Health Care Protected, Benefits Improved

Health care was an extremely difficult issue in this round of bargaining, but our national negotiating team at Ford successfully resisted the company’s efforts to shift many substantial costs to our members. Negotiators saved our HMOs and PPOs and made key improvements in several areas.

HMO, PPO Coverage Maintained

The company pushed to restrict your choice of health plans. Your negotiating team successfully resisted these efforts and the existing HMO and PPO plans remain available in addition to the National PPO plan. Dental HMOs were also maintained.

Effective March 1, 2008, the office visit co-pay in all HMO plans increases to $25 for HMO subscribers who are active employees. Also effective March 1, 2008, a $100 emergency room co-pay was added for HMO subscribers who are active employees. This co-pay is waived if the patient is admitted to the hospital.

Effective Jan. 1, 2008, those enrolled in the Blue Preferred Plus PPO and the Blue Select PPO will have a $150 in-network deductible for single coverage and a $300 in-network deductible for multiple-party coverage. The following services will not be subject to the plan deductibles: prescription drug co-pay, office visit co-pay, durable medical equipment, prosthetic and orthotic appliances, mental health and substance abuse and certain preventive screenings.

Effective Jan. 1, 2008, there will also be a $100 emergency room charge for active employees in these two PPOs, which is waived if the patient is admitted to the hospital.

HMO and PPO plans remain subject to annual review for cost effectiveness under the Alternative Plan Value Letter. In addition, effective March 1, 2008, the National PPO (NPPO) will provide five office visits per active worker per year at a co-pay of $25 per visit, if their HMO or PPO plan has to be dropped and no other HMO or PPO plan is available in their area.

Prescription Drug Co-pays

Effective Jan. 1, 2008, mail-order prescription drug co-pays for active workers enrolled in the National PPO (NPPO) increase by $3 for a 90-day supply to $10 for generic, $15 for brand, and $19 for erectile dysfunction (ED) drugs.

As of Jan. 1, 2008, certain over-the-counter antihistamines and vitamins will no longer be covered under the prescription drug program. In addition, the mail-order maintenance drug list was updated, adding more than 30 drugs and removing four drugs for patient safety reasons.

Physician Extender Services Now Covered

Health care access will be improved, as physician extenders (non-physician practitioners) are now covered in the NPPO plan. These include practitioners such as advanced practice nurses and physician’s assistants.

Preventive Tests Improved

Effective Jan. 1, 2008, a number of additional preventive and screening tests were added to the NPPO coverage.

A woman whose mammogram is inconclusive is now eligible to have an MRI for additional cancer screening as recommended by the American Cancer Society.

Annual eye exams will also be covered under the vision benefit to help detect high blood pressure, heart disease and high cholesterol at an earlier stage.

A screening colonoscopy is now covered once every 10 years beginning at age 50. People with a high risk of colorectal cancer based on family history or genetic factors can have this test every two years starting at age 25 and every year as of age 40.

Hospice Care Can be Extended

The cap on covered hospice services can now be exceeded by the enrollee if authorization is obtained from the health insurance carrier’s case management program.

Dental Improvements

The annual dental maximum and lifetime orthodontic maximums for dental coverage were increased.

Effective Jan. 1, 2008, the annual maximum will increase to $1,850 (from $1,700), and the orthodontic maximum will increase to $2,200 (from $1,800).

There were other dental changes, including:

• Full-mouth bitewing X-rays will be covered once per year for children 14 and younger and once every two years for 15 and older.

• Participants are eligible for two brush biopsies per year to screen for oral cancer.

• Fluoride trays for those undergoing chemotherapy will be covered.

• Those with a documented history of periodontal disease can now have four cleanings per year, up from three.

DME and P&O Updated

Durable medical equipment (DME) and prosthetic and orthotic (P&O) coverages have been updated to Medicare levels.

Hearing Aid Coverage

Effective Jan. 1, 2008, hearing aid coverage will be improved so that active members receive a $2,000 allowance for hearing aids, ear molds and associated devices every three years.

In addition, Ford and UAW continue to evaluate a network provider system for hearing aids, which would improve access and quality, as well as result in cost savings for actives and retirees. Upon implementation, retirees will get two digital hearing aids under the network.

Eligibility Changes

There were changes to eligibility for certain dependent children. Principally supported children who are enrolled in the program as of ratification will be “grandfathered” – and there will be no new principally supported coverage available afterward. Legal guardianship has been limited to minor children who are related by blood to a primary enrollee or spouse. In addition, effective Jan. 1, 2009, children 19 and older will be covered only if they are full-time students. Such full-time student coverage will be available through age 24.

Community Health Care Initiatives Maintained

The existing Community Health Care Initiative sites were maintained.

Immunizations Updated

Immunization coverage was expanded to include new doses and new vaccines per national recommendations.

Ambulance Coverage Improved

Effective Jan. 1, 2008, services will now be covered if the ambulance treats the participant at the scene but does not actually transport them to a medical facility.

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