles, co-insurance, maximum out-of-pocket, co-payments are much higher than the plan with a monthly contribution. This is your choice you can have a maximum annual out-of-pocket $370 single member $752 family with an $10 single member, $21 family monthly contribution out of your pension check or elect not to have the contribution taken out of your check and your annual out-of-pocket maximums will $2,500 single member $5,000 family using an in-network provider. If you go out-of-network your annual out-of-pocket maximums will double to $5,000 single member, $10,000 family.

If you have questions about any changes after reading our newsletter, please come in to see a Benefits Representative for clarification or call a Benefits Representative. Articles in newspapers are almost always inaccurate in some way…trust your Local Benefit Representatives to inform you with correct information. A meeting in Detroit, Michigan was called on Friday, October 28th to ensure that your Benefits Representatives are well informed.

 

To our members who are eligible for Medicare D Prescription Drug Program:

 

If you sign up for Medicare D your General Motors Paid Prescription program will be cancelled, therefore we do not recommend enrolling. If you have further questions please contact a Benefit Representative.

 

New Phone Numbers:

 

Jerry Johns: 410-631-3064

Holly Brightbill-Stinebaugh: 410-631-3096

Fax: 410-631-3084

 

The Benefits Office is now located at:

2400 Broening Highway Suite 200

Baltimore, MD 21224

 

Jim Streets: 443-425-1584

Fax: 443-425-1468

10301 Philadelphia Road

White Marsh, MD 21163

 

We are asking that members who mail bills or other benefit issues to us still use the Union Hall address. Please remember to write UAW TRUCK PLANT BENEFITS on the envelope. The Union Hall address is 1010 South Oldham Street, Baltimore, Maryland 21224.

 

For our voluntary lay off members – ensuring you receive your check each week is easy! Every Monday fax your paperwork to CISA

On Tuesday go to the website, www.layoffbenefits.com

Type in your social security number

Click view paid and pending history

Your pending payment for the form you mailed yesterday should be on the bottom

If it does not show by Wednesday morning be sure to fax it again, chances are they did not receive your fax

For our members who transfer – Please remember to change your address and phone number with plant personnel. To ensure that we have your correct information you can also email us at local239benefitsreport@hotmail.com

We will need to contact you if you are laid off at your new plant and are eligible for Maryland Unemployment.

Problems with the Benefit Administrator Fidelity continue to erupt on a daily basis. Please remember that if find a problem with your benefits to contact your benefit plans representative immediately. Do not assume that the situation will work itself out.

We are still experiencing problems with United Healthcare processing hearing aid claims. If you are in need of a hearing aid you MUST use a participating provider in order to receive ANY benefits. Please contact United Healthcare at 1-800-241-9964 or a Benefit Plans Representative for a participating provider listing and the five steps you must take.

In order to receive the highest level of benefits for Physical Therapy Traditional Care Network you must use an in-network provider. Remember, under our plan we have NO COVERAGE for services rendered by a chiropractor. A Participating licensed Physical Therapist must render physical therapy. For Physical Therapy we have coverage for up to 60 visits per calendar year per condition by a participating provider.

As a reminder to those with Diabetes; Glucose monitors, lancets, and test strips are covered (subject to Medicare/GM guidelines). You may obtain them at no cost to you only at participating Northwood NPN providers. Northwood NPN may be contacted at 1-800-936-9314.If you are a member who is in need of any Durable Medical Supply please contact either Northwood at the above number or your Benefit Plans Representative to ensure you use a participating provider. You are sanctioned if you do not use a participating provider.

Check with Cole Managed Vision at 1-800-638-0166 or your Benefit Plans Representative for providers near you. A provider listing may be obtained at the Cole Managed Vision website at https://www.eyemedvisioncare.com/memweb/Login Group #80140.

Claims that the provider is submitting for lab work with ROUTINE or SCREENING as the diagnosis or no diagnosis at all will be denied. Lab work must be submitted with a MEDICAL DIAGNOSIS, by the Doctor, which justifies the test before it will be considered for coverage.

Under Supplemental Agreement Exhibit C (Health Care Program) we are allowed one PAP, PSA (over the age 40) every year, and Mammograms (baseline at age 40, 1 to 2 per year between ages 40 through 49 depending on risk factors and physician recommendations, each year after age 50) these tests may be submitted with the screening diagnosis. UAW International Bargaining Committee successfully negotiated the addition of the following screenings which went into effect July 1, 2004 for Traditional Care Network enrollees, when a Network provider provides such services: One fecal occult blood test per year, beginning at age 50; one flexible sigmoidoscopy exam, or one barium enema, every 5 years, or one colonoscopy every 10 years, beginning at age 50 and one total serum cholesterol with low density lipoprotein test every 5 years beginning at age 20. These tests may be submitted with the routine or screening diagnosis.

Members under the Delta Dental Plan are encourage to ask for a predetermination from the carrier through your participating provider for any services which cost is estimated to go above $200.00. A Predetermination letter will be mailed to both you and the provider showing patient responsibility for services rendered. Our contract allows for a maximum payment of $1,700 per person total per year and a lifetime orthodontic maximum of $2,000.You are encouraged to register at http://www.deltadental.com/ you may view claims online, search for dentists, download claim forms and this site has lots of information pertaining to oral health.

Please be aware that you have the same ability to get almost any prescription drug by mail order. The savings and ability to get a 90-day supply for $5.00 without going to the drug store every month is a great incentive to begin using the mail order program. You can receive up to 90 day supply with this option. As a reminder, refills should be called in when you have 14-21 days worth of medication left to ensure you receive your medication in time. If you have ordered mail order prescriptions and are about to run out due to a shipping problem please contact a Benefit Plans Representative immediately. Please continue to use participating pharmacies for short-term prescriptions that you need right away (ex. Antibiotics, newly prescribed drugs) The Medco-Health website is www.medcohealth.com

 

Beneficiary changes are not taken over the phone. To make a beneficiary change call GM Benefits & Service Center at 1-800-489-4646 to request a beneficiary form. Once completed the form must be returned to that center in the provided pre-addressed envelope. You may also go online to www.gmbenefits.com to update beneficiary information.

If you would like to have the Monthly Report emailed to you or have a general question about your Benefits that you would like answered in a future Report please email us at local239benefitsreport@hotmail.com. This is a great way for us to know which areas of our Benefit Plan we need to highlight in our Report. Please note that individual issues will not be addressed by Electronic Mail, only general questions will be accepted.

 

A Notary Public is available to you at no cost in the Benefits Office at Point Breeze, please see Holly.

 

Please remember that the Benefits Office at Point Breeze will close from December 24th thru January 2nd.

Have a happy and safe Holiday.

Fraternally

Holly Brightbill-Stinebaugh

Jerry Johns

Francine Jenkins