Health care benefits improved, expanded and protected

Health care reform continues to be at the center of national debate from the kitchen table to the halls of Congress. Nearly 50 million people remained uninsured in 2010, and many Americans find their health benefits slashed or eliminated. Health care reform will remain a hot-button issue in today’s political climate and one that the UAW will continue to strongly support.The UAW believes that access to affordable and quality health care is a moral right for all.The UAW has been a constant champion for health care reform and strongly supports the Patient Protection and Affordable Care Act (PPACA), signed into law by President Obama in 2010.

During this round of negotiations, it was a priority of the union to maintain benefits and negotiate enhanced health care coverage that would supply our members with above-standard care and provide a direct tie-in with the PPACA.

Prescription drug coverage 

The UAW Chrysler bargaining team held firm on no new increases in health care prescription drug costs for the life of the proposed agreement. The team was also able to expand the maintenance drug list.

Office visits

Effective Jan. 1, 2012, modifications to health care for hourly active employees and their dependents will be provided with unlimited office visits by in-network providers at a $25 co-payment per visit. Also, an annual wellness physical will be included and paid in full.

Coverage will expand to include an urgent care benefit at participating providers with a co-payment of $50, and emergency services now also carry a co-payment of $100 if the patient is not admitted to the hospital for treatment.

Increased coverage for hyperbaric oxygenation  treatment 

Outpatient hyperbaric oxygenation treatment will now include the following conditions: diabetic wound care, chronic refraction osteomyelitis, osteoradionecrosis and soft tissue radionecrosis.

Pre-hospice

Coverage for pre-hospice consists of evaluation, consultation, education and support services with a lifetime maximum of 28 visits prior to the enrollee electing hospice care. Pre-hospice coverage allows concurrent continuation of curative treatment until the enrollee is ready to forego curative care.

Hospice

UAW Chrysler members will now be eligible for hospice if life expectancy is 12 months or less (changed from six months).There is a lifetime maximum of 365 days which may be extended through case management. It was previously 210 days.

Hearing aid coverage

• Expanded hearing aid coverage to include diagnostic testing.
• A Hearing Aid Network will also be implemented that will allow two hearing aids every three years within a $2,000 maximum benefit structure.

Physical, occupational and speech therapy benefit expanded  

Enrollees are entitled to now receive physical therapy, occupational and speech therapy services provided in a doctor’s office setting in addition to all PTO therapy facilities. Diagnosis codes for physical therapy willalso be expanded to include things such as wound therapy and debridement.

Improved dental care coverage 

Dental care coverage was upgraded so that UAW Chrysler hourly members now receive composite resins for all fillings when restoring posterior teeth, regardless of surface. Additionally, enrollees at risk for oral cancer or with unresolving oral lesions or ulcerations, will now have coverage for one brush biopsy per calendar year.

Other improvements include:

• Single tooth, endosteal implant with coverage up to 50 percent of cost and subject to the annual maximum.
• Enrollees will now receive one occlusal guard, covered up to 90 percent and subject to annual maximum, every five years instead of just one in a lifetime.

Fluoride trays for patients undergoing radiation therapy treatment for head and neck will now be covered at 100 percent.

VEBA

This agreement shows a strong,o ngoing commitment to protect the health care benefits of our retirees. The UAW and Chrysler are in the process of addressing the company’s accounting, tax, legal and other concerns. Once these concerns are addressed, 10 percent of the Profit Sharing Fund will be diverted to the UAW Retiree Medical Benefits Trust.

Health care benefits provided under Patient Protection and Affordable Care Act made contractual

On March 23, 2010, President Obama signed into law the Patient Protection and Affordable Care Act (PPACA) health care reform bill. The PPACA gives access to insurance for over 30 million Americans with numerous provisions to take effect over several years and broadens private and public health insurance coverage, including increasing coverage of pre-existing conditions. With the additional coverage provided because of the PPACA, the UAW negotiated the following additions to the health care program for hourly active employees and their dependents:

Expanded coverage with PPACA

During this round of negotiations, Chrysler Hourly active workers will now be provided with up to five well-baby visits for children from 13 months of age through 35 months of age.Within a calendar year, for children ages 36 months through age 17, one well-child visit is allowed.

Additional coverage includes an annual, routine physical exam per calendar year for enrollees age 18 or older. All female enrollees will be provided with annual, routine gynecological exams.

Cholesterol screening coverage has been expanded to include children ages 24 months to 21 years, in addition to men over the age of 35. Screenings will also be provided for men, ages 21 to 35, with potential increased risk of coronary heart disease, and at-risk women over the age of 20.

In addition, specified lab services will now be covered including one abdominal, aortic aneurysm by ultrasound per lifetime, osteoporosis screenings for women and infectious screenings for all enrollees.

There were also gains in prenatal care with the addition of prenatal screenings, infectious screenings, and consultations regarding healthy diet, breastfeeding and tobacco use. Newborns will now be eligible for developmental screening and evaluation up to age 30 months, along with prevention screening at birth for congenital hypothyroidism, metabolic/hemoglobin, phenylketonuria and sickle cell.

Preventative services and care was expanded to include infectious screenings, autism screening, obesity screening, blood pressure screening and depression screening.These preventative services are covered as part of the routine physical exam and not separate, billable items per the carrier.

Diabetes self management education/training

Diabetes is a serious and costly disease that is among the most prevalent chronic conditions experienced by our members and their families. It is also known that the disease progression is controllable in many cases. This new benefit breaks new ground for our members with assistance in avoiding serious complications of diabetes and in better managing its progression. Effective Jan. 1, 2012, in-network coverage for diabetes self-management education and training for members and their dependents enrolled in a Chrysler-sponsored health plan prescribed by a physician, nurse practitioner or physician assistant will be provided.

The service would be provided for members with:

• Type 1, Type 2, pre-gestational and gestational diabetes.
• Inadequate glycemic control.
• Change in treatment either from no diabetes medication to any diabetes medication or from oral medications to insulin shots.
• High risk for complications.
• Amputation of lower limbs for endocrine, nutritional and metabolic disorders.
• Skin grafts and wound debridement for endocrine, nutritional and metabolic disorders.
• Nutritional and miscellaneous disorders related to diabetes.

The program provides:

• One year of initial training with a certified diabetes educator. Follow up and refresher education and  training with a certified diabetes educator in subsequent years when a new prescription is written based on medical necessity.
• Nutrition counseling as a part of diabetes self-management and education training.

Retiree health care

Retiree health care benefits are controlled by the Voluntary Employee Beneficiary Association, or VEBA, which is administered by an independent board of trustees and is not part of the UAW Chrysler collective bargaining  agreeement. The VEBA board holds regular meetings to assess retiree health care benefits and will keep you informed as progress is made toward finding solutions to health care concerns expressed by UAW Chrysler retirees.