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1

Unless specifically noted, this book describes benefitprograms for UAW-represented hourly employees ofFord Motor Company.

Your handbook is divided into sections — one for eachbenefit program and one section to describe administra-tive and ERISA information. Once you turn to the sectionin which you’re interested, look for information using:

••••• The table of contents on the divider tab— with page numbers for that section

••••• The overview page— with the major points of that plan

••••• An in-depth explanation— with a summary of each plan

••••• Examples and tables— with an easy-to-understand summary of certain

plan features

If you cannot find the answers to your benefits ques-tions in this handbook, call the NESC or contact yourlocal UAW Benefits Representative.

Introduction

This Handbook Section: Begins on This Page

Health Care Plan 7

Life and Disability Insurance Program 101

Retirement Plan 141

Supplemental Unemployment Benefit(SUB) Plan 169

Guaranteed Income Stream(GIS) Benefit Program 179

UAW-Ford Legal Services Plan 193

Tax-Efficient Savings Plan ForHourly Employees (TESPHE) 205

Profit Sharing Plan 243

Ford Money Market Account 251

Administrative, ERISA, and Family andMedical Leave Act of 1993 Information 253

Dependent Care Assistance Plan 263

2 Introduction

Introduction

This handbook contains an explanation of youremployee benefits based on the documents,policies and negotiated Agreements by whichthese benefits are provided. If there is anydifference between the Plan texts, negotiatedAgreements and this handbook, the Plan textsand negotiated Agreements always will govern.

The Company reserves the right to end, suspendor amend these plans, subject to the applicableCollective Bargaining Agreement. Amendmentsalso will be made to comply with applicablestatutes and regulations. If changes are made, youwill be notified.

Benefit Program Description EligibilityHealth Care Plan For full-time em- Employees on the first

ployees, provides day of the month afterhospital, surgical, acquiring seven monthsmedical, prescrip- of senioritytion drug, dentalvision care, andhearing aid cover-ages; and for part-time employeeshospital, surgical,medical; and forthose hired prior toMarch 1, 1982,prescription drugcoverage

Life and Disability Provides financial Regular full-timeInsurance Program insurance program employees

protection in case ofdisability or death

Retirement Plan Pays a monthly Participation is auto-benefit when you matic for employeesretire, based ontype of retirement,date of retirementand years ofcredited service

Supplemental Provides income Employees with oneUnemployment benefits if you are year of seniority who:Benefit (SUB) Plan laid off • Are on a

qualifying layofffrom a Contract Unit

• Have reported at astate employmentoffice, if required

• Are in an AutoSUBstate or have appliedfor Regular Benefitseither in person orby mail

• Qualify for a RegularBenefit of at least $2

Guaranteed Income Provides income Employees with 10Stream (GIS) protection and or more years ofBenefit Program certain health and seniority and on a

life insurance qualifying layoffbenefits for long-service employeesafter SUB ends

UAW-Ford Legal Provides certain Full-time employeesServices Plan legal services for 90 days after

covered matters date of hiresuch as willpreparation,house closings,adoption, anddivorce

Tax-Efficient Offers you an Employees on theSavings Plan for opportunity to save active employmentHourly Employees and invest on a roll three months(TESPHE) pre-tax or after initial date

after-tax basis of hireProfit Sharing Plan Provides additional Full-time

income (in the form employees who haveof check, TESPHE been hired byor Ford Money December 31 ofMarket Account the plan yearcontributions) basedon Company profits

Dependent Care Allows you to make All full-timeAssistance Plan pre-tax contributions employees

into an account thatreimburses you foreligible dependentcare expenses

Highlights

Your employee benefits are important for you andyour family. They are described in this handbook.

Benefits are a valuable part of your compensation as aFord employee represented by the UAW.

You and your dependents may be eligible for the benefitprograms negotiated by Ford Motor Company and the UAW(see Volumes II, III and IV of the UAW-Ford CollectiveBargaining Agreement). The following chart outlines eachof the benefit programs, as well as the requirements youmust meet to be eligible for those benefits. Refer to thesections within your handbook for complete information.

Introduction 3

What do you do if you have questions about your benefits?

When you have a benefits question, you may be able to findthe answer in this handbook, your Annual Earnings andBenefits Summary, and benefits bulletins posted in yourarea. If you cannot find the answer to your question fromthese sources, call the National Employee Services Center(NESC) or contact your local UAW Benefits Representative.

Benefits service from the NESCThe NESC was opened in 1993 to provide improved benefitservice for you and your family. The Human Resources As-sociates receive specialized training that enables them toassist you with your needs. The UAW National Ford Depart-ment is represented at the NESC. The goal of the NESC isto provide “Best-In-Class” benefits service by offering:

• Toll-free phone access • Experts to handle• Simplified processing complex cases

of benefit requests • Fewer forms and• Personal service and faster service

benefits counseling

Comments and suggestions for improving service shouldbe sent to the Quality Coordinator, National EmployeeServices Center, P.O. Box 6214, Dearborn, Michigan 48121.

The NESC cannot assist you with your leave of absence,except to answer questions related to your health careeligibility. You must contact your local hourly personneloffice to initiate or close a leave of absence, or to addressany employment termination for an expired medical leave.

How do you call the NESC?To reach the NESC system call 1-800-248-4444.

Human Resources Associates are available Monday throughThursday, from 8:00 a.m. to 5:00 p.m. (Eastern Time) andFridays from 9:00 a.m. to 4:00 p.m. (Eastern Time), excepton Company holidays.

Convenient account accessThe Fidelity Service Center for Ford Motor Company gen-erally provides 24-hour access to TESPHE account infor-mation and permits a variety of transactions to be initi-ated, toll-free, from any touch-tone telephone. Fidelity rep-resentatives are available 15½ hours a day from 8:30 a.m.to midnight (Eastern Time) on business days.

You can manage your TESPHE account almost entirelyover the phone with the Fidelity Service Center or throughFidelity’s Internet access www.netbenefits.fidelity.com.Forms will not be necessary for most transactions.

To use the Fidelity Service Center, you will need to establisha PIN (personal identification number). The first time you callFidelity, you will be asked to establish your PIN.

Your Benefits Service DirectoryHere’s a quick directory for assistance with your benefitsquestions:For this information: Call:

Health Care Plan• Health care claims, dependent The number on your Health Care

status or benefit coverage Plan I.D. card

• To add or delete dependents or NESCfor problems that cannot beresolved with your HealthCare Plan

Life Insurance Program• Company-provided coverage UNICARE

1-313-336-5550 or1-800-843-8184

• Optional Group life insurance, Mutual of Omahadependent group life insurance, 1-847-299-9393 oror optional accident insurance 1-800-742-8215

• To file a death claim NESC

Disability Insurance Program• To file claims or ask about UNICARE

accident and sickness and 1-800-572-1581 orextended disability benefits 1-313-336-5550

Retirement Plan NESC

Supplemental Unemployment Your local hourlyBenefit (SUB) Plan personnel office

Guaranteed Income Stream (GIS) UNICAREBenefit Program 1-313-336-5550 or

1-800-843-8184

UAW-Ford Legal Services Plan Your local legal servicesplan office (see page 200)

Tax-Efficient Savings Plan for Fidelity Service CenterHourly Employees (TESPHE) 1-800-544-3333

1-508-787-9902 (fromoverseas call collect)1-800-847-0348 (TDD phone linefor the hearing impaired)

Profit Sharing Plan• Eligible pay problems Your local hourly

personnel office• All other matters NESC

Dependent Care Assistance Plan FBD Consulting1-888-537-4643

Other Personnel MattersAddress changes, anniversary Local hourlyawards, U.S. Savings Bonds, personnel officeUnited Way, vehicles, FERA,suggestions, education programs,vacation, direct deposit of paycheck,tax withholding of wages, and leavesof absence

4 Introduction

Not applicable

Not applicable

Provides:

• RegularBenefits

• Short WeekBenefits

• Lump-sumSeparationPayment

Your eligibility ends.

Participation ends.

If you areworkingfor theCompany

If you areon anapprovedmedicalleave

If you arelaid off

If you retire

Provides benefits forcovered hospital, surgical,medical, prescription drug,dental, vision care andhearing aid expenses

Coverages continue for thegreater of:

• A period equal to youryears ofseniority atdisability

• The period during whichyou receive ExtendedDisability Benefits

Coverages continue for thegreater of a period of timedetermined by:

• Your years of seniority onlast day worked beforelayoff

• The period during whichyou receive ExtendedDisability Benefits

Coverage continues for you,your spouse or same-sexdomestic partner and youreligible dependents.

Coverage may continue foryour spouse and eligibledependents.

Provides protection of:

• Life and Accidental Death andDismemberment Insurance

• Survivor Income Benefits

• Accident and Sickness Benefits

• Extended Disability Benefits

• Safety Belt User Benefits

• Optional Employee GroupLife Insurance (employee-paid)

• Optional Dependent Group LifeInsurance (employee-paid)

• Optional Accident Insurance(employee-paid)

Accident and Sickness Benefitsprovide a Benefit for up to 52weeks; Extended DisabilityBenefits may provide a monthlybenefit after Accident andSickness Benefits end.Other coverages may continuebased on your years of seniority.

Certain coverages continue forthe greater of a period of timedetermined by:

• Your years of seniority on lastday worked before layoff

• Your eligibility for SUB on lastday worked before layoff

• Your receipt of ExtendedDisability Benefits

Accident and Sickness Benefitsmay be reinstated if you becomedisabled during a qualified layoffunder the SUB Plan and areeligible for a Regular Benefitunder the SUB Plan while insuredfor Life Insurance.

Life Insurance coveragecontinues in full (paid by Ford)until age 65. At age 65, reducedamounts of Life Insurance maycontinue for the rest of your life ina “Continuing Group LifeInsurance” amount

Life Insurance is paid to yourbeneficiary, based on your basehourly rate. If you have asurvivor, he or she may beeligible for Transition and BridgeSurvivor Income Benefits.

If you die as the result of anaccident, your beneficiary alsomay receive a benefit under theAccidental Death and Dismem-berment Insurance Plan.

You earn credit toward apension based on hours forwhich you receive pay fromthe Company.

Participation continues andservice credits accrue for alimited period; DisabilityRetirement may beavailable.

Participation continues andservice credits accrue for amore limited period,provided you retain yourseniority. (Special rules forGIS may apply, however.)

If vested, you may receivea monthly pension basedon your Benefit ClassCode, date of retirement,and years of creditedservice.

If vested and a survivorshipoption is in effect, yoursurviving spouse mayreceive a benefit.

Life and Disability Health Care Plan Insurance Program Retirement Plan SUB Plan

An overview: How your benefits work together

If you die

Introduction 5

Offers on a pre-tax orafter-tax basis savingsand investmentopportunities.

Contributions aresuspended. In someinstances, accounts maybe paid upon request.

Contributions aresuspended. Distribution ismade after you reach age65, if you so electotherwise, distribution willbegin at age 70½ . Youmay request earlierdistribution at or aftertermination.

Contributions end. Youmay request distribution ofall or part of your accountat or after termination. Youmay elect distributionwhen you reach age 65, oryou may elect to leaveyour assets in the Plan,otherwise distribution willbegin at age 70½.

Your account is paid toyour beneficiary asprovided under the Plan.If your beneficiary is yoursurviving spouse, thespouse may elect to retainthe account.

Not applicable

Not applicable

May provide longer-seniority employeeswith income protectionand certain life andhealth insurancebenefits duringextended layoffperiods once SUB isexhausted.

Your eligibility ends.

If you were laid off andwere eligible for GISbenefits at death, yourbeneficiary will receive$16,000 in Company-paid life insurance.

Provides certain legalservices for coveredmatters such as willpreparation, houseclosings, adoption,and divorce.

Coverage continues.

Coverage continues for18 months.

Coverage continues.

Coverage may continuefor your eligible spouseand eligible dependents.Under some conditions,coverage for covereddependents andsurviving spouses nototherwise eligible shallcontinue only until theend of the sixth monthfollowing the month inwhich the employee orsurviving spouse dies.

GIS Benefit UAW-Ford Legal Dependent CareProgram Services Plan TESPHE Profit Sharing Plan Assistance Plan

Provides additionalincome based onCompany profits.

Your Profit Share isbased on a formulathat generallyexcludes compensa-tion received while onapproved medicalleave.

Your Profit Share isbased on a formulathat generallyexcludes compensa-tion received while onlayoff.

Participation ends.You receive a ProfitShare based oneligible pay earnedto date of yourretirement.

Your Profit Share,based on eligible payearned to date of yourdeath, is paid to yourbeneficiary.

You must enroll toparticipate; mid-yearchanges are allowed ifyou experience aqualifying life event.

Participation ends.Claims may besubmitted for servicesreceived while inactive status.




7777

After an overview of your Health Care Plan, thissection of your handbook covers:

Health Care PlanAn Overview

Page

Eligibility for Health Care Coverage 11

Hospital-Surgical-Medical Coverage 25

Prescription Drug Coverage 45

Dental Coverage 53

Vision Care Coverage 59

Hearing Aid Coverage 67

Pilot Programs 71

Health Care Claims 73

Your Privacy Rights (HIPAA) 79

Important Medicare Information 83

Other Health Care Plan Information 93

8 Health Care Plan

An overview of the Plan

Your Health Care Plan, which includes Hospital -Surgical-Medical-Prescription Drug-Dental-Vision Care-Hearing Aid coverages, provides important protectionfor you, your spouse and your eligible dependents.

Your health care benefits cover most health-related ex-penses. As an hourly Ford employee represented by theUAW, you may be eligible for the following categories ofhealth care coverage:• Hospital-Surgical-Medical• Prescription Drug• Dental• Vision Care• Hearing Aid

More details follow.

One of the general primary objectives of the Company inconjunction with the UAW is to provide you with access toquality health care services. The Company is not a healthcare provider and it will not be responsible for any liabilitystemming from the care you or your dependents receivefrom a specific health care provider. Nothing in this hand-book (or any other explanation of benefits provided to youby or on behalf of the Company) should be considered arepresentation as to the quality of specific health careservices you or your dependents will receive from a par-ticular provider.

BCBS National PPO Plan / UNICARE Traditional Plan andAlternative Plans

In most areas of the country, hospital-surgical-medi-cal coverage is available under alternative health careplans. In some areas, dental coverage is availableunder alternative dental care plans.

The alternatives to the BCBS National PPO Plan, theUNICARE Traditional Plan, and the BCBS Traditional Den-tal Plan are as follows:

Alternatives to the:BCBS National PPO BCBS TraditionalPlan/UNICARE Dental PlanTraditional Medical Plan

HMO (Health Maintenance DHMO (Dental HealthOrganization) Maintenance Organization)

PPO (Preferred ProviderOrganization)

Brief descriptions of the Traditional and alternative planoptions available are presented below.

UNICARE Traditional Medical PlanWith the UNICARE Traditional Medical Plan, you gener-ally may receive medical care from any doctor or hospitalyou choose.

BCBS National PPO PlanEffective September 1, 2004, the BCBS Traditional Plan wasconverted to a Preferred Provider Organization (PPO) Plan.The plan is now called the BCBS National PPO Plan.

If you are enrolled in the BCBS National PPO Plan, youmust use National PPO in-network hospitals, physiciansand pharmacies to receive the maximum benefits pay-able under the plan. If you use out-of-network NationalPPO Plan providers, you will be required to pay an addi-tional 10% co-insurance for covered services.

Refer to the “What is the National PPO Plan” section ofthis handbook for additional information regarding NationalPPO Plan provisions.

HMO (Health Maintenance Organization)When you join an HMO, most of your health care is coveredin full, when services are provided by the physiciansaffiliated with the HMO Plan you choose. The HMO usuallyis associated with specific hospitals. The doctor youchoose will coordinate all of your health care needs. Youusually can choose a different physician for each memberof your family. HMOs generally cover office visits and puta great deal of emphasis on preventive care such asimmunizations, allergy testing, well-baby care, andphysical exams. Services received outside the HMOnetwork of providers are not covered unless preauthorizedby the Plan or in an emergency.

Health Care Plan

Health Care Plan 9

PPO (Preferred Provider Organization)When you join a PPO, you may receive care from anyphysician affiliated with the Plan. A PPO also gives you theoption of receiving medical services from a doctor or hospitalnot affiliated with the Plan, but you will be responsible forpaying more of the costs yourself. PPOs generally providepartial coverage (but less than HMOs) for office visits andpreventive care from affiliated providers.

Traditional Dental PlanThe Traditional Dental Plan has not changed. You mayselect any licensed dentist, and he or she is reimbursedby the Plan for covered services. The Traditional DentalPlan generally pays a percentage of the approved amountfor covered procedures, up to an annual dollar maximum(or a lifetime maximum for orthodontics). In addition, whenyou receive services from a DenteMAX provider, the costyou pay is often less.

DHMO (Dental Health Maintenance Organization)If there is a DHMO available in your area, you may choosecoverage under the DHMO regardless of which MedicalPlan you choose. If you choose a DHMO, you must receiveyour dental care from a dentist who is affiliated with thatDental Plan. A DHMO generally pays all or most of thecost for covered procedures from affiliated dentists withmore favorable (or even no) dollar maximums than underthe Traditional Dental Plan.

11

Health Care PlanEligibility for Health Care Coverage

This section of your handbook answers thesequestions:

Page

Who is eligible for health care coverage? 12

How do I enroll when first eligible? 16

How do I add a new dependent to mycoverage after my initial eligibility? 16

When do I remove my dependent fromcoverage? 17

When can I change my medical and dentalplan elections? 17

12 Health Care Plan — Eligibility for Health Care Coverage

Health Care PlanEligibility for Health Care Coverage

Who is eligible for health care coverage?

You, your spouse or same-sex domestic partner andyour dependent children may be eligible for Com-pany-paid coverages if you are a hourly employeerepresented by the UAW.

Your spouse’s eligibilityYour spouse is eligible for health care coverage. A common-law spouse is eligible for coverage if the relationship isrecognized by the laws of the state in which you areenrolled, provided you meet requirements fordocumentation of the status as may be necessary by lawand required by the Company.

Social Security Numbers

You must provide the Social Security number of your spouseor same-sex domestic partner and your dependent childrenwho are covered under the health care plans. If your depen-dent has not been assigned a Social Security number, onemust be obtained and provided to the NESC within six monthsof adding the dependent to coverage. Otherwise, your de-pendent will be removed from coverage.

Your same-sex domestic partner may be eligible forCompany-paid health care coverage if all the followingcriteria are met:• You are the same sex• You have shared a continuous committed relationship

for at least 6 months, intend to do so indefinitely, andhave no such relationship with any other person

• You are jointly responsible for each other’s welfare andfinancial obligations

• You reside in the same household• You are not related by blood to a degree of kinship that

would prevent marriage from being recognized underthe laws of your state of residence

• You reside in a state where marriage between personsof the same sex is not recognized as a valid marriageby the state, or if residing in a state that recognizessame-sex unions, have entered into such union as rec-ognized by the state

• You are both over age 18, of legal age, and legally com-petent to enter a contract

• Neither of you are married to a third party• If same-sex marriages or other forms of same-sex unions

become a legal option in the state in which you reside, alegal marriage or other such legal union is required to es-tablish or retain eligibility for Company-paid health carecoverage for your same-sex domestic partner

Health Care Plan — Eligibility for Health Care Coverage 13

Your children’s eligibility

Your children and children of your spouse are generallyeligible for dependent health care coverage if ALL of thefollowing FIVE eligibility rules are met:

1. Relationship

“Children” include:• Your natural child• Your stepchild• You or your spouse’s legally adopted child• A child placed for legal adoption under age 18• A child by legal guardianship• Your surviving spouse’s child if the child was eligible to

be enrolled prior to your death

2. Age• Generally eligible until the end of the year they reach

age 25 if they meet all other eligibility criteria. Depen-dent children will be removed from coverage at age 19unless the employee, retiree or surviving spouse re-sponds to a written notification to continue coverage.

• No age restriction for totally and permanently disableddependents if the dependent was determined by the Com-pany to be totally and permanently disabled prior to theend of the calendar year in which they turned age 25 andwere eligible and enrolled as a totally and permanentlydisabled dependent prior to the end of that year.

A dependent is determined to be totally and perma-nently disabled if they have a medically determinablephysical or mental condition which prevents them fromengaging in substantial gainful activity and which canbe expected to result in death or be of long-continuedor indefinite duration.

3. Marital Status• Unmarried

4. Residency or Court Order• Must live with the employee, retiree or surviving spouse

as a member of their householdor

• The employee or retiree must be legally responsible forproviding health coverage for the child such as througha divorce decree, court order, or a Qualified MedicalChild Support Order (QMCSO).

Students are considered to be living with the enrolleewhile they are away at school.

5. Dependency or Court Order• Must be eligible to be legally claimed as an exemption

by the employee, retiree, spouse, or surviving spouseunder Section 151 of the Internal Revenue Code forfederal income tax purposes. Totally and permanentlydisabled dependents are considered to have met this“dependency” eligibility rule if they earn less than$10,000 per year from regular employment and are con-sidered dependent under Section 152 of the InternalRevenue Code for federal income tax purposes.or

• The employee or retiree must be legally responsible forproviding health coverage for their child such as througha divorce decree, court order, or a Qualified MedicalChild Support Order (QMCSO).

Eligibility Tip:

Under federal law, full-time students no longer qualify asdependents for federal income tax purposes during thetax year they become age 24 when their income reachesthe IRS exemption amount for that year.


Your sponsored dependentsYou may also enroll your sponsored dependents (regardlessof age) for hospital, surgical, medical, prescription drug andhearing aid coverage (but not dental or vision coverage).Sponsored dependents are persons other than your spouseor eligible dependent children. A sponsored dependent:• Must be related to you by blood or marriage, or• If not related by blood or marriage, they must reside

with you as a member of your household• Must be dependent on you for more than one-half of his

or her support (as defined by the Internal Revenue Code)and must either qualify in the current year for dependencytax status or have been reported as a dependent onyour most recent income tax return.

• Must have been a resident of the United States for atleast one full year prior to being enrolled

• Must be legally entitled to remain in the United Statesindefinitely before becoming eligible for coverage

Coverage for a sponsored dependent enrolled at the timeof an employee or retiree’s death may be continued by thesurviving spouse while such surviving spouse is enrolledfor coverage. A surviving spouse may not add a new spon-sored dependent to the coverage.

The cost for sponsored dependent coverage is paidby the employee, retiree or surviving spouse.

Your principally supported children’s eligibility

Principally supported children are generally eligible for de-pendent health care coverage if ALL of the following FIVEeligibility rules are met:

1. Relationship• Children related by blood or marriage to the employee

or retiree (for example, a grandchild, niece or nephew).

2. Age• Generally eligible until the end of the calendar year they

reach age 25 if they meet all other eligibility criteria.Dependent children will be removed from coverage atage 19 unless the employee, retiree or surviving spouseresponds to a written notification to continue coverage.

• No age restriction for totally and permanently disableddependents if the dependent was determined by the Com-pany to be totally and permanently disabled prior to theend of the calendar year in which they turned age 25 andwere eligible and enrolled as a totally and permanentlydisabled dependent prior to the end of that year.A dependent is determined to be totally and perma-nently disabled if they have a medically determinablephysical or mental condition which prevents them fromengaging in substantial gainful activity and which canbe expected to result in death or be of long-continuedor indefinite duration.

3. Marital Status• Unmarried

4. Residency

• Must live with the employee, retiree or surviving spouseas a member of their household.


5. Dependency• Must be legally claimed as an exemption by the em-

ployee, retiree or surviving spouse under Section 151of the Internal Revenue Code for federal income taxpurposes on their most recent tax return or who qualifyin the current tax year for dependency tax status.

A surviving spouse may continue coverage for a princi-pally supported child enrolled by a deceased employee orretiree prior to death, but may not enroll a new principallysupported child unless such child was eligible to be en-rolled by the deceased employee or retiree on their dateof death.


Your same-sex domestic partner’s children eligibilityYour same-sex domestic partner’s children are generallyeligible for dependent health care coverage if ALL of thefollowing FIVE eligibility rules are met:

1. Relationship• Your same-sex domestic partner’s children related by

birth, legal adoption, or placement for legal adoptionfor a child under age 18.

2. Age• Generally eligible until the end of the calendar year they

reach age 25 if they meet all other eligibility criteria.Dependent children will be removed from coverage atage 19 unless the employee, retiree or surviving spouseresponds to a written notification to continue coverage.

• No age restriction for totally and permanently disableddependents if the dependent was determined by the Com-pany to be totally and permanently disabled prior to theend of the calendar year in which they turned age 25 andwere eligible and enrolled as a totally and permanentlydisabled dependent prior to the end of that year.

A dependent is determined to be totally and perma-nently disabled if they have a medically determinablephysical or mental condition which prevents them fromengaging in substantial gainful activity and which canbe expected to result in death or be of long-continuedor indefinite duration.

3. Marital Status

• Unmarried

4. Residency

• Must live with the employee, retiree or surviving same-sex domestic partner as a member of their household.


5. Dependency• Must be eligible to be legally claimed as an exemption

by the employee, retiree or surviving same-sex domes-tic partner under Section 151 and 152 of the InternalRevenue Code for federal income tax purposes.

• Totally and permanently disabled dependents are con-sidered to have met this “dependency” eligibility rule ifthey earn less than $10,000 per year from regular em-ployment and are considered dependent under Section152 of the Internal Revenue Code for federal incometax purposes.


How do I add a new dependent to my coverage aftermy initial eligibility?Once you determine that they meet eligibility, contactthe NESC.

• Ensure your dependent meets eligibility under “Who iseligible for health care coverage?”

• Refer to “When coverage begins” for the effective dateof coverage for your dependents.

Your spouse and childrenCall the NESC to initiate the enrollment within 30 days ofthe event (for example, marriage, birth, adoption, placementfor adoption, or court order).

Your same-sex domestic partner and your same-sex domesticpartner’s childrenCall the NESC to initiate the enrollment process. AnEnrollment Kit will be mailed to your home address.

Your sponsored dependents

Call the NESC to initiate the enrollment process.

The NESC will inform you of any required documentationfor proving eligibility for any dependents you enroll forcoverage. Failure to furnish any required documentationwill result in denial of coverage.

Your identification card

Once you are eligible and enrolled for coverage, you willreceive identification (ID) cards from the plans you enrollin. These cards should be presented to health careproviders as confirmation of coverage for you, your spouseand your eligible dependents. Sponsored dependents willreceive their own ID cards. For more information on IDcards, see the “Health Care Claims” section.

How do I enroll when first eligible?You will be sent enrollment information approximatelytwo months prior to your initial eligibility date.

To elect coverage for yourself only, please call theAutomated Telephone System (VRU) at 1-800-333-7444.The Automated Telephone System is open 24 hours a day/365 days a year.

To elect coverage for yourself and eligible dependents,please call the NESC at 1-800-248-4444 to make yourelection. You will need to provide your dependents’ names,Social Security numbers and birthdates.

You should make your medical and dental plan electionsapproximately two months prior to your effective date.This will allow the health care plans sufficient time tosend you your identification cards prior to your effectivedate of coverage.

Your medical election automatically determines yourprescription drug, vision and hearing aid coverages, if eligible.You do not need to separately enroll in these coverages.


When do I remove my dependent from coverage?You are responsible for notifying the NESC to remove adependent from your Company-paid coverage as soon asthey no longer meet eligibility.

Removing dependents when they lose eligibility will eliminateany action by the Company to recover any health care claimsor premiums incurred by an ineligible dependent.

You can also get information about self-pay continuationof coverage options.

Benefit overpayment recovery

If the Plan determines that your act (such as adding a per-son not eligible under the Plan) or omission (for example,failing to remove a person no longer eligible under the Plan)results in or contributes to an overpayment under this Pro-gram, you will be sent written notice from the Company andyou must repay the amount of overpayment.

If repayment is not made within 60 days following thedate of the written notice, the Company has the right, inaccordance with and subject to any limitations underapplicable federal laws, to make, or arrange to havemade, deductions for recovering such overpaymentsfrom any present or future compensation or benefitspayable under the Ford H-S-M-D-D-V Program which areor become payable to you. Deductions for suchoverpayments will not exceed $100 per paycheck exceptin cases of fraud or willful misrepresentation.

When can I change my medical and dental plan elections?You may change your plan elections during any month ofthe year .

Under the Hourly Rolling Enrollment system, there is nolonger a specific enrollment period. You may change yourmedical and/or dental plan elections during any month ofthe year (provided 12 months have elapsed since yourlast change) and you are eligible for coverage.

To make a change, call the Automated Telephone System(VRU) at 1-800-333-7444 and follow the prompts to changeyour medical and/or dental elections. The Automated Tele-phone System is open 24 hours a day / 365 days a year.You will receive a confirmation statement in the mail any-time you make a change through the Automated TelephoneSystem. Your election takes effect on the 1st day of the2nd month following your election.

Hourly Rolling EnrollmentIf you call during the Your election takes month of: effect on:

January March 1February April 1March May 1April June 1May July 1June August 1July September 1August October 1September November 1October December 1November January 1December February 1

Once you make a change to your medical and/or dentalplan, you must wait 12 months to make another change.Certain limited changes are allowed during the 12-monthperiod. You must call the NESC to determine if a changeis allowable.

You also may call the Automated Telephone System at 1-800-333-7444 to:• Cancel a pending election made within the same month• Review a pending election made within the same month• Hear who your current medical provider and dental

provider are• Request plan benefit summaries


When coverage begins Company-paid hospital, surgical and medical coverage,prescription drug, dental, vision care and hearing aidcoverage begins:

If you are a new employee or are rehired First day of the month following the month in which you are“actively at work” after acquiring seven months of seniority.

Month of Hire Coverage Begins*

January September 1February October 1March November 1April December 1May January 1June February 1July March 1August April1September May 1October June 1November July 1December August 1

* If you are scheduled to be at work, but you are absent due to a disability, illness or injury, you will be deemed to be “actively at work” for purposes of this section.

For your spouse The same day as your coverage, or if later, on your marriagedate. Coverage for a common-law spouse is effective on the latestto occur of the effective date of your coverage, or the date of avalid enrollment and receipt by the Company of any necessarysupporting documentation.

For your same-sex domestic partner The later of the effective date of your coverage, or the date youraffidavit is signed and notarized, provided that you notifiedthe Company within 30 days from the date the affidavit isnotarized. Otherwise, coverage is effective on the later of theeffective date of your coverage or the first of the month followingthe date the NESC receives your completed affidavit and anyrequired documentation.


When coverage begins Company-paid hospital, surgical and medical coverage,prescription drug, dental, vision care and hearing aidcoverage begins:

For your eligible dependent children The later of the effective date of your coverage, the date they firstmeet the eligibility criteria, or in the case of:

Birth − the date of birth

Legal Adoption - the date of placement in your household or petition foradoption, whichever occurs earlier, or the date of the assumption andretention of a legal obligation for total or partial support

Legal Guardianship - the date of petition for guardianship and residenceexcept that the residence requirement may be waived if the primaryenrollee is legally responsibility for the provision of health care

Stepchild - the date the child becomes a member of your household

Principally Supported Child - the first day of the month following themonth in which a valid enrollment is completed and any necessarysupporting documentation is received

Court Order, Divorce Decree or Qualified Medical Child SupportOrder (QMCSO) - the date of the court order, divorce decreeor QMCSO

Children of your Same-Sex Domestic Partner - The later of theeffective date of your coverage, or the date your affidavit is signed andnotarized provided that you notified the Company within 30 daysfrom the date the affidavit is notarized. Otherwise, coverage iseffective on the later of the effective date of your coverage or the firstof the month following the date the NESC receives your completedaffidavit and any required documentation.

For your sponsored dependent The later of the effective date of your coverage or the first day ofthe month following the month of receipt by the Company of anysupporting documentation required by the Company to proveeligibility.The effective date of coverage for a sponsored dependentpreviously enrolled as such, and whose coverage as a sponsoreddependent was discontinued, is the first day of the sixth monthfollowing the month in which a valid enrollment is completed.


When coverage ends

Generally, health care coverages (except dental coverage)end the last day of the month following the month youwere last at work.

If you terminate your employment or are discharged, allyour health care coverages (except dental coverage) endon the last day of the month in which your employment isterminated (or as of the employment termination date whenadministratively feasible).

If you have a grievance pending to protest your termination,all of your health care coverages end the last day of themonth after the month in which you are discharged. Youmay, however, continue coverage after Company-paidcoverage terminates by paying the cost while the grievanceis pending.

If you go on leave of absence (other than a medical leaveor FMLA leave), all of your health care coverages (exceptdental coverage) end the last day of the month followingthe month in which you leave. If you wish, you maycontinue health care coverage (except dental coverage)during the leave for up to twelve consecutive months bymaking payments for coverage.

Dental coverage usually ends the last day of the month inwhich you leave. If you terminate your employment, dentalcoverage ends the last day you work. If you have agrievance pending to protest your termination, coverageends the last day of the month following the month inwhich you last worked. You may continue your dentalcoverage by paying the cost if there is a grievance pendingor if you are on an approved local Union leave.

When coverage is continuedIf you are on an approved medical leave of absence,health care coverage for you, your spouse and your eli-gible dependents continues while you are away from workfor up to the greater of:

• A period of time equal to the number of years of senior-ity you had when you left

• The period of time during which you receive ExtendedDisability Benefits

If you are on a FMLA leave of absence, health care cov-erage for you, your spouse and your eligible dependentscontinue while you are away from work for the duration ofthe FMLA leave. FMLA leaves are limited to a total of 12weeks of absence in a calendar year.

If you are on a qualifying layoff under the Ford-UAWSupplemental Unemployment Benefit (SUB) Plan, healthcare coverage for you, your spouse and your eligible de-pendents continues for the greater time period either fromthe schedule below:

Your years of seniority Number of monthson the last day you coverage will beworked prior to layoff provided without cost

to you

Less than 1 01 but less than 2 22 but less than 3 43 but less than 4 64 but less than 5 85 but less than 6 106 but less than 10 1210 and over 24

OR• One full calendar month of layoff (up to 24 months) for

each full four weeks of Regular Benefits to which yourCredit Units as of October 29, 1990 (or as of the lastday worked prior to layoff in the event the 1987 SUBPlan is reinstated prior to your layoff) entitle you basedon your seniority and the Credit Unit Cancellation Baseunder the provisions of the 1987 SUB Plan

OR• The period of time during which you receive Extended

Disability Benefits

When your months of continued coverage are up, youmay continue coverage for up to 12 consecutive monthsby making payments for coverage.


If you are laid off and eligible for benefits from theGuaranteed Income Stream (GIS) Benefit Program, you,your spouse and your eligible dependents may be eligiblefor GIS Hospital-Surgical-Medical coverage. For more in-formation, see the “Guaranteed Income Stream (GIS)Benefit Program” section of this handbook.

If you retire under the Ford-UAW Retirement Plan with 10or more years of credited service under Company retire-ment plans (excluding deferred vested retirees), healthcare coverage continues for you, your spouse and youreligible dependents. Coverage also continues if you werehired prior to September 30, 1996 and leave the Companyafter reaching age 65 (unless you are discharged) and arenot eligible for a benefit under the Retirement Plan.

Retirees eligible for Medicare Part B must enroll and main-tain continued enrollment in Medicare Part B to be eligibleto receive the Special Age 65 Benefit. Proof of Part Bparticipation may be required. Employees with End StageRenal Disease who are enrolled in voluntary Medicarecoverage also may receive a payment equal to the Spe-cial Age 65 Benefit.

Retirees, surviving spouses and dependents eligible forMedicare Part A must enroll in, maintain, and use Medi-care Part A coverage.

If you die and your surviving spouse and eligible de-pendents are not eligible for continuation of coverageas described in the “Who is eligible for health care cov-erage?” section, their coverage ends on the last day ofthe month after the month in which you die. Your spouse,however, while eligible to receive Survivor Income Ben-efits from the Life and Disability Insurance Program maycontinue Hospital-Surgical-Medical, Prescription Drugand Hearing Aid coverage) for himself or herself andany dependents who were eligible or sponsored at thetime of your death. Your spouse must enroll for suchcoverage within three months of your death and mustpay for that continued coverage.

Your spouse’s eligibility for coverage ends on theearliest to occur of:• The date your coverage ends

• The date of a final decree of divorce

• The date your marriage is annulled

• The last day of the month following the month in whichyou die unless:

• You were retired or eligible to retire at the time of yourdeath and your spouse is eligible for a surviving spousebenefit under the Ford-UAW Retirement Plan

• Your surviving spouse is eligible to receive BridgeSurvivor Income Benefits from the Life and Disabil-ity Insurance Program (or would be eligible exceptthat your surviving spouse was age 60 or older atthe time of your death), Company-paid coverage(other than dental and vision) continues for the fol-lowing continuation period:

— 24 months following the month in which you dieif your death occurs on or after October 25, 1999,and prior to January 1, 2004, or if your deathoccurs on or after January 1, 2004, and you haveless than 10 years of credited service under Com-pany retirement plans at the time of your death

— 30 months following the month in which you dieif your death occurs on or after January 1, 2004,and you have 10 or more years of credited ser-vice under Company retirement plans at the timeof your death

• The date your surviving spouse remarries if yourdeath is the result of an occupational injury causedsolely by employment with the Company

• The date your surviving spouse is not enrolled inMedicare Part B coverage

• The date of your spouse’s or surviving spouse’s death• The date your spouse or surviving spouse no longer

meets any other eligibility requirements of the Plan


Your children’s eligibility for coverage ends on theearliest to occur of:• The date your coverage ends

• The date the child no longer resides with you

• The date the child ceases to be dependent upon you oryour spouse as defined in Section 151 of the InternalRevenue Code for federal income tax purposes (ex-cept a totally and permanently disabled dependent mayearn up to $10,000)

• The date of marriage of the child

• The date your principally supported dependent ceases tobe dependent on you as defined in Section 151 of theInternal Revenue Code for federal income tax purposes

• The last day of the month the qualified legal require-ment to provide health care coverage for your child hasterminated or no longer meets Plan requirements

• The date your 24-year-old dependent exceeds the federalincome tax earnings limitation

• The last day in the calendar year in which the childbecomes age twenty-five, except in the case of a to-tally and permanently disabled child

• The date a child over age twenty-five is no longer to-tally and permanently disabled

• The date your surviving spouse’s or surviving same-sex domestic partner’s coverage ends

• The date your same-sex domestic partner’s child nolonger resides with you or is no longer principally de-pendent upon you as defined under Section 151 and152 of the Internal Revenue Code for federal incometax purposes

• The date of your child’s death

• The date your child no longer meets any other eligibil-ity requirements of the Plan

Your same-sex domestic partner’s eligibility for cov-erage ends on the earliest to occur of:• The date your coverage ends

• The date your relationship ends

• The last day of the month following the month in whichyou die unless:

• You were retired or eligible to retire at the time ofyour death (not including your eligibility for a de-ferred vested benefit) and if hired on or after Sep-tember 30, 1996, you had at least ten years of cred-ited pension service, in which case your same-sexdomestic partner qualifies for continued coverage

• Your surviving same-sex domestic partner is eli-gible to receive Bridge Survivor Income Benefits fromthe Life and Disability Insurance Program (or wouldbe eligible except (i) he/she was age 60 or older atthe time of your death, or (ii) you died on or afterAugust 1, 2000 and before September 29, 2003—Company-paid coverage (other than dental and vi-sion) continues for the following continuation period:

— 24 months following the month in which you dieif your death occurs on or after August 1, 2000,and prior to January 1, 2004, and you have lessthan 10 years of credited service under Companyretirement plans at the time of your death

— 30 months following the month in which you dieif your death occurs on or after January 1, 2004,and you have 10 or more years of credited ser-vice under Company retirement plans at the timeof your death

• The date your same-sex domestic partner marries orenters into a same-sex domestic partnership if yourdeath is the result of an occupational injury causedsolely by employment with the Company

• The date of your partner’s death• The date your partner no longer meets any other

eligibility requirements of the Plan


Your sponsored dependent’s eligibility for coverageends on the earliest to occur of:• The last day of the month in which the person ceases

to meet the eligibility criteria

• The last day of the month preceding the month for whichthe required contribution was due but not paid

• The date the employee, retiree or surviving spouse’s cov-erage ends. In the case of the employee or retiree’s death,coverage for such sponsored dependent shall cease onthe last day of the month following the month in which theenrollee dies, unless the sponsored dependent’s cover-age is continued by the surviving spouse

• The date of your sponsored dependent’s death

Additional informationIf you transfer from salaried to hourly employment or vice-versa, call the NESC and a Human Resource Associatewill assist you regarding your enrollment options and theenrollment process.

Under certain circumstances, you may choose to continueyour group (Ford) health care coverage. Refer to the “OtherHealth Care Plan Information” section for detailed informa-tion on when you can pay to continue coverage or convertyour coverage to an individual policy.

Health Care Plan — Hospital-Surgical-Medical Coverage 25


Page

What is the National PPO Plan? 26

How does Hospital-Surgical-Medicalcoverage work? 27

What hospital-related services are covered? 29

What surgical and medical services are covered? 32

What benefits are provided for emergencies? 34

What benefits are provided for treatment at askilled nursing facility? 34

What benefits are provided for coordinatedhome care? 35

What benefits are provided for hospice care? 35

What is Coordinated Care Management? 36

What is Complex Care Management? 36

What benefits are provided for durablemedical equipment? 37

What benefits are provided for prosthetic andorthotic appliances? 38

What benefits are provided for mastectomy? 39

How does the Managed Care Program (MCP)for psychiatric care and substance abusetreatment work? 40

What benefits are provided for psychiatric careand substance abuse treatment under the MCP? 41

What Hospital-Surgical-Medical servicesare not covered? 42

How does coverage under an HMO orPPO work? 43

Health Care PlanHospital -Surgical-Medical Coverage

26 Health Care Plan — Hospital-Surgical-Medical Coverage

Health Care PlanHospital-Surgical-Medical Coverage

What is the National PPO Plan?

Effective September 1, 2004, the BCBS TraditionalHospital-Surgical-Medical Plan was converted to aPreferred Provider Organization (PPO) Plan. The plan isnow called the National PPO Plan and continues to beadministered by BCBS.

If UNICARE is your Traditional Hospital-Surgical-Medicalclaims processor, you are not affected by the PPO con-version at this time.

This conversion does not apply to the other existing PPOplans, HMO plans, Dental plans, SVS Vision, NationalFoot Care, the National DME and P&O SUPPORT Pro-gram or the Prescription Drug plan.

The same Hospital-Surgical- Medical services that werecovered under the Traditional Plan are still covered underthe National PPO Plan. The difference is that the NationalPPO Plan has an in-network benefit level and an out-of-network benefit level.

In-Network benefit level

If you receive covered services from an in-network BCBSNational PPO Plan provider, there is no change to the ben-efit that would have been paid under the Traditional Plan.

To determine whether your physician participates in the BCBSNational PPO Network, you may call Blue Cross Blue Shieldat 1-800-810-2583, or search the BCBS website at http://www.bcbs.com/healthtravel/finder.html for information.

Out-of-Network benefit level

If you receive covered services from an out-of-networkBCBS National PPO Plan provider, you will be required topay an additional 10% co-insurance for those coveredservices. The most you will pay for the 10% out-of-net-work co-insurance is $250 per person or $500 per family,each calendar year.• In addition, if you use an out-of-network BCBS Na-

tional PPO Plan provider who is also a non-participat-ing provider with the BCBS Traditional Plan, you maybe responsible for any changes above the BCBS maxi-mum allowable payment amount.

• If, however, you receive covered services from an out-of-network BCBS National PPO Plan provider who isa participating provider with the BCBS Traditional Plan,covered charges will be subject to the 10% out-of-net-work co-insurance, but you should not be balance-billedfor charges above the BCBS maximum allowable pay-ment amount (and if you are balance billed in this case,you are not responsible to pay those additional chargesabove the BCBS maximum allowable amount.)

Mental Health & Substance Abuse Program

Coverage for psychiatric care and substance abuse treat-ment is unchanged; active employees should continue toutilize the Managed Care Psychiatric and Substance AbuseProgram. Refer to “How does the Managed Care ProgramWork?” later in this section for additional information.

If You have Medicare

BCBS enrollees who have Medicare are included in theNational PPO Plan. If you are an active employee withMedicare and your UAW-Ford coverage is primary, you aresubject to the 10% out-of-network co-insurance.

If Medicare is your primary carrier (meaning Medicare paysfirst), covered charges are not subject to the 10% co-in-surance for out-of-network services under the Ford Plan.

Out-of-Network referrals

Covered referrals can be made only by in-network BCBSNational PPO Plan providers. If your in-network PPO pro-vider refers you to an out-of-network provider and obtainsapproval from BCBS, covered approved services fromthe out-of-network provider will be paid at the in-networkbenefit levels.

Services received out-of-network without an approvedreferral are subject to the 10% out-of-network coinsurance.You may also be responsible for any charges above theBCBS maximum allowable payment amount, if the pro-vider does not participate with the BCBS Traditional Plan.

Important notes

Throughout the rest of this health care section, referenceto “the Plan” means the information stated applies to boththe BCBS National PPO Plan and the UNICARE Tradi-tional Plan.

All claim examples and coverage descriptions in thissection assume that National PPO enrollees are utilizingin-network National PPO Plan providers. UNICARE doesnot distinguish between par ticipating and non-participating providers.


How does Hospital-Surgical-Medical coverage work?

Hospital-Surgical-Medical benefi ts cover mostmedically necessary health care services for you andyour eligible dependents.

Note: BCBS National PPO in-network and out-of-net-work benefit levels may apply.

Hospital-Surgical-Medical benefits are provided for cov-ered hospital, surgical and medical expenses for you andyour eligible dependents. Covered services include hospi-tal room and board charges, along with customaryhospital-related services and supplies and some outpa-tient and home care services. Surgical-Medical benefitscover the reasonable and customary (maximum allowablepayment amount) charges, as defined below, for physi-cians’ services, surgery, tests and most otherhealth-related expenses.

Information relating to your eligibility for Hospital-Surgical-Medical coverage is provided in the “Eligibilityfor Coverage” section.

Reasonable and customary charges (the maximum allowablepayment amount)In determining what constitutes a reasonable and cus-tomary charge (the maximum allowable payment amount),the claims processor may take the following into account:• The customary fee which the individual physician most

frequently charges the majority of patients for a similarservice or procedure

• The prevailing range of fees charged in the same areaby physicians of similar training and experience for theperformance of a similar service or procedure

• Unusual circumstances or complications requiring ad-ditional time, skill and experience relating to a particu-lar service or procedure

• Contracted provider arrangements

The predetermination featureYour Hospital-Surgical-Medical coverage has a specialfeature, “predetermination.” Predetermination determineswhether hospital admission is appropriate. Once thehospital admission is approved, an appropriate length ofstay is established and your physician and the hospitalwill be notified. Your covered charges then will be paidaccording to your plan’s provisions.

The predetermination feature requires physicians and hos-pitals, not you, to notify and obtain approval from theclaims processor before non-emergency hospitalizationcan occur. Emergency admissions must be reported within24 hours by providers. Predetermination is not requiredfor a maternity admission.

While you are in the hospital, the length of your stay willcontinue to be reviewed.

If you have been notified that predetermination approvalfor hospitalization has been denied but you elect to behospitalized, you will pay 20% of your covered hospitalexpenses, the first $100 of your physician expense and20% of the remaining covered physician expenses up toa calendar year maximum of $750 per individual or $1,500per family. After this amount is reached, covered servicesare paid according to your plan’s provisions for the re-mainder of that calendar year.

If you are admitted to the hospital but are not notified thatyour hospital admission has been denied, you will not beheld responsible for the extra predetermination charges inthe paragraph above incurred for covered services. Youwill be held harmless from the provider’s errors of com-mission or omission.


The voluntary second surgical opinion feature


Effective September 1, 2004, the mandatory second sur-gical opinion program that applied to certain elective sur-gical procedures was eliminated. You are no longer requiredto obtain a second opinion in order to receive full planbenefits. The second opinion program is now strictly vol-untary, described as follows.

The voluntary second surgical opinion feature is designedto enhance quality of care and to reduce unnecessaryinpatient surgery. This feature provides you and youreligible dependents with additional information on therisks and benefits of the surgery as well as availabletreatment alternatives.

When you and your eligible dependents are faced withcovered surgery, a second surgical opinion may helpyou decide:

• If an operation is necessary

• If a different treatment is more appropriate

If you decide to seek a voluntary second surgical opinion,benefits will be provided under the Plan for the cost of thesecond opinion, including the physician’s consultation andany necessary x-ray and laboratory tests. When the secondopinion does not agree with the first, a third opinion also iscovered under the Plan. Non-surgical medical consultationsalso are covered under the Plan when recommended bythe second opinion physician because of medicalcomplications which may affect your surgery.

Second and third opinions are covered only when theyrelate to covered surgeries that take place in an inpatientor outpatient hospital setting, or approved ambulatorysurgery facility. They are covered only when performed bya M.D., D.O., D.P.M. or oral surgeon. Second and thirdopinions are not covered when performed by a Chiropractor,Psychologist or Dentist. Also, the second and third opinionscannot be sought from the physician who performed yourinitial diagnosis.

BCBS National PPO Plan members must utilize in-networkPPO providers for surgical opinions to be paid at 100% ofthe maximum payment allowed under the plan. Opinionsperformed by out-of-network PPO providers will be subjectto the 10% out-of-network co-insurance amount. You mayalso be responsible for any charges above the BCBSmaximum payment allowed when you utilize an out-of-network PPO provider who does not participate with theBCBS Traditional Plan.

No matter what the second or third opinions are, you’restill free to choose whether or not to have the surgery.Even if the second opinion states that surgery isunnecessary, your Hospital-Surgical-Medical coverage stillprovides benefits for the surgery, as long as the surgeryis a covered procedure.

The case management featureAnother feature of your Hospital-Surgical-Medical cover-age is “case management.” Case management is a pro-cess of substituting alternative, non-hospital care for tra-ditional inpatient care. The alternative care may consist ofcovered services and, in addition, services over and abovepresent coverage such as private duty nursing in the hometo allow patients who would otherwise be confined to ahospital to live a more normal life within the family setting.The primary objective of case management is to designalternative treatment plans that maintain or improve thequality of life while providing more cost effective care.

You and your eligible dependents can participate in thecase management program if the patient has remaininghealth care benefit eligibility and the patient and the at-tending physician agree to the alternative treatment planprior to implementation. Participation in the plan is volun-tary. You may elect to return to your regular health carecoverage at any time (assuming such health care ben-efits have not been exhausted).


What hospital-related services are covered?

Generally, when you or your eligible dependents areconfined in a hospital, most services are covered. Ben-efits also are paid for approved outpatient care.

Hospital coverage as an inpatientHospital benefits are paid under the plan for covered ser-vices for up to 365 days while you or your eligible depen-dents are confined in a hospital. Up to 45 of the 365 daysare covered for treatment of a mental or nervous condi-tion or pulmonary tuberculosis. A new 365- or 45-day pe-riod begins when you have not been in the hospital or asimilar facility (e.g., a skilled nursing facility, a day ornight care center or residential substance abuse treat-ment facility) for 60 consecutive days.


Covered services include:• Semiprivate room and board charges, including all regu-

lar daily services. Charges for a private room are cov-ered at the hospital’s standard rate for a semiprivateroom, unless you need a private room for intensive careor isolation. If you choose a private room, you pay theamount over the semiprivate rate

• Hospital services and supplies, including general nurs-ing care, meals and special diets

• Intensive care• Drugs and medicines• Oxygen and gas therapy• Use of operating rooms, other surgical treatment rooms

and delivery rooms• Anesthesia given by a qualified hospital employee• Certain blood services and their administration, includ-

ing whole blood and packed red blood cells• Hemodialysis when provided by a qualified hospital• Dressings and casts• Physical and electroshock therapy provided by the hospital• Use of the hospital’s radium, cobalt and radioactive

isotopes

• Chemotherapy and its administration, including mostoral chemotherapy and drug injections, but not experi-mental chemotherapy drugs (similar chemotherapy ad-ministered in the physician’s office or the patient’s homealso is covered)

• Use of durable medical equipment, as described in the“What benefits are provided for durable medical equip-ment?” section

• X-rays, EKGs, two-dimensional echocardiography anddigital subtraction angiography

• Prosthetic appliances• Laboratory services• Intermittent positive breathing therapy• Rehabilitation care• Pulmonary function evaluation• Hyperbaric oxygenation• Psychological testing administered by a qualified

hospital employee• Skin bank, bone bank and soft tissue bank• Costs for human organ transplants, including:

— Locating, evaluating, removing, preserving andtransplanting human organs and tissues

— Care of potential and actual donors, to the extentnot covered by any other medical plan

• Maternity care (including routine nursery care of newborns)

Maternity and Newborn Infant Health CoverageConsistent with the “Newborns’ and Mothers’ Health Pro-tection Act of 1996” (NMHPA), in connection with child-birth for a covered mother or newborn child, your coveragedoes not restrict benefits to, or require authorization for,any hospital length of stay of less than:• 48 hours following vaginal delivery• 96 hours following caesarean delivery

Of course, the mother and physicians may decide on ashorter stay if appropriate, and all other Plan provisionsare unchanged. Alternative plans, such as HMOs andPPOs, follow the same rule as well.


Outpatient services for covered surgery at an AmbulatorySurgical Facility (ASF) or Freestanding Ambulatory Surgi-cal Center (FASC) approved by the Plan are covered. Tobe approved by the Plan, an ASF or FASC must meetcertain licensing, accreditation, and similar criteria, andalso satisfy Plan standards which may consider whethermore facility capacity is needed in a given area. Checkwith the Plan before you are treated at such a facility tofind out if it is an approved facility.

Effective January 1, 2004, outpatient hospital chargesrelated to dental services are covered under the Hospi-tal-Surgical-Medical plan based on Control Plan guide-lines for enrollees with special needs (e.g., Down’s Syn-drome, autism, spastic conditions), medical conditionsthat are marginally controlled, or dental conditions thatmay adversely impact their medical conditions (e.g.,uncontrolled diabetes with periodontal disease). Chargesfor the actual dental services will continue to be paid byyour dental plan.

Effective September 29, 2003, following documentationof no measurable signs of healing following at least 30days of standard wound therapy, up to 60 hospital outpa-tient hyperbaric oxygenation treatments per condition percalendar year are covered for conditions which are cov-ered by Medicare and which meet criteria established bythe Control Plan. Treatment must be administered in achamber and for the treatment of wounds and must beused in addition to standard wound care. Continued treat-ment with hyperbaric oxygen therapy is not covered if mea-surable signs of healing have not been documented withinany 60-day period of treatment (within any 30-day periodfor diabetic wounds).

Hospital coverage as an outpatient


The benefits listed above in the “Hospital coverage asan inpatient” section are covered under your plan’s ben-efit structure when you receive them on an outpatientbasis from a hospital when ordered by the attending phy-sician, except:• Medications are covered only when dispensed and used

in the hospital in connection with the use of operating orsurgical treatment rooms, anesthesia or physical therapy.

• Laboratory services are covered only when used withoutpatient surgery, emergency treatment or treatmentof accidental injuries or when received within 72 hoursof a hospital admission.

• Up to 60 treatments per calendar year (per condition)are covered for outpatient physical therapy in a hospi-tal or approved physical therapy facility.* The limitmay be renewed after surgery or a distinct aggravationof the original condition. The outpatient physical therapybenefit includes coverage for separately billed speech,hearing and functional occupational therapy (whetheror not provided in conjunction with physical therapy).

• A separate series of 60 treatments also may be avail-able for speech therapy to treat congenital and severedevelopmental speech disorders for children under agesix. Benefits may be paid after attainment of age sixfor continuous treatment which began prior to age sixup to the 60-visit limit. To qualify, therapy must not beavailable through a public agency.

Outpatient observation bed care is covered under yourplan’s benefit structure when it meets Plan criteria.

Infusion therapy is covered under your plan’s benefit struc-ture in the hospital outpatient department (or thephysician’s office) in accordance with Plan criteria.*

Some outpatient services are provided outside of the hos-pital—in a physician’s office or another facility (e.g., askilled nursing facility). Information relating to these ben-efits is explained in the following sections: “What surgicaland medical services are covered?”; “What benefits areprovided for treatment at a skilled nursing facility?”; “Whatbenefits are provided for coordinated home care?”; “Whatbenefits are provided for psychiatric care and substanceabuse treatment under the MCP?”

* Call your claims processor to verify if a facility or plannedtreatment is approved.


Ambulance servicesAmbulance services are a covered benefit under the fol-lowing conditions:• Ambulance services must be medically necessary• The provider of the ambulance service must meet

Medicare criteria for approval

Ground transportation between facilitiesA physician must prescribe services which necessitateuser of ground ambulance transportation between facilities.

Ambulance benefits are provided for local ground trans-portation within the greater metropolitan area when the needfor services arises and for purposes of:• Transferring (one-way or round trip) of a hospital

inpatient, or patient seen in the emergency room, toanother local hospital when a lack of needed treatmentfacilities, equipment or staff physicians exists at thefirst hospital, or

• Transporting (one-way or round trip) of a hospitalinpatient to a non-hospital facility for examination witha covered CAT, MRI or PET scan and the followingconditions are met:

— The services are not available in the hospital wherethe member is inpatient and are not available in acloser local hospital, and

— The free-standing facility providing the treatment isapproved by any applicable state planning agencyor comparable approval process

Emergency transportation: ground / air /water

Benefits for emergency transportation services are pro-vided for ground ambulances effective January 1, 2000,and for air and water ambulances effective January 1, 2004.Services are covered for emergency transportation for:• Transporting a patient one-way from the scene of an

emergency incident to the nearest available facilityqualified to treat the patient.

• Transporting a patient one-way or round trip from thehome to the nearest available facility qualified to treatthe patient.

• Medical emergency/accidental injury patients are providedone-way transportation from the home to the facility. Thereturn trip following stabilization is not covered.

• Home-bound patients are provided round triptransportation from the home to the facility and backwhen medically necessary and when other means oftransportation could not be used without endangeringthe patient’s health.

Coverage at nonparticipating hospitalsSee “What is the National PPO Plan” at the beginningof this section for information on Blue Cross in-net-work and out-of-network coverage.

Participating / nonparticipating provisions do not apply toUNICARE. If your claims processor is UNICARE, all ap-proved hospital charges are covered under the normalhospital coverage rules.

If you are covered by Blue Cross, some special hospi-talization rules apply. Most hospitals in the United Statesare described as “participating” by Blue Cross. A par-ticipating hospital is a facility that is approved by BlueCross and receives full payments from Blue Cross forcovered services.

If your claims processor is Blue Cross and you are admit-ted to a nonparticipating hospital, hospital coverage willpay up to a maximum benefit of:• $250 a day toward covered hospital services (including

$20 for ancillary services) you receive as an inpatientin an acute care hospital

• $15 per day for services in other than an acute carehospital (e.g., a mental health facility) and

• $35 for each condition for services received on an out-patient basis

• Emergency services immediately following serious (e.g.,life threatening) bodily injury or medical emergenciesare covered, not to exceed the average amount paid tononparticipating hospitals within the Plan area

You should find out which of your local hospitals participatesin Blue Cross before you need emergency hospital care.Blue Cross or the facility can tell you if it is “participating.”


• Charges for anesthesia and its administration inconnection with surgical, medical or obstetrical carewhen administered by a physician other than the one incharge of the case

• General anesthesia services when performed and billeddirectly by a nurse anesthetist where legally permitted

• Effective September 29, 2003, continuous passive motion(CPM) will be covered after knee surgery if initiated withinthe first 48 hours following surgery, and utilized a maximumof 20 days immediately following surgery

• Physicians’ services for hemodialysis• Therapeutic radiological services, if necessary for the

treatment of an illness or injury• Physicians’ services to administer chemotherapy• Effective January 1, 2004, coverage is provided for

pulmonary function tests provided in accordance withControl Plan criteria for location of service, includingthe hospital outpatient and physician office setting

• CAT scans and MRI services are covered benefitswhen ordered by a physician, and performed onapproved equipment

• Diagnostic X-rays, laboratory and pathology tests whenrelated to diagnosis of an illness or injury (miniatureplates, screening procedures and diagnostic X-raysrelated to a routine physical exam are not covered)

• PAP smear tests performed once every 12 months un-less prescribed more frequently by a licensed physi-cian for one of the following medical conditions:— Previous surgery for a vaginal, cervical or uterine

malignancy— Presence of a suspect lesion in the vaginal, cervi-

cal or uterine areas— A positive PAP smear leading to surgery and requir-

ing post-operative PAP smear• Routine mammography screening in accordance with

guidelines established by the American Cancer Societyas follows:— A baseline mammogram at age 40— A mammogram every one to two years between

ages 40 through 49 depending on risk factors andphysician recommendation

— A mammogram once each year after age 50 is attained

In addition, effective September 29, 2003, enrolleesdetermined to be at increased risk for breast cancerbased on family history (1st degree family member),genetic factors or previous breast cancer are eligibleto undergo annual mammography examinations begin-ning at age 25.

What surgical and medical services are covered?Surgical-Medical benefits cover many surgical andmedical services you and your eligible dependentsreceive.


Your Surgical-Medical benefits cover the reasonable andcustomary (maximum allowable payment amount) chargefor certain medical and surgical services which include:

• General inpatient care for medical and non-pulmonarytubercular conditions by the physician rendering theservice for hospital bed patients for an unlimited num-ber of days

• Surgical fees—for all generally accepted operative andcutting procedures, including laser surgery for coveredprocedures necessary for the diagnosis and treatmentof diseases, injuries, fractures, dislocations and recon-structive surgery for the following:— The correction of conditions resulting from acciden-

tal injuries or traumatic scars— The correction of congenital anomalies— Reconstructive plastic surgery to correct deformi-

ties resulting from medically necessary surgery dueto malignancy or fibrocystic disease and reconstruc-tive surgery when there is a visual impairment

• Physician services to donors and potential donors formedically recognized human organ or tissue transplantsto the extent not covered by any other medical plan

• Heart, heart-lung, lung, pancreas and liver transplants,up to a $25,000 limit on physicians’ and surgeons’ fees

• Assistant surgical physicians’ fees for certain procedures,if an intern, resident or staff physician is not available

• Necessary surgical, medical or obstetrical consultationby another physician, if requested by the physician incharge of your case when you are an inpatient

• Delivery of a child or children, necessary pre- and post-natal care and routine laboratory services in connec-tion with normal maternity care

• Routine medical care of the newborn and a separatebenefit for initial inpatient examination of the newbornwhen provided by:— A physician other than the delivering physician— The physician who administered the anesthesia

during delivery


• PSA (Prostate-Specific Antigen) screening testing onceeach calendar year for enrollees ages forty (40) andolder provided the test is performed in accordance withguidelines established by the American Cancer Society.PSA tests used to confirm a diagnosis of cancer or totrack the progress of the disease, and to determine theeffectiveness of their treatment being given will continueto be covered regardless of age. Effective September29, 2003, a second screening within the same calendaryear will be provided if the first PSA test indicates aPSA level of 4.0 or higher.

• Proctoscopic examinations with biopsy; after you reachage 40, proctoscopic examinations without a biopsyare covered once every three years

• Effective September 29, 2003, enrollees determined tobe at increased risk for colorectal cancer based on fam-ily history or genetic factors, are eligible to undergocolonoscopy and/or flexible sigmoidoscopy and fecaloccult blood examinations every 2 years as of age 25,and annually as of age 40

• Effective January 1, 2004, the Cancer Antigenscreening test (CA-125) is covered:

— Once per calendar year for those enrollees age 25and older with family history of ovarian cancer (1st

degree family member)

— At the time of diagnosis of ovarian cancer, and upto three follow-up tests per calendar year todetermine the effectiveness of therapy

— Up to twice per calendar year for those who havebeen diagnosed with ovarian cancer and who are inclinical remission

• Hepatitis C (HCV) screen if an enrollee is at risk or whensigns or symptoms may indicate a Hepatitis C infection

• Procedures that require a physician’s expertise forinjection, implantation, insertion, fitting and removal ofcovered contraceptives

• Cosmetic bonding of eight front teeth for children ageeight through the end of the calendar year in which theybecome age 19 because of severe tetracycline staining,severe fluorosis, hereditary opalescent dentin, orameleogenesis inperfecta, but not more frequently thanonce in any period of three consecutive years

Your Surgical-Medical benefits also cover the reasonableand customary charge (maximum allowable paymentamount) for:• Physical therapy for non-Medicare enrollees, in an of-

fice setting by a physician or an independent physicaltherapist (but not a chiropractor) participating with orapproved by the Plan, and subject to treatment limitstogether with outpatient hospital-based therapy

• Physician services during covered hospital outpatientobservation bed care

• Administration of rabies vaccines necessitated by re-cent exposure to a rabid or potentially rabid animal.Effective September 29, 2003, regardless of where ini-tial treatment is performed, follow-up treatments maybe performed in a physician’s office or a hospital out-patient setting

• One flu shot per calendar year, administered in accor-dance with Plan criteria. In addition, effective Septem-ber 29, 2003, enrollees are covered for immunizationsas recommended by the Centers for Disease ControlAdvisory Committee on Immunization Practices andfor the cost of separately billed charges for administer-ing the injection of covered immunizations, but not anyrelated office visit charges. (For BCBS National PPOmembers, these services are covered in-network only.)

• Effective January 1, 2004, well-baby care servicesas defined by the Control Plan up to six visits prior toage two. (Covered in-network only for BCBS NationalPPO members.)

• In-network office visits for BCBS National PPO mem-bers will be regarded as a covered service, but with a100% member co-pay. Office visit charges paid by themember will not apply to the $250 individual or $500family annual out-of-pocket maximum described ear-lier in this section.

This provision does not apply to out-of-network officevisits or to UNICARE members.


What benefits are provided for treatment at a skilled nurs-ing facility?

Benefits are paid if you receive care from an ap-proved skilled nursing facility (sometimes referred toas a convalescent or long-term illness care facility).

In some situations, your physician may find it appropriateto discharge you from the hospital and transfer you to askilled nursing facility for further treatment. Or your physi-cian may admit you directly into an approved skilled nurs-ing facility without prior hospitalization, if it is an appropri-ate site for treatment.

If you receive services from a skilled nursing facility,Hospital-Surgical-Medical benefits will be provided for:

• Semiprivate room and board charges and related services

• A maximum number of physicians’ visits equal to twovisits per week

Benefits for general conditions are provided for up to 730days or two days for every one day of unused hospitalcare. For example, if you are admitted to a skilled nursingfacility after spending 100 days in the hospital, you canreceive benefits for up to 530 days while you are in theskilled nursing facility.

A new 730-day period begins when you have not been inthe hospital, a skilled nursing facility, a day or night carecenter or residential substance abuse treatment facilityfor 60 consecutive days.

No benefits are provided for custodial care or treatmentof tuberculosis.

What benefits are provided for emergencies?

Generally, most services you will need in the event ofan emergency are covered by Hospital-Surgical-Medical benefits.

Benefits are provided for treatment of accidental injuriesand certain health-threatening or disabling medical emer-gencies. A “health-threatening” or disabling medical emer-gency is a condition that:• Could place your health in danger or cause significant

impairment of bodily functions• Requires professional medical attention and treatment• Has symptoms which occur suddenly and unexpectedly• Is treated within 72 hours of the time the condition started• Has signs or symptoms, verified by a physician at the

time of treatment, confirming the health-threatening ordisabling condition

Benefits are provided in full for hospital emergency roomservices in participating hospitals only if your condition isa medical emergency or accidental injury. Physicians’services for the initial examination and treatment also arecovered wherever administered. Follow-up care is notcovered under the emergency benefit.


What benefits are provided for coordinated home care?

If you receive care at home, instead of a hospital orother facility, certain services are covered.

Under certain circumstances, your physician, with yourapproval, may have you receive continuing care from anapproved home health care agency (if one is available inyour area), if you are discharged early from a hospital orother approved facility. Your physician also may recom-mend that you receive home health care services withoutprior hospitalization.

Hospital-Surgical-Medical benefits are provided for up tothree home care visits for each remaining hospital or con-valescent care day as long as you remain medically eli-gible. Charges for the following services received during ahome care visit are covered:• Necessary nursing care• Drugs, supplies, laboratory tests and other related

services• Necessary services of a part-time health aide employed

by the agency• Physical therapy and speech therapy

These benefits are available only through an approvedhome health care agency. Custodial care and physicians’visits to your home are not covered.

Home care kidney machinesHospital-Surgical-Medical benefits cover the use of anartificial kidney machine in your home for hemodialysistreatment. Included are reasonable and necessaryexpenses for supplies and for installing and maintainingthe equipment.

If you use such a machine, you may be eligible for Medi-care benefits, regardless of your age. Your local SocialSecurity office has more information.

Infusion therapyInfusion therapy covered in the hospital outpatient andphysician’s office may also be covered under the coor-dinated home care when approved in accordance withPlan criteria.

What benefits are provided for hospice care?

Hospital-Surgical-Medical benefits are available forhospice care in approved programs in most locations.

Focusing on the patient and the patient’s family as the unitof care, Hospital-Surgical-Medical benefits are availablefor hospice care through approved hospice care programsin most locations for persons having a life expectancy ofsix months or less. Participation in the program is volun-tary and requires concurrence of the attending physician.

Generally, five levels of care are provided by the hospicecare program:• Routine home care to maintain the terminally ill patient

at home• Continuous home care for periods of crisis where pre-

dominantly skilled continuous care is necessary tomanage the patient’s acute medical symptoms

• Inpatient respite care in an approved inpatient facilityto provide caring family members or other persons car-ing for the patient a short period of relief

• General inpatient care for pain control or acute orchronic symptom management of the patient

• Nursing home care with hospice support for hospicepatients who are medically stable but unable to returnhome because no primary care support is available

Hospice care programs within specific areas will be basedon available resources. Consequently, hospice care cover-age may differ between areas. Contact the Health Care Planin which you are enrolled for coverage available in your areaand to determine any lifetime maximum benefit amount.

Note: If you anticipate meeting the limit, you may requestto be admitted into the Case Management Program.


What is Complex Care Management?

If you are a non-Medicare, UAW-Ford memberenrolled in the BCBS National PPO Plan or theUNICARE Traditional Plan, you may be eligible toparticipate in this program.


Complex Care Management is a voluntary and confiden-tial program for BCBS National PPO and UNICARE Tradi-tional members facing a serious illness. Facing a seriousillness can be frightening and confusing. The Complex CareManagement program is designed to:• Provide you with health care information and support

you and your family in your decision making process.• Act as your advocate and educate you about treatment

options so that you can make informed decisions aboutwhich treatments are right for you.

• Act as a central point of contact to coordinate medi-cal services.

• Ease the burden of managing a complex illness, allowingyou to focus on the most important thing⎯your health.

• Help you maintain control of the care you receive.

• Work with your physicians to coordinate treatment.

The Complex Care Management Program is administeredby Blue Cross and Blue Shield of Michigan andParadigmHealth (formerly Franklin Health, Inc.).

To learn more about the Complex Care Management Program,please contact ParadigmHealth toll free at 1-877-233-1694.

What is Coordinated Care Management?

If you are a non-Medicare, UAW-Ford member withcoverage through the BCBS National PPO Plan, youmay be eligible to participate in this program.

Coordinated Care Management (CCM) is a voluntary andconfidential program for members with illnesses such as:• Heart disease• Diabetes and• Asthma

which caused a hospital stay or two or more emergencyroom visits in the last twelve months.

CCM can work with the physician you are already seeing.It can help you and your physician by:• Developing treatment plans and• Providing access to necessary healthcare services and

educational programs

If you meet the eligibility criteria and decide to participate,here is what happens:• You are assigned a nurse care manager (a registered nurse)

to help you and your physician coordinate your care• Your nurse care manager contacts you to ask ques-

tions about your health, medications, etc.• Your nurse care manager talks to your physician• Your nurse care manager works with you and your phy-

sician to design a personal treatment plan based onyour diagnosis, risk factors, and health care needs

• You begin receiving services

CCM can cover services in addition to the benefits ordi-narily covered by your health plan. Depending on yourpersonal needs, your treatment plan may include:• Cardiac rehabilitation• Diabetic educational classes• Doctor’s office visits• Supervised exercise classes• Nutritional counselingand more.

If you are interested in CCM, please call its toll free num-ber to learn more:

1-800-768-6787

Participants are encouraged to complete the CCM pro-gram. Most participants complete the CCM Program in 6to 12 months, depending on factors such as their custom-ized (specific) goals. However, a member can stop par-ticipating at any time and continue to receive regular Planbenefits. Any extra benefits provided through CCM willstop once a member leaves the CCM program.


What benefits are provided for durable medicalequipment?

Hospital-Surgical-Medical benefits generally are pro-vided for durable medical equipment covered byMedicare Part B and certain other equipment.

If you are enrolled in the BCBS National PPO Plan or theUNICARE Traditional Plan, you are covered under the UAW-Ford National DME and P&O SUPPORT Program. As ofJanuary 1, 2002, Medicare enrollees are also covered un-der the SUPPORT Program.

The UAW-Ford National DME and P&O SUPPORT Pro-gram provides convenient access to quality products andskilled professional care through a national network forpersons whose physical condition requires using in-homedurable medical equipment (DME), respiratory or certainhyperalimentation services.

For services that are not provided in a hospital or otherfacility setting, the SUPPORT Program will generally coverall medically necessary DME covered services when theyare arranged for by the SUPPORT Program.

Generally, DME benefits pay for a wide range of non-hospitaldurable medical equipment services including thoseapproved by Medicare Part B as approved by the Company-Union Committee or as collectively bargained. Examplesof durable medical equipment covered by Medicare Part Bare as follows:• Hospital beds and related equipment• Equipment used to increase mobility• Certain bathroom aids and therapeutic equipment• Oxygen and breathing apparatus• Health monitoring devices• Repair (but not routine maintenance) of approved

equipment• Certain nutritional tube feedings

The following are examples of additional equipment alsocovered by the Program:

• Type I portable insulin infusion pumps and blood sugarmonitoring devices for diabetics

• Blanket supports

• Neuromuscular stimulators

• Electromagnetic bone growth stimulators

• Positional transportation chairs

• Pressure gradient supports when prescribed for circu-latory insufficiency conditions to promote and restorenormal fluid circulation in the extremities and when pre-scribed to enhance and prevent scarring of burn patients

• Phototherapy (bilirubin) light with photometer, for infantsunder the age of one who have a diagnosis ofhyperbilirubinemia

• Special features which are necessary to adapt other-wise covered equipment for use by children

• Continuous passive motion (CPM) devices for use onelbow and shoulder after surgery and after a total kneereplacement. In addition, effective September 29, 2003,CPM will be covered after knee surgery if initiated withinthe first 48 hours following surgery, and utilized amaximum of 20 days immediately following surgery.

Out-of-Network servicesIf covered services are ordered from a provider outside ofthe SUPPORT network, the SUPPORT Program will pay80% of the maximum payment amount (this is the ap-proved amount for covered services). You will be respon-sible for the remaining 20% of the maximum payment upto an annual $500 out-of-pocket maximum. After you havemet your annual out-of-pocket maximum, the SUPPORTProgram will reimburse you 100% of the maximum feepayment allowed for covered services. Also you may beresponsible for paying the difference between the actualamount billed by the out-of-network provider and the maxi-mum payment amount. This difference may be substan-tial. In order to avoid or limit out-of-pocket costs, you orthe out-of-network provider should call the SUPPORT Pro-gram to determine if the services are covered, the ap-proved payment allowed, and amount of the provider’s billfor which you may be responsible.

Note: SUPPORT Program co-pays do not apply towardBCBS National PPO co-pay maximums.

Customer service information

You or your provider may call 1-800-831-0999 to obtain ser-vices or to ask questions. One call coordinates all of yourSUPPORT Program care. Services are provided 24 hours aday, seven days a week. You are required to have a prescrip-tion from your physician to obtain services or equipment.


• Effective January 1, 2004, individually fitted arch sup-ports used with a shoe that is not attached to a brace(excluding those persons enrolled in the National FootCare Program). Coverage is limited to arch supportsthat are prescribed in writing by a physician for an or-thopedic, neuromuscular, vascular or insensate foot con-dition approved by the Control Plan (excluding flat feet)that has failed to respond to a course of appropriateconservative treatment (e.g., physical therapy, injec-tions, anti-inflammatory medications), or when pre-scribed arch supports as part of post surgical care.Once administratively feasible, all arch supports mustbe obtained from a provider approved by the UAW-FordNational DME and P&O SUPPORT Program. No addi-tional payment will be made for separately billedcharges for fitting the arch support. Adult enrollees areeligible for replacement arch supports only if receivedmore than 36 months after receipt of the most recentprevious arch support for the same condition for whichbenefits were payable under this plan. Arch supportsfor children may be replaced after 12 months if requiredby growth of the child

• Wigs are covered for enrollees under age 18 (any ageeffective January 1, 2004) who lose their hair as a resultof undergoing chemotherapy (or, effective January 1,2004, radiation therapy). Up to $200 ($250 on or afterJanuary 1, 2004) is available to cover the wig, wig standand tape in the first year, and up to $125 is available insubsequent years

Generally, prosthetic and orthotic appliances mustbe furnished through facilit ies approved by theSUPPORT Program.

To obtain service, you or the provider simply call 1-800-831-0999; one call coordinates all of your SUPPORTProgram care. Services are provided 24 hours a day,seven days a week. You are required to have aprescription from your physician to obtain servicesor equipment.

What benefits are provided for prosthetic andorthotic appliances?

Hospital-Surgical-Medical benefits are provided forprosthetic and orthotic appliances approved by Medi-care Part B and certain other items.

The UAW-Ford National DME and P&O SUPPORT Pro-gram provides convenient access to quality products andskilled professional care through a national network forpersons whose physical condition requires prosthetic &orthotic (P&O) appliances.

For covered appliances, the SUPPORT Program will gener-ally cover all medically necessary P&O covered applianceswhen they are arranged for by the SUPPORT Program.

A prosthetic or orthotic “appliance” is, generally, artificialequipment needed to replace a nonfunctioning or missingpart of the human body. Appliances prescribed by yourphysician are covered at the hospital’s charge or thereasonable and customary amount (maximum allowable)if billed by another provider. The expense for replacing,repairing, fitting, and adjusting a device also is coveredwith certain limits.

To be a covered benefit, prosthetic and orthotic appliances,including external appliances and excluding experimentalor research appliances or devices, must be payable byMedicare Part B and approved by the Company-Union Com-mittee or as collectively bargained.

In addition, the following items are covered subject to anystated conditions and to the other provisions of the HealthCare plan and this section, even if not Medicare approved:• Any style of orthopedic footwear, other than a basic

oxford, when the shoes are an integral part of a cov-ered brace

• All orthopedic shoe inserts, arch supports and shoemodifications, used with a shoe that is attached to acovered brace


Out-of-Network servicesIf covered services are ordered from a provider outside ofthe SUPPORT network, the SUPPORT Program will pay80% of the maximum payment amount (this is the ap-proved amount for covered services). You will be respon-sible for the remaining 20% of the maximum payment upto an annual $500 out-of-pocket maximum. After you havemet your annual out-of-pocket maximum, the SUPPORTProgram will reimburse you 100% of the maximum feepayment allowed for covered services. Also you may beresponsible for paying the difference between the actualamount billed by the out-of-network provider and the maxi-mum payment amount. This difference may be substan-tial. In order to avoid or limit out-of-pocket costs, you orthe out-of-network provider should call the SUPPORT Pro-gram to determine if the services are covered, the ap-proved payment allowed, and amount of the provider’s billfor which you may be responsible.

Note: SUPPORT Program co-pays do not apply towardBCBS National PPO co-pay maximums.

Customer service information

You or your provider may call 1-800-831-0999 to obtainservices or to ask questions. One call coordinates all ofyour SUPPORT Program care. Services are provided24 hours a day, seven days a week. You are required tohave a prescription from your physician to obtain ser-vices or equipment.

What benefits are provided for mastectomy?

Surgery, reconstruction and prostheses following amastectomy are covered.

Note: BCBS National PPO in-network and out-of-network benefit levels may apply.

Consistent with the “Women’s Health and Cancer RightsAct of 1998,” your benefits cover a member who under-goes a mastectomy and who elects breast reconstructionin connection with the mastectomy.

While the other benefits of the Plan apply as well, cover-age specifically includes:• Reconstruction of the breast on which the mastectomy

has been performed• Surgery and reconstruction of the other breast to pro-

duce a symmetrical appearance• Prostheses and physical complications of all stages of

mastectomy, including lymphedemas

Coverage is subject to all other plan provisions andrequirements. If you choose an HMO or PPO, it willcover these services subject to its plan provisionsand requirements.


Blue Cross and Blue Shield of Michigan (BCBSM) is re-sponsible for initial assessment and referral for emergencyand out-of-area care, and performs the utilization reviewfunction for the program.

Under certain circumstances, you may receive full ben-efits without first visiting the CDR. For example, you maygo directly to a mental health provider who participateswith the MCP. In addition, you may receive full benefitcoverage in hospital emergency cases or when you useyour own personal physician under conditions that maybe considered appropriate.

Generally, to receive full benefits, all covered servicesrendered in the care and treatment of psychiatric and sub-stance abuse conditions must be received from partici-pating providers. The panel of providers may include thefollowing types of facilities and providers:

Facilities• Hospitals• Outpatient facilities• Detoxification facilities• Residential care facilities• Day care and night care facilities• Halfway houses• Skilled nursing facilities

Providers• Psychiatrists• Ph.D. psychologists• Masters degreed and licensed psychiatric social workers• Clinical nurse specialists with advanced training in ado-

lescent or adult mental health nursing

If you are enrolled in an alternative plan (HMO or PPO), youare encouraged to use the CDR to obtain an assessment,differential diagnosis and a recommended treatment planas well.

How does the Managed Care Program (MCP) for psychi-atric care and substance abuse treatment work?

You and your eligible dependents receive full ben-efits when services are authorized by the Central Di-agnostic and Referral Agency, and you receivetreatment from a participating provider.

If you are an active employee enrolled in the BCBS Na-tional PPO and UNICARE Traditional plans, benefits forpsychiatric care and substance abuse treatment are pro-vided through a managed care, limited provider program.The Managed Care Program (MCP) is designed to improvethe quality of care and facilitate access to appropriate pro-viders. The Central Diagnostic and Referral Agencies (CDR)under the Employee Support Services Program are thecase managers. Generally, to receive full benefits, you arerequired to use the CDR for the following services:• Assessment• Differential diagnosis• Treatment plan development• Referral to a provider• Follow-up for after care


What benefits are provided for psychiatric care andsubstance abuse treatment under the MCP?

Hospital-Surgical-Medical benefits are provided forpsychiatric care and substance treatment for up to45 days in a hospital or residential facility. Certainoutpatient psychiatric or substance abuse care alsois covered.

Benefits received from participating providersThe following psychiatric and substance abuse benefitcoverages will be provided under the MCP if you are en-rolled in the BCBS National PPO Plan or UNICARE Tradi-tional Plan, receive services authorized by the CDR (orthe Administrator for emergency and out-of-area care) andreceive treatment from a participating provider:••••• Inpatient care. Benefits for inpatient treatment of a psy-

chiatric or substance abuse condition are paid in fullfor up to 45 days of care, including any necessarydetoxification days. The 45 days are renewable whenyou have been out of facility care for a continuous pe-riod of sixty (60) days. This 60-day provision applies tohospital and any residential facilities.

••••• Outpatient care. Hospital-Surgical-Medical coverageprovides up to 35 visits per calendar year for psychiat-ric care and 35 visits per calendar year for substanceabuse treatment. There are no lifetime visit limits. Thefirst 20 outpatient visits, whether for psychiatric careor substance abuse treatment, are paid in full. For vis-its 21-35, if services are provided for substance abusetreatment, benefits also are paid in full. However, forvisits 21-35 for psychiatric care, the Plan covers 75%;you pay 25% of Program costs. Visits with the CDR foran initial assessment, diagnosis and referral, or forshort-term problem solving do not count against theannual 35-visit limit.

••••• Other benefits. Program benefits also include:— Up to 90 visits to a night care or day care treatment

facility for psychiatric care; each visit reduces thenumber of remaining inpatient days by one-half day

— A lifetime maximum benefit of 120 days in a half-way house; no more than 90 days are provided inany one calendar year

— Psychological testing when approved by the CDRas medically necessary or when authorized byBCBSM as medically necessary in an emergencyor out-of-area situation

Benefits received from nonparticipating providers• Benefits can be fully covered when received from non-

participating providers in the following situations:— Full plan benefits may be provided if you are re-

ferred to a nonparticipating provider outside of thepanel network by the CDR

— Under certain situations, full benefits may be pro-vided even though you did not visit the CDR initially.To receive full Plan payment in cases of an emer-gency or where you may be out-of-area, your at-tending provider must call BCBSM within 24 hoursof providing initial care. BCBSM may then approvethe initial care and refer your case to the appropri-ate CDR for case management. When the CDR, inconsultation with your attending provider, deter-mines it is appropriate, you may be referred to aparticipating provider. In certain situations after con-sultation with BCBSM, the CDR may judge it appro-priate to treat your nonparticipating provider as aparticipating provider for your case

— If you receive outpatient psychiatric care directly froma physician general practitioner, M.D. or D.O., theprovider will receive full reasonable payment for theinitial service if the provider contacts BCBSM within24 hours of providing such service. BCBSM willapprove payment for the initial service and refer thecase to the appropriate CDR. Up to two additional visitsmay be approved by the CDR if it and the physiciangeneral practitioner agree upon the necessity of care.If continuing care is needed, the CDR will facilitatetransfer of your care to another provider

• If you receive psychiatric care services from non-participating providers other than as described above,you will receive the following reduced benefits:— For inpatient services in a general acute care hospi-

tal, the Plan pays $160 per day plus $20 per day forancillaries; in a psychiatric hospital, the Plan pays$15 per day

— For physician (either M.D. or D.O.) services for psy-chiatric care provided on an inpatient or outpatientbasis, the Plan pays 50% of the reimbursement thatwould be made to a participating physician underthe MCP

— No benefits are payable for services received fromnon-participating, non-physician providers, such aspsychologists or social workers

• If you receive substance abuse services from non-participating providers (whether physicians or non-physicians), no benefits are payable except asdescribed above in cases of emergency or where youare referred by the CDR


• Outpatient care for regular treatment of chronic condi-tions which require repeated visits, except as specifi-cally provided for psychiatric conditions, drug and al-cohol abuse and hemodialysis

• Outpatient psychiatric services for mental disorders whichare not expected to improve with treatment or servicesextending beyond the period necessary for evaluation anddiagnosis of mental deficiency or retardation

• Hospitalization principally for observation or diagnosticevaluation, diagnostic X-rays, laboratory tests orphysical therapy

• Surgical-medical or other professional charges for ster-ilization reversals of either sex, or for abortion, exceptwhen medically necessary

• Removal of corns, calluses, and clavus and nail trimming• Removal of wax from ear• Services or supplies available under public plans or pro-

grams such as Workers’ Compensation• Services or supplies furnished in a United States gov-

ernment hospital not operated for the public at large, orelsewhere at government expense

• Surgery for cosmetic or beautifying purposes, exceptthat reconstructive surgery for the following is covered:— The correction of conditions resulting from acciden-

tal injuries or traumatic scars— The correction of congenital abnormalities or— Reconstructive plastic surgery to correct deformi-

ties resulting from medically necessary surgery dueto malignancy or fibrocystic disease and reconstruc-tive surgery when there is a visual impairment

• Chiropractic office visits• Office visits received outside the BCBS National PPO

Network; i.e. through UNICARE and National PPO Planout-of-network providers

• For any exclusions with respect to HMO or PPO cover-age, contact the individual plan

What Hospital-Surgical-Medical services are not covered?

No benefits are paid for the Hospital-Surgical-Medi-cal services below.

Hospital-Surgical-Medical benefits provided under the Na-tional PPO Plan (BCBS) / Traditional Plan (UNICARE) donot cover certain services. These services include but arenot limited to:• Admissions and treatment before your coverage starts• Hospitalization principally for dental care or other den-

tal services, except for multiple extractions or removalof unerupted teeth under general anesthesia for hospi-tal patients when another hazardous medical conditionexists and effective January 1, 2004, except for dentaltreatment within a hospital on an outpatient settingbased on Control Plan guidelines, for enrollees with spe-cial needs (e.g., Down’s Syndrome, autism, spastic con-ditions), medical conditions that are marginally con-trolled, or dental conditions that may adversely impacttheir medical conditions (e.g., uncontrolled diabetes withperiodontal disease)

• Air and water ambulance services obtained prior toJanuary 1, 2004

• Custodial or domiciliary care (care that doesn’t requirecontinuous skilled medical or nursing services)

• Care, services, supplies or devices which are experi-mental or research in nature; Federal Drug Administra-tion (FDA) approval does not necessarily mean a pro-cedure or supply has been removed from the plan’sexperimental list

• Routine physical exams, premarital, pre-employmentor preschool exams, similar exams or tests not directlyrelated to a diagnosis

• Admission and treatment for weight reduction or dietcontrol unless plan criteria are met


How does coverage under an HMO or PPO work?

In some areas of the country, you may choose toreceive health care from an alternative—health main-tenance organization (HMO) or preferred provider or-ganization (PPO).

If you live in an area served by an alternative plan such asa “Health Maintenance Organization” (HMO) or “PreferredProvider Organization” (PPO) which is made available bythe mutual agreement of Ford and the UAW, you may electHMO or PPO coverage in place of the BCBS National PPOPlan or UNICARE Traditional Plan for Hospital-Surgical-Medical and Prescription Drug coverage. You also may becovered for Vision Care under an HMO or PPO. If you areenrolled in any HMO or PPO which does not provide visioncoverage, your vision care provider is SVS Vision ManagedCare, Inc.

You may elect an HMO or PPO alternative, if one isavailable in your area (if you have been enrolled in yourcurrent plan for at least 12 months) by calling theAutomated Telephone System at 1-800-333-7444.

Health maintenance organizations (HMOs)When you belong to an HMO, most of your health care iscovered in full. In order to receive benefits, you must obtainall of your health care services from the group ofphysicians, hospitals or other providers affiliated with theHMO, except in the case of an emergency or upon referralby the HMO.

Preferred provider organizations (PPOs) other than BCBS Na-tional PPOIn a PPO arrangement, certain participating health careproviders, the “preferred providers,” provide health careservices. You choose your physician or hospital from a list ofthose who participate. If you elect to go outside the PPOplan for services, some co-payments are required except foremergency care or for referrals by network providers.

In addition to Hospital-Surgical-Medical benefits, servicessuch as office visits may be covered. You receive full ben-efits only if you use a physician who participates in thePPO unless your physician refers you to a provider out-side the PPO or for emergency care.

For more information about the HMO or PPO option,contact the Automated Telephone System at 1-800-333-7444 to request health care plan benefit summaries. Youmay contact the HMO or PPO directly for detailedinformation about the plan.

45

Health Care PlanPrescription Drug Coverage


Page

Am I covered under the PrescriptionDrug Plan? 46

How does Prescription Drug coverage work? 46

What medications are covered? 47

What are the Prescription Drug co-payments? 47

Who administers the Prescription DrugProgram? 48

Can I go to any retail pharmacy? 48

How does the home delivery program (Medco by Mail) work? 49

How are maintenance drugs covered? 50

How does the Generic Prescription DrugProgram work? 52

What Prescription Drugs are not covered? 52

46 Health Care Plan — Prescription Drug Coverage

How does Prescription Drug coverage work?

The Prescription Drug plan helps you pay the cost of cov-ered prescription drugs you or your family might need. You,your spouse and your eligible dependents may have pre-scriptions filled at a participating or non-participating phar-macy or through the home delivery program (Medco byMail). You pay less if you go through a participating phar-macy, and even less if you go through the home deliveryprogram (Medco by Mail). You also pay less for genericrather than brand name drugs.

Health Care PlanPrescription Drug Coverage — BCBS National PPO Plan / UNICARE Traditional Plan

Am I covered under the Prescription Drug Plan?

You automatically receive this Prescription Drug coverageif you are enrolled in the National PPO Plan (BCBS) /Traditional Plan (UNICARE) and meet the Prescription Drugcoverage eligibility criteria. Information relating to youreligibility for prescription drug coverage is provided in the“Eligibility for Health Care coverage” section.

Note: If you are enrolled in a plan other than the NationalPPO Plan (BCBS) / Traditional Plan (UNICARE),contact your Plan for benefit information.

47Health Care Plan — Prescription Drug Coverage 47

What medications are covered?

Prescription Drug benefits cover the initial prescription andrefills for medications which are not available without aprescription. To qualify, the container must read either: “RxOnly” or “Caution: Federal Law prohibits dispensing with-out a prescription.” In addition, injectable insulin, whichmay not require a prescription, is covered by the plan.Allergy serums which are prescribed for you on an ongo-ing basis are covered. Also, the retail price or home deliv-ery price of the quantity prescribed must be more than theco-payment amount.

InsulinBenefits are provided for a one-month supply of dispos-able syringes and needles for injection of insulin whenprescribed with a one-month supply of insulin, or a three-month supply of disposable syringes and needles for in-jection of insulin when prescribed with a three-month sup-ply of insulin, or, if greater, 100 disposable syringes andneedles when prescribed with a three-month supply of in-sulin. Disposable syringes and needles and insulin mustbe prescribed on the same date and the disposable sy-ringes/needles and insulin must be filled together.

One co-payment applies to the total prescription when filledtogether —insulin, needles and syringes. If syringes andneedles are prescribed on a different date than the insu-lin, or filled on a different date than the insulin, the sy-ringes and needles are not covered.

Dosage quantitiesYou can receive up to a 34-day supply of medication if pur-chased from a retail pharmacy. Through the home deliveryprescription drug program (Medco by Mail), you can receiveup to a 90-day supply of any covered prescription drugs.

What are the Prescription Drug co-payments?

If you go to a participating retail pharmacy or through thehome delivery prescription drug program (Medco by Mail),the co-payments are as follows:

National PPO Plan (BCBS) /Traditional Plan (UNICARE)

Generic Brand-name

Retail Pharmacy: $5 $10Up to a 34-day supply

Home Delivery: $2 $2Up to a 90-day supply


Can I go to any retail pharmacy?

To receive the maximum benefits available for retail phar-macies, you must have your prescription filled at a par-ticipating pharmacy. To locate a participating pharmacynear your home or workplace or while traveling, callBCBSM Ford/UAW Service Center at 1-800-482-5146.

When you use a participating retail pharmacyYou must present your BCBSM ID card and prescriptionto the retail pharmacist. You pay a co-payment for eachcovered prescription order or refill. You do not have to sub-mit a claim form when you use a participating pharmacy.BCBSM will automatically reimburse the participating pro-vider for the remaining cost.

If you or an eligible member needs to take a prescriptiondrug on a long-term basis, you may need to obtain itthrough home delivery (Medco by Mail). Review the sec-tion on “The Home Delivery Program” later in this section.

When you use a non-participating retail pharmacyYou pay the full price (100%) of the prescription at thetime of purchase and obtain a receipt. Call the BCBSMFord/UAW Service Center at 1-800-482-5146 to obtain aclaim form. Once received, submit your completed claimform to BCBSM - Medco Health, P.O. Box 2096, Lee’sSummit, MO 64063-7096. The prescription receipt mustbe attached to the form. For your records, make a photo-copy of your claim and receipt. You will be reimbursed75% of the allowed amount after deducting the co-pay-ment. You may also have to pay the pharmacy’s retaildrug charges above the allowed amount.

If your prescription is filled by a physician or dentistIf your prescription is filled at your physician or dentist’soffice, or if you receive medication from anyone (otherthan a pharmacy) licensed to fill prescriptions, you paythe entire cost and file a claim with the claims processor.You will be reimbursed up to the amounts described abovefor use of a non-participating retail pharmacy.

Who administers the Prescription Drug Program?

If you are enrolled for National PPO Plan (BCBS) / Tradi-tional (UNICARE) health care coverage, your prescriptiondrug coverage is administered by Blue Cross and BlueShield of Michigan (BCBSM) and Medco Health. BCBSMand Medco Health are responsible for drug utilization re-view functions and quality assurance mechanisms.


How does the home delivery program (Medco by Mail)work?

The home delivery program (Medco by Mail) offers you aconvenient way to get your prescription medications. Youwill be able to save money by buying your prescriptionsthrough this mail order program. Under the home deliveryprogram (Medco by Mail) you pay only $2 to receive up toa 90-day supply of brand or generic instead of paying $5(generic) or $10 (brand-name) at a retail pharmacy for upto a 34-day supply.

For medications included on the UAW-Ford MaintenanceDrug List, the first three times you fill a prescription on orafter January 1, 2004, you may go through a retail phar-macy. Beginning with the fourth fill, you must go throughthe home delivery program (Medco by Mail) in order tohave a maintenance drug covered. Refer to the Mainte-nance Drug List that follows to check whether your medi-cation falls under this provision. Be careful when you checkthe list. For questions on a specific medicine, call BCBSat 1-800-482-5146 or contact your physician.

You also may go through the home delivery program(Medco by Mail) for medications not on the MaintenanceDrug List. This will save you time and money.

Note: The Generic Prescription Drug Program describedlater in this section also applies to the home deliv-ery program (Medco by Mail) as well as retail.

Follow these steps to get started using the home deliveryprogram (Medco by Mail):

Note: After 3 refills (the initial fill and 2 refills), youMUST go through the home delivery program(Medco by Mail) in order for any maintenancedrug to be covered.

To mail your order:Step 1: Ask your doctor for a new prescription for up to a

90-day supply, plus refills for up to one year. Makesure that you have at least a two-week supply onhand. If not, ask your doctor for a prescription forup to a 34-day supply that you can fill at a partici-pating retail pharmacy while you wait for your homedelivery prescription to arrive.

Step 2: Complete a home delivery order form and attachthe original prescription (you may want to retain acopy for your records). You may obtain an orderform and envelope by calling Medco Health Solu-tions, Inc. at 1-800-778-0735. You also can obtainor print a home delivery order form online, onceyou have registered at www.medcohealth.com, orfrom your Union Benefit Representative.

Step 3: Mail the new prescription in the envelope provided.You may pay the home delivery co-payment bycredit card, check, or money order. If you prefer topay for all of your orders by credit card, you maywant to join the Medco Health automatic paymentprogram. You can enroll by visiting the Medco Healthwebsite, www.medcohealth.com, or by callingMedco Health toll-free at 1-800-948-8779.

When you order your prescriptions by mail, your prescrip-tions are delivered, postage-paid, generally 7 to 11 daysfrom the date you mailed your order.

If you are a first-time visitor to medcohealth.com™, pleasetake a moment to register your contract number (locatedon your BCBS ID card). A recent retail or home deliveryprescription number is also helpful in registering.

To fax your order:

Step 1: Same as above.

Step 2: Provide your doctor with your contract numberlocated on your BCBS ID card. Ask your doctor tocall 1-888-327-9791 for instructions on how to faxa prescription. Afterward, you may wish to callMedco Health at 1-800-778-0735 and verify thatyour doctor’s fax was received. You will be billedlater for your order.

When your doctor faxes your prescription, your prescrip-tions are generally delivered 5 to 8 days from the dateyour doctor faxes the prescription.

Note: only your doctor’s office is permitted by law to faxyour prescriptions to Medco Health.

For questions about your home delivery prescription(such as order status, account balances or shipmentinformation), call 1-800-778-0735.


Maintenance DrugsHow are maintenance drugs covered?

“Maintenance drugs” are certain prescription drugs takenregularly, over a long period, for conditions such as highblood pressure, arthritis and asthma. Effective January 1,2004, maintenance drugs listed on the Ford/UAW Mainte-nance Drug List will no longer be covered when dispensedby a retail pharmacy in 100-unit and 200-unit dosages, ifgreater than a 34-day supply.

Maintenance drugs on the list will only be covered ifobtained through the home delivery program (Medco byMail), after you have filled a prescription three times onor after January 1, 2004, at a retail pharmacy. If youcontinue to fill the prescription at a retail pharmacy afterthe first 3 fills, you will be responsible for the entirecost of the medication. You may continue to get short-term prescription drugs (for example, antibiotics) andother prescription drugs not on the maintenance druglist from retail pharmacies.

You may receive up to a 90-day supply at each fill throughthe home delivery prescription drug program (Medco by Mail).

Prescription drugs may be added to or removed from themaintenance drug list from time to time by mutual agree-ment of the UAW and the Company.

Refer to the table on the next page to help determinewhether your prescription drug(s) are on the maintenancedrug list.

Be careful when you check the maintenance drug list. Adrug may have other names that are not listed. For ques-tions on a specific medicine, call BCBS at 1-800-482-5146.


BRAND NAME GENERIC NAMELopid GemfibrozilLopressor Metoprolol TartrateLotensin Benazepril HCLLozol IndapamideMavik TrandolaprilMevacor LovastatinMicronase / Diabeta GlyburideMidamor Amiloride HCLMinipress Prazosin HCLModuretic Amiloride / HCTZMonopril Fosinopril SodiumMotrin IbuprofenMysoline PrimidoneNaprelan Naproxen SodiumNaprosyn NaproxenNaqua TrichlormethiazideNaturetin BendroflumethiazideNeptazane MethazolamideNitrobid / Nitrostat NitroglycerinNormodyne / Trandate Labetalol HCLNorpace DisopyramideNorvasc Amoldipine BesylateOgen / Ortho-est EstropipateOrinase TolbutamidePaser Para-Aminosalicylic AcidPavabid Papaverine HCLPersantine DipyridamolePlendil FelodipineProvachol Pravastatin SodiumPremarin / Estratab Estrogens (Conj. or Estd.)Premarin w / Methyltest Methyltest, Estrog., ConjPremphase / Prempro Estrogen, Con /

M-Progest AcetateProcan / Pronestyl Procainamide HCLProcardia / Procardia XL NifedipineProventil / Ventolin Albuterol SulfateProvera Medroxyprogest AcetatePTU PropylthiouracilQuinaglute Quinidine GluconateQuinidex Quinidine SulfateRelafen NabumetoneRenese PolythiazideSectral Acebutolol HCLSer-Ap-Es HCTZ / Hydralazine /

ReserpineSerpasil ReserpineSinemet Carbidopa / LevodopaSingulair Montelukast SodiumSular NisoldipineTenex Guanfacine HCLTenoretic Atenolol / ChlorthalidoneTenormin AtenololTheo-24 TheophyllineTheo-Dur / Slo-Phyllin TheophyllineTiazac Diltiazem HCLTimoptic Timolol MaleateTolinase TolazamideToprol XL Metoprolol SuccinateUniphyl TheophyllineUnivasc Moexipril HCLVaseretic Enalapril Maleate / HCTZVasotec Enalapril MaleateVisken PindololVoltaren Diclofenac SodiumZaroxolyn MetolazoneZebeta Bisoprolol FumarateZestoretic / Prinzide Lisinopril / HCTZZestril / Prinivil LisinoprilZocor SimvastatinZyloprim Allopurinol

BRAND NAME GENERIC NAMEAccolate ZafirlukastAccupril Quinapril HCLAdalat CC NifedipineAldactazide Spironolactone/HCTZAldactone SpironolactoneAldomet MethyldopaAltace RamiprilAlupent Metaproterenol SulfateAmaryl GlimepirideAnaprox Naproxen SodiumAnsaid FlurbiprofenApresoline HydralazineArmour Thyroid ThyroidArtane TrihexyphenidylBenemid ProbenecidBlocadren Timolol MaleateBrethine Terbutaline SulfateBumex BumetanideCalan / Isoptin / Verelan Verapamil HCLCapoten CaptoprilCapozide Captopril/HCTZCardene Nicardipine HCLCardizem Diltiazem HCLCardura Doxazosin MesylateCatapres Clonidine HCLClinoril SulindacCogentin Benztropine MesylateCombipres Clonidine / ChlorthalidoneCorgard NadololCozaar Losartan PotassiumCrystodigin DigitoxinCytomel Liothyronine SodiumDiabinese ChlorpropamideDiamox AcetazolamideDilantin Phenytoin SodiumDiovan ValsartanDiuril ChlorothiazideDyazide / Maxzide HCTZ / TriamtereneDymelor AcetohexamideDynacirc IsradipineDyrenium TriamtereneEc-Naprosyn NaproxenEldepryl Selegiline HCLEnduron MethyclothiazideEstrace EstradiolEstratest Methyltest;Estrog., Estd.Estratest H.S. Methyltest, Estrog., Estd.Euthroid / Thyrolar LiotixExna BenzthiazideGlucophage Metformin HCLGlucotrol GlipizideGlucotrol XL GlipizideGlynase Glyburide (micronized)Hydrodiuril HydrochlorothiazideHygroton ChlorthalidoneHytrin Terazosin HCLInh IsoniazidInderal Propranolol HCLInderide Propranolol / HCTZIndocin IndomethacinIsordil / Sorbitrate Isosorbide DinitrateKaon-CL Potassium GluconateKay Ciel / Slow K / K-Dur Potassium ChlorideKerlone Betaxolol HCLLanoxin DigoxinLasix FurosemideLescol Fluvastatin SodiumLevothroid / Synthroid Levothyroxine SodiumLipitor Atorvastatin CalciumLodine EtodolacLoniten Minoxidil

HCL = HydrochlorideHCTZ = Hydroclorothiazide

Ford / UAWMaintenance Drug ListAs of September 2003


Generic Prescription DrugsHow does the Generic Prescription Drug Program Work?

Note: The Generic Prescription Drug Program applies tothe home delivery program (Medco by Mail) as wellas retail.

The Generic Prescription Drug Program is designed to re-quire the use of generic drugs. Generic equivalent drugsprovide the same potency and effectiveness as brand-namedrugs ⎯ and, they usually cost a lot less.

At retail pharmacies and through the home delivery pro-gram (Medco by Mail), where legally permissible, your phar-macist will automatically substitute generic equivalentdrugs in place of brand name drugs when a generic ex-ists. When a substitution occurs, you receive the genericdrug, and you pay the generic co-payment instead of thebrand-name co-payment.

If your physician prescribes a specific drug for which thereis no generic substitute, you get the brand-name drug, andyou pay the brand-name co-payment.

If YOU request a brand-name drug for which there is ageneric substitute, you will get the brand-name drug. How-ever, you will be responsible for the generic co-payment,PLUS the full cost difference between the brand and ge-neric drug.

If YOUR DOCTOR prescribes a brand-name drug when ageneric drug equivalent is available, and your doctor indi-cates on your prescription that a generic drug substitution isnot permitted (for example, by writing DAW, Dispense asWritten), then for your first prescription fill, you will pay thebrand-name drug co-payment, plus up to $10 of the costdifference between the brand-name and generic drug. Yourdoctor will need to request a review if you need to continuereceiving this drug. See box below for further information.

Should your doctor feel there are special circumstancesfor which you need the brand-name drug, ask your doctorto request a review by calling Medco Health at 1-800-841-5409. Medco Health will send you and your doctor writtennotification of the decision. If your review is approved, youwill receive authorization to purchase the brand-name drugfor the brand-name drug co-payment for as long as youremain on that medication, If your review is approved, youwill also receive a refund on the most recent fill for thecost difference that you paid in excess of the brand-nameco-payment. If the review is not approved, you must paythe generic co-payment, plus the full difference in costbetween the brand-name and generic drugs for all futurerefills. For additional information see “What are the NewClaims and Appeal Procedures for Health Care Plans” and“Voluntary Level of Appeal” in the Health Care Claims sec-tion of the handbook.

What Prescription Drugs are not covered?

Prescription Drug benefits provided under the National PPOPlan (BCBS) / Traditional Plan (UNICARE) do not includecharges for the following services, supplies and medications.• Drugs for which the provider’s charge is less than the

applicable co-payment• Drugs requiring a prescription by state but not by

federal law• Covered drugs which are consumed entirely at the time

and place where the prescription is written*• Non-prescription contraceptive medication, devices, ap-

pliances, or supplies• Reusable syringes and needles, multi-use syringes and

disposable needles• Charges for administering a covered drug*• Charges for more than a 34-day supply of a covered

drug through a retail pharmacy• Charges for more than a 90-day supply of a drug filled

through the prescription drug home delivery program(Medco by Mail)

• Charges for more refills than your physician or dentistspecifies or refills after a year from the original date ofthe prescription

• Charges for medication furnished on an inpatient or out-patient basis, if the charge is covered by any otherhealth care coverage

• Medication provided under Workers’ Compensation orother government plans

• Medication prescribed by a non-licensed provider

• Drugs which are not medically necessary

• Investigational or experimental drugs

• Medications received before you or your dependent wascovered under the Plan or after coverage ends

• Maintenance drugs filled at a retail pharmacy after re-ceiving the same prescription drug at the same thera-peutic strength three times at a retail pharmacy

* Certain items may be covered under your medical/surgical program

53

Health Care PlanDental Coverage


Page

How does Dental coverage work? 54

What dental services are covered? 55

What is the Enhanced TraditionalDental Plan? 56

What is paid for orthodontia? 57

When is a treatment plan necessary? 57

What dental services are not covered? 58

How does coverage under an alternativedental plan work? 58

54 Health Care Plan — Dental Coverage

How does Dental coverage work?

The Traditional Dental benefits are provided for mostdental services.

Under the Traditional Plan, Dental plan benefits cover mostdental services for you, your spouse or eligible same-sexdomestic partner, and your eligible dependents. Benefitsare paid at 100%, 90% or 50% of the covered expense,depending on the service you receive. You do not have tosatisfy a deductible. The maximum dental benefit payablein a calendar year is $1,600 per person in 2003 and 2004,and $1,700 effective January 1, 2005 and thereafter.

Most orthodontic services are covered at 50%. There is alifetime maximum of $1,800 for orthodontia for each cov-ered person under age 19 effective January 1, 2003 throughDecember 31, 2004, and $2,000 effective January 1, 2005and thereafter.

Effective January 1, 1997, payments for covered dentalservices related to the repair of accidental injury to soundnatural teeth due to a sudden unexpected impact fromoutside the mouth will not count against the annual ben-efit limit or the lifetime orthodontic limit. Regularco-payments will be required for all such services.

Information relating to your eligibility for Dental cover-age is provided in the “Eligibility for Health CareCoverage” section.

Covered servicesYour Traditional Dental benefits cover a dentist’s chargeswhich you are required to pay for necessary dental ser-vices and supplies, but only to the extent that such chargesare “reasonable and customary.” In determining what con-stitutes a reasonable and customary charge, the claimsprocessor takes the following into account:

• The usual fee which the individual dentist most fre-quently charges the majority of patients for a serviceor supply

• The prevailing range of fees charged in the same areaby dentists of similar training and experience

• Unusual circumstances or complications requiring ad-ditional time, skill and experience

If you have a dental problem that can be treated in morethan one way, the procedure that provides a cost-effective,professionally satisfactory result is covered.

Are dental services covered in an outpatient hospital setting?

Refer to the “Hospital-Surgical-Medical Coverage” sectionfor information on dental services received at an outpa-tient hospital setting.

Health Care PlanDental Coverage

Health Care Plan — Dental Coverage 55

What dental services are covered?

Expenses for most dental services are covered at 100%,90% or 50% of the reasonable and customary charge.

Services covered at 100%These services are paid at 100% of the reasonable andcustomary charge:• Routine oral exams and cleaning and scaling, but not

more than twice for each covered person during anycalendar year

• Three cleanings per calendar year if you have a docu-mented history of periodontal disease; a fourth clean-ing is allowed during the two calendar years followingperiodontic surgery

• Topical application of fluoride• Space maintainers to replace prematurely lost teeth for

covered children under age 19 (coverage will terminatethe end of the day immediately preceeding the coveredchild’s 19th birthday)

• Emergency treatment to relieve dental pain

Services covered at 90%These services are paid at 90% of the reasonable andcustomary charge:• Dental X-rays, including full mouth X-rays once each

period of five consecutive calendar years, supplemen-tary bitewing X-rays once in any calendar year and suchdental X-rays as required for the diagnosis of a spe-cific treatment

• Extractions• Oral surgery• Fillings made of amalgam, silicate, acrylic, synthetic

porcelain and composites to restore diseased or acci-dentally injured teeth

• General anesthetics and intravenous sedation whennecessary and used with oral or dental surgery

• Periodontics and treatment of other gum or mouth tis-sue diseases

• Endodontics, including root canal therapy• Injection of antibiotics by the attending dentist• Repair or recementing of crowns, inlays, onlays, bridge-

work and dentures; or relining or rebasing dentures morethan six months after installation, but not more thanonce in any period of 36 consecutive months

• Inlays, onlays, gold fillings or crown restorations butonly when a tooth, as a result of extensive caries orfractures, cannot be restored with the filling materialsdescribed above

• Replacement of crowns more than three (3) years afterinstallation of an initial or replacement crown if the crownhas been damaged and cannot be made serviceable,or if there is recurrent decay under the existing crownor decay at a crown-to-natural-tooth margin that cannotbe repaired by a direct-fill restoration

Services covered at 50%These services are paid at 50% of the reasonable andcustomary charge:• Initial installation of fixed bridgework, including inlays

and crowns as abutments• Initial installation of partial or full removable dentures,

including any attachments and adjustments during thesix months after installation

• Replacement of an existing partial or full removabledenture or fixed bridgework by a new denture or bridge-work, or the addition of teeth to an existing partial re-movable denture or to bridgework if:— The replacement or addition of teeth is necessary

to replace teeth extracted after the existing dentureor bridgework was installed

— The existing denture or bridgework cannot be madeserviceable and, if installed under this Plan, at leastfive years have passed since its installation

— The existing denture is an immediate temporary den-ture and replacement of a permanent denture oc-curs within 12 months of the first installation of theimmediate temporary denture

• Orthodontia (teeth straightening), as described in the“What is paid for orthodontia?” section and

Services covered under Hospital-Surgical-Medical coverageBenefits are provided under Hospital-Surgical-Medicalcoverage for cosmetic bonding of eight front teeth for chil-dren age eight through the end of the calendar year inwhich they become age 19 if required because of severestaining, but not more frequently than once in any periodof three consecutive years.


What is the Enhanced Tradtional Dental Plan?

The Enhanced Traditional Dental Plan is a nationwidedental provider network.

The Enhanced Traditional Dental Plan offers a nationwidedental provider network through an agreement betweenBlue Cross Blue Shield and DenteMax. When you receiveservices from a DenteMax provider, your out-of-pocketexpenses will be lower than those you would incur if youreceived services from a non-DenteMax provider.

The DenteMax Preferred Provider Network is a network ofover 48,000 dentists in 50 states who have agreed to accepta discounted fee as full payment for covered services. Useof the DenteMax Network is voluntary, but you may savemoney if you use a DenteMax dentist. There is no commit-ment required, family members can switch back and forth atwill. Since the DenteMax dentist accepts less for coveredservices, your co-payment amounts will be lower, and youwill not be balance-billed for charges above the DenteMaxapproved amount. This schedule is typically 10-30% belowthe average charges of non-DenteMax dentists. You alsosave money because DenteMax provides a higher level ofcoverage for certain services. For example:

Traditional DenteMax

Fillings 90% 100%Root Canals 90% 100%Gum Treatments 90% 100%Extractions 50% 70%Bridgework 50% 70%Dentures 50% 70%Orthodontics 50% 60%

You can save hundreds of dollars on many procedures byusing a DenteMax provider (refer to the Enhanced Tradi-tional Dental Plan Letter of Understanding in Volume IV ofthe UAW-Ford Collective Bargaining Agreement for addi-tional information).

Built-in Predetermination

The DenteMax enhanced dental program requires predeter-mination for complex or expensive services ($200 or more).

However, if a DenteMax dentist neglects to predeterminethe covered service with BCBSM, you will not beresponsible for the higher amount. For example, if anetwork dentist installed a crown without predeterminingthe case prior to treatment and BCBSM determined that afilling was an acceptable form of treatment, you would beresponsible for only the co-payment on a filling, not thebalance for the crown.

Traditional dental benefits remain the same if you use anon-network DenteMax dentist. You can still save moneyif you use a participating dentist who has agreed to acceptBlue Cross Blue Shield’s maximum payment amount forcovered services. However, you should always ask yourdentist if he or she participates with DenteMax becauseusing a DenteMax dentist will save you additional moneyand stretch your annual and lifetime maximums.

Finding a DenteMax Network dentist is easy

There are over 48,000 generalist and specialist DenteMaxnetwork dentists nationwide. Ask your current dentist ifhe/she is in the DenteMax network. If the dentist is not inthe network, you may locate a network dentist or nomi-nate your dentist by submitting the dentist’s name, ad-dress and phone number by calling:

DenteMax at 1-800-752-1547

If you wish to locate a DenteMax dentist near where youlive or work, please refer to the DenteMax Dental Providerdirectory from your Union Benefit Representative. You mayalso find a list of DenteMax providers atwww.dentemax.com or by calling them at 1-800-752-1547.

Health Care Plan — Dental Coverage 57

What is paid for orthodontia?

For eligible persons under age 19, Traditional Dentalbenefits are paid at 50% of covered orthodontic ser-vices, up to an annual maximum per covered person.

Orthodontia is a special part of your Dental benefits. Ben-efits are provided for teeth-straightening programs for eli-gible persons, as long as continuous treatment beginsbefore age 19.

Dental benefits are paid at 50% of reasonable and cus-tomary charges for all covered services relating to orth-odontic treatment, up to an $1,800 lifetime maximum percovered person through December 31, 2004, and $2,000thereafter. “Orthodontic treatment” includes preventive andcorrective treatment of dental irregularities resulting frominjury or the abnormal growth and development of teeth.

Covered services include:• Diagnostic procedures and treatment, including oral ex-

ams related to orthodontia• Surgical therapy• Appliance therapy• Functional/myofunctional therapy (when related to

surgical therapy)

When is a treatment plan necessary?

A “treatment plan” must be filed in advance if chargesare expected to be $200 or more.

If the estimated charges are less than $200 or if emer-gency care is involved, your dentist need not obtain apredetermination of benefits, as described below. Oncethe work is completed, a claim form must be submitted.

If treatment of planned dental work is expected to be $200or more, however, your dentist will need to file a predeter-mination of benefits or “treatment plan” with the claimsprocessor before treatment begins—unless emergencycare is necessary. The claims processor then can autho-rize payments before your dentist begins work, and youwill know in advance exactly how much your Dental cov-erage will pay.

A treatment plan works as follows:• Your dentist decides what treatment is needed and de-

scribes it on the appropriate form, along with an esti-mate of treatment charges. This form is available fromthe claims processor

• You and your dentist then will be notified what portion ofthe total expenses will be paid by your Dental coverage.The claims processor will take into account any alterna-tives that may be used to accomplish the same result

• After the dental work is complete, you or your den-tist should send the claim back to the claims pro-cessor for payment

If a treatment plan is required but not submitted in ad-vance, the claims processor reserves the right to deter-mine the benefits payable, taking into account alternateprocedures, services or courses of treatment, based onaccepted standards of dental practice.


What dental services are not covered?

Under the Traditional Plan, no benefits are paid forthe dental services below.

Under the Traditional Plan, certain dental expenses are notcovered. These include:• Benefits payable by your other Health Care coverages• Work not done by a dentist, except scaling and cleaning

of teeth and topical application of fluoride by a licenseddental hygienist under a dentist’s supervision

• Veneers for crowns or pontics on teeth, other than the10 upper and lower anterior teeth

• Services or supplies that are cosmetic in nature,including charges for personalization or characterizationof dentures

• Prosthetic devices (including bridges), crowns, inlays,onlays and their fitting, if you were not covered whenthey were ordered or if they are not installed or deliveredwithin 60 days after the day your coverage ends

• Replacement of lost, missing or stolen prosthetic devices• Failure to keep a scheduled visit with the dentist• Replacement or repair of an orthodontic appliance• Charges for services which are compensated under

Workers’ Compensation• Charges for services rendered through a medical de-

partment, clinic, or similar facility provided or main-tained by the patient’s employer

• Charges for services or supplies for which no charge ismade that the patient is legally obligated to pay or forwhich no charge would be made in the absence of dentalexpense coverage

• Charges for services or supplies, which are notnecessary, according to accepted standards of dentalpractice, or which are not recommended or approvedby the attending dentist

• Charges for services or supplies which do not meetaccepted standards of dental practice and that areconsidered experimental

• Services or supplies received as a result of war, declaredor undeclared

• Services or supplies furnished or payable by anygovernment or governmental agency, or any governmentalprogram or law under which you could be covered, unlesspayment is legally required

• Duplicate appliances• Charges for completion of any insurance forms• Sealants and oral hygiene and dietary instruction• A plaque control program• Implantology• Services or supplies for periodontal splinting• Treatment of temporomandibular joints (TMJ) syndrome,

except for certain initial diagnostic procedures

How does coverage under an alternative dental plan work?

In some areas of the country, you may choose to receiveDental coverage through an alternative dental plan.

If you live in an area served by an alternative dental planwhich is approved by Ford and the UAW, you may electDental coverage under that plan in place of the TraditionalPlan’s coverage.

With the Hourly Rolling Enrollment system, there is nolonger a specific enrollment period. You may change yourdental plan election during any month of the year (pro-vided 12 months have elapsed since your last change).

To make a change, call the Automated Telephone Systemat 1-800-333-7444 and follow the prompts to change yourdental election. The Automated Telephone System is open24 hours a day / 365 days a year. You will receive a confirma-tion statement in the mail anytime you make a change throughAutomated Telephone System. Your election takes effect onthe 1st day of the 2nd month following your election.

For detailed information on the availability of and thecoverage provided by an alternative dental plan, con-tact the Automated Telephone System to request benefitsummaries and determine which plans you are eligible tochoose from. Detailed information related to the plan canbe provided by the dental carrier. The benefit summariesinclude the phone number to the carrier.

Refer to the section “Eligibility for Health Care Coverage”for more details on changing your election.

59

Health Care PlanVision Care Coverage


Page

Am I covered under the Vision Care Program? 60

Who administers the Vision Care Program? 60

What expenses are covered under theProgram when services are providedby a Network provider? 61

Is there a warranty on lenses and/or framesobtained from a Network provider? 61

How do I obtain services from aNetwork provider? 62

Can I visit an opthalmologist? 62

What expenses are covered under the programwhen services are provided by a non-Networkprovider and I live more than 25 milesfrom a Network provider? 63

What expenses are covered under the programwhen services are provided by a non-Networkprovider and I live within 25 miles of aNetwork provider? 63

What expenses are covered if I have anemergency and I can’t get to aNetwork provider? 64

What limitations apply to the VisionCare Program? 64

What expenses are not covered under the Vision Care Program? 65

60 Health Care Plan — Vision Care Coverage

Health Care PlanVision Care Coverage

Am I covered under the Vision Care Program?

If you are enrolled in the National PPO Plan (BCBS)/Tra-ditional Plan (UNICARE) for health care coverage, or in aHealth Maintenance Organization (HMO) or Preferred Pro-vider Organization (PPO) that does not provide Vision Carecoverage, this section describes your Vision Care Pro-gram. If you are enrolled in an HMO or PPO that providesvision care coverage, your HMO or PPO will mail youinformation on your vision care coverage.

Information relating to your eligibility for Vision Carecoverage is provided in the “Eligibility for Health Carecoverage” section.

Who administers the Vision Care Program?

SVS Vision Managed Care, Inc. administers the VisionCare Program and a panel network consisting of SVS Vi-sion and other affiliated providers (the “Network”) provideservices. You and your eligible dependents receive themost comprehensive vision care coverage when you re-ceive services from a Network provider. You generally in-cur greater out-of-pocket expenses when you obtain ser-vices from a non-Network provider.

Health Care Plan — Vision Care Coverage 61

What expenses are covered under the program whenservices are provided by a Network provider?

The following expenses are covered when services areobtained from a network provider.

SCHEDULE 1NETWORK PROVIDER SCHEDULE

Services: Coverage:

Vision testing exam Full CoverageReexamination $45 (by an ophthalmologist)

Regular lenses: (glass or plastic) Full Coverage• Single vision• Bifocal• Trifocal• Special (lenticular, aspheric, etc.)Lens Options: Full Coverage• Tints equal to Rose 1 and 2• Scratch resistant coating for those age 13 and under

• Lenses more than 65 millimeters in diameter

Frames – Standard frames Full Coverage – Designer frames $40

Contact lenses (instead ofeyeglasses)• Not medically necessary

– Hard or soft contact lenses $75– Professional fees $40

(fitting and follow-up)• Medically necessary to Up to $350

achieve 20/70 in better eye or tocorrect keratoconus, irregularastigmatism, or irregular cornealcurvature as diagnosed by an M.D.or O.D., includes professional feesand contact lenses

Is there a warranty on lenses and/or frames obtainedfrom a Network provider?

Most lenses or frames received from a Network providerare under warranty for two years. (There is a one-yearwarranty for rimless frames.) The warranty begins the dayyou receive your lenses and/or frames and works accord-ing to a point system.During the two-year warranty period (or one-year periodfor rimless frames), a total of 10 replacement points areprovided for services received. When any eyeglass partis repaired or replaced, the point value of the replacedpart, as described below, will be subtracted from the totalnumber of points remaining.

10 Replacement PointsEach lens ....................... 2 pointsEach temple ................... 2 pointsFrame front ..................... 2 points

Broken parts must be submitted to qualify for this replace-ment plan. Scratched lenses are not covered. If you useall 10 replacement points before the end of the warrantyperiod, you will be responsible for paying any additionalrepair or replacement costs. For more information on thewarranty, call SVS’s toll-free number: 1-800-225-3095.


How do I obtain services from a Network provider?

Contact a Network provider for an appointment and let themknow that you are an hourly UAW-Ford employee with SVScoverage. To obtain the location of the nearest Network pro-vider, call this toll-free number: 1-800-225-3095.

Can I visit an ophthalmologist?

Normally, you will be seen by a Doctor of Optometry foryour vision examination. If you prefer, or if your optom-etrist suggests, you may have an ophthalmologist per-form your vision exam. You may choose any licensed oph-thalmologist. You will be reimbursed for the exam basedon the following Schedule 2 coverage levels (regardlessof where you live or where your ophthalmologist is located).

If you have your vision exam performed by an optom-etrist, your optometrist may refer you to an ophthalmolo-gist for medical reasons. Your reexamination by an oph-thalmologist is covered if performed by a Network pro-vider within 60 days from the date of your initial examina-tion. You may receive partial coverage under the following“Schedule 2” if you go to a non-Network provider, and youlive more than 25 miles from a Network provider. (For thoseresiding within 25 miles of a Network provider, referral mustbe made by a Network provider.)


What expenses are covered under the program whenservices are provided by a non-Network provider and Ilive more than 25 miles from a Network provider?

If you live more than 25 miles from a Network provider,and you choose to receive services from a non-Networkprovider, you will be reimbursed up to the lesser of theactual charge or the following amounts:

SCHEDULE 2NON-NETWORK PROVIDER SCHEDULE

LIVE MORE THAN 25 MILES FROM A NETWORK PROVIDER

Services Coverage

Vision testing examination $45Reexamination by an ophthalmologist $45Regular lenses: (glass or plastic) • Single vision $59• Bifocal $79• Trifocal $99

• Special $99 (lenticular, aspheric, etc.)

Lens Options: $0 • Tints equal to Rose 1 and 2 • Scratch resistant coating for those age 13 and under• Lenses more than 65 millimeters in diameter

Frames (standard or designer frame) $49

Contact lenses (instead of eyeglasses)

– not medically necessary; including $89 hard or soft contact lenses and professional fees (fitting and follow-up)– medically necessary to achieve 20/70 $200 in better eye or to correct keratoconus,

irregular astigmatism, or irregular corneal curvature as diagnosed by M.D. or O.D. including professional fees and contact lenses

What expenses are covered under the program whenservices are provided by a non-Network provider and Ilive within 25 miles of a Network provider?

If you live within 25 miles of a Network provider, and youchoose a non-Network provider, you will be reimbursed upto the lesser of the actual charge or the following amounts:

SCHEDULE 3NON-NETWORK PROVIDER SCHEDULE

LIVE WITHIN 25 MILES OF A NETWORK PROVIDER

Services Coverage

Vision testing examination $0Reexamination by an ophthalmologist $0

Regular lenses: (glass or plastic) $13 • Single vision • Bifocal

• Trifocal • Special (lenticular, aspheric, etc.)

Lens Options: $0 • Tints equal to Rose 1 and 2 • Scratch resistant coating for those age 13 and under• Lenses more than 65 millimeters in diameter

Frames (standard or designer frame) $13

Contact lenses (instead of eyeglasses)– not medically necessary; including $37 hard or soft contact lenses and professional fees (fitting and follow-up)– medically necessary to achieve 20/70 $52.50 in better eye or to correct keratoconus irregular astigmatism, or irregular corneal

curvature as diagnosed by M.D. or O.D. including professional fees and contact lenses


What expenses are covered if I have an emergency and Ican’t get to a Network provider?

If you have an emergency and you are unable to reach aNetwork provider, you may receive covered emergencyservices from a non-Network provider (subject to Programlimits). For this purpose, an “emergency” is considered apermanent visual impairment of such nature that failure toreplace lost or broken lenses and/or frames could jeopar-dize your safety or well-being. You will be reimbursed upto the amounts listed under “Schedule 2”.

What limitations apply to the Vision Care Program?

Program benefits are limited to:• One vision testing examination in any period of 24

months plus one referral when medically necessary toan ophthalmologist for re-examination within 60 daysfrom the date of initial examination. For those residingwithin 25 miles of a Network provider, referral must bemade by the Network provider.

• One pair of lenses and frames or contact lenses in anyperiod of 24 months.

• Children to the end of the calendar year in which theybecome sixteen years of age, who are diagnosed ashaving severe, progressive myopia (i.e., nearsighted-ness with myopia of 2.00 diopters or greater andprogressing at the rare of 1.00 diopter or more per yearin the meridian of greatest change) will be eligible foran additional examination 12 months (365 days) afterthe most recent examination paid for by the Program.

If the examination reveals a change of 1.00 diopter ormore has occurred during the preceding 12 months,appropriate corrective lenses (but not frames) will beprovided by the Program. If the change is less than1.00 diopter, lenses will not be provided by the Pro-gram until 24 months have elapsed since the Programprovided the most recent lenses. Subsequent exami-nations will be limited to the normal 24-month intervalunless the child is again diagnosed as having severeprogressive myopia.

• If you (or your eligible dependent) are insulin-dependentdiabetics, you may obtain a vision testing examinationannually. If a change of .5 diopter or 10 degree axis oc-curs, you may receive one pair of new lenses on an an-nual basis at the new prescription (but not frames).

In order to receive these benefits, insulin-dependentenrollees must provide a letter from their personal phy-sician to the optometrist or opthamologist stating they(or their eligible dependent) are insulin-dependent. Forthose enrolled in an HMO or PPO plan and who arecovered under the SVS Program, the annual eye examwill be provided at an HMO or PPO location as a planbenefit and the lenses, if necessary, would be obtainedfrom an SVS location as a SVS plan benefit.

• When eligible for lenses, and until the enrollee’s thir-teenth birthday, coverage will be provided for scratch-guard coating on plastic lenses when received from aNetwork provider. Scratch-guard coating will be coveredunder the Program not more frequently than once ev-ery two calendar years.


What expenses are not covered under the Vision CareProgram?

This Vision Care Program does not provide coveragefor any of the following services or procedures:• Visual training, orthoptics, visual therapy for learning

disorders, low vision aids, aniseikonic lenses,aphakic lenses (if for condition of surgical aphakia)and tonography

• Medical or surgical treatment (these benefits may beprovided by your Hospital-Surgical-Medical coverage)

• Drugs or any other medication not administered forthe purpose of a vision testing exam

• Vision testing exams, lenses or frames provided forany condition, disease, ailment or injury arising outof and in the course of employment

• Vision testing exams, lenses or frames ordered be-fore you were eligible or after coverage terminated

• Lenses or frames which are not necessary accordingto accepted standards of ophthalmic practice, orwhich are not ordered or prescribed by your physi-cian or optometrist

• Charges for vision testing exams, lenses or framesif covered by a government health care program

• Charges for vision testing exams, lenses or frameswhich are payable under any other group coverage

• Lenses or frames ordered while coverage is in effectbut delivered more than 60 days after coverageterminates

• Charges which exceed the reimbursement levelsstated above or which otherwise exceed Plan benefits

67

Health Care PlanHearing Aid Coverage


Page

How does Hearing Aid coverage work? 68

What Hearing Aid expenses are covered? 68

What is covered under the Digital HearingAid National Pilot program? 69

What Hearing Aid expenses are not covered? 70

6868 Health Care Plan — Hearing Aid Coverage

Health Care PlanHearing Aid Coverage

How does Hearing Aid coverage work?

Under the National PPO Plan (BCBS)/Traditional Plan(UNICARE), benefits are provided for hearing aid ser-vice when obtained from participating providers.

Under the National PPO Plan (BCBS)/Traditional Plan(UNICARE), benefits are provided for audiometric exams,hearing aid evaluations and hearing aids and replacementear molds for children up to age seven when services areobtained from participating providers. If necessary, thesame benefits will be provided again after 36 months havepassed since your last examination for a hearing problem.Up to four replacement ear molds are covered annuallyfor children up to age three and up to two for children agesthree to seven.

Information relating to your eligibility for Hearing Aidcoverage is provided in the “Eligibility for Health Carecoverage” section.

For benefits to be paid, Hearing Aid services must beobtained from a participating provider. Your claimsprocessor has a list of participating providers and suppliers.

What Hearing Aid expenses are covered

For the initial hearing aid payable under this Plan or for aperson under age 18, you first must obtain a medical ex-amination of the ear by a physician. This physician’s ex-amination is not a covered benefit.

To receive benefits you must obtain:

• An audiometric exam performed by a participating phy-sician or audiologist to measure the extent of hearingloss. An “audiometric” exam measures hearing acuityor sharpness. This exam must be performed after or inconjunction with a physician’s most recent medicalexam of the ear if for an initial hearing aid or for a per-son under age 18 and must result in a determinationthat a hearing aid would compensate for the loss ofhearing. The reasonable and customary charge for thisexam is covered.

• A hearing aid evaluation test to prescribe the makeand model of the hearing aid which will best improveyour hearing. This test must be performed by a partici-pating physician or audiologist when indicated by themost recent audiometric exam.

Effective October 1, 2003, hearing aid coverage paysup to $122 for this test. Beginning in 2004, the amountwill be adjusted on October 1 of each year to reflectincreases in the Consumer Price Index. Your claimsprocessor can tell you how much the coverage cur-rently pays for the hearing aid evaluation test.

• A hearing aid prescription filled and fitted by a par-ticipating dealer. A prescription from the participatingphysician or audiologist is required when a hearing aidis purchased.

Hearing Aid coverage will pay the dealer’s cost for thehearing aid, including binaural hearing aids for childrenthrough the end of the calendar year in which they be-come age 19, plus fees for dispensing the hearing aid,including ear molds and follow-up visits within six monthsof fitting if the hearing aid is prescribed in conjunction withthe most recent audiometric exam and hearing aid evalu-ation test and is the make and model prescribed by thephysician or audiologist.

Health Care Plan — Hearing Aid Coverage 69

What is covered under the Digital Hearing Aid NationalPilot program?

Effective January 1, 2004, through September 14, 2008,digital hearing aids may be obtained in place of stan-dard hearing aids. Digital hearing aids will be coveredup to the greater of 40 percent of the acquisition cost(up to a maximum of $900), or the benefit payable for astandard hearing aid.

If the initial exam reveals that the hearing loss may becorrected by ear surgery, that surgery could be coveredby Hospital-Surgical-Medical benefits. See the “Hospi-tal-Surgical-Medical coverage” section for more details.

To be covered, your audiometric and evaluation test mustbe performed by a participating physician or licensedaudiologist. “Physician” means an otologist, otolaryn-gologist or otorhinolaryngologist who is certified to per-form a medical examination of the ear to determinewhether you have a loss of hearing acuity.

An “audiologist” is a person who has an advanced col-lege degree in audiology or speech pathology, is certi-fied by the American Speech-Language-HearingAssociation and is qualified in the state where he orshe practices.

You should present your health care identification cardto the participating provider at the time covered ser-vices are obtained. Participating providers will bill yourclaims processor directly for covered services.

7070 Health Care Plan — Hearing Aid Coverage

What Hearing Aid expenses are not covered?Under the National PPO Plan (BCBS)/Traditional Plan(UNICARE), no Hearing Aid benefits are paid for theservices below.

Certain hearing aid-related services are not covered.These include:

• Services and equipment obtained from non-participatingproviders

• Medical or surgical treatment (this may be covered byyour Hospital-Surgical-Medical benefits)

• Drugs or other medications (this may be covered byyour Prescription Drug benefits)

• Audiometric exams and hearing aid evaluation testsperformed and hearing aids ordered before coveragebecomes effective or after coverage ends, unless ahearing aid is prescribed before coverage ends and isdelivered and fitted within 60 days

• Replacement of lost or broken hearing aids• Replacement parts for, and repairs of, hearing aids,

except replacement ear molds for children up to ageseven (7)

• Eyeglass-type hearing aids, to the extent the chargefor such hearing aids exceeds the standard coveredhearing aid expense

• The cost for more than one audiometric exam, hearingaid evaluation test and hearing aid (including ear mold),except for binaural hearing aids for children through theend of the calendar year in which they become age 19,during any period of 36 consecutive months

• Audiometric exams, hearing aid evaluation tests andhearing aids that are not necessary, do not meet ac-cepted standards of practice or are not recommendedby a physician

• In the case of an initial hearing aid or any hearing aidfor a person under age 18, charges for hearing aid evalu-ation tests and hearing aids which are not recommendedor approved by a physician

• Experimental services or supplies• Services provided under Workers’ Compensation or other

government plans• Services or supplies provided in a United States gov-

ernment hospital not operated for the general public

71

Health Care PlanPilot Programs


Page

What is a pilot program? 72

What pilot programs are in effect? 72

72 Health Care Plan — Pilot Programs

What is a pilot program?

In some areas of the country, part of your Health Carecoverage may be provided through a pilot program.

From time to time, Ford and the UAW may agree to imple-ment “pilot programs” with the goal of providing high qual-ity, cost effective care.

The following briefly describes some pilot programs nowin effect. The National Employee Services Center canadvise you if a pilot program is in effect in your area.

Health Care PlanPilot Programs

What pilot programs are in effect?

In some parts of the country, some pilot programsalready have been implemented.

Several pilot programs are in effect in certain areas of thecountry. These include:• Foot Care through National Foot Care Program for

Michigan, Ohio, Illinois and Missouri employees withNational PPO Plan (BCBS)/Traditional (UNICARE)and Blue Preferred Plus PPO plan coverage

• Preadmission testing program• Cardiac Rehabilitation program for Michigan employ-

ees with National PPO Plan (BCBS) plan coverage• Long-Term Care Pilot Program for employees at the

Louisville Assembly and Kentucky truck plants and theireligible dependents

• Digital Hearing Aid National Pilot Program. Refer to the“Hearing Aid Coverage” section for further details.

The coverage provided under the Foot Care program issummarized next.

Foot Care programIf you are employed in Michigan, Ohio, Illinois or Mis-souri, have National PPO Plan (BCBS)/Traditional(UNICARE) and Blue Preferred Plus PPO Plan coverageand are not enrolled in Medicare, your foot and ankle carecoverage is provided through the National Foot Care Pro-gram (NFCP), Inc. You will be assigned to an NFCP pro-vider within 25 miles of your residence. If you live morethan 25 miles from an NFCP provider, NFCP will makearrangements for you to receive care from a podiatrist orother physician in your area.

Benefits are paid in full when you receive covered footcare expenses from NFCP or one of its affiliated providers.If you receive services from a nonparticipating provider,foot and ankle care expenses generally are paid at 50%,and certain services, such as office visits, physicaltherapy, and orthotics are not covered at all. If you requirean amputation or accidental injury care for foot or ankleinjury, benefits are paid under your Hospital-Surgical-Medical coverage.

Some examples of covered expenses are office visits,foot and ankle examinations, whirlpool therapy, variousfoot and ankle treatments and follow-up care for an acci-dental foot or ankle injury.

Laboratory services received in connection with foot careare paid by the Foot Care program.

For more information about the pilot Foot Care program,contact NFCP at this number: 1-800-922-1695.

73


Page

Who processes health care claims? 74

What is the identification card used for? 75

How are health care claims filed? 75

What are the new Claims and AppealProcedures for the National PPO (BCBS) /Traditional (UNICARE) Health Care Plans? 77

Health Care PlanHealth Care Claims

74 Health Care Plan — Health Care Claims

Explanation of benefitsWhenever a National PPO Plan (BCBS)/Traditional HealthCare Plan (UNICARE) claim is processed, you will receivean Explanation of Benefits (EOB) statement from yourclaims processor giving information about the service andbenefits paid.

If you have a question about your EOB statement, con-tact the appropriate claims processor at the address shownon the statement or the phone number on the back of yourID card.

Standard of ReviewThe Plan Administrator or its designee shall have fullpower and authority to administer the H-S-M-D-D-V Pro-gram and to interpret its provisions including, but notlimited to, discretionary authority to determine eligibilityfor and entitlement to Program benefits, and any finaldecisions shall be subject only to an arbitrary and ca-pricious standard of review.

Who processes health care claims?

Your health care claims generally are processed by aclaims processor.

If you are covered under the National PPO Plan(BCBS)/Traditional Medical Plan (UNICARE), the claimsprocessor that applies to you is listed below. If you havecoverage through an alternative or pilot plan (e.g., anHMO, PPO or Dental HMO), your claims will be pro-cessed through those organizations.

Health Care Location: Your ClaimsCoverage: Processor is:

Hospital-Surgical- Illinois or UNICARE LifeMedical-Hearing Aid Oklahoma and HealthTraditional Plan Insurance(UNICARE) Company

Hospital-Surgical- Any other state Blue Cross andMedical-Hearing Aid or the District Blue ShieldNational PPO Plan of Columbia(BCBS)

Foot Care Illinois, National FootMichigan, Care Program,Missouri, Inc.Ohio

Any other Blue Cross and state or the Blue ShieldDistrict ofColumbia

Prescription Any state or Blue CrossDrug the District of Blue Shield of

Columbia Michigan/Medco Health

Dental Any state or Blue Crossthe District of Blue Shield ofColumbia Michigan

Vision Care Any state SVS Visionor the District Managed Careof Columbia Inc.unless enrolledin an HMO orPPO plan thatprovides visioncare

The address and telephone numbers of these claimsprocessors are provided later in this book in the sectioncalled “Administrative, ERISA, and Family and MedicalLeave Act of 1993 Information.”

Health Care PlanHealth Care Claims

Health Care Plan — Health Care Claims 75

What is the identification card used for?

You present your identification card to most healthcare providers.

Generally, you will receive one card for yourself and an-other for your spouse. You may get additional cards if nec-essary. Contact the health care plan in which you are en-rolled for information on how to obtain additional cards.

Your cards identify the group (Ford-UAW) through whichyou are enrolled for health care. The National PPO Plan(BCBS)/Traditional Medical Plan (UNICARE) and mostHMOs and PPOs issue identification cards. Present yourcard when you, your spouse or an eligible dependent re-quires health care services. When you present your card,you may be asked to show additional identification.

If your identification cards are lost or stolen, contactthe health care plan in which you are enrolled immedi-ately. Only you, your spouse and your covered depen-dents are permitted to use the cards. Any attempt tomisuse your health care identification card may be aviolation of law. Misuse also may subject you to disci-plinary action by your employer, including discharge. Itis a felony in most states to lend your health care cardto anyone not listed on your insurance coverage and toknowingly enroll people or retain persons on your con-tract who do not meet the Program’s eligibility rules. Forexample, ex-spouses must be removed from your cov-erage immediately upon divorce. (See “Eligibility Sec-tion” for more information on eligibility).

How are health care claims filed?

Different claims procedures apply to each coveragein the Health Care Plan.

Most claim forms are available from your provider. If yourprovider does not have the appropriate claim form, contactyour claims processor.

BCBS National PPO Plan Hospital-Surgical-MedicalIf your claims processor is Blue Cross and Blue Shieldand you receive Hospital-Surgical-Medical services froman in-network BCBS National PPO Plan provider, the pro-vider will bill the claims processor directly for coveredservices. You are not required to file a claim. After claimsare paid, you will receive an Explanation of Benefits (EOB)statement showing what was paid.

If your claims processor is Blue Cross and Blue Shieldand you receive services from an out-of-network BCBSNational PPO Plan provider who is participating with theBCBS Traditional Plan, the provider will bill the claims pro-cessor directly for covered services. You are not requiredto file a claim. After claims are paid, you will receive anExplanation of Benefits (EOB) statement showing whatwas paid.

If your claims processor is Blue Cross and Blue Shieldand you receive services from either an out-of-networkBCBS National PPO Plan provider who is not participat-ing with the BCBS Traditional Plan, OR you receive Hear-ing Aid services, follow these steps:

1. Verify whether the provider will submit a claim to BCBSdirectly on your behalf. If not, have the provider fill outthe provider’s section, then complete your portion andsubmit the claim form to the local office of your claimsprocessor. Be sure to enclose your itemized bills orstatements along with cash register receipts, cancelledchecks, money order stubs or a paid receipt. Also besure to keep copies of the claim form, bills and receipts.The originals will not be returned to you.

2. You will be paid directly for covered services and willreceive an Explanation of Benefits statement showinghow much was considered and paid.


UNICARE Hospital-Surgical-Medical, and Hearing Aid coveragesYour provider can submit bills directly to UNICARE at P.O.Box 4570, Dearborn, MI 48120. Payment for covered ser-vices will be made directly to the provider. After claimsare paid, you will receive an Explanation of Benefits (EOB)statement showing what was paid.

If your provider requires immediate payment for servicesrendered and/or will not bill UNICARE directly, please fol-low these steps:

1. On the date services are rendered, obtain a completeitemized bill from the provider. The itemized bill shouldindicate to whom UNICARE should issue benefits, andshould be submitted to UNICARE; P.O. Box 4570,Dearborn, MI 48120 for payment.

2. You will receive reimbursement from UNICARE forcovered services for which you paid the provider directly.

3. You will receive an Explanation of Benefits statementshowing what services were covered and to whom ben-efits were paid.

For Hearing Aid benefits provided through UNICARE, youshould first obtain a UNICARE Hearing Benefit Claim Formby contacting the UNICARE Dearborn Service Center at1-800-843-8184. The Hearing Benefit Claim Form shouldbe completed by your provider when services are per-formed and submitted to UNICARE; P.O. Box 2560,Dearborn, MI 48123. You will receive an Explanation ofBenefits (EOB) statement showing what was paid.

Questions pertaining to your UNICARE benefits maybe directed to the UNICARE Dearborn Service Centerat 1-800-843-8184.

Durable Medical Equipment and Prosthetic and OrthoticAppliances (DME and P&O)When you obtain covered DME and P&O services from aSUPPORT network provider under the Ford National DMEand P&O Program, no claim forms are necessary and youwill not receive a bill.

If services are performed by a provider outside the SUP-PORT network, submit a claim or itemized bill to theSUPPORT Program, UAW / Ford National DME and P&OProgram, P.O. Box 82060, Rochester, MI 48308-2060, 1-800-831-0999.

Prescription Drug coverageWhen you obtain prescription drugs from the Blue Crossand Blue Shield/Medco Pharmacy Program or one of itsaffiliated providers, no claim forms are required. If youelect to receive services from a nonparticipating provider,obtain a prescription receipt and submit with a claim formto Blue Cross and Blue Shield/Medco. You will bereimbursed for covered expenses. For additionalinformation see the “Prescription Drug Coverage” sectionof this handbook.

Dental coverageTo receive benefits under the Traditional Dental Plan, a claimform must be filed with your claims processor. Generally,your provider will file a claim for you. If he or she doesn’t, youwill need to file the claim. On the claim form, you decidewhether to have payment made to you or your dentist.

Remember, if dental expenses are expected to be $200 ormore, your dentist should file a “treatment plan” beforedental work begins. See the “Dental Section” of thishandbook for more information.

If you are enrolled in a Dental HMO, you will not have tocomplete claim forms.

Health Care Plan — Health Care Claims 77

Vision Care coverage

If you or your dependent receives Vision Care servicesfrom a SVS Network provider, no claim forms are required.If you or your dependent elects to receive services from anon-Network provider, claim forms are required. You mayobtain a claim form from SVS Vision Managed Care, Inc.,(1-800-225-3095 or www.svsvision.com), or your UAW Ben-efits Representative. Submit your completed claim form,along with your itemized receipt, to SVS Vision ManagedCare, Inc., P.O. Box 464, Mt. Clemens, MI 48046-0464.You will be reimbursed up to the amounts described in the“Vision Care Coverage” section of this handbook.

Foot Care coverage (Michigan, Illinois, Missouri and Ohio em-ployees only)When you obtain covered foot care services from a Na-tional Foot Care Program (NFCP) provider, no claim formsare required. If you elect to receive services from a non-participating provider, obtain a claim form from NFCP (1-800-922-1695) or your UAW Benefits Representative. Then,complete and submit the claim to NFCP. Generally, claimsmust be submitted within 12 months after the date ser-vices were rendered. You will be reimbursed up to theamounts described in the “What pilot programs are in ef-fect?” section of this handbook.

What are the new Claims and Appeal Procedures forthe National PPO (BCBS) / Traditional (UNICARE) HealthCare Plans?

This section describes the new health care plan claimsand appeals procedures that have been implemented incompliance with the Department of Labor’s (DOL’s) newregulations governing how health care plans process claimsand handle appeals. This section also describes the newinquiry procedures. The regulations apply to all health careclaims received by your Ford health care plan on or afterJanuary 1, 2003.

The regulations mandate specific time frames for claimsprocessing and for responding to appeals of adverse ben-efit determinations, as defined in the DOL regulations.Although the regulations apply to all health care plans,the specific time limits may vary by plan. (For plans otherthan National PPO (BCBS) and Traditional (UNICARE),contact the Plan directly).

If you have a question about your benefit coverage on aclaim, you can submit a verbal or written inquiry to yourhealth care plan. An appeal may be submitted without aprior inquiry.

While health care plans will handle claims for benefit cov-erage, eligibility-only appeals and inquiries will continueto be handled by Ford at the NESC. The regulations applyto any appeal involving a claim for benefits. The regula-tions do not apply to determinations of eligibility that arenot attached to a claim.

Effective January 1, 2003, all non-urgent appeals mustbe submitted in writing. The appeal must be submitted toyour health care plan, and not to Ford Motor Company.Include a copy of all previous correspondence and all avail-able supporting documentation.

If you are not satisfied with a health care plan’s responseto your appeal, you may choose to initiate civil action inthe appropriate court under section 502(a) of the EmployeeRetirement Income Security Act of 1974 (ERISA) asamended. National PPO Plan (BCBS) / Traditional HealthCare (UNICARE) enrollees and self insured PPO enroll-ees may also submit a voluntary appeal. Voluntary ap-peals can be submitted the same time as civil action pro-ceedings. Please refer below to the National PPO Plan(BCBS) / Traditional Health Care Plan (UNICARE) and BluePreferred Plus PPO section for information on the volun-tary appeals process.

This is a general description of the new health care planclaims and appeals procedures. These procedures aredescribed in detail in official plan documents. If these de-scriptions inadvertently disagree with the plan documents,the plan documents will prevail.


National PPO Plan (BCBS) / Traditional Plan (UNICARE) Medi-cal, Dental, Hearing, and Prescription Drug Plans and Blue Pre-ferred Plus PPOBelow are the claims and appeals procedures for the HourlyNational PPO Plan (BCBS) and/or UNICARE TraditionalMedical, Dental, Hearing, and Prescription Drug Plans,and the Hourly Blue Preferred Plus PPO of Michigan.

ClaimsThere are new DOL time limits on the amount of time aplan has to process your claim.

• Urgent Pre-Service Claims - Plans have 72 hours toprovide you with a benefit determination on an urgentpre-service claim.

• Non-urgent Pre-Service Claims - Plans have up to 15days to provide you with a benefit determination on anon-urgent pre-service claim. This time frame can beextended by the Plan by 15 days.

• Post-Service Claims - Plans have up to 30 days to pro-vide you with a benefit determination on a post serviceclaim. This time frame may be extended by the Plan by15 days.

Urgent care claims are those claims in which the time peri-ods for making non-urgent determinations could seriouslyjeopardize the life or health of the member or the ability ofthe member to regain maximum function; or in the opinion ofa physician with knowledge of the member’s medical condi-tion, would subject the member to severe pain that cannotbe adequately managed without the care or treatment that isthe subject of the claim. Pre-service claims are only thoseclaims where the health care plan requires pre-approval inorder to authorize coverage of the service.

AppealsYou may appeal an adverse benefit determination within190 calendar days from the date of notification. The notifi-cation date generally is the date of the Explanation ofBenefits (EOB) form you receive from your health careplan. The appeal must be in writing and should be submit-ted to the address shown on the EOB form for appeals.Please include your contract and group number, daytimephone, service date(s), and any documentation support-ing your appeal, including a copy of the EOB form. If an-other person will be representing you, you must submit awritten form authorizing that person to act on your behalf.Please contact your health care plan’s Customer ServiceDepartment or your UAW Benefits Representative for acopy of the authorization form. The timing for responsediffers for urgent and non-urgent appeals.

• Urgent Pre-Service Appeals - Plan must notify claim-ant of decision within 72 hours of receiving an urgentpre-service appeal.

• Non-urgent Pre-Service Appeals - Plan must notifyclaimant of decision within 30 days of receipt of a non-urgent pre-service appeal.

• Non-urgent Post-Service Appeals - Plan has up to 60days to provide a written response.

Voluntary Level of AppealFord has established an additional, voluntary level of ap-peal, after the DOL-required appeal process has beenexhausted. You may submit a Voluntary Appeal to Ford ifyou are dissatisfied with the health care plan’s determina-tion of your appeal. You should send the Voluntary Appealwith a copy of all previous correspondence and all avail-able supporting documentation to the National EmployeeService Center, Health Care Voluntary Appeals, P.O. Box6214, Dearborn, Michigan 48121-6214. The voluntary ap-peal level has no timing requirements mandated by DOL.However, the Company and the UAW have agreed to thefollowing timing for the Voluntary Appeal process:

• Timing for submitting Voluntary Appeal: The enrollee orhis or her authorized representative has 60 calendardays from the date of the plan’s denial to request avoluntary appeal.

• Pre-service urgent response time: The Company has25 calendar days from the date the request is receivedto respond to a request for a voluntary appeal.

• Pre-service and post-service non-urgent response time:The Company has 60 calendar days from the date therequest is received to respond to a request for a volun-tary appeal.

Note: If you are not satisfied with your National PPO Plan(BCBS) or Traditional Medical Plan (UNICARE), Dental,Hearing or Prescription Drug Plan’s response to yourDOL appeal, you may either (1) submit a voluntaryappeal to Ford and then initiate a civil action in theappropriate court if you are still not satisfied, or (2)submit a voluntary appeal at the same time as civilaction or (3) immediately initiate a civil action withoutusing the voluntary appeal process.

Health Maintenance Organizations (HMO), Dental Health Main-tenance Organizations (DHMO), Fully Insured Preferred Pro-vider Organization (PPO), National Foot Care Program and theSVS Vision Managed Care ProgramEach HMO, DHMO, fully insured PPO, National Foot CareProgram and the SVS Vision Managed Care Program hasan appeal process in place. Please contact the customerservice department of your plan for detailed informationabout their appeals process and the new timing require-ments, or refer to the Plan’s Explanation of Benefits (EOB)for more information.

Please note that the National PPO Plan (BCBS) / Tradi-tional Health Care Plan (UNICARE) and Blue PreferredPlus PPO Claims and Appeals process (including the vol-untary level of appeal) described above in this sectiondoes not currently apply to HMOs, DHMOs, or fully in-sured PPOs. In the event this changes in the future, youwill be notified in writing.

See the “Administrative, ERISA, and Family MedicalLeave Act of 1993 Information” section for certain rightsunder ERISA.

79

Health Care PlanHIPAA Privacy Practices

This section of your handbook answers thisquestion:

Page

Is my health care information keptprivate under HIPAA? 80

80 Health Care Plan — HIPAA Privacy Practices

Is my health care information kept private under HIPAA?

NOTICE OF PRIVACY PRACTICES UNDER THEHEALTH INSURANCE PORTABILITY AND ACCOUNT-ABILITY ACT OF 1996 (HIPAA)

This notice describes how medical information about youmay be used and disclosed by your insurance companyor Ford and how you can get access to this informationand its uses. Please review it carefully.

Ford provides its employees and Medicare/non-Medicareretirees/surviving spouses and their eligible dependents anumber of benefits, including hospital, surgical medical,prescription drugs, dental and others. This notice appliesto employees and retirees/surviving spouses and theireligible dependents who participate in the following healthcare plans, referred to below as “Group Health Plans”:

• BCBS National PPO Plan/UNICARE Traditional PlanHospital-Surgical-Medical-Drug-Hearing-Dental ExpenseProgram for Hourly Employees

• Self-funded Preferred Provider Organizations (Michiganonly at this time)

Please note that, depending on the circumstances, the term“Group Health Plans” as used in this Notice may mean mul-tiple Group Health Plans or a single Group Health Plan.

Please note that employees and retirees/survivingspouses and their eligible dependents who choose toreceive benefits through a Health Maintenance Orga-nization (HMO), fully-insured Preferred Provider Or-ganization (PPO) or other fully-insured plan will re-ceive a Notice of Privacy Practices related to thosebenefits directly from those insurers.

Group Health Plans maintain the confidentiality of yourmedical information related to your Group Health Plancoverage. This Notice describes the Group Health Plans’legal duties and privacy practices with respect to that in-formation. This Notice also describes your rights and theGroup Health Plans’ obligations regarding the use and dis-closure of your medical information.

The Group Health Plans are required by the Health Insur-ance Portability and Accountability Act of 1996 (HIPAA),as amended, to maintain the privacy of your ProtectedHealth Information (PHI). PHI is the information createdor received by or on behalf of the Group Health Plans thatidentifies you or which, on a reasonable basis, could beused to identify you and includes:

• Information that relates to your past, present, or futurephysical or mental health or condition;

• The provision of health care to you; or• The past, present, or future payment for the provision

of health care to you

This information may be maintained or transmitted eitherelectronically or in any other form or medium.

Please note that your medical file located at any Fordmedical office (i.e., the Plant Medical) is not consideredPHI and thus is not subject to this Notice. However, whilethis excluded area is not subject to HIPAA, there is otherlegislation and/or Company safeguarding procedures, aswell as the “Confidentiality of Health Care Information” let-ter located in Volume IV of the Collective Bargaining Agree-ment between the UAW and Ford Motor Company, to main-tain appropriate levels of confidentiality.

“Minimum Necessary” requirements apply to the uses anddisclosures of your PHI. Use and disclosure is limited tothe amount of information reasonably necessary toaccomplish the intended purpose (i.e., for group healthplan administration).

The Group Health Plans are permitted under HIPAA touse your PHI in certain ways described below:

How the Group Health Plans may use or disclose your healthinformation

For treatment

While the Group Health Plans generally do not use or disclosePHI for treatment, they are permitted to do so if necessary.

For payment

The Group Health Plans may use and disclose your PHIto others to facilitate payment for treatment and services.For example, the Group Health Plans may provide infor-mation to a provider or a third-party payor, such as aninsurance company, regarding amounts that are coveredunder the Group Health Plans. The information may iden-tify you, your diagnosis, and treatment or supplies usedin the course of treatment.

For health care operations

The Group Health Plans may use and disclose your PHIfor operational purposes. For example, your PHI may bedisclosed to certain employees of the Group Health Plans,or third parties retained or hired by the Group Health Plans,for customer service, enrollment, due diligence, qualityimprovement, business planning, and cost management.This information may identify you, your diagnosis, andtreatment or supplies used in the course of treatment.

Plan sponsor

The Group Health Plans may disclose PHI to Ford MotorCompany, for health care operation purposes. At no timewill the Group Health Plans disclose information for em-ployment-related actions or decisions.

Within Ford, information can only go to certain individu-als, namely those located at the NESC, on an as-neededbasis. These individuals have been trained and certifiedin HIPAA.

Health Care Plan — HIPAA Privacy Practices 81

Required by law

The Group Health Plans may use and disclose informa-tion about you as required by law. For example, the GroupHealth Plans may disclose information:

• For judicial and administrative proceedings pursuant tolegal authority;

• To report information related to victims of abuse, ne-glect, or domestic violence pursuant to legal authority;or

• To assist law enforcement officials in their lawenforcement duties as required by law.

Other permitted uses and disclosures

While the Group Health Plans generally do not use or dis-close PHI for the following purposes, the Group HealthPlans may disclose PHI:

• To a health oversight agency (such as Medicare orMedicaid);

• For government functions (for reasons of national security);• To avert a serious health or safety threat;• For post-mortem identification; or• To comply with Workers’ Compensation laws.

Other issues

Other uses and disclosures will be made only with yourwritten authorization. You may revoke the authorization inwriting, except to the extent that the Group Health Planshave relied on your authorization.

Your health information rights under HIPAA

You have the right to:

• Request a restriction or limitation on the Group HealthPlans’ use or disclosure of your PHI for payment orhealth care operations purposes as set forth above.You also have the right to request a limit on the PHI theGroup Health Plans disclose about you to someonewho is involved in your care or the payment of yourcare. The Group Health Plans are not required toagree to your request. If the Group Health Plans doagree, the Group Health Plans will comply with yourrequest unless the information is needed to provide youwith emergency treatment.

• Obtain a paper copy of the Notice of Information Prac-tices upon request.

• Inspect and copy your PHI that is contained in therecords maintained, used, collected or disseminatedby the Group Health Plans. Usually, this includes themedical and billing records maintained by the GroupHealth Plans, but does not include psychotherapy notesto which the Group Health Plans may have access.(You may be charged for the costs of copying, mailing,or other supplies directly associated with your request).

• Request an amendment to your PHI if you believe thePHI the Group Health Plans have about you is incor-rect or incomplete. You have this right as long as yourPHI is maintained by the Group Health Plans. The GroupHealth Plans may deny your request for amendment if:— Your request is not in writing, or it does not include

a reason to support the request;— Or the PHI to which your request refers:

• Was not created by the Group Health Plans, un-less the person or entity that created the PHI isno longer available to make the amendment;

• Is not part of the medical information, enrollment,payment, claims adjudication or managementrecords kept by the Group Health Plans;

• Is not part of the information you would be permit-ted to inspect or copy; or is accurate and complete.

• Request the Group Health Plans to communicate withyou about your PHI in a certain manner or at a certainlocation. For example, you may request that the GroupHealth Plans contact you only at home and not at work.The Group Health Plans will accommodate all reasonablerequests if you clearly state that you are requesting aconfidential communication because you feel that disclo-sure could endanger your life. You must make sure yourrequest specifies how or where you wish to be contacted.

• Receive an accounting of disclosures made of your PHI,except those based on an authorization for treatment,payment or health care operations.

Personal or designated representatives

You may exercise your Health Information Rights underHIPAA through a personal or designated representative.Your personal or designated representative will be requiredto produce evidence of authority (i.e., authorization formor other legal authority) to act on your behalf before beinggiven access to your PHI or being allowed to take anyaction for you. Copies of an authorization form can beobtained from the National Employee Services Center and/or from a Union Benefit Representative.

The Group Health Plans can deny your personal or des-ignated representative access to PHI in order to protectpeople who depend on others to exercise their rightsunder these rules and who may be subject to abuse orneglect. This also applies to personal representativesof minors.

82 Health Care Plan — HIPAA Privacy Practices

Complaints

You may complain to the Group Health Plans and to theSecretary of the Department of Health and Human Ser-vices if you believe your privacy rights have been violated.You will not be retaliated against for filing a complaint.

Obligations of the Group Health Plans

The Group Health Plans are required to:

• Maintain the privacy of PHI.• Provide you with this Notice of their legal duties and

privacy practices with respect to PHI.• Abide by the terms of this Notice.• Notify you if we are unable to agree to a requested

restriction on how your information is used or disclosed.• Accommodate reasonable requests to communicate

PHI by alternative means or at alternative locations.

The Group Health Plans reserve the right to change theirinformation practices and to make the new provisions effec-tive for all protected PHI they maintain. Revised Notices willbe made available to you through the Group Health Plan.

State law may provide for additional protection of yourhealth information. Please contact the person identifiedbelow for more information. The UAW-Ford Collective Bar-gaining Agreement, Volume IV, “Confidentiality of HealthCare Information” also provides protection on confidenti-ality of medical information.

Contact information

If you have any questions, complaints or wish to exerciseany of your Health Information Rights under HIPAA asdescribed herein, contact:

Enrollment Information

National Employee Services Center (NESC)P.O. Box 6214Dearborn, MI 48121-62141-800-248-4444

Claims and Billing - Contact your health care plan car-rier directly.

No change to plans

Except for the privacy rights described in this Notice, noth-ing contained in this Notice shall be construed to changeany rights or obligations you may have under the GroupHealth Plans. You should refer to the Group Health Plansdocuments for complete information regarding any rightsor obligations you may have under the Group Health Plans.

83

Health Care PlanImportant Medicare Information


Page

What is Medicare? 84

Who is eligible for Medicare? 85

Does Medicare cost anything? 85

How do I enroll in Medicare Part A? 86

How does my Ford medical coveragecoordinate with Medicare Part A? 86

What will happen if I don’t present my MedicareI.D. card to the doctor or hospital? 87

How do I enroll in Medicare Part B? 87

What is the Special Age 65 Benefit? 88

How do I apply for the Special Age 65 Benefit? 88

What happens if I don’t enroll inMedicare Part B? 89

Why should my spouse and dependentsenroll in Medicare Part B? 89

Where do I go if I have questions aboutMedicare? 90

If I am eligible for Medicare, how does the FordMedicare enrollment policy apply to me?(Medicare Information table) 91

84 Health Care Plan — Important Medicare Information

Health Care PlanImportant Medicare Information

IMPORTANT MEDICARE INFORMATION FOR FORDMEDICARE-ELIGIBLE EMPLOYEES, RETIREES ANDSURVIVING SPOUSES

The purpose of this section is to provide you with impor-tant information regarding Medicare and to tell you howenrollment in Medicare affects your benefits under theBCBS National PPO Plan or the UNICARE TraditionalMedical Plan.

Late enrollment in Medicare B may cause your survivingspouse to be responsible for substantial medical costsand may result in Medicare late enrollment penalties. Forsurviving spouses, failure to comply with the Company’spolicy regarding enrollment in Medicare Part B may resultin loss of eligibility for Company-paid coverage under themedical plan.

Action Required

• If you are covered under the National PPO Plan (BCBS)or the Traditional Medical Plan (UNICARE), please readthis material explaining the Ford Medicare enrollmentpolicy under the Ford health care plan.

• When applicable, you and your dependents must enrollin Medicare Part A.

• Surviving spouses age 65 or older must enroll in Medi-care Part A and Part B in order to be eligible for com-pany payment of Ford medical coverage.

What is Medicare?

Medicare is our country’s health insurance program forthe elderly and disabled.

Medicare has two parts:

• Medicare Part A - Hospital Insurance. Most people arenot required to pay for Part A.

— Medicare Part A helps pay for hospital stays, verylimited skilled nursing care, some home healthcare and hospice care. Medicare Part A does notcover long-term nursing home care or most pre-scription drugs.

• Medicare Part B - Medical Insurance. Most peoplepay a monthly premium for Part B which is adjustedeach year by Centers for Medicare and MedicaidServices (CMS).

— Medicare Part B helps pay for doctor’s services, X-rays, diagnostic tests, ambulance services and out-patient hospital care.

Health Care Plan — Important Medicare Information 85

Who is eligible for Medicare?

• Most people age 65 or older, who are citizens orpermanent residents of the United States, are eli-gible for Medicare based on their own (or theirspouse’s) employment history.

• Before age 65, you are eligible for Medicare if you havebeen receiving Social Security disability benefits for24 months.

• If you have end-stage renal disease (permanent kid-ney failure requiring dialysis or a kidney transplant),you may be eligible for Medicare at any age.

Does Medicare cost anything?

• In almost all cases, there is no cost to you or yourspouse for Medicare Part A. A Medicare tax deductionfor Part A was taken from your or your spouse’s pay-checks during the years you worked.

• There is however a monthly premium (cost) for Medi-care Part B; this premium is adjusted annually by Cen-ters for Medicare and Medicaid Services (CMS).


How do I enroll in Medicare Part A?

• If you are receiving Social Security Benefits at age 65,you will automatically be enrolled in Medicare Part A,at no cost to you. Prior to your 65th birthday, you willreceive a Medicare I.D. card in the mail.

• If you have been receiving Social Security DisabilityBenefits for 24 months or longer, you will automaticallybe enrolled in Medicare Part A at no cost to you.

• If you can’t find your Medicare card, you can request anew card from Social Security by calling 1-800-772-1213.

NOTE: If you are age 65 or older and retired, and notreceiving a Social Security check, you must enrollfor Medicare Part A. Enrollment is not automaticat age 65 unless you are receiving Social SecurityBenefits. You can enroll at your local SocialSecurity Administration Office, by calling 1-800-772-1213, or online at www.ssa.gov. Please notethat if you delay your enrollment and you receivemedical services, you may be responsible for allor most of the charges which Medicare Part Awould have paid.

How does my Ford medical coverage coordinate withMedicare Part A?

The Ford health care plan first determines what it wouldpay if you had no other coverage. The plan then subtractsMedicare benefits and pays the difference. As long asyou are eligible for Medicare Part A and are not activelyworking, your health care claims will be paid under theassumption that you are enrolled in Medicare Part A. YourFord health care plan benefits will be reduced for anybenefits that are available under Part A whether or notyou are actually enrolled. As long as you are enrolled inMedicare, your total level of benefits will not changebecause of your Medicare coverage. Only the source ofpayment will change.

Medicare and the Ford health care plan do not cover allyour health care costs. In some cases, the Ford healthcare plan will cover costs not covered by Medicare. Forexample, most covered prescription drugs will continue tobe paid by your Ford health care plan. For those chargesthat are covered by your Ford health care plan, but notMedicare, the Ford plan will pay without considering yourMedicare coverage.


How do I enroll in Medicare Part B?

• You are/were automatically eligible for Medicare Part Bif you are eligible for Medicare Part A.

• If you are receiving a Social Security benefit and are eligiblefor Medicare coverage, you were enrolled automaticallyin Medicare Parts A and B at the same time.

NOTE: Although you may have previously declinedMedicare Part B coverage, you do not have theoption to decline Medicare Part A as long as youcontinue to receive a Social Security benefit.

• The premium for Medicare Part B is deducted from yourSocial Security check.

What will happen if I don’t present my Medicare I.D. cardto the doctor or hospital?

• If you are eligible for Medicare Part A, your Ford medicalplan will check to see if Medicare has paid its sharebefore processing your claim.

• Any services that would have been paid by MedicarePart A will be rejected by your Ford health care plan.This will cause a delay in payments to your providersand may require you to work with your provider tosubmit the claim to Medicare. For example, if you wereadmitted to a hospital as an inpatient and you did notpresent your Medicare I.D. card, your Ford coveragewould pay only the Medicare Part A deductible amount.You would be responsible for working with your providerto submit the balance of the hospital bill to Medicare.


How do I apply for Special Age 65 Benefit?

• To apply for this benefit, please mail a photocopy ofyour Medicare Health Insurance card showing theeffective date of your Medicare medical insurance to:

National Employee Services CenterP.O. Box 6214Dearborn, MI 48121-6214Attn: RSU - Medicare

• A photocopy of your Medicare Health Insurance card,showing the effective date of your Medicare medicalinsurance must be received by the Company beforeyour Special Age 65 Benefit can be started.

What is the Special Age 65 Benefit?

• Ford provides a Special Age 65 Benefit payable to retireesand surviving spouses, who are at least age 65,receiving a retirement benefit (other than deferredvested), are eligible for Ford health care and enrolled inMedicare Part B. Active employees with End StageRenal Disease and employees in receipt of disabilitybenefits are also eligible to receive this special benefit,provided they are enrolled in Medicare Part B.

• If you are eligible, the Special Age 65 Benefit will beincluded in your pension check. Active employees withEnd Stage Renal Disease and employees in receipt ofdisability benefits are paid through the disability plan.

• Your spouse is not eligible for the Special Age 65 Benefit.However, your surviving spouse will be eligible for theSpecial Age 65 Benefit when you die, if he or shereceives a survivor pension benefit and is enrolled inMedicare Part B when eligible.

• In some circumstances, you may be eligible to receivea Special Age 65 Benefit before you are age 65. Youmust apply for this benefit. You must be enrolled inMedicare Part B to receive this benefit.

• For more information, refer to the Medicare InformationTable at the end of this section.


What happens if I don’t enroll in Medicare Part B?

• If you decide not to take Part B when first eligible, shouldyou choose to enroll later, the monthly premium cost toyou for Part B will go up by 10% of the Part B premiumcost for each 12-month period that you could have beenenrolled. Ford will not reimburse you for this penalty.

• If you did not enroll when first eligible, and later chooseto enroll, you must wait until the next Medicare Part Bopen enrollment period, which is January 1 throughMarch 31 of each year. Your Medicare Part B will beeffective on July 1 of the year you enroll.

• The BCBS National PPO Plan and the UNICARETraditional Medical Plan do not pay for some servicesthat would be covered by Medicare Part B, such asoffice visits.

• If you are a surviving spouse who is age 65 or older,you will lose Company paid health care coverage untilsuch time as you enroll in Medicare Part B.

Why should my spouse and dependents enroll in Medi-care Part B?

• If your spouse is age 65 or older, and is not enrolled inMedicare Part B when you die, he or she will not be eligiblefor the Company paid health care coverage until he or sheis enrolled in Medicare Part B. Since the Part B openenrollment period is from January 1 to March 31 of eachyear, and the coverage does not become effective untilJuly 1, this could leave your spouse with no coverageother than Medicare Part A for an extended period of time.Your surviving spouse does have the ability to cash paythe Ford premium amount to continue the Ford medicalcoverage until the next Medicare open enrollment.

• If you are not actively working and you have a spouseor a dependent who is not yet age 65 but is eligible forMedicare, Medicare will be their primary insurancecoverage when they enroll. Enrolling in Medicare PartB allows the Medicare program to pay its share of yourhealth care costs, which also helps Ford better manageits costs.

• Additionally, the BCBS National PPO Plan and theUNICARE Traditional Medical Plan do not pay for someservices that would be covered by Medicare Part B, suchas office visits. Enrollment in Medicare Part B may reduceyour total out-of-pocket health care expenses.


Where do I go if I have questions about Medicare?

The Social Security Administration and Medicare areavailable to answer your questions at the following:

• The Social Security Administration Office

1-800-772-1213 • Online at www.ssa.gov

• Medicare

1-800-MEDICARE (1-800-633-4227) • Medicare online at www.medicare.gov


If I am eligible for Medicare, how does the Ford Medicare enrollment policy apply to me?

Medicare Information Table

Employment Is Medicare Is Medicare Eligible for Ford How are my benefitsStatus Part A Part B Special Age 65 coordinated with

required*? required? Benefit? Medicare?

You are actively No No No The Ford health care planworking for the will continue to be theCompany primary payer of eligible

health care expensesand Medicare will be thesecondary payer (if youare enrolled) as long asyou are actively working.

You are actively Yes, when No Yes. The Ford health care planworking for the first eligible* An employee with will continue to be theCompany AND End Stage Renal primary payer of eligibleyou have End- Disease who is health care expensesStage Renal enrolled in Medicare for an initial 30-monthDisease (permanent Part B is eligible to coordination period. Atkidney failure receive the Special the end of the 30 months,requiring dialysis or Age 65 benefit Medicare becomes thea kidney transplant) towards the Medicare primary payer.

Part B premium. Youmust apply for thisbenefit.

You are on a Yes, when No Yes. An employee If you have been off fromleave/layoff and first eligible* who is receiving Ford’s work for more than sixhave been off UAW disability benefits months and you arework for six and is enrolled in enrolled in Medicare,months Medicare Part B is Medicare becomes the

eligible to receive the primary payer of eligibleSpecial Age 65 health care expenses forbenefit towards the you and any of yourMedicare Part B Medicare eligible depen-premium. You must dents (if they areapply for this benefit. enrolled in Medicare).

You are retired, Yes, when No Yes. You may be Medicare becomes thedisabled and first eligible* eligible to receive the the primary payer ofunder age 65 Special Age 65 Benefit eligible health care

before you are age 65. expenses for you andYou must be enrolled any of your dependentsin Medicare Part B enrolled in Medicareto receive this benefit. when you retire.You must apply for thisbenefit.

* Members who are eligible for Medicare Part A, whether or not they are actually enrolled, will have all benefits avail-able under the Ford health care plan reduced to the extent payment or benefit is available or would be available underMedicare Part A.


Medicare Information Table

Employment Is Medicare Is Medicare Eligible for Ford How are my benefitsStatus Part A Part B Special Age 65 coordinated with

required*? required? Benefit? Medicare?

You are retired and Yes, when No Yes. The Special Age 65 Medicare becomes theage 65 or older first eligible* benefit is payable to primary payer of eligible

retirees, who are at least health care expenses forage 65, enrolled in Medi- you and any of yourcare Part B and receiving dependents enrolled inFord’s UAW retirement Medicare when youbenefits (other than a retire.deferred vested benefit).You must be enrolled inMedicare Part B to receivethis benefit. You must applyfor this benefit.

You are a Yes, when Yes, at Yes. The Special Age 65 Medicare is the primarysurviving spouse first eligible* age 65 Benefit is payable to payer of eligible health

surviving spouses care expenses forwho are enrolled in Medicare eligibleMedicare Part B and surviving spouses.receiving Ford’s UAWretirement benefits (otherthan a surviving spousebenefit payable as a defer-red vested benefit). You mustapply for this benefit.

* Members who are eligible for Medicare Part A, whether or not they are actually enrolled, will have all benefits availableunder the Ford health care plan reduced to the extent payment or benefit is available or would be available underMedicare Part A.

93

Health Care PlanOther Health Care Plan Information


Page

How does the Health Care Plan coordinatewith other group health care plans? 94

How does the Health Care Plan coordinate withmedical coverage through auto insurance? 95

How is the Health Care Plan affectedwhen my spouse or I am age 65 or olderand I still am working? 95

When may the Plan recover benefits thatwere paid? 96

When may I continue my coverage under the“Cash Pay” rules? 96

When may I continue my coverageunder COBRA? 97

Can I convert my coverage to anindividual policy? 100

May I obtain a Certificate of CreditableCoverage for credit against another (non-Ford)plan’s Pre-existing Condition Clause? 100

94 Health Care Plan — Other Health Care Plan Information

How does the Health Care Plan coordinate with othergroup health care plans?

If you or a covered dependent is covered by anothergroup health care plan, your Health Care Plan coor-dinates with that plan.

Your Health Care Plan may be coordinated with other grouphealth care plans to which you or your eligible dependentsbelong. This means that all plans together pay no morethan 100% of allowable expenses for you or your depen-dents. An “allowable expense” is any expense covered atleast in part by one of the plans.

When a health care claim is made, benefits are coordi-nated as follows:• The primary plan pays benefits first, without regard to

any other plan• The secondary plan pays benefits so that the total ben-

efits paid will not be greater than your allowable expense

No plan pays more than it would without the coordina-tion provision.

A plan without a coordinating provision always is the pri-mary plan. If all plans have a coordinating provision, ben-efits will be coordinated as follows:• The plan covering the patient as an employee, rather

than as a dependent, will be the primary plan• If the patient is a dependent covered by more than one

plan, the plan of the employee whose birthday occursfirst in the calendar year is primary. If the birthdays arethe same day, the plan that has covered the dependentlonger is primary

If you are separated or divorced, however, the plans payin this order:• The plan of the parent with responsibility for health care

is primary, if the court has established one parent asfinancially responsible for health care

• The plan of the parent with custody of the child• The plan of the stepparent married to the parent with

custody of the child• The plan of the parent that does not have custody of

the child

When a determination cannot be made, the plan that hascovered the patient longer is primary, unless the patient isretired, laid off or the dependent of a retired or laid-offemployee. In this case, the plan that has covered the pa-tient for less time is primary.

The Health Care Plan will pay the benefits explained inthis section when it is the primary plan. When it is thesecondary plan, it will pay the difference between ben-efits paid from the primary plan and the benefits explainedin the “Hospital-Surgical-Medical coverage” section of thishandbook. It’s important to indicate on your claim form ifyou have any other insurance coverage so that each claimsprocessor pays the correct amount.

Coordination of benefits does not apply to other groupcoverage where you or a member of your family is payingone-half or more of the cost or to non-group coverage whichis privately purchased.

Health Care PlanOther Health Care Plan Information

Health Care Plan — Other Health Care Plan Information 95

How does the Health Care Plan coordinate with medicalcoverage through auto insurance?

The Plan also coordinates with personal injury protectioncoverage in those states with no-fault auto insurance laws.Benefits under this plan are secondary to no-fault autoinsurance coverage.

How is the Health Care Plan affected when my spouse orl am age 65 or older and l still am working?

When you or your spouse are age 65 or older andyou are still working for Ford, you may have cover-age under both the Health Care Plan and Medicare.

When you or your spouse are age 65 or older, you still areworking for Ford and you or your spouse are eligible for Medi-care, the Health Care Plan automatically will continue to bethe primary payor of eligible Health Care expenses; Medi-care Part A will be the secondary payor of benefits. Yourclaims should be submitted to your claims processor firstand then to Medicare for complementary benefits. Medicareprovides some additional benefits under Part B such as of-fice visits which are not paid by the National PPO Plan(BCBS) / Traditional Health Care Plan (UNICARE). Thoseeligible for Medicare Part A should enroll.

When Medicare becomes primary, for example when youretire, Ford coverage will pay only the balance over whatMedicare would pay if you are enrolled.

Hospital, surgical and medical benefits are coordinatedwhile covered by both Ford and Medicare. Ford prescrip-tion drug, dental, vision care and hearing aid benefits arenot affected by Medicare.

Refer to the section “Important Medicare Information” forfurther details.


When may l continue my coverage under the “cashpay” rules?

(Also refer to the COBRA section of this handbookfor additional information.)

You may continue coverage for yourself and yourdependents after Company-paid coverage ends by payingthe Plan’s cash pay rate under certain circumstances.

For example, if you are laid-off, you may continue hospital,surgical, medical, prescription drug, vision and hearingaid coverages (but not dental coverage) during a layoffwithout a break in seniority for up to 12 months after yourCompany-paid coverage ends.

If you go on an approved leave of absence (other than fordisability), you may continue your hospital, surgical,medical, prescription drug, vision care and hearing aidcoverages for up to 12 months by paying the Plan’s cashpay rate.

Certain categories of surviving spouses may pay the Plan’scash pay rate to continue hospital, surgical, medical,prescription drug and hearing aid coverage (but not dentalor vision care coverage) after Company-paid coverageends for themselves and dependents who were eligible orsponsored at the time of your death.

• “Cash-pay” coverage may only be continued as long asthe surviving spouse is eligible to receive survivor in-come benefits under the Group Life and Disability In-surance part of the program (including for this purpose,a surviving spouse whose survivor income benefit isnot payable because she is receiving Mother’s Insur-ance Benefits). A surviving spouse who would be eli-gible for Bridge Survivor Income Benefits except thatsuch spouse is age 60 or older may cash-pay to con-tinue coverage until the end of the month in which thespouse reaches age 65.

If you are not eligible for continued Company-paid cover-age, but have the option of continuing coverage underCompany cash-pay rules by paying 100% of the full grouprate for a certain period of time, you may choose betweencontinuing coverage under Company cash-pay rules orunder COBRA rules, but not both.

When may the Plan recover benefits that were paid?

Subrogation

If benefits are paid under the Plan for an injury or conditioncaused by the actions of another person, the Plan may beentitled to recover payment from another insurance com-pany, third party, or you if payment has been made to youby another insurance company or third party. This right ofrecovery is called Subrogation.

The Company has asked Vengroff, Williams & Associates,Inc. (VWA) to be the subrogation administrator and reviewcertain claims when there is an indication that an injury orcondition may have been the result of an accident.

If you are contacted by VWA on behalf of the Company,you are required to complete any incident reports sent toyou and provide copies of any documents requested.

In the event you fail to repay the Plan for payment made toyou by another insurance company or third party, the Planmay offset future benefit payments by withholding pay-ment until the entire amount due is reimbursed.

Additionally, the Plan’s rights shall not be reduced by rea-son of the make-whole doctrine.

Benefit overpayment recovery

You (or your surviving spouse) must notify the NESC ofchanges in dependent eligibility. If your child marries, forexample, you must call immediately to remove the childfrom your Company-provided coverage

If the Company determines that an act (such as adding aperson not eligible under the Plan) or omission (for ex-ample, failing to remove a person no longer eligible underthe Plan) of an employee, retiree or enrollee results in orcontributes to an overpayment under this program, youmust repay the amount of overpayment within 60 days.

If repayment does not occur within 60 days, subject tofederal laws, the Company has the right to make, or ar-range to have made, deductions for recovering such over-payments from any present or future compensation or ben-efits payable under the Ford Health Care Plan which are orbecome payable to such primary enrollee. Any payroll de-ductions for such overpayments will not exceed $100 forany one paycheck, except in cases of fraud or willful mis-representation. The Company will not make any deduc-tions for recovery from the Ford-UAW Retirement Plan.


Qualifying Events — dependent childrenIn the case of a dependent child of an active employeecovered by the Company’s group health care plan, COBRAprovides that the child may continue Ford coverage athis/her own expense if he/she loses Company-paidcoverage because of:• The termination of the employee’s employment (for rea-

sons other than gross misconduct)• A reduction in the employee’s hours of employment• The death of the employee• The divorce or legal separation of the parents• The child ceasing to be a “dependent child” as defined

in the Company’s group health care plan

Notification of Qualifying EventsThe covered employee, spouse or dependent child whowishes to elect to continue coverage at his/her ownexpense under COBRA must notify the NESC at 1-800-248-4444 within 60 days of the following qualifying events:• Divorce or legal separation• A dependent child ceasing to be a “dependent child” as

defined in the Company’s group health care plan• Death, if it results in loss of coverage

For other Qualifying Events (termination of employmentor reduced hours of employment), your employer will no-tify the COBRA Coordinator within 30 days.

Upon receipt of appropriate notice of the occurrence of aQualifying Event, the Ford COBRA Coordinator will, within14 days, send an election notice to those individuals eli-gible to elect to continue coverage. If you wish to con-tinue group health care coverage under COBRA, you mustreturn a completed election form to the COBRA Coordina-tor within 60 days of the date the COBRA Coordinatorsent you the election form, or the date coverage stops,whichever is later. If you do not choose to continue cover-age, your Company’s group health care coverage will endaccording to the provisions of that Plan.

When may l continue my coverage under COBRA?

If you are not eligible for Company-paid continuationof coverage, you may be eligible to continue cover-age at your own expense.

In addition to the Company’s continuation of coverage pro-visions as described in other parts of this section, youand your dependents also may be entitled to continue eachindividual’s health care coverage at your own expense un-der the provisions of the Consolidated Omnibus BudgetReconciliation Act (COBRA) of 1985. COBRA is a federallaw that gives certain eligible participants the right to tem-porarily continue health care coverage at group rates. Ifyou or a covered family member should become ineligiblefor Company-paid coverage because of what COBRA callsa “Qualifying Event” (described below), you may be ableto continue your coverage at 102% of group rates for alimited period of time (note that this information is intendedonly as a summary of the COBRA law; eligibility, etc.,under the law will be determined at the time you apply).

NOTE: Each individual covered under your contract has aseparate individual right to COBRA continuedcoverage.

Qualifying Events — employeesIf you are an active employee covered by the Company’sgroup health care plan, COBRA provides that you maycontinue Ford coverage at your own expense if you lose itbecause of:• The termination of your employment (for any reason

other than gross misconduct on your part)• A reduction in your hours of employment• You fail to return to work at the conclusion of a FMLA

leave of absence

Qualifying Events — spousesIf you are the spouse of an active employee covered bythe Company’s group health care plan, COBRA providesthat you may continue Ford coverage at your own ex-pense if you lose Company-paid coverage because of:• A termination of the employee’s employment

(for reasons other than gross misconduct)• A reduction in the employee’s hours of employment• The death of the employee• Divorce or legal separation from the employee


Your costYour cost to continue health care coverages under COBRAwill be 102% of the full group rate in effect at the timecontinued coverage begins. Cost-of-coverage information willbe provided by the COBRA Coordinator if a Qualifying Eventoccurs. If the group rate changes, you will be required to paythe revised amount. You are not required to make any COBRApayment until 45 days after the date on which you make theinitial election to continue coverage. However, you will berequired to pay for your coverage retroactively to the datethe Company-paid coverage ended.

For those who are eligible, as described later, for suchadditional coverage because you are determined by theSocial Security Administration to have been disabled (asdefined by the Social Security Act) before the first 60days of continuation coverage has elapsed, the cost tocontinue coverage for an additional 11 months for quali-fied beneficiaries is 150% of the full group rate for the 11months of COBRA coverage following your initial 18months of coverage (which was paid at 102% of the fullgroup rate).

Effect of Company continuation provisions on COBRAUnder the Company’s health care plans, provisions existfor continuing Company-paid coverage for a period of timeafter you stop working, for example, when you are on aqualifying layoff. Periods of Company-paid continuation ofcoverage following a qualifying event will be counted aspart of your COBRA continuation period. Please consultthe above section of this handbook for specific details onCompany-paid continuation provisions.

Whether or not you continue your coverage under COBRA,you may convert to the individual coverage offered byyour claims processor within 30 days of the time yourCOBRA coverage ends. See “Can I convert my coverageto an individual policy?” in this section for more informationon conversion coverage.

Other provisionsIf you or your eligible dependents elect to continue yourhealth care coverage under COBRA, it will be identical tothe coverage you were eligible for before the QualifyingEvent. You may choose to continue coverage under anyor all of the following three categories of coverage:• Hospital, surgical, medical, prescription drug and

hearing aid• Vision care• Dental

You may choose any combination of these plans, pro-vided you were enrolled in the coverage before the quali-fying event. You are also eligible to change plans at anytime after being enrolled in a plan for 12 months. Gener-ally, if at the time of the Qualifying Event you had groupmedical coverage and coverage under separate plans,such as vision or dental plans, you are eligible to continuethose plans too, but you are not required to do so. If somecoverages stop while others continue at Company ex-pense, you may elect, and pay for, only those coveragesthat are no longer Company-paid.

If you are not eligible for continued Company-paid cover-age, but have the option of continuing coverage underCompany cash-pay rules by paying 100% of the full grouprate for a certain period of time, you may choose betweencontinuing coverage under Company cash-pay rules orunder COBRA rules, but not both.

Termination of COBRA coverageIf you or your dependents lost Ford coverage because ofyour termination of employment or reduction in hours, youor your dependents may continue the coverage for 18months. However, if you are continuing coverage for 18months and a second Qualifying Event occurs that wouldcause your spouse or dependent children to lose cover-age (i.e., death of the employee or retiree, divorce or legalseparation, a child ceasing to be a “dependent child”), theCOBRA continuation period is expanded so that they maycontinue coverage on their own COBRA contract for amaximum of 36 months measured from the date of thefirst event.

If you or anyone in your family is determined by the SocialSecurity Administration (SSA) to have been disabled underthe Social Security Act before the 60th day of COBRAcoverage and you notify NESC at 1-800-248-4444 within60 days of the later of (1) the SSA’s determination and (2)the date on which a qualifying event occurs, and in allcases before the expiration of the 18-month COBRAcontinuation period, you and your family members maybe eligible for COBRA coverage for a maximum of 29months rather than 18 months.

If you are subsequently determined by SSA to no longerbe disabled under the Social Security Act, you mustnotify NESC at 1-800-248-4444 within 30 days of theSSA’s determination.


You also should be aware that your health care coveragecontinued under COBRA will be terminated before the end ofthe 18- or 36-month period for any of the following reasons:• Failure to make the required payment on time• Coverage under any other group health care plan which

does not contain an exclusion or limitation with respectto any preexisting condition of the covered beneficiary

• Your entitlement to Medicare (i.e., eligible for and en-rolled in Part A, Part B or both)

• Voluntary cancellation of coverage• The Company no longer provides group health care cov-

erage to any of its employees or retirees

NOTE: COBRA coverage for your spouse and eligibledependents will not be terminated for at least 36months from the date you first became entitled toMedicare if that period of time is longer than 18 monthsfollowing the date of your termination of employment.

NOTE: If you become entitled to Medicare prior to thedate you are eligible to elect COBRA, you are stilleligible to elect to continue your coverage underCOBRA. However, if you become entitled toMedicare after your election to continue yourcoverage under COBRA, your COBRA coveragewill be terminated.

Once coverage under COBRA has been terminated, itwill not be reinstated.

For additional informationIf you have any questions about COBRA, contact the des-ignated COBRA Coordinator, UNICARE Life and HealthInsurance Company, P.O. Box 6067, Dearborn, Michigan48121-6067. Phone: (313) 336-2351 or 1 (800) 843-8184.UNICARE does not insure or act as plan administrator (asdefined by ERISA) for this program but does provide theadministrative service for Ford.

Will continuation of coverage be available to my same-sex do-mestic partner if he or she is no longer eligible under the FordPlan (due to a qualifying event)?Yes. Ford has made “cash pay” continuation coverage un-der the Ford group medical plans available for purchaseby former same-sex domestic partners in such situationsfor a limited time (generally up to 36 months) at grouprates. Same-sex domestic partners do not qualify forCOBRA coverage under the federal government’s regula-tions covering COBRA continuation of coverage. Instead,the Company offers COBRA-like “cash pay” continuationof coverage with eligibility rules and payment arrangementssimilar to COBRA coverage for same-sex domestic part-ners who no longer qualify for coverage. Contact the NESCat 1-800-248-4444 to obtain detailed rules.

You or your former same-sex domestic partner must notifythe NESC at 1-800-248-4444 within 60 days of the date thesame-sex domestic partnership terminates. Otherwise, yourformer same-sex domestic partner will lose the opportunityto purchase “cash pay” continuation coverage.

Will continuation of coverage be available to the children of mysame-sex domestic partner when they cease to meet the eligibil-ity criteria?Yes. COBRA continuation coverage will be available asexplained above when the children no longer meet theeligibility criteria of the Ford plan (for example, when theymarry, when they no longer reside in your household, whenthey are no longer principally dependent on you or whenthey reach age 25) or when the employee loses eligibility.

Company-paid coverage will stop on the day in which theyno longer meet the eligibility criteria. You must notify theNESC within 60 days from the date the dependent no longermeets the Ford eligibility criteria. Otherwise, the opportunityto purchase continuation coverage will be lost.


May l obtain a Certificate of Creditable Coverage forcredit against another (non-Ford) plan’s PreexistingCondition Clause?

If you become covered under another group health careplan, coverage under the Ford Health Care Plan may counttoward satisfying any preexisting condition clausecontained in the new plan. For example, if your new healthcare plan excludes coverage for certain pre-existingconditions for six months, and you had Ford coverage fora total of three months, you may present a Certificate ofCreditable Coverage from Ford to reduce the exclusionaryperiod to three months.

Without evidence of creditable coverage, you may besubject to a preexisting condition for up to 12 months (18months for late enrollees) after your enrollment date in yournew, non-Ford coverage, depending on that Plan’s terms.

You will be provided a Certificate of Creditable Coverage,free of charge, from the Ford Health Care Plan:

• when you lose coverage under the Plan• when you become entitled to elect COBRA continua-

tion coverage• when your continuation coverage ceases, if you request

it before losing coverage, or if you request it up to 24months after losing coverage.

The Ford Health Care Plan does not contain a pre-existingcondition clause.

Can l convert my coverage to an individual policy?

In addition to the Company “cash pay” rules and COBRAcontinuation provisions, you or your covered dependentsalso have the option of converting your group medicalcoverage to an individual plan when you:

• Cease active employment• Reach the end of the period allowed under your

Company’s health care continuation provisions• Stop paying for COBRA coverage

Your coverage may be converted to an individual policy with-out proof of good health if you do so within 30 days of thetime your Company’s health care coverage or COBRA cov-erage stops. The coverage to which you convert and therates may not be identical to the Company’s plan. Prescrip-tion drug, hearing aid, vision and dental coverages may notbe converted. Check with your medical plan claims proces-sor about the availability of conversion coverage.

NOTE: To convert to an individual policy, contact yourcarrier within 30 days of when coverage stops.

101

Life and Disability Insurance Program

After an overview of the Life and DisabilityInsurance Program, this section of yourhandbook answers these questions:

Page

Who is eligible and what are thebasic coverage details? 102

What are Life Insurance Benefits? 104

What are Accidental Death andDismemberment Benefits? 107

What are Survivor Income Benefits? 108

What are Optional Group LifeInsurance Benefits? 109

What are Dependent Group LifeInsurance Benefits? 112

What are Optional Accident Insurance Benefits? 114

What are Safety Belt User Benefits? 119

What if a claim is denied for Life Insurance,AD&D, Safety Belt User or Survivor Income? 120

What are Accident and Sickness Benefits? 121

What are Extended Disability Benefits? 126

What happens if I stop working for any reason? 130

How do I or my survivor apply for benefits? 133

Will taxes be withheld from myDisability Benefits? 135

What if a claim for Accident and Sickness orExtended Disability Benefits is denied? 135

When does coverage end? 136

What other circumstances mightaffect benefits? 137

Summary of Administrative Information 138

102 Life and Disability Insurance Program

An overview of the Program

The Life and Disability Insurance Program providesimportant financial protection for you and your familyif you die, become disabled or terminally ill.

If you die, become disabled or terminally ill, you or yourfamily has financial protection through the Life and Dis-ability Insurance Program. Through the Program, you maybe eligible for:• Life Insurance—paying a benefit if you die or become

terminally ill• Accidental Death and Dismemberment Insurance—

paying a benefit to you if you suffer a covered disability,or to your beneficiary if you die as the result of an accident

• Survivor Income Benefits—providing monthly incometo your eligible survivors after you die

• Optional Group Life Insurance Benefits—paying abenefit if you have enrolled in this coverage to yourbeneficiary in the event of your death

• Dependent Group Life Insurance Benefits—payinga benefit to you if you have enrolled in this coverageand a covered dependent dies

• Optional Accident Insurance Benefits—paying a benefitif you have enrolled in this coverage: to you if you suffer acovered dismemberment or if a covered dependent diesas the result of an accident; to your beneficiary if you dieas the result of an accident; to your covered dependentwho suffers a covered dismemberment

• Safety Belt User Benefits—paying a $15,000 benefitif you or another covered participant dies as a result ofan automobile accident while wearing a qualified pas-senger restraint

• Accident and Sickness Benefits—providing a weeklybenefit for up to 52 weeks if you are injured or sick andunable to work

• Extended Disability Benefits—providing a monthlybenefit after Accident and Sickness benefits end, if youare totally disabled and unable to work


Who is eligible and what are the basic coverage details?

EligibilityYou’re eligible for the Life and Disability InsuranceProgram if you’re:• A regular full-time Ford employee• Represented by the UAW under the Collective Bargain-

ing Agreement effective September 29, 2003.

When coverages beginYour coverages become effective as shown here:

Life Insurance,Accidental Optional Group AccidentDeath and Life Insurance, andDismemberment Dependent SicknessInsurance Group Life Safety andand Survivor Insurance and Belt User Extended

Your Income Optional Accident Benefit DisabilitySituation Benefits Insurance Program Benefits

You’re First day of First day of First day First dayhired or the month the month of the of therehired following following the 8th month 6th month

the date date you’re following followingyou’re employed the date the dateemployed and enroll you’re you’re

for this employed employedemployee-paid benefit

You’re re- Date of your reinstatement (for any coverage in effect at the timeinstated you terminated prior Ford Employment)

You Date of your reinstatementreturn If you’re placed on layoff (rather than reinstated), Life Insurance,from Accidental Death and Dismemberment Insurance and Survivormilitary Income Benefits coverages become effective on the date you’re laid off.service

If you are absent from work due to sickness or injury onthe day your coverage ordinarily would start, coveragewill begin on the first day you return to active work.

If you die as a result of bodily injuries caused solely byyour employment with the Company, your coverage maybegin sooner than shown on the table. Your Life Insur-ance, Accidental Death and Dismemberment Insuranceand Survivor Income Benefits coverages will begin as ofthe date you were employed if your death was due to ajob-related accident in which:

• The cause and result of your accident were unexpectedand definite as to time and place

• Your death otherwise would have entitled your benefi-ciary to an accidental death benefit



When coverages endYour coverages end when your employment with the Com-pany terminates, except under certain conditions as de-scribed in the “What happens if I stop working for anyreason?” section.

How your benefits are determinedYour Survivor Income Benefits, Safety Belt benefits, Op-tional Group Life Insurance, Dependent Group Life Insur-ance and Optional Accident Insurance are fixed dollaramounts, as described later in this section. Your Life In-surance, Accidental Death and Dismemberment Insurance,Accident and Sickness benefits* and Extended DisabilityBenefits* are based on your base hourly rate on the lastday you worked preceding your death or disability or, ifhigher, the rate determined in the following section. (Thisis your base hourly rate before any contributions to theTax-Efficient Savings Plan for Hourly Employees.) Yourbase hourly rate does not include shift differentials, over-time, cost-of-living allowance or other extras.

Certain rules, however, apply:

In this situation: Your benefits are based on:

You are under an Your average straight-time hourly earningsincentive plan (not including shift differentials, overtime,

cost-of-living allowance or other extras)during the four pay periods you worked immediately preceding January 1, April 1,July 1 and October 1 or if higher, the greater ofthe scheduled amounts applicable to you asdescribed in the “If your base hourly ratechanges” section on the last two dates on whichInsurance Bracket changes took effect,immediately preceding death or disability

You are assigned a Your base hourly rate at the time of injury,lower-rated job while you are at work and receiving weeklybecause of an Workers’ Compensation or if higher, theoccupational greater of the scheduled amounts applicable toinjury — resulting you as described in the “If your base hourlyin a reduction in pay rate changes” section on the last two dates

on which Insurance Bracket changes tookeffect, immediately preceding death or disability

If your base hourly rate changesThe level of your Life Insurance and disability benefitscoverage changes if a change in your base hourly rateputs you into a new “coverage bracket.” Specifically:

If You receive You are in a The change ina change in new coverage your coveragepay effective: bracket on: will take effect on:

October 2-January 1 January 1 February 1January 2-April 1 April 1 May 1April 2-July 1 July 1 August 1July 2-October 1 October 1 November 1

If you are absent from work due to sickness or injury on the day your change incoverage is due to take effect, the change won’t take effect until the day youreturn to work.

Your costUnder the UAW-Ford Agreement, the Company pays thefull cost of your Life Insurance, Accidental Death and Dis-memberment Insurance, Survivor Income Benefits, SafetyBelt User Benefits, Accident and Sickness benefits andExtended Disability Benefits coverages:

••••• For any months you receive pay from the Company••••• For certain months when you are away from work

For certain other months when you are away from work,you may continue coverage beyond the period for whichthe Company pays the cost by paying a monthly contribu-tion. (The “What happens if I stop working for any rea-son?” section has more details.)

Optional Group Life Insurance, Dependent Group Life Insur-ance and Optional Accident Insurance are voluntary. If youchoose to enroll, you pay a monthly premium for coverage.

Naming a beneficiaryFor some benefits, you will be asked to name a benefi-ciary—the person you want to receive your insurance ifyou die. You may change any beneficiary you have namedat any time. (See the “What other circumstances mightaffect benefits?” section for more details.)

* For accident and sickness benefits and extended disability benefits, if you become disabled again for an old accidentor illness without having returned to work for three (3) consecutive months, the benefits will be the amount you wouldhave received under a continuation of your prior claim.


What are Life Insurance benefits?

If you die while insured, your beneficiary may receivea Life Insurance benefit. If you become terminally ill,you may be eligible to receive a benefit. Any benefitamount is based on your base hourly rate.

Eligibility for benefitsThe Company provides Life Insurance:• For any month you are eligible and receive pay from

the Company for any time during that month• For certain periods of time when you are away from

work (see the “What happens if I stop working for anyreason?” section for more details)

• At a reduced level for certain periods of time after themonth in which you become age 65, if you are insuredat that time

• For as long as you live if you are eligible at the timeyou retire (see the “Continuing Group Life InsuranceAmount” section for more details)

Benefit amount upon death prior to age 65If you are under age 65 and die from any cause whileinsured, your beneficiary will receive the Life Insuranceamount shown here:

Insurance Your Lifecode If your base hourly rate1 is: Insurance is:

A Up to but less than $17.80 $40,500B $17.80 but less than $18.15 $41,000C $18.15 but less than $18.50 $42,500D $18.50 but less than $18.85 $43,000E $18.85 but less than $19.20 $44,000F $19.20 but less than $19.55 $44,500G $19.55 but less than $19.90 $45,500H $19.90 but less than $20.25 $46,500I $20.25 but less than $20.60 $47,000J $20.60 but less than $20.95 $47,500K $20.95 but less than $21.30 $48,500L $21.30 but less than $21.65 $49,000M $21.65 but less than $22.00 $50,000N $22.00 but less than $22.35 $50,500O $22.35 but less than $22.70 $51,500P $22.70 but less than $23.05 $52,500Q $23.05 but less than $23.40 $53,000R $23.40 but less than $23.75 $54,000S $23.75 but less than $24.10 $54,500T $24.10 but less than $24.45 $55,500U $24.45 but less than $24.80 $56,500V $24.80 but less than $25.15 $57,000W $25.15 but less than $25.50 $58,000X $25.50 but less than $25.85 $58,500Y $25.85 but less than $26.20 $59,500Z $26.20 but less than $26.55 $60,500AA $26.55 but less than $26.90 $61,000BB $26.90 but less than $27.25 $62,000CC $27.25 but less than $27.60 $62,500DD $27.60 but less than $27.95 $63,500EE $27.95 but less than $28.30 $64,500FF $28.30 but less than $28.65 $65,000GG $28.65 but less than $29.00 $66,000HH $29.00 but less than $29.35 $67,500II $29.35 but less than $29.70 $68,000JJ $29.70 but less than $30.05 $69,000KK $30.05 but less than $30.40 $70,000LL $30.40 but less than $30.75 $70,500MM $30.75 but less than $31.10 $71,500NN $31.10 but less than $31.45 $72,000OO $31.45 but less than $31.80 $72,500PP $31.80 but less than $32.15 $73,000QQ $32.15 but less than $32.50 $74,000RR $32.50 but less than $32.85 $75,000SS $32.85 but less than $33.20 $75,500TT $33.20 but less than $33.55 $76,500UU $33.55 but less than $33.90 $77,000VV $33.90 but less than $34.25 $78,000WW $34.25 but less than $34.60 $79,000XX $34.60 but less than $34.95 $79,500YY $34.95 but less than $35.30 $80,500ZZ $35.30 and over $81,000

1 If an employee is under an incentive plan, coverage is basedupon average straight time hourly earnings.

The above amounts will be reduced by any amount ofinsurance paid prior to your death due to terminal illness.


If you last worked before September 29, 2003, your LifeInsurance amount is shown in the Collective BargainingAgreement in effect when you last worked.

Benefit amount after age 65When you reach age 65, your Life Insurance will be graduallyreduced if you are insured, but not below a Continuing GroupLife Insurance amount if you’re eligible for that coverage.

If you are insured at age 65 as a retiree, the reduction eachmonth after age 65 is 2% of the amount in force at age 65.

If you are insured after age 65 other than as a retiree, yourLife Insurance will increase as shown in the table if yourbase hourly rate increases. Your insurance, however, willbe reduced by 2% of that insurance amount for each monthyou are over age 65. Nevertheless, until age 70 your in-surance will not be reduced below 65% of the amount thatwas in force at age 65 adjusted to reflect any pay increasesyou may have received after that age. At age 70, yourinsurance will not be reduced below 50%. Further reduc-tions are made at age 75, 80 and so on.

If you become insured after age 65, your Life Insurancewill be determined as shown in the table, reduced by 2%of that amount for each month you are over age 65, asthough you had been insured since age 65. Nevertheless,your insurance will not be reduced below the amounts de-scribed above as long as you have Company-paid coveragebeyond age 65 other than as a retiree.

Continuing Group Life Insurance amountIf you are insured at age 65 and have 10 or more yearsunder the Retirement Plan and the Life and Disability In-surance Program, your Life Insurance is continued by theCompany at a reduced level until you die.

In determining whether you have the required 10 years tobe eligible for Continuing Group Life Insurance, your yearsunder the Retirement Plan and the Life and Disability In-surance Program are the sum of:

• Your years of credited service under the Retirement Plan

• Your years of participation in the Life and Disability In-surance Program after you last cease active work andbefore you reach age 65

The level of your Continuing Group Life Insurance amountis determined in the following manner:

Your = Your Life x 1½% Your yearsContinuing Insurance in under the RetirementGroup Life force at age 65 Plan and the Life andInsurance or later (based Disability Insuranceamount on your last Program (as

day worked) described above)

The minimum amount of Continuing Group Life Insuranceis the greater of 15% of Life Insurance in force at age 65(with 10 years of credited service) or $5,000. If the amountof Life Insurance in force at age 65 is less than $5,000and you do not return to work thereafter, the ContinuingGroup Life Insurance is the amount of Life Insurance inforce at age 65 or $500, whichever is greater.

An exampleIf your base hourly rate is $25.60, your Life Insurance ben-efit as an active employee under age 65 would be $58,500.

Assume you go on a medical leave of absence at age 63with 23 years of credited service under the RetirementPlan. You then are away from work on medical leave untilage 65 when you retire on a Normal Retirement.

Your Life Insurance while you were on medical leave wouldcontinue at the level in effect on your last day worked—$58,500. When you retire at age 65, your Life Insurancewould start reducing at the rate of 2% per month ($1,170)until it reaches a Continuing Group Life Insurance amountof $21,938.


If your last named beneficiary dies before you do, or if nobeneficiary designation is in effect at your death, yourinsurance will be paid, in this order, to:• Your surviving spouse or same-sex domestic partner• Your surviving children (divided equally among them)• Your surviving mother or father (or to both equally)

If there are no such survivors, your insurance will be paidto the executor or administrator of your estate.

Be sure to update your beneficiary designation on file withthe carrier. If you don’t, your benefit could be delayed orpaid to someone other than the person you want to re-ceive the benefit.

Life insurance is not assignable, unless the assignment ismade in writing and consented to by the insurer in writing.

Benefit If You Become Terminally IllYou may elect to receive a portion of your life insuranceproceeds, up to 50% of coverage if you become terminallyill. “Terminal illness” means an injury or sickness expected toresult in death within one year without any reasonable pros-pect of recovery as determined by the insurer.

The amount of life insurance remaining in force will bereduced by the amount paid. This option does not apply toindividuals who:• Are cash paying for life insurance while a grievance is

pending, or while on layoff or leave of absence• Are permanently and totally disabled individuals who

have drawn on their life insurance benefits• Have irrevocably assigned their life insurance and• When all or a part of life insurance is to be paid to a

former spouse as a part of the divorce decree

Converting to an individual policyIf you leave the Company or no longer are eligible for cov-erage, you can convert, within 31 days of the time cover-age ends, to any individual life insurance policy then cus-tomarily issued by the carrier except term insurance. Thisis done by making application and paying the requiredpremium to one of the UNICARE Life and Health Insur-ance Company offices. The maximum amount of the indi-vidual policy will be equal to the amount of your Life Insur-ance in force when you left the Company, including Survi-vor Income Benefits.

The Continuing Group Life Insurance amount is based on:

Your Life Insurance x 1½% x The sum of:on the last day • 23 years of creditedworked service under the

Retirement Plan

• 2 years of participation inthe Life and DisabilityInsurance Programafter you ceased activework and before youreached age 65

How your benefits are paidAs soon as satisfactory proof of your death is submittedto the carrier, your life insurance benefit will be paid toyour beneficiary(ies). If $10,000 or more is payable to abeneficiary, an interest paying money market account willbe established under the provisions of UNICARE ControlPlus Account #1-800-551-7564 Mail: P.O. Box 1210 Spring-field, MA 01101. A beneficiary may withdraw the accountbalance at any time. Additional information will be pro-vided to your beneficiary in the event of your death.

At your death, the carrier may deduct up to $5,000 fromthe benefit—to be paid to any person or persons who haveincurred burial expenses on your behalf.

Naming a beneficiaryYou may name a beneficiary you want to receive your LifeInsurance. You have the right to name the beneficiary ofyour choice—and to change that beneficiary at any timeby notifying the carrier.

Your beneficiary will be the last designation indicated onthe carrier’s records. When the carrier receives notice of abeneficiary change, the change takes effect on the datethe notice was signed even though the carrier may re-ceive the notice of change after your death. If the carriermakes a payment on account of your death before receiv-ing the notice of change, however, the carrier will not beliable for another benefit payment.


What are Accidental Death and Dismemberment Benefits?

If you suffer certain dismemberments or die as the resultof an accident, Accidental Death and Dismemberment(AD&D) Insurance pays a benefit if you are insured atthe time of the injury and at the time of the loss.

Benefit amountIf you are insured for Accidental Death and Dismember-ment (AD&D) Insurance, you are covered for two types ofbenefits:• Death benefits. If you die while insured as the result of

an accidental bodily injury within two years after theinjury occurred, your beneficiary will receive an acci-dental death benefit. The benefit equals one half of theLife Insurance amount in force. This amount is paid inaddition to your Life Insurance benefit.

If your base hourly rate is $25.60, for instance, you’reeligible for a Life Insurance benefit of $58,500. You’realso eligible for an accidental death benefit of $29,250if your death is accidental.

• Dismemberment benefits. Accidental Death and Dis-memberment Insurance also pays a benefit if you suf-fer a covered dismemberment or loss of sight as a re-sult of an accidental bodily injury within two years ofthe injury. The benefit you receive will be a percentageof your Life Insurance benefit—depending on the na-ture of your loss:

Accidental Death andLoss Dismemberment Benefit

Accidental death or Equal to ½ Life Insuranceaccidental loss of more than in forceone of the following: hand,foot or sight of an eye

Accidental loss of one of the Equal to ¼ Life Insurancefollowing: hand, foot or sight in forceof an eye

Loss of a hand or foot means loss by severance at or above thewrist or ankle joint; and loss of sight of an eye means total andirrecoverable loss of sight.

If you file a dismemberment claim, the carrier reservesthe right to examine you while a claim is pending—at itsexpense—as often as it may reasonably require. (In thecase of an accidental death, the carrier also reserves theright to conduct an autopsy, if permitted by law.)

Maximum benefitsTotal payment for losses from a single accident cannot bemore than one-half of your Life Insurance benefit unless youdie as a result of a job-related accident. In that instance, thebenefit paid will be three times the scheduled amount of theAccidental Death and Dismemberment Benefit. Your benefi-ciary will receive this benefit if your death results:• From accidental bodily injuries caused solely by your

employment with the Company• Solely from an accident in which the cause and results

are unexpected and definite as to time and place

Some losses aren’t coveredAccidental Death and Dismemberment Insurance does notpay benefits for any loss caused by:

• An act of war• Self-destruction or intentionally self-inflicted injury• Disease, or bodily or mental infirmity—or medical or

surgical treatment of that condition• Any infection (except infection caused by an external

visible wound sustained in an accident)• Your act of aggression, participation in a felonious en-

terprise or illegal use of drugs

How your benefits are paidAs soon as satisfactory proof is submitted to the carrier,your accidental death benefit will be paid to yourbeneficiary(ies). If $10,000 or more is payable to a benefi-ciary, an interest paying money market account will beestablished for the beneficiary under the provisions ofUNICARE’s “Control Plus” Account. A beneficiary maywithdraw the account balance at any time. Additional in-formation will be provided to your beneficiary in the eventof your death.

Accidental dismemberment benefits will be paid in a lumpsum only—as soon as satisfactory proof of your loss isreceived by the carrier.

BeneficiaryAccidental death benefits are paid to the beneficiary ofyour Life Insurance.

Accidental dismemberment benefits are paid to you.

When coverage endsGenerally, your Accidental Death and DismembermentInsurance coverages will continue as long as you con-tinue working for the Company. When you terminate youremployment, your coverage will end (subject to the condi-tions described in the “What happens if l stop working forany reason?” section).


What are Survivor Income Benefits?

If you have one or more survivors, they may be eli-gible for Survivor Income Benefits—first Transitionbenefits; then, in some cases Bridge benefits.

Transition Survivor Income BenefitsIf you die while covered for Survivor Income Benefits,your eligible survivor will receive a monthly Transition ben-efit for up to 24 months. Payments will begin on the firstday of the month after you die and continue for the next23 months as long as there is at least one eligible survi-vor. If on the first day of any month after your death thereis no eligible survivor, no benefit will be paid for that orany subsequent month.

If you last worked on or after September 29, 2003, themonthly Transition benefit is $650. The benefit is reducedto $350 if your eligible survivor is entitled to receive oneof the following Social Security benefits:

• Unreduced old-age (retirement) benefits

• Survivor benefits not reduced for age

• Disability benefits

For months in which two or more eligible survivors sharea benefit, each survivor’s share is computed as a fractionof the benefit that would be paid to him or her as a solesurvivor, according to his or her own eligibility for SocialSecurity benefits.

If you last worked prior to September 29, 2003, your Tran-sition Survivor Income Benefits amounts are shown inthe Collective Bargaining Agreement in effect when youlast worked.

Your eligible survivorsSurvivor Income Benefits are paid:• First, to your eligible surviving widow, widower, or same-

sex domestic partner (Class A or B)• Next, if you do not have an eligible surviving widow or

widower, to your eligible surviving children, dividedequally (Class C)

• Finally, if you do not have an eligible widow, widower orchild, to your eligible surviving parents, divided equallybetween the two (Class D)

If on the first day of any month after your death there is noeligible survivor, no benefit will be paid for that or anysubsequent month.

The eligibility requirements for a survivor are:

At the time aAt the time benefit is

Survivor classes of your death payable

A. Widow, whether Married to you for Livingor not remarried at least one year

B. Widower, Married to you for Livingwhether or not at least one yearremarried

C. Children • Unmarried and Living and stillunder age 21 satisfying the

• Unmarried, legally eligibilityresiding with you requirements atand dependent on the time of youryou at the time of deathyour death:- Either under

age 25- Totally and

permanentlydisabled

Children include: Natural-born children born prior to thefirst of the month following your death,legally adopted children, or childrenfor whom legal adoption proceedingswere undertaken or stepchildren whoresided with you at your death.In certain circumstances, unmarriedchildren of a same-sex domesticpartner

D. Father or mother You were providing Livingby blood or at least 50% ofadopting support duringparent calendar year

immediatelypreceding yourdeath

Same-sex domestic partners are eligible for benefits if theyare determined to be qualified for at least one year. Same-sex domestic partner status must be demonstrated whenfiling a claim.

Bridge Survivor Income BenefitsIf you have an eligible spouse, he or she may qualify foradditional Bridge Survivor Income Benefits at the end ofthe Transition Survivor Income Benefits period. Your spouseis eligible if:• He or she has not remarried and• He or she was at least 45 years old at the time you

died or his or her age at your death (rounded to thenearest 1/12) plus your years of credited service underthe Retirement Plan totals 55 or more

• He or she was eligible to receive 24 Transition Ben-efit payments


If your spouse or same-sex domestic partner is eligible,he or she will receive a monthly Bridge benefit of $650, ifyou last worked on or after September 29, 2003, until theearliest of:• Death• Remarriage/new same-sex domestic partner• Reaching age 62 or• Reaching age 62 and one month provided your spouse is:

— Not eligible to receive a Social Security Widow’s orWidower’s benefit during that additional month

— Not eligible for a survivor benefit under theRetirement Plan

— Eligible to receive and has applied for a reducedSocial Security old-age (retirement) benefit that firstwill be paid during the second month following his orher 62nd birthday

• Reaching an age when full Widow’s or Widower’s insur-ance benefits are available under the Social SecurityAct, as amended

No additional Survivor Income Benefits will be payable forany month a widow or widower is eligible (because of thecare of a child) to receive Social Security Mother’s Insur-ance benefits or comparable benefits for a Father.

If you last worked prior to September 29, 2003, your BridgeSurvivor Income Benefits amount is shown in the Collec-tive Bargaining Agreement in effect when you last worked.

Waiver of benefitsWhen it’s to your surviving spouse’s advantage to waiveSurvivor Income Benefits, he or she may do so by com-pleting the carrier’s form. The waiver will take effect on thefirst day of the second month after the waiver is receivedby the carrier or, if later, at the beginning of the periodcovered by the waiver.

Survivor Income Benefits will not be payable for any pe-riod covered by the waiver. Any month in which a Transi-tion benefit is not paid because of a waiver, however, stillwill be counted for purposes of determining the 24-monthTransition Benefit payment maximum.

Your eligible surviving spouse may revoke the waiver bycompleting the appropriate form furnished by the carrier.

Attachment of benefitsTo the extent permitted by applicable law, monthly Survi-vor Income Benefits shall not be subject to attachment orother encumbrance or subject to the debts or liability ofany eligible survivor.

What are Optional Group Life Insurance benefits?

You may buy Optional Group Life Insurance cover-age to supplement the life insurance coverage paidfor by the Company.

EligibilityYou are eligible for Optional Group Life Insurance on thefirst day of the month following the month you:• Are employed• Are insured for Company-paid life insurance under the


If you enroll within the 31-day period following your eligi-bility date, you won’t have to provide evidence of yourgood health.

When coverage beginsYour Optional Group Life Insurance coverage will take effect:

If you enroll: Coverage will begin on this date:

On or before the day First day of the month following youryou are eligible for hire or rehire dateOptional Group LifeInsurance

During the 31-day First day of the month following yourperiod after your enrollmenteligibility date

During the 31-day Once you have provided satisfactoryperiod following proof that such family change hasmarriage or taken place during the 31-day periodacquisition of a immediately prior to such enrollment,child or children first day of the month after the carrierby birth or adoption approves that evidence, provided you

are actively at work on that date,otherwise on the first day workedthereafter

After the 31st day Once you have provided yourfollowing eligibility satisfactory proof of your good health,date first day of the month after the carrier

approves that evidence

For the insurance to become effective you must be actively at work onthe date the insurance would otherwise become effective. If you arenot then actively at work, the insurance becomes effective on the dateyou return to active work, provided you still are eligible.


Benefit amountYou may elect one of the following schedules of OptionalGroup Life Insurance:

Amount of Life Insurance

Schedule 1 $ 10,000Schedule 2 $ 20,000Schedule 3 $ 30,000Schedule 4 $ 40,000

Schedule 5 $ 50,000Schedule 6 $ 75,000Schedule 7 $100,000Schedule 8 $125,000Schedule 9 $150,000Schedule 10 $175,000Schedule 11 $200,000

Changing your coverage amountsYou may change your Optional Group Life Insuranceamount if you wish. Your change in coverage will take ef-fect as shown here:

If you wish to: The change will take effect:

Increase your coverage Once you have provided satisfactoryamount because you proof that such family change hashave married or acquired taken place during the 31-day perioda child or children by birth immediately prior to such enrollment,or adoption during the first day of the month after the carrier31-day period preceding approves that evidence, provided youenrollment for increased are actively at work on that date,coverage otherwise on the first day worked

thereafter

Increase your coverage Once you have provided satisfactoryamount for any reason proof of your good health, first day ofother than such family the month after the carrier approveschange as above that evidence, provided you are

actively at work on that date,otherwise on the first day workedthereafter

Decrease your First day of the month after the lastcoverage amount month for which you made required

contributions for coverage at thehigher amount (satisfactory proof ofgood health is not required)

Your contributions

Optional Group Life Insurance is voluntary. If you enrollfor this coverage, you’ll have to pay a monthly premium inadvance. The required monthly contributions for each$1,000 of life insurance are based on your age:

ACTIVE EMPLOYEE CONTRIBUTION RATES

Monthly contribution foreach $1,000 of insurance:

Employee’s age* After 1-1-04

Less than 30 $ 0.04430-34 $ 0.06135-39 $ 0.07840-44 $ 0.12045-49 $ 0.21550-54 $ 0.41155-59 $ 0.60060-64 $ 1.02065-69 $ 1.955

70-74 $ 3.25975-79 $ 4.96980-84 $ 7.12785-89 $ 10.26390-94 $ 14.41695 & over $ 24.435

* When the employee attains a birthday which places theemployee in a higher age bracket, the monthly contributionwill change on the first day of the calendar month next fol-lowing the month in which such birthday occurs.

Premiums are payable in advance through payroll deduc-tions for each month of coverage.If you cease active employment, payroll deductions will bediscontinued and you must make your premium contributionsdirectly to the carrier to continue coverage. If you do not makepremium contributions, your coverage will terminate. The car-rier will not advise you of payments due.

Some examplesIf after 12-31-03 you are age 42 and you want $40,000 oflife insurance (Schedule 4), your monthly contribution wouldbe $4.80. That is:

$40,000 ÷ $1,000 = 4040 x $0.120 = $4.80

If after 12-31-03 you are age 50 and you want $75,000 oflife insurance (Schedule 6), your monthly contribution wouldbe $30.82. That is:

$75,000 ÷ $1,000 = 7575 x $0.411 = $30.82


Naming a beneficiaryYou may name a beneficiary you want to receive yourOptional Group Life Insurance. You have the right to namethe beneficiary of your choice—and to change thatbeneficiary at any time by notifying the carrier. It isimportant to name a beneficiary for Optional Group LifeInsurance even though you want the beneficiary to be thesame as the beneficiary you have named for yourCompany-paid life insurance.

Your beneficiary will be the last designation indicated onthe carrier’s records. When the carrier receives notice of abeneficiary change, the change takes effect on the datethe notice was signed even though the carrier may re-ceive the notice of change after your death. If the carriermakes a payment on account of your death before receiv-ing the notice of change, however, the carrier will not beliable for another benefit payment.

If your last named beneficiary dies before you do, or if nobeneficiary designation is in effect at your death, yourinsurance will be paid, in this order, to:• Your surviving spouse or qualified same-sex domes-

tic partner• Your surviving children (divided equally among them)• Your surviving mother or father (or to both equally)

If there are no such survivors, your insurance will be paidto the executor or administrator of your estate.

Be sure to update your beneficiary designation on file withthe carrier. If you don’t, your benefit could be delayed orpaid to someone other than the person you want to re-ceive the benefit. Remember to update your beneficiarydesignations on both your Company-paid and OptionalGroup Life Insurance.

How benefits are paidThe amount of Optional Group Life Insurance will be paid—as soon as satisfactory proof of your death is submittedto the carrier—in one sum or if you request, in accordancewith any of the settlement options made available by thecarrier. In the event that you have not made a settlementoption prior to your death, then the option provision maybe made by the beneficiary entitled to receive the Op-tional Group Life Insurance.

This insurance is term insurance without cash, loan orpaid-up values.

AssignmentOptional Group Life Insurance may be assigned if theassignment is made by you in writing and the carrier con-sents in writing.

When coverage endsThe following chart shows when Optional Group Life In-surance ends:

Your situation: When coverage ends:

You cease to be insured That dateunder the Life andDisability Insurance Program

You do not make your Last day of the month forcontribution for coverage which you made the required

monthly contribution

You terminate employment Last day of that month

The Optional Group Life That dateInsurance Program isterminated

Converting to an individual policyIf you no longer are eligible for coverage, you can con-vert, within 31 days of the time coverage ends, to anyindividual life insurance policy then customarily issued bythe carrier except term insurance. This is done by makingapplication and paying the required premium to the carrier.The maximum amount of the individual policy will be equalto the amount of your Optional Group Life Insurance inforce when your coverage ends.


What are Dependent Group Life Insurance Benefits?

You may buy Dependent Group Life Insurance cov-erage, if you wish—to cover your spouse, qualifiedsame-sex domestic partner, and unmarried, depen-dent children. If your covered spouse, same-sex do-mestic partner, or dependent dies from any cause, abenefit will be paid to you.

EligibilityYou are eligible for Dependent Group Life Insurance onthe first day of the month following the month you:• Are employed• Are insured for Life Insurance under the Life and Dis-

ability Insurance Program• Have at least one “eligible dependent,” as defined by

the Plan

If you enroll within the 31-day period following your eligi-bility date, you won’t have to provide evidence of yourdependents’ good health.

Your eligible dependentsFor purposes of Dependent Group Life Insurance benefits,your eligible dependents are your spouse, same-sex do-mestic partner and unmarried dependent children over 14days of age. Dependent children include:• Your children by birth, legal adoption or legal guardian-

ship while they legally reside with and are dependenton you

• Your spouse’s or same-sex domestic partner’s childrenwho are:— In your spouse’s custody— Dependent on your spouse— Residing with you

• Children as defined above who do not reside with youbut are your legal responsibility for the provision ofhealth care

• Children who reside with and are related to you by bloodor marriage—for whom you provide principal supportas defined by the Internal Revenue Code and who:— Were reported as dependents on your most recent

income tax return— Qualify in the current year for dependency tax status

Children are included until the end of the calendar year inwhich they reach age 25. Children will be covered, how-ever, regardless of age if they are totally and permanentlydisabled, provided that after the end of the calendar yeara child reaches age 19, that child:• Is dependent on you according to the Internal

Revenue Code• Legally resides with you and is a member of your

household• Your child is “totally and permanently” disabled as long

as the disability:• Is a medically-determinable physical or mental condition• Keeps your child from engaging in substantial gainful

activity• Is expected to result in death or to be of long-continued

or indefinite duration

If your spouse or same-sex domestic partner also is eli-gible for this coverage, only one of you may enroll yourchildren as dependents.

When coverage beginsYour dependents’ insurance coverage will take effect:


On or before the day First day of the month following youryou are eligible for hire or rehire dateDependent GroupLife Insurance

During the 31-day First day of the month following yourperiod after your enrollmenteligibility date

After the 31st day Once you have provided satisfactoryfollowing your proof of your dependent’s goodeligibility date health, first day of the month after the

carrier approves that evidence

For the insurance to become effective, you must be actively at work onthe date the insurance would otherwise become effective. If you arenot then actively at work, the insurance becomes effective on the dateyou return to active work, provided you still are eligible.


Benefit amountAs an active employee, you have seven levels of cover-age to choose from:

BENEFIT AMOUNT

Your Spouse Each Child

Option I $ 5,000 $ 2,000

Option II $10,000 $ 4,000

Option III $15,000 $ 6,000

Option IV $20,000 $ 8,000

Option V $25,000 $10,000

Option VI $30,000 $12,000

Option VII $35,000 $14,000

Option VIII $40,000 $16,000

Option IX $50,000 $20,000

Option X $60,000 $24,000

Option XI $75,000 $30,000

Changing your coverage amountsYou may change your Dependent Group Life Insuranceamounts if you wish. Your change in coverage will takeeffect as shown here:


Increase your dependents’ Once you have provided satisfactorycoverage amounts proof of your dependents’ good

health, first day of the month after thecarrier approves that evidence,provided you are actively at work onthat date, otherwise on the first dayworked thereafter

Decrease your dependents’ First day of the month after the lastcoverage amounts month for which you made required

contributions for coverage at thehigher amount (satisfactory proof ofgood health is not required), whetheror not you are actively at work.

Your contributionsDependent Group Life Insurance is voluntary. If you enrollfor this coverage, you’ll have to pay a monthly premium.Regardless of the number of dependents you have, yourpremium is based on your age and the amount of cover-age you select:

MONTHLY RATES PER $1,000 OF INSURANCE(Effective 1-1-2004)

Dependents of Employees and Retirees,and Surviving Spouses and Same-Sex Domestic Partners

of Deceased Employees or Retirees Monthly Rates

Employee’s or Dependents of Dependents ofRetiree’s Age Employees Retirees, Surviving

Spouses andSame-SexDomestic Partner ofEmployee orRetiree

Under 30 $.08 $.0830-34 $.102 $.10235-39 $.128 $.12840-44 $.178 $.178

45-49 $.256 $.25650-54 $.390 $.39055-59 $.618 $.61860-64 $.892 $.892

65-69 $1.488 $1.48870-74 $2.278 $2.349*75-79 $3.296 $3.403**80-84 $4.532 $4.672**

85-89 $5.964 $6.155**90-94 $7.692 $7.931**95 and over $10.072 $10.389**

*For dependents of retirees, surviving spouses and same- sex domes-tic partners of deceased employees and retirees, maximum coverageis 75% of scheduled insurance amount in force on last day employee orretiree worked.

** For dependents of retirees, surviving spouses and same- sexdomestic partners of deceased employees and retirees, maximumcoverage is 37.5% of scheduled insurance amount on last dayemployee or retiree worked.

Premiums are payable in advance through payroll deduc-tions for each month of coverage.

If you cease active employment, payroll deductions willbe discontinued and you must make your premium contri-butions directly to the carrier to continue coverage. If youdo not make premium contributions, your dependent cov-erage will terminate. The carrier will not advise you ofpayments due.


What are Optional Accident Insurance Benefits?

Optional Accident Insurance Benefits (EmployeePaid coverage) are benefits you may choose topurchase for coverage that will be paid in additionto the Accident Insurance coverage that is paid forby the Company.

EligibilityYou are eligible for Optional Accident (Employee Paid)Insurance on the first day of the month following themonth of employment, providing you are insured forCompany-paid life insurance under the Life andDisability Insurance Program.

You may purchase this benefit for yourself (Employeecoverage), or for yourself, your spouse, same-sex domesticpartner and eligible dependents (Family coverage).

When coverage beginsYour Optional Accident Insurance coverage will take effect:


On or before the day First day of the month following youryou are eligible for eligibility dateOptional AccidentInsurance

After your eligibility The first day of the month nextdate following the date of enrollment

or change

For the insurance to become effective you must be actively at work onthe date the insurance would otherwise become effective. If you arenot then actively at work, the insurance becomes effective on the dateyou return to active work, provided you still are eligible.

Amount of InsuranceCoverage must be purchased in units of $10,000. You maybuy a principal sum of up to ten (10) times annual basepay, rounded to the next $10,000, up to a maximum ben-efit of $500,000.

BeneficiaryYou are your covered dependents’ beneficiary for purposesof Dependent Group Life Insurance.

How benefits are paidThe insurance will be paid to you in a lump sum as soonas satisfactory proof of your dependent’s death is submit-ted. The insurance is term insurance without cash, loan orpaid-up values.

When coverage endsThe chart below shows when Dependent Group LifeInsurance ends:

Your situation: When coverage ends:

You cease to have any The date you cease to have“eligible dependents” an eligible dependent

You cease to be insured That dateunder the Life andDisability Insurance Program

You do not make your Last day of the month forrequired contribution which you made the requiredfor coverage monthly contribution

You terminate employment Last day of the month

The Dependent Life That dateInsurance Program isterminated

In the event of your death, your spouse or same-sex domestic partnerwill be able to continue his or her coverage and that of your eligibledependents who were enrolled at the time of your death.

Premium amounts will be based on your spouse’s or same-sex domes-tic partner’s age.

Converting to an individual policyIf coverage ends, your dependent, at his or her option,may convert to any individual life insurance policy thencustomarily issued by the carrier, except term insurance.This is done by making application within 31 days of ces-sation of coverage and paying the required premium tothe Mutual of Omaha office. The maximum amount of theindividual policy will be equal to the amount of life insur-ance provided for the dependent under this policy.


Loss of life or a bodily injuryIf you sustain an accidental bodily injury which results inone of the following losses within 365 days of the acci-dent, the following schedule applies:

Amount ofLoss* Accident Insurance

Loss of life The Principal SumLoss of both hands or both feet The Principal SumLoss of one hand and one foot The Principal SumLoss of the entire sight of both The Principal SumeyesLoss of speech and hearing The Principal SumLoss of the entire sight of one eye The Principal Sumand one hand or footLoss of one hand or one foot One-Half of the

Principal SumLoss of the entire sight of one eye One-Half of the

Principal SumLoss of speech or hearing One-Half of the

Principal SumLoss of thumb and index One-Quarter of thefinger (of the same hand) Principal Sum

* “Loss”, used with reference to hand or foot, means completeseverance through or above the wrist or ankle joint; as used withreference to eye, means irrecoverable loss of the entire sight thereof;as used with reference to speech and hearing, means entire andirrecoverable loss of speech or hearing and as used with referenceto thumb and index finger, means complete severance through orabove metacarpophalangeal joints.

If you elect Family Coverage, both you and eligible familymembers are insured; your spouse or same-sex domesticpartner is covered for an amount equal to fifty percent(50%) of your coverage and each other eligible dependentis covered for ten percent (10%) of your coverage.

Benefits under this provision will not be paid under anycircumstances for more than one of the losses, the great-est, sustained by you or your covered family member asthe result of any one injury.

Paralysis BenefitsIf you sustain an accidental bodily injury that results inpermanent paralysis within 365 days of the accident, thefollowing schedule applies:

Quadriplegia The Principal SumParaplegia/Triplegia Three-Quarters of the Principal SumHemiplegia/Uniplegia One-Half of the Principal Sum

If you elect Family Coverage, your spouse or same-sexdomestic partner is covered for an amount equal to fiftypercent (50%) of your coverage and each other eligibledependent is covered for ten percent (10%) of your coverage.

If you sustain an accidental bodily injury that results ina permanent paralysis within 365 days of the accidentand less than The Principal Sum is payable by reasonof such loss and you thereafter suffer a greater loss asa result of the same accidental bodily injury within such365 day period following the accident, the excess ben-efit amount will be payable.

Comatose BenefitIf you sustain an accidental bodily injury that results inlapse into a comatose state within 365 days of theaccident, a benefit equal to one percent (1%) of thePrincipal Sum shall be payable on the 32nd day of thecoma and each month thereafter for a maximum of 100months, or until death if earlier at which time any balancewould be paid. If you regain consciousness, benefits shallcease and coverage for Optional Accident Insurance wouldresume only upon re-enrollment and payment of premiums.

If you elect Family Coverage, your spouse or same-sexdomestic partner is covered for an amount equal to fiftypercent (50%) of your coverage and each other eligibledependent is covered for ten percent (10%) of your coverage.

Special Education BenefitIf Family Coverage has been elected and you die as aresult of a covered accident, an additional benefit in theamount of up to six percent (6%) of the Principal Sum(subject to a maximum of $7,000/per year, effective Janu-ary 1, 2004 for covered accidents occurring on or afterthat date) will be paid for each eligible dependent childenrolled within 365 days of your death as a full-time stu-dent in an accredited college or university.

This benefit is payable annually for a maximum of fourconsecutive years providing the eligible child consecu-tively continues his/her education as a full-time student.Benefits beyond the first year require evidence that thechild has successfully completed all academic require-ments of the prior school year.

No payment will be made for room, board, or other living,traveling, or clothing expenses.

If there is no dependent child who qualifies, an additionalbenefit of $1,000 will be paid to the beneficiary.


Continuation of coverage for surviving spouseIf an employee’s or retiree’s coverage ends due to theirdeath, a covered spouse or same-sex domestic partnermay continue coverage for themselves and dependentchildren by paying the applicable premium.

For enrolled survivors, coverage is provided at no cost forthe first 12 months from the date of the employee’s death.

The elected coverage for the surviving spouse or samesex domestic partner may be continued until age 65, atwhich time they will be allowed to convert coverage to theRetiree Plan. Eligible dependents who are enrolled at thetime of conversion to the Retiree Plan may also be cov-ered provided they continue to meet eligibility requirementsand pay applicable premium.

Coverage will terminate if spouse or same-sex domesticpartner remarries or establishes a new same-sex domes-tic partner or for non-payment of required premium.

Seat Belt BenefitIf Family coverage is elected, you, your surviving spouse,same-sex domestic partner or an eligible dependent diesas a result of an automobile accident while wearing a quali-fied passenger restraint, up to $10,000 is payable for eachmember whose life is lost.

A passenger restraint qualifies for purposes of the Pro-gram as long as it is:• An unaltered seat belt or lap and shoulder restraint in-

stalled by the automobile manufacturer or provided bythe manufacturer ⎯ and installed by an authorizeddealer of that manufacturer

• If the covered participant is a child, a restraint that hasbeen approved by the National Highway Traffic SafetyAdministration and is:− Properly secured− Used as recommended for children of like age and weight

For purposes of the Program, an automobile is a conven-tional, private passenger land motor vehicle. Automobilesinclude:• Vans• Four-wheel drive vehicles• Self-propelled motor homes• Trucks with a factory-rated load capacity of 2,000

pounds or lessAutomobiles do not include:• Custom-made specialty vehicles• Vehicles such as:

− Motorcycles− Dune buggies− Snowmobiles and

• Vehicles used for:− Farming− Commercial business− Military business− Racing− Any type of competitive speed event

Special Child Care Center BenefitIf Family Coverage is elected, upon the death of you oryour insured spouse or your same-sex domestic part-ner from a covered accident, the beneficiary will receivean additional benefit in the amount of six percent (6%)of the Principal Sum (subject to a maximum of $7,000/per year, effective January 1, 2004 for covered acci-dents occurring on or after that date) for up to four yearsfor each eligible dependent child, under the age of 13,enrolled (or who becomes enrolled within 90 days) in aqualified child care center.

If there is no dependent child who qualifies, an additionalbenefit of $1,000 will be paid to the employee’s beneficiary.

Spousal Occupational Training ExpenseIf Family Coverage is elected and you die as a result of acovered accident, a surviving spouse or same-sex do-mestic partner who participates in a formal occupationaltraining program in order to become specifically qualifiedfor active employment in an occupation for which he/shewould not have sufficient qualification otherwise, will bereimbursed for expenses actually incurred up to 6% of thePrincipal Sum (subject to a maximum of $7,000 effectiveJanuary 1, 2004 for covered accidents occurring on orafter that date).

To be reimbursed, such expenses must be reasonableand necessary and must be incurred within three (3) yearsof the date of the death. No payment will be made forroom, board, or other living, traveling, or clothing expenses.

Common Disaster BenefitIf Family Coverage is elected and you and your insured spousesuffer a loss of life in the same covered accident, or sepa-rate covered accidents which occur within 48 hours of eachother (common disaster), the amount payable by reason ofyour spouse’s death will equal the amount payable by rea-son of your death. The common disaster benefit for you andyour insured spouse will not exceed $1,000,000.

Repatriation BenefitFor losses occurring on or after January 1, 2004, if aninsured employee or retiree or, if family coverage is elected,a covered spouse, same-sex domestic partner or depen-dent child, sustains a loss of life as a direct result of acovered accident, both the accident and death occurringat a distance of 100 miles or more from the deceasedperson’s principal residence, reimbursement up to a maxi-mum benefit of $5,000 will be made for the expenses in-curred for preparation of the body and its transportation tothe city of his/her principal residence.


ExclusionsThe policy doesn’t cover loss caused or contributed by:

• Suicide or self-destruction or any attempt thereat,whether sane or insane

• Bodily infirmity, sickness or disease• Medical or surgical treatment (except medical or surgi-

cal treatment necessitated only due to an injury)• War, declared or undeclared, or any act of war except

while you are outside the United States and Puerto Ricoon Company assignment or while your insured depen-dents are outside the United States and Puerto Ricobecause of your assignment provided, however, that amember of an Organized Reserve Corps or NationalGuard Unit is covered during short periods of trainingor participation in public ceremonies

• Injury sustained while serving in the armed forces ofany country, for which period premiums will be refunded

• Injury sustained while engaged in or taking part in aero-nautics and/or aviation of any description or resultingfrom being in an aircraft; this policy covers riding as apassenger but not as an operator or crew member, in oron, boarding or unloading from any aircraft having acurrent and valid airworthiness certificate or any trans-port type aircraft operated by the Military Airlift Com-mand (MAC) of the United States of America or by anysimilar air transport service of any duly constitutedgovernmental authority of the recognized governmentof any nation anywhere in the world; persons who arenot members of the operating crew of any aircraft, whoare engaged in testing, measuring, calibrating and similaroperations, shall be considered passengers and notcrew members

• Your or your insured dependent’s act of aggression, par-ticipation in a felonious enterprise or illegal use of drugs

Changing your coverage amountsYou may change your Optional Accident Insurance amountif you wish. Your change in coverage will take effect asshown here:


Increase your The first day of the month following thecoverage amount date of change, provided you are

actively at work on that date, otherwiseon the first day worked thereafter

Decrease your First day of the month after the lastcoverage amount month for which you made required

contributions for coverage at the higheramount whether or not you are activelyat work on that day

Your contributionsOptional Accident Insurance is voluntary. If you enroll forthis coverage you’ll have to pay a monthly premium inadvance. The required monthly contribution for each$10,000 is $.28 for Employee Coverage and $.48 for Fam-ily Coverage.

Premiums are payable in advance through payroll deduc-tions for each month of coverage.

If you cease active employment, payroll deductions will bediscontinued and you must make your premium contribu-tions directly to the carrier to continue coverage. If you donot make premium contributions, your coverage will termi-nate. The carrier will not advise you of payments due.

Some examplesYou want $40,000 of Employee Coverage; your monthlycontribution would be $1.16. That is:

$40,000 ÷ $10,000 = 44 x $0.28 = $1.12

You want $150,000 of Family Coverage; your monthly con-tribution would be $7.20. That is:

$150,000 ÷ $10,000 = 1515 x $0.48 = $7.20


Your eligible dependents for Family CoverageFor purposes of Optional Accident Insurance benefits, youreligible dependents are your spouse and unmarried de-pendent children. Dependent children include:• Your children by birth, legal adoption or legal guardian-

ship—while they legally reside with and are dependenton you

• Your spouse’s or same-sex domestic partner’s childrenwho are:— In your spouse’s custody— Dependent on your spouse— Residing with you

• Children as defined above who do not reside with you butare your legal responsibility for the provision of health care

• Children who reside with and are related to you by bloodor marriage—for whom you provide principal supportas defined by the Internal Revenue Code and who:— Were reported as dependents on your most recent

income tax return— Qualify in the current year for dependency tax status

Children are included until the end of the calendar year inwhich they reach age 25. Children will be covered, how-ever, regardless of age if they are totally and permanentlydisabled, provided that after the end of the calendar yeara child reaches age 19, that child:• Is dependent on you according to the Internal Revenue Code• Legally resides with you and is a member of your household

Your child is “totally and permanently disabled” as long asthe disability:• Is a medically-determinable physical or mental condition• Keeps your child from engaging in substantial gain-

ful activity• Is expected to result in death or to be of long-continued

or indefinite duration

If your spouse also is eligible for this coverage, only oneof you may enroll your children as dependents.

Naming a beneficiary and how benefits are paidIf you die as a result of accidental death while insured forOptional Accident Insurance, the amount of the insurancein force will be paid to the person or persons you desig-nated as beneficiary.

Your beneficiary will be the last designation indicated onthe carrier’s records. If the carrier makes a payment onaccount of your death before receiving the notice ofchange, however, the carrier will not be liable for anotherbenefit payment. When the carrier receives notice of abeneficiary change, the change takes effect on the datethe notice was signed even though the carrier may receivethe notice of change after your death.

When the carrier receives notice of a beneficiary change,the change takes effect on the date the notice was signed.

If your last named beneficiary dies before you do, or if nobeneficiary is in effect at your death, the Optional Acci-dent Insurance will be paid to your surviving wife or hus-band, if living; if not living, equally to your surviving chil-dren; if none survive, to either your mother or father, or toboth equally if both survive; if there are no such survivors,to your estate.

If your covered spouse or other covered dependent diesas a result of an accident while insured for Optional Acci-dent Insurance, the amount of such insurance in force onaccount of the dependent shall be paid in a lump sum toyou (the employee is the beneficiary for Optional Acci-dent Insurance). Your insurance certificate shall set forththe procedure for payment of insurance in case a covereddependent dies after your death.

All other benefits are payable to the injured person suffer-ing the loss.


When coverage endsFor you, Optional Accident Insurance automatically endson the earliest of the following:

• The date you cease to be insured under the Group Lifeand Disability Insurance Program

• If you do not make your required contribution for OptionalAccident Insurance when due, the last day of the monthimmediately preceding the month for which you madethe required monthly contribution

• The date of discontinuance of Optional AccidentInsurance under the Insurance Program

For a dependent, other than in the instance of your death,Optional Accident Insurance shall automatically end onthe earliest of the following:• On the date of termination of your insurance• On the date your dependent no longer is an “eligible

dependent”• If you do not make your required contribution, the last

day of the month for which you made the requiredmonthly contribution

For a dependent, in the event you die while enrolled in theFamily Coverage Option, Optional Accident Insurance shallautomatically end on the earlier of the following:• On the date your dependent ceases to be an “eligible

dependent”• On the date your surviving spouse remarries• On the date your same-sex domestic partner marries or

enters into a new same-sex domestic partner relationship• On the date of discontinuance of Optional Accident In-

surance under the Insurance Program• After twelve (12) months following the date of your death

What are Safety Belt User Benefits?

If you, your surviving spouse, same-sex domesticpartner or an eligible dependent dies as a result ofan automobile accident while wearing a qualified pas-senger restraint, a $15,000 benefit may be paid.

EligibilityIf you, your surviving spouse, same-sex domestic part-ner or eligible dependents have Company-paid benefitsunder the Health Care Plan, you are covered participantsin the Safety Belt User Benefit Program.

Benefit amountIf you or another covered participant dies as a result ofbodily injury caused solely by an automobile accident thatoccurs while the participant is properly using a qualifiedpassenger restraint, the Program pays $15,000. The acci-dent must occur in the United States or Canada and deathmust occur within 365 days of the accident’s date.

The Program pays only one $15,000 benefit for eacheligible person who dies as a result of a covered auto-mobile accident.

A passenger restraint qualifies for purposes of the Pro-gram as long as it is:• An unaltered seat belt or lap and shoulder restraint in-

stalled by the automobile manufacturer or provided bythe manufacturer—and installed by an authorized dealerof that manufacturer

• If the covered participant is a child, a restraint that hasbeen approved by the National Highway Traffic SafetyAdministration and is:— Properly secured— Used as recommended for children of like age and

weight


What if a claim is denied for Life Insurance, AccidentalDeath and Dismemberment (AD&D), Safety Belt User orSurvivor Income?

This section contains a description of the proceduresfor seeking review of a denied claim for Life Insur-ance, AD&D, Safety Belt User or Survivor Income.

If a claim for benefits or participation is denied, you shouldreceive written notification within ninety (90) days of thedate that the claim is received. If the Insurer requires moretime to review your claim, determination may be delayedan additional 90 days. You will receive notice of the delaywhich will include the reasons for delay and the date afinal decision can be expected.

When a claim is denied, you will receive a written notice.The notice will explain the reason for the denial, refer tothe specific Plan provision or provisions on which the de-nial is based, describe what additional information, if any,is necessary to consider a further appeal, and describehow to appeal your claim.

In all cases, a final decision will be reached, and you willbe notified within 180 days after your written request for areview is received by the Plan Administrator.

A claim for Life Insurance, AD&D or Survivor Income ben-efits should be addressed to:

UNICARE Life and Health Insurance CompanyDearborn Service Center3200 GreenfieldDearborn, Michigan 48120

A claim for Safety Belt User benefits should be ad-dressed to:

Mutual of OmahaFord Hourly Optional Insurance PlanSuite 1162720 South River RoadDes Plaines, IL 60018

Review of denial of the claim by the UAW-Ford Group Life andDisability Appeal CommitteeIn the event that the Plan Administrator denies the claim,you may appeal the claim by submitting your request forappeal in writing to the UAW-Ford Group Life and Disabil-ity Appeal Committee. The request for review must befiled within sixty (60) days after you receive the writtennotification of denial of the claim, and the appeal shouldinclude pertinent documents and all issues and commentsshould be submitted in writing.

For purposes of the Program, an automobile is a con-ventional, private passenger land motor vehicle. Auto-mobiles include:• Vans• Four-wheel-drive vehicles• Self-propelled motor homes• Trucks with a factory-rated load capacity of 2,000

pounds or less

Automobiles do not include:• Custom-made specialty vehicles• Vehicles such as:

— Motorcycles— Dune buggies— Snowmobiles and

• Vehicles used for:— Farming— Commercial business— Military business— Racing— Any type of competitive speed event

Some deaths aren’t covered

The Program won’t pay benefits for deaths of a coveredparticipant caused by:• An act of war• Self-destruction or intentionally self-inflicted injury while

sane or insane• Disease or bodily or mental infirmity, or medical or sur-

gical treatment of that condition• Any infection (except infection caused by an injury sus-

tained in a covered automobile accident) or• An act of aggression or participation in a felonious en-

terprise by the covered participant.

BeneficiaryYou are the beneficiary if you are living. If you die beforethe covered participant, the benefit will be paid, in thisorder, to:• Your surviving spouse or same-sex domestic partner• Your surviving children (divided equally among them)• Your surviving mother or father (or to both equally)

If there are no such survivors, the benefits will be paid tothe estate of the deceased covered participant.

When coverage endsCoverage will end when eligibility for Company-paid HealthCare Plan coverage ends.


The UAW will appoint three members and alternate membersto the Committee. Three additional members of theCommittee are appointed by the Company. The members ofthe Committee and the alternate members receive noadditional compensation for Committee services.Address appeal request to:

Ford Motor CompanyP.O. Box 3139Melvindale, MI 48122-0139Attn: Life and Disability Plan Specialist andUAW-Ford Group Life and Disability Committee

The request for appeal should clearly indicate the reason(s)why you think your claim should not have been denied. Youare encouraged to submit copies of any additional documents,records, information or comments you think have a bearingon your claim. If an extension is required because informa-tion is incomplete, the review period will be adjusted fromthe date the notice was sent to the date the complete infor-mation is received. Your appeal will be considered at theAppeal Committee’s next regularly scheduled meeting. If anextension is required because information is incomplete, thereview period will be adjusted from the date the notice wassent to the date the complete information is received. If anextension is needed, you will receive a written notice beforethe extension period begins.

Written notice of a decision will be made not later thanfive (5) days after the decision has been made by theAppeal Committee. Your notice will include the final deci-sion and the specific reasons for denial and reference topertinent Plan provisions on which the denial is basedand a statement that you are entitled to receive, uponrequest and free of charge, reasonable access to and cop-ies of, all documents, records and other information rel-evant to your claim for benefits. The notice will also ad-vise you of your right to bring a civil action under ERISAfollowing an adverse benefit determination of appeal. Nolegal action may be brought until after the claims and ap-peals procedures have been exhausted. No legal actioncan be taken later than two years after the claim accrues.

Denial of other insurance claimsIn the event that a claim for benefits under DependentGroup Life, Optional Group Life, or Optional Group Life isdenied, the insurer responsible for providing such ben-efits shall handle the initial claim and any requests forreview of the denial according to the applicable claimsprocedures and policies of the insurer. The Appeal Com-mittee shall have no responsibility to review any suchclaims or denials of any such claims by the insurer.

What are Accident and Sickness Benefits?

Accident and Sickness benefits can replace a portionof your pay for up to 52 weeks of illness, injury orpregnancy-related disability.

Eligibility for benefits

You’re eligible for Accident and Sickness benefits if you:• Become wholly and continuously disabled by an acci-

dental bodily injury, sickness or pregnancy while cov-ered for Accident and Sickness benefits

• Cannot perform all duties of your job• Furnish the claims processor with written notice and

satisfactory proof of your disability on a timely basis• Are under a physician’s care

Treatment in an alcohol or drug abuse facility qualifiesas being under a physician’s care, as long as:— The facility is an inpatient residential, day treatment

or outpatient substance abuse treatment facilityapproved for benefits under the Health Care Plan

— The physician-director of the facility, or a physician-consultant selected by the facility, certifies your dis-ability based on information and recommendationfurnished by the therapist supervising your therapy;a certifying physician must be a licensed Doctor ofMedicine (M.D.) or Doctor of Osteopathy (D.O.)

Claims processorUNICARE Life and Health Insurance Company is pres-ently the claims processor under an administrative ser-vices agreement with the Company.


If you last worked before September 14, 2003, your Acci-dent and Sickness benefits are shown in the CollectiveBargaining Agreement in effect when you last worked.If you are absent from work for part of a week, your Acci-dent and Sickness benefits are based on one-fifth of theweekly benefit for each regular workday of disability (wherestate laws permit).

Special provisions apply to employees at operations utiliz-ing three crew or alternate production schedules. In thoseinstances, the benefit for each regular workday of disabilitywill be an amount calculated in accordance with the agree-ment with the union for operation of an alternative work sched-ule at the plant at which the employee works.

If you have less than one year of seniority, your Accidentand Sickness benefits will be 75% of the weekly benefitamount for periods of disability occurring prior to the dateone year of seniority is attained, subject to reduction forother benefits (as described in the “Other sources of ben-efits” section).

Benefit amountYour weekly Accident and Sickness benefits are deter-mined according to your base hourly rate:

Weekly AccidentInsurance and Sickness

Code If your base hourly rate is: Benefits are:

A Up to but less than $17.80 $425B $17.80 but less than $18.15 $430C $18.15 but less than $18.50 $440D $18.50 but less than $18.85 $450

E $18.85 but less than $19.20 $455F $19.20 but less than $19.55 $465G $19.55 but less than $19.90 $475H $19.90 but less than $20.25 $480

I $20.25 but less than $20.60 $490J $20.60 but less than $20.95 $500K $20.95 but less than $21.30 $505L $21.30 but less than $21.65 $515

M $21.65 but less than $22.00 $525N $22.00 but less than $22.35 $530O $22.35 but less than $22.70 $540P $22.70 but less than $23.05 $550

Q $23.05 but less than $23.40 $555R $23.40 but less than $23.75 $565S $23.75 but less than $24.10 $575T $24.10 but less than $24.45 $585

U $24.45 but less than $24.80 $590V $24.80 but less than $25.15 $600W $25.15 but less than $25.50 $610X $25.50 but less than $25.85 $615

Y $25.85 but less than $26.20 $625Z $26.20 but less than $26.55 $635AA $26.55 but less than $26.90 $640BB $26.90 but less than $27.25 $650

CC $27.25 but less than $27.60 $660DD $27.60 but less than $27.95 $665EE $27.95 but less than $28.30 $675FF $28.30 but less than $28.65 $685

GG $28.65 but less than $29.00 $690HH $29.00 but less than $29.35 $700II $29.35 but less than $29.70 $710JJ $29.70 but less than $30.05 $715

KK $30.05 but less than $30.40 $725LL $30.40 but less than $30.75 $735MM $30.75 but less than $31.10 $740NN $31.10 but less than $31.45 $750

OO $31.45 but less than $31.80 $760PP $31.80 but less than $32.15 $765QQ $32.15 but less than $32.50 $775RR $32.50 but less than $32.85 $785

SS $32.85 but less than $33.20 $795TT $33.20 but less than $33.55 $800UU $33.55 but less than $33.90 $810VV $33.90 but less than $34.25 $820

WW $34.25 but less than $34.60 $825XX $34.60 but less than $34.95 $835YY $34.95 but less than $35.30 $845ZZ $35.30 and over $850


When benefits beginIf you have an accident, your Accident and Sickness ben-efits begin the first day of disability. If you are absent fromwork due to sickness, pregnancy, or an accident whichoccurred more than one year prior to the present disabil-ity, benefits begin on the eighth day you are disabled, oron the first day:• That you are hospitalized at least 18 consecutive hours,

or that the hospital charges you for room and board• Of treatment for alcohol or substance abuse in a resi-

dential facility approved for such treatment or• After the day you have an outpatient surgical proce-

dure for which you are entitled to at least $25 in ben-efits under the H-S-M Program

Any day you work less than four hours due to your acci-dent or sickness is considered a day of disability.

When benefits endFor one continuous period of disability, Accident and Sick-ness benefits end when you are able to return to work orafter the lesser of:

• 52 weeks• A period equal in duration to your service (on the date

the disability began) since your most recent date ofhire or rehireRegardless of your length of service, your Accident andSickness benefits can continue for up to 52 weeks, if:— You still are hospitalized for the same disability at

the end of this period— You are receiving lost-time benefits under Work-

ers’ Compensation or other laws providing benefitsfor job-related accidents or sickness—because ofyour employment. (These do not include benefitsfor dismemberment)

Successive periods of disabilityYou may be absent due to the same or related disabilitiesfor several periods of time. Successive periods of absencedue to the same or related disabilities are considered onecontinuous disability unless:

You areemployed in: AND Before another absence:

California or You are back to work for 2 orNew Jersey more consecutive weeks

All Other Locations You are back to work for 3consecutive months or more

You will be considered to have returned to work if you work 4 or morehours on each working day (where state laws permit).

If a new illness or accident disables you after you havereturned to work, you can make a new claim for benefits.You also can make a new claim for benefits if an old acci-dent or illness disables you again after your return to work,as described above.

If you become disabled again for an old accident or ill-ness without having returned to work for three consecu-tive months or more, the benefits shall be the amount youwould have received under a continuation of the prior claim.


If You Are Effect on Your AccidentReceiving: and Sickness Benefits:

Accident and Sickness (and Extended DisabilityBenefits if necessary) will be suspended until theoverpayment is recovered

• If your first claim for Social Security DisabilityBenefits is denied and your attorney successfullyappeals that denial, you will have to repay theclaims processor any overpayment of your benefitsless your related attorney’s fees within 30 days ofreceiving the Social Security Disability Benefitsaward. (Your attorney’s fees may not, however,exceed 25% of the overpayment due the claimsprocessor.) Attorney fees for services before yourinitial denial of Social Security Disability Benefitswill not reduce the amount of overpayment due tothe claims processor

California Accident and Sickness benefits will be reduced byState State Unemployment Compensation DisabilityDisability Benefits for which you’re eligible—whether or not youCompensation have rejected or waived your rights to those benefits.

New York and Accident and Sickness benefits are at least equalNew Jersey to the benefits required by State Law.State DisabilityBenefits

Holiday pay Accident and Sickness benefits are not payable foror other pay any day you are entitled to holiday pay or receive payreceived from for at least a regular work day (defined as 8 hours orthe Company the hours you are scheduled to work under an

alternate work schedule).If you receive pay for less than a regular work day (asdefined above), the total of the pay you receive andthe disability benefits payable cannot exceed thenumber of hours you work in a regular day (as definedabove) multiplied by your base hourly rate.

SubrogationIf your disability is the result of an event that creates alegal liability in another person or entity and you seek torecover economic or compensatory damages through le-gal or other action against that person or entity, the Com-pany may initiate or join the action to recover the cost ofthe benefits paid to you by the plan. If you recover mon-ies, economic or compensatory through personal injuryaction, the payments can be offset from the disabilitybenefit. You must notify the Company or UNICARE in theevent you initiate legal action to enforce your right to re-covery from another party.

Other sources of benefitsYour Accident and Sickness benefits may be affected byother benefits you receive:

If You Are Effect on Your AccidentReceiving: and Sickness Benefits:

Unemployment You are not entitled to Accident andCompensation Sickness benefits while:

• You are eligible for unemployment benefitsunder any unemployment compensation law

• You are entitled to unemployment benefits,but rejected or waived your right toreceive them

Workers’ Your Accident and Sickness benefits areCompensation reduced by the amount of any lost-time

Workers’ Compensation benefits to whichyou’re entitled. Accident and Sickness benefitsare not payable or an occupational disability ifyou have waived your rights to Workers’Compensation benefits.Your Accident and Sickness benefits will not bereduced if you are receiving Workers’Compensation for:

• A dismemberment• The 100% loss of use of a body member• A work-related, permanent partial disability

unrelated to the disability for which you areapplying for benefits

Social Security Accident and Sickness benefits will be reduced by theweekly equivalent (one monthly benefit equals 4.33weekly benefits) of any disability benefit or old-age(retirement) benefit (except for Social Security old-agebenefits reduced because of age) and payable for thesame period of disability.

For purposes of determining your Accident andSickness benefits:• It is presumed at the 40th week of disability that you

were eligible for Social Security Disability Benefitsas of the 26th week after your disability began. Italso is presumed that your Social Security DisabilityBenefits should have commenced at the 26th weekand that your Accident and Sickness benefits shouldhave been reduced effective the 26th week of disabilityby the amount of your Social Security benefit

• If you provide evidence that you have applied forSocial Security Disability Benefits within six monthsafter disability began, your Accident and Sicknessbenefits will not be reduced until a determination ismade by Social Security on your claim. If SocialSecurity Disability Benefits are awarded, yourAccident and Sickness benefits will be reduced bythe amount of the primary Social Security benefitwhich you actually receive. Any benefits paid to youprior to a Social Security determination, which arelater determined not to be payable because of aSocial Security award, are an overpayment whichmust be repaid. If not repaid within 30 days, future


How to file your claimTo initiate a disability claim, call UNICARE at this tollfree number, 1-800-572-1581, and report your claim byphone. Please be prepared to supply UNICARE with thefollowing information:

• Your last day of work• The name, address and phone number of your treat-

ing physician

UNICARE will verify your last day of work with the Com-pany along with your rate of pay and tax withholding infor-mation. If you know that you are going to be out for adisability leave (for example, if you have a scheduled op-eration), you can call UNICARE with this information aheadof time.

After you initiate your claim with this phone call, UNICAREwill send you:

1) A “notice of claim” form and

2) Instructions for your physician to contact UNICAREwith the necessary medical information to determineyour disability and appropriate length of absence.

You should return the notice of claim form to UNICARE andgive your physician the instructions for contacting UNICARE.

In order to process your claim, UNICARE must receive asigned copy of the notice of claim. To expedite the pro-cessing of your claim, you may have your physician callUNICARE regarding your case as soon as possible. Offi-cial deadlines for submitting this information are outlinedin the next section.

Notice and proof of claimYou must provide written notice of claim to UNICARE within20 days after you become disabled, or as soon as is rea-sonably possible. Proof of your injury or sickness alsomust be provided to UNICARE within 90 days after theend of your covered disability.

If you fail to furnish this proof within the time required,your claim will not be honored unless:• It was not reasonably possible for you to give such

proof within the time required• You provide the proof as soon as reasonably pos-

sible and, in no event, except in the absence of legalcapacity, later than one year from the time proof isotherwise required

Physical examinationUNICARE has the right to have you examined by an impartialmedical examiner, at its expense, while your Accident andSickness claim is pending or being paid. Failure to report foran examination without good cause will result in denial ortermination of Accident and Sickness benefits.

The results of the examination by an appropriate medicalspecialist are final and binding.

Mileage reimbursement for Impartial Medical Examination (IME)If an IME is scheduled for you at a location farther than 40miles one-way (or the distance you drive to work, if greater)from your residence, you can request reimbursement fromUNICARE at a rate of 36 cents per mile for actual milesdriven from your residence to the IME physician’s office andback using the most direct route available. You should re-quest mileage reimbursement before your appointment. Mile-age reimbursement will be made after you have kept yourappointment with the IME examiner.

Application for Social Security Disability BenefitsYou are expected to file for Social Security Disability Ben-efits at the appropriate time (see Social Security Presump-tion Rules . If you have questions regarding this process,you should contact UNICARE at 1-800-572-1581.

Waiver of benefitsIf you have one or more years of seniority, you may waiveirrevocably any right to Accident and Sickness benefitsfor any period of disability by completing a waiver formfurnished by the claims processor. Accident and Sicknessbenefits shall not be payable for any period of disabilitycovered by such a waiver.


What are Extended Disability Benefits?If your disability continues beyond the period you’reentitled to receive Accident and Sickness benefits,Extended Disability Benefits may provide monthlypayments for an extended period of time.

Eligibility for benefitsYou’re eligible for Extended Disability Benefits if:• You’re covered for Accident and Sickness benefits• Your disability continues beyond the period that you

were eligible for Accident and Sickness benefits and• You are totally disabled, which means:

— You are not engaged in any regular occupation oremployment for remuneration or profit and

— You are prevented by bodily injury or disease fromengaging in any regular occupation or employmentwith the Company at the plant or plants where youhave seniority

Claims processorUNICARE Life and Health Insurance Company is pres-ently the claims processor under an administrative ser-vices agreement with the Company.

Phone: 1-800-572-1581

Benefit amountYour maximum Extended Disability Benefits are determinedaccording to:• Your base hourly rate on your last day of work and• Your number of years of credited service under the Re-

tirement Plan or your number of years of participationunder the Life and Disability Insurance Program

If you have less than 10 years of credited service under theRetirement Plan and less than 10 years of participation inthe Life and Disability Insurance Program, your monthly ben-efit is shown in Column I. If you have 10 or more years ofcredited service or 10 or more years of participation in theLife and Disability Insurance Program, your monthly benefitis shown in Column II. For AAI employees, years of creditedservice under the Retirement Plan and years of participationin the Life and Disability Insurance Program include relevanttime at Ford and at AAI.

The Extended Disability Benefits shown in the table be-low will be reduced by the amount of benefits from othersources for which you are eligible:

BENEFIT AMOUNT: Your Monthly ExtendedDisability Benefits are:

( I ) ( II )Insurance If your base Less than 10 or

Code hourly rate is: 10 years more years

A Up to but less than $17.80 $1,525 $1,680B $17.80 but less than $18.15 $1,560 $1,715C $18.15 but less than $18.50 $1,590 $1,745D $18.50 but less than $18.85 $1,620 $1,780

Reinstatement of Accident and Sickness benefits during layoffYour Accident and Sickness benefits will be reinstated if you:• Become wholly and continuously disabled while on a

qualifying layoff as defined in the 1999 Ford-UAWSupplemental Unemployment Benefit Plan (SUB Plan)or are found to be medically disabled by the plant phy-sician upon recall from a qualifying layoff or are certi-fied by your physician to be unable to return to workbecause of disability and

• Are insured for Life Insurance and• Are eligible for a Regular Benefit under the SUB Plan

or have been employed by another employer immedi-ately before becoming disabled

If you wish to receive benefits, you must submit noticeand proof of your claim to UNICARE within the time limitsdescribed above.With respect to each week for which a benefit is claimed,you also must:• Be unable to perform all duties of your job• Be under the care of a physician (as defined in the

Accident and Sickness benefits section) and• Be otherwise eligible to receive a benefit under the SUB

Plan or, if the 1987 SUB Plan is reinstated, have to yourcredit at least a Credit Unit under the 1987 SUB Plan

If you were receiving Regular Benefits under the SUB Planimmediately before you became disabled, Accident andSickness benefits will begin on the first day following thelast day a Regular Benefit was payable to you. If you werenot receiving Regular Benefits, Accident and Sicknessbenefits will begin on the first day of qualifying disability.

Benefits will not continue after you cease to satisfy thedisability requirements. If, however, you remain on quali-fying layoff under the SUB Plan, benefits are payable forremaining days in the same week (as defined in the SUBPlan) for which you do not receive a Regular Benefit.

Reinstated Accident and Sickness benefits will not be paidfor any week in which:• You receive an Accident and Sickness benefit (see the

“What are Accident and Sickness benefits?” sectionfor more details) or an Extended Disability Benefit or

• If the 1987 SUB Plan is reinstated, the Credit Unit Can-cellation Base under the SUB Plan is below the appli-cable dollar amount at which a SUB benefit is payableaccording to your seniority

Your Reinstated Accident and Sickness benefits will bereduced by the amount of any disability benefit you re-ceive for the same week under a plan paid in whole or inpart by another employer.

Reinstated Accident and Sickness benefits are governedby the applicable Accident and Sickness benefits provi-sions described earlier.


Your Monthly ExtendedDisability Benefits are:

( I ) ( II )Insurance If Your Base Less Than 10 or

Code Hourly Rate is: 10 Years More Years

E $18.85 but less than $19.20 $1,650 $1,815F $19.20 but less than $19.55 $1,680 $1,845G $19.55 but less than $19.90 $1,710 $1,880H $19.90 but less than $20.25 $1,740 $1,915

I $20.25 but less than $20.60 $1,770 $1,945J $20.60 but less than $20.95 $1,800 $1,980K $20.95 but less than $21.30 $1,830 $2,015L $21.30 but less than $21.65 $1,860 $2,045

M $21.65 but less than $22.00 $1,890 $2,080N $22.00 but less than $22.35 $1,920 $2,115O $22.35 but less than $22.70 $1,950 $2,145P $22.70 but less than $23.05 $1,985 $2,180

Q $23.05 but less than $23.40 $2,015 $2,215R $23.40 but less than $23.75 $2,045 $2,245S $23.75 but less than $24.10 $2,075 $2,280T $24.10 but less than $24.45 $2,105 $2,315

U $24.45 but less than $24.80 $2,135 $2,350V $24.80 but less than $25.15 $2,165 $2,380W $25.15 but less than $25.50 $2,195 $2,415X $25.50 but less than $25.85 $2,225 $2,450

Y $25.85 but less than $26.20 $2,255 $2,485Z $26.20 but less than $26.55 $2,290 $2,515AA $26.55 but less than $26.90 $2,320 $2,550BB $26.90 but less than $27.25 $2,350 $2,585

CC $27.25 but less than $27.60 $2,380 $2,615DD $27.60 but less than $27.95 $2,410 $2,650EE $27.95 but less than $28.30 $2,440 $2,685FF $28.30 but less than $28.65 $2,470 $2,715

GG $28.65 but less than $29.00 $2,500 $2,750HH $29.00 but less than $29.35 $2,530 $2,780II $29.35 but less than $29.70 $2,560 $2,815JJ $29.70 but less than $30.05 $2,590 $2,850

KK $30.05 but less than $30.40 $2,620 $2,880LL $30.40 but less than $30.75 $2,650 $2,915MM $30.75 but less than $31.10 $2,680 $2,950NN $31.10 but less than $31.45 $2,710 $2,980

OO $31.45 but less than $31.80 $2,740 $3,015PP $31.80 but less than $32.15 $2,770 $3,045QQ $32.15 but less than $32.50 $2,800 $3,080RR $32.50 but less than $32.85 $2,830 $3,115

SS $32.85 but less than $33.20 $2,860 $3,145TT $33.20 but less than $33.55 $2,890 $3,180UU $33.55 but less than $33.90 $2,920 $3,215VV $33.90 but less than $34.25 $2,950 $3,245

WW $34.25 but less than $34.60 $2,980 $3,280XX $34.60 but less than $34.95 $3,010 $3,315YY $34.95 but less than $35.30 $3,040 $3,345ZZ $35.30 and over $3,070 $3,380

If you last worked before September 14, 2003, your Extended Dis-ability Benefits are shown in the Collective Bargaining Agreement ineffect when you last worked.

Benefits payable for less than a full month are prorated—based on the ratio of calendar days of eligibility to totalcalendar days in the month.

If you become disabled again for an old accident or ill-ness without having returned to work for three consecu-tive months or more, the benefits shall be the amount youwould have received under a continuation of the prior claim.

Other sources of benefitsOther sources of benefits are:• Benefits under any retirement plan for Company employees• Lost-time benefits under Workers’ Compensation laws

or other laws providing benefits for occupational injuryor disease, including lump-sum settlements (excludingspecific allowances for loss, or 100% loss of use of abody member, or permanent partial disability paymentsfor a work-related disability unrelated to the disabilityfor which Extended Disability Benefits are payable)

• Disability or old-age (retirement) primary Social Secu-rity benefits to which you are entitled (except for retire-ment benefits reduced because of your age at the timeyou receive them); this includes any similar benefitsarising from future legislation and

• Benefits under any state or federal law providing ben-efits for lost time because of disability, except benefitsfor total disability due to pneumoconiosis

Extended Disability Benefits are reduced by the amountsyou receive from other sources. To determine the amountspaid from other sources, those benefits paid on a weeklyor lump-sum basis are converted to monthly amounts (bymultiplying the weekly amount by 4.33).

SubrogationIf your disability is the result of an event that creates alegal liability in another person or entity and you seek torecover economic or compensatory damages through le-gal or other action against that person or entity, the Com-pany may initiate or join the action to recover the cost ofthe benefits paid to you by the plan. If you recover mon-ies, economic or compensatory through personal injuryaction, the payments can be offset from the disabilitybenefit. You must notify the Company or UNICARE in theevent you initiate legal action to enforce your right to re-covery from another party.


Duration of benefitsThe duration of benefits is based on your years of senior-ity or, for AAI employees, your combined years of AAIand Ford service, and your last day worked before disabil-ity began:

EXTENDED DISABILITY BENEFITS WILL CONTINUE

If: Until:

1. You have 10 or more years Your recovery or attainment ofof seniority on the date age 65, whichever is soonerdisability began

2. You have less than 10 years The sooner of your recovery,of seniority on the date attainment of age 65 or thedisability began number of full months of seniority

at the onset of disabilityminusthe number of weeks for whichyou are entitled to receiveAccident and Sickness benefits

For purposes of determining the maximum period ofmonthly Extended Disability Benefits, a month in whichbenefits are partially or wholly offset by benefits from othersources is counted as a full month. A month during whichyou engage in some gainful occupation or employmentfor which you are not reasonably qualified by education,training or experience also is counted as a full month.

For those employees who have less than 10 years of se-niority when the disability commenced, the total numberof months during any previous period of eligibility for Ex-tended Disability Benefits, regardless of whether the dis-ability was for the same or a related condition, will reducethe maximum number of monthly benefit payments whichyou are eligible to receive.

Offset for Social Security Disability Insurance benefitsIn determining the amount of your Extended DisabilityBenefits (EDB), you are immediately presumed to be eli-gible for Social Security Disability Insurance Benefits(SSDIB). However, if you made a timely application for(SSDIB) and have not received a determination on thatapplication, you may request that the Company waive thepresumption of eligibility for SSDIB under the EDB pro-gram. To obtain the waiver, the Company should be providedwith a voluntary authorization to deduct from your ben-efits under the Retirement Plan any overpaymentattributable to a retroactive SSDIB award for the periodcovered by the waiver. The Retirement Plan deduction au-thorization is voluntary and may be cancelled at any time.It would be used only in those cases in which the futureEDB amount you are owed is not sufficient to allow recov-ery of the overpayment within a reasonable period of time.However, if the Retirement Plan deduction authorizationis cancelled before an overpayment is fully repaid, a col-lection agency may be used to recover any remainingoverpayment amount.

Offset for benefits from the Ford-UAW Retirement PlanAfter you have received EDB for 24 months, your EDBwill be reduced by the amount of retirement benefit forwhich you are presumed to be eligible if you have notpreviously applied for benefits under the Ford-UAW Re-tirement Plan, or if you applied for retirement benefits buthave not yet received a determination on your application.This provision does not apply to you if you applied forretirement benefits and received a determination on yourapplication prior to the twenty-fourth month. The amountdeducted from your EDB based on presumed eligibility forretirement benefits will be paid to you if you provide evi-dence that your application for retirement benefits wasdenied, unless the reason for the denial was your refusalto accept vocational rehabilitation services. If you applyfor Retirement Plan benefits after the twenty-fourth monthof your eligibility for EDB and your application is approved,the amounts deducted prior to the scheduled effective dateof the retirement will not be paid to you

After Extended Disability Benefits begin, any increasesin the amount of other benefits mentioned above will notaffect the amounts payable from Extended DisabilityBenefits—unless the increase represents an adjustmentin the benefit originally determined.

You may be required to verify the amounts of your incomefrom other sources while you are eligible for ExtendedDisability Benefits.


Regardless of your seniority at the time of disability, ifyou become disabled at or after age 63 and if otherwiseeligible, benefits are payable in accordance with thefollowing schedule:

Maximum durationYour age at commencement of extendedof disability disability benefits

63 and 0 months but less than 12 months68 and 1 month68 and 1 month but less than 11 months68 and 2 months68 and 2 months but less than 10 months68 and 3 months68 and 3 months but less than 9 months68 and 4 months

68 and 4 months but less than 8 months68 and 5 months68 and 5 months but less than 7 months68 and 6 months68 and 6 months and older 6 months

Benefits may be suspendedExtended Disability Benefits will be suspended for theperiod of your return to work if:• Your return to work is not effective to qualify you for a

new period of Accident and Sickness benefits or• You engage in some gainful occupation or employment

for which you are reasonably qualified by education,training or experience

Work determined to be primarily for training under a rec-ognized program of vocational rehabilitation will not dis-qualify you for Extended Disability Benefits.

UNICARE may require you to provide proof that you haveno other employment. If this information is not provided,benefits will be suspended until the time that they areprovided and it is determined that you did not engage ingainful occupation or employment.

If your Extended Disability Benefits are discontinued becauseyou no longer satisfy the disability requirement, and withintwo weeks of the date of such discontinuance and beforeyou return to work with the Company, you again becomedisabled so as to satisfy the disability requirements, monthlyExtended Disability Benefits will be resumed.

Special Medicare benefitIf you are an Extended Disability Benefits recipient en-rolled in voluntary Medicare coverage (Part B), you willreceive the following special benefit:

Your Monthly Special Benefitis the lesser of the generallyapplicable Medicare Part B

Starting this date: Premium or this amount:

January 1, 1999 $45.50

January 1, 2000 $61.50

January 1, 2004 $76.20

Special benefit payments will begin on the first day of themonth after the month you notify the claims processorthat you have enrolled for Part B coverage. If you alreadyare receiving a special benefit for your Part B paymentsthrough the Retirement Plan or Health Care Plan, how-ever, you will not receive duplicate payments.

Special payments are paid along with Extended DisabilityBenefits. If you do not receive an Extended DisabilityBenefit payment because other benefit sources exceedthe monthly Extended Disability Benefit amount, you stillwill receive this special payment.

Physical examinationUNICARE has the right to have you examined by an im-partial medical examiner, at its expense, while your Ex-tended Disability Benefits claim is pending or being paid.Failure to report for an examination without good causewill result in denial of Extended Disability Benefits.

The results of the examination by an appropriate medicalspecialist are final and binding.

Mileage reimbursement for Impartial Medical Examination (IME)If an IME is scheduled for you at a location farther than 40miles one-way (or the distance you drive to work, if greater)from your residence, you can request reimbursement fromUNICARE at a rate of 36 cents per mile for actual milesdriven from your residence to the IME physician’s office andback using the most direct route available. You should re-quest mileage reimbursement before your appointment. Mile-age reimbursement will be made after you have kept yourappointment with the IME examiner.

Waiver of benefitsYou may waive irrevocably your right to receive ExtendedDisability Benefits for any period of disability by complet-ing a waiver form furnished by the claims processor. NoExtended Disability Benefits shall be payable for any pe-riod of disability covered by such waiver.


If you have one or more years of seniority, your Life Insur-ance, Accidental Death and Dismemberment Insuranceand Survivor Income Benefits may continue for a longerperiod of time, at no cost to you, during a layoff meetingthe conditions of the Supplemental Unemployment Ben-efits Plan (Article l, Section 3). You’ll receive these addi-tional coverages for the greater of:

• The number of months (up to 24 months) for which youare eligible based on your years of seniority on your lastday worked before layoff (or the date placed on layoff ifyou are a returning veteran) according to this table:

If your year(s) of seniority Coverage will be providedon the last day worked for up to this number ofbefore layoff were: months at No Cost to You:

Less than 1 0

1 but less than 2 2

2 but less than 3 4

3 but less than 4 6

4 but less than 5 8

5 but less than 6 10

6 but less than 10 12

10 and over 24

OR

One full calendar month of layoff (up to 24 months) foreach full 4 weeks of Regular Benefits to which your CreditUnits as of the last day worked prior to layoff entitle youbased on your seniority and the Credit Unit CancellationBase under the provisions of the 1987 SUB Plan.

If, after your last day worked before layoff, you are cred-ited with Credit Units under the SUB Plan, the Credit UnitCancellation Base as of the date you are entitled to becredited with Credit Units will be used.

If you remain on layoff beyond the period of time for whichcoverage is provided at no cost, you may continue cover-age for up to an additional 12 months. To do so, you will berequired to make monthly contributions. The contributionamount is based on your base hourly rate and your levelof coverage at the time your employment terminated.

If you become eligible for reinstated Accident and Sick-ness benefits during layoff, the Company will provide Lifeand Accidental Death and Dismemberment Insurance andSurvivor Income Benefits while you are eligible to receiveExtended Disability Benefits after receipt of reinstatedAccident and Sickness benefits.

What happens if l stop working for any reason?

If you stop working or are away from work, life insur-ance and disability benefits coverages will be affected.

If you quit or are dischargedIf your employment is terminated because of a quit ordischarge, your coverage terminates as of the date youquit or are discharged. If, however, you are dischargedand have a grievance pending to protest your loss ofseniority, coverage for life insurance will continue to theend of the month you were discharged and up to twoadditional months. Coverage for disability benefits ter-minates as of the end of the month in which employ-ment terminates.

If your employment is terminated for failing to report oroverstaying leave, your coverage terminates as of the endof the month in which seniority is broken.

If you terminate employment between ages 60 and 65,you may be eligible to continue certain Life and DisabilityInsurance Program coverages.

Life Insurance and Survivor Income Benefits coveragesremain in effect for 31 days following your last day worked.(See the “What are Life Insurance benefits?” and “Whatare Survivor Income Benefits?” sections for more details.)

If you are laid offIf you are laid off, all your coverages will continue for onemonth after the month in which you are laid off.

If you are a returning veteran and are placed on layoff in-stead of being reinstated, your Life Insurance, AccidentalDeath and Dismemberment Insurance and Survivor IncomeBenefits will continue at no cost to you for the rest of themonth in which you are placed on layoff. (A returning veteranis an employee applying for re-employment who would beentitled to reinstatement as a military service veteran underthe Collective Bargaining Agreement.)


If you’re on a medical leave of absenceIf you cease active work because of a disability, all of yourcoverages will continue up to a period of time equal to yourseniority when your absence began. If you remain continu-ously and totally disabled beyond that time, you can con-tinue Life Insurance and Accidental Death and Dismember-ment Insurance coverages by making monthly contributions.

If your absence is due to pregnancy, the Company willcontinue all your coverages through the month followingthe month of delivery. If your disability continues beyondthat time, your coverages also will continue as for anyother disability.

If you’re on a non-medical leave of absenceIf you go on an approved non-medical leave of absence(except while serving as International Union Represen-tative), all of your coverages for Life Insurance, Acci-dental Death and Dismemberment Insurance and Survi-vor Income Benefits will continue for the first full monthof your leave. You may continue coverage beyond thattime up to the end of your approved leave by makingmonthly contributions.

If you go on an approved Union Leave of Absence whileserving as an International Union Representative, you maycontinue your Life Insurance, Accidental Death and Dis-memberment Insurance and Survivor Income Benefitscoverages by making monthly contributions.

If you retireIf you take early or special early retirement under the Re-tirement Plan, the Company will continue your full LifeInsurance and Accidental Death and Dismemberment In-surance coverages until you reach age 65. After you reachage 65, your Life Insurance will be continued at a reducedlevel until you die.

If you take disability retirement under the Retirement Plan,the Company will continue your Life Insurance, Acciden-tal Death and Dismemberment Insurance and SurvivorIncome Benefits until you reach age 65. After you reachage 65, your Life Insurance will be continued at a reducedlevel until you die.

If you are uninsured and retire under the Retirement Planbefore age 65, the following applies. If you did not returnto work from layoff or leave of absence, you will becomeinsured on the first day of the month following the monthyou broke seniority, due to that retirement, for the samecoverages you otherwise would have been eligible to re-ceive at the time of your retirement, in the amount youhad in force while last working. The Company will con-tinue those coverages for you until you reach age 65, atwhich time your Life Insurance will be continued at a re-duced level (as described in the “Continuing Group LifeInsurance amount” section).

See the “What are Life Insurance benefits?” section fordetails on coverage after you reach age 65.

If you terminate employment between ages 60 and 65If you terminate employment for any reason except retire-ment between ages 60 (or prior to that age if you still areinsured at age 60) and 65 and you had at least five yearsof creditable service under the Retirement Plan at age 60,you may continue your Life Insurance, Accidental Deathand Dismemberment Insurance and Survivor Income Ben-efits coverages under the Program until you reach age 65by making monthly contributions. If, however, you are ter-minated for total and permanent disability, the Companywill pay the cost for you.

If you have a grievance pendingThe Company will continue your Life Insurance, Acciden-tal Death and Dismemberment Insurance and SurvivorIncome Benefits coverages if you have a grievance pend-ing to protest your disciplinary layoff or your loss ofseniority from:• Discharge• Failure to report or• Overstaying leave

Coverage will continue for the month of discharge plus upto two additional months.

To continue coverage after the period in which your lossof seniority or disciplinary layoff occurred, you will needto make monthly contributions.

If you are reinstated or if your disciplinary layoff is re-duced after this period, the Company will reimburse youfor the continuation payments that the Company wouldhave made had you remained at work.

Disability coverage terminates as of the end of the monthin which your employment terminates.


Contribution Schedule for Continuing Coverage

Insurance If your base Schedule ScheduleCode hourly rate is: I II

A Up to but less than $17.80 $33.24 $20.00B $17.80 but less than $18.15 $33.67 $20.00C $18.15 but less than $18.50 $34.96 $21.00D $18.50 but less than $18.85 $35.39 $21.25

E $18.85 but less than $19.20 $36.25 $21.75F $19.20 but less than $19.55 $36.68 $22.00G $19.55 but less than $19.90 $37.54 $22.50H $19.90 but less than $20.25 $38.40 $23.00

I $20.25 but less than $20.60 $38.83 $23.25J $20.60 but less than $20.95 $39.26 $23.50K $20.95 but less than $21.30 $40.12 $24.00L $21.30 but less than $21.65 $40.55 $24.25

M $21.65 but less than $22.00 $41.41 $24.75N $22.00 but less than $22.35 $41.84 $25.00O $22.35 but less than $22.70 $42.70 $25.50P $22.70 but less than $23.05 $43.56 $26.00

Q $23.05 but less than $23.40 $43.99 $26.25R $23.40 but less than $23.75 $44.85 $26.75S $23.75 but less than $24.10 $45.28 $27.00T $24.10 but less than $24.45 $46.14 $27.50

U $24.45 but less than $24.80 $47.00 $28.00V $24.80 but less than $25.15 $47.43 $28.25W $25.15 but less than $25.50 $48.29 $28.75X $25.50 but less than $25.85 $48.72 $29.00

Y $25.85 but less than $26.20 $49.58 $29.50Z $26.20 but less than $26.55 $50.44 $30.00

AA $26.55 but less than $26.90 $50.87 $30.25BB $26.90 but less than $27.25 $51.73 $30.75

CC $27.25 but less than $27.60 $52.16 $31.00DD $27.60 but less than $27.95 $53.02 $31.50EE $27.95 but less than $28.30 $53.88 $32.00FF $28.30 but less than $28.65 $54.31 $32.25

GG $28.65 but less than $29.00 $55.17 $32.75HH $29.00 but less than $29.35 $56.46 $33.50II $29.35 but less than $29.70 $56.89 $33.75JJ $29.70 but less than $30.05 $57.75 $34.25

KK $30.05 but less than $30.40 $58.61 $34.75LL $30.40 but less than $30.75 $59.04 $35.00MM $30.75 but less than $31.10 $59.90 $35.50NN $31.10 but less than $31.45 $60.33 $35.75

OO $31.45 but less than $31.80 $60.76 $36.00PP $31.80 but less than $32.15 $61.19 $36.25QQ $32.15 but less than $32.50 $62.05 $36.75RR $32.50 but less than $32.85 $62.91 $37.25

SS $32.85 but less than $33.20 $63.34 $37.50TT $33.20 but less than $33.55 $64.20 $38.00UU $33.55 but less than $33.90 $64.63 $38.25VV $33.90 but less than $34.25 $65.49 $38.75

WW $34.25 but less than $34.60 $66.35 $39.25XX $34.60 but less than $34.95 $66.78 $39.50YY $34.95 but less than $35.30 $67.64 $40.00ZZ $35.30 and over $68.07 $40.25

Your contributions for continuing coverageThe following chart summarizes reasons why youremployment may terminate and whether or not your LifeInsurance coverage may continue:

You then cancontribute

The Company according tocontinues your contribution

Your situation: coverage for: schedule # :

You quit or are — —discharged

You have a Month of I Igrievance pending discharge plus

up to twoadditional months

You are laid off First month (plus I Iadditional monthsfor which you mayqualify)

You’re on a leave First month Iof absence (exceptmedical or Unionleave)

You’re on a Union First month IIIleave of absence(Local Union)

You’re on a Union Through month in IVleave of absence which leave is(International Union) issued

You’re on a medical Length of your I Ileave of absence absence due to

disability but notto exceed a periodequal to your seniority

You take early or Entire period —special earlyretirement

You take disability Entire period —retirement

You terminate — I Ibetween ages60 and 65

To continue coverage beyond the period for which theCompany pays for your coverage, the monthly contributionyou are required to pay depends on the insurance bracketyou were in as of the last day worked and the kinds ofinsurance coverage which can be continued. Contributionsfor Schedules I, II, III, and IV are listed on the next page.


Schedule III. Your contribution is 60¢ per $1,000 life insur-ance in addition to $5.00 a month.

Schedule IV. Your contribution is 60¢ per $1,000 life insurance.

Your contributions for the coverages available to you shouldbe mailed to, or paid in person at:

UNICARE Life and Health Insurance CompanyDearborn Service Center3200 GreenfieldDearborn, Michigan 48120(313) 336-5550 or1-800-843-8184

Mailing Address:P.O. Box 2090Dearborn, Michigan 48123

Payment will be due on the first day of each month forthat month’s coverage. Payment will be accepted any-time within that month. Late payments are not accept-able, however, and can result in permanent terminationof your coverage.

If you return to work from layoff in a month for which youhave made payment, you will be reimbursed by UNICAREfor that payment.

The carrier will not advise of payments due. Makingtimely premium payments is your responsibility.

Optional Group Life Insurance, Dependent Group Life Insur-ance and Optional Accident InsuranceYou may continue Optional Group Life Insurance, Depen-dent Group Life Insurance and Optional Accident Insur-ance coverage for certain periods when you are not atwork. For more details, see the sections “What are Op-tional Group Life Insurance benefits?”, “What are Depen-dent Group Life Insurance benefits?” and “What are Op-tional Accident Insurance benefits?”.

If you leave for another reasonIf your employment is terminated for a reason not describedin this section, the company continues your coveragesuntil the end of that month.

How do I or my survivor apply for benefits?

Before you or your beneficiary can receive Life andDisability Insurance Program benefits, you must file aproper claim.

Claiming Death, Dismemberment or Survivor Income BenefitsYou or your beneficiary should make a claim as soon aspossible in the event of death or dismemberment.

To begin the process for a death claim, your familyor beneficiary will need to provide copies of the deathcertificate certified by the governmental unit maintain-ing the record.

Death certificates usually are kept on file in the Depart-ment of Health of the city or county where death oc-curred. You may contact that office directly to obtainthe number of death certificate copies you need. Usu-ally, only certain members of the immediate family mayobtain these copies.

The funeral home director might obtain the death certifi-cate copies for your family.

To file a claim for Life Insurance, Accidental Deathand Dismemberment Insurance or Survivor IncomeBenefits, follow these steps:

1. Claims for all active employees should be reported di-rectly to:

Ford Motor CompanyP.O. Box 3139Melvindale, Michigan 48122-01391-800-248-4444

2. All other claims, including retiree claims, should be re-ported directly to:

UNICARE Life and Health Insurance CompanyDearborn Service Center3200 GreenfieldDearborn, Michigan 481201-800-843-8184

Mailing Address:P.O. Box 2090Dearborn, Michigan 48123-2090


To file a claim for Optional Group Life Insurance,Dependent Group Life Insurance or Optional AccidentInsurance Benefits, follow these steps:

1. Contact the carrier directly:

Mutual of OmahaFord Hourly Optional Insurance PlanSuite 1162720 South River RoadDes Plaines, Illinois 60018(847) 299-93931-800-742-8215

2. Complete the notice of claim form obtained from thecarrier. Then return the form and a certified copy of thedeath certificate to the carrier.

3. You may receive a form requesting additional informa-tion from the carrier.

To file a claim for Safety Belt User Benefits, followthese steps:

1. Contact the carrier directly:

Mutual of OmahaFord Hourly Optional Insurance PlanSuite 1162720 South River RoadDes Plaines, Illinois 60018(847) 299-93931-800-742-8215

2. Within 30 days of the date of death, you or your benefi-ciary must submit the following information to the carrier:

— Written notice of the loss and a certified copy of thedeath certificate and

— Evidence sufficient to prove that the covered par-ticipant was properly wearing a qualified passengerrestraint as defined by the Program

3. If it is not reasonably possible to submit the requiredinformation within 30 days, you or your beneficiary willhave up to one year to make the claim.

Claiming disability benefitsTo file a claim for Accident and Sickness or ExtendedDisability Benefits, follow these steps:

1. Your claim should be reported directly to:

UNICARE Life and Health Insurance CompanyDearborn Service Center3200 GreenfieldDearborn, Michigan 481201-800-572-1581

Mailing Address:P.O. Box 4479Dearborn, Michigan 48126

2. If you are employed in California and become disabled,you must apply for State Unemployment Compensa-tion Disability Benefits.


Will taxes be withheld from my disability benefits?

Yes, taxes will be withheld from all disability paymentsjust as they are from your paychecks.

Withholding will be based on your current exemptionstatus on record with the Company. When your exemp-tion status is not available, the withholding amountswill be determined as if you were single and claimingzero exemptions until the claims processor is providedwith Form W-4.

If you wish to change your exemption status while youare receiving disability benefits, you may contact the claimsprocessor regarding the submission of updated Form W-4.Changes submitted to the claims processor will take ef-fect as soon as possible for future benefits only. Your ex-emption status will be obtained from the Company payrollrecords each time you file a claim. For that reason, youmust submit Form W-4 changes for each claim if you de-sire a different level of tax withholding than appears onCompany payroll records. Any Form W-4 changes that aresubmitted to the claims processor will not affect yourCompany payroll records.

Your disability benefits also will be reduced by the amountof any applicable court order directing the Company towithhold from your wages or benefits. Court orders fordependent support, bankruptcy, tax levies, garnishment,etc. which are on file with payroll services or served di-rectly upon UNICARE will apply to your disability ben-efits. The amount withheld will be sent by UNICARE tothe court involved. An explanation of withholding will beincluded on your disability benefit draft.

What if a claim for Accident and Sickness or ExtendedDisability Benefits is denied?

This section contains a description of the proceduresfor seeking review of a denied claim.

If a claim for benefits or participation is denied, you shouldreceive written notification within forty-five (45) days ofthe date that the claim is received. If the Plan Administra-tor requires more time to review your claim, determinationmay be delayed an additional 60 days. You will receivenotice of the delay which will include the reasons for de-lay and the date a final decision can be expected.

Your first level of appeal is a review of the denied claim bythe Plan Administrator.

Review of denial by the Plan AdministratorIf a claim is denied, you will receive a written notice. Thenotice will explain the reason for the denial, refer to thespecific Plan provision or provisions on which the denialis based, describe what additional information, if any, isnecessary to consider a further appeal, and describe howto appeal your claim.

In the event of a denial, you may request a review by thePlan Administrator by submitting an appeal in writing. Yourrequest for review must be submitted within one hundredeighty (180) days after you receive the written notificationof denial of the claim. Within forth-five days following re-ceipt of your appeal letter, the Plan Administrator will no-tify you of their decision. Special circumstances may re-quire an extension of time for processing. If your claimhas been denied, the notice will describe the specific rea-sons for the denial.

In all cases, a final decision will be reached, and you willbe notified within 120 days after your written request for areview is received by the Plan Administrator.

First level appeals should be addressed to:UNICARE Life and Health Insurance CompanyDearborn Service Center3200 GreenfieldDearborn, Michigan 48120


When does coverage end?

Coverage will end when you no longer are eligible forthe Program.

The description for each benefit area under the Programincludes a discussion of when coverage ends. Additionally,coverage under the Life and Disability Insurance Programautomatically will end on the earliest of:• The date the Program terminates;• The end of the period for which you last made

contributions for continuing coverage;• The end of the month you are transferred within the

Company to an ineligible class of employees;• Unless specifically provided otherwise, the end of the

month you stop active work (unless you continue yourinsurance coverage as described in the “What happensif l stop working for any reason?” section); or

• The day you quit or are discharged, unless you have agrievance pending to protest your loss of seniority.

Review of denial of the appeal by the CommitteeIn the event that the Plan Administrator denies theappeal of a claim, you may request further review ofyour claim by submitting your request for appeal in writingto the UAW-Ford Group Life and Disability AppealCommittee. The procedures and time limits for reviewingthe appeal are the same as the appeal to the PlanAdministrator as listed on the previous page.

The UAW will appoint three members and alternate mem-bers to the Committee. Three additional members of theCommittee are appointed by the Company. The membersof the Committee and the alternate members receive noadditional compensation for Committee services.Address appeal requests to:

Ford Motor CompanyP.O. Box 3139Melvindale, MI 48122-0139Attn: Life and Disability Plan Specialist andUAW-Ford Group Life and Disability Committee

The request for appeal should clearly indicate the reason(s)why you think your claim should not have been denied bythe Plan Administrator. You are encouraged to submit cop-ies of any additional documents, records, information orcomments you think have a bearing on your claim.You will be notified of the outcome of your appeal in writ-ing, within forty-five (45) days from the date the writtennotice is received, unless special circumstances requirean extension of time for processing. Your notice will in-clude the final decision and the specific reasons to sup-port the decision. No legal action may be brought untilafter the claims and appeals procedures have been ex-hausted. No legal action can be taken later than two yearsafter the claim accrues.


What other circumstances might affect benefits?

This section of your handbook has summarized your Lifeand Disability Insurance Program coverages. Additionalcircumstances, however, might affect your benefits.

Accident or disabilityIt is important to remember these things about disabilitycoverage for an accident or sickness:• The Program covers most disabilities from illness or

injury as long as you remain under a physician’s care• If you have two separate or unrelated disabilities not

separated by a return to work, you may receive ben-efits for the second period of disability, as long as youmeet certain requirements

• If you’re receiving disability benefits from other sources,including Social Security, it’s your obligation to let theclaims processor know

• If your disability ends, payments stop

Assigning your benefitsYou and your beneficiary may assign your Life Insurance,Accidental Death and Dismemberment Insurance andOptional Group Life Insurance by making your assignmentin writing with the carrier. Neither you nor your survivorsmay assign your Survivor Income Benefits, DependentGroup Life Insurance, Optional Accident Insurance, SafetyBelt User Benefits, Accident and Sickness Benefits orExtended Disability Benefits.

Certain court orders relating to domestic relations mat-ters could require that your benefits (or a part of yourbenefits) be paid to someone else—your spouse or chil-dren, for example. This could apply to benefits paid to youas well as to any beneficiary. If the carrier or claims pro-cessor determines that the court order qualifies, paymentswill be made according to the order. As soon as you areaware of any court proceedings which may affect yourLife and Disability Insurance Program benefits, contactthe National Employee Services Center at 1-800-248-4444.

Attachment of Survivor Income BenefitsTo the extent permitted by applicable law, Survivor IncomeBenefits are not subject to attachment or other encumbranceor subject to the debts or liability of any survivor.

Filing claimsNo benefits can be paid until you or your beneficiary filesa claim. If you have questions, contact the National Em-ployee Services Center at 1-800-248-4444.

If a disability benefit is overpaidIf a disability benefit is overpaid for any reason, you willreceive a written notice that you should repay that amountdirectly to the claims processor.

If you do not pay that amount promptly, the claims pro-cessor has the right to deduct the overpaid amount fromfuture benefit payments. At the claims processor’s request,the Company may deduct the overpaid amount from yourfuture paychecks. However, repayment of overpaymentscaused solely by Company or carrier error is only requiredif notice is given within one year from the date an over-payment is established.

If you or your beneficiary are incompetentIf you or your beneficiary are incompetent or otherwiseincapable of giving a valid release, the carrier or claimsprocessor may withhold payment until a guardian is ap-pointed. In the case of weekly or monthly benefits, pay-ment may be made to any relative by blood or marriage orto any other individual or institution appearing to the car-rier or claims processor to have assumed custody of theperson. The liability of the carrier or claims processor shallbe fully discharged to the extent of such payment.

Naming a beneficiaryYou may name a beneficiary you want to receive your LifeInsurance, Accidental Death and Dismemberment Insur-ance, Optional Group Life Insurance and Optional Acci-dent Insurance if you die. You have the right to name thebeneficiary of your choice — and to change that benefi-ciary at any time by notifying the carrier. When the carrierreceives notice of a beneficiary change, the change takeseffect on the date the notice of change was signed eventhough the carrier receives the notice after your death. Ifthe carrier makes a payment on account of your deathbefore receiving the notice of change, however, it will notbe liable for another payment.

These beneficiary details do not apply to your SurvivorIncome Benefits, Dependent Life Insurance and SafetyBelt User Benefit Program.


Summary of Administrative Information

Plan Benefits Administered Name: Number: Type of Plan: Cost Paid By: Trustee: or Insured Through:

Group Life and Disability Insurance Program

Life Insurance 521 Welfare plan The Company pays None Life Insurance, Accidental DeathAccidental providing life premiums to the and Dismemberment Insurance,Death and insurance carrier in amounts and Survivor Income Benefits areDismemberment reflecting the number provided by:Insurance and and amount of claims Group Policy 17-GCCSurvivor Income paid UNICARE Life and HealthBenefits Insurance Company

3200 GreenfieldDearborn, Michigan 48120(313) 336-55501-800-843-8184

Accident and 521 Welfare plan Benefits are paid by Comerica Bank Except for employees in New YorkSickness providing the Company either 411 West and New Jersey, Accident andBenefits and disability directly or through a Lafayette Sickness and Extended DisabilityExtended benefits trust fund established Detroit, Michigan Benefits are paid by Ford MotorDisability by the Company. If 48226 Company either directly or throughBenefits you live in New York (313) 222-4000 a trust fund. Claims are reviewed

or new Jersey, 1-800-521-1190 and approved or provided bybenefits are paid by (outside Michigan) UNICARE Life and Healtha carrier Insurance Company

3200 GreenfieldDearborn, Michigan 481201-800-572-1581For employees in New York andNew Jersey, benefits are insuredby John Hancock (and adminis-tered by UNICARE Life and HealthInsurance Company) (Group Policy17-GCC)

Optional Group 521 Welfare plan offering Participating None Mutual of OmahaLife Insurance life insurance Employees Ford Hourly Optional InsurancePlan Suite 116

2720 South River RoadDes Plaines, Illinois 60018(847) 299-93931-800-742-8215

Dependent 521 Welfare plan offering Participating None Mutual of OmahaGroup Life life insurance for your Employees Ford Hourly OptionalInsurance dependents Insurance PlanPlan Suite 116

2720 South River RoadDes Plaines, Illinois 60018(847) 299-93931-800-742-8215



Plan Benefits Administered Name: Number: Type of Plan: Cost Paid By: Trustee: or Insured Through:

Group Life and Disability Insurance Program

Optional Accident 521 Welfare plan Participating None Mutual of OmahaInsurance Plan offering accident Employees Ford Hourly Optional InsurancePlan

insurance for you Suite 116and your 2720 South River Roaddependents Des Plaines, Illinois 60018

(847) 299-93931-800-742-8215

Safety Belt User 521 Welfare plan providing Ford Motor None Mutual of OmahaBenefit Program life insurance in the Company Ford Hourly Optional InsurancePlan event of death of a Suite 116

covered participant 2720 South River Roadresulting from an Des Plaines, Illinois 60018automobile accident (847) 299-9393in which a qualified 1-800-742-8215passenger restraintwas used

141141141141

Retirement Plan

After an overview of your benefits from theRetirement Plan, this section of yourhandbook answers these questions:

Page

What are participation requirementsunder the Plan? 142

What are service credits? 143

What determines your Retirement benefit? 144

How is your Life Income Benefit calculated? 145

What are the four types of Retirement? 145

What is Normal Retirement? 146

What is Regular Early Retirement? 147

What is Special Early Retirement? 151

What is Disability Retirement? 153

What is the Special Age 65 Benefit? 156

What are your survivorship coverage options? 156

What is a deferred vested benefit? 160

How do you apply for a RetirementPlan Benefit? 162

How are taxes paid on your Retirementbenefits? 163

Who pays for Retirement benefits? 163

What circumstances might affectRetirement benefits? 164

Can Plan provisions change? 165

How do you file a claim? 165

What if a claim of benefits or participationis denied? 166

142 Retirement Plan


The Ford-UAW Retirement Plan provides you withmonthly income during your retirement years.

The Plan pays monthly benefits as long as you have atleast 5 years of credited service or Employee RetirementIncome Security Act (ERISA) service.

You must apply for benefits before any payments fromthe Plan can begin. To apply, you must contact the NESCat 1-800-248-4444 to obtain an application form 60 to 90days before you wish benefits to commence. Formsmust be signed and dated prior to the retirement effec-tive date and returned to the NESC on a timely basis.Applications signed after the effective date may be madeeffective the month following signature and may resultin a loss of benefits. If you need any information aboutthe Plan, you can call the NESC.

There are four types of retirement under the Plan:

• Normal Retirement

• Regular Early Retirement

• Special Early Retirement

• Disability Retirement

There are different eligibility requirements for each typeof retirement.

The Plan also includes provisions under which you maybe paid a:

• Temporary Benefit

• Supplemental Allowance

In addition to benefits provided for your retirement years,benefits may be payable to your spouse if you die, as longas you have completed 5 years of Plan service or ERISAService (10 years if you don’t accrue service after 1988).

If you leave the Company before you are eligible to retireand you have completed at least 5 years of Plan serviceor ERISA Service (10 years if you don’t accrue serviceafter 1988), you are eligible for deferred vested benefits.

What are participation requirements under the Plan?

If you are an hourly employee covered by the Ford-UAW Agreement, you are eligible to participate inthe Plan.

You automatically participate in the Plan if you are:• An hourly Ford employee• Represented by the UAW under the Collective Bargaining

Agreement which became effective September 15, 2003

Your participation begins on your hire date. The Companypays the full cost of benefits provided under the Plan.

You do not have any rights to receive benefits under thePlan until you are eligible to retire or you are entitled toreceive deferred vested benefits. “Deferred” means yourbenefits are payable at a later date—in this case, on orafter age 55. “Vested” means you’ve earned a right toreceive benefits from the Plan.

Retirement Plan

Retirement Plan 143

What are service credits?

Your service credits are credits used in determiningyour eligibility for benefits and the benefit amount.

Service credits are used in determining your eligibility andbenefit amount. Once the hours for which you receivedpay in a calendar year are counted, you then are given afull or partial year of credited service under the Plan, basedon the table shown below:

SERVICE CREDITSIf your hours in a calendar year are: Your credited service is:

1,615 or more hours 1.0 year1,445 but less than 1,615 hours 0.9 year1,275 but less than 1,445 hours 0.8 year1,105 but less than 1,275 hours 0.7 year1,935 but less than 1,105 hours 0.6 year1,765 but less than 1,935 hours 0.5 year1,595 but less than 1,765 hours 0.4 year1,425 but less than 1,595 hours 0.3 year1,255 but less than 1,425 hours 0.2 year1,285 but less than 1,255 hours 0.1 yearLess than 85 hours None

You earn credited service after March 1, 1950 based onhours for which you receive pay from the Company. Anhour for which a premium is paid is counted as only onehour. If you have Company service for employment beforeMarch 1, 1950 and were actively employed after that date,you may receive credit for this prior service. If you areaffected, the NESC can obtain more information for you.For the period of your service before 1966, your creditedservice will not be less than your seniority as of Decem-ber 31, 1965 excluding seniority for military service beforeCompany employment.

You cannot accrue credited service after you have a breakin seniority (described later in this section), unless youlater reestablish seniority.

You also earn credited service during layoff between Janu-ary 1, 1951 and January 1, 1968 as well as layoff betweenJanuary 1, 1974 and January 1, 1990 depending on yourseniority on specific dates, if you apply for credited ser-vice before your retirement, as shown on the following table:

If you were absent because of layoff And you had at leastin the following calendar years: 5 years seniority as of:

1951-1955 11/19/731956-1962 1/1/711963-1967 10/1/791974-1976 10/1/93

1976-1979 10/1/031979-1983 10/1/84 or 10/1/991984-1985 10/1/961986-1989 10/1/03

You can receive credit for 40 hours for each completecalendar week of layoff multiplied by the applicablepercentage shown below:

Seniority on the above dates: Percent:

20 years or more 100%15 years but less than 20 years 175%10 years but less than 15 years 150%15 years but less than 10 years 125%

You can earn credited service during certain periods whenyou are not receiving pay from the Company if a break inseniority has not occurred.• Layoff or Company-approved sick leave if you received

pay for at least 170 hours during the year your absenceoccurred (for years after 1967)

• Layoff or Company-approved sick leave in a secondcalendar year if your absence continues into a sec-ond year and you received pay for at least 170 hoursduring the year in which your absence began (for yearsafter 1969):— you may receive credit for 40 hours of service per

week up to a maximum of 1,530 hours during anysingle, continuous absence due to layoff or Company-approved sick leave

— in addition, you may receive credit during your continu-ing absence due to layoff (but not Company-approvedsick leave) beginning on or after March 1, 1982 up to amaximum of 1,700 hours if you:— are at work on or after March 1, 1982— have 10 or more years of seniority at the time

of layoff and— have received service credit of 1,530 hours due

to your absence

• Approved Union, credit union or military leave• Approved pregnancy sick leave between March 1, 1950

and January 1, 1968 (up to a maximum of 0.3 year ofcredited service during each period of absence), if youapply for it before your retirement, and

• Approved sick leave while receiving Workers’ Compen-sation (if Workers’ Compensation benefits are termi-nated because of a state law that automatically termi-nates benefits after a certain length of time, or becausean employee reaches a maximum medical improvementlevel, credited service can continue as long as the com-pensable disability continues)

• Approved leave for up to 8 years to occupy public of-fice at the State or Federal level.STATE: Governor, Lt. Governor, Attorney General, Au-ditor, Treasurer, Secretary of State or Legislator.FEDERAL: President, Vice President or Member ofCongress.

144 Retirement Plan

Other conditions for which you may receive service creditsSpecial credited service rules apply if you:• Have prior service outside the Contract Unit• Were employed by a foreign subsidiary of the Company• Were employed on certain job classifications at a Com-

pany grey iron foundry• Were employed in certain departments within the Coke

Ovens Operations or Ingot Mold Foundry

If any of these conditions apply to you, you may contactthe NESC for information on how your service is counted.

Break in seniorityIf you terminate employment in a way that constitutes abreak in seniority under the 2003 Collective BargainingAgreement, you will stop accumulating service eventhough you might have been accruing it until then andyour benefit rate will freeze.

If you have a break in seniority on or after March 1, 1950and return to work for the Company and regain seniority,all the credited service you had earned before you left theCompany will be restored.

If you had a break in seniority before March 1, 1950, theNESC can help you determine whether you may receiveservice credit for the period before your break.

You may not earn more than 1.0 of credited service forany calendar year.

What determines your Retirement benefit?

The amount of your monthly Retirement benefit isbased on the Benefit Class Code of your job classifi-cation, the type of retirement, your retirement dateand your credited service.

Your Benefit Class Code is determined by the base hourlyrate of the classification you have held for the longestperiod of time during the 24 months immediately beforeyour last day worked.

There are four Benefit Class Codes. Each job classifica-tion is assigned a Benefit Class Code determined by thebase hourly rate of the classification, as shown below:

FOR JOB CLASSIFICATIONS AS OF 10/1 /03WITH A MAXIMUM BASE HOURLY RATE OF:

TheBenefit Oct. 1, 2003 Oct. 1, 2004 Oct. 1, 2005 Oct. 1, 2006Class Through Through Through and afterCode is: Sept. 30, 2004 Sept. 30, 2005 Sept. 30, 2006

A $25.615 or less $25.615 or less $26.125 or less $26.910 or less

B $25.620-$25.890 $25.620-$25.890 $26.130-$26.410 $26.915-$27.200

C $25.895-$27.060 $25.895-$27.060 $26.415-$27.600 $27.205-$28.430

D $27.065 and $27.065 and $27.605 and $28.435 andover over over over

If your job is covered under an incentive job classification,your incentive earnings are included in determining yourBenefit Class Code.

Your Benefit Class Code may change because of:• A promotion• A transfer• An increase in the maximum base hourly rate of your

job classification

Retirement Plan 145

How is your Life Income Benefit calculated?

Your Life Income Benefit is calculated under a for-mula described here.

Your Life Income Benefit is calculated as follows:

Your Life Income Benefit ratetimes

your years of credited service

Your Life Income Benefit rate is a key factor in determin-ing the amount of your retirement benefit from the Planregardless of the type of your retirement.

Once you’ve determined your Benefit Class Code andthe date of your retirement, you can find your Life In-come Benefit rate on the table below. The table showsthe Life Income Benefit rate initially payable at retire-ment as well as the increases occurring during the termof the Agreement.

Your Life Income Benefit Ratesfor the Following MonthsAre Shown Here:

If Your And Your 10/1/03 10/1/04 10/1/05 10/1/06Retirement Benefit Class Through Through Through and AfterDate is Code Is: 9/1/04 9/1/05 9/1/06

10/1/03 A $47.45 $48.80 $49.85 $50.90and later B $48.00 $49.05 $50.10 $51.15

C $48.25 $49.30 $50.35 $51.40

D $48.50 $49.55 $50.60 $51.65

For exampleSuppose you are retiring as of January 1, 2004, are at age65 and not married, with 30 years of credited service. Let’salso assume the base hourly rate of your job classifica-tion at this time is $25.805.

By looking at the table shown earlier in the section onBenefit Class Codes, you determine that your BenefitClass Code is B.

You then must determine your Life Income Benefit rate.According to the table, your Life Income Benefit rate is$48.00 as of January 1, 2004.

Your Life Income Benefit from January 1, 2004 throughSeptember 1, 2004 is:

$48.00 times 30 years = $1,440.00

Your Life Income Benefit from October 1, 2004 throughSeptember 1, 2005 is:

$49.05 times 30 years = $1,471.50

Your Life Income Benefit from October 1, 2005 throughSeptember 1, 2006 is:

$50.10 times 30 years = $1,503.00

Your Life Income Benefit from October 1, 2006 and later is:$51.15 times 30 years = $1,534.50

What are the types of Retirement?

The four types of retirement are: Normal, RegularEarly, Special Early and Disability Retirement.

There are four types of retirement under the Plan gener-ally applicable to employees who have not broken senior-ity: Normal Retirement, Regular Early Retirement, Spe-cial Early Retirement and Disability Retirement.

Here’s a short summary of the eligibility requirements foreach type of retirement. The following pages describe eachtype of retirement in more detail:

Type of Retirement: Eligibility Requirements:

Normal Retirement • Age 65 or older with at least oneyear of credited service*

Regular Early • Age 55 but less than age 65 withRetirement at least 10 years credited service

• Any age with at least 30 yearscredited service

Special Early • Age 55 but less than age 65 withRetirement at least 10 years credited

service and retire under mutuallysatisfactory conditions

• Age 50 with at least 10 years creditedservice and laid off due to certain plantclosings.(The date of the layoff and the plantclosing both must occur after 10/1/84.)

Disability • Under age 65Retirement • At least 10 years of credited service and

• Totally and permanently disabledfor at least 5 months

Although you may otherwise be eligible to retire, your re-tirement will be deferred if you receive:

• A separation payment under the Voluntary Termina-tion of Employment Program after the end of the al-location period

• A separation payment under the Supplemental Unem-ployment Benefit Plan

• A GIS Redemption Payment under the Guaranteed In-come Stream Benefit Program

Please consult the specific plans described in other sec-tions of this handbook or the 2003 Collective Bargain-ing Agreement for the periods of time retirement mustbe deferred.

If you are not eligible for retirement, you may be eligiblefor deferred vested benefits. Deferred vested benefits aredescribed later in this section.

* You must have 10 years of credited service to be eligiblefor company sponsored post-retirement healthcare andlife insurance.

146 Retirement Plan

What is Normal Retirement?

Normal Retirement is a benefit you are eligible to re-ceive at age 65 and after.

EligibilityYou are eligible for Normal Retirement at age 65 if youhave seniority and at least one year of credited service. Ifyou are eligible for benefits under the Guaranteed IncomeStream (GIS) Benefit Program, you may retain youreligibility for Normal Retirement even though you haveincurred a break in seniority.

Your normal retirement date will be the first day of the monthafter you have reached age 65 and apply for retirement.

If you do not retire when you have reached age 65, youmay retire on the first day of any month thereafter.

If you do not retire when you reach age 65, you canapply for normal retirement anytime thereafter. You willbe sent a notice advising that the Plan has suspendedyour normal retirement benefits as a result of yourcontinued employment. This notice is a U.S. Departmentof Labor requirement under 29 Code of FederalRegulations Section 2530.203-3. You need not takeaction nor reply to this communication. Your benefitswill continue to be administered under the terms of thePlan as explained in this summary. If you reach age70½ in 1999 or later, you will have your distributiondeferred until retirement. Deferral of your age 70½distribution will result in an actuarial adjustment whenyour benefit is paid.

Benefit amountYour benefits at Normal Retirement may be made up of aLife Income Benefit and a Special Age 65 Benefit. TheSpecial Age 65 Benefit is described later in the “What isthe Special Age 65 Benefit?” section.

Survivorship coverage and the related payment methodsare described in the “What are your survivorship coverageoptions?” section.

Your Life Income BenefitYour Life Income Benefit amount is determined using theformula shown in the “How is your Life Income Benefitcalculated?” section.

If you return to workIf you return to work for the Company after you retire, youwill continue to receive your Life Income Benefit and Spe-cial Age 65 Benefit. You will not, however, earn additionalservice credits during your reemployment.

An example of monthly normal retirement benefitsYour monthly retirement benefit would be calculatedas follows if:• You are married and retire at age 65 on April 1, 2004

with 30 years of credited service• Your Benefit Class Code is B• Your spouse is three years younger than you

At Retirement

Life Income Benefit $1,368.00Special Age 65 Benefit $ 76.20

Your Benefit $1,444.20

Survivor Benefit $ 889.20

$48.00 (Life Income Benefit rate) x 30 (years of creditedservice) x 95% (Survivorship Coverage adjustment). Thebenefit amount would be $1,440.00 ($48.00 x 30) withoutthe Survivorship Coverage.

Special Age 65 Benefit is the lesser of the applicableMedicare Part B Premium or $76.20. (See conditionsregarding your participation in Medicare Part B applicableto this benefit.)

Equals 65% of the Life Income Benefit amount after the Survivor-ship Coverage adjustment. The monthly Special Age 65 Benefitwill be added to the surviving spouse benefit when such spousereaches age 65.

Retirement Plan 147

What is Regular Early Retirement?

If you meet the eligibility requirements, you can retirebefore age 65 and receive a Regular Early Retire-ment benefit under the Plan.

EligibilityYou are eligible for Regular Early Retirement if you:• Retire between age 55 and 65 and have at least 10

years of credited service• Retire at any age and have 30 or more years of cred-

ited service• Have seniority when you first meet the age and service

requirements

If you are eligible for benefits under the Guaranteed IncomeStream (GIS) Benefit Program at age 62 or later, you mayretain your eligibility for Regular Early Retirement eventhough you have incurred a break in seniority.

Benefit amountYour benefits at Regular Early Retirement may be madeup of a Life Income Benefit, a Supplemental Allowanceand a Special Age 65 Benefit. The Special Age 65 Benefitis described later in the “What is the Special Age 65 Ben-efit?” section.

Survivorship coverage and the related payment methodsare described in the “What are your survivorship coverageoptions?” section.

Your Life Income BenefitYour Life Income Benefit is determined using the formulashown in the “How is your Life Income Benefit calculated?”section. If, however, you are under age 62 when you re-tire, your benefit will be reduced based on your age whenyour benefit begins:

EARLY RETIREMENT BENEFIT REDUCTION

Percentage of Percentage ofAge When Life Income Age When Life IncomeBenefit Begins Benefit Payable Benefit Begins Benefit Payable

62 or over 100.0% 50 38.3%61 93.3% 49 35.4%60 86.7% 48 32.8%59 80.8% 47 30.4%

58 75.2% 46 28.2%57 69.4% 45 26.1%56 63.5% 44 24.3%55 57.9% 43 22.6%

54 53.2% 42 21.0%53 48.9%52 45.0%51 41.5%

If you retire between the ages shown, the percentage of the LifeIncome Benefit payable will be prorated based on whole months.

To illustrate, if you are not married and are under age 62when you retire, your Life Income Benefit is calculatedas follows:

Your Life Income Benefit ratetimes

your years of credited servicetimes

the percentage of your Life Income Benefit payable

Your reduced Life Income Benefit may be restoredIf you are not married and retire before age 62, your fullLife Income Benefit will be payable beginning at age 62and one month if at retirement:• You have at least 30 years of credited service• Your age and years of credited service added together

total at least 85

148 Retirement Plan

Supplemental AllowanceYou also may receive a Supplemental Allowance until age62 and one month* if you apply for retirement benefits withinfive years of the last day you worked for the Company.

There are two types of Supplemental Allowance payableunder the Plan—the early retirement supplement (betterknown as “30 and out”) and the interim supplement. Eachsupplement type has its own set of eligibility requirementsin addition to the general requirements described.

In any case, if you retire and then are reemployed bythe Company, your Supplemental Allowance stops dur-ing your reemployment.

If you have at least 30 years of credited service, you are eligibleto receive an early retirement supplement.Your early retirement supplement is the amount which,when added to your Life Income Benefit (unreduced forsurvivorship) and Temporary Benefit (if applicable), willbring your total benefit payable under the Plan up to theamount listed in the table that follows.

Your Total Monthly Benefit Payable(Until Age 62 and One Month*)

Under the Plan for the FollowingMonths is shown here:

If Your 10/1/03 10/1/04 10/1/05 10/1/06Retirement Through Through Through andDate is 9/1/04 9/1/05 9/1/06 After

10/1/03 $2,805 $2,875 $2,950 $3,020and after

Your early retirement supplement begins when you retire andcontinues through the month following your 62nd birthday*.

If you are receiving the early retirement supplement andyou become eligible to receive a Social Security disabilitybenefit or any other unreduced Social Security benefit,you must contact the Retirement Board office and advisethem of the award. The Social Security award reducesyour early retirement supplement by the amount of theTemporary Benefit that would have been payable to you ifyou had retired as a disability retiree under the Plan.

* or until you are eligible for 80% of your full SocialSecurity retirement benefit if you were born between 1/1/41 and 9/14/45.

If you have less than 30 years of credited service, youare eligible to receive an interim supplement.

The amount of your interim supplement is:

Your years of credited service

timesyour interim supplement rate

Your interim supplement rate depends on your age whenyou retire. The following table shows the interim supple-ment rate payable at retirement as well as the increasesoccurring during the term of the 2003 Agreement:

Monthly interim supplement rate forRetirements effective 10/1/03 and later

If You 10/1/03 10/1/04 10/1/05 10/1/06Retire Through Through Through andat age 9/1/04 9/1/05 9/1/06 After

55 $20.10 $20.70 $21.35 $21.9056 $23.75 $24.45 $25.20 $25.8557 $28.70 $29.50 $30.45 $31.2558 $33.65 $34.60 $35.70 $36.60

59 $37.55 $38.60 $39.85 $40.8560-61 $43.45 $44.70 $46.10 $47.30

If you retire between the ages shown in the table, your in-terim supplement rate will be prorated based on whole months.

Your interim supplement begins at retirement and contin-ues through the month following your 62nd birthday*. Ifyou become eligible to receive a Social Security disabilitybenefit or other Social Security benefit not reduced be-cause of your age, you must notify the Retirement Boardto stop the interim supplement.

It’s important to remember that even though you may be-come disabled after you’ve retired and received paymentsfrom the Plan, you cannot switch from Regular Early Re-tirement to Disability Retirement.

Discharged EmployeesA discharged employee under age 62 at the time of dis-charge is not eligible to receive a Supplemental Allowance.

Retirement Plan 149

* or until you are eligible for 80% of your full SocialSecurity retirement benefit if you were born between1/1/41 and 9/14/45.

Maximum monthly benefitIf you retire before you attain age 62 and one month, yourtotal monthly benefit (your Life Income Benefit and anySupplemental Allowance) may not exceed 80% of yourmonthly base earnings. If your total benefit otherwise wouldexceed the 80% ceiling, your Supplemental Allowance (butnot your Life Income Benefit) will be reduced by an amountnecessary to provide you with a total monthly benefit equalto 80% of your monthly base earnings.

Your monthly base earnings equal 1731/3 times your high-

est straight-time hourly rate in effect for you during the90 calendar days immediately preceding your last dayworked, plus the cost-of-living allowance in effect onyour last day worked.

If you return to workIf you return to work for the Company after you retire, youwill continue to receive your Life Income Benefit and Spe-cial Age 65 Benefit (if any). You will not, however, receivea Supplemental Allowance or earn additional service cred-its during your reemployment.

An example of monthly Regular Early Retirement benefitspayable before age 62 with less than 30 years of credited serviceYour monthly retirement benefit would be calculated asfollows if:

• You retired at age 60 on April 1, 2004 with 24 years ofcredited service

• Your Benefit Class Code is B and• Your spouse is three years younger than you.

At Retirement At Age 62* At Age 65

Life IncomeBenefit $ 948.84 $ 990.35 $1,011.11

InterimSupplement $1,042.80 — —

Special Age65 Benefit — — $1,076.20

Your Benefit $1,991.64 $ 990.35 $1,087.31Survivor Benefit $ 616.74 $ 643.72 $ 657.22

$48.00 (Life Income Benefit rate) x 24 (years of creditedservice) x 86.7% (early retirement factor) x 95%(Survivorship Coverage adjustment). The benefit amountwould be $998.78 ($48.00 x 24 x 86.7%) without theSurvivorship Coverage.

$43.45 (interim supplement rate for retirement at age 60) x24 (years of credited service).

$50.10 (Life Income Benefit rate) x 24 (years of creditedservice) x 86.7% (early retirement factor) x 95%(Survivorship Coverage adjustment). The benefit amountwould be $1,042.48 ($50.10 x 24 x 86.7%) without theSurvivorship Coverage.


Equals 65% of the Life Income Benefit amount after applyingthe early retirement factor and the Survivorship Coverageadjustment. The monthly Special Age 65 Benefit will beadded to the surviving spouse benefit when such spousereaches age 65.

$51.15 (Life Income Benefit rate) x 24 (years of creditedservice) x 86.7% (early retirement factor) x 95% (Survi-vorship Coverage adjustment). The benefit amount wouldbe $1,064.32 ($51.15 x 24 x 86.7%) without the Survi-vorship Coverage.

150 Retirement Plan

An example of monthly Regular Early Retirement benefits payablebefore age 62 with 30 or more years of credited service

Your monthly retirement benefit would be calculated asfollows if:• You retired at age 60 on April 1, 2004 with 30 years of

credited service• Your Benefit Class Code is B• Your spouse is three years younger than you


Life IncomeBenefit $1,176.48 $1,427.85 $1,457.77

Early RetirementSupplement $1,556.52 — —

Special Age 65Benefit — — $ 76.20

Your Benefit $2,733.00 $1,427.85 $1,533.97Survivor Benefit $ 889.20 $ 928.10 $ 947.55

$48.00 (Life Income Benefit rate) x 30 (years of creditedservice) x 86.7% (early retirement factor) minus $72.00($48.00 x 30 x 5%) (amount of Survivorship Coverageadjustment based on the unreduced benefit that would bepayable if then age 62). The benefit amount would be$1,248.48 ($48.00 x 30 x 86.7%) without the SurvivorshipCoverage.


$2,805.00 (scheduled total benefit amount before age62) minus $1,248.48 (Life Income Benefit beforeSurvivorship Coverage adjustment) = $1,556.52 EarlyRetirement Supplement.


Equals 65% of the Life Income Benefit amount after theSurvivorship Coverage adjustment that was or would havebeen payable at age 62 or death. The monthly Special Age65 Benefit will be added to the surviving spouse benefitwhen such spouse reaches age 65.


An example of monthly Regular Early Retirement benefits pay-able after age 62

Your monthly retirement benefit would be calculated asfollows if:• You retired at age 62 and one month* on April 1, 2004

with 30 years of credited service• Your Benefit Class Code is B• Your spouse is three years younger than you

At SSAAt Retirement 80% Date At Age 65


Early RetirementSupplement $1,365.00 — —


Your Benefit $2,733.00 $1,397.93 $1,533.98Survivor Benefit $ 889.20 $1,908.66 $1,947.56

$48.00 (Life Income Benefit rate) x 30 (years of credited service) x 95% (Survivorship Coverage adjustment). The benefit amount would be $1,440.00 ($48.00 x 30) without the Survivorship Coverage.


On the date you are eligible to receive 80% of your fullSocial Security benefit, your Early Retirement Supplementwill be discontinued.

$51.15 (Life Income Benefit rate) x 30 (years of creditedservice) x 95% (Survivorship Coverage adjustment). Thebenefit amount would be $1,534.50 without theSurvivorship Coverage.


Equals 65% of the Life Income Benefit amount after theSurvivorship Coverage adjustment. The monthly SpecialAge 65 Benefit will be added to the surviving spouse benefitwhen such spouse reaches age 65.

* or until you are eligible for 80% of your full Social Securityretirement benefit if you were born between 1/1/41 and9/14/45.

Retirement Plan 151

What is Special Early Retirement?

Special Early Retirement is a benefit paid if you retireunder certain circumstances with 10 years of cred-ited service.

EligibilityYou are eligible to receive Special Early Retirement ben-efits if you:• Retire when you are between age 55 and 65 and have

at least 10 years of credited service• Retire under mutually satisfactory conditions• Have seniority immediately before retirement

• Have been laid off due to a plant closing or discontinu-ance of operations

Beginning October 1, 1984 you also are eligible for SpecialEarly Retirement if you:• Retire when you are at least age 50 and have at least

10 years of credited service• Have been laid off because of a plant closing and no

other plants are in the same labor market as definedunder preferential placement, or beginning October 1,1987, as defined by the State Employment SecurityCommission in the state where the plant is located.(Under this provision, the date of the layoff and plantclosing both must occur on or after October 1, 1984.)

Benefit amountYour benefits at Special Early Retirement may be madeup of a Life Income Benefit, a Temporary Benefit, aSupplemental Allowance and a Special Age 65 Benefit.The Special Age 65 Benefit is described later in the “Whatis the Special Age 65 Benefit?” section.

Survivorship coverage and related payment methods aredescribed in the “What are your survivorship coverageoptions?” section.

Your Life Income BenefitYour Life Income Benefit is determined using the formulashown in the “How is your Life Income Benefit calculated?”section. There is no reduction in benefits because of age.

Temporary BenefitA Temporary Benefit also is payable at Special Early Re-tirement. This benefit begins when you retire and contin-ues through the month following your 62nd birthday*. How-ever, if you become eligible to receive a Social Securitydisability benefit or other Social Security benefit not re-duced because of your age, you must notify the Retire-ment Board to stop the Temporary Benefit.

Your Temporary Benefit is based on this formula:

Your Temporary Benefit ratetimes

your years of credited service(up to 30 years)

Your monthly Temporary Benefit rate is based on the dateyou retire, as shown here, and does not increase duringthe term of the contract.

If your Your MaximumRetirement Your Temporary Monthly Temporarydate is: Benefit Rate is: Benefit is:

10/1/03 through $45.75 $1,372.509/1/04

10/1/04 through $47.05 $1,411.50 9/1/05

10/1/05 through $48.50 $1,455.00 9/1/06

10/1/06 and later $49.80 $1,494.00

Supplemental AllowanceYou also may receive an early retirement supplement ifyou have at least 30 years of credited service and if yourunreduced Life Income Benefit combined with yourTemporary Benefit does not exceed the applicable 30-and-out benefit.


152 Retirement Plan

Maximum monthly benefitIf you retire before you have reached age 62 and onemonth*, your total monthly benefit (Life Income Benefitand any Temporary Benefit, whether payable or not, andSupplemental Allowance) may not exceed 80% of yourmonthly base earnings.

If your total benefit otherwise would exceed the 80% ceiling,only your Supplemental Allowance (but not your Life IncomeBenefit or your Temporary Benefit) will be reduced by anamount necessary to provide you with a total monthly ben-efit equal to 80% of your monthly base earnings.

Your monthly base earnings equal 1731/3 times your high-est straight-time hourly rate in effect for you during the90 calendar days immediately preceding your last dayworked plus the cost-of-living allowance in effect on yourlast day worked.

If you return to workIf you return to work for the Company after you retire, youwill continue to receive your Life Income Benefit, TemporaryBenefit and Special Age 65 Benefit (if any). You will not,however, receive a Supplemental Allowance or earnadditional service credits during your reemployment.

An example of monthly Special Early Retirement benefits payablebefore age 62 with less than 30 years of credited service

Your monthly retirement benefit would be calculated asfollows if:• You retired at age 60 on April 1, 2004 with 25 years of




TemporaryBenefit $1,143.75 — —




$45.75 (Temporary Benefit rate) x 25 (years of creditedservice). The Temporary Benefit is payable until you be-come eligible for a Social Security disability benefit (orother Social Security benefit not reduced because of yourage) or until one month after you attain age 62, whicheveris earlier*.






Retirement Plan 153

What is Disability Retirement?

A Disability Retirement is a benefit that you may beeligible for if you have 10 years of credited serviceand become totally and permanently disabled.

EligibilityYou are eligible to receive Disability Retirement benefits ifyou have seniority when you meet the following requirements:• Are under age 65• Have at least 10 years of credited service• Have been totally and permanently disabled for at least

five months

Under special circumstances your surviving spouse maybe eligible for the survivor’s benefit if you have appliedfor disability retirement but do not live for the five monthsnormally required for disability retirement. (For additionalrequirements, see the survivorship section.)

If you are eligible for benefits under the Guaranteed In-come Stream (GIS) Benefit Program, you may retain youreligibility for Disability Retirement even though you haveincurred a break in seniority.

Definition of disabilityYou are considered totally and permanently disabled underthe Plan if the Retirement Board determines that:• You have an injury or disease that prevents you from

engaging in any regular occupation or employmentwith the Company at the plant or plants where youhave seniority

• You are not engaged in any regular occupation or employ-ment for pay or profit (unless for purposes of rehabilitation)

• Your disability is considered to be permanent and con-tinuous for your lifetime

You will be required to have a medical exam to prove yourinitial disability. Other medical exams may be required fromtime to time to prove your continuing disability.

Incapacity resulting from service in the armed forces ofany country is not covered by the Plan unless you accu-mulate at least five years of seniority after separation frommilitary service and before incapacity occurs.

You will not receive a disability retirement benefit in any monthyou are receiving weekly Accident and Sickness benefitsfor the entire month under any plan to which the Companyhas contributed. If you are receiving Accident and Sicknessbenefits for part of the month, you will be paid a proportion-ate amount of your disability retirement benefit.

Benefit AmountYour benefits at Disability Retirement may be made up ofa Life Income Benefit, a Temporary Benefit, a SupplementalAllowance and a Special Age 65 Benefit. The Special Age65 Benefit is described later in the “What is the SpecialAge 65 Benefit?” section.Survivorship options and related payment methods are de-scribed in the “What are your survivorship options?” section.

Your Life Income BenefitYour Life Income Benefit is determined using the formulashown in the “How is your Life Income Benefit calculated?”section. There is no reduction in benefits because of age.

Temporary BenefitA Temporary Benefit is payable at Disability Retirementonly if you provide evidence that you have applied forSocial Security disability benefits and your applicationwas denied.

This benefit begins when you retire and continues throughthe month following your 62nd birthday*. If you becomeeligible to receive a Social Security disability benefit orother Social Security benefit not reduced because of yourage, your Temporary Benefit stops.

Your Temporary Benefit is based on this formula:

Your Temporary Benefit ratetimes

your years of credited service(up to 30 years)

Your monthly Temporary Benefit rate is based on the dateyou retire, as shown in this table and does not increaseduring the term of the contract.

If your Your MaximumRetirement Your Temporary Monthly Temporarydate is: Benefit Rate is: Benefit is:

10/1/03 through $45.75 $1,372.509/1/04

10/1/04 through $47.05 $1,411.50 9/1/05

10/1/05 through $48.50 $1,455.00 9/1/06

10/1/06 and later $49.80 $1,494.00


154 Retirement Plan

Supplemental AllowanceYou also may receive an early retirement supplement ifyou have at least 30 years of credited service and if yourunreduced Life Income Benefit combined with your Tem-porary Benefit does not equal the applicable 30-and-outbenefit. The Plan assumes you receive a Temporary Ben-efit even if no Temporary Benefit is payable because youare eligible for Social Security disability benefits.

Any Supplemental Allowance or Temporary Benefit youreceive after you become eligible for a Social Securitydisability benefit or other Social Security benefit not re-duced because of your age will be recovered from yourfuture Life Income Benefit. If you notify the RetirementBoard within 15 days after your receipt of a retroactiveSocial Security disability award, the amount of overpay-ment of any temporary benefit or supplement for the ear-lier period will be reduced by the attorney fees awarded bySocial Security for a successful appeal not exceeding 25%of the award. You will need to pay the Board within 30days of written notice of the award of the net overpay-ment, however.

Maximum monthly benefitIf you retire before you have reached age 62 and onemonth, your total monthly benefit (Life Income Benefit andany Temporary Benefit, whether payable or not, and Supple-mental Allowance) may not exceed 80% of your monthlybase earnings.

If your total benefit otherwise would exceed the 80% ceiling,only your Supplemental Allowance (but not your Life IncomeBenefit or your Temporary Benefit) will be reduced by anamount necessary to provide you with a total monthly ben-efit equal to 80% of your monthly base earnings.

Your monthly base earnings equal 1731/3 times your highest

straight-time hourly rate in effect for you during the 90 calen-dar days immediately preceding your last day worked plusthe cost-of-living allowance in effect on your last day worked.

How long do payments continue?Disability Retirement benefits end when you no longer meetthe requirements for total and permanent disability or whenyou reach age 65, whichever is earlier. After age 65, you willreceive normal retirement benefits . This will be done auto-matically. You will not be notified of this change.

If you return to workThe Retirement Board of Administration determines if adisability retiree may return to work for the Company. Ifyour disability ends before age 65 and you are approvedto return to work, your retirement benefit will stop. You willreceive service credits earned both before and after yourDisability Retirement but not during the period of your re-tirement. Your Disability Benefit will also stop if you arefound to be in gainful employment outside the Company.

Retirement Plan 155

An example of monthly disability retirement benefits payable ator after age 55 with less than 30 years of credited serviceYour monthly retirement benefit would be calculated asfollows if:• You retired at age 60 on April 1, 2004 with 25 years of




TemporaryBenefit $1,143.75 — —



$48.00 (Life Income Benefit rate) x 25 (years of credited service) x95% (Survivorship Coverage adjustment). The benefit amount wouldbe $1,200.00 ($48.00 x 25) without the Survivorship Coverage.

$45.75 (Temporary Benefit rate) x 25 (years of creditedservice). The Temporary Benefit is payable until youbecome eligible for a Social Security disability benefit (orother Social Security benefit not reduced because of yourage) or until one month after you attain age 62, whicheveris earlier*.

$50.10 (Life Income Benefit rate) x 25 (years of credited service) x95% (Survivorship Coverage adjustment). The benefit amount wouldbe $1,252.50 ($50.10 x 25) without the Survivorship Coverage.




An example of monthly disability retirement benefits payablebefore age 55 with less than 30 years of credited serviceYour monthly retirement benefit would be calculated asfollows if:

• You retired at age 50 on April 1, 2004 with 25 years ofcredited service

• Your Benefit Class Code is B• Your spouse is the same age as you

At Retirement At Age 55 At Age 62* At Age 65

Life IncomeBenefit $ 1,051.20 $1,214.82 $ 1,214.82 $ 1,214.82

TemporaryBenefit $ 1,143.75 $ 1,143.75 — —

SpecialAge 65Benefit — — $ 76.20

Your $2,194.95 $2,358.57 $1,214.82 $1,291.02Benefit

Survivor $ 525.60 $ 789.64 $ 789.64 $ 789.64Benefit

$48.00 (Life Income Benefit rate) x 25 (years of creditedservice) x 87.6% (Special Disability Survivorship Coverageadjustment). The benefit amount would be $1,200.00 ($48.00x 25) without the Special Disability Survivorship Coverage.

$45.75 (Temporary Benefit rate) x 25 (years of creditedservice). The Temporary Benefit is payable until youbecome eligible for a Social Security disability benefit (orother Social Security benefit not reduced because of yourage) or until one month after you attain age 62, whicheveris earlier*.



Equals 50% of the Life Income Benefit amount after theSpecial Disability Survivorship Coverage adjustment;payable to the surviving spouse after the retired employeewould have reached age 55 (assuming the retiree diedbefore reaching age 55). The monthly Special Age 65Benefit will be added to the surviving spouse benefit whenthe spouse reaches age 65.

Equals 65% of the Life Income Benefit amount after theSurvivorship Coverage adjustment. The monthly Special Age65 Benefit will be added to the surviving spouse benefit whensuch spouse reaches age 65. (Medicare Part B $76.20)

* or until you are eligible for 80% of your full Social Security retirementbenefit if you were born between 1/1/41 and 9/14/45.

156 Retirement Plan

What are your survivorship coverage options?

There are three automatic and two optionalsurvivorship coverage options under the Plan.

If you are legally unmarried, the automatic or optional sur-vivorship coverage does not apply to you. Otherwise, thePlan offers three automatic payment options—the Survi-vorship Coverage, the Special Disability SurvivorshipCoverage and the Pre-Retirement Survivorship Coverage.

The Payment Option in If you are married foreffect for you is the: at least one year and are:

Survivorship • Receiving retirement benefitsCoverage (including deferred vested benefits) or

eligible for Regular Early orNormal Retirement or between age 50and age 55 and eligible for immediateSpecial Early Retirement

• At least age 55 on Disability Retirementor have 30 or more years creditedservice at Disability Retirement

Special Disability • On Disability Retirement andSurvivorship • Under age 55 and have less than 30Coverage years credited service

Pre-Retirement • An employee with 5 years creditedSurvivorship service or ERISA ServiceCoverage (10 such years if you don’t

accrue service after 1988)• A former employee with 5 years

credited service or ERISA Service(10 such years if you don’taccrue service after 1988)

• Not eligible for the SurvivorshipCoverage or the Special DisabilitySurvivorship Coverage

If you are married and want your benefit paid for yourlifetime only, you can reject the applicable option shownabove. Your spouse must agree to this decision by giv-ing written consent witnessed by a Plan representativeor notary public.

Keep in mind that if you are married for less than oneyear at the time of your retirement, you will have nosurvivorship coverage in effect until your first weddinganniversary. At that time, you will be appropriately cov-ered under the Survivorship Coverage or the SpecialDisability Survivorship Coverage, unless you and yourspouse elect otherwise.

What is the Special Age 65 Benefit?

Special Age 65 is a benefit payable to retirees andsurviving spouses who are at least age 65, receivingretirement benefit and enrolled in Medicare Part B.

A Special Age 65 Benefit is included in your retirementcheck when you are receiving a retirement benefit (otherthan a deferred vested benefit), you are at least age 65and enrolled in Medicare Part B. Although included in yourretirement check, the Special Age 65 Benefit is a healthbenefit and is funded through the health plans.

In some circumstances, you may be eligible to receive aSpecial Age 65 Benefit before you are age 65. You mustapply for this benefit. To be eligible you must be enrolledfor voluntary medical insurance under Medicare, commonlyknown as Medicare Part B.

Commencing on or after January 1, 2004, the monthlyage 65 benefit is the lesser of $76.20 or the applicableMedicare Part B premium.

Your surviving spouse who is at least age 65 may receivea Special Age 65 Benefit when he or she is receiving aretirement benefit and is enrolled in Medicare Part B (otherthan a surviving spouse benefit payable as a result of adeferred vested benefit or a pre-retirement survivor ben-efit). Surviving spouses must be enrolled or enroll forMedicare Part B when first eligible to continue companypaid health care.

Retirees eligible for Medicare Part B must enroll and main-tain continued enrollment in Medicare Part B to be eligibleto receive the Special Age 65 Benefit. Proof of Part Bparticipation may be required.

Retirement Plan 157

The Survivorship CoverageWith this coverage, you receive an income for life andyour surviving spouse receives continuing income in theevent of your death.

If you are otherwise eligible for Normal or Regular EarlyRetirement, your spouse will be eligible for this survivorbenefit as though you retired on regular early or normalretirement at death. You must have been married to yourspouse for one year at the time of your death.

Your spouse’s benefit is based on your Life Income Ben-efit if you are at least age 62 at the time of your death.Otherwise, it is based on the Life Income Benefit thatwould have been payable to you at age 62 had you re-tired on regular early or normal retirement on the date ofyour death.

There is a reduction made in your Life Income Benefitpaid during your lifetime to provide this survivor protec-tion. If you and your spouse are within five years of eachother’s age, the reduction is 5%. This percentage reduc-tion will vary by one-half percent for each year more thanfive that your spouse is younger or older than you.

To illustrate:

You are paid thispercentage of your lifeincome benefit to account

If your spouse is: for the survivorship coverage:

10 years younger than you 92 1/2 %9 years younger than you 93%8 years younger than you 931/2 %7 years younger than you 94%

6 years younger than you 941/2 %The same age as you and up to6 years younger or older 95%6 years older than you 951/2 %7 years older than you 96%

8 years older than you 961/2 %9 years older than you 97%

10 years older than you 971/2 %

Note: The percentage may never exceed 100%.

These reductions in your benefit are effective on thelatest of:• Your retirement date• The first day of the month following your first wedding

anniversary if married less than one year at retirement• Your 55

th birthday, if you are on Disability Retirement

before age 55 with less than 30 years of credited service

After your death, 65% of your reduced Life Income Benefitwill be paid each month to your spouse. This amount doesnot include any Temporary Benefit or SupplementalAllowance that was payable to you.

Survivor benefits begin on the first day of the monthfollowing your death and receipt of an application fromyour surviving spouse. However, if you are between age50 and age 55 when eligible for immediate Special EarlyRetirement but die before you retire or before benefitpayments begin, your spouse will be eligible for a survivorbenefit beginning when you would have reached age 55as though you retired on Regular Early Retirement.

Your spouse will not receive a benefit in any month he orshe is receiving a Transition or Bridge Survivor IncomeBenefit under the Life and Disability Insurance Program.

Your Life Income Benefit will be restored to the amountpayable without the survivorship election if:• Your spouse dies before you do and you submit a

cer tif ied copy of the death cer tif icate to theRetirement Board

• You are divorced, the divorce decree does not prohibitcancellation of the Survivorship Coverage, and youcancel your election, unless a qualified domesticrelations order provides otherwise, or you obtain writtenconsent from your former spouse

The increase will be effective the first of the month afteryou submit proper notice and proof of death or final decreeof divorce to the Retirement Board.

You may elect a Survivorship Coverage if you marry orremarry after retirement and you:• Are receiving retirement benefits other than deferred

vested benefits• Have not previously rejected the Survivorship Coverage• Do not have any survivorship coverage in effect• Apply before you have been married eighteen months

The amount of your benefit reduction and the percentagethat will be payable to your spouse will be determined byPlan provisions in effect at the time of your retirement.

158 Retirement Plan

Pre-Retirement Survivorship CoverageIf you should die as an employee or former employee andyou are not eligible for Regular Early or Normal Retirement,the Pre-Retirement Survivorship Coverage may apply.

This option is automatic for employees and becomeseffective when you have 5 years of credited service orERISA Service (10 such years if you don’t accrue serviceafter 1988). If you leave the Company and were eligiblefor the option at the time you left, the Pre-RetirementSurvivorship Coverage continues in effect until yourretirement benefit begins.

Benefit amountIf you die while the Pre-Retirement Survivorship Cover-age is in effect, a monthly benefit will be paid to yoursurviving spouse.

The amount paid to your surviving spouse will be 50% ofyour Life Income Benefit. Your Life Income Benefit is basedon the rate in effect at the time of your death. If you havea break in seniority prior to your death, the Life IncomeBenefit will be paid at the rate in effect at the time of thebreak in seniority.

When payments beginWhether you are an employee or former employee, if youdie before age 55, benefits begin on the first day of themonth following application by your surviving spouse, butin no event before the month following the day you wouldhave reached age 55.

If you broke seniority before age 55 but die after age55, benefits start on the first day of the month followingyour death and receipt of an application from your sur-viving spouse.

Your surviving spouse will receive monthly benefits forlife. If the present cash value of your surviving spouse’sretirement benefit is less than $3,500, however, he or shewill receive the benefit in a single lump sum.

If the lump sum payment is at least $200, your survivingspouse may elect to have any portion of the distributionpaid directly to an IRA or his or her tax-qualified Plan. If adirect rollover is not elected, the taxable portion of thedistribution will be subject to mandatory 20% federalincome tax withholding.


The Special Disability Survivorship CoverageWith this coverage, you receive an income for life andyour surviving spouse receives an income in the event ofyour death, if married twelve months. This option remainsin effect until you have reached age 55.

There is a reduction made in your Life Income Benefit toprovide the Special Disability Survivorship Coverage. Thereduction is based on your age and your spouse’s age, asshown for selected ages in the table below:

You are paid this percentage of yourLife Income Benefit to account forthe Special Disability SurvivorshipCoverage if your spouse is:

Your agewhen Disability 5 years Same 5 yearsBenefits begin younger Age older50 86.8% 87.6% 88.6%40 88.2% 89.0% 90.0%30 91.9% 92.5% 93.3%

If you die while this option is in effect, and have beenmarried for twelve months, 50% of your reduced Life In-come Benefit will be paid for the lifetime of your spouse.Payments will begin on the first of the month following themonth you would have been age 55.

For your spouse to receive benefits, you must be marriedat retirement and for at least one year as of the date ofyour death.


Remember, this option remains in effect only until you havereached age 55. When you have reached age 55, the reduc-tion in your Life Income Benefit for the Special DisabilitySurvivorship Coverage will cease. At that time if you aremarried, you will be covered by the Survivorship Coverageunless you and your spouse reject the coverage.

If prior to your becoming age 55 your spouse dies or youbecome divorced, the provisions regarding cancellationdescribed earlier would apply.

Under the following circumstances, your survivingspouse will be eligible for the survivor’s benefit of a dis-ability retiree if you have applied for disability retire-ment but do not live for the five months normally re-quired for disability retirement.• You must be on a medical leave of absence (except in the

case of an occupational illness or injury) for at least onemonth and have applied for disability retirement. If anoccupational illness or injury, or terminal illness results indeath, then the one month waiting period does not apply.

• Satisfactory medical evidence must be provided to theRetirement Board to support that your death wasdirectly or indirectly the result of the medical conditionwhich gave rise to the medical leave of absence(excluding death as a result of homicide, suicide, oraccidental death), or be the result of an occupationalaccident or injury.

Retirement Plan 159

Optional forms of survivorship coverageBeginning January 1, 2004, you can elect someone otherthan a spouse for a survivor’s benefit. If you are married,your spouse must consent to this election in writing andhave their consent witnessed by a notary. You can alsoelect your spouse for one of these optional survivor ben-efits, but generally the automatic options provide morevalue for you and your spouse over your lifetimes.

Optional 50% Surviving Beneficiary benefitThis option provides you a reduced monthly benefit forlife and 50% of your benefit to a beneficiary of choiceupon your death. The reduction in your benefit is based onyour age and your beneficiary’s age. The reduction factorsare greater than those used in the Automatic SurvivorshipCoverage Options described earlier.

This option is available to members who apply for Normal,Regular Early, Special Early or Deferred Vested retirement.This option cannot be elected after retirement benefitscommence and is not available to employees who applyfor Disability Retirement. Further, this option cannot becanceled due to death of the beneficiary or divorce if electedfor a spouse.

Optional 100% Surviving Beneficiary benefitThis option provides you with a reduced monthly benefitfor life and up to 100% of your benefit to a beneficiary ofchoice upon your death. The reduction in your benefit isgreatest under this method because a greater percentageof your benefit will continue to be provided to a survivorafter your death.

This option is available to members who apply for Normal,Regular Early, Special Early or Deferred Vested retirement.This option cannot be elected after retirement benefitscommence and is not available to employees who applyfor Disability Retirement. Further, this option cannot becanceled due to death of the beneficiary or divorce ifelected for a spouse.

If the beneficiary you elect is up to 10 years younger thanyou, or is your spouse, 100% of your reduced benefit willbe payable to your beneficiary upon your death for theirlifetime. If your beneficiary is not your spouse and is 11 ormore years younger than you, the percentage yourbeneficiary will receive is regulated by the Internal RevenueCode (Section 1.40(a)(9) - 6T A-2(c)(2)). An example ofthe percentage payable to a beneficiary under thissurvivorship option is illustrated as follows:

NON SPOUSE 100% CONTINGENT ANNUITANTPERCENTAGE FOR BENEFICIARY MORE

THAN 10 YEARS YOUNGER

Beneficiary Years Younger Permitted Percentage for Than Participant Beneficiary

10 or less years younger 100%

11 years younger 96%

12 93%

13 90%

14 87%

15 84%

16 82%

17 79%

18 77%

19 75%

20 73%

21 72%

22 70%

23 68%

24 67%

25 66%

26 64%

27 63%

28 62%

29 61%

30 60%

31 59%

32 59%

33 58%

34 57%

35 56%

36 56%

37 55%

38 55%

39 54%

40 54%

41 53%

42 53%

43 53%

44 and greater 52%

160 Retirement Plan

Early receipt of deferred vested benefitsIf you choose to begin payments before age 65, your LifeIncome Benefit will be reduced. The amount of the reduc-tion depends on the number of years and months youreceive payments before age 65 as shown in the table:

Age when Deferred Percentage of LifeVested Benefit begins: Income Benefit payable:

64 93.3%63 86.7%62 80.0%61 73.3%

60 66.7%59 60.7%58 55.4%57 50.6%

56 46.4%55 42.5%

If you retire between the exact ages shown in the table,the percentage of the Life Income Benefit payable will bepro-rated based on whole months.

If you had a break in seniority after June 1, 1955 but be-fore October 1, 2003, your eligibility for deferred vestedbenefits and the benefit amount will be based on the Planprovisions in effect at the time of your break.

What is a deferred vested benefit?

If you leave the Company for reasons other thanretirement, you may be eligible for a deferredvested benefit.

EligibilityYou are eligible to receive a deferred vested benefit if youhave a break in seniority and you:

• Have at least 5 years of credited service under the Plan,5 years of ERISA Service (described later in thissection) or 10 such years if you don’t accrue serviceafter 1988

• Are not eligible for any other retirement benefit underthe Plan

Benefit amountYour deferred vested benefit is calculated as follows:

The Life Income Benefit ratefor a deferred vested benefit

based on the date of your break in senioritytimes

your years of credited service

Keep in mind that years of ERISA Service may be usedto determine your eligibility for a benefit, but to determinethe amount of your Life Income Benefit, years of creditedservice as defined under the Plan are used.

The Life Income Benefit rates for deferred vested benefitsare:

If the date The Life Incomeyou have Benefit Rate fora break in And your Benefit your Deferredseniority is: Class Code is: Vested Benefit is:

10/1/03 through A $47.459/30/04 B $48.00

C $48.25D $48.50

10/1/04 through A $48.80 9/30/05 B $49.05

C $49.30D $49.55

10/1/05 through A $49.85 9/30/06 B $50.10

C $50.35D $50.60

10/1/06 and later A $50.90B $51.15C $51.40D $51.65

A reduced benefit can begin as early as age 55—as longas you make application at least 90 days before you wantpayments to start.

Retirement Plan 161

Survivorship coverageIf you are legally unmarried, the automatic survivorshipcoverage does not apply to you but you may elect one ofthe optional forms for someone other than a spouse. Ifyou are married for at least one year when you begin re-ceiving deferred vested benefits, the Plan automaticallyprovides the Survivorship Coverage.

You can reject the automatic Survivorship Coverage andchoose to have a monthly benefit during your lifetime withpayments stopping at your death, or you may elect one ofthe optional survivorship options. Your spouse must agreeto this decision, however, by giving written consent wit-nessed by a Plan representative or notary public.

A special Pre-Retirement Survivorship Coverage pro-tects your spouse before you begin receiving deferredvested benefits.

The Pre-Retirement Survivorship Coverage is in effectautomatically for vested employees. If you left the Com-pany and the Pre-Retirement Survivorship Coverage wasin effect at the time you left, it continues in effect (regard-less of age) until your Plan benefit begins.

More information about both survivorship coverages is in the“What are your survivorship coverage options?” section.

ERISA ServiceIf you leave the Company before you have earned 5 yearsof credited service under the Plan (10 years of such ser-vice if you don’t accrue service after 1988), you will beeligible to receive a deferred vested benefit if you have 5years of ERISA Service (10 years of such service if youdon’t accrue service after 1988). Your benefit amount, how-ever, will be based on your years of credited service un-der the Plan.

You are eligible to be credited with ERISA Service whenyou have completed one year of service and are then atleast age 21 (age 25 prior to January 1985).

You earn a year of ERISA Service for all years you’ve workedat least 750 regular time hours for the Company except:• Years of ERISA Service before age 18 (age 22 if you

have no credited service under the Plan after Decem-ber 31, 1984)

• Years of ERISA Service before January, 1971 unlessyou have at least three years of credited service underthe Plan after December 31, 1970

• Years before January, 1976 which would be lost underthe Plan’s break in seniority rules in effect on Decem-ber 31, 1975

• Years of ERISA Service before a one-year break inERISA Service until you complete one year of serviceafter the break; a one-year break in ERISA Service is acalendar year in which you do not complete 376 ERISAHours of Service; an ERISA Hour of Service meanseach regular time hour for which you are paid for theperformance of duties

• Years of ERISA Service before consecutive one-yearbreaks in ERISA Service which equal the greater offive or your aggregate years of ERISA Service beforethe break; (this provision applies to employees at workon or after January 1, 1985; prior to January 1, 1985,ERISA Service before a break that was equal to orgreater than your ERISA Service was not counted)

In determining whether you have an ERISA break, the fol-lowing will be counted as ERISA Hours of Service eventhough you’re away from work (on or after January 1, 1985)due to:• Your pregnancy• The birth of your child• Placement of a child with you for adoption• Caring for your child immediately following birth or

placement• Any reason that qualifies you for a leave under the Fam-

ily and Medical Leave Act of 1993, for absences com-mencing on or after September 17, 1993

Up to 376 hours for such absences will be counted toprevent a break in ERISA Service in the year in whichyour absence begins. If you don’t need any hours thatyear to reach 376, the hours will be credited to you thefollowing year to prevent a break if your absence contin-ues into that year.

162 Retirement Plan

Once your retirement benefit commences, and you havequestions, write or call:

Ford-UAW Retirement Board of AdministrationP.O. Box 6050Dearborn, Michigan 481211-800-829-8833

Be sure to include your Social Security number (or yourspouse’s Social Security number, if he or she is the em-ployee) on any correspondence.

Payments may be delayed if you do not keep the Retire-ment Board informed of your current mailing address.

If you disagree with the Board’s findings, you may make awritten request to the Plan Administrator for a review ofyour claim. A detailed discussion of what to do in thisevent is covered in the “Administrative and ERISA Infor-mation” section of the handbook.

How do you apply for a Retirement Plan benefit?

When you are ready to ret ire, the NationalEmployee Services Center (NESC) can help youfile an application.

Processing your application requires many steps. Thismeans you should apply for benefits at least 90 days be-fore you’d like payments to begin.

You must apply for benefits before any payments fromthe Plan can begin. To apply, you must contact the NESCat 1-800-248-4444 to obtain an application form 60 to90 days before you wish benefits to commence. Formsmust be signed and dated prior to the retirement effec-tive date and returned to the NESC on a timely basis.Applications signed after the effective date may be madeeffective the month following signature and may resultin a loss of benefits. If you need any information aboutthe Plan, you can call the NESC.

If you die before retirement, a Customer Service Repre-sentative at the NESC can help your surviving spouseapply for any benefits that may be due. The applicationmust be completed by your surviving spouse and returnedto the NESC before survivor benefits can commence.

Payment of benefits must be approved by theRetirement Board:• For disability retirements the Board must determine that

you meet the Plan’s eligibility requirements• For return to work applications by disability retirees the

Board must determine that your disability has endedand must approve your return to work

• Your benefits are effective the first day of the first monthafter you file your application, or later if you sign yourapplication after the effective date or voluntarily choosea later date for your benefit to commence

Your first payment normally will be made about six weeksafter your retirement date. Subsequent payments will bemailed by the first of each month and each is an advancepayment for that month.

You can make arrangements to have direct deposit orelectronic funds transfer of your pension check to a bankor other financial institution of your choice. You may changethese arrangements by advising the Retirement Board.

Retirement Plan 163

How are taxes paid on your Retirement benefits?

Your retirement benefits are taxed as you receive them.

When you receive benefits from the Plan, those benefitsare taxed as ordinary income.

Federal tax law requires the Company to withhold incometaxes from your benefits unless you tell the Company notto withhold tax. Whether or not you want tax withheld, youshould complete Forms W-4P and submit it to the Retire-ment Board. Forms W-4P are available from the NESC,the Retirement Board, a local office of the Internal Rev-enue Service or Comerica Bank.

If you do not submit any Forms W-4P, the Companyautomatically will withhold taxes from your benefits andwill assume you are married and claim three withhold-ing allowances.

If no taxes are withheld from your benefit, or if the amountwithheld is not enough to cover the actual taxes due, youmay be required to make estimated tax payments.

State tax withholding will apply in those states that requirewithholding. As with federal withholding, the Company willwithhold unless you tell the Company not to withhold stateincome tax. You may elect voluntary state tax withholdingin those states that permit voluntary withholding.

Who pays for Retirement benefits?

The Plan is non-contributory. This means the Com-pany pays for it and you don’t contribute.

The Company makes contributions to a special PensionFund. The amount of the Company’s contributions is deter-mined by an independent actuary in accordance with thefunding policy adopted by the Company. No portion of con-tributions to the Pension Fund or its assets is paid or setaside for the account or benefit of any individual employee.

The assets of the Pension Fund are held in a trust. Themoney in the trust can be used only to pay benefits andadministrative costs of the Plan and cannot be returnedto the Company until all benefits have been paid.

The trustee makes all payments from the Plan.Investments of the trust money are made by investmentmanagers appointed under the Ford Motor Company MasterTrust Fund. These investment managers are banks, trustcompanies and investment advisors. A portion of the Fundnot exceeding 10% may be invested by the Company.

164 Retirement Plan

Payment of small amountsIf the present cash value of your surviving spouse’sretirement benefit is less than $3,500, your spouse willreceive his or her benefit in a single lump sum.

If the lump sum payment is at least $200, your survivingspouse may elect to have any portion of the distributionpaid directly to an IRA or his or her tax-qualified Plan. If adirect rollover is not elected, the taxable portion of thedistribution will be subject to mandatory 20% federalincome tax withholding.

Assignment of benefits and deductionsYour retirement benefits cannot be assigned, transferred,pledged, sold or attached. The Plan honors QualifiedDomestic Relations Orders, however, in assigning benefitsunder a divorce settlement and applicable child supportpayments. Also, the trustee may be authorized by theRetirement Board and as approved by you to deduct BlueCross/Blue Shield payments, union dues, TESPHE loanrepayments, benefit plan overpayments or as required bylaw to deduct required taxes from your retirement benefits.Certain Workers’ Compensation payments are deducted,if you file the claim later than two years after retiring orafter breaking seniority.

If you or your spouse is incapacitatedIf the Retirement Board finds that any person to whom abenefit is payable is unable to handle his or her affairs,payments may be made to a duly appointed representa-tive as determined by the Retirement Board.

What circumstances might affect Retirement benefits?

Some circumstances could cause your benefits to bedenied, delayed or reduced.

The Plan is designed to provide you with a continuing in-come after active employment ends, but some situationscould affect Plan benefits. Those situations are summa-rized here.

If you leave the CompanyIf you leave the Company permanently for any reasonbefore age 65 and you have less than 5 years of creditedservice or ERISA Service (10 years of such service if youdon’t accrue service after 1988), no benefits are payableto you or your surviving spouse.

If you die• If the survivorship coverage is rejected, no benefits are

payable• If the survivorship coverage was elected, benefits may

be payable per Plan provisions

Applying for benefitsPayments will begin only after application is made andapproved. Until you apply for benefits and provide infor-mation requested by the Company or the Retirement Board,no payments will be made.

You may contact the National Employee Services Center(NESC) by writing or calling:

Ford National Employee Services CenterP.O. Box 6214Dearborn, Michigan 48121-62141-800-248-4444

Be sure to include your Social Security number (or yourspouse’s Social Security number, if he or she is the em-ployee) on any correspondence.

Retirement Plan 165

Can Plan provisions change?

Under certain circumstances, Plan provisions maychange. Those circumstances are explained here.

Neither the Company nor the UAW may amend or terminatethe Plan while the 2003 Agreement is in effect without theconsent of the other party. The Agreement expires onSeptember 14, 2007.

At that time, the Plan may be renewed automatically forsuccessive one-year periods, unless Ford or the UAW giveswritten notice at least 60 days before the applicableexpiration date. When such notice is given, the Agreementand Plan may be modified, amended or terminated.

The Pension Benefit Guaranty Corporation (PBGC)Benefits under this Plan are insured by the PensionBenefit Guaranty Corporation (PBGC) if the Planterminates. Generally, the PBGC guarantees mostvested normal retirement benefits, early retirementbenefits and certain disability and survivors’ pensions.The PBGC does not guarantee all types of benefits undercovered plans and the amount of benefit protection issubject to certain limitations.

The PBGC guarantees vested benefits at the level in effecton the date of plan termination. If a plan has been in effectless than five years before it terminates, or if benefitshave been increased within the five years before plantermination, the whole amount of the plan’s vested benefitsor the benefit increase may not be fully guaranteed.Further, there is a ceiling on the amount of monthly benefitthat PBGC guarantees, which is adjusted periodically.

For more information on the PBGC insurance protectionand its limitations, contact the Company or the PBGC.Inquiries to the PBGC should be addressed to theAdministrative Review and Technical Assistance Division,PBGC, 1200 K Street NW, Washington, D.C. 20005-4026.The PBGC also may be reached by calling (202) 326-4000.

How do you file a claim?

You have the right to file a claim if you do not agreewith the administration of your retirement benefit.

You may make a claim for benefits or participation bymaking a request in accordance with the Plan.

166 Retirement Plan

If the Plan Administrator or an employee of the Board ofAdministration determines that an extension of time forprocessing is required, written notice of the extension shallbe furnished to you prior to the termination of the initialninety (90) day period (forty-five (45) day period if theclaim is related to a disability pension claim). In no eventwill the extension exceed a period of ninety (90) days (ora period of thirty (30) days for disability pension claims)from the end of such initial period.In regard to a disability pension claim, if prior to the end ofthe first thirty (30) day period the Plan Administrator or anemployee of the Board of Administration determines thatdue to matters beyond control of the Plan, a decision can-not be rendered within that extension period, the periodfor making the determination may be extended for up toan additional thirty (30) days. The extension notice willindicate the special circumstances requiring an extensionof time and the date by which the Plan expects to renderthe determination.

If an extension is required because the information in thedisability claim is incomplete, the extension notice willspecifically explain:

• The standards on which entitlement is based;

• The unresolved issues that prevent a decision;

• The additional information required for a decision; and

• That you have at least forty-five (45) days to providethe information being requested.

If such additional information is required, the period be-tween the date of the request and the date of your re-sponse is not included when calculating the decisiondeadline.

What if a claim of benefits or participation is denied?

Denial of a claimIf a claim for benefits or participation is denied in whole orin part, the member will receive written notification fromthe Plan Administrator or an employee of the Board ofAdministration within ninety (90) days (within forty-five(45) days if the claim is related to a disability pensionclaim) from the date your claim for benefits or participationis received. The notice will be deemed given upon mailing,full postage prepaid in the United States mail or on thedate sent electronically to you.

The decision will be in writing and it will include:• The specific reason or reasons for the denial;• Reference to the specific Plan provisions on which the

denial is based along with a copy of the Plan provi-sions or a statement that one will be furnished at nocharge per your request;

• A description of any additional material or informationnecessary for you to perfect the claim and an explana-tion of why such material is necessary; and

• A description of the Plan’s review procedures and thetime limits applicable to such procedures, along with astatement of your right to bring a civil action under Sec-tion 502(a) of the Employee Retirement Income Secu-rity Act (ERISA) of 1974, as amended, following a denialfor benefits on review.

If the denial for benefits is because of a disability claim,the denial of the claim will be based on the following:• If an internal rule, guideline, protocol, or other similar

criterion was relied upon in making the claim denial,either the specific rule, guideline, protocol, or other simi-lar criterion; or a statement that such rule, guideline,protocol or other similar criterion that was relied uponin making the claim denial will be provided free of chargeto you at your request; and

• If the claim denial is based on a medical necessity orexperimental treatment or similar exclusion or limit, ei-ther an explanation of the scientific or clinical judgmentfor the determination, (applying the terms of the Planto your medical circumstances), or a statement thatthe explanation will be provided free of charge uponyour request.

Retirement Plan 167

Review of denial of disability pension claim to the Board ofAdministrationIn the event that the Plan Administrator or the Board ofAdministration denies a disability pension claim, you may:

• Request a review upon appeal by written application tothe full Board of Administration;

• Review pertinent documents; and

• Submit issues and comments in writing.

The Board of Administration must take into account allcomments, documents, records and other informationsubmitted by you relating to the claim, without regard towhether the information was submitted or considered inthe initial benefit determination.

You must request a review upon an appeal of the denial ofthe claim within one hundred eighty (180) days after youreceive the written notification of denial of the claim.

The Board of Administration:• Will give no deference to the earlier decision;• Will provide for review by a named fiduciary who did

not make the initial decisions and who is not a subordi-nate of the initial decision maker;

• If the decision involves a medical judgment, providethat named fiduciary must consult with a health careprofessional who is independent of any health care pro-fessional involved in the initial denial; and

• Provide for identification of all medical or other ex-perts consulted who have appropriate training and ex-perience in the field of medicine involved in the medi-cal judgment.

A decision, as appropriate, shall be made within forty-five(45) days after receipt of your request for review, unlessspecial circumstances require an extension of time forprocessing. One forty-five (45) day extension will be avail-able to the Board of Administration if necessary due tomatters beyond the control of the Plan and with writtennotice to you. The extension notice will specify the cir-cumstances requiring the extension and the expected dateof the determination. If an extension is required becausethe information is incomplete, the review period will betolled from the date the notice was sent to the date infor-mation is received. In the event an extension is needed,written notice of the extension will be provided to you priorto the commencement of the extension.

Review of denial of the claim (other than disability) to the Boardof AdministrationIn the event that the Plan Administrator or an employee ofthe Board of Administration denies a claim, you may:

• Request a review upon appeal by written application tothe full Board of Administration;

• Review pertinent documents; and• Submit issues and comments in writing.

The Board of Administration must take into account allcomments, documents, records and other informationsubmitted by you relating to the claim, without regard towhether the information was submitted or considered inthe initial benefit determination.

You must request a review upon an appeal of the denial ofthe claim within sixty (60) days after you receive the writ-ten notification of denial of the claim. It will be consideredat the Board of Administration’s next regularly scheduledmeeting. If it is filed within thirty (30) days of the nextmeeting, a decision by the Board of Administration will bemade by the date of the second meeting after receipt ofyour request for review. Under special circumstances anextension of time for processing may be required, in whichcase a decision will be rendered by the date of the thirdmeeting. If an extension is required because informationis incomplete, the review period will be adjusted from thedate the notice was sent to the date the complete infor-mation is received. In the event an extension is needed,written notice of the extension will be provided to you priorto the commencement of the extension.

Written notice of a decision will be made not any laterthan five (5) days after the Board of Administration hasmade a decision. The decision will be in writing and itwill include:• The specific reason or reasons for the denial;• Specific reference to pertinent Plan provisions on which

the denial is based along with a copy of the Plan provi-sions or a statement that one will be furnished at nocharge upon your request;

• A statement that you are entitled to receive, upon re-quest and free of charge, reasonable access to, andcopies of all documents, records and other informationrelevant to your claim for benefits; and

• A statement of your right to bring a civil action undersection 502(a) of the Employee Retirement Income Se-curity Act (ERISA) of 1974, as amended, following adenial for benefits on review.

168 Retirement Plan

The decision will be in writing and it will include:

• The specific reason or reasons for the claim denial;• Reference to the specific Plan provisions on which the

determination is based along with a copy of the Planprovisions or a statement that one will be furnished atno charge upon your request;

• A statement that you are entitled to receive, upon re-quest and free of charge reasonable access to, andcopies of all documents, records and other informationrelevant to your claim for benefits;

• A statement of your right to bring a civil action underSection 502(a) of the Employee Retirement Income Se-curity Act (ERISA) of 1974, as amended, following adenial for benefits on review;

• If an internal rule, guideline, protocol or other similarcriterion was relied upon in making the claim denial,either the specific rule, guideline, protocol or other similarcriterion; or a statement that such rule, guideline, pro-tocol or other similar criterion that was relied upon inmaking the claim denial will be provided free of chargeto you at your request;

• If the claim denial is based on a medical necessity orexperimental treatment or similar exclusion or limit, ei-ther an explanation of the scientific or clinical judgmentfor the determination, applying the terms of the Plan toyour medical circumstances or a statement that theexplanation will be provided free of charge upon yourrequest; and

• The following statement: “You and your Plan may haveother voluntary alternative dispute resolution options, suchas mediation. One way to find out what may be availableis to contact your local U.S. Department of Labor Officeand your State insurance regulatory agency.”

Such notice shall be deemed given upon mailing, full post-age prepaid in the United States mail of if providedelectronically to you.

Decision of the Retirement Board

Decisions of the Board of Administration are final and con-clusive and are only subject to the arbitrary and capriciousstandard of judicial review.

Limitations PeriodNo legal actions for benefits under the Plan may be broughtagainst the Plan until after the claims and appeal proce-dures have been exhausted. Unless the Employee Retire-ment Income Security Act (ERISA) of 1974, as amended,specifically provides a different period of limitations, legalactions under the Plan for benefits must be brought notlater than two (2) years after the claim arises. No otheraction may be brought against the Plan more than six (6)months after the claim arises.

169169

Supplemental Unemployment Benefit (SUB) Plan

After an overview of your SupplementalUnemployment Benefit (SUB) Plan, this sectionof your handbook answers these questions:

Page

Who is eligible for Regular Benefits? 170

Who is not eligible for Regular Benefits? 171

How are Regular Benefits determined? 172

How long are Regular Benefits paid? 173

How do you apply for Regular Benefits? 173

Who is eligible for Automatic Short WeekBenefits? 174

How are Automatic Short Week Benefitsdetermined? 174

Are Separation Payments payable underthe Plan? 175

How is the SUB Plan financed? 176

Who is eligible to receive Layoff MovingAllowances? 177

What other circumstances might affectSUB Plan Benefits? 178

170 Supplemental Unemployment Benefit (SUB) Plan


The Ford-UAW Supplemental Unemployment Benefit(SUB) Plan provides financial security during layoffsfor eligible hourly employees represented by the UAW.

An overviewIf you are laid off from the Company and meet the eligibilityrequirements, you may be eligible for:• Regular Benefits — providing a weekly income for full

weeks of layoff; Regular Benefits are a supplement tobenefits provided under state unemployment systems

• Automatic Short Week Benefits — providing additionalincome in a short workweek

• Lump-Sum Separation Payments — paying a lump-sum benefit if you are separated from the Companyunder certain circumstances

A Layoff Moving Allowance also is available under theCollective Bargaining Agreement. This Allowance pays alump-sum benefit if you are laid off, begin work at anotherplant and move your residence as a result.


Who is eligible for Regular Benefits?

If you are on layoff from a Ford-UAW Contract Unit,you may be eligible for Regular Benefits under theSUB Plan.

Eligibility requirementsYou may be eligible for Regular Benefits under the SUBPlan if you are an Employee and:• Have at least one year of Seniority• Are on a qualifying layoff from a Contract Unit be-

cause of:— A reduction in force (including closing of a plant

or operation)— A temporary layoff or— Your inability to do work offered by the Company,

even though you are able to perform other work inthe plant that you would be entitled to if you hadsufficient Seniority

• Have reported at a state employment office, if requiredby your state

• Have applied for Regular Benefits either in person orby mail and

• Qualify for a Regular Benefit of at least $2

State unemployment compensation (UC) benefitsIn addition to the eligibility requirements described in theprior section, you must have received a state UC benefit,or be ineligible for one because you:• Did not have a sufficient period of employment or earn-

ings to qualify for state UC benefits• Have exhausted your state UC benefits• Worked or had earnings in the week that disqualified

you for state UC benefits or waiting week credit• Were employed full time by an employer other than the

Company and are not eligible for an Automatic ShortWeek Benefit

• Are serving a waiting week under the state UC systemwhile you are laid off out of line of Seniority (with cer-tain exceptions)

• Are serving:— A second waiting week within your state UC system

benefit year— A waiting week which occurred within less than 52

weeks since your last waiting weekor

— A waiting week immediately following a week forwhich you received a state UC benefit

Supplemental Unemployment Benefit (SUB) Plan

Supplemental Unemployment Benefit (SUB) Plan 171

• Refuse a Company offer of work that you have an optionto refuse under the Collective Bargaining Agreement

• Are on layoff because you are unable to do your regularjob, or other work offered by the Company, providedyou are able to do other work in the plant that you wouldbe entitled to if you had sufficient Seniority

• Have failed to claim a state UC benefit because payfrom the Company would result in a state UC benefit ofless than $2

• Are receiving pay for military service for a periodfollowing your release from active duty or were on short-term active duty of 30 days or less

• Are entitled to benefits for retirement or disability thatwould be payable while you are working full time

• Are on layoff for part of a week and have been denied astate UC benefit because for another part of the sameweek you were on a disciplinary layoff or layoff becauseof strike or other concerted action or received anystatutory or Company Accident and Sickness benefitor Company retirement benefit

• Have been denied a state UC benefit and it would becontrary to the intent of the Plan to deny you a benefit

• Are otherwise qual i f ied for unemploymentcompensation and SUB Regular Benefits, except forhaving failed to satisfy your state system reportingor certification requirements

The term “state unemployment compensation (UC) benefit”or “state system benefit” throughout this section includescertain allowances for training, Trade ReadjustmentAllowances and certain Workers’ Compensation benefits.

If you exhaust your state unemployment compensationSome special rules apply if you exhaust your stateunemployment compensation and apply for RegularBenefits. In that instance, you must:• Be able to work, be available for work and maintain

an active registration for work with the stateemployment service

• Do what a reasonable person would do to obtain work and• Apply for or accept suitable work that the state

employment service or the Company lets you knowis available

Who is not eligible for Regular Benefits?

Certain circumstances affect your benefit eligibilityunder the Plan.

You are not eligible for Regular Benefits if you:• Are laid off:

— For disciplinary reasons— Because of a strike, slowdown, work stop page,

picketing (whether or not by Ford-UAW employees)or concerted action—at a Company plant or plants—or any dispute of any kind involving Ford-UAWemployees at a Company plant or elsewhere

— Through your own fault— Because of any war or hostile action of a foreign power— Because of sabotage (including arson) or insurrection— Beyond the first two consecutive full weeks of layoff

for which a Regular Benefit is payable in any periodof layoff because of any act of God

• Refuse a Company offer of work that you cannot refuseunder the Collective Bargaining Agreement

• Are in military service or on a military leave (other thanshort-term duty of 30 days or less)

• Are eligible for or claiming any statutory accident orsickness benefit, or other disability benefit (other thana disability benefit you would get even if working fulltime or a lost-time Workers’ Compensation benefit whilenot disabled) or a Company retirement benefit (youreligibility for a regular early or normal retirement benefitif you are not yet receiving the benefit, however, willnot disqualify you)

• Are receiving SUB payments from another employeror are eligible to receive them from another employerwith whom you have more Seniority than you havewith the Company

• Are receiving or are eligible to receive SUB paymentsunder any other Ford SUB Plan or

• Are eligible for an Automatic Short Week Benefit


How are Regular Benefits determined?

Your SUB amount is determined by your weekly after-tax pay, certain other pay and state system benefits.

The weekly Regular Benefits calculationYour weekly Regular Benefits are figured according to aformula:

95% of your Weekly After-Tax Pay

less $30.00

less any State System Benefit,pay from the Company* excludingcall-in pay, and earnings in excessof the greater of $10 or 20% of such

wages from another employer ormilitary pay in excess of $10.00

Your weekly After-Tax Pay is:

Your Weekly Straight-Time Pay(including any cost-of-living allowance

in effect at time of calculation)

reduced by

all federal, state and municipal taxes andcontributions required to be withheld by the

Company based on the number of exemptionsyou may claim on your tax return, excludingexemptions taken for old age and blindness

The $30.00 reduction takes into account the work-relatedexpenses you do not have when you are on layoff.

An exampleSuppose you are married and have two children, live inDetroit and receive a state UC benefit of $362. Let’s alsoassume your weekly straight-time pay for 40 hours of workis $1025.40. All federal, state and municipal taxes andcontributions on your pay come to $216.91. As a result,your after-tax pay is $808.49.

Your Regular Benefit from the Plan for a full week oflayoff would be:

$808.49 your after-tax payx 95% times the rate

$768.06- 30.00 less work-related expenses

$738.06- 362.00 less state UC benefit

$ 376.06 your before-tax benefit

You would receive $376.06 from the Plan, less withhold-ing taxes such as federal, state and local income taxeson that amount.

*80% of vacation pay received from the Company during Vacation Shutdown, under certain circumstances.

Your Regular Benefit would be $738.06 less withholdingtaxes such as federal, state and local income taxes—ifyou were otherwise eligible for SUB and either:

• Did not receive a state UC benefit for one of the reasonslisted in the “Who is eligible for Regular Benefits?”section or

• Exhaust your state UC benefit

Note: If you fail to apply for SUB benefits when you arefirst eligible, the SUB benefit will be reduced by the stateUC benefit for which you otherwise were eligible.

Maximum benefitsIn most instances, Regular Benefits are paid with nomaximum. There is an exception, though. The maximumbenefit is $195 if you refuse an offer of work by theCompany (even though you had an option under theCollective Bargaining Agreement to refuse such work) ifsuch a refusal:

• Results in your disqualification for state UC benefits or• Occurs or such layoff continues after you have ex-

hausted your state UC benefits

The maximum will not apply, however, if you are a skilledTool & Die, Maintenance and Construction or Power Houseemployee and refuse an offer of work other than work inTool Room Departments, Maintenance Departments andPower House Departments.

Reduced benefitThe following provision will apply only in the eventthe terms of the 1987 SUB Plan are reactivated.

If you have less than 20 years of Seniority and the CUCBis below $144.50, the Regular Benefit will be reduced by20% but not to an amount less than five dollars. If youhave less than 10 years of Seniority and the CUCB isbelow $44.50, a Regular Benefit will not be paid to you.

Benefit overpaymentsIf for any reason you receive a benefit payment that shouldnot have been paid or should have been paid in a lesseramount, the Plan provides for recovery of the overpaymentamount. The overpayment will be recovered from futurebenefit payments or from regular paychecks.


How long are Regular Benefits paid?

The duration of SUB Regular benefit payments isdetermined by the Loss of Seniority due to ContinuousUnemployment provisions of the Collective BargainingAgreement (except for the 48-week limit on volume-related layoffs).

How do you apply for Regular Benefits?

An electronic application will be automaticallysubmitted for you if you receive a UC benefit paymentand work in a state where the automated SUBapplication process has been implemented (Michigan,Minnesota, Missouri, Kentucky and Ohio as ofDecember 2003). Otherwise, you may apply forRegular Benefits in person or by mail. For instructionson how to apply by mail, contact the Company SUBoffice at the location where you work.

When to applyYou must apply for Regular Benefits within 60 calendardays after the end of the week for which you claim thebenefit. You may apply after this time limit, however, ifyou retroactively become eligible for state UC benefits oryour state UC benefit amount is adjusted retroactively,which in turn affects your eligibility or benefit amount underthis Plan. You must submit a new application form eachweek you claim a Regular Benefit. Regular Benefitpayments are mailed to your home.

Information to be providedThe application form asks:• The amount of any state UC and other benefits you

have received. These include Workers Compensationbenefits, Retirement Plan benefits, Trade ReadjustmentAllowances, benefits under any other SUB-type plansand state or federal disability payments and

• The amount of your earnings for each day in the weekfrom any source other than the Company

You also must submit evidence that shows you:

• Have received a state UC benefit• Are entitled to receive a state UC benefit or• Are ineligible for a state UC benefit for a reason under

the Plan, described in the “Who is eligible for RegularBenefits?” section

Your Company SUB office can tell you what is consideredqualifying evidence in your state.


How are Automatic Short Week Benefits determined?

Automatic Short Week Benefits are based on yourstraight-time pay and your hours worked.

Your Automatic Short Week Benefits are equal to:80% of your straight-time pay

(including any cost-of-living allowance)for each hour less than 40 not paid for

or made available to you during the week.

In determining your hours made available for purposes ofthe Plan, there are two important points to keep in mind:• If, before a layoff during a week, notice of intent to

work overtime has not been given to employees bythe Company, overtime that is worked or availableduring that week but after the layoff and is not in-cluded in determining hours paid or made availableduring the week

• Overtime hours that otherwise would be counted arenot counted as hours made available if you are pro-hibited from working due to written restrictions im-posed by your personal physician and agreed to bythe plant physician

An exampleSuppose your straight-time hourly rate (including any cost-of-living allowance) is $25.635, you work 24 hours andyou are on a qualifying layoff for the remaining 16 hours ofthe workweek.

Your Automatic Short Week Benefit is computed as follows:

$ 25.635 hourly rate plus COLAx 80% times short week percentage$ 20.005- 16 times hours laid off

$ 328.00 short week benefit amount

The $328.00 short week benefit amount when added toyour regular pay of $615.24 will total $943.24 for the week.

This total is paid in one check. It is subject to all federal,state and local income taxes and all other deductionsnormally taken from your pay.

Applying for benefitsGenerally, you do not need to apply for Automatic ShortWeek Benefits. If you believe you are entitled to anAutomatic Short Week Benefit and do not receive it onthe day it normally would be paid, however, submit a writtenapplication to the Company within 60 days of the day suchbenefit was payable. Also, submit a written application ifthe Automatic Short Week Benefit you receive is smallerthan the amount you believe you are entitled to.

Who is eligible for Automatic Short Week Benefits?

In certain circumstances, you may be eligible for Au-tomatic Short Week Benefits.

Eligibility requirementsYou may be eligible for an Automatic Short Week Benefit if:• You have at least one year of Seniority• You work for the Company during the week or:

— you receive some jury duty pay, bereavement payor military pay from the Company or

— you receive only holiday pay during the week fromthe Company and you received an Automatic ShortWeek Benefit or had 40 hours paid for or madeavailable in the previous week

• Because of layoff, the hours paid for or made availableto you by the Company are less than 40 and

• Generally, you meet all of the eligibility requirementsnecessary to receive a Regular Benefit except you:— need not have any Credit Units and— need not have registered and reported to a state

employment office


Are Separation Payments payable under the Plan?

Under certain circumstances, you may be eligible fora lump-sum Separation Payment.

The Separation Payment amount depends on:• Your Seniority as of your last day on the Active

Employment Roll and• Your hourly rate

Eligibility requirementsYou are eligible to receive a Separation Payment if you:• Have at least one year of Seniority on the last day you

are on the Active Employment Rolls of the Company• Have been laid off for at least 12 continuous months

(unless you are on a permanent layoff and appear tohave no further employment opportunity with theCompany) or have become totally and permanentlydisabled and are ineligible for a Company retirementbenefit solely because you have less than 10 years ofcredited service

• Do not have a break in Seniority between the date ofyour layoff and the earliest date you can apply for aSeparation Payment and

• Do not refuse an offer of work by the Company (unlesspermitted by the Collective Bargaining Agreement)between layoff and the earliest date that you can apply

The payment amountYour Separation Payment is based on your Base HourlyRate plus the cost-of-living allowance in effect on yourlast day worked and your years of Seniority. Your Seniorityis translated into a specific number of hours of separationpay you will receive using the following table:

SEPARATION PAYMENT TABLE

Hours of Hours ofpay you pay you

Years of seniority: receive: Years of seniority: receive:1 but less than 02 50 16 but less than 17 770

2 but less than 03 70 17 but less than 18 840

3 but less than 04 100 18 but less than 19 920

4 but less than 05 135 19 but less than 20 1,000









13 but less than 14 570 28 but less than 29 1,87514 but less than 15 630 29 but less than 30 1,98015 but less than 16 700 30 and over 2,080

In the event the provisions of the 1987 SUB Planare reactivated, the following method of calculat-ing the amount of a Separation Payment also willbe available to employees who were at work on orafter March 1, 1982:

The cash equivalent of your remaining RegularBenefits otherwise payable from the SUB Plan

plus

the cash equivalent of any insurancecontinuation coverage you are eligible to

receive (unless eligible for insurancecontinuation due to retirement)

minus

the amount of any Regular Benefits received afteryour application for a Separation Payment was made

Under both methods, the amount you receive is reduced by:• Any Moving Allowance you have received• Any amounts which must be withheld by law or regula-

tion, such as taxes• SUB overpayments and• Any SUB payments you received for weeks after your

last day worked

To receive a Separation PaymentTo receive a Separation Payment, you must apply within24 months (36 months if you have at least 10 years ofSeniority and you were at work on or after March 1,1982) after your layoff or disability period begins. Anexception is made, however, if you become totally andpermanently disabled and are not eligible for a disabilityretirement benefit because you do not have 10 years ofcredited service and you are receiving an Extended Dis-ability Benefit under Section 13 of the Life and Disabil-ity Insurance Program. If this is the case, you may ap-ply for a Separation Payment on or before the 30th dayfollowing the last month you were eligible to receive anExtended Disability Benefit.


How is the SUB Plan financed?

During the term of the 2003 Agreement payment ofbenefits will continue to be made from the trust. Thistrust is funded by Company contributions that aremade periodically, based on benefits to be paid.

Effect of Separation Payment on SeniorityIf you accept a Separation Payment, you:• Agree that such payment is a lump-sum payment

allocable to an inactive period (“Allocation Period”) duringwhich no other pay or benefits or rights of employmentshall apply

• Shall cease to be an Employee and your Seniority shallbe deemed to have been broken as of the date yourapplication for such Separation Payment was receivedby the Company (“Termination Date”) for all purposes

• Shall not be able to receive a special early retirementunder any Company retirement plan

• Shall not be permitted to retire under any Company re-tirement plan during the Allocation Period following theTermination Date and

• Cannot grow into retirement if ineligible as of the breakin Seniority (but without prejudice to any right to a de-ferred vested benefit)

The Allocation Period in weeks shall equal your Separa-tion Payment divided by one-half the unreduced SUB Regu-lar Benefit you received, or would have received, for thecurrent period of layoff.

If you return the Separation Payment draft within 30 daysof the date of the draft, your Seniority will be reinstated. Ifyou later are rehired by the Company, you cannot refundthe payment and your Seniority cannot be reinstated.

If you are eligible for an immediate pension benefit underthe Ford-UAW Retirement Plan, at the time of your breakin service (due to receipt of a SUB Separation Payment),you shall upon completion of the Allocation Period andapplication for a pension benefit become eligible for post-retirement health care and life insurance on the same ba-sis as other retirees. For purposes of applying the termsof the Ford-UAW Retirement Plan, you shall not be treatedas a deferred vested retiree by reason of your receipt of aSUB Separation Payment.

If you are rehiredIn the event that you are rehired by the Company withinthree years from the date of a prior separation from theCompany, you may later become entitled to receive a sec-ond Separation Payment that would take into account theearlier Separation Payment.


Who is eligible to receive Layoff Moving Allowances?

A Layoff Moving Allowance is provided if certain con-ditions are met.

You may receive a Layoff Moving Allowance from the Com-pany if:• You are laid off from a plant due to:

— a discontinuance of an operation and you accept anoffer of work at another Company plant (as providedin Section 28(b) of Article IX of the CollectiveBargaining Agreement) or

— a reduction in force and you accept an offer of workat another Company plant pursuant to preferentialplacement provisions or other special placement pro-grams agreed to by the Company and UAW

• There are 50 miles or more between plant locations• You move your residence as a result• You have at least one year of Seniority• You have not incurred a break in Seniority on or before

the date you apply for a Moving Allowance and• You have completed any mutual evaluation period that

applies to you under the preferential placementarrangement or other special placement program

For the standard Moving Allowance, you must apply withinsix months after the date you start work at your newlocation. The amount of your Moving Allowance is equalto the Separation Payment to which you are entitled, as ofthe date your Moving Allowance application is received.The maximum Moving Allowance payable is listed on thefollowing table:

MAXIMUM MOVING ALLOWANCE

Miles Between Single MarriedPlant Locations Employees* Employees

50-99 $1,270 $2,820

100-299 $1,414 $3,107

300-499 $1,534 $3,259

500-999 $1,860 $3,849

1,000 or more $2,149 $4,425

* If you are single, widowed, divorced or legally separated and yourchildren live with you and so relocate with you, the maximumallowance for a married employee applies.

Where the distance to the new location exceeds 200 milesand you are from a closed location or a location where noother in-zone locations exist and you have no prospect ofrecall, you will receive an additional $1,000.

Enhanced Moving AllowanceAn Enhanced Moving Allowance is available for eligibleemployees who (1) apply for the Enhanced MovingAllowance prior to entering into agreements concerningthe sale of their home or movement of their householdgoods, (2) utilize the Associates Relocation ManagementCompany, Inc. preferred real estate brokers and van linesand (3) terminate their seniority at all other locations.

If you qualify and elect the Enhanced Moving Allowance,you will receive up to a maximum of $23,500, of which$6,500 will be provided as a signing bonus to covermiscellaneous up-front cash expenditures. The $17,000balance will be paid by the Associates RelocationManagement Company, Inc. as direct reimbursement foractual expenditures incurred within 6 months of theeffective date of relocation.

Reimbursable expenses include all of the following:• Real estate commission and closing costs on sale of

your present home• Points and closing costs (title insurance, transfer taxes,

and miscellaneous lender taxes) on purchase of a newhome, and

• Household goods move (full van lines or self drive)

After one year of employment, you may receive any remainingbalance of the $17,000 up to a maximum of $7,000.

Spousal relocation assistance also will be providedthrough Associates Relocation Management Company,Inc. to assist the spouse in finding employment in thenew location.

If you receive the Enhanced Moving Allowance, you willterminate your seniority at all other locations and,therefore, not be eligible for recall/rehire or Return toBasic Unit.


Application for an Enhanced Moving AllowanceTo obtain the Enhanced Moving Allowance you must submitan application to the Human Resources office where youpresently work prior to entering into agreements for thesale of your present residence, purchase a new residenceand move household goods. The application form isavailable at your Human Resources office.

Moving Allowance LimitationsAny Moving Allowance you receive will be deducted fromany subsequent Separation Payment and reduced by theamount of any moving allowance available under any stateor federal law.

Only one Moving Allowance is payable when two or moreCompany employees of the same family living in the samehome are relocated.

If you relocate pursuant to preferential placementprovisions or other special placement programs, you mayreceive a maximum of two Moving Allowances during theterm of the 1999 Agreement.

The Company also provides a Transfer Moving Allowancefor active employees transferred under certain conditionsas outlined under Section 28(a), Article IX of the CollectiveBargaining Agreement.

The services of the UAW-Ford Relocation Services Centerare available to provide information to help you with sellingyour existing home, buying a home at the new location,moving household goods and gaining knowledge of thenew community.

What other circumstances might affect SUB PlanBenefits?

This section of your handbook has described howthe SUB Plan works. Some other circumstances mightaffect your benefits, however.

Appeal proceduresIf you believe you have been improperly denied a Benefitor Separation Payment, or receive a Benefit or SeparationPayment that is smaller in amount than that to which youbelieve you are entitled, you may file an appeal. Such anappeal must be in writing and must be filed with your localSUB office within 30 days following date of mailing of thepayment, notice of denial or suspension of SUB or aSeparation Payment or within 30 days of payment of anAutomatic Short Week Benefit that is smaller in amountthan that to which you believe you are entitled.

A local SUB Plan Committee has been established foreach Company location. There are two membersrepresenting the UAW and two members representing theCompany who will consider your appeal. If the localCommittee denies the appeal, there is no further appeal.

If the local Committee does not resolve the issue, a furtherappeal may be made at the request of the employee tothe Ford-UAW Board of Administration for SUB. This Boardincludes three Company members and three UAWmembers. The Plan provides for an impartial chairman.There is no appeal from the Board’s decision.

If the Plan terminatesIf the Plan terminates, all assets remaining in the SUB Fundwill be used to pay Plan Benefits to eligible employees forone year, unless the assets are exhausted sooner.

Plan provisions that provide for additional Companycontributions to the SUB Fund when the CUCB falls belowcertain levels will not apply if the Plan terminates.

After the end of the first year after Plan termination, theCompany and the UAW will negotiate a program that willspecify how any assets remaining in the Fund will beallocated.

179

Guaranteed Income Stream (GIS) Benefit Program

After an overview of the Guaranteed Income Stream(GIS) Benefit Program, this section of your handbookanswers these questions:

Page

Who is eligible for GIS Benefits? 180

How are GIS Income Benefits determined? 183

What is GIS Insurance Coverage? 185

How do you receive GIS Benefits? 185

What is the GIS Redemption Payment? 186

What is the GIS Moving Allowance Benefit? 187

What other circumstances might affectGIS Benefits? 187

180 Guaranteed Income Stream (GIS) Benefit Program

An overview of the Program

If you are laid off for an extended period of time, youmay be eligible to receive Guaranteed Income Stream(GIS) Income and Insurance Benefits.

The GIS Program offers greater financial security for longerseniority employees and their families during extended layoffperiods by providing:• Guaranteed income protection• Hospital-Surgical-Medical Insurance coverage and• Life Insurance coverage


Guaranteed Income Stream (GIS) Benefit Program

Who is eligible for GIS Benefits?

If you are a full-time Ford employee represented bythe UAW, and are on a qualifying layoff, you may beeligible for GIS Benefits.

Qualifying layoffsTo be eligible for GIS Benefits, you must be on a qualifyinglayoff. A “qualifying layoff” is a layoff due to:• A reduction in force• The closing of an operation or facility or• Inability to do work offered, though able to perform other

work for which you have insufficient Seniority

Qualifying layoffs do not include layoffs that:• Result from the exercise of inverse Seniority rights

under the Collective Bargaining Agreement or• Are a result of:

— disciplinary action— strikes— slowdowns— work stoppages— picketing (whether or not by Ford-UAW employees)— a concerted action at a Company facility or any labor

dispute involving Ford-UAW employees (regardlessof locations) or

— war, sabotage or insurrection, an act of God or yourown actions

Guaranteed Income Stream (GIS) Benefit Program 181

Other eligibility requirementsYou also must meet the requirements shown in the following table:

You Must Meet These Requirements:

• Be at work with the Company in an UAW-represented contract unit on orafter March 1, 1982 (the Program’s effective date)

• Have the required Seniority:

— 10 years of Seniority as of your last day worked if laid off for any reasonon or after October 22, 1990

— 15 years of Seniority as of your last day worked if laid off for any reasonprior to October 22, 1990

— 10 years of Seniority as of your last day worked if your layoff is due toa plant closing after October 28, 1984, and your last day worked is afterOctober 28, 1984, or

— 10 years of Seniority if your last day worked was after October 28, 1984,and if your layoff is up to 5 years before a plant closing announcementand the plant closes after October 28, 1984

• Have no remaining SUB entitlement or have waived your remaining SUBentitlement

• Be working for a subsequent employer or be able and available for work:

— As defined by your state’s Public Employment Service or

— By participating in a vocational training program approved by the Com-pany and the Union

• Keep an active registration with the Public Employment Service based onthe procedures and practices of your state’s unemployment service

• Be on a qualifying layoff for the entire week for which you claim benefits and

• Provide information required by the Company or its agent to verify eligibilityfor and determine the amount of GIS Benefits. (For more information, seethe “What other circumstances might affect GIS Benefits?” section.)

Subject to These Limitations:

• If you are unable to receive SUB payments because your SUB entitlementwas cancelled due to misrepresentation or fraud, you cannot receive GISBenefits

• If you are not working for a subsequent employer, you must meet all eligibil-ity requirements (not including minimum number of qualifying weeks ofwork) for state unemployment compensation (UC) benefits. If you haveexhausted your unemployment benefits, you will not have to meet thestate’s reporting requirements

GIS ELIGIBILITY REQUIREMENTS


Continuing eligibilityIn addition, to remain eligible for GIS Benefits during aqualifying layoff, you must:• Retain your Seniority, or lose Seniority only because

you are on layoff for a longer period of time thanpermitted by your Company Seniority

• Appear for all scheduled job interviews unless yourfailure to appear is for Good Cause (Good Cause forfailing to appear for an interview includes personalphysical incapacity, death in your immediate family, juryduty or an act of God; if these situations occur, youmust report for your interview as soon as possible afterthat time and provide evidence to justify your absence)and

• Accept any offer of Company employment which youare capable of performing, subject to these conditions:— Company employment includes both hourly and

salaried positions at any United States Companyfacility; if an interview or employment offer is morethan 50 miles from your residence and last Companywork location, the Company will offer to payreasonable interview expenses; your eligibility forGIS Benefits will not be terminated for refusal toaccept an offer of employment if the employmentoffered is more than 50 miles from your residenceand last Company work location

— The requirement to accept Company work includesaccepting interviews and employment offersextended after you have been notified of a probablefuture layoff, even if such offers occur prior to youractual layoff; benefits are not paid when you declinealternative Company employment opportunities orjob interviews available that could avoid, delay orreduce the duration of the layoff

— If the Collective Bargaining Agreement permitsrefusal of alternate employment without forfeitingeligibility for Regular Benefits under the SUB Plan,you can decline the offer to accept Company workwithout penalty; when you have this right, you mayrefuse interviews and/or employment offers forcertain hourly jobs for up to the earlier of two yearsfollowing your last day worked or your last day ofeligibility for a Regular Benefit under the SUB Plan

If you are disabledYour eligibility for GIS Benefits may continue even whileyou are disabled. Specifically, if you become wholly andcontinuously disabled as a result of an injury or illnessthat began after the beginning of your qualifying layoff,you may be entitled temporarily to modified GIS IncomeBenefits. GIS Benefits for disabled employees are ex-plained in the “What other circumstances might affect GISBenefits?” section.

Wholly and continuously disabled employees are notrequired to maintain an active registration with a PublicEmployment Service while receiving modified GIS In-come Benefits.


How are GIS Income Benefits determined?

The GIS Program provides income benefits basedon your pay and your Seniority.

The GlS Income Benefit calculationYour guaranteed income level is a one-time calculationusing the following information as of your last day worked:

• Your base hourly wage rate• Your cost-of-living allowance and• Your Seniority

Your guaranteed income level is:50% of your Weekly Before-Tax Base Earnings

plus

1% for each whole year of Seniority over 15 asof your last day worked (not to exceed 75%)

The following table shows guaranteed income levels ac-cording to Seniority:

GUARANTEED INCOME LEVEL

If your full Then your GIS If your full Then your GISyears of Benefit is this years of Benefit is thisseniority as percentage of seniority as percentage ofof last day weekly before-tax of last day weekly before-worked were: base earnings: worked were: tax base earnings:

10 through 15 50 28 63

16 51 29 64

17 52 30 65

18 53 31 66

19 54 32 67

20 55 33 68

21 56 34 69

22 57 35 70

23 58 36 71

24 59 37 72

25 60 38 73

26 61 39 74

27 62 40 and over 75

The pay information used in the calculation is based on:• Your base hourly wage rate on your last day at work or• Incentive pay or a higher hourly rate received within 90

days of your last day worked (one year if your layoffwas due to a plant closing), if applicable

Your base hourly rate plus your cost-of-living allowanceon your last day at work is multiplied by 40 hours todetermine your Weekly Before-Tax Base Earnings.

An exampleSuppose that you have 19 years of Seniority. Your basehourly rate was $21.00 and your cost-of-living allowancewas $.32 per hour on your last day worked.

Your Weekly Before-Tax Base Earnings are:

$ 21.00 Your base hourly rate+ .32% Your cost-of-living allowance

$ 21.32 Your total hourly ratex 40 Times the hours per week

$ 852.80 Your weekly pay

Your guaranteed income level is:

$ 852.80 Your weekly pay+ .54% Percentage of weekly before-tax earnings

$ 460.51 Your guaranteed income level

Maximum income benefitThere is a limit to what you can receive from the Program,however. The maximum guaranteed income level is thelower of:• 75% of Weekly Before-Tax Base Earnings as of your

last day worked or• 95% of Weekly After-Tax Base Earnings as of your last

day worked, less $30.00This is the amount used to determine a Regular Benefitunder the SUB Plan payable on the last day workedprior to layoff. The after-tax calculation is based on thenumber of exemptions you may claim on your tax re-turn, excluding exemptions taken for old age and blind-ness, as of your last day worked.

• If you are eligible under any Company plan or programthen in effect to receive, at your option, either a monthlyretirement benefit unreduced for age because of (1) acontingent event unrelated to age or (2) disability or amonthly retirement benefit containing a supplementalallowance based on attaining a specific number of yearsof service, the weekly equivalent of the monthly amountof the retirement benefit that would be payable.

In determining the maximum guaranteed income level, theweekly equivalent of benefits paid on a monthly basis iscomputed by dividing the monthly benefit amount by 4.33.


GIS Income Benefit offsetsYour actual GIS Income Benefit for any calendar Week willbe adjusted, according to the following table, to reflect:• Any money you receive from employment• Any Statutory Benefits you are paid or are eligible to

receive, except Social Security old age or disabilitybenefits

• Any outstanding debts owed to the Company or to theSUB Fund

• Applicable taxes

The table has more details:

INCOME BENEFIT OFFSETS

GIS Benefits are These are Based onReduced by: but are not Limited to:

• 100% of Statutory • Benefits payable underBenefits — State unemployment

compensation laws— The Trade Readjustment Act— Veterans’ benefits and

retirement acts— Governmental pensions and— Workers’ Compensation

(excluding specific allowancesfor 100% loss of the use of orloss of a body member)

• 100% of certain income • Benefits related to:or benefits from — Disabilitysubsequent employment — Termination

• 100% of earnings not — Unemploymentrealized because yourefuse or are absentfrom work as a temporarypart-time (TPT) employeewith the Company

• 80% of gross earnings • Earnings received oravailable from subsequentemployment such as:— Wages— Tips— Commissions— Bonuses— Vacation Pay— Value of employer provided

meals, board, transportationor housing

• 80% of gross earnings • Earnings not realizedfrom subsequent due to:employment not realized — Illnessbecause of absence — Personal leave of absence

• 80% of earnings as a — StrikeTPT employee — Disciplinary layoff

Income and Statutory Benefits not attributable to a spe-cific week will be allocated in an equitable manner.

An exampleSuppose that you are entitled to a maximum guaranteedincome level of $450 per week. In your job with asubsequent employer, you earn $8 per hour at yourregularly scheduled 40-hour-per-week job and are noteligible for any Statutory Benefits. During a particular week,your work record is as follows:

Hours HoursPaid: Absent: Explanation:

Monday 8.0 — —

Tuesday 4.0 4.0 Sent home by supervisorparts shortage

Wednesday 8.0 — —

Thursday — 8.0 Illness

Friday 8.0 — —

Saturday 6.0* — —

Total 34.0 12.0

*4 hours worked at time and one-half.

Your Income from Other Sources is:

34 Hours paid+ 8 Hours absent

42x $8.00 Hourly rate

$336.00 Weekly pay

Your benefit is offset by:

$336.00 Weekly payx 80% Reduction for gross earnings

$268.80 Pay subject to guaranteed incomelevel calculation

Your guaranteed income benefit is:

$450.00 Maximum guaranteed income level- 268.80 Pay subject to guaranteed income

level calculation

$181.20 Guaranteed Income Benefit


What is GIS Insurance coverage?

The GIS Program provides Life Insurance and supple-mentary Hospital-Surgical-Medical coverage. If yourlayoff commenced on or after October 25, 1999, yourhealth insurance will include Hospital-Surgical-Medi-cal-Prescription Drug-Vision-Hearing Aid Coverage.

While you are eligible for GIS Benefits, you also are entitledto Life Insurance and Hospital-Surgical-Medical coverage.

Life Insurance coverageYou are eligible for $16,000 in Company-paid Life Insurancepayable to your designated beneficiary if you die.

Hospital-Surgical-Medical Insurance coverageYou also are entitled to Hospital-Surgical-Medical coverageequivalent to an active employee’s Blue Cross-Blue Shieldcoverage. This coverage does not include drug, dental,vision or hearing aid coverage unless your layoffcommenced on or after October 25, 1999.

Your GIS Insurance coverage supplements any otherHospital-Surgical-Medical coverage which you or yourdependent(s) receive or are eligible to receive. Coveragefor which you or your dependent(s) pay more than one-half of the premium cost is not included in determiningyour current amount of coverage.

This coverage will provide the difference between any Hos-pital-Surgical-Medical benefits provided or available from othersources and the coverage provided to active employees.

An exampleSuppose you are eligible for GIS Benefits and areemployed with another company when you incur coveredsurgical expenses of $1,000. Ford surgical coverage foractive employees would provide a benefit of $1,000 foryour expenses. Coverage provided by the other companycovers $800 of the expenses. Coverage under the GISProgram will provide a $200 supplement to bring your totalcoverage up to the $1,000 that would have been availablehad you been an active Company employee.

How do you receive GIS Benefits?

To receive GIS Income or Insurance Benefits, youmust file an application with the GIS Administrator.

Applications for GIS Benefits may be filed in person or bymail. You must submit a separate application for each weekof income benefits you are claiming. The income benefitapplication must be received by the GIS Administrator within60 calendar days after the end of the week for which youare claiming benefits.

Income benefit paymentsA weekly GIS Income Benefit of at least $100 is paid assoon as practical after the GIS Administrator receives allnecessary information. If the amount payable for a givenweek is less than $100, payment will be made after theweek in which accumulated benefits equal at least $100.If GIS eligibility is terminated or suspended, all unpaidincome benefits are made as soon as practical.

Eligibility for Insurance benefitsGIS Hospital-Surgical-Medical and Life Insurancecoverages begin when you:

• Become eligible for GIS Benefits• Have exhausted Company-paid insurance coverage

provided under the Insurance Program

Based on the Collective Bargaining Agreement, mostemployees who become eligible for GIS Benefits will beentitled to 24 months of Company-paid insurancecontinuation following layoff. If you become eligible forGIS Benefits prior to 24 months following layoff, GISInsurance coverage will not begin until all other Company-paid insurance coverage is exhausted.

Continuing your Insurance coverageWhen GIS Benefits are suspended, as described in the“What other circumstances might affect GIS Benefits?”section, you may continue insurance coverage by payingthe full cost. When you pay this cost, your coverage maycontinue until the earlier of:

• Resumption of eligibility for GIS Benefits at Com-pany cost

• Suspension of eligibility for GIS Insurance coverage• Termination of your eligibility for GIS Benefits or retirement


Administrative proceduresWhen you become eligible for GIS Insurance coverage,you’ll receive claims filing information.

When GIS Benefits are suspended, or when you file anappeal on a termination of GIS eligibility, you will receiveinformation on continuing coverage at your own cost.

Finally, if you believe GIS Benefits have been improp-erly suspended, terminated, denied or paid in a smalleramount than required, an appeal procedure is available.Appeals must be submitted in writing on forms providedby the Company and must be received within 70 calen-dar days following:• The mailing date for the income or Redemption Payment• Notice of denial of benefits or• Notice of termination or suspension of benefits

A Board of Appeals has been established with three UAWmembers and three Company members. An impartialchairman is appointed to rule on issues where the regularmembers of the Board are unable to reach a majoritydecision. The ruling of the Board of Appeals is final andbinding on the Company, the Union and the employee.

What is the GIS Redemption Payment?

Your future GIS Income and Insurance Benefits maybe paid in a lump sum.

If you wish, you may elect a lump-sum RedemptionPayment instead of continued or future GIS Income andInsurance Benefits.

To receive a Redemption Payment you must:• Meet all eligibility requirements for GIS Benefits and• Make proper application within 60 months after your

layoff began

Your lump-sum Redemption Payment will be $5,000,reduced by:• The gross amount of any previous GIS Income Benefits

you had received or applied for• The value of GIS Insurance coverage provided before

your Redemption Payment application was approved• Any outstanding debts owed to the Company, including

overpayments under GIS or SUB and• All amounts required to be withheld by law or regulation,

including taxes

If you accept a Redemption Payment, you:• Shall continue to be an Employee, and your Seniority

will not be affected, except you shall cease to be anEmployee and your Seniority shall be deemed to havebeen broken if you also receive a Separation Paymentunder the SUB Plan

• Shall not be eligible to receive a special early retirementunder any Company retirement plan and

• Shall not be permitted to retire under any Companyretirement plan during the Allocation Period

The Allocation Period in weeks shall equal yourRedemption Payment divided by one-half the unreducedGIS Income Benefit you received, or would havereceived, for the current period of layoff.

If you elect a Separation Payment under the SUB Planand a Redemption Payment under GIS, your Seniority shallbe deemed to have been broken as of your TerminationDate. If you are not eligible for an immediate pension ben-efit under the Retirement Plan on the Termination Date,you shall be treated as a deferred vested retiree.

If you elect only a Redemption Payment and do not electa Separation Payment, your Seniority shall be broken onthe date when the period of your current layoff exceedsyour Seniority. If your Seniority breaks prior to your reach-ing age 55, with less than 30 years of credited serviceunder the Retirement Plan, you shall be treated as a de-ferred vested retiree and shall not be eligible for early re-tirement benefits.


What is the GIS Moving Allowance benefit?

If you begin work at another Company location as aresult of GIS placement efforts, you may receive aMoving Allowance.

To receive a GIS Moving Allowance, you must:• Begin work at another Company location as a result of

GIS placement efforts• Apply within six months after the date you start work

at the new location and• Provide evidence of your relocation

The maximum Moving Allowance payable is indicated below:

MOVING ALLOWANCE

Miles Between Single MarriedPlant Locations Employees* Employees

50-99 $1,270 $2,820

100-299 $1,414 $3,107

300-499 $1,534 $3,259

500-999 $1,860 $3,849

1,000 or more $1,149 $4,425

* If you are single, widowed, divorced or legally separated and yourchildren live with you and so relocate with you, the maximumallowance for a married employee applies.

An additional $1,000 will be added to the moving allow-ance of an employee from a closed location or a locationwhere there are no other in-zone locations and there is noprospect of recall, if the distance to the new location ex-ceeds 200 miles.

The allowance is reduced by any Moving Allowance pay-ments you receive or are eligible to receive for relocationunder any present or future federal or state legislation.

The UAW-Ford Relocation Services Center is available toprovide relocating employees with guidance in house buy-ing and selling, moving of household goods, and new com-munity orientation.

What other circumstances might affect GIS Benefits?

Your GIS Benefits are meant to provide protection foryou. But, you should be aware of some circumstancesthat might affect them.

Overpayment of benefitsIf your GIS Income Benefits are overpaid, you will be no-tified in writing of the amount and reason for such over-payment. You have 30 calendar days from the receipt orattempted delivery of the notice to return the overpay-ment. Specific instructions for making repayment will beincluded with the notice.

If you do not repay the overpayment:• After 30 days, your future GIS Income Benefits are

withheld until the overpayment is recovered in full• If you are not receiving income benefits, after 90 days,

your GIS Insurance coverage is suspended until theearlier of:— the time you make full repayment or— your eligibility for income benefits resumes so that

the overpayment can be recovered

• Any of your present or future Company-paid income orbenefits may be withheld to recover the overpayment

Repayment is not required if:• The total amount of overpayment is $3 or less or• Notice was not given within one year from the date

an overpayment, caused solely by Company error,was established


If you are disabledYour regular GIS Income Benefits are suspended duringperiods of total disability due to injury or illness. The GISProgram provides modified income benefits for limited dis-ability periods while you are on a qualifying layoff. Thesebenefits are subject to the following conditions:• You must be wholly and continuously disabled and un-

der a physician’s care• You must be able to verify your disability; the proce-

dures for furnishing proof of disability will be similar tothose used for Accident and Sickness benefits whiledisabled under the Life and Disability Insurance Pro-gram and may include examination by an independentphysician; specific procedures will be provided whenyou apply for this modified income benefit

• The maximum benefit level is the lesser of:— the regular guaranteed income level or— the applicable Accident and Sickness benefit under

the Life and Disability Insurance Program if you weredisabled as of your last day worked prior to layoff

Payments while disabled are reduced by any Statu-tory Benefits and Income from Other Sources whichyou receive or are eligible to receive. This includes100% of any disability benefits available from sub-sequent employers.

• Benefits are received for a limited time; eligibility forGIS Income Benefits while wholly and continuously dis-abled ceases at the earlier of:— eligibility for disability retirement benefits under the

Retirement Plan, regardless of whether you applyfor such benefits or

— payment of 52 weekly GIS Income Benefits whiledisabled

Regardless of the number of separate periods of dis-ability, such benefits will not exceed a total of 52 weeks,counted on a cumulative basis.

• There is a one-week waiting period to receive benefits;all GIS Income Benefits are suspended during the firstfull calendar week of each disability; this week doesnot count toward the cumulative 52-week limit; partialweeks of absence at the beginning or end of a disabil-ity period do not result in total suspension of GIS In-come Benefits; the GIS Income Benefit received dur-ing these partial weeks is reduced, however, for wagesor other compensation lost while off work

Suspension of GIS BenefitsYour eligibility for GIS Income and Insurance Benefits willbe suspended (even though you may not have applied foror yet become eligible to receive GIS Benefits) if, duringan otherwise qualifying layoff, you:• Refuse or fail to appear for an interview, or refuse

an offer of suitable employment with another em-ployer that was arranged for or identified by theCompany, an agent of the Company, or a PublicEmployment Service

GIS Benefits are not suspended if you fail to appear foran interview for Good Cause, such as personal physi-cal incapacity, death in the immediate family, jury dutyor an act of God. You must report as soon as possibleafter that time and provide evidence to substantiateyour absence.

Suitable employment includes any position you arecapable of performing regardless of wage rate or othercompensation, as long as it is within a 50-mile radiusof your home or last Company work location.If you are working for another employer, you are notrequired to interview or accept employment if:— The new position is expected to pay less than 120%

of your average earnings for the last four Weeks ofcurrent employment or

— Your current earnings result in a zero GIS IncomeBenefit

You also are not required to accept an interview for aposition in a contract unit at any Company or non-Company location at which an active labor dispute isor was in progress, as long as that refusal would notdisqualify you from receiving state unemploymentcompensation benefits.

If you were not working when benefits were sus-pended, GIS eligibility is reinstated when you obtainfull-time employment.

If you were working when GIS Benefits were suspended,eligibility is reinstated when:— You terminate the job with the original employer and

obtain full-time employment elsewhere or— Your regular earnings with the original employer equal

or exceed the level that would have allowed you torefuse the interview or job offer without suspendingeligibility because of the 120% rule


Full-time employment for purposes of reestablishingsuspended GIS Benefits is defined as a job for whichyou are regularly scheduled to work 32 or more hoursper week. Full-time employment does not include self-employment or employment without a fixed wage, suchas on a commission basis, where you earn less than75% of the average weekly income for the last fourweeks of employment prior to suspension.

Suppose that you are working in a job which pays$150 per week, and you refuse an offer of a job pay-ing $210 per week. According to the 120% rule, youmust accept any offer of a job paying more than$180 per week, since $150 x 120% = $180. You re-fused the offer or a job paying $210 per week. Forthat reason, your GIS eligibility is suspended.

Your GIS eligibility is reinstated when your currentpay of $150 per week increases at least $30 to $180per week.

When suspended GIS Income Benefits are rein-stated, the GIS Income Benefit offset is based onthe larger of:— Earnings you could have received had you not re-

fused the job or interview, or failed to appear for aninterview or

— Earnings from any subsequent employer

• Terminate a job with a subsequent employer thatwas arranged for or identified by the Company, agentof the Company or a Public Employment Serviceby reason of quit, discharge, retirement or any otherreason over which you have some degree of control.GIS Benefits are not suspended if you quit a job solelyto accept a different position that was arranged for oridentified by the Company, an agent of the Company ora Public Employment Service.GIS eligibility is reinstated when you again commencefull-time employment with a subsequent employer.When suspended GIS Income Benefits are reinstated,the GIS Income Benefit offset is based on the larger of:— The average weekly income for the last four Weeks

of employment from which you terminated or— Earnings from any subsequent employer

• Cease to work with a subsequent employer becauseof a strike or a personal leave of absence of oneweek or more. GIS eligibility is reinstated upon returnto full-time employment. Income benefits are not sus-pended during partial weeks of absence at the begin-ning or end of a strike or personal leave. Any wages orother compensation that you lose during these partialWeeks of any such absence reduce GIS income Ben-efits, however.

• Become disabled due to injury or illness. Disabilitystatus means that you are unable to continue workingfor a subsequent employer or are not able and avail-able for new employment as defined by your state’sPublic Employment Service.

• Unlike other types of suspension, GIS Insurance Cov-erage is not suspended if you become disabled. In ad-dition, you may be entitled to a modified income ben-efit while totally and continuously disabled for up to acumulative total of 52 weeks, as described in the “Ifyou are disabled” section.

• Cease employment that reestablished previouslysuspended GIS Benefits. GIS Benefits are suspendedagain, following a reinstatement of suspended benefits,if you once again cease work, for any reason, includinglayoff prior to completing 13 consecutive weeks of full-time employment.

Even if you complete 13 consecutive weeks of full-time employment, GIS Benefits also are suspended ifyou cease work by reason of quit, discharge, retire-ment or any other reason over which you had somedegree of control.

Benefits are reinstated when you return to full-timeemployment. You will have to satisfy a new 13-weekrequirement and your previous work will not count,unless you have stopped work because of a strike orphysical disability. In this case, work accumulatedprior to the period of strike or disability can be re-tained and used for meeting the 13-Week requirementto reinstate eligibility, as long as you return to workwith the same employer.

The benefit offset for reestablished GIS IncomeBenefits is based on the larger of:— The highest average weekly income received for the

last four weeks of employment with any of theemployers where you ceased work and had GISBenefits suspended or

— Income from any subsequent employer


Termination of GIS BenefitsYour eligibility for GIS Income Benefits and Insurance cov-erage ends at the earliest of:

• Resumption of full-time employment with the Com-pany. If you begin full-time employment at any Com-pany location, regardless of whether the job is a sala-ried or hourly position or is represented by a differentunion, generally, your GIS Benefits are terminated. Workas a temporary part-time (TPT) employee with the Com-pany does not terminate GIS eligibility. Earnings asso-ciated with either working on or being absent from aTPT assignment, however, will reduce GIS IncomeBenefits, as explained in the, “How are GIS IncomeBenefits determined?” section.

• Acceptance of a GIS Redemption Payment. If youaccept a Redemption Payment and subsequently arerecalled or rehired by the Company, you must work 15years to become eligible for any future GIS Benefitsthat may be available.

• Death. GIS Benefits payable for periods prior to ter-mination of eligibility because of death, or becauseyou are not able to manage your own affairs due tophysical or mental incapacity, will be paid to the ap-propriate legal representative or relative as determinedby the Company.

• Retirement under any Company plan, regardless ofyour age or the type of retirement. Additionally, GISeligibility ceases if you become eligible for DisabilityRetirement under the Retirement Plan, regardless ofwhether you apply for such retirement benefits. GISeligibility is reinstated for disability retirees who recoverbut have insufficient Seniority to return to work.

• Refusal or failure to appear for an interview, orrefusal of an offer of Company employment. GISeligibility is not terminated if you fail to appear for aninterview for Good Cause, such as personal physicalincapacity, death in your immediate family, jury dutyor an act of God. You must report as soon as pos-sible after that time, however, and provide evidenceto justify your absence.

Benefits are not terminated if the employment or in-terview is at a different Company location which ismore than 50 miles from your home and last Com-pany work location.

An exception to the requirement to accept any Com-pany work is made only where the Collective Bargain-ing Agreement permits refusal of a Company offer ofwork without forfeiting eligibility for Regular Benefitsunder the SUB Plan. When you have this right, youmay refuse interviews and/or offers of Company em-ployment up to the earlier of two years following yourlast day worked or your last day of eligibility for a RegularBenefit under the SUB Plan.

Refusal of employment offers for temporary part-time(TPT) positions with the Company does not terminateGIS eligibility. GIS Income Benefits are reduced forweeks when such assignments are available (see the“How are GIS Income Benefits determined?” section).

• Loss of Company Seniority. For any reason exceptfor being on layoff for a period of time greater than per-mitted by your Company Seniority.

• Refusal to apply for a Statutory Benefit that couldoffset GIS Benefits. Examples of such Statutory Ben-efits include unemployment compensation, Trade Re-adjustment Act payments, Social Security, veterans’benefits and retirement payments, Workers’ Compen-sation and governmental pensions.

You are not required to apply for any Statutory Benefitswith eligibility requirements that include an income ormeans test, such as Aid to Dependent Children andgeneral assistance payments, except Medicaid or simi-lar programs with similar intent.

• Failure to provide on a timely basis informationrequired by the Company to establish eligibility forany amount of GIS Benefits. To continue receivingGIS Benefits, you must provide information to confirmyour ongoing eligibility. If you do not provide this infor-mation as requested within 60 days, your GIS Benefitswill be terminated.


This information includes but is not limited to:— Income from Other Sources of employment such

as: wages, salary, tips, commissions, bonuses,vacation pay, disability pay, supplemental unemploy-ment compensation and the value of employer-pro-vided meals, board and transportation

— Income lost due to any absence from subsequentemployment

— Statutory Benefits (payable under federal, stateor local laws, regulations or statutes) you are re-ceiving or for which you are eligible and must ap-ply such as: unemployment compensation, Fed-eral Social Security Act benefits, veterans’ ben-efits and retirement payments, governmental pen-sions, Medicaid, Trade Readjustment Act benefitsand Workers’ Compensation

— With the exception of Medicaid or similar programswith similar intent, you need not apply for StatutoryBenefits that require a means or income test toqualify; examples of Statutory Benefits that requirea means test include Aid to Dependent Children andGeneral Assistance. While you are not required toapply for benefits which include a means test, pay-ments actually received from such programs reduceGIS Income Benefits and, for that reason, must bereported to the Company

— Health insurance coverage available from othersources such as: benefits provided by a subsequentemployer or coverage available to you as adependent, such as medical benefits provided byyour spouse’s employerThis does not include coverage for which you oryour dependent(s) pay more than one-half thepremium cost.

— Verification that you are actively registered with thePublic Employment Service

— Current information on your employment status suchas when you: commence employment, rejectemployment offers (provided for or arranged by theCompany, an agent of the Company or a PublicEmployment Service), are laid off, are discharged,quit, transfer locations, take a leave of absence orare promoted or demoted resulting in a change inyour compensation or benefits

And, you must furnish any waivers, releases or otherevidence required by governmental agencies or theCompany to verify the information you provide.

193193193193

UAW-Ford Legal Services Plan

After an overview of the UAW-Ford Legal ServicesPlan, this section of your handbook answersthese questions:

Page

Who is eligible and what aresome basic coverage details? 194

For what matters can fulllegal services be provided? 196

Can services be providedfor an appeal? 196

For what legal matters isoffice work provided? 197

For what legal matters isa referral provided? 197

What expenses are not covered? 198

How do I receive Plan services? 198

What are other Plan details? 199

Where are Plan offices located? 200

194 UAW-Ford Legal Services Plan


At one time or another, most of us need the help of acompetent attorney. The UAW-Ford Legal ServicesPlan can provide important assistance when thesesituations arise.

When you encounter a legal problem, the UAW-Ford LegalServices Plan can go to work for you. Depending on thecircumstances, the Plan may provide three types of services:

• Full legal services for such things as wills, adoptions,consumer complaints and real estate closings. Theseservices are provided at no cost to you. In some situa-tions, you also may receive full services for an appealof a decision

• Office work for matters such as divorce and trafficand criminal offenses. You pay no cost for these services

• Referrals to a Cooperating Attorney for certain othermatters. In this case, you pay the fees for servicesprovided — but at specified rates for the type of workbeing done

Services are provided directly by the Plan’s legal staff ifyou live near an office where the Plan’s legal staff is lo-cated. If you live outside of an area where the Plan’s legalstaff is available, services are provided by a CooperatingAttorney. (A Cooperating Attorney is an independent at-torney who has contracted to provide services to Planmembers through the Plan.)

Who is eligible and what are some basic coverage details?

You, your spouse and your dependent children maybe covered by the Plan. Coverage generally beginsafter you have been employed 90 days.

EligibilityYou’re eligible for the UAW-Ford Legal Services Plan if you:

• Are a full-time hourly employee represented by the UAWand

• Have been employed for 90 days

You also are eligible if you retire and are eligible for benefits(other than deferred vested benefits) under the Ford-UAWRetirement Plan

Your dependents also may be eligible for coverage. Yourdependents include:• Your spouse, to whom you are currently married. (A

spouse by common law marriage is covered only ifcommon law marriage is recognized by the laws inyour jurisdiction)

• Your or your spouse’s unmarried dependent children, untilthe end of the calendar year in which they reach age 25.Children include natural or legally adopted children andchildren for whom you are the legal guardian. The childmust live with you or be your legal responsibility

• All individuals who may be legally claimed as your de-pendents under Section 152 of the Internal RevenueCode for Federal income tax purposes

• Your same sex domestic partner, consistent with theCompany’s healthcare benefit eligibility criteria

Legal Services Plan


When coverage beginsCoverage begins when you attain seniority.

When coverage endsGenerally, your coverage ends when you leave the Company.

Coverage for your dependents generally ends on the dayyour coverage ends or when the dependent relationshipends. This occurs for your spouse if you become divorcedor your marriage is annulled. It occurs for your depen-dents when they no longer may be legally claimed as de-pendents under Section 152 of the Internal Revenue Codefor federal income tax purposes.

Coverage for you and your dependents also will end if youlose your seniority rights. (Coverage will continue while aUnion grievance related to your seniority rights is pend-ing, however.)

If you lose your seniority rights, but are later reinstated orreacquire them, you will become eligible on the date theyare reacquired.

When coverage is continuedUnder the following circumstances, coverage may con-tinue after the time it normally would end:• If you are laid off, coverage for you and your depen-

dents will continue for 24 months after the last day ofthe month in which your layoff begins

• If you are on an approved leave of absence, cov-erage for you and your dependents continues duringthe leave

• If you retire and are eligible for retirement benefits (otherthan deferred vested benefits) under the Ford-UAWRetirement Plan, coverage for you and your eligibledependents will continue after you retire

• If you die, coverage for your spouse may continue ifhe or she is eligible for:— Surviving spouse benefits under the Retirement

Plan— Transition or Bridge Survivor Income Benefits under

the Life and Disability Insurance Program

or

— Health care Benefits

Under these conditions, coverage would continue untilthose benefits end.

If your spouse is not eligible for any of these benefits,coverage ends twelve months following the month in whichyour death occurs.

Coverage for your eligible dependents and same-sexdomestic partners ends twelve months following themonth in which you death or your surviving spouse’sdeath occurs.

• If your unmarried child has a physical or mentaldisability which prevents the child from doing anysubstantial gainful activity, coverage can continue af-ter the calendar year in which he or she reaches age25. To qualify:— The child must live in your or your surviving spouse’s

household— The disability must be medically determinable

and

— The disability must be expected either to continue fora long or indefinite period or result in death

Plan costThe Company pays all the costs of the Plan. For years,coverage under the Plan was provided tax free to Planmembers in accordance with Section 120 of the InternalRevenue Code. That Section and the tax exclusion pro-vided by it for Plan members expired June 30, 1992. With-out Section 120, the Company must “impute” income toall Plan members. Imputed income is income that is notactually received as pay, but it is subject to federal, stateand local income and Social Security (FICA) taxes.

Plan administrationMoney the Company contributes goes into a trust fund.The trustee of the fund is Comerica Bank. Money in thefund is used for the sole purpose of paying Plan benefits.It cannot be returned to the Company, Union or Adminis-trative Committee. An Administrative Committee is madeup of three members appointed by the Union, three mem-bers appointed by the Company and one member ap-pointed jointly by the Union and the Company. A Plan Di-rector is chosen by this Administrative Committee.


For what matters can full legal services be provided?

The Plan provides full legal service benefits for mat-ters such as wills, adoptions, consumer complaints,real estate closings and termination of Social Secu-rity benefits.

If you or your dependents require legal services for any ofthe items listed below, the Plan will provide all necessaryand appropriate legal services. This includes an attorney’sservices, court work, court costs, filing fees and deposi-tion and discovery charges for:• Suspension or termination of Social Security disability

benefits• Probate proceedings• Wills, codicils and trusts• Guardianships• The adoption or legitimization of a child• Name changes• Consumer complaints and warranties (including litiga-

tion on plaintiff claims exceeding $700)• Contracts for goods and services (including litigation

on plaintiff claims exceeding $700)• Defending a collection action on personal or family debts• Defending a garnishment• Repossession and replevin (recovery) of goods• Personal bankruptcy• Denial of insurance claims or loss of insurance cover-

age (except against the Company or Company-sponsored insurance plans)

• IRS audits and administrative proceedings (adminis-trative appearances only)

• Tenant representation• Leases on personal or family residences• Property damage (real and personal)• Real estate matters for a personal or family residence,

including closings, purchases, mortgages, sales, fore-closures, boundary disputes, title disputes, zoningmatters and eminent domain

• Property tax assessment disputes• Uncontested divorces, uncontested custody, uncon-

tested non-support, and uncontested alimony in juris-dictions in which an attorney is required to appear incourt to finalize the proceedings

• Post-divorce modification of child support order and ali-mony order, provided that the cause is a material changein the participant’s earnings from the Company (only)

• Termination of parental rights (excluding cases wherecriminal charges are involved)

Can services be provided for an appeal?

For certain matters, you can receive full legal ser-vices to appeal a decision. In some cases, however,approval by the Administrative Committee is required.

The Plan will provide full legal services for appeals on thesematters:• Defending a collection action on personal or family debts• Defending a garnishment• Repossession or replevin (recovery) of goods• Personal bankruptcy• Consumer complaints and warranties• Contracts for goods and services• Denial of insurance claims or loss of coverage• Medicare claims, but only if, in the opinion of the Direc-

tor or his/her designee, there is a substantial likelihoodof prevailing on such appeal

Appeals for the following matters also will be covered whenapproved by the Plan’s Administrative Committee:• Suspension or termination of Social Security disability

benefits• Probate proceedings• Wills, codicils and trusts• Guardianships• Adoption or legitimization of children• Name changes• Tenant representation• Leases on personal or family residences• Property damage (real and personal)• Real estate matters for a personal or family residence,

including closings, purchases, mortgages, sales, fore-closures, boundary disputes, title disputes, zoningmatters and eminent domain

• Property tax assessment disputes


For what legal matters is office work provided?

Office work is provided for such things as trafficoffenses, divorce, public assistance claims andveteran’s benefit claims.

The Plan covers office work by an attorney, in his or heroffice, for the matters listed below. Office work includessuch things as document preparation, advice, correspon-dence and telephone calls for:• Social Security claims other than disability suspensions

or terminations• Veterans’ benefits claims• Food stamp or other public assistance claims• Moving violations and other traffic offenses (but not

parking violations)• Misdemeanors• Juvenile offenses• Divorce, separation, annulment, dissolution, mainte-

nance and child custody• Nonsupport and alimony• Naturalization, immigration and deportation• Federal, state and local claim to taxes (excluding tax

return preparation)

If you need legal services beyond office work for thesematters, you may be referred to a Cooperating Attorney.At that time, benefits for office work will end. You will beresponsible for paying the Cooperating Attorney’s charges,as explained in the next section.

Family Planning MattersThe Plan provides office work services to prepare for orrespond to the death or incapacity of an Employee/Retiree’s or Spouse’s parent. Office work services maybe provided in the areas of guardian-ship, probate, wills,trusts, and real estate matters. The Plan can only providethese services if all necessary family members consentto the Plan’s representation and waive conflicts of interest.

For what legal matters is a referral provided?

For legal services beyond those covered by otherparts of the Plan, you may be referred to a Cooper-ating Attorney. You pay the attorney’s fees at speci-fied rates.

You can receive a referral to a Cooperating Attorney:• When you require full legal services for a matter not

covered by the Plan’s full legal service benefits• When you need legal services beyond office work for

matters covered by office work only

In these cases, you may be referred to a CooperatingAttorney. Cooperating Attorneys have an agreementthrough the Plan to provide legal services to Plan mem-bers. You pay the cost of the services according to a sched-uled fee determined by the Plan.

If you have questions or concerns about the services youreceive from a Cooperating Attorney, you may call thePlan’s legal staff for advice on how to handle the situation.


What expenses are not covered?

While many legal services are provided, some ex-penses are not covered.

The Plan does not cover legal expenses for the follow-ing matters:• Any action pending before April 1, 1985 (the effective

date of the Plan)• Legal services which are not considered personal legal

services by law (for example, for matters involving afamily business)

• Workers’ Compensation or Unemployment Compensa-tion matters involving the Company

• Any bankruptcy proceeding that would result in dis-charge of a debt owed to the Company, the Union orany benefit Plan or trust established or maintained bythe Company

• Proceedings against any benefit Plan or arising out ofany benefit Plan established or maintained by the Com-pany, including proceedings against any trust or insur-ance carrier through which such benefits are providedto the Company, employees or retirees

• Any dispute between you and the Company, its subsid-iaries, its dealers or any of its officers or agents

• Fines and penalties, whether civil or criminal• Any judgment for civil damages• Proceedings involving disputes between you and an-

other Plan member, unless you and the other Planmember are represented separately

• Any non-legal costs associated with the purchase orsale of real estate

• Matters involving election laws, or warrant to any civiloffice

• Any dispute involving this Plan• Any proceeding against the Union, any of its subordi-

nate or affiliated bodies, or the officers or agents ofsuch or against any labor organization representingemployees of the Company

• Any proceeding in which the Union would be prohibitedfrom defraying the cost of legal services under law orany proceeding arising under the National Labor Rela-tions Act or Labor Management Relations Act

• Tax return preparation

How do I receive Plan services?

Services are provided by the Plan’s legal staff or by aCooperating Attorney.

If you live near a Plan officeIf you live near a Plan office, legal services are provideddirectly by the Plan’s legal staff. Plan offices are listed inthe next section. You may call the Plan office in your area,collect, for an appointment. If you wish, you may talk toan attorney over the phone before making an appointment.

If you do not live near a Plan officeIf you do not live near a Plan office, you may call thenational office for a referral to a Cooperating Attorney inyour area. In this case, the Plan pays the CooperatingAttorney for all services provided they are covered by thePlan. To reach the national office, call toll-free:• In Michigan: 1-800-482-5007 or• Outside Michigan: 1-800-645-5203

Some things to keep in mindIn many cases, sound advice or a step taken early cankeep a minor legal problem from turning into a major one.You’ll receive the most benefit from the Plan if you con-tact an attorney as soon as you are aware of a situation inwhich legal counsel is needed.

The attorney providing Plan services represents you onan individual basis. You are entitled to the attorney’s soleprotection of your interests.

Information exchanged between you and an attorney istreated confidentially. That information is not released tothe Company, Union or other persons.


If you are dissatisfied with work performedIf you or a dependent are dissatisfied with the work per-formed under the Plan or by a Cooperating Attorney, youmay turn in a written complaint to the Plan’s AssistantDirector. Within 50 days following the date you submit yourcomplaint, the Plan’s Director will send you a written deci-sion on your complaint.

If you are dissatisfied with the decision, you may make awritten appeal to the Administrative Committee within 30days. The appeal should state your reasons for a changein the Director’s decision.

As soon as possible, you will receive a written notice fromthe Director stating the final decision on your complaint.

Coordination of benefitsThe Plan does not provide legal services in matters forwhich you or a dependent are entitled to services or ben-efits through another plan or insurance. In the event ofduplicate coverage, the other plan or insurance contractwould provide benefits before this Plan.

Services may be limited or denied if you and another Planmember — or two or more covered family members —have a legal dispute, since representing two covered per-sons could result in a conflict of interest. If the dispute isbetween you and another family member, you would beentitled to services covered by the Plan. Your dependentwould need to obtain an outside attorney and pay result-ing costs and fees. If the conflict is between you and an-other Plan member, services provided by the Plan gener-ally are provided through separate Cooperating Attorneys.

What are other Plan details?

Following is additional information about the UAW-Ford Legal Services Plan.

Legal matters arising from U.S. and Canadian laws are coveredThe Plan covers legal problems arising under the laws ofthe United States and Canada — or any state, common-wealth, district, territory, province or political subdivisionof the United States or Canada. Legal matters arising fromother laws are not covered.

No assignment of benefitsBenefits under this Plan cannot be assigned, pledged,attached or made subject to debts.

If the Plan is terminatedAlthough termination of the Plan is unlikely, the Companyand Union reserve the right to terminate or amend thePlan. If funds are available at Plan termination, legal rep-resentation of matters pending would continue until thematter is concluded, or for one year, whichever is earlier.If funds are not available to continue representation, ben-efits would be prorated based on available assets.


Where are Plan offices located?

Plan offices are located in many states throughoutthe country.

AlabamaDecatur 401 Lee Street, N.E.

Amsouth Bank BuildingSuite 600Decatur, Alabama 35602(256) 353-1555

Madison Meadow Green Centre9238 Madison BoulevardSuite 750Madison, Alabama 35758(256) 461-7526

DelawareNewark 200 Continental Drive

Suite 212Newark, Delaware 19713(302) 366-0513

FloridaClearwater Northwood Commons

2454 McMullen Booth RoadBuilding B, Suites 424 & 425Clearwater, Florida 33759(877) 309-1787

GeorgiaAtlanta 1740 Century Circle N.E.

Suite 12Atlanta, Georgia 30345(404) 248-0808

777 Cleveland Avenue, S.W.Suite 607Atlanta, Georgia 30315(770) 761-3116

IllinoisBelvidere Landmark Financial Center

600 South State StreetSuite 200Belvidere, Illinois 61008(815) 544-2525

Burr Ridge Harris Bank Hinsdale Building101 Burr Ridge ParkwaySuite 200Burr Ridge, Illinois 60521(630) 850-9700

Calumet City 1579 Huntington DriveCalumet City, Illinois 60409(708) 868-7520

IndianaAnderson 1106 Meridian Plaza

Suite 300Anderson, Indiana 46016(765) 646-6076

Fort Wayne 3110 Mallard Cove LandCovington Creek Professional VillageFort Wayne, Indiana 46804(260) 432-7403

Indianapolis 5155 Shadeland AvenueSuite 300Indianapolis, Indiana 46226(317) 543-5001

3750 Guion RoadSuite 185Indianapolis, Indiana 46222(317) 926-7036

Kokomo 217 Southway Blvd. EastSuite 106Kokomo, Indiana 46902(765) 884-6400

Marion 220 South Norton AvenueSuite 1Marion, Indiana 46952(765) 662-8411

Muncie 1100 Martin Luther King, Jr. Blvd.Suite 1Muncie, Indiana 47304(765) 288-8980

New Castle 2002 South Memorial DriveNew Castle, Indiana 47362(800) 263-6361

KansasKansas City Gateway No. II Building

Suite 10024th and State AvenuesKansas City, Kansas 66101(913) 321-1619

KentuckyLouisville Austin Bldg.

Suite 1171939 Goldsmith LaneLouisville, Kentucky 40218(502) 456-4222

LouisianaShreveport 6007 Financial Plaza

Suite 704Shreveport, Louisiana 71129(318) 688-3960

MarylandBaltimore Maritime Center

6610 Tributary StreetSuite 210Baltimore, Maryland 21224-6514(410) 633-5600


MichiganBay City 4139 East Wilder Road

Bay City, Michigan 48706-2266(689) 684-3300

Belleville Pinnacle Plaza6056-6058 Rawsonville RoadBelleville, Michigan 48111(734) 483-4612

Dearborn 5220 Oakman BoulevardDearborn, Michigan 48126(313) 943-5300

Detroit 7430 Second AvenueSuite 1000Detroit, Michigan 48202(313) 875-6033(313) 872-4600

Flint 5125 Exchange DriveFlint, Michigan 48507(810) 257-0430

G-2370 South Linden Rd.Flint, Michigan 48532(810) 720-0044

432 North SaginawSuite 504Flint, Michigan 48502(810) 257-0412

Lansing 6500 Mercantile WaySuite 3Lansing, Michigan 48911(517) 887-2838

Livonia 33067 SchoolcraftLivonia, Michigan 48150(734) 427-4505

Monroe 898 South TelegraphMonroe, Michigan 48161(734) 242-9700

Pontiac Pontiac Place140 South SaginawSuite 700Pontiac, Michigan 48342(248) 858-5850

Portage 590 West Centre AvenuePortage, Michigan 49024(269) 324-3106

Saginaw Morley BuildingOne Tuscola StreetSaginaw, Michigan 48607(989) 776-6650

Saline 601 WoodwardSaline, Michigan 48176(734) 429-4272

Shelby Township 52188 Van Dyke AvenueShelby Township, Michigan 48316(586) 254-0302

Sterling Heights 42140 Van Dyke AvenueSuite 110Sterling Heights, Michigan 48314(586) 254-0320

Taylor 20600 Eureka RoadSuite 620Taylor, Michigan 48180(734) 282-8118

Three Rivers 1519 North Main StreetThree Rivers, Michigan 49093(269) 279-5291

Warren Comerica Bank - Warren Building30500 Van Dyke AvenueSuite 700Warren, Michigan 48093(586) 574-4400(586) 573-1800

Waterford Waterford Medical-Dental Village950 Cass Lake RoadSuite 115Waterford, Michigan 48328(248) 738-8879

Wayne 36129 East MichiganWayne, Michigan 48184(734) 721-5483

Wixom 29600 Wixom RoadWixom, Michigan 48393(248) 669-3860

Wyoming 4433 Byron Center Road S.W.Wyoming, Michigan 49509(616) 531-7722

Ypsilanti 1011 Emerick StreetYpsilanti, Michigan 48197(734) 482-4500

MinnesotaSt. Paul 2233 University Avenue

Wright BuildingSuite 235St. Paul, Minnesota 55114(651) 641-0647


MissouriLake St. Louis 1000 Lake St. Louis Boulevard

Suite 120Lake St. Louis, Missouri 63367(636) 561-2057

Liberty One Victory DriveSuite 201Liberty, Missouri 64068(816) 781-7791

St. Ann 500 Northwest PlazaSuite 710St. Ann, Missouri 63074(314) 291-6868

Sunset Hills 10820 Sunset Office DriveSuite 141Sunset Hills, Missouri 63127(314) 822-9330

New JerseyTrenton 1230 Parkway Avenue

Suite 203West Trenton, New Jersey 08628(609) 882-5555

Woodbridge Woodbridge Center10 Woodbridge Center DriveSuite 730Woodbridge, New Jersey 07095(732) 602-1166

New YorkCheektowaga 4285 Genesee Street

Suite 3Cheektowaga, New York 14225(716) 632-1644

Hamburg 4819 South Park AvenueHamburg, New York 14075(716) 646-5530

Lockport 90 Professional ParkwayP.O. Box 877Lockport, New York 14095-0877(716) 433-1991

Rochester 1200-C Scottsville RoadSuite 361Rochester, New York 14624(585) 436-7720

Syracuse 6712 Brooklawn ParkwaySuite 200Syracuse, New York 13211(315) 437-6655

OhioAustintown 1570 S. Canfield-Niles Road

Building B, Suite 101Austintown, Ohio 44515(330) 799-7711

Canton 4801 Dressler Road, N.W.Suite 176Canton, Ohio 44718(330) 493-8955

Cincinnati 4010 Executive Park DriveSuite 2258040 Hosbrook RoadCincinnati, Ohio 45236(513) 984-2640

175 East Main StreetSuite 150Cincinnati, Ohio 45103(513) 735-6440

Cleveland 707 Brookpark RoadBrooklyn Heights, Ohio 44109(216) 741-2365

Columbus 5212 West Broad StreetColumbus, Ohio 43228(614) 878-9262

Dayton 111 West First StreetSuite 1045Dayton, Ohio 45402(937) 222-6090

Defiance 1500 Baltimore RoadDefiance, Ohio 43512(419) 782-2253

Elyria/Lorain 347 Midway Blvd.Suite 312Elyria, Ohio 44035(440) 324-2409

Euclid Pena Building27801 Euclid AvenueSuite 250Euclid, Ohio 44132(216) 261-8904

Lima 209 North Main StreetSuite 2ALima, Ohio 45801(419) 227-1405

Macedonia 8536 Crow DriveSuite 110Macedonia, Ohio 44056(330) 467-5030

Mansfield 1075 National ParkwayP.O. Box 2668Mansfield, Ohio 44906(419) 529-4560


Sandusky 3116 Bardshar RoadSandusky, Ohio 44870(419) 625-0536

Toledo 3360 West LaskeyToledo, Ohio 43623(419) 471-1489

OklahomaOklahoma City 3901 Southeast 29th Street

Del City, Oklahoma 73115(405) 677-2670

TennesseeNashville Cavelier Building

95 White Bridge PikeSuite 411Nashville, Tennessee 37216(615) 356-6280

Spring Hill Stephen P. Yokich2nd FloorP.O. Box 1797Spring Hill, Tennessee 37174-1797(931) 487-9818

TexasArlington 2225 East Randol Mill Road

Suite 427Arlington, Texas 76011(817) 633-2283

WisconsinJanesville 20 East Milwaukee Street

Suite 400Janesville, Wisconsin 53545(608) 755-1586

Milwaukee 5007 South Howell AvenueMilwaukee, Wisconsin 53207(414) 482-7160

UAW-FORD Legal Services Plan200 Albert Kahn Building

7430 Second AvenueDetroit, Michigan 48202

Administrative CommitteeRebecca Eisenberg, Chair

625 State StreetUniversity of Michigan Law School

Ann Arbor, Michigan 48109

MEMBERS:

Paul QuickAdministrative AssistantUAW National Ford DepartmentUAW Solidarity House8000 East Jefferson AvenueDetroit, Michigan 48214

Lee MezzaDirectorEmployee BenefitsFord Motor Company NESCDearborn, Michigan 48120

Dave PickettAssistant DirectorUAW National Ford DepartmentUAW-Ford National Programs151 West Jefferson AvenueDetroit, Michigan 48232

Kathryn LaLondeHuman ResourcesFord Motor Company NESCDearborn, Michigan 48120

Daniel SherrickGeneral CounselUAW Solidarity House8000 East Jefferson AvenueDetroit, Michigan 48214

Stephen M. KulpAttorneyOffice of General CounselFord Motor CompanyParklane Towers WestDearborn, Michigan 48126

Robert W. Esler, DirectorJeff Hartzel, UAW Coordinator

205205205205

The information contained in the section of Your Employee Benefits handbook entitled “Tax-Efficient Savings Plan For HourlyEmployees” constitutes part of a prospectus covering securities that have been registered under the Securities Act of 1933.

March 1, 2005

Tax-Efficient Savings Plan For Hourly Employees

After an overview of the Tax-Efficient Savings Plan forHourly Employees (TESPHE), this section of yourhandbook answers these questions:

Page

Who can participate in TESPHE? 207

How are contributions made to your account? 208

How is money contributed to the Plan? 209

What are the investment options? 211

How can you exchange assets? 213

How can you borrow from the Plan? 215

How are assets paid from the Plan? 217

When would assets be paid automaticallyfrom the Plan? 220

What are the tax consequences of mywithdrawal or distribution? 221

When do you contact the FidelityService Center for Ford Motor Company? 227

What circumstances might affect Plan benefitsor life events that might affect your account? 228

Can TESPHE provisions change? 232

Administration and other information 232

Appendix 237

206 Tax-Efficient Savings Plan for Hourly Employees

Tax-Efficient Savings Plan for Hourly Employees(A Supplemental Savings Plan)


TESPHE makes saving for the future convenient andtax efficient.

TESPHE gives you a convenient way to save and investmoney to help you achieve your long-term financial goals.And it has some significant advantages:

Under TESPHE, you have:• A systematic savings and investment program. You

can save up to 50% of eligible pay from eachpaycheck. You also can save all or part of any ProfitSharing payment.

• An opportunity to become a stockholder of theCompany.

• A choice of Pre-Tax, or After-Tax Contributions,or both.

• For employees age 50+, an opportunity to makeadditional Pre-Tax Contributions in the form ofCatch-Up Contributions.

• Unique tax advantages. Your Pre-Tax Contributions arededucted from your eligible pay before you have fed-eral income tax and most state and local income taxeswithheld. Also, earnings on your contributions are shel-tered from taxes while they’re in the Plan. Other taxadvantages also may be available at payout.

Assets attributable to Pre-Tax Contributions cannot be with-drawn prior to age 59 1/2 or termination of employment, ex-cept for financial hardship. Further, a taxable withdrawal ofsavings from the Plan prior to age 59 1/2 may be subject tocertain tax penalties. For more information, refer to thesection entitled “What are the Tax Consequences of mywithdrawal or distribution?” section.• Investment opportunities. You may choose among 34

investment options. These choices offer a wide rangeof risk/return preferences and will allow you to accom-modate different investment goals.

• Daily transactions. You may make exchanges betweenmost investment options, make withdrawals or initiateloans on any business day. Generally, transaction re-quests confirmed before 4:00 p.m. Eastern Time will beeffective at the close of the business day.

• Daily account valuation. Your account will be valuedeach business day to provide up-to-date account infor-mation when you need it.

• Deferred distribution. In most cases, you may elect to leaveyour assets in the Plan after you leave the Company.

The Tax-Efficient Savings Plan for Hourly Employees

is intended to constitute a plan described in Section404(c) of the Employee Retirement Income SecurityAct, and Title 29 of the Code of Federal RegulationsSection 2550.404c-1. The fiduciaries of the Plan maybe relieved of the liability for any losses which are thedirect and necessary result of investment instructionsgiven by a member or beneficiary.

Account statementsAs soon as practicable after the end of each quarter, astatement of your account will be provided. You will alsobe able to request a statement whenever you want one.The statement shows your savings and investments,the value of your account, and other information regard-ing your account.

If you think that there is an error in your quarterly state-ment, you should notify the Fidelity Service Center forFord Motor Company in writing within 30 days after youreceive it. If you do not notify the Fidelity Service Centerfor Ford Motor Company of errors, we will assume thatyour statement is correct.

Performance History SheetIf you are a participant in the TESPHE, you will be providedwith the Performance History Sheet with your QuarterlyAccount Statement. Otherwise, the Performance HistorySheet may be requested by calling the Fidelity ServiceCenter for Ford Motor Company.

You can always obtain performance data on all of theavailable investment options through Fidelity NetBenefits®at netbenefits.fidelity.com. After logging in, select theAccounts tab. Scroll down the left-hand menu selection toInvestment Resources, then select “Performance”. All ofthe available options will be listed. Select any investmentoption to obtain additional information (e.g., fund overview,quick stats, rankings/ratings, performance, volatilitymeasures, top holdings, fees & expenses, fund facts andprices and distributions). If you do not have web access,call the Fidelity Service Center for Ford Motor Companyand request a mutual fund prospectus.

Note to Participants Who Are Not Active EmployeesAs you review this document, keep in mind that somePlan features, such as making contributions andrequesting loans, do not apply to retirees, terminatedemployees, alternate payees and beneficiaries, andcertain other participants who are not activeemployees.

Tax-Efficient Savings Plan for Hourly Employees 207

Who can participate in TESPHE?

TESPHE participation is voluntary. You can enroll uponbecoming eligible.

EligibilityYou’re eligible to participate in TESPHE three months afteryour original date of hire if:• You’re an hourly employee of Ford Motor Company (the

Company or Ford) or a participating subsidiary and• You’re on the active employment roll as a full-time or

part-time employee

If you leave Ford and later return, your eligibility continuesto be based on your original date of hire.

How to enrollParticipation in TESPHE is voluntary. If you want to par-ticipate in the Plan, you must elect to make contributions.• To have a portion of your weekly eligible pay contrib-

uted to TESPHE, you must enroll by calling the Fidel-ity Service Center for Ford Motor Company at1-800-544-3333 or by accessing Fidelity NetBenefitsat netbenefits.fidelity.com. (See “Managing Your Account”in the Appendix at the end of this section.) You mayenroll as early as two weeks prior to your eligibility date.It could take up to two pay periods before your elec-tions become effective, following your eligibility date,after you enroll.When you elect to contribute, you must indicate thepercentage of your eligible pay to be contributed toTESPHE. You also must choose how your savings willbe invested among the 34 available investment options.

• To re-enroll for weekly contributions, call the FidelityService Center for Ford Motor company, or accessFidelity NetBenefits at netbenefits.fidelity.com. (See“Managing Your Account” in the Appendix at the endof this section).

• You may also enroll by electing to have all or a portionof any Profit Sharing payment contributed to TESPHEduring the special open enrollment period as announcedby the National Employee Services Center (NESC). Ifyou have not otherwise enrolled, your participationwould then begin on Profit Sharing Day which occursby March 15 of any year a Profit Sharing payment ismade. Remember that a Profit Sharing contribution toTESPHE is a one-time annual election. To continuepayroll deductions, you must indicate the percentageof your eligible pay to be contributed to TESPHE.(Please note that if you are already enrolled in TESPHE,you may also elect to contribute any Profit Sharingpayments.) All Profit Sharing payments are consideredPre-Tax Contributions.

Electing or changing your savings contributionsYou may elect or change the percentage of eligible payyou contribute to TESPHE by calling the Fidelity ServiceCenter for Ford Motor Company or by accessingNetBenefits. Normally, your contribution election or changewill be effective in the following week’s paycheck if yourrequest is made prior to 4:00 p.m. Eastern Time, Thurs-day; the second paycheck thereafter if made after 4 p.m.Eastern Time, Thursday. (It could take up to two pay peri-ods before the election or change becomes effective.)

The chart in “Managing Your Account” located in the Ap-pendix at the end of this section provides specific detailson navigating NetBenefits to perform transactions (e.g.,enrolling, changing your savings contributions, exchanges(transfers) between investment options, etc.).


How are contributions made to your account?

You can choose to save a portion of your eligible payand certain other compensation in the Plan.

When you enroll in the TESPHE, you elect how much tosave and whether you will save through Pre-Tax Contri-butions, After-Tax Contributions (or both), or, for partici-pants age 50+, Catch-Up Contributions. You can saveup to 50% of your eligible pay in any combination ofPre-Tax Contributions and After-Tax Contributions, inwhole percentages. Eligible participants may contributeup to 50% of eligible pay as Catch-Up Contributions.However, there are limitations on your contributions asdescribed later in this section.

Pre-Tax Contributions from Eligible PayYou can designate from 1% to 50% of your eligible payas Pre-Tax Contributions under TESPHE. Pre-Tax Con-tributions are subject to an Internal Revenue Code im-posed annual limit. The annual limit including any profitsharing contributions (but excluding Catch-Up Contribu-tions) through 2006 is: 2005 ($14,000); 2006 ($15,000).The dollar limit may be adjusted for inflation in 2007and later years. Pre-Tax Contributions are made withbefore-tax dollars.

Additional Pre-Tax Catch-Up Contributions from Eligible PayIf you are at least age 50 (or will attain age 50 by the endof the calendar year), you can designate up to 50% ofeligible wages as Catch-Up Contributions. This featuregives eligible employees the opportunity to make additionalpre-tax contributions over the applicable annual regulatorylimits or the TESPHE Plan limit. The annual Catch-Up limitthrough 2006 is: 2005 ($4,000); 2006 ($5,000). You will benotified if regulations are passed to extend the ability tocontribute Catch-Up Contributions beyond 2006. (See theAppendix at the end of this section for more informationon Catch-Up Contributions.

Here’s how it works:Your Pre-Tax Contributions are deducted from your eligiblepay and contributed to your TESPHE Pre-Tax Contribu-tions account before current federal income taxes arewithheld. In effect, your taxable pay for current federalincome tax purposes is lowered by the amount of yourPre-Tax Contributions. However, your Pre-Tax Contribu-tions are subject to social security tax, state and localincome taxes in locations where required.

You eventually will pay income taxes on the value of yourPre-Tax Contributions assets, including any related earn-ings, when they are withdrawn or distributed from yourPlan account. For more information on tax treatment atthe time of withdrawal or distribution, read the “SpecialTax Notice” section.

After-Tax Contributions from Eligible PayYou may designate from 1% to 50% of your eligible payas After-Tax Contributions and subject to the Internal Rev-enue Code limits described in “Limitations on TESPHEContributions”. After-Tax Contributions are subject to fed-eral income taxes, social security taxes, and state or lo-cal income taxes which are withheld.

Any taxes on investment earnings are deferred until theearnings are paid to you. However, you won’t pay taxesagain on the amount of your After-Tax Contributions whenyou receive them from the Plan. For more information ontax treatment at the time of withdrawal or distribution, readthe “Special Tax Notice” section.

A combination of Pre-Tax Contributions and After-TaxContributionsYou can authorize Pre-Tax Contributions, After-Tax Contribu-tions, or a combination of both, up to 50% of your eligiblepay, subject to the Internal Revenue Code limitations de-scribed in “Limits on TESPHE Contributions” section.

Contribution Spillover ElectionThe Contribution Spillover Election is provided so that youmay preserve your rate of savings due to the applicationof the annual limit on Pre-Tax Contributions. This electionauthorizes the Company to deduct After-Tax Contributionsfrom your base pay, instead of Pre-Tax Contributions, inthe event that you reach the dollar limit. If you are makingboth After-Tax Contributions and Pre-Tax Contributionswhen you reach the annual pre-tax limit, your After-TaxContributions percentage will be equal to the sum of yourPre-Tax Contributions percentage, up to 10%, and yourAfter-Tax Contribution percentage. If you are not makingAfter-Tax Contributions, your new After-Tax Contributionspercentage will be equal to your Pre-Tax Contributionspercentage, up to 10%.


How is money contributed to the Plan?

Subject to legal limits, you can elect to have up to50% of your eligible pay and all or part of any ProfitSharing payment contributed to TESPHE.

There are three ways money can be contributed to yourTESPHE account:• Automatic payroll contributions (deducted directly from

your eligible pay)• Contribution of all or a portion of any Profit Sharing

payment, and• Rollover from prior employer’s plan

Payroll contributionsYou can designate from 1% to 50% of your eligible pay tobe contributed to your TESPHE account. The percentageyou choose will be deducted from your eligible pay andadded to your account weekly as soon as possible, usu-ally within two business days of payday.

The Fidelity Service Center for Ford Motor Company willrefer to your TESPHE contributions as Pre-Tax Contribu-tions, After-Tax Contributions or Catch-Up Contributions.

Under TESPHE, your “eligible pay” is generally your regu-lar base pay for straight-time hours. “Eligible pay” cannotexceed 40 hours per week and includes:• Straight-time hours• Straight-time portion of overtime hours• Holiday and vacation pay (including the related excused

absence allowance)• Incentive pay• Bereavement pay• Jury duty pay• Short-term military duty pay• Cost-of-living allowance applicable to eligible pay

listed above

The Performance Bonus Payments are issued to you in aseparate check. TESPHE contributions are automaticallydeducted at the same payroll deduction percentage asyour weekly payroll contributions, and will be invested inthe same investment options.

Your eligible pay under this Plan does not include overtimepremium pay, Christmas bonus, shift differential, orweekend premiums.

Profit Sharing PaymentsIf you’re eligible to contribute to TESPHE, you also mayelect to have all or a portion of any Profit Sharing pay-ments contributed as Pre-Tax Contributions to yourTESPHE account.

Any contributions directed to your TESPHE account fromProfit Sharing payments will be invested in accordancewith your most recent investment elections, except asnoted below.

If you have never made an investment election or if youhad ceased to actively contribute to the TESPHE prior toOctober 1, 1995, and have not made an election since,any contributions from Profit Sharing payments will beinvested in the Interest Income Fund. You may then ex-change your Profit Sharing contributions to other invest-ment options, subject to the Plan’s exchange rules foundin that section of this handbook.

Rollover from subsidiary planUnder certain circumstances, you may elect to have thePlan accept a transfer from a savings plan of a subsidiarywhere you were previously employed of fully vestedamounts, either in the form of cash or Company stock,provided such acceptance would not require the Plan toprovide benefits in an amount or form not otherwise pro-vided under the Plan. Amounts transferred will be investedin accordance with your elections among the investmentoptions available under the Plan. Thereafter, all such as-sets shall be subject to all the provisions of the Plan ap-plicable to any other assets credited to your account.

Rollover from prior employer’s planHistorically, you could arrange for a rollover of the taxableportion of cash from a total distribution from a similar quali-fied plan of your last employer or a conduit IRA. (A conduitIRA is one that holds nothing more than the distributionfrom your prior employer’s plan, plus earnings, and is notmixed with other IRA assets). Beginning January 1, 2002,you may also roll over distributions from 403(b) arrange-ments (tax-free annuities), 457 plans (governmental plans)and traditional IRAs, and after-tax amounts from a quali-fied plan. The after-tax contributions from another qualifiedplan must be made directly between your prior employerplan and TESPHE in a direct rollover. TESPHE may notaccept after-tax rollover contributions from an IRA.

You may also roll over an eligible distribution from yourdeceased spouse or former spouse (as a result of a Quali-fied Domestic Order) from the plans listed above.


You may:• Have the cash assets transferred from the plan of your

prior employer directly to TESPHE (direct rollover); or• Contribute to TESPHE all or a portion of the cash assets

distributed to you from your prior employer’s plan,provided you make the contribution within 60 days afteryou receive the distribution (60-day rollover)

You should be aware that once your assets are trans-ferred into the TESPHE, they are subject to Plan with-drawal and distribution rules.

You may make a rollover to TESPHE without waiting thenormal three months for eligibility. You may contact theFidelity Service Center for Ford Motor Company at 1-800-544-3333 for more information if you would like to arrangea rollover and to obtain the necessary forms.

Contributions following qualified Military ServiceA member of the Plan who is reinstated following qualifiedmilitary service, as defined in the Uniformed ServicesEmployment and Reemployment Rights Act, may elect tohave contributions made to the Plan from such member’swages paid following such qualified military service thatshall be attributable to the period contributions were nototherwise possible due to military service. Such additionalcontributions shall be based on the amount of wages andProfit Sharing payment that the member would have re-ceived but for military service and shall be subject to theprovisions of the Plan in effect during the applicable pe-riod of military service. Such contributions shall be madeduring the period beginning upon reemployment followingmilitary service and ending at the lesser of (i) five years or(ii) the member’s period of military service multiplied bythree. Such additional contributions will not be taken intoaccount in the year in which they are made for purposesof any limitation or requirement generally imposed on con-tributions by the Internal Revenue Code. However, suchcontributions, when added to contributions previouslymade, will not exceed the applicable limits in effect duringthe period of military service if the member had continuedto be employed by the Company during such period. Fur-ther, payments on any loan or loans outstanding duringthe period of military service will be extended for a periodof time equal to the period of qualified military service.

Limits on TESPHE contributionsComplex tax rules govern contribution levels to plans likeTESPHE. The following information is based on tax lawsin effect as of January 1, 2004:• Your pre-tax TESPHE contributions are subject to an

annual limit. The annual limit through 2006 is: 2004($13,000); 2005 ($14,000); 2006 ($15,000), includingany contributions from your Profit Sharing payment,but excluding any Catch-Up Contributions. The an-nual limit may be adjusted for inflation in future yearsbeyond 2006.

• The tax law tries to encourage fair rates of savingsamong employees at all pay levels. If the savings ratesamong all TESPHE participants do not meet certainInternal Revenue Service (IRS) guidelines, the Com-pany may need to adjust individual savings rates ofhighly compensated employees to comply with theseguidelines. The IRS defines highly compensated em-ployees as those who received compensation from theCompany in excess of $90,000 in the prior year. Thisfigure may be adjusted to reflect changes in cost ofliving in future years.

• In addition, TESPHE contributions from both payrolldeductions and from Profit Sharing payments cannotexceed the lesser of $41,000 or 100% of your compen-sation. NOTE: The $41,000 may be adjusted for infla-tion in later years.) For this purpose, compensation isyour gross earnings from April 1 through March 31. Gen-erally, the $41,000 annual limit is prorated weekly. Youmay be affected by this weekly limit if you are contrib-uting on a weekly basis at or near the maximum TESPHEcontribution rate of 50%. As a result, your requestedcontributions from Profit Sharing would be reduced andany reduction will be paid by check. (Please note thatCatch-Up Contributions are not subject to the $41,000annual limit.)

Contributions will be adjusted to comply with these limits.


What are the investment options?

You can invest in any of the 34 available investmentoptions.

The Plan offers a diversified line-up of passively managed,actively managed and life stage investment options fromwhich you may choose. These options provide a range ofrisk/return preferences.

A booklet entitled Your Investment Guide contains a briefdescription of the available investment options as well assome educational material. Please call Fidelity at 1-800-544-3333 to obtain a copy of this booklet. You may alsoprint a copy from NetBenefits at netbenefits.fidelity.com.

The current investment options and the accompanyingVoice Response System (VRS) codes are listed below.

Available Investment Options (VRS Code)

Life Stage Funds:• Fidelity Freedom Income Fund® (00369)• Fidelity Freedom 2000 Fund® (00370)• Fidelity Freedom 2010 Fund® (00371)• Fidelity Freedom 2020 Fund® (00372)• Fidelity Freedom 2030 Fund® (00373)• Fidelity Freedom 2040 Fund® (00718)

Equity Funds - Passively Managed:• BGI EAFE Equity Index Fund - Class T (44715)• Common Stock Index Fund (99527)• Domini Social Equity Fund (93967)• Ford Stock Fund (20207)• U.S. Extended Market Index Fund (10152)• Vanguard Institutional Index Trust - Institutional Plus

Shares (20745)

Equity Funds - Actively Managed - Domestic:• Fidelity Capital Appreciation Fund (00307)• Fidelity Contrafund® (00022)• Fidelity Dividend Growth Fund (00330)• Fidelity Equity-Income Fund (00023)• Fidelity Growth Company Fund (00025)• Fidelity Magellan® Fund (00021)• Fidelity Real Estate Investment Portfolio (00303)• Janus Aspen Growth Portfolio - Institutional (20569)• Neuberger Berman Genesis Fund - Class I (45418)• Oakmark Select I Fund (92778)• Royce Low-Priced Stock Fund (22434)• Vanguard Explorer Fund - Admiral Class (44702)

Equity Funds - Actively Managed - International:• Fidelity Overseas Fund (00094))• Morgan Stanley Institutional Fund, Inc. - Global Value

Equity Portfolio - Class A (93984)• T. Rowe Price International Discovery Fund (99542)• Templeton Foreign A Fund (99500)

Fixed Income:• Bond Index Fund (99529)• Interest Income Fund (97981)• PIMCO Real Return Fund - Institutional Class (96095)• PIMCO Total Return Fund - Institutional Class (99622)• T. Rowe Price High Yield Fund (99544)• PIMCO Total Return Fund III - Institutional Class (91391)


There are no fees for any of the investment options at thetime of purchase, and any normal sales charge or “load”of any fund offered under the Plan is waived. However, allof the investment options have management fees andother operating expenses associated with them. Ford willpay all fees and expenses of the Ford Stock Fund and themanagement fees of the Common Stock Index Fund andthe Bond Index Fund. All other fees and expenses arededucted from the assets of the particular option.

• Plan Administrative Expenses are the costs ofmaintaining the Plan’s day-to-day operations. Theseexpenses include the cost of all services such asrecordkeeping, loan processing and annual maintenancefees, statements, and education. Generally, Ford MotorCompany pays Plan administrative expenses.

• Expense Ratios is the percentage of the fund’s assetsused to pay for the fund’s operating expenses. Mutualfund expense ratios are reported in “basis points”. Abasis point is 1/100th of one percent. (Note: You will beprovided with an update of the expense ratios for theavailable investment options in TESPHE each year.)Example: If a fund charges a fee of 55 basis points,the fund’s return is reduced by 55/100ths of one per-cent (0.0055) annually to cover expenses. If you have$10,000 invested in that hypothetical fund, $55.00annually would be deducted from your investment inthat fund. Fees are deducted from the fund’s returnson a daily basis (the fund’s basis points charged di-vided by 365).

In addition, certain funds may charge participants a “re-demption” fee or impose a short-term trading restriction atthe time the participants move money out of the fund.

The management fees, operating expenses, redemptionfees and short-term trading restrictions, if any, and anyother fees associated with the mutual funds are explainedin each fund’s individual prospectus. You should requestand read the mutual fund’s prospectus prior to making adecision involving that fund. You may obtain a free mutualfund prospectus by calling the Fidelity Service Center forFord Motor Company at 1-800-544-3333. You may alsoview fund information online, or request a mutual fund pro-spectus at Fidelity NetBenefits by accessingnetbenefits.fidelity.com.

Responsibility of membersUnder the Plan, you are solely responsible for the se-lection of your investment options. Ford Motor Com-pany, the Trustee, any appointed Fiduciary, the PlanAdministrator, the Fidelity Service Center for FordMotor Company, the Union, and employees and agentsof the Company are not empowered to provide invest-ment advice. The fact that an investment option is avail-able for investment under the Plan should not beconstrued as a recommendation for investment in thatoption. It should be noted that the market price andthe rate of return on each investment option may fluc-tuate over time and in varying degrees. Accordingly,the proceeds realized from such investments, if any,will depend on the prevailing market price of the in-vestments at a particular time, which may be more orless than the amount expended initially. There is noassurance that the investment options will achievetheir objectives.

The Plan is intended to constitute a plan described inSection 404(c) of the Employee Retirement Income Se-curity Act, and Title 29 of the Code of Federal Regula-tions Section 2550.404c-1. The fiduciaries of the Planmay be relieved of liability for any losses which arethe direct and necessary result of investment instruc-tions given by a participant or beneficiary.

Investing your contributionsYou must invest your contributions in increments of 1%with a minimum of 5% for each investment option youselect. Your contributions will be deducted from your weeklypaychecks and will be invested in the options you haveelected as soon as possible, usually within two businessdays after payday.

Changes in investment electionsYou may change your Pre-Tax Contributions and After-Tax Contributions investment elections by calling the Fi-delity Service Center for Ford Motor Company or throughFidelity NetBenefits at netbenefits.fidelity.com. Your newinvestment elections will be effective as of the close ofbusiness on any business day if your request is madeand confirmed prior to the close of the New York StockExchange (usually 4:00 p.m. Eastern Time) on that day. Ifyour request is made or confirmed after this time or onnon-business days such as weekends or holidays, yournew investment elections will be effective as of the closeof business on the next business day.


Making an investment option selectionBefore you select any of the investment options, be sureto request a prospectus for the mutual funds offeredthrough the Plan from Fidelity. You can also view fundinformation online at Fidelity NetBenefits atnetbenefits.fidelity.com under the Accounts tab. Just se-lect Performance under “Investment Resources” from theleft-hand menu. You can obtain complete descriptions ofcertain funds that are only available through Ford savingsplans and are not publicly traded from the Your Invest-ment Guide brochure. You may obtain brief descriptionson the remaining investment options and general invest-ment information from the brochure. Contact the FidelityService Center for Ford Motor Company at 1-800-544-3333to obtain a copy. You may also view or print a copy of theYour Investment Guide brochure from NetBenefits. Oncelogged on to your account, select the Investment Guidelink under Plan News.

How can you exchange assets?

You can exchange assets between investmentoptions daily.

Assets may be exchanged from any one investment optiondirectly to any other single investment option, subject tocertain fund restrictions. You may initiate one or moreexchanges daily. For example, on any day, you couldexchange the value of a portion of your Common StockIndex Fund assets and reinvest the value of those assetsin the Bond Index Fund and then request a secondexchange from the Common Stock Index Fund and reinvestthe value of those assets in the Templeton Foreign Fund⎯ Class A.

Assets may be exchanged in dollar amounts, percentageof current balance (in increments of 1%) or number ofshares or units. The minimum exchange amount is $250,or the entire value of the assets invested in the option if$250 or less.

Making an exchangeYou may request an exchange by calling the Fidelity Ser-vice Center for Ford Motor Company or through FidelityNetBenefits at netbenefits.fidelity.com. Your exchange willbe effective as of the close of business on any businessday if your request is made and confirmed prior to theclose of the New York Stock Exchange (usually 4:00 p.m.Eastern Time) on that day. If your request is made or con-firmed after this time or on non-business days, such asweekends or holidays, your exchange will be effective asof the close of business on the next business day. Be-cause of high call volume near the close of the market attimes, you may wish to call early to be sure your requestis made and confirmed before the deadline. A businessday is any day that the New York Stock Exchange is open.


Short-term Redemption Fees

Several mutual funds in the TESPHE impose a short-termredemption fee, which is charged to discourage short-termbuying and selling of fund shares. Short-term redemptionfees are disclosed in each mutual fund’s prospectus. Sincethese fees are subject to change at any time by the fund,you should always consult the fund’s most recent prospec-tus or contact Fidelity for current short-term redemptionfee information.

Trading Restrictions

The investment options in the TESPHE may impose limitson how frequently you may trade into and/or out of theinvestment option. For example, a fund may not allow youto exchange back into the fund if you exchange out of thefund within the previous 90 days. You may contact Fidelityfor up-to-date information on a fund’s trading restrictions.

Exchange Privileges

The investment options available through the TESPHEreserve the right to modify or withdraw the exchange privi-leges at any time, including rejecting any transactionsdeemed to be disruptive to the fund manager’s ability tomanage the fund’s portfolio. This may include, but is notlimited to substantive dollar amounts and/or frequent“round-trip” transactions. (Generally, a “round-trip” is definedas an exchange into and out of, or out of and into, thesame fund.) You are able to make exchanges out of a fundat any time.

If your transaction is rejected by the fund, Fidelity, as theprovider of recordkeeping services for the TESPHE, is notnotified until the following business day. At that time, af-fected participants are notified and the transaction is re-versed (monies are reinvested into the fund(s) from whichthe exchange was originally processed). Please note thatneither Ford nor Fidelity has the ability to influence thefund’s decision with respect to modifying or withdrawingexchange privileges.

Exchange Privileges regarding the Ford Stock Fund

Effective December 1, 2004, you may exchange out of theFord Stock Fund at any time. You are limited to five (5)exchanges per month into the Fund. This restriction is sub-ject to change. As with other investment options, be sureto confirm trading restrictions on the Ford Stock Fund withFidelity prior to investing in this Fund.


How can you borrow from the Plan?

Loans may give you access to your account whileyou’re still working at Ford.

You may borrow from the value of your TESPHE assets, ifyou’re an active employee, either full-time or part-time.Effective February 1, 2004, employees on leave of ab-sence from the Company may initiate loans while on leave,unless they have a history of loan default. Assets will besold to provide cash for your loan. You then pay back youraccount (at a competitive rate of interest) over time.

Know the facts before you act••••• The more you borrow, the less money you have to

potentially grow to supplement your retirement.Leave your money untouched and you could be lookingat a better retirement lifestyle or an earlier retirement.

••••• Your loan money misses out on growth opportuni-ties in a rising market.You want your money invested when the market is rising.After all, that’s how money invested in your TESPHE ac-count can grow. But if you take out any of your TESPHEassets for a loan, that money is not invested and, there-fore, is missing an opportunity for growth.

••••• If you default on your loan, the IRS considers theoutstanding balance (plus accrued interest since thelast loan payment) a distribution.The distribution will be subject to ordinary income taxes,and possibly a 10% early withdrawal penalty if you’reyounger than age 59½.

••••• The interest and principal you repay to your accountmay be subject to double taxation.One of the benefits of participating in the TESPHE isthat you are able to make Pre-Tax Contributions. YourPre-Tax Contributions are not subject to taxes until youwithdraw them at retirement, or for some other reason.The repayments and interest you pay back on a loanare made on an after-tax basis and added to either yourpre-tax, after-tax source, and/or roll over sources basedon how the monies were deducted from your accountto provide loan proceeds. The interest and principal,that goes back into your pre-tax source (and in somecases, your rollover sources) and interest that goesback into your after-tax source most likely will be sub-ject to taxes a second time when you eventually with-draw them, depending on your individual circumstance.You are encouraged to speak with your financial advi-sor regarding your personal tax situation.

Eligible assetsThe maximum amount you may borrow is the lesser of:••••• 50% of the aggregate value of your account, but not

more than $50,000, or••••• $50,000 reduced by the difference between your high-

est loan balance under all Ford plans during the previ-ous 12 months (ending on the day before the effectivedate of your loan from the TESPHE) and your loan bal-ance on the effective date of your loan.

You can apply for one loan each calendar year, and youmay have up to four loans outstanding at any time. Usu-ally, you may choose a loan repayment period of from oneto five years in one-year increments. If the loan is beingused to buy or construct your principal residence, youmay select a repayment period of ten years. The mini-mum loan amount is $1,000. Loan amounts over this mini-mum may be requested in $100 increments.

Interest chargesLoan interest rates are set monthly but will not changeduring the term of the loan. The interest rate will be theprime rate as quoted in The Wall Street Journal in the“Money Rates” section of the paper as of the last busi-ness day of the month preceding the month in which theloan is taken. If more than one rate is quoted in The WallStreet Journal on the day the loan rate is set, the lowestrate will be used.

Interest you pay on your loan will be credited to your ac-count. Under current tax laws, you may not deduct yourinterest payments for loans obtained after 1986 on yourtax return.


Applying for a loan

When you apply for a loan, you can specify the order inwhich your eligible assets are to be sold to provide cashfor the loan. The market value of assets sold to providecash for your loan will be transferred to a loan investmentaccount from which your loan will be made.

You may request a loan for one to five years by calling theFidelity Service Center for Ford Motor Company or ac-cessing NetBenefits at netbenefits.fidelity.com. You mustspeak with a Fidelity Service Center for Ford Motor Com-pany representative if you wish to specify the order inwhich your eligible assets are to be sold. If you use theautomated telephone system or request a loan onlinethrough NetBenefits, your assets will be sold proportion-ately from each investment option. Your loan will be effec-tive as of the close of business on any business day ifyour request is made and confirmed prior to the close ofthe New York Stock Exchange (usually 4:00 p.m. EasternTime) on that day. If your request is made and confirmedafter this time or on non-business days such as week-ends or holidays, your loan will be effective as of the closeof business on the next business day. Because of highcall volume near the close of the market at times, youmay wish to call early to be sure your request is madebefore the deadline. A business day is any day that theNew York Stock Exchange is open.

A ten-year loan can be used only to buy or construct yourprincipal residence. It may not be taken to refinance anexisting residence, make a balloon payment on an exist-ing mortgage, or purchase a second home or land. If youwould like a ten-year loan, you must first request an appli-cation for a ten-year loan from the Fidelity Service Center.The completed application and a copy of your purchaseagreement from a realtor or homeowner, your builder’scontract, or your bridge loan due to relocation, should bemailed to the Fidelity Service Center for Ford Motor Com-pany. Your ten-year loan must be issued before the clos-ing on the purchase of your primary residence.

Your loan check will be mailed to you within three to fivebusiness days after your request is effective. Interestbegins accruing on the first day following the day the loanis effective. When you receive the check, you will be pro-vided Truth-in-Lending information. Your endorsement onthe back of the check indicates your agreement to thepromissory note’s repayment conditions.

Loan Repayments

Effective January 1, 2004, you can accelerate the payoffof your loan by making additional payments above yourscheduled payments. These payments must be made inthe form of a cashiers or certified check or a money order.Call the Fidelity Service Center for Ford Motor Companyat 1-800- 544-3333 for details.

••••• Active full-time hourly employees. Your loan repay-ments will be payroll-deducted from your weekly pay-checks. Normally, payroll deductions will begin the nextpayday if your loan is effective on or before the secondThursday preceding that payday; otherwise, the follow-ing payday.

••••• Part-time employees, transfers to a non-participat-ing subsidiary. You will be sent a coupon book for youruse in making loan repayments directly to Fidelity.

••••• Layoffs, leaves, transfers to salaried. You will be senta coupon book for your use in making loan repaymentsdirectly to Fidelity. Generally, when you return to workfrom leave or layoff, or if you return to work as a full-time hourly employee, payroll deductions will beginautomatically. To avoid missed payments in the eventloan deductions do not begin upon return to the activehourly rolls, be sure to contact Fidelity if the loan de-duction is not reflected on your first paycheck.

••••• Retirees/Terminations. Generally, if you do not payoff your loans in full at the time of retirement or termi-nation, you will be sent a coupon book for your use inmaking monthly loan repayments directly to Fidelity. Ifyou authorized loan deductions from your pensionchecks before September 27, 1995, that deduction willcontinue and you will not receive a coupon book.

••••• Loans taken out beginning January 1, 2004. InternalRevenue Service (IRS) regulations stipulate that Planparticipants who:— have a history of a loan default (now or in the future);

and— initiate a TESPHE loan beginning January 1, 2004,

or later; and— cannot continue loan repayment via payroll

deduction due to layoff, retirement, separation fromactive employment (all leaves), or otherwise becomepayroll ineligible

will not be allowed to continue repayment of loan viacoupons. The participant must pay off any loans takenout beginning January 1, 2004 in full or they willdefault, and the principal and any accrued interestwill be subject to income taxes and if applicable, thepenalty for early withdrawal.Loans taken out prior to January 1, 2004 are not sub-ject to this IRS regulation and participants may continueto make repayments via a coupon book if they becomeineligible for repayment via payroll deduction.


Examples:Susan Jones defaulted on a TESPHE loan in 2003. InFebruary 2004, Susan takes out a new loan and she issubsequently laid off in May 2004. Under IRS regula-tions governing TESPHE loans, Susan will not be per-mitted to continue repayment of the February 2004 loanvia a coupon book while on layoff. She must either paythe loan off in full or the loan will default.John Smith has no history of a loan default. He takesout a loan in 2004. John, like Susan above, is laid off inMay 2004. Because he does not have a history of anyprior loan default, he may continue loan repaymentsvia coupon book while on layoff.

Remember to always verify that your loan payment is be-ing deducted from your paycheck. If it is not, contact theFidelity Service Center for Ford Motor Company immedi-ately so that they can take corrective action.

If you are required to make loan payments via coupons,Fidelity will mail the coupon book within 15 days of notifi-cation of your change in status (e.g., leave, layoff, termi-nation, etc). If you do not receive the coupon book withinthis timeframe, contact Fidelity immediately so that theycan take corrective action.

Ultimately, YOU are responsible for loan repayments.If loan payments are not being deducted from yourpaycheck (active employees), or if you have not re-ceived coupons to make loan payments (inactive em-ployees, part-time employees, transfers to salaried,layoffs or terminated/retired employees), you mustcontact the Fidelity Service Center for Ford Motor Com-pany immediately.

If you do not comply with the Plan’s loan repayment provi-sions (e.g., failure to make payments on time), the out-standing loan balance (principal and accrued interest) willbe treated as a deemed distribution of assets and will besubject to federal, state, and local income taxes, and pos-sible early withdrawal penalties. The Trustee will report thetaxable amount of this distribution to the IRS and you willbe sent a Form 1099-R.

Investment of loan repayments

Loans taken before October 1995: Loan repayments, in-cluding interest, will be invested in the Interest IncomeFund and can be exchanged to other investment options,subject to the Plan’s exchange rules on page 213.

Loans taken after October 1995: Loan repayments,including interest, will be invested in accordance with yourmost recent investment elections, except as noted below.

If you ceased to actively contribute to the TESPHE prior toOctober 1, 1995, and, have not made an election since, yourrepayments including interest will be invested in the InterestIncome Fund, and can be exchanged to other investmentoptions subject to the Plan’s exchange rules. See the “Howcan you exchange assets?” section for details.

How are assets paid from the Plan?

Generally, assets must stay in your TESPHE accountuntil you retire or terminate employment from theCompany or attain age 59 1/2 . Withdrawals from youraccount may be available under certain conditions.

TESPHE is intended to help you save for the long term. Youhave access to your TESPHE account with some restric-tions. However, your Pre-Tax Contributions cannot be with-drawn while you’re still working (including leaves of absence)for the Company unless you attain age 591/2 or have a finan-cial hardship. For information on the tax implications of with-drawal including penalty for certain withdrawals before age591/2, see the “Tax Consequences” section.

After-Tax ContributionsYou may withdraw all or a portion of your After-Tax assetsat any time.

Pre-Tax ContributionsUnder current tax law, you may withdraw all or a portion ofyour assets after you reach age 591/2, terminate employ-ment, or have an approved financial hardship.

Withdrawals after you reach age 591/2

You may make a withdrawal of all or a portion of youraccount balance at any time after you reach age 591/2. Ifyou make a withdrawal at age 591/2. or later, your contribu-tions will continue unless you request a cancellation throughthe Fidelity Service Center for Ford Motor Company orthrough Fidelity NetBenefits. You may continue to havecontributions made to your TESPHE account as long asyou work for the Company.

Hardship withdrawals before you reach age 591/2

The requirements for a financial hardship are:• You must have an immediate and heavy financial need,

and• The withdrawal must be necessary to satisfy such

financial need, and• The amount of the hardship withdrawal cannot be in

excess of the heavy financial need

Hardship withdrawals are limited to the value of yourTESPHE assets (including earnings and dividends) on De-cember 31, 1988, plus Pre-Tax TESPHE contributions (notearnings or dividends) made after December 31, 1988.

A hardship withdrawal will provide you with monies rolledover from another plan described in the “Rollovers fromprior employer’s plan” section and monies attributable toPre-Tax Contributions. A hardship withdrawal cannot berolled over to another eligible plan or IRA.


If your hardship withdrawal is approved, you will besuspended from making Pre-Tax, After-Tax, or Catch-Upcontributions to the savings plans of the Company, or itssubsidiaries, for 12 months, from eligible pay or any othertype of compensation, such as profit sharing contributions.Contributions will resume after the 12- month period, unlessyou request a cancellation through the Fidelity ServiceCenter for Ford Motor Company or through NetBenefits.

You may contact the Fidelity Service Center for Ford Mo-tor Company to initiate a hardship withdrawal and to ob-tain more information.

Systematic withdrawal with a series of payments from your account• After termination of employment or attainment of

age 591/2 . At any time after you terminate employmentor reach age 591/2, you may elect to receive paymentof your Plan account in monthly, quarterly, semi-an-nual or annual installments over a period of time youspecify. You may choose any period of time in wholeyears over which you would like payments to be madeas long as the period is at least one year, and no greaterthan a number of years approximately equal to your lifeexpectancy at the age at which you make the election,or a number of years approximately equal to your jointlife expectancy with your spouse or other beneficiary.The Fidelity Service Center for Ford Motor Companywill be able to tell you from IRS tables what the aver-age life expectancy is, based on your age and informa-tion on the age of your beneficiary that you provide.

Regardless of how you choose the number of yearsover which you want systematic payments to be made,the manner of determining the amount of each pay-ment will be the same and will be based on the value ofyour account at the effective date of payment of eachinstallment and the number of installments remainingto be paid. For example, if you specify a period of tenyears and monthly payments, the number of install-ments would be 120. The amount of the first paymentwill be equal to the value of your account on the effec-tive date of payment divided by the total number ofinstallments; that is, 120. The amount of the next in-stallment would be based on the value of your accountat the time of payment of the next installment dividedby the number of installments remaining; that is, 119.For the last installment, the entire value of your ac-count would be paid to you.

The amount for each installment will be withdrawn pro-portionally from each investment election in which youhave assets on the effective date of each installment.

Participants who are not active employeesIf you make an election for systematic withdrawal withpayments before you reach age 591/2, you may be subjectto an early withdrawal tax penalty of 10% of the amount ofeach installment paid to you before you reach age 591/2,unless you elect payment over a period at least equal toyour life expectancy (based on your age) or to your lifeexpectancy jointly with that of your beneficiary under thePlan (based on your age and the age of your beneficiary).If you make this election so that you avoid the penaltyand later change your election before you reach age 591/2,payments under your changed election must be made overthe longer of a period of at least five years or a periodextending beyond your attainment of age 591/2 if you wishto avoid the tax penalty of 10% that would be imposed onpayments made before you attain age 591/2, including pay-ments already made before you changed your election.You should consult with your tax advisor.

In the event the payments made under the systematicwithdrawal you have elected are less than the amountsrequired to be distributed after you reach age 701/2 andyou have terminated employment, an additional amountwill be distributed to you in December of each year in anamount necessary to satisfy the minimum required distri-bution amounts as described on page 220.

If you retire or terminate employment, you may withdrawall or a portion of your TESPHE assets effective on anybusiness day.

If you are on a leave of absence or layoff, or transfer tosalaried roll, a successor company or to a non-participat-ing subsidiary, you are subject to the same withdrawalprovisions as an active employee.

If you are an alternate payee because you were awardedassets under a Qualified Domestic Relations Orders(QDRO), you will be treated in accordance with the termsstated in the court order. For more information, see the“What circumstances might affect Plan benefits?” section.


Direct rolloverIf you elect to withdraw assets or expect to receive adistribution of assets from TESPHE, you may instruct theTrustee to make a direct rollover of eligible assets toanother employer’s qualified plan (similar to TESPHE),governmental plans, plans of tax-exempt organizations orto a traditional IRA (if the receiving plan permits and agreesto separately account for the transferred amounts).

In a direct rollover, assets can be transferred withoutpenalty or payment of income tax. Generally, your as-sets attributable to Pre-Tax Contributions (includingCatch-Up Contributions, After-Tax Contributions and allassociated earnings are eligible for direct rollover. Af-ter-Tax Contributions may be rolled over only to an IRAor annuity described in Sections 408(a) or (b) of theInternal Revenue Code, or to a qualified plan describedin Sections 401(a) or 403(b) of the Internal RevenueCode that agree to account for the amounts transferred.To qualify as a direct rollover, the assets must be trans-ferred by Fidelity to the receiving eligible plan or IRA.You should contact the Fidelity Service Center for FordMotor Company at 1-800-544-3333 for the forms neces-sary to arrange a direct rollover.

If you receive a withdrawal or distribution from TESPHEand you do not elect a direct rollover, the taxable portionof the withdrawal or distribution is subject to a mandatory20% federal income tax withholding from any cash dis-tributed. You may make a rollover of eligible assets afteryou receive a withdrawal or distribution, but the 20% with-holding on the taxable portion of the withdrawal or distri-bution from TESPHE still applies.

See the special tax notice on page 221 which was preparedby the Internal Revenue Service and modified for TESPHE.You should consult your personal tax advisor to ensurethat any actions you take are to your best advantage.

Making a withdrawalYou may request a withdrawal of all or a portion of youreligible assets by calling the Fidelity Service Center forFord Motor Company or through Fidelity NetBenefits atnetbenefits.fidelity.com.

Your withdrawal will be effective as of the close of busi-ness on any business day if your request is made andconfirmed prior to the close of the New York Stock Ex-change (usually 4:00 p.m. Eastern Time) on that day. Ifyour request is made and confirmed after this time or onnon-business days such as weekends or holidays, yourwithdrawal will be effective as of the close of business onthe next business day.

Because of high call volume near the close of the marketat times, you may wish to call early to be sure your re-quest is made before the deadline. A business day is anyday that the New York Stock Exchange is open.

Withdrawal checks will be mailed to you within three tofive business days after your request has been processed.You may also request that proceeds be paid to you elec-tronically (wired to your bank account).

How withdrawals are paidIf you request a withdrawal, the value of your Ford StockFund assets, if any, will be paid in cash, unless you requesta stock certificate. You may request that any whole sharesof Ford Common Stock represented by your units in theFord Stock Fund be issued as a certificate by talking to arepresentative at the Fidelity Service Center. In this case,fractional shares will be paid in cash. The certificaterepresenting whole shares will be in your name or, if yourequest it, in your name and the name of another personyou designate. If you request a withdrawal from the FordStock Fund and you request a stock certificate, you willreceive a stock certificate for your assets in the fund.

Any assets withdrawn from other investment options willbe paid to you in cash.


Dividends on stock in the Ford Stock FundYou have the option of receiving a distribution in cash orreinvesting the dividends attributable to your equivalentshares of Ford Common Stock based on the units held inthe Ford Stock Fund, unless you make an election to havethe dividends reinvested in your account.

If you enrolled in the SSIP on or after January 1, 2002, yourproportionate share of any cash dividends will be handled inthe same manner as they had been immediately prior to thisdate (either distributed to you in cash or reinvested in theFord Stock Fund, depending on your arrangement).

If you enrolled January 1, 2002 or after, your proportion-ate share of any quarterly cash dividends paid on the FordStock Fund will be reinvested in your account in the FordStock Fund in the Plan, unless you elect to have themdistributed to you in cash.

The amount of such cash dividend not distributed gener-ally will be used by the Trustee to acquire additional sharesof Ford Common Stock. To the extent such dividends re-main in the Plan, the number of units in your account willbe increased to reflect the acquisition by the Trustee ofthose additional shares.

You may change your dividend election at any time bycontacting the Fidelity Service Center for Ford Motor Com-pany or by accessing Fidelity NetBenefits atwww.netbenefits.fidelity.com. After accessing your ac-count, select the Accounts tab. Scroll down the left-handmenu and select Dividend Election under the AccountManagement section.

With respect to the Ford Stock Fund, the amount of anysuch cash payment made directly to you maybe reducedto comply with legal restrictions on the amount that maybe paid out to all members in total. The amount in totalthat may be paid out of the Ford Stock Fund is limited tocash dividends received by the plan on Ford CommonStock shares that have not been in the Plan continuouslysince January 1, 1989, without regard to Ford CommonStock shares associated with individual accounts.

Payments of dividends are not subject to the 10% earlywithdrawal penalty and are generally not subject to in-come tax withholding. They are considered taxable incomesubject to ordinary income tax rates and are not eligiblefor rollover to an IRA or another employer’s qualified plan.

Only shares of Ford stock in the Plan by 4:00 p.m. East-ern Time one day prior to the ex-dividend date are eligiblefor the dividend payment. Payment will be made as soonas practicable after receipt by Fidelity of the dividend.

When would assets be paid automatically from the Plan?

In some circumstances, distributions will be made byTESPHE even if you do not request them.

All or a portion of your TESPHE assets will be distributedto you under certain circumstances even if you do notrequest them. Usually, you will be notified before a distri-bution is made. In this situation, you may wish to consultyour tax advisor regarding alternatives available to you.

Accounts valued at less than $3,500Your assets in the TESPHE will be distributed to you aftertermination of employment if the value of your assets isless than $3,500 on the effective date of any prior with-drawal or distribution from your account. This value is de-termined within 90 days after termination and excludesany rollover amounts. If you were a Plan participant onSeptember 30, 1995, you are not subject to this minimumdistribution requirement.

After termination of employmentIf you elect to have the Plan retain your assets after youattain age 65 and assets remain in the Plan when youattain age 701/2, they will be distributed to you by the re-quired beginning date. These distributions are referred toas minimum required distributions, or MRDs. The requiredbeginning date is April 1 of the calendar year following thecalendar year in which you attain age 701/2. Thereafter, theMRDs must be distributed by December of each year.

In general, the applicable distribution period is obtainedfrom the Internal Revenue Code Uniform Lifetime Tableand is based solely on your age as of your birthday in therelevant distribution calendar year. If the sole beneficiaryis your spouse, however, the distribution period is the longerof the distribution period from the Uniform Lifetime Table,or in the case of a spouse beneficiary who is more than10 years younger than, you the joint life expectancy ofyou and your spouse.

Generally, payout under the distribution schedule for man-datory age 701/2 payments would permit you to leave yourassets in TESPHE for the longest possible period (if youhave terminated employment). The amount of any manda-tory age 701/2 distribution would be reduced by the amountof payments made earlier in the year under any other with-drawal election. For example, assume during any givenyear you requested a $1,000 withdrawal from your account.The mandatory 701/2 distribution is processed in Decem-ber and amounts to $4,000. Only $3,000 would be distrib-uted to you in that year to satisfy the remaining minimumrequired distribution payment. While MRD rules require thata minimum amount be distributed to you, you may electto receive a greater amount under the withdrawal optionsdescribed in the section titled “How are assets paid fromthe Plan?”


If you dieIf you die, the assets in your account will be payable toyour beneficiary. If your beneficiary is not your survivingspouse, the assets will be distributed as soon aspracticable after your death.

If your beneficiary is your surviving spouse, specialrules apply:• If you elected a distribution schedule which commences

before your death, your account will continue to be paid toyour surviving spouse according to your schedule.

• At any time, your surviving spouse can elect a lumpsum distribution.

• If distribution has not commenced at the time of yourdeath, your surviving spouse will be considered a par-ticipant for purposes of distribution under TESPHE. Yoursurviving spouse shall be deemed to attain age 701/2

on the date you would have attained 701/2 and may electthe ‘life expectancy’ method for distribution.

• While your surviving spouse retains your account inTESPHE, he or she will be able to exchange amongthe investment options as any other participant.

• In the event of the death of your surviving spouse, theaccount will be paid to your surviving spouse’s estate.

It is important that you keep your beneficiary designationup to date and your current address on file at your hourlypersonnel activity. For information on beneficiaries, seepage 228.

Loans unpaid at termination of employmentYou are required to repay your outstanding loans in full atthe time you retire or to use a coupon book available throughthe Fidelity Service Center for Ford Motor Company tomake loan repayments. If you do not repay your loansaccording to Plan provisions, Fidelity will report to youand the IRS that a distribution of assets equal to the out-standing loan balance was made, some or all of whichmay be taxable.

NOTE: Final regulations governing loans from TESPHErequire that repayments of loans initiated beginning Janu-ary 1, 2004 (by members who have a history of loan de-fault) must be payroll deducted. As a result, such loansmust be paid off once participants are separated from theCompany. Using a coupon book to continue loan repay-ments will not be an option. See the “Loan Repayments”section for details.)

How distributions are paidDistributions are paid in a similar manner as withdraw-als, as described in the “How are assets paid from thePlan?” section.

Direct rolloverDistributions made after termination or retirement, otherthan mandatory distributions, are generally eligible forrollover, as described in the “How are assets paid fromthe Plan?” section.

What are the tax consequences of my withdrawal ordistribution?

You may owe taxes after all or a portion of youraccount is paid to you.

SPECIAL TAX NOTICE

The tax law contains several complex rules regarding thetaxation of withdrawals and distributions. The Internal Rev-enue Service has prepared a summary of many of theserules in the following “Special Tax Notice”. The Companyhas inserted references to TESPHE to assist you. Thisnotice contains important information you will need beforeyou decide how to receive withdrawals or distribution pay-ments from TESPHE. Regulatory changes affecting thisnotice may not be updated in the TESPHE immediately.As a result, the notice may not always be current. How-ever, Fidelity is required to send you the most recent no-tice prior to processing a distribution or withdrawal.

A rollover is a payment by you or Fidelity of all or part ofyour benefit to another plan or IRA that allows you to con-tinue to postpone taxation of that benefit until it is paid toyou. This notice describes the federal tax rules applicableto “eligible rollover distributions”. Your distribution paymentcannot be rolled over to a Roth IRA, a SIMPLE IRA, or aCoverdell Education Savings Account (formerly known asan education IRA). An “eligible employer plan” includes aplan qualified under section 401(a) of the Internal Rev-enue Code (including a 401(k) plan), profit-sharing plan,defined benefit plan, stock bonus plan, and money pur-chase plan; a section 403(a) annuity plan; a section 403(b)tax-sheltered annuity; and an eligible section 457(b) planmaintained by a governmental employer (governmental457 plan).

An eligible employer plan is not legally required to accepta rollover. Before you decide to roll over your payment toanother employer plan, you should find out whether theplan accepts rollovers and, if so, the types of distributionsit accepts as a rollover. You should also find out about anydocuments that are required to be completed before thereceiving plan will accept a rollover. Even if a plan acceptsrollovers, it might not accept rollovers of certain types ofdistributions, such as after-tax amounts. If this is the case,and your distribution includes after-tax amounts, you maywish instead to roll your distribution over to a traditionalIRA or split your rollover amount between the employerplan in which you will participate and a traditional IRA. Ifan employer plan accepts your rollover, the plan may re-strict subsequent distributions of the rollover amount ormay require your spouse’s consent for any subsequentdistribution. A subsequent distribution from another em-ployer plan or an IRA that accepts your rollover may alsobe subject to different tax treatment than distributions fromthe TESPHE. Check with the administrator of the otheremployer plan or the trustee of the IRA that is to receiveyour rollover prior to making the rollover.


Your right to waive the 30-day notice periodGenerally, neither a direct rollover nor a payment can bemade from the TESPHE until at least 30 days after yourreceipt of this notice. Thus, after receiving this notice,you have at least 30 days to consider whether or not tohave your withdrawal directly rolled over. If you do notwish to wait until this 30-day notice period ends beforeyour election is processed, you may waive the notice pe-riod by making an affirmative election indicating whetheror not you wish to make a direct rollover. Your withdrawalwill then be processed in accordance with your electionas soon as practical after it is received by Fidelity.

Payments that can and cannot be rolled overPayments from the TESPHE may be “eligible rollover dis-tributions.” This means that they can be rolled over to atraditional IRA or to an eligible employer plan that acceptsrollovers. Payments from the TESPHE cannot be rolledover to a Roth IRA, or SIMPLE IRA, or a Coverdell Edu-cation Savings Account (formerly an education IRA).

Fidelity will be able to tell you what portion of your pay-ment is an “eligible rollover distribution”.

After-tax contributions. If you made after-tax contribu-tions to the TESPHE, these contributions may be rolledinto either a traditional IRA or to certain employer plansthat accept rollovers of the after-tax contributions. Thefollowing rules apply:

• Rollover into a traditional IRAYou can roll over your after-tax contributions to a tradi-tional IRA either directly or indirectly. Fidelity will beable to tell you how much of your payment is the tax-able portion and how much is the after-tax portion.If you roll over after-tax contributions to a traditionalIRA, it is your responsibility to keep track of, and re-port to the IRS on the applicable forms, the amount ofthese after-tax contributions. This will enable the non-taxable amount of any future distributions from the tra-ditional IRA to be determined.Once you roll over your after-tax contributions to a tra-ditional IRA, those amounts CANNOT later be rolledover to an employer plan.

• Rollover into an employer planYou can roll over after-tax contributions from an em-ployer plan that is qualified under Internal Revenue Codesection 401(a) or a section 403(a) annuity plan to an-other such plan using a direct rollover if the other planprovides separate accounting for amounts rolled over,including separate accounting for the after-tax employeecontributions and earnings on those contributions.

SUMMARY

A payment from TESPHE that is eligible for “rollover” canbe taken in two ways. You can have all or any portion ofyour payment either 1) paid in a “direct rollover” or 2)paid to you. A rollover is a payment of your TESPHEdistribution that you make to your traditional individualretirement arrangement (IRA) or to another eligible em-ployer plan that will accept it. A “direct rollover” is a pay-ment made directly to a traditional IRA or another quali-fied plan that accepts rollover. This choice could affectthe tax you owe.

If you choose a Direct Rollover:• Your payment will not be taxed in the current year and

no income tax will be withheld.• Your payment will be made directly to your traditional

IRA or, if you choose, to another eligible employer planthat accepts your rollover. Your TESPHE payment can-not be rolled over to a Roth IRA, a SIMPLE IRA, or aneducation IRA because these are not traditional IRAs.

• The taxable portion of your payment will be taxed laterwhen you take it out of the traditional IRA or the em-ployer plan. Depending on the type of plan, the laterdistribution may be subject to different tax treatmentthan it would be if you received a taxable distributionfrom the TESPHE.

If you choose to have a TESPHE payment that is eligible forrollover paid to you• You will receive only 80% of the taxable amount of the

payment because the TESPHE is required to withhold20% of the taxable amount of the payment and send itto the IRS as income tax withholding to be creditedagainst your taxes.

• The taxable amount of your payment will be taxed inthe current year unless you roll it over. Under limitedcircumstances, you may be able to use special taxrules that could reduce the tax you owe. However, ifyou receive the payment before age 591/2, you also mayhave to pay an additional 10% tax.

• You can roll over all or part of the payment by paying itto your traditional IRA or to an eligible employer plan(that accepts your rollover) within 60 days of receivingthe payment. The amount rolled over will not be taxeduntil you take it out of the traditional IRA or eligibleemployer plan.

• If you want to roll over 100% of the payment to a tradi-tional IRA or a qualified employer plan, you must findother money to replace the 20% that was withheld.If you roll over only the 80% that you received, you willbe taxed on the 20% that was withheld and that is notrolled over.


You can also roll over after-tax contributions from asection 403(b) tax-sheltered annuity to another section.403(b) tax-sheltered annuity using a direct rollover ifthe other tax-sheltered annuity provides separate ac-counting for amounts rolled over, including separateaccounting for the after-tax employee contributions andearnings on those contributions.

You CANNOT roll over after-tax contributions to a gov-ernmental 457 plan.

If you want to roll over your after-tax contributions toan employer plan that accepts these rollovers, you can-not have the after-tax contributions paid to you first.You must instruct Fidelity to make a direct rollover onyour behalf. Also, you cannot first roll over after-taxcontributions to a traditional IRA and then roll over thatamount into an employer plan.Fidelity will be able to tell you if your payment includesamounts that cannot be rolled over.

The following types of payments cannot be rolled over:

• Payments spread over long periods. You cannot rollover a payment if it is part of a series of equal (or almostequal) payments that are made at least once a yearand that will last— Your lifetime (or your life expectancy), or— Your lifetime and your beneficiary’s lifetime

(or a period measured by your joint l ifeexpectancies), or

— A period of ten years or more• Required minimum payments. Beginning in the year

you reach age 701/2 or retire, whichever is later, acertain portion of your payment cannot be rolled overbecause it is a “required minimum payment” that mustbe paid to you.

• Hardship Distributions. A hardship distribution cannotbe rolled over.

• Corrective Distributions. A distribution that is madeto correct a failed nondiscrimination test or becauselegal limits on certain contributions were exceededcannot be rolled over.

• Loans treated as Distributions. The amount of aTESPHE loan that becomes a taxable deemeddistribution because of a default cannot be rolled over.However, a loan offset amount is eligible for rollover.Fidelity will be able to tell you if distribution of your loanqualifies for rollover treatment.

Direct rolloverYou can choose a direct rollover of all or any portion ofyour payment that is an “eligible rollover distribution”, asdescribed above. In a direct rollover, the eligible rolloverdistribution is paid directly from TESPHE to a traditionalIRA or an eligible employer plan that accepts rollovers. Ifyou choose a direct rollover, there is no income tax with-holding on the taxable portion of your payment for whichyou choose a direct rollover until you later take it out ofthe traditional IRA or eligible employer plan.

Direct rollover to a Traditional IRA. You can open atraditional IRA to receive the direct rollover. If youchoose to have your payment made directly to atraditional IRA, contact an IRA sponsor (usually afinancial institution) to find out how to have your paymentmade in a direct rollover to a traditional IRA at thatinstitution. If you are unsure of how to invest your money,you can temporarily establish a traditional IRA to receivethe payment. However, in choosing a traditional IRA,you may wish to consider whether the traditional IRAyou choose will allow you to move all or a part of yourpayment to another traditional IRA at a later date withoutpenalties or other limitations. See IRS Publication 590,Individual Retirement Arrangements, for moreinformation on traditional IRAs (including limits on howoften you can roll over between IRAs).

Direct rollover to a plan. If you are employed by a newemployer that has an eligible employer plan, and you wanta direct rollover to that plan, ask the administrator of thatplan, ask the administrator of that plan whether it will acceptyour rollover. An eligible employer plan is not legallyrequired to accept a rollover. Even if your new employer’splan does not accept a rollover, you can choose a directrollover to a traditional IRA. If the employer plan acceptsyour rollover, the plan may provide restrictions on thecircumstances under which you may later receive adistribution of the rollover amount or may require spousalconsent to any consequent distribution. Check with theplan administrator of that plan before making your decision.

Direct rollover of a series of payments. If you receive apayment that can be rolled over to a traditional IRA or aneligible employer plan that will accept it, and it is paid in aseries of installments for less than ten years, your choiceto make or not make a direct rollover for a payment willapply to all later payments in the series until you changeyour election. You are free to change your election for anylater payment in the series.

Change in tax treatment resulting from a direct rollover.The tax treatment of any payment from the eligibleemployer plan or traditional IRA receiving your directrollover might be different than if you received your benefitin a taxable distribution directly from the TESPHE. Forexample, if you were born before January 1, 1936, youmight be entitled to ten-year averaging or capital gaintreatment, as explained below. However, if you have yourbenefit rolled over to a section 403(b) tax-sheltered annuity,a governmental 457 plan, or a traditional IRA in a directrollover, your benefit will no longer be eligible for that specialtreatment. See the sections below entitled “Additional 10%tax if you are under age 591/2 and “Special Tax Treatment ifyou were born before January 1, 1936.”


Example. Suppose your payment that can be rolled overis $10,000, and you choose to have it paid to you. You willreceive $8,000, and $2,000 will be sent to the IRS asincome tax withholding. Within 60 days after receiving the$8,000, you may roll over the entire $10,000 to a tradi-tional IRA or eligible employer plan. To do this, you rollover the $8,000 you received from the TESPHE, and youwill have to find $2,000 from other sources (your savings,a loan, etc.). In this case, the entire $10,000 is not taxeduntil you take it out of the traditional IRA or eligible em-ployer plan. If you roll over the entire $10,000, when youfile your income tax return you may get a refund of the$2,000 withheld.

If, on the other hand, you roll over only $8,000, the $2,000you did not roll over is taxed in the year it was withheld.When you file your income tax return, you may get a re-fund of part of the $2,000 withheld. (However, any refundis likely to be larger if you roll over the entire $10,000.)

Additional 10% tax if you are under age 591/2. If youreceive a payment before you reach age 591/2

and you

do not roll it over, then, in addition to the regular incometax, you may have to pay an extra tax equal to 10% ofthe taxable portion of the payment. The additional 10%tax does not apply to (1) payments that are paid to youbecause you separate from service with your employerduring or after the year you reach age 55, (2) paymentsthat are paid because you retire due to disability, (3)payments that are paid to you as equal (or almost equal)payments over your life or life expectancy (or your andyour beneficiary’s lives or life expectancies), (4) divi-dends paid with respect to stock by an employee stockownership plan (ESOP) as described in Internal Rev-enue Code section 404(k), (5) payments that are paiddirectly to the government to satisfy a federal tax levy,(6) payments that are paid to an alternate payee undera qualified domestic relations order, or (7) paymentsthat do not exceed the amount of your deductible medi-cal expenses. See IRS Form 5329 for more informationon the additional 10% tax.

The additional 10% tax will not apply to distributions froma governmental 457 plan, except to the extent the distri-bution is attributable to an amount you rolled over to thatplan (adjusted for investment returns) from another typeof eligible employer plan or IRA. Any amount rolled overfrom a governmental 457 plan to another type of eligibleemployer plan or to a traditional IRA will become subjectto the additional 10% tax if it is distributed to you beforeyou reach age 591/2, unless one of the exceptions applies.

Payment paid to youIf your payment can be rolled over and the payment ismade to you, it is subject to 20% income tax withholdingon the taxable portion (state tax withholding may alsoapply). The payment is taxed in the year you receive itunless, within 60 days, you roll it over to an IRA or aneligible employer plan that accepts rollovers. If you do notroll it over, special tax rules may apply.

Note: Dividend payouts as described in “Dividends onStock in the Ford Stock Fund” on page 220 are not sub-ject to 20% withholding.

Income tax withholding:

Mandatory withholding. If any portion of the paymentcan be rolled over and you do not elect to make a directrollover, TESPHE is required by law to withhold 20% ofthe taxable amount. This amount is sent to the IRS asincome tax withholding. For example, if your eligible rolloverdistribution is $10,000, only $8,000 will be paid to youbecause TESPHE must withhold $2,000 as income tax.However, when you prepare your income tax return for theyear, unless you make a rollover within 60 days (see“Sixty-day rollover option” below), you must report the full$10,000 as a taxable payment from TESPHE. You mustreport the $2,000 as tax withheld, and it will be creditedagainst any income tax you may owe for the year. Therewill be no income tax withholding if your payments for theyear are less than $200.

Voluntary withholding. If any portion of your payment istaxable but cannot be rolled over, the mandatory withhold-ing rules described above do not apply. In this case, youmay elect not to have withholding apply to that portion. Ifyou do nothing, an amount will be taken out of this portionof your payment for federal income tax withholding. Toelect out of withholding, please contact the Fidelity Ser-vice Center for Ford Motor Company for the election formand related information.

Sixty-day rollover option. If you have an “eligible rolloverdistribution” paid to you, you can still decide to roll over allor part of it to a traditional IRA or an eligible employer planthat accepts rollovers. If you decide to roll over, you mustcontribute the amount of the payment you received toa traditional IRA or eligible employer plan within 60days after you receive the payment. The portion of yourpayment that is rolled over will not be taxed until you takeit out of the traditional IRA or the eligible employer plan.

You can roll over up to 100% of the eligible rollover distri-bution, including an amount equal to the 20% that waswithheld. If you choose to roll over 100%, you must findother money within the 60-day period to contribute to thetraditional IRA or the eligible employer plan to replace the20% that was withheld. On the other hand, if you roll overonly the 80% that you received, you will be taxed on the20% that was withheld.


Special tax treatment if you were born before January1, 1936. If you receive a payment from TESPHE and youdo not roll it over to a traditional IRA or an eligible em-ployer plan, the payment will be taxed in the year youreceive it. However, if it qualifies as a lump-sum distribu-tion, it may be eligible for special tax treatment. A lump-sum distribution is a payment, within one year, of yourentire balance under TESPHE that is payable to you be-cause you have reached age 591/2 or have separated fromservice with the Company. For a payment to qualify as alump-sum distribution, you must have been a participantin TESPHE for at least five years before the year in whichyou received the distribution. The special tax treatmentfor lump-sum distributions is described below.

Ten-year averaging. If you receive a lump-sum distribu-tion and you were born before January 1, 1936, you canmake a one-time election to figure the tax on the paymentby using “10-year averaging” (using 1986 tax rates). “Ten-year averaging” often reduces the tax you owe.

Capital gain treatment. If you receive a lump-sum distri-bution and you were born before January 1, 1936, youmay elect to have the part of your payment that is attrib-utable to your pre-1974 participation in TESPHE (if any)taxed as long-term capital gain at a rate of 20%.

There are other limits on the special tax treatment forlump-sum distributions. For example, you can generallyelect this special tax treatment only once in your lifetime,and the election applies to all lump-sum distributions thatyou receive in that same year. If you have previously rolledover a payment from TESPHE, you cannot use this spe-cial tax treatment for later payments from TESPHE. Ifyou roll over your payment to a traditional IRA, a govern-mental 457 plan, or 403(b) tax-sheltered annuity, you willnot be able to use this special tax treatment for later pay-ments from that IRA, plan, or annuity. Also, if you roll overonly a portion of your payment to a traditional IRA, gov-ernmental 457 plan, or 403(b) tax-sheltered annuity, thisspecial tax treatment is not available for the rest of thepayment. Additional restrictions are described in IRS Form4972, which has more information on lump-sum distribu-tions and how you elect the special tax treatment.

Employer stock or securities. There is a special rule fora payment from TESPHE that includes Ford CommonStock. To use this special rule, (1) the payment must qualifyas a lump-sum distribution, as described above (or wouldqualify except that you do not yet have five years of par-ticipation in the TESPHE) or (2) the Ford Common Stockincluded in the payment must be attributable to After-TaxContributions, if any. Under this special rule, you may havethe option of not paying tax on the “net unrealized appre-ciation” of the stock until you sell the stock.

Net unrealized appreciation generally is the increase inthe value of the Ford Common Stock represented byunits of the Ford Stock Fund during the time they werecredited to your TESPHE account. For example, if FordStock Fund units were contributed to your TESPHE ac-count when Ford Common Stock was worth $1,000 butthe stock was worth $1,200 when you received it, youwould not have to pay tax on the $200 increase in valueuntil you later sold the stock.

You may instead elect not to have the special rule applyto the net unrealized appreciation. In this case, your netunrealized appreciation will be taxed in the year you re-ceive the stock, unless you roll over the stock. The stock(including any net unrealized appreciation) can be rolledover to a traditional IRA or another eligible employer planeither in a direct rollover or a rollover that you make your-self. Generally, you will no longer be able to use the spe-cial rule for net unrealized appreciation if you roll the stockover to a traditional IRA or another eligible employer plan.

If you receive only Ford Common Stock in a payment thatcan be rolled over, no amount will be withheld. If you re-ceive cash in addition to Ford Common Stock in a pay-ment that can be rolled over, the 20% withholding amountwill be based on the entire taxable amount paid to you(including the value of the Ford Common Stock) deter-mined by excluding net unrealized appreciation. However,the amount withheld will be limited to the cash (excludingFord Stock) paid to you.

If you receive a certificate for Ford Common Stock in apayment that qualifies as a lump-sum distribution, thespecial tax treatment for lump-sum distributions describedabove (such as 10-year averaging) also may apply. SeeIRS Form 4972 for additional information on these rules.


How to obtain additional information from the IRSThis notice summarizes only the federal (not state or lo-cal) tax rules that might apply to your payment. The rulesdescribed above are complex and contain many condi-tions and exceptions that are not included in this notice.Therefore, you may want to consult with a professionaltax advisor before you take a payment of your benefitsfrom the TESPHE. Also, you can find more specific infor-mation on the tax treatment of payments from qualifiedretirement plans in IRS Publication 575, Pension andAnnuity Income and IRS Publication 590, Individual Re-tirement Arrangements. These publications are availablefrom your local IRS office or the IRS’s Internet web site atwww.irs.gov or by calling 1-800-TAX-FORMS.

The information contained in the Special Tax Notice wasestablished by the IRS in Notice 2000-11. You may wishto contact the IRS or your personal tax advisor to discusschanges in the tax law since its original publication.

Repayment of TESPHE Loans. If you end your employ-ment and have an outstanding loan, TESPHE may reduce(or “offset”) your balance by the amount of the loan youhave not paid. The amount of your loan offset is treatedas a distribution to you at the time of the offset and will betaxed unless you roll over an amount equal to the amountof your loan offset to another eligible employer plan or atraditional IRA within 60 days of the date of the offset. Ifthe amount of your loan offset is the only amount youreceive or are treated as having received, no amount willbe withheld from it. If you receive other payments of cashor property from TESPHE, the 20% withholding amountwill be based on the entire amount paid to you, includingthe amount of the loan payment. The amount withheld willbe limited to the amount of other cash or property paid toyou (other than Ford Common Stock). The amount of adefaulted plan loan that is a taxable deemed distributioncannot be rolled over.

Surviving spouses, alternate payees, and other beneficiariesIn general, the rules summarized above that apply topayment to employees also apply to payments to sur-viving spouses of employees and to spouses or formerspouses who are “alternate payees.” You are an alter-nate payee if your interest in the TESPHE results froma “Qualified Domestic Relations Order”, which is an or-der issued by a court, usually in connection with a di-vorce or legal separation.

If you are a surviving spouse or an alternate payee, youmay choose to have a payment than can be rolled overpaid in a direct rollover to a traditional IRA or to an eligibleemployer plan. If you have the payment paid to you, youcan keep it or roll it over yourself to a traditional IRA or toan eligible employer plan. Thus, you have the samechoices as the employee.

If you are a beneficiary other than a surviving spouse oran alternate payee, you cannot choose a direct rollover,and you cannot roll over the payment yourself.

If you are a surviving spouse, an alternate payee, or an-other beneficiary, your payment is not subject to the addi-tional 10% tax described above, even if you are youngerthan age 591/2.

If you are a surviving spouse, an alternate payee, or an-other beneficiary, you may be able to use the special taxtreatment for lump-sum distributions and the special rulefor payments that include Ford Common Stock, as de-scribed above. If you receive a payment because of theemployee’s death, you may be able to treat the paymentas a lump-sum distribution if the employee met the appro-priate age requirements, whether or not the employee hadfive years of participation in the TESPHE.


When do you contact the Fidelity Service Center forFord Motor Company?

Fidelity Service Center for Ford Motor Company letsyou manage your TESPHE account over the phone.

Convenient account accessThe Fidelity Service Center for Ford Motor Company gen-erally provides 24-hour access to TESPHE account infor-mation and permits a variety of transactions to be initi-ated, toll free, from any touch-tone telephone. Fidelity rep-resentatives are available 151/2 hours a day from 8:30 a.m.to midnight (Eastern Time) on business days.

You can manage your TESPHE account almost entirelyover the phone with the Fidelity Service Center for FordMotor Company or through Fidelity’s Internet accessNetBenefitsSM at www.netbenefits.fidelity.com. Mosttransactions, including exchanges (transfers), loans, andwithdrawals may be initiated online and do not requirepaper forms.

Establishing your PINTo use the Fidelity Service Center for Ford Motor Com-pany, you will need to establish a PIN (personal identifica-tion number). The first time you call Fidelity or accessyour account via NetBenefits, you will be asked to estab-lish your PIN. This is very important because your PINallows access to confidential information about yourTESPHE account. Without your PIN, you will not be ableto access your account. Your PIN is a number you choose,six to twelve digits.

How to access your accountTo access your TESPHE account, you’ll need to enteryour social security number or Alternate Customer ID andyour PIN when you call or use NetBenefits. To avoid unau-thorized access to your TESPHE account, it’s very im-portant to keep your PIN confidential at all times. Conver-sations initiated through a Fidelity Service Representa-tive will be recorded.

To use the automated telephone system or speak to arepresentative, you should call:

• Fidelity Service Center for Ford Motor Company:1-800-544-3333

• From Overseas, follow these instructions:Dial your country’s AT&T access number + 800-544-3333 (do not dial the leading “1”). From the U.S., ac-cess numbers are available by calling 1-800-331-1140.From anywhere in the world, access numbers are alsoavailable online at www.att.com/traveler, or from yourlocal operator. If you are calling from an area not sup-ported by AT&T Direct, please use the following inter-national collect phone number: 508-787-9902. Followthe prompts and you will be connected to the FidelityService Center for Ford Motor Company.

• TDD Phone Line for the Hearing Impaired:1-800-847-0348

To use NetBenefits, use the following URL:netbenefits.fidelity.com.

All conversations initiated through a Fidelity repre-sentative will be recorded.

Refer to the chart in the Appendix at the end of thissection for information on managing your account.

Transaction deadlines• Changes in contribution investment elections, ex-

changes, loans for one to five years, and withdraw-als. Your transaction will be effective as of the close ofbusiness on any business day if your request is madeand confirmed prior to the close of the New York StockExchange (usually 4:00 p.m. Eastern Time) on that day.If your request is made or confirmed after this time oron non-business days such as weekends or holidays,your transaction will be effective as of the close of busi-ness on the next business day.

• Electing or changing your savings contributions.Your contribution election change may take up to twopay periods before it becomes effective.

Because of high call volume near the close of the marketat times, you may wish to call early to be sure your re-quest is made by the deadline. A business day is any daythat the New York Stock Exchange is open.


What circumstances might affect Plan benefits or lifeevents that may affect your account?

You should be aware of circumstances that mightaffect your benefits and your account.

Naming a beneficiaryIf you die before assets in your account are distributed toyou, your beneficiary will become entitled to your benefitas follows:

• If you’re married at the time of your death, your surviv-ing spouse will become entitled to the assets in youraccount, unless you designate someone else as yourbeneficiary. Your spouse must consent to this alterna-tive beneficiary designation in writing, as required bylaw, and your spouse’s consent must be witnessed bya notary public.

• If you’re not married and you’re covered under the Com-pany-paid life insurance plan at the time of your death,assets in your TESPHE account will be distributed tothe person(s) entitled to receive your benefits undersuch plan, unless you designate someone else. Youmay name a different beneficiary for TESPHE by re-questing an alternative beneficiary designation formfrom the Fidelity Service Center for Ford Motor Com-pany and filing the form with UNICARE.

• If you’re not married and you’re not covered under theCompany-paid life insurance plan at the time of yourdeath, assets in your account will be distributed to yourestate, unless you designate a beneficiary. You mayname a beneficiary for TESPHE by requesting an alter-native beneficiary designation form from the FidelityService Center for Ford Motor Company and filing theform with UNICARE.

You may change or revoke your beneficiary designationat any time. If you terminate employment and decide toleave your TESPHE assets in the Plan, you should besure that your beneficiary elections are in order.

Beneficiaries may not make further beneficiary designations.

If you or your beneficiary is incapacitatedPayment of your account may be withheld until a legalrepresentative is appointed if you or your beneficiary be-comes legally incapacitated or incompetent.

Changes in laws and regulationsThe Plan is subject to approval by the Internal RevenueService and other governmental bodies. As laws andregulations change, the Plan may require amendment aswell. If changes affect your benefits, you will be notified.

Ensuring accuracyAs you enter information in the Fidelity Service Centersystem to initiate a TESPHE transaction, its voice re-sponse system will:

• Tell you if your entry fails to meet plan guidelines• Repeat your entry so you can verify its accuracy

Written confirmation of your transaction will be mailed toyour address-of-record in your personnel file within threeto five business days.

If you have questionsAll questions and issues regarding TESPHE should bedirected to the Fidelity Service Center for Ford Motor Com-pany representatives. You should call the NESC at 1-800-248-4444 only if the Fidelity Service Center for Ford Mo-tor Company representatives are unable to help you.


Transfer of benefitsPayments from the Plan are intended to be made to youor your eligible spouse or beneficiary. Payments cannotbe transferred, assigned, pledged or garnisheed. The Planmust honor qualified domestic relations court orders,however, in assigning benefits for a divorce settlement orchild support payment.

Assignment of benefits; liensBenefits under qualified retirement plans like the TESPHEgenerally may not be assigned or alienated except in ac-cordance with a judgment, decree, or order that is issuedunder state domestic relations law that relates to the pro-vision of child support, alimony, or marital property rightsto a spouse, former spouse, child, or other dependent of aplan participant. Such an order must meet the require-ments of a Qualified Domestic Relations Order (QDRO)as defined in Section 206(d) of the Employee RetirementIncome Security Act of 1974, as amended, (ERISA) asdetermined by the Company. No benefits under TESPHEare subject to legal process or attachment for the pay-ment of any claim except as described above.

In case of divorce or legal separationIf you are involved in a divorce or legal separation and re-quire information concerning your qualified plan benefits, youshould consult your quarterly statement with respect to theTESPHE or review your account through NetBenefits atwww.netbenefits.fidelity.com. If further information is required,you should contact the Fidelity Service Center for Ford Mo-tor Company at 1-800-544-3333.

If you would like to receive a QDRO Sample Model Orderthat is acceptable to the Company, please contact theFidelity Service Center for Ford Motor Company, Atten-tion: QDRO Administration Group, P.O. Box 770003, Cin-cinnati, OH 45277-0066. Other forms of QDROs may beacceptable if they comply with the legal requirements setforth in Section 206(d) of ERISA and Section 414(p) ofthe Internal Revenue Code of 1986, and can be adminis-tered in accordance with the guidelines of the Plan asdetermined by the Company.

Upon your divorce or legal separation and entry of theorder, a complete copy of the QDRO must be sent to Fi-delity Service Center for Ford Motor Company, Attention:QDRO Administration Group, P.O. Box 770003, Cincin-nati, Ohio 45277-0066.

Upon your divorce or legal separation and entry of theorder, a complete copy of the Judgment of Divorce mustbe sent to the NESC, P.O. Box 6214, Dearborn Michigan,48121-6214 for review of any additional benefit impact.

You may, of course, elect to withdraw all or a portion ofyour assets at any time, effective on any business day.


NOTE: Final regulations governing loans from TESPHErequire that repayment of loans initiated beginningJanuary 1, 2004 (by Members who have an outstand-ing defaulted loan) must be payroll deducted. As aresult, such loans must be paid off once participantsare separated from the Company. Using a coupon bookto continue loan repayments will not be an option.See the “Loan Repayments” section for more details.

If you leave your assets in the Plan

You may leave your assets in the Plan in the event youremployment with Ford ends as described above.

If you choose to have the Plan retain your assets, unlessyou elect an earlier distribution, they will be distributed toyou beginning when you attain age 701/2. These distribu-tions are referred to as minimum required distributions, orMRDs. The required beginning date is April 1 of the calen-dar year following the later of the calendar year in whichyou reach 701/2 or terminate. Therefore, the MRDs mustbe distributed by December of each year. In general, theapplicable distribution period is obtained from the InternalRevenue Code Uniform Lifetime Table and is based solelyon your age as of your birthday in the relevant distributioncalendar year. If the sole beneficiary is your spouse, how-ever, the distribution period is the longer of the distributionperiod from the Uniform Lifetime Table, or, in the case of aspouse beneficiary who is more than 10 years youngerthan you, the joint life expectancy of you and your spouse.

Under the MRD schedule, generally, you will receive asmaller amount, allowing you to leave your assets in thePlan for a longer period of time. However, while MRD rulesimpose a minimum amount that you must receive, youmay elect to receive a greater amount under other with-drawal options.

You may also receive a distribution if your account is belowa certain amount.

See the “When would assets be paid automatically fromthe Plan?” section for more details.

You may, of course, elect to withdraw all or a portion ofyour assets at any time, effective on any business day.

If you die

Please refer to “When would assets be paid automaticallyfrom the Plan?”.

Life events affecting TESPHECertain life events will affect your TESPHE account.

Employment status changesTransfer to salaried rolls or to a non-participatingsubsidiary

Your contributions cease upon transfer. You may be eligiblefor a different plan.

Family status changes

Marriage

Your spouse becomes the beneficiary for your TESPHE.

New child (birth, adoption, etc.)

This has no effect on your TESPHE account.

Death of your spouse

Your life insurance beneficiary will become the beneficiaryof your TESPHE unless you have designated or designateanother beneficiary.

Change in you spouse’s employment

This has no effect on your TESPHE account.

Relocation

Be sure to change your address on Company records. Oncecompleted, your new address information will be transmittedto Fidelity. It is also prudent to verify with Fidelity that youraddress change is updated in their system.

If your employment ends (e.g., retirements, quits,discharges)

Your contributions to the TESPHE cease at the time oftermination of employment when you are no longer re-ceiving a paycheck from the Company. Your assets maybe exchanged effective any business day among invest-ment elections in accordance with Plan provisions. Youmay initiate partial withdrawals or a total distribution atany time, effective any business day, in accordance withPlan provisions.

You cannot initiate new loans. Any outstanding loan bal-ances must be repaid in full at or before separation ofemployment, or you may elect to make loan payments byutilizing a coupon book.


Leaves of absence and layoff

Medical leave of absence

Your contributions and payroll deductions for loanrepayments cease. You may continue to make loanpayments on existing loans once you are no longerreceiving a paycheck from the Company. When you areremoved from the active employment rolls (e.g., after 90days of continued disability), you will receive a couponbook with which to make loan payments. Until you receivea coupon book, you may send payments to Fidelity.(Acceptable forms of payment: cashiers or certified checkor money order.)

Unpaid leave of absence

Your contributions and payroll deductions for loanrepayments cease. You may initiate new loans, unlessyou have a history of loan default. You must make loanrepayments by utilizing a coupon book.

Layoffs

Your contributions and payroll deductions for loanrepayments cease. You may not take out new loans.You must continue to make loan payments on existingloans once you are no longer receiving a paycheck fromthe Company.

Generally, you will receive a coupon book once your leaveor layoff status is transmitted to Fidelity from the Company.Since failure to make payments will result in loan default,you should contact Fidelity if you do not receive the couponbook within 15 days of your Leave of Absence (includingmedical leaves greater than 90 days) or layoff.

Failure to make payments will result in a warning letteradvising of potential loan default. If, after receiving thewarning letter you do not make the required payment, asstipulated in the warning letter and within the prescribedtime frame, your loan will default. (See “How can you borrowfrom the Plan?” for consequences of loan defaults.

General InformationNote: Final regulations governing loans from TESPHErequire that repayment of loans initiated beginningJanuary 1, 2004 by Members who have a history ofloan default must be payroll deducted.

Using a coupon book to continue loan repaymentswill not be an option. (See the “Loan Repayments”section for details.)

Participants on leave or layoff are subject to the samewithdrawal provisions as active employees. (See “How areassets paid from the Plan?” for more details.)

You may continue to manage your account (e.g., makeexchanges between investment options) in accordancewith Plan provisions.

Return from a leave of absence or layoff

Your contributions and payroll deductions for loan paymentswill resume automatically. Always check your pay stub toassure deductions resume. If for some reason they donot, contact Fidelity immediately to request that they makethe necessary arrangements to resume loan deductionthrough payroll deduction.


Administration and other information

The following information per tains to theadministration of the TESPHE.

Administration of the TESPHEThe TESPHE is sponsored by Ford Motor Company, andthe Company is the Plan administrator.

The Company has been designated “named fiduciary” pur-suant to the requirements of the Employee RetirementIncome Security Act of 1974 (ERISA), as amended andhas the power to control and manage the operation andadministration of the TESPHE.

The Company has established a Tax-Efficient Savings PlanCommittee (the Committee), all the members and alter-nate members of which are employees of the Company.The members of the Committee and the alternate mem-bers receive no additional compensation for Committeeservices as members or as alternate members. Exceptfor non-delegable functions of the Trustee, the Committeeadministers the TESPHE, interprets its provisions and pre-scribes regulations and forms in connection therewith. In-terpretations of the provisions of the TESPHE by the Com-mittee are final and conclusive.

The Company and Fidelity Management Trust Company(FMTC) have entered into a Trust Agreement pursuant towhich FMTC acts as Trustee under the TESPHE. The Com-pany may amend the Trust Agreement and change theTrustee. The Trustee has custody of the funds receivedfrom the Company as contributions or received as earn-ings thereon, and makes all purchases, sales and redemp-tions of securities in accordance with the provisions ofthe TESPHE.

The Pension Benefit Guaranty Corporation (PBGC)TESPHE is a defined contribution pension plan. Thismeans that the Plan defines the contribution to be madeto your account, but it does not mean that you’ll receive aspecific amount when your account is paid out. Since nobenefit is guaranteed, TESPHE accounts are not insuredby the PBGC.

Can TESPHE provisions change?

It is possible the Plan could be changed or could endin the future.

The Plan is expected to continue in effect until the end ofthe 2003 Ford-UAW Collective Bargaining Agreement.

At that time, the Plan may be renewed automatically forsuccessive one-year periods, unless Ford or the UAWmakes a written request to modify the Plan at least 60days before September 14, 2007, or any anniversary ofthat date. A request to terminate the Plan must be madewithin the same deadlines.

Subject to the 2003 Agreement, the Company Board ofDirectors may at any time change, suspend or terminatethe Plan partially or completely. No change may reducethe value of your account, however, from what it was onthe day before the change.

Your current account balance also is protected if the Planis merged or consolidated with another plan, or if youraccount is transferred to another plan. Immediately afterthe change, your account balance under the new plan wouldbe at least equal to the balance under this Plan just be-fore the change.

A change or suspension in the Plan may not change yourright for the continued investment of your TESPHE ac-count, your right to make approved withdrawals, or yourright to a final payout.

The Company may change, suspend or end the Plan foremployees if the Tax-Efficient Savings Plan Committeefinds that the laws of a state or country where they livemake the Plan disproportionately expensive and inconve-nient to administer.

A change, suspension or termination will take effect nosooner than the date the Company notifies the Trusteeand participating companies. A retroactive change is al-lowed, however, if it is required to keep the Plan or thetrust fund in compliance with legal requirements.

If the Plan is terminated, the Company may direct theTrustee to pay out the assets in all accounts as of thetermination date. Any Profit Sharing contribution to thePlan for 2007, however, will be administered as describedin the Plan even if the Plan is terminated that year.


Investment Process CommitteeThe Company, by action of the Vice President, Financeand Treasurer, the Group Vice President, Corporate Hu-man Resources, and the Vice President and General Coun-sel created an Investment Process Committee. The In-vestment Process Committee shall:

• Recommend investment process guidelines to the VicePresidents (above) for their approval;

• Review the investment process guidelines for continu-ing appropriateness;

• Recommend changes to the guidelines for approval bythe Vice Presidents (above);

• Review the performance of investment options pursu-ant to the investment process guidelines and make rec-ommendations regarding the addition to, deletion, orreplacement of investment options under the Plan; and

• Review the overall line-up of investment options to en-sure that, in total, the Plan’s objectives are achieved

The Investment Process Committee shall be respon-sible for maintaining the investment options under thePlan solely in the interest of the Plan’s members andtheir beneficiaries.

Employee Stock Ownership Plan (ESOP)A portion of the TESPHE is designated as an EmployeeStock Ownership Plan (ESOP). The ESOP was estab-lished in the Plan effective January 1, 1989 and con-sists of all the shares of Company Stock in the Plan,including all shares allocated to participants’ accounts,all forfeited shares and all assets attributable to contri-butions made after December 31, 1988. The Trustee shallhold, invest, transfer and distribute shares of CompanyStock and all other assets in the ESOP in accordancewith the Plan document.

Other informationThe following documents filed or to be filed with the Secu-rities and Exchange Commission are incorporated hereinby reference:

• Ford’s, and the Plan’s latest annual reports filed pursu-ant to Section 13(a) or 15(d) of the Securities ExchangeAct of 1934 (the “1934 Act”) which contain, either di-rectly or by incorporation by reference, certified finan-cial statements for Ford’s latest fiscal year for whichsuch statements have been filed

• All other reports filed pursuant to Section 13(a) or15(d) of the 1934 Act since the end of the fiscal yearcovered by the annual reports referred to in the pre-ceding paragraph

• The description of Ford’s Common Stock contained inRegistration Statement No. 333-38352 filed by Fordunder the Securities Act of 1933

All documents subsequently filed by Ford pursuant toSections 13(a), 13(c), 14 and 15(d) of the 1934 Act, priorto the filing of a post-effective amendment which indicatesthat all securities offered have been sold or whichderegisters all securities then remaining unsold, shall bedeemed to be incorporated herein by reference and to bea part hereof from the date of filing such documents.

Each person to whom a copy of this material is delivered willbe provided without charge, upon written or oral request ofsuch person, a copy of any and all of the information thathas been incorporated by reference in this material (not in-cluding exhibits to the information that is incorporated byreference unless such exhibits are specifically incorporatedby reference into the information that this material incorpo-rates) and any other documents required to be delivered toparticipants. Written or telephone requests for such informa-tion related to Ford should be directed to Ford at its Share-holder Relations Department, P.O. Box 1899, Dearborn, Michi-gan 48121-1899, telephone: (800) 555-5259 or (313) 845-8540.

Written or telephone requests for information about theTESPHE that the Fidelity Service Center for Ford MotorCompany is unable to answer or inquiries directed to theTax-Efficient Savings Plan Committee, which administersthe TESPHE, should be directed to the National EmployeeServices Center, Savings Plans Administration, Ford Mo-tor Company, P.O. Box 6214, Dearborn, MI 48121-6214,telephone (313) 248-4444 or 1-800-248-4444.

The TESPHE was established pursuant to the CollectiveBargaining Agreement dated October 14, 1984, betweenthe Company and the International Union, United Auto-mobile, Aerospace and Agricultural Implement Workersof America, UAW (the Union), and was approved by theBoard of Directors of the Company on November 8, 1984.The TESPHE was amended and continued pursuant tothe Collective Bargaining Agreement dated September 15,2003, between the Company and the Union. Contributionsto the TESPHE commenced in March 1985.

TESPHE is subject to certain provisions of the EmployeeRetirement Income Security Act of 1974, as amended(ERISA), including generally, the reporting and disclosure,participation and vesting, fiduciary responsibility, and ad-ministration and enforcement provisions in Title I of ERISA.TESPHE is also qualified under Sections 401 (a) and 401(k)of the Internal Revenue Code of 1986, as amended.


If Fidelity determines that an extension of time for pro-cessing is required, written notice of the extension will befurnished to you prior to the termination of the initial 90-day period. In no event will such extension exceed a pe-riod of ninety (90) days from the end of the initial period.The extension notice will indicate the special circumstancesrequiring an extension of time and the date by which thePlan expects to render the determination.

Review of denial of the claim by the CommitteeIn the event that Fidelity denies a claim for benefits orparticipation, you may:

• Request a review by filing a written appeal to theCommittee,

• Review pertinent documents, and• Submit written comments, documents, records and

other information relating to the claim for benefits

The Committee must take into account all comments,documents, records, and other information submitted byyou relating to the claim, without regard to whether theinformation was submitted or considered in the initial ben-efit determination.

You may send your written appeal to: National EmployeeServices Center (NESC), Savings Plan Administrator, P.O.Box 6214, Dearborn Michigan 48121-6214.

You must request a review upon an appeal of the denial ofthe claim within sixty (60) days after you receive the writ-ten notification of denial of the claim. The appeal will beconsidered at the Committee’s next regularly scheduledmeeting. If it is filed within thirty (30) days of the nextmeeting, a decision by the Committee shall be made bythe date of the second meeting after receipt of the yourrequest for review. Under special circumstances, an ex-tension of time for processing may be required, in whichcase a decision shall be rendered by the date of the thirdmeeting. If an extension is required because informationis incomplete, the review period will be tolled from datethe notice was sent to the date information is received. Inthe event such an extension is needed, written notice ofthe extension will be provided to you prior to the com-mencement of the extension.

The TESPHE is intended to constitute a plan described insection 404(c) of ERISA. The fiduciaries of the TESPHEare relieved of liability for any losses which are the directand necessary result of investment instructions given bymembers of the TESPHE.

The detailed provisions of the Plan, not the summary,govern the actual rights and benefits to which you may beentitled. If there is a conflict between this summary andthe Plan document, the Plan document will control.

Address changesIt is your responsibility to keep your address current inthe Company’s records. Notices about the Plan will besent to your most recent address.

Appeal procedureIf you have a claim for benefits under the TESPHE, or if youthink there is an error in the administration of your TESPHEaccount or an error relating to the amount of your TESPHEdeduction from your Profit Share or eligible pay, you shouldcontact the Fidelity Services Center for Ford Motor Com-pany at 1-800-544-3333. The Fidelity Service Center for FordMotor Company will attempt to resolve your concerns infor-mally. If that does not prove possible, you should submityour claim to the Fidelity Service Center for Ford Motor Com-pany in writing.

If a claim is deniedIf Fidelity denies a claim for benefits or participation inwhole or in part, you will receive written notification within90 days from the date the claim for benefits or participa-tion is received. The notice will be deemed given uponmailing, full postage prepaid in the United States mail oron date sent electronically to you. The decision will be inwriting and it will include:

• The specific reason or reasons for the denial;• Reference to the specific plan provision(s) on which

the denial is based, along with a copy of the Planprovision(s) or a statement that one will be furnished atno charge per your request;

• A description of any additional material or informa-tion necessary for you to perfect the claim and anexplanation of why such material or information isnecessary; and

• A description of the Plan’s review procedures and thetime limits applicable to such procedures, along with astatement of your right to bring civil action under Sec-tion 502(a) of the Employee Retirement Income Secu-rity Act (ERISA) of 1974, as amended, following a claimdenial for benefits on review.


Written notice of a decision will be made not any laterthan five (5) days after the Committee has made a deci-sion. The decision will be in writing and it will include:• The specific reason or reasons for the denial;• Specific reference to pertinent Plan provision(s) on

which the denial is based, along with a copy of suchPlan provisions or a statement that one will be furnishedat no charge upon your request;

• A statement that you are entitled to receive, upon re-quest and free of charge, reasonable access to, andcopies of, all documents, records and other informa-tion relevant to your claim; and

• A statement of your right to bring an action under Sec-tion 502(a) of the Employee Retirement Income Secu-rity Act (ERISA) of 1974, as amended.

The notice will be deemed given upon mailing, full post-age pre-paid in the United States mail, or on the date sentelectronically to you.

Decision of the CommitteeDecisions of the Committee are final and conclusive andare only subject to the arbitrary and capricious standardof judicial review.

Limitations periodNo legal actions for benefits under the Plan may be broughtagainst the Plan until after the claims and appeal proce-dures have been exhausted. Unless the Employee Retire-ment Income Security Act (ERISA) of 1974, as amended,specifically provides a different period of limitations, legalactions under the Plan for benefits must be brought nolater than two (2) years after the claim arises. No otheractions may be brought against the Plan more than six (6)months after the claims arises.

Tax Reduction Act Stock Ownership PlanThe Tax Reduction Act Stock Ownership Plan (TRASOP)was terminated on May 31, 1989, and assets in partici-pants’ accounts were distributed from the trust to partici-pants or beneficiaries, or transferred to participants’ ac-counts in Company savings plans like the TESPHE inaccordance with their elections and provisions establishedto terminate the plan.

Trustee and recordkeeperThe Plan Trustee is Fidelity Management Trust Company.Fidelity Investments Institutional Operations Company, Inc.will provide the recordkeeping and administrative services.Their address is:

82 Devonshire StreetBoston, MA 02109

Your rights under the Employee Retirement Income SecurityAct of 1974 (ERISA), as amended

The TESPHE is designed to meet the requirements estab-lished by ERISA. The Plan will be amended to conformwith any changes in the law or government regulations.

As a participant in the TESPHE, you’re entitled to certainrights and protections under ERISA. Included are the rightto receive certain Plan information and the right to file alawsuit if you believe your rights have been violated.

Here is a listing of your rights under ERISA:• You may visit the National Employee Services Center

(NESC) and in some cases Ford World Headquarters,and examine all Plan documents without charge. Con-tact the NESC on where you must visit. These includethe Plan itself, the trust agreement for the Plan, theannual financial reports, the Plan description, and allother official Plan documents.

• With reasonable written notice, copies of Plan documentswill be made available for review at other locations.

• You may obtain copies of Plan documents by writingthe Plan administrator at: National Employee ServicesCenter (NESC), Savings Plan Administrator, P.O. Box6214, Dearborn, Michigan 48121-6214.

• The Company may make a reasonable charge for copies.• You will receive a written summary of the Plan’s an-

nual financial report. The Plan administrator is requiredby law to furnish you with a copy of this summaryannual report.

• You also may obtain a copy of the annual reports andother Plan documents at the U.S. Department of Labor’sPublic Disclosure Room at the Pension and WelfareBenefit Administration in Washington, D.C.

• You may not be discharged or discriminated against toprevent you from obtaining a benefit or for exercisingyour ERISA rights.


Basic TESPHE InformationPlan Name: Tax Efficient Plan for Hourly

Employees

Plan Sponsor: Ford Motor CompanyHenry Ford II World CenterRoom 1037One American RoadDearborn, MI 48126-2748

Employer 38-0549190IdentificationNumber:

Plan Number: 025Type of Plan: Defined Contribution

Pension Plan(401(k), ESOP)

Plan Administrator: Ford Motor Company(313) 248-4444(800) 248-4444

Type of Administrative services for theAdministration: Plan are provided by:

Ford Motor CompanyNational Employee ServicesCenter, UNICARE (undercontract), and FidelityManagement Trust Company(under a trust agreement andsupplemental contracts).

Trustee: Fidelity Management Trust Co.82 Devonshire StreetBoston, MA 02109

Agent for Service Ford Motor Companyof Legal Process: One American Road

1037Dearborn, MI 48126-2748

Alternatively, legal process may be served on the Plantrustee

Plan Funding: Company & Employee FundedAssets of the TESPHE areheld in trust

Plan Year: January1 to December 31

If your claim for a benefit is denied in whole or part:• You will receive a written explanation from the Plan

administrator.• You have the right to have your claim reviewed and

reconsidered.

Besides creating rights for plan participants, ERISA alsospells out certain duties for people who are responsiblefor operating the plan. These people are called “fiducia-ries”. The fiduciaries of a plan have a duty to operatethe plan prudently and in the interest of plan partici-pants and beneficiaries.

There are steps you can take to enforce your ERISA rights.For example:• If you request materials from the Plan and don’t re-

ceive them within thirty (30) days, you may file suit ina federal court. In such a case, the court may requirethe plan administrator to provide the materials and payyou up to $110 a day until you receive the materials -unless the materials were not sent because of reasonsbeyond the control of the administrator.

• If your claim for benefits is denied in whole or in partafter a final review, you may file suit in a state or fed-eral court.

• If the fiduciaries misuse the Plan’s money or if you arediscriminated against for asserting your ERISA rights,you may seek help from the U.S. Department of Laboror file suit in a federal court. If you file a suit, the courtwill decide who should pay costs and legal fees. If youwin your suit, the court may order the person you havesued to pay the costs and fees. If you lose your suit, orif the court decides your suit was frivolous, the courtmay order you to pay the costs and fees.

If you have any questions about the TESPHE, you shouldcontact the National Employee Services Center (NESC).If you have any questions about this statement or yourrights under ERISA, you should contact the nearest officeof the Pension and Welfare Benefits Administration, U.S.Department of Labor, listed in your telephone directory ofthe Division of Technical Assistance and Inquiries, Pen-sion and Welfare Administration, U. S. Department of La-bor, 200 Constitution Avenue N.W., Washington, D.C. 20210.


Appendix

How the Catch-Up Contribution feature works and important information to consider

• Your Catch-Up contribution is a separate election. You may elect up to 50% (in whole percent increments) of youreligible pay on a pre-tax basis each payroll period as a Catch-Up Contribution. This election is in addition to yourregular TESPHE payroll deduction of up to 50%.

• If your regular TESPHE payroll deductions stop because you have reached certain limits during the year (the IRS pre-tax deferral, the TESPHE contribution limit, the IRS 415 dollar limit), you can continue making Catch-Up Contributionsfor future payroll periods.

• You may make changes to your Catch-Up Contribution deferral percentage at any time. Generally, changes are effec-tive within 1 to 2 pay periods.

• Your Catch-Up Contributions will be invested in the same manner as the investment elections you have chosen foryour regular TESPHE pre-tax deferrals. Take this opportunity to review all of your contribution investment choices.

• When you reach the Catch-Up Contribution limit, your Catch-Up Contributions automatically will stop.• Catch-Up Contribution elections will not carry over from year to year. You will have to make new elections each year,

so please mark this as a “to-do” activity on your calendar for the beginning of each year. You may begin making newelections in January of each year.

If you would like to take advantage of the Catch-Up Contribution feature:

• Log on to Fidelity NetBenefitssm at www.netbenefits.com.• Click the “Access My Benefits” icon and proceed to log in.• On the Accounts tab, under Account Management, select the Deductions option.• Click Change.• Under Current Payroll Deduction Elections, click Change.• Select Employee Pre-Tax Catch-Up from the drop down list.• Select the percentage of your eligible pay that you would like to contribute as a catch-up contribution, up to a maxi-

mum of 50%.• Once you have selected the percentage, click on the gray Update Payroll Deduction button at the bottom of the page.• If you elect to receive a paper confirmation, it will be mailed to your home shortly after you make your catch-up

contribution election.• You can also contact the Fidelity Service Center for Ford Motor Company at 1-800-544-3333. The voice response

system is available virtually 24 hours per day, and representatives are available on business days from 8:30 a.m. tomidnight, Eastern Standard Time.


Q: What are Catch-Up Contributions?

A: Catch-Up Contributions are additional pre-tax elective deferrals above the following limits:(a) TESPHE limit of 50% of eligible pay;(b) annual IRS pre-tax deferral limit (schedule below); or(c) the annual IRS 415 defined contribution dollar limit

Q: What are the annual pre-tax and catch-up limits through 2010?A:

Year Annual IRS Pre-Tax Annual Catch-Up Total Annual IRS Pre-Tax Contributions Deferral Limits Contribution Limits for Participants Age 50+

2004 $13,000 $3,000 $16,000

2005 $14,000 $4,000 $18,000

2006 $15,000 $5,000 $20,000

2007 -2010 Indexed for inflation Indexed for inflation Sum of annual Pre-tax and catch-upcontribution limits

Q: How do I know whether I can make Catch-Up Contributions?

A: If you are age 50 or older, or will reach age 50 on or before December 31, you can make a catch-up contribution electionfor the year. Any Catch-Up Contributions you elect will not affect your regular pre-tax contribution amounts.

Q: I am interested in making a Catch-Up Contribution, but I won’t be 50 years old until October. Can I participatebeginning in January, or do I need to wait until after my 50th birthday?

A: You can elect to make Catch-Up Contributions beginning in January as long as you will be at least 50 years old on orbefore December 31.

Q: This year, through my regular TESPHE payroll deductions, I have already reached the IRS pre-tax deferral limit,so my regular TESPHE pre-tax deferrals have stopped for the rest of the year. Can I still make a catch-upcontribution election?

A: Yes, even though your regular TESPHE pre-tax deferrals have stopped for the remainder of the year, you can still makeCatch-Up Contributions.

Q: Once I elect to make Catch-Up Contributions, what will happen if I stop my regular TESPHE payroll deductionsand then restart them at a later time?

A: Your Catch-Up Contributions will not stop automatically if your regular TESPHE payroll deductions stop. However, tothe extent you have not reached the annual IRS pre-tax deferral limit or the TESPHE contribution limit of 50% by theend of the calendar year, any Catch-Up Contributions will be re-characterized to regular pre-tax deferral contributions.

Q: Can I make Catch-Up Contributions after I take a hardship withdrawal, which results in suspension of TESPHEpayroll deductions?

A: No. In order to make Catch-Up Contributions, you must be eligible to make regular payroll deductions under theTESPHE. If you take a hardship withdrawal, your right to make regular TESPHE payroll deductions is suspendedtemporarily. If you take a hardship withdrawal and you previously elected to make Catch-Up Contributions, your Catch-Up Contributions automatically will stop. Once the suspension is expired, you may elect to resume your Catch-UpContributions. Your Catch-Up Contributions will not automatically resume at the deferral rate in effect prior to thesuspension. You will need to make a new election. (Note: Other withdrawals that do not result in a suspension ofTESPHE payroll deductions will not affect Catch-Up Contributions.

Q: I know that I want to make Catch-Up Contributions every year. Will my catch-up election carry over from year toyear?

A: No. You will need to make new elections each year.

Q: Can I choose a dollar amount for my Catch-Up Contribution or does it have to be a percentage?

A: At this time, only Catch-Up Contribution elections that are a percentage of your eligible pay will be accepted. You mayelect to defer up to 50% of your eligible pay as Catch-Up Contributions. You will be notified if additional methods forcalculating Catch-Up Contributions become available.


Q: What will happen when I reach the catch-up dollar limit for any given year?

A: Once you reach the catch-up dollar limit for the year, your Catch-Up Contributions automatically stop. You will need tomake a new election for any subsequent years in which you wish to make Catch-Up Contributions.

Q: Can my Catch-Up Contribution deferral percentage be different than my regular TESPHE pre-tax payroll deduc-tion?

A: Yes, it can be more or less than your regular TESPHE payroll deduction. For example, if your regular payroll pre-taxdeduction is 8%, you may elect to defer between as little as 1% or as much as 50% of your eligible pay to catch-up.

Q: I contributed Catch-Up Contributions to another employer’s 401(k) plan. Will I be able to contribute the fullannual catch-up amount to the TESPHE, too?

A: A catch-up eligible participant cannot make total Catch-Up Contributions that exceed the annual catch-up limit byparticipating in more than one eligible plan, whether related or unrelated employers sponsor the plans. Participantshave a duty to monitor whether their Catch-Up Contributions have exceeded the annual limit; however, if this occurs,please contact the Savings Plan Administrator at 1-800-248-4444.

Q: Can I track how much catch-up money I am contributing? Will it appear on my paycheck stub?

A: Your Catch-Up Contribution amounts will not appear on your paycheck stub as a separate line item, but will be includedin your pre-tax total. They will also show on your quarterly TESPHE statements from Fidelity. Also, you may track yourCatch-Up Contribution dollar amount at anytime by accessing your account online at NetBenefits.

Steps

1. Access your account at Fidelity NetBenefitssm at www.netbenefits.fidelity.com.

2. On the Home Page, click the “Access My Benefits” link and proceed to log on to your Ford TESPHE account.

3. Select the Accounts tab; under Account Detail on the left bar, click History.

4. Select the time period you wish to display (up to 24 months).

5. Click Retrieve History.

6. On right side of next screen, next to “View by”, click “Source”. You will be able to see each Pre-Tax Catch-Up Contri-bution amount by date.


Managing your account

Accessing and managing your account is easy. Through Fidelity’s online account management service, automated phoneservice, or phone service representatives, you can easily get the information you need whenever you want it. Note that theautomated phone service has a speech recognition feature that lets you request most transactions with a simple word orphrase.

NOTE: Fidelity may change the organization of its NetBenefits Website from time to time. As a result, the naviga-tional steps detailed in this document may change. If you have questions regarding how to use NetBenefits,contact the Fidelity Service Center for Ford Motor Company at 1-800-544-3333 for assistance.

HOW TO: USE THIS CHANNEL:

Online 24-hour accessLog on at netbenefits.fidelity.com,click on the “Access My Benefits”icon category.

ENROLL IN THE PLAN • Select the “Access My Account” icon. X X• Select the New User Registration link to establish PIN #.• Click on Ford TESPHE on the Home Page.• Select the “Begin Enrolling” link on the Welcome page, and complete all of items under the “Steps to Enroll” until you receive an Enrollment Summary. To help you determine your contribution amount, there is a link to a “Take Home Pay Calculator” that shows how various contribution levels could affect your take-home pay and savings over time. (NOTE: If you do not select a specific investment option(s), for your contributions, they will be invested in the Interest Income Fund as the default investment option.)

ACCOUNTINFORMATION

Obtain plan Click on Planning tab from the Home X Xinformation Page and then Your Company Ford Plan.

Review investment Click on the Accounts tab from the X Xinformation (investment Home Page and then Performanceoption descriptions, under Investment Resources.mutual fundprospectuses andperformance)

Obtain quotes for all Click on the Accounts tab from the X Xinvestment options Home Page and then Quotes under

Investment Resources.

Check your current Available on the NetBenefitssm Home X Xaccount balances Page. For more detail, click on the

Accounts tab, view by source or fund.

Review account Click on the Accounts tab from the X Xhistory Home Page, then History under

Account Detail.

Voice Response System800-544-3333Virtually any time, day or night

Fidelity ServiceRepresentatives800-544-3333Mon.-Fri. 8:30 a.m.to midnight, ET


INVESTMENTCHANGES

Change your Click on the Accounts tab from the X Xcontribution amounts Home Page, then Deductions under(Pre-Tax, After-Tax or Account Managementage 50+ catch-up)

Exchange between 1 Click on the Accounts tab from the X Xcurrent investments Home Page, then Exchanges under

Account Management

Change how future Click on the Accounts tab from the X Xcontributions are Home Page, then Contributions underinvested Account Management

ADMINISTRATIVECHANGES

Change address Change your address in your Labor Not Available Not Available(active employees only) Relations office.

Change address 1 Not Available Not Available X

Terminated EmployeesNOTE: Retirees mustcontact Comerica at1-800-647-3674

Set up or change a Go to NetBenefitssm at X XPIN netbenefits.fidelity.com and select the

“Access My Account” icon. Select theappropriate link and follow the prompts.

Order plan literature Click on the Accounts tab from the X XHome Page, then Plan Literature underInvestment Resources.

LOANS ANDWITHDRAWALS

Model a loan Click on the Accounts tab from the X XHome Page, then Loans underAccount Management.

Request a general loan Click on the Accounts tab from the X XHome Page, then Loans underAccount Management.

Request a home loan Click on the Accounts tab from the X X(a loan application will Home Page, then Loans under Accountbe mailed to your home Management.address)

Review outstanding Click on the Accounts tab from the X Xloan information Home Page, then Loans under Account

Management, then Existing Loans

1 For security purposes, employees who change their TESPHE address by calling Fidelity will be prohibited from requesting a withdrawal, loan or transfer for 15 days.










LOANS ANDWITHDRAWALS(continued)

Establish electronic Click on the Accounts tab from the X Xloan payment Home Page, then Loans under Account

Management, then Existing Loans thenclick on the “Make a Single Payment”icon.

Review amount Click on the Accounts tab from the X Xavailable to withdraw Home Page, then Withdrawals under

Account Management

Request a withdrawal Click on the Accounts tab from the X XHome Page, then Withdrawals underAccount Management

Request a full payout Not Available X X(age 591/2 andterminated/retiredparticipants)

Request a hardship Not Available Not Available Xwithdrawal

Request a rollover Not Available Not Available Xdistribution

ROLLOVERDISTRIBUTIONS

Inquire about rolling Not Available Not Available Xmoney into the plan

Request a rollover form Click on Planning tab from the Home X X(form has instructions on Page and then Your Company Plan,how to process a rollover then Forms and Notices (Rollover Form)into plan)

Roll over money into Not Available Not Available Xthe plan

243243

Profit Sharing Plan

After an overview of the Profit Sharing Plan, thissection of your handbook answers these questions:

Page

Who is eligible for Profit Sharing? 244

How are Profit Shares determined? 245

What is your Profit Share? 246

How do you receive your share? 247

What circumstances might affect yourProfit Share? 249

Can the Profit Sharing Plan change? 250

244 Profit Sharing Plan


Profit Sharing is one of your well–earned rewards. Itreflects the importance of your cooperation and per-formance to Ford’s success and is a result of nego-tiations with the UAW.

The Profit Sharing Plan is designed to reward your effortswhich result in Ford’s profitability. Through the Plan:• Each year that the Company generates profits from U.S.

Operations, Ford will set aside a portion of these profits.• The money allocated for Profit Sharing is divided among

the Plan participants.• Each Plan participant receives a portion of these prof-

its, called a “Profit Share.”• Your Profit Share is based on your eligible pay for the

year and can be:— paid by check— put in the Tax–Efficient Savings Plan for Hourly

Employees (TESPHE)— deposited in the Ford Money Market Account or— a combination of these.It’s your choice.

If you decide to have the Company contribute all or a partof your share to TESPHE, the provisions on investments,transfers, withdrawals, etc., that cover other TESPHEcontributions will apply.


Who is eligible for Profit Sharing?

If you were hired on or before December 31 of thePlan year, you may be eligible for Profit Sharing.

Eligibility

You’re eligible for Profit Sharing if you:• Were hired on or before December 31 of the Plan year

(the Plan year is the same as a calendar year)• Are a full-time hourly employee of Ford Motor Com-

pany at one of the U.S. Operations included in thePlan and

• Are employed in a Unit to which this Plan is applicable.

Your eligibility is not affected if, during the Plan year:• You are on layoff or approved leave• You retire or• Your employment terminates because the Company

sells the operation where you work.

Beneficiaries of eligible employees who die during the Planyear also are eligible for Profit Sharing.

You are not eligible if:• Your employment terminated during the Plan year (with-

out being reinstated) for reasons other than retirement,death or sale of an operation

• You work on a temporary part–time basis or• You are employed at certain subsidiaries, including

Ford Land (if this is the case, other profit sharingplans may apply)

If you’re eligible for Profit Sharing, your individual ProfitShare is based on your eligible pay.

Profit Sharing Plan


How are Profit Shares determined?

Each year that Company profits are generated, Fordwill make Profit Sharing payments.

Shortly after the end of the year, the Company determinesits profits and sales for the year from U.S. Operations. U.S.Operations does not include profits and sales of Ford Landand certain other subsidiaries and operations.

Profits and salesThe Company makes payments under the Profit SharingPlan when these profits are generated.

The Plan takes into account profits that Ford earns beforeincome taxes and before calculation of Profit Sharing un-der the Hourly Profit Sharing Plan, Profit Sharing that wouldhave been paid to eligible salaried employees under theProfit Sharing Plan for Salaried Employees in the U.S.had that plan not been terminated and executive annualincentive compensation. Profits of certain unconsolidatedsubsidiaries are included on an after–tax basis, althoughthe sales of such subsidiaries are not.

The relationship between profits and sales is important incalculating the amount of profits that will be shared underthe Profit Sharing Plan. As profits increase to specificlevels, the percentage on which your Profit Share is basedalso increases.

Determining the Total Profit ShareFord begins determining your share of profits by calcu-lating the “Total Profit Share.” It is figured according tothis formula:

6% of + 8% of + 10% of + 14% of + 17% ofprofits profits profits profits profitsup to between between between over

1.8% of 1.8% 2.3% 4.6% 6.9% ofsales and and and sales

2.3% of 4.6% of 6.9% ofsales sales sales

For any year that profits are generated, the Total ProfitShare will be at least equal to $50 times the number ofhourly and salaried employees in U.S. Operations.

When the Total Profit Share has been determined, it thenis divided between the hourly and salaried employeesbased on the number of employees in each. For example,if 70% of the employees eligible for Profit Sharing arehourly employees, then 70% of the Total Profit Share willgo to the Profit Sharing Plan for hourly employees. Theresulting amounts represent the “Allocated Profit Share”for each Profit Sharing Plan.

The amount of the Total Profit Share and the Allocated ProfitShare are certified by independent public accountants.

The next section describes how your share of this amountis calculated.


What is your Profit Share?

Your share of the Total Profit Share is based on youreligible pay.

Once the Allocated Profit Share is determined, your ProfitShare then can be calculated. Your Profit Share dependson your eligible pay.

Eligible payYour Profit Share is calculated using only your “eligible”pay. Eligible pay includes:• Straight-time hourly base wages (for straight-time hours

and overtime hours)• Straight-time cost-of-living allowance (for straight-time

hours and overtime hours)• Straight-time shift premiums (for straight-time hours and

overtime hours)• Vacation and excused absence allowance• Holiday pay• Seven-day operations bonus• Apprentice training incentive payments• Bereavement pay• Jury duty pay• Short-term military duty pay• Call-in pay• Grievance awards (that represent back pay that is eli-

gible pay for any Plan year)• Performance Bonus Plan• Christmas bonus and• Up-front lump sum payments (2003 plan year only).

Special adjustments to eligible pay may be made inthe event of compensation received under a gradualreturn-to-work-program

Eligible pay excludes overtime, Saturday, Sunday and holi-day premium payments. These examples show how eligiblepay is determined when premium payments are made:

Included in Excluded fromIf you work: Eligible Pay: Eligible Pay:

10 hours on 8 hours of straight- 1 hour of premiuma regularly time pay for regularly pay for overtimescheduled scheduled hours,workday plus 2 hours of

straight-time pay forovertime

10 hours of 10 hours of straight- 5 hours of premiumovertime on time pay for working pay for a Saturdaya Saturday 10 hours

10 hours of 10 hours of straight- 10 hours of premiumovertime on time pay for working pay for a Sundaya Sunday 10 hours

8 hours on 8 hours of straight- 8 hours of premiuma holiday time pay for working pay for the holiday

8 hours of straight-time pay for theholiday

Other excluded payAll other pay categories are excluded, including:• Suggestion awards• Any inputted income as may be required by law, includ-

ing the cost of group life insurance in excess of $50,000and the cost of the Legal Services Plan and

• Participants’ Profit Shares

Special provisionsIf you are on a qualified local Union leave, you may becredited with straight-time base pay and COLA for up to40 hours per week.

Special provisions also apply for certain employees whowork part of the year and receive Workers Compensationpayments. If these provisions apply, you may be creditedwith straight–time base pay and COLA for up to 40 hoursper week.

Your date of participationIf you meet the Plan’s eligibility requirements before Janu-ary 1 of any Plan year, your Profit Share will be based onyour eligible pay for the entire year. If you meet the re-quirements during the year, your share will be based onyour eligible pay after your date of participation. Gener-ally, your “date of participation” is your date of hire. If you’reeligible but are laid off or on approved leave at the begin-ning of the year and then return to work, your share will bebased on your eligible pay after you return to work.


Your Profit ShareAfter eligible pay is calculated, your Profit Share is deter-mined by a two-part formula.

First, the Profit Sharing percentage factor is determined:

Allocated Profit Share for hourly employees

divided by

total eligible pay of all eligible hourly employees

equals

Profit Sharing percentage factor

Second, your share is calculated:

Profit Sharing percentage factor

times

your eligible pay

equals

your Profit Share

An exampleSuppose your eligible pay for the year totals $32,000. Ifthe Profit Sharing percentage factor for the year is 5%,here’s how your Profit Share is determined:

5% x $32,000 = $1,600

When you receive your distribution, your pay stub will showhow your Profit Share was calculated.

Keep in mind that the actual Profit Sharing percentagefactor will change from year to year, and so will your eli-gible pay. Also, this amount may be subject to withholdingof applicable federal, state and local income taxes, FICAtaxes (including Social Security and Medicare) and de-ductions for Union dues.

How do you receive your share?

You can take your Profit Share by check, have it con-tributed to TESPHE or Money Market, or elect somecombination of these options.

How your Profit Share is paid to you is your decision.You can:• Receive a check for your share• Have the Company contribute your share on your be-

half to the Tax–Efficient Savings Plan for HourlyEmployees (TESPHE)

• Have the Company direct your share to the Ford MoneyMarket Account or

• Elect a combination of these options.

If you don’t make an election, your Profit Share will bepaid by check.

Direct deposit is not an option.

Because tax issues can be complicated, you may want totalk with a tax advisor for more information before makingyour Profit Share decision.

Any Profit Sharing payment for the Plan year will be madeby March 15 of the following year.

Choosing cashIf you decide to take all or part of your share in cash,you’ll receive a check for the net amount from Ford.Checks will be distributed on Profit Sharing Day. Keep inmind that this is your Profit Share based on profits fromthe previous year.

Profit Shares you receive by check are considered taxableincome, so Ford will withhold amounts for applicablefederal, state and local income taxes and FICA taxes.


Choosing TESPHEIf you prefer and you are eligible to contribute to TESPHE,you can direct the Company to contribute all or part ofyour Profit Share, in 1% increments, to TESPHE as apre-tax contribution.

Any amount contributed to TESPHE is not subject tofederal income taxes until you receive a distribution inthe future. (The same may be true for state and localincome taxes, depending on where you live and work.)In addition, the investment earnings on the amount yousave are not taxed while they remain in TESPHE as apre-tax contribution.

Profit Sharing is subject to FICA taxes even if you electto have the Company contribute your Profit Share toTESPHE. If you have part of your Profit Share contributedto TESPHE, FICA taxes and any required state and localincome taxes on the portion contributed to TESPHE willbe withheld from your remaining cash payment, or fromyour next regular paycheck if necessary. Any Profit Sharecontributed to TESPHE will be invested in accordancewith your most recent investment elections, except asnoted below.

If you have never made an investment election or if youhad ceased to actively contribute to the TESPHE prior toOctober 1, 1995, and have not made an election since,any contributions from profit sharing will be invested inthe Interest Income Fund. You may then exchange yourprofit sharing contributions to other investment options,subject to the Plan’s exchange rules.

In general, the assets in your TESPHE account may bedistributed upon your request when you retire or leave theCompany. If you want to withdraw tax–efficient savingsassets before you leave the Company or retire, you mustbe at least age 59½ or prove financial hardship under thetax laws in effect.

For more information on TESPHE, see that section of thishandbook.

Choosing Ford Money Market AccountYou may authorize the Company to direct all or a portionof your Profit Share to the Ford Money Market Accountif you have an account open under that program and areinvesting in it through payroll deduction. Profit Sharesdirected to the Ford Money Market Account areconsidered taxable income, so Ford will withhold amountsfor applicable federal, state and local income taxes andFICA taxes.

Union duesAny required Union dues also will be deducted from yourProfit Share, whether you take your Profit Share by check,have it contributed to TESPHE, have it directed to theFord Money Market Account, or a combination of these. Ifyou take all or part of your Profit Share by check, thenecessary Union dues will be deducted from your cashpayment. If you have the Company contribute all of yourProfit Share to TESPHE, Union dues on the full amount ofyour Profit Share will be deducted from your nextpaycheck. If you have all or part invested in the Ford MoneyMarket Account, the necessary Union dues will bededucted from any portion received in cash or, to the extentnecessary, from the amount contributed to the Ford MoneyMarket Account.


What circumstances might affect your Profit Share?

You should be aware of some circumstances thatmight affect your benefits from the Profit Sharing Plan.

Naming a beneficiaryIf you die while you are eligible for Profit Sharing, theProfit Share you have earned will go to the person orpersons who are your beneficiaries. Your beneficiary isthe person who receives payment of the Company’s GroupLife Insurance benefit. You may designate a differentbeneficiary for this Plan, however, if you wish.

If all or part of your Profit Share was contributed toTESPHE and you die, your TESPHE account (includingthe amount contributed from your Profit Share) will go toyour TESPHE beneficiary.

Designations and changes of beneficiaries must be filedin writing with the Company.

Assignment of benefitsIn most cases, benefits from the Plan cannot be assigned.If you become divorced or separated, or if your Profit Shareis garnisheed, certain court orders could require that partof your Profit Share be paid to someone else — your formerspouse or children, for example. This could apply tobenefits paid to you as well as to any beneficiary.

If the Plan Administrator determines that the court orderqualifies, payments will be made according to the order.

Prior year paymentsIf you do not receive a Profit Share because you areterminated during the year for discharge, failure to reportor overstaying a leave, and your seniority is reinstated ina later Plan year through the grievance procedure, youwill receive your Profit Share after your service isreinstated. The amount will be based on your eligible payreceived for the prior Plan year and the percentage factorfor that Plan year.

If you receive a retroactive Worker’s Compensationpayment for a prior year for which you were eligible for aProfit Share, you may be eligible to receive a ProfitShare payment based on the time period covered bythe retroactive payment.

If you or your beneficiary is incapacitatedIf you or your beneficiary are incompetent, incapaci-tated or have not yet reached the age of majority, theCompany may make payment to an appropriate indi-vidual and fully discharge its liability. This individual maybe a relative by blood or marriage or any other indi-vidual or institution appearing to have assumed cus-tody of you or your beneficiary.

If your claim is deniedIf you disagree with the Company regarding your eligibilityfor Profit Sharing or the amount of your Profit Share, youshould contact a Human Resources Associate at the Na-tional Employee Services Center (NESC) for a full review.

If your Profit Share is underpaidIf an error is made when calculating your Profit Share andyou were underpaid more than $3, the Company will paythe difference within 60 days after determining the error.

If your Profit Share is overpaidIf your Profit Share is overpaid by more than $3, youwill receive a written notice of the amount that you shouldrepay to the Company. If you do not repay this amount,the Company wil l deduct it from a subsequentpaycheck(s). Deductions will not be more than $30 fromany paycheck. If necessary, your Profit Share for thenext year will be reduced.

Repayment is not required if:• The total amount of overpayment is $3 or less or• You are not given notice of the overpayment within 120

days after the overpayment was made.

TransfersIf you’re transferred to the salaried payroll during theyear, you’ll receive a Profit Share from this Plan basedon your eligible pay earned while you participated inthis Plan. Your eligibility and earnings as a salariedemployee will be covered under the salaried Perfor-mance Bonus Plan.


Can the Profit Sharing Plan change?

It is possible the Plan could end or be changed inthe future.

The 2003 Collective Bargaining Agreement between FordMotor Company and the UAW authorizes the Profit SharingPlan through 2007 At that time, the terms of this Plan aresubject to renegotiation.

Any Profit Sharing for 2007 will be administered asdescribed in this Plan even if this Plan is terminatedthat year.

The Company has the authority to control and managethe operation and administration of this Plan. The Companyalso has the authority to interpret Plan provisions, exceptas otherwise specifically provided in the 2003 Agreement.

Any disagreement between the Company and the UAWover the interpretation of the terms of this Plan as providedin the 2003 Agreement may be submitted to a mutuallyacceptable, impartial person for resolution at the requestof either party. If the Company and the UAW can’t agreeon an acceptable, impartial person, the Umpire under theAgreement will make the appointment. The impartialperson’s decision will be limited to Profit Share amountsallocated or distributed during the year the decision is madeand subsequent Plan years, and will be binding on theUAW, its members, the participants and the Company.

251

Ford Money Market Account

For information about the Ford Money Market Account, call1-800-580-4778 or go to www.fordcredit.com/moneymarket

253253253253

As a Ford hourly employee represented by the UAW,you should be aware of some important administrativedetails of the Plans. This section of your handbookcontains explanations of these Programs and hasanswers to these questions:

Page

What are the administrative details ofthe Plans? 254

What are my ERISA rights? 260

What are my rights under theFamily and Medical Leave Act of 1993? 261

Administrative, ERISA, and Family andMedical Leave Act of 1993 Information

254 Administrative and ERISA Information

What are the administrative details of the Plans?

Information regarding your employee benefit Plansis filed with the federal government and must meetcertain administrative requirements under govern-ment regulations. This section contains administra-tive details regarding the Plans.

Covered employeesThis handbook contains descriptions of benefits availableto hourly UAW-represented employees (and their eligibledependents) of Ford Motor Company, AAI EmployeeServices Company, L.L.C., and Volvo Cars North America,L.L.C. under the Collective Bargaining Agreement effectiveSeptember 15, 2003. You can obtain a copy of the CollectiveBargaining Agreement by writing to the Plan Administrator.You also can review a copy of the Collective BargainingAgreement at your work location.

Plan AdministratorThe Plan Administrator (and point of contact) for all ofyour benefit Plans except those shown below is:

Plan AdministratorFord Motor CompanyNational Employee Services CenterP.O. Box 6214Dearborn, Michigan 48121-62141-800-248-4444 — Inside Ford: ext. 84444

The Tax-Efficient Savings Plan for Hourly Employees(TESPHE) is administered through:

Fidelity Institutional RetirementServices Company, Inc.(A division of Fidelity InvestmentsInstitutional Services Company, Inc.)82 DevonshireBoston, MA 021091-800-544-3333

The Plan Administrator (and point of contact) for the Supple-mental Unemployment Benefit (SUB) Plan and the Guar-anteed Income Stream (GIS) Benefit Program is:

Plan AdministratorFord Motor Company, Human ResourcesOne American RoadDearborn, Michigan 48126(313) 845-2698

The Plan Administrator for the UAW-Ford Legal ServicesPlan is:

Administrative Committeec/o Robert EslerDirector, UAW-Ford Legal Services Plan7430 2nd AvenueDetroit, Michigan 48202(312) 872-5200

Plan SponsorFord Motor Company is the Plan Sponsor of all your Plans.

Administrative, ERISA, and Family andMedical Leave Act of 1993 Information

Employer numberThe federal government has assigned Ford Motor Companyan employer identification number for tax purposes. It is EIN38-0549190. The assigned employer identification numberfor AAI Employee Services Company, L.L.C. is EIN 38-2606038. The assigned employer identification number ofVolvo Cars North America, L.L.C. is EIN 31-1814807.

Agent for Service of Legal ProcessLegal process may be served upon the Plan Administra-tor or the Agent for Service of Legal Process:

SecretaryFord Motor CompanyOne American RoadDearborn, Michigan 48126(313) 322-3000

For SUB, legal process also can be served upon the Trusteeof the Plan:

Comerica BankP.O. Box 75000Detroit, Michigan 48243(313) 222-4000 or1-800-521-1190 (outside of Michigan)

For the Retirement Plan, legal process also can be servedupon the Trustee of the Plan:

The Northern Trust Company50 S. LaSalle StreetChicago, Illinois 60675(312) 630-6000

For TESPHE, legal process also can be served upon theTrustee of the Plan:

Fidelity Management Trust Company82 DevonshireBoston, MA 021091-800-544-3333

Plan YearThe TESPHE Plan Year is December 31 through December 30. ThePlan Year for all other plans is January 1 through December 31.

Plan terminationFord Motor Company intends for your Plans to continueindefinitely. No changes may be made until the expirationof the 2003 Collective Bargaining Agreement, except asrequired by law or as mutually agreed between Ford MotorCompany and the UAW. The 2003 Collective BargainingAgreement expires on September 14, 2007.

If the Retirement Plan should terminate, the PensionBenefit Guaranty Corporation (PBGC), a government-owned corporation guaranteeing certain pension benefits,would protect all or a portion of your benefit. See theRetirement Plan section of your handbook for more details.

Further, each section of your handbook has details describingwhat would happen if a particular Plan should end.

Administrative and ERISA Information 255

PlanPlan Name: Number: Type of Plan: Cost Paid By: Trustee: Benefits Administered or Insured Through:

Health Care Plan Administrative services for health carebenefits are provided by the following organizations:

If you Your Claimswork in: processor is:

National PPO 520 Welfare plan Benefits are paid by None Illinois or Unicare Life and Health(BCBS) / Traditional providing the Company. The Oklahoma Insurance CompanyPlan (UNICARE) Hospital-Surgical- Company pays fees P.O. Box 4570Hospital-Surgical- Medical Hearing Aid to carriers and other Dearborn, Michigan 48120Medical-Hearing benefits organizations for (313) 336-5550Aid coverages administrative services 1-800-843-8184

and claims processing.All other states Blue Cross and Blue Shieldand the District Ford Service Centerof Columbia P.O. Box 2089

Detroit, MI 48231-20891-800-482-5146

DME and P&O 520 Welfare plan Benefits are paid by None All states UAW / Ford National DME andSUPPORT Program providing Durable the Company. The P&O SUPPORT Programfor National PPO Medical Equipment Company pays fees P.O. Box 82060(BCBS) / Traditional and Prosthetic and to carriers for Detroit, Michigan 48308-2060Plan (UNICARE) Orthotic Appliances administrative services 1-800-831-0999

benefits and claims processing

Prescription Drug 520 Welfare plan Benefits are paid by None All states and National Managed Carecoverage for providing the Company. The the District of Program BCBSMNational PPO Prescription Company pays fees Columbia Ford Service Center(BCBS) / Traditional Drug benefits to carriers for P.O. Box 2089Plan (UNICARE) administrative services Detroit, MI 48231- 2089

and claims processing. 1-800-482-5146

HMOs , PPOs & 520 Welfare plan Depending upon the None Various states Various alternative plansDHMOs: Alternative providing Hospital- plan, the Company (i) (HMOs , PPOs & DHMOs)Hospital-Surgical-Medical Surgical-Medical pays the benefit and Visit www.benefitcompanion.comPrescription Drug or Prescription Drug fees to carriers for for a list of available plans.Dental coverages* or Dental benefits administrative services Company name: UAW Ford

and claims processing, Password: myhealthor (ii) pays a premiumto the carrier to fullyinsure the benefit.

Traditional Dental 520 Welfare plan Benefits are paid by None All states and Blue Cross and Blue Shieldcoverage providing Dental the Company. The the District of of Michigan

benefits Company pays fees Columbia Ford Service Centerto the carrier for P.O. Box 2089administrative services Detroit, MI 48231- 2089and claims processing. 1-800-482-5146


* Some HMO / PPO plans may include Vision and Hearing Aid coverages — varies by plan.

Plan filing and funding informationThe Employee Retirement Income Security Act of 1974, as amended (ERISA) requires that additional administrativeinformation about your benefits be provided. A table with more information follows.


PlanPlan Name: Number: Type of Plan: Cost Paid By: Trustee: Benefits Administered or Insured Through:

Health Care Plan

If you Your Claimswork in: processor is:

Vision Care 520 Welfare plan The Company pays None All states SVS, Inc.coverage* providing a monthly premium to and the District Ford/UAW Vision Care Program

Vision Care the carrier to fully of Columbia, P.O. Box 464benefits insure the benefit. unless provided 155 South Gratiot

The carrier pays by your HMO Mt. Clemens, Michiganthe claims. 48046-0464

(810) 468-73701-800-225-3095

National PPO Plan 520 Welfare plan The Company pays None Michigan, Ohio, National Foot Care Program, Inc.(BCBS) / Traditional providing Health a monthly premium to Illinois, and P.O. Box 760547Plan (UNICARE) and Care benefits the carrier to fully Missouri Lathrup Village, MichiganBlue Preferred Plus insure the benefit. 48076-9894PPO Foot Care The carrier pays (248) 559-2579coverage the claims. 1-800-922-1695


* Unless provided by your HMO



Plan Benefits AdministeredPlan Name: Number: Type of Plan: Cost Paid By: Trustee: or Insured Through:

Group Lifeand DisabilityInsurance Program

Life Insurance, 521 Welfare plan The Company pays None Life Insurance, Accidental DeathAccidental Death and providing life premiums to the carrier and Dismemberment Insurance,Dismemberment insurance in amounts reflecting and Survivor Income BenefitsInsurance and the number and amount are provided by:Survivor Income of claims paid Group Policy 17-GCCBenefits UNICARE Life and Health

Insurance Company3200 Greenfield RoadDearborn, Michigan 48120(313) 336-55501-800-843-8184

Accident and Sickness 521 Welfare plan Benefits are paid by the Comerica Bank Except for employees in New YorkBenefits and Extended providing Company either directly 411 West and New Jersey, Accident andDisability Benefits disability or through a trust fund Lafayette Sickness and Extended Disability

benefits established by the Detroit, Michigan Benefits are paid by Ford MotorCompany 48226 Company either directly or through

(313) 222-4000 a trust fund. Claims are reviewedIf you live in New York or 1-800-521-1190 and approved or provided by:New Jersey, benefits are (outside Michigan) UNICARE Life and Healthpaid by a carrier Insurance Company

3200 GreenfieldDearborn, Michigan 48120(313) 336-55501-800-572-1581For employees in New York andNew Jersey, benefits are insured byJohn Hancock (and administered byUNICARE Life and Health

Insurance Company)(Group Policy 17-GCC)

Optional Group Life 521 Welfare plan Participating employees None Mutual of Omaha Insurance CompanyInsurance Plan offering life Ford Hourly Optional Insurance Plan

insurance Suite 1162720 South River RoadDes Plaines, Illinois 60018(847) 299-93931-800-742-8215

Dependent Group 521 Welfare plan Participating employees None Mutual of Omaha Insurance CompanyLife Insurance Plan offering life Ford Hourly Optional Insurance Plan

insurance for Suite 116your dependents 2720 South River Road

Des Plaines, Illinois 60018(847) 299-93931-800-742-8215



Group Lifeand DisabilityInsuranceProgram

Optional Accident 521 Welfare plan Participating None Mutual of Omaha Insurance CompanyInsurance Plan offering accident employees Ford Hourly Optional Insurance Plan

insurance for you Suite 116and your 2720 South River Roaddependents Des Plaines, Illinois 60018

(847) 299-93931-800-742-8215

Safety Belt User 521 Welfare plan providing Ford Motor None Mutual of Omaha Insurance CompanyBenefit Program life insurance in the Company Ford Hourly Optional Insurance Plan

event of death of a Suite 116covered participant 2720 South River Roadresulting from an Des Plaines, Illinois 60018automobile accident (847) 299-9393in which a qualified 1-800-742-8215passenger restraintwas used

Supplemental 503 Welfare plan providing Ford Motor Company Comerica Bank Plan AdministratorUnemployment supplemental income pays full cost of the Plan P.O. Box 75000 Ford Motor CompanyBenefit (SUB) Plan benefits to eligible up to the limits of the m/c 3464 Human Resources

employees for certain Plan Detroit, Michigan One American Roadperiods in the event of 48243 Dearborn, Michigan 48126a qualifying layoff (313) 222-4000 (313) 845-2698

1-800-521-1190(outside Michigan)

Guaranteed 504 Welfare plan providing Ford Motor Company None Plan AdministratorIncome Stream income and insurance pays full cost of the Ford Motor Company(GIS) Benefit protection to certain Plan up to a total Human ResourcesProgram eligible long-seniority liability limit One American Road

employees while on a Dearborn, Michigan 48126qualifying layoff (313) 845-2698

Ford Motor 001 Pension plan Ford Motor Company The Northern Plan AdministratorCompany-UAW providing defined makes contributions to Trust Company Ford Motor CompanyRetirement Plan benefits (a the Pension Fund to 50 S. LaSalle Street National Employee Services Center

defined benefit fund the normal and Chicago, Illinois P.O. Box 6214plan) amortized past-service 60675 Dearborn, Michigan 48121-6214

cost, as determined by (312) 630-6000 1-800-248-4444an independent actuary 1-800-521-1190– based on ERISA and (outside Michigan)the RetirementAgreement




Ford Motor 025 Defined contribution Generally, Fidelity Management Fidelity Investments InstitutionalCompany Plan Ford Motor Company Trust Company Operations CompanyTax-Efficient pays Plan 82 Devonshire (A division of Fidelity ManagementSavings Plan for administrative Boston, MA 02109 Trust Company, Inc.)Hourly Employees expenses. 1-800-544-3333 82 Devonshire(TESPHE) For eligible employees Boston, MA 02109

who elect a wage 1-800-544-3333reduction orcontribution from 1% to50% of pay and/orthose who elect todeposit their annualProfit Share, the Company will contribute thosefunds to a trust fund.

Ford Motor None Unfunded Ford Motor Company None Plan AdministratorCompany Profit arrangement for makes payments under Ford Motor CompanySharing Plan for employee profit the Profit Sharing Plan National EmployeeHourly Employees sharing; not an when profits are Services Centerin the United States ERISA plan generated P.O. Box 6214

Dearborn, Michigan 48121-62141-800-248-4444

UAW-Ford 540 Welfare plan Ford Motor Company Comerica Bank Administrative CommitteeLegal Services providing legal 100 Renaissance c/o Robert Esler Director,Plan for UAW- services Center UAW-Ford Legal Services PlanRepresented Detroit, Michigan 7430 2nd AvenueHourly Employees 48243 Detroit, Michigan 48202of Ford Motor (313) 222-4000 (313) 872-5200Companyin the 1-800-521-1190United States (outside Michigan)

Dependent None Wage reduction Participating None FBD Consulting, Inc.Care Assistance program to employees P.O. Box 7955Plan provide pre-tax Shawnee Mission, KS 66027-0955

savings on the (888) 537-4643cost of eligibledependent careexpenses



What are my ERISA rights?

You have certain rights under the Employee Retire-ment Income Security Act of 1974.

The Employee Retirement Income Security Act of 1974(ERISA), as amended, entitles you to know certain detailsabout your benefits. ERISA also gives you certain legalprotection. It allows you and all other Plan participants to:

Receive information about your plan and benefits• Examine, without charge, and during regular working

hours, all Plan documents, including Plan contracts andcopies of all Plan documents filed with the U.S. De-partment of Labor, such as detailed annual reports andPlan descriptions. Documents are kept in the office ofthe Plan Administrator, but may be sent to you within10 days after your written request is received.

• Obtain a copy of all Plan documents and other Planinformation by writing to your Personnel Benefits Rep-resentative or the Plan Administrator. The Administra-tor may make a reasonable charge for copies.

• Receive a summary of the Plan’s annual financialreports. The Plan Administrator is required by law tofurnish each participant with a copy of the summaryannual report.

• Obtain, upon written request, a statement telling youwhether you have a right to receive a benefit from theRetirement Plan at normal retirement age (age 65) and,if so, what your benefits would be at normal retirementage if you stop working under the Plan now. If you donot have a right to a benefit, the statement will tell youhow many more years you have to work to have a rightto such a benefit. You also have a right to a statementof your benefits under TESPHE. You must request thisstatement in writing. The Company must provide thestatement free of charge, but is not required to giveyou more than one statement per calendar year.

Continue group health plan coverage• Continue health care coverage for yourself, spouse or

dependents if there is a loss of coverage under theplan as a result of a qualifying event. You or your de-pendents may have to pay for such coverage.

• Reduce or eliminate exclusionary periods of coveragefor pre-existing conditions under your group health plan,if you have creditable coverage from another plan. Youshould be provided a certificate of creditable coverage,free of charge, from your group health plan or healthinsurance issuer when you lose coverage under the plan,when you become entitled to elect COBRA continua-tion coverage, when your COBRA continuation cover-age ceases, if you request it before losing coverage, orif you request it up to 24 months after losing coverage.Without evidence of creditable coverage, you may besubject to a pre-existing condition exclusion for 12months (18 months for late enrollees) after your enroll-ment date in your coverage.

For additional information, see “May I obtain a Certificateof Creditable Coverage for Credit Against Another (Non-Ford) Plan’s Preexisting Condition Clause?” in the OtherHealth Care Plans section of this handbook.

Prudent actions by Plan FiduciariesIn addition to creating rights for Plan participants, ERISAimposes duties upon the people who are responsible forthe operation of the Plans. These people are called “fidu-ciaries” of the Plans. They have a duty to act prudently inyour interest and the interests of other Plan participantsand beneficiaries.

No one may fire you or discriminate against you to pre-vent you from obtaining a benefit or exercising your rightsunder ERISA.


Enforce your rightsIf your claim for any benefit is denied in whole or in part,you must receive a written explanation of the reason forthe denial. You have the right to have the Plan Administra-tor review and reconsider your claim.

Under ERISA, there are steps you may take to enforce allthese rights. For instance:• If you request materials in writing from the Plan Admin-

istrator and you do not receive them within 30 days,you may file suit in a federal court; in such a case, thecourt may require the Plan Administrator to provide thematerials and pay you up to $110 a day until you re-ceive the materials, unless the delay is because of rea-sons beyond the Administrator’s control

• If your claim for benefits is improperly denied, in wholeor in part, you may file suit in a state or federal court

• If you disagree with the Plan’s decision or lack thereofconcerning the qualified status of a domestic relationsorder or a medical child support order, you may file suitin federal court

• If the Plan fiduciaries misuse a Plan’s money or if youare discriminated against for asserting your rights, youmay get help from the U.S. Department of Labor or youmay file suit in a federal court

The court will decide who should pay court costs andlegal fees. If you are successful, the court may order theperson you have sued to pay these costs and fees. If youlose, the court may order you to pay these costs andfees, for example, if it finds your claim is frivolous.

Assistance with your questionsIf you have questions about this statement of your rightsunder ERISA, or if you need assistance in obtaining docu-ments from the Plan Administrator, you should contactthe nearest area office of the Employee Benefits SecurityAdministration, U.S. Department of Labor, listed in yourtelephone directory or the Division of Technical Assistanceand Inquiries, Employee Benefits Security Administration,U.S. Department of Labor, 200 Constitution Avenue N.W.,Washington, D.C. 20210. You may also obtain certain pub-lications about your rights and responsibilities under ERISAby calling the publications hotline of the Employee Ben-efits Security Administration at 1.866.444.EBSA(3272).

If you have any questions about the Plans, you shouldcontact the NESC by mail at:

National Employee Services CenterP.O. Box 6214Dearborn, Michigan 48121-6214

Or you may call 1-800-248-4444Within Ford: ext. 84444

What are my rights under the Family and Medical LeaveAct (FMLA) of 1993?

You have certain rights and responsibilities under theFamily and Medical Leave Act (FMLA) of 1993.

Leave entitlementThe FMLA entitles you, if you are eligible, to take up to atotal of 12 weeks of unpaid job–protected leave during a12-month period for any of the following reasons:• For the birth or placement of a child for adoption or

foster care• To care for your spouse, child or parent with a serious

health condition• For a serious health condition that makes you unable

to perform your job

Until further notice, a calendar year will be used to definethe 12-month period.

FMLA leave for the birth or placement of a child for adop-tion or foster care must conclude within 12 months of thebirth or placement of the child with you.

FMLA leave may be taken intermittently — which meanstaking leave for a single injury or illness in several blocksof time, or by reduction of the normal weekly or daily workschedule — whenever medically necessary to care for aseriously ill family member, or because you are seriouslyill and unable to work.

The Company is responsible for determining if your leavewill be considered as FMLA leave, based on informationyou provide. Generally, leave cannot be credited as FMLAleave after the leave has ended. Also, subject to certainconditions, you may choose to use accrued paid leave assome or all of the FMLA leave.

In some instances, FMLA leaves will be concurrent withPersonal or Medical Leaves of Absence.

Under the 2003 Collective Bargaining Agreement,qualifying FMLA time that is comparable under theAccident and Sickness Insurance provisions of theGroup Life and Disability Insurance Program will not becounted against your 12 week FMLA entitlement unlessyou elect to have it so counted. You will continue tohave all your FMLA rights for qualifying leave withoutregard to whether you elect to have the leave countagainst your 12 week entitlement.


Notice and certificationWhen you seek to use FMLA leave, you may be requiredto provide:

• 30-day advance notice of the need to take FMLA leavewhen the need is foreseeable (mandatory)

• Notice as soon as practicable when the need for leave isunforeseeable (mandatory), and in no event more thantwo days after the need for leave becomes known (ex-cept where such notice cannot be given within two days)

• Medical certification supporting the need for leave dueto a serious health condition affecting you, your spouse,child, or parent

• Second or third medical opinions (at the Company’sexpense) and periodic recertification generally no moreoften than every 30 days and

• Periodic reports during FMLA leave regarding your sta-tus and intent to return to work

When planning medical treatment, the Company may, forjustifiable cause, require you to attempt to schedule thecare so as to avoid disrupting the Company’s operation.

Following a FMLA leave of absence due to your medicalcondition, you will be required to comply with theCompany’s fitness-for-duty certification prior to returningto work.

Future changes in FMLA proceduresThe Company may change the above procedures to re-flect relevant changes in the law and/ the gaining of addi-tional administrative experience; however, any changeswill not reduce leave provided by the Collective Bargain-ing Agreement.

Vacations and FMLA LeavesAbsence from work due to a Family and Medical LeaveAct leave to care for a family member identified above,with a serious health condition, or due to the birth of anemployee’s child or the placement of a child with the em-ployee for adoption or foster care, will not be counted incomputing the 35 days of absence for purposes of vaca-tion eligibility.

Employee eligibilityTo be eligible for FMLA benefits, you must have workedfor the Company:

1) For a total of at least 12 months and2) At least 1,250 hours within the previous 12-month period

Continuation of health care coverageThe Company will continue health care coverage for you,your spouse and your eligible dependents while you areon leave if such coverage was provided by the Companybefore the FMLA leave began.

Such coverage will be on the same terms as if you hadcontinued to work. You also may be entitled to continuehealth care coverage for other dependents at your ownexpense while on FMLA leave (such as Sponsored De-pendent coverage). However, the Company may recoverpremiums paid to maintain your health care coverage ifyou fail to return to work from FMLA leave for a reasonother than the continuation of a serious health conditionor circumstances beyond your control.

Job restorationUpon timely return from FMLA leave, you will be restoredto your original job, or to an equivalent job with equivalentpay, benefits and other employment terms and conditions.

If you remain on a leave of absence after exhaustion ofFMLA entitlement, you will receive the benefits and jobrestoration rights provided under the Collective Bargain-ing Agreement.

However, your use of FMLA leave cannot result in theloss of any employment benefit that you earned or wereentitled to before using FMLA leave.

263

Dependent Care Assistance Plan

After an overview of your Dependent CareAssistance Plan, this section of yourhandbook covers:

Page

Your Dependent Care Assistance Plan 264

How do I enroll? 265

How does the Dependent Care AssistancePlan Work? 266

What rules apply to the Dependent CareAssistance Plan? 267

How do I get reimbursed from the DependentCare Assistance Plan? 270

What situations affect participation? 271

264 Dependent Care Assistance Plan

Dependent Care Assistance Plan


The Dependent Care Assistance Plan helps you stretchyour budget by letting you set aside tax-free dollars to payfor the cost of dependent care and elder care expenses.

The Dependent Care Assistance PlanYou may use the Dependent Care Assistance Plan toreimburse yourself for child care or elder care expensesyou have during the year. You use the money you contributeto this account to pay yourself back for services youreceive from providers such as nursery schools andlicensed day care centers.

Your Dependent Care Assistance Plan

Your Dependent Care Assistance PlanFord offers you tax-savings opportunities through theDependent Care Assistance Plan. You designate a specifiedamount of your wages, up to $5,000 annually, from yourpay on a pre-tax basis for child care or elder care expensesyou have during the year. You determine the amount ofbefore-tax dollars to contribute from your paycheck to aDependent Care Assistance Plan. Then you may use thatmoney during the plan year to reimburse yourself fordependent care expenses. You pay for your eligibleexpenses yourself and submit your paid receipts orcancelled checks and claims documentation (i.e., signedclaim form and itemized bill) for reimbursement.

The Dependent Care Assistance Plan has a number ofadvantages. It helps you save and pay for anticipatedexpenses. It also lets you set aside money on a before-tax basis. That means dollars are contributed from yourpaycheck to the Dependent Care Assistance Plan beforetaxes are taken out. Money is never taxed — not evenwhen you take a reimbursement. This reduces yourtaxable income.

No CoverageYou may choose not to participate.


How do I enroll?

Participation in the Dependent Care Assistance Planis optional. You may enroll if this plan meets the needsof you and your qualified dependents.

EligibilityFord employees are eligible to participate in the Depen-dent Care Assistance Plan. You may use the DependentCare Assistance Plan to reimburse yourself for depen-dent care expenses for your dependents.

Your dependents must meet the definition of qualified depen-dents for you to be reimbursed for their eligible dependentand elder care expenses.

Qualified dependentsYou may cover certain expenses for the care of your quali-fied dependents through the Dependent Care AssistancePlan. To be eligible, a qualified dependent must be:

• A child, under age 13, who

— Lives with you more than half of the tax year,

and

— Does not provide more than half of his or her ownsupport

or• A relative of any age who

— Is mentally or physically unable to care for himselfor herself,

— Lives with you more than half of the taxable year,and

— Does not have an annual gross income exceedingthe exemption amount ($3,200 for 2005)

In addition, special eligibility rules apply to dependentsfor whom you claim expenses under the Dependent CareAssistance Plan. See the “What rules apply to the Depen-dent Care Assistance Plan?” section for complete details.

EnrollmentYou must enroll in the Dependent Care Assistance Planduring the annual enrollment period to participate. You mayenroll when you first become a seniority employee andeach plan year during annual enrollment. You may changeyour Dependent Care Assistance Plan elections duringthe plan year only if you have certain types of family sta-tus or life event changes (such as marriage, a change inyour spouse’s employment, the birth of a child, etc.).

CostTo participate in the Dependent Care Assistance Plan, youmust make weekly contributions from your paycheck through-out the plan year to your account. You may not make lump-sum contributions. You contribute dollars to the DependentCare Assistance Plan on a before-tax basis.

When account participation is effective• During annual enrollment, participation becomes ef-

fective on January 1 and continues through the endof December

• If elected during the plan year, participation becomeseffective when you become eligible for health care orthe first day of the eighth month following your date ofhire or rehire

• As soon as practicable after a qualified life event, thePlan Administrator will be able to tell you when yourcontributions will start based on the timing of your no-tification of a life event


Tax AdvantagesThe money you deposit in the Dependent Care AssistancePlan is never taxed — not when it goes into your accountand not when you receive reimbursement for an eligibleexpense. Here are the taxes you save:• Federal income taxes• Social Security taxes• State and local income taxes (in most cases)

When you save on taxes, your dollars go further to helpyou pay for the cost of elder care or dependent care ex-penses, as the following example shows. Suppose youcontribute $1,000 to the Dependent Care Assistance Planand are in the 15% tax bracket. You could save $150 infederal income taxes and $76 in Social Security (FICA)taxes for a total of $226. Your savings could be even greaterwhen you add state and local tax savings.

POSSIBLE TAX SAVINGS

Total amount Estimated annual federal incomecontributed and Social Security tax savings

to spending 15% 28% 31%accounts bracket bracket bracket

$ 100 $ 22 $ 35 $ 38

$ 250 $ 56 $ 88 $ 96

$ 500 $ 113 $ 175 $ 193

$1,000 $ 226 $ 350 $ 386

$2,500 $ 566 $ 875 $ 966

$5,000 $1,132 $1,750 $1,932

These are estimates. Your actual savings will depend on yourincome and filing status. These estimates are based on federalincome and Social Security taxes only. Your state and localtaxes also may be reduced. Figures are based on 1999 taxrates. This example is based on an employee’s wages only.

Before-tax contributions reduce the amount of your paythat is subject to Social Security taxes. If your earningsare less than the Social Security wage base, you’ll paylower Social Security taxes and may receive a smallerSocial Security benefit when you retire. However, the taxadvantages generally offset any slight reduction in SocialSecurity benefits.

If you have any questions about taxes and how you couldbe affected, contact your personal tax advisor.

How does the Dependent Care Assistance Plan work?

Dependent Care Assistance Plan is like a checkingaccount. You deposit before-tax payroll deductions,and then use the account to pay yourself back forcertain expenses.

Dependent Care Spending AccountsThe Dependent Care Assistance Plan lets you set asidedollars that you can use throughout the plan year to reim-burse yourself for elder care and dependent care expenses.These accounts have special tax advantages; the moneyyou set aside in them is never taxed, so your dollars gofurther to help you pay for eligible expenses.

Using spending accounts• Estimate your expenses — estimate in advance how

much your eligible expenses will be for the plan year• Decide how much you want to contribute — you

can deposit from $50 to $5,000 into your accountduring each plan year; some limits apply however(these are explained later); your contributions will bededucted in equal amounts from each paycheckthroughout the plan year

• File a claim — when you have eligible expenses, payfor them as you normally would; then submit your paidreceipts or cancelled checks and claim documentation(i.e., itemized bill) — along with a signed claim form toFBD Consultants, the Plan Administrator

• Receive your reimbursement — any reimbursementsyou receive from the Dependent Care Assistance Planwill be tax free, meaning they won’t be taxed when youreceive them


What rules apply to the Dependent Care Assistance Plan?

Because the Dependent Care Assistance Plan offers spe-cial tax advantages, certain rules apply to using the account.

These rules are:

• In general, you may not change the amount you contrib-ute to your account during the plan year; however, if youhave certain family status or life event changes, you maychange the amount you contribute to your account

• You can be reimbursed from the accounts only forservices provided during the plan year — from January1 through December 31; if you join the plan mid-yearbecause you are a new hire or rehire, you can fileclaims only for services provided after you become aplan participant

• Other limitations for receiving reimbursements from theDependent Care Assistance Plan may apply if you endyour employment during the plan year

• Under IRS rules, if you don’t use all of the moneyin your account, you must forfeit the excess; youhave until March 31 to file claims for servicesreceived during the plan year ending the priorDecember 31; claims postmarked after March 31cannot be accepted

Maximum contribution limitsBecause of IRS rules, your maximum contribution tothe Dependent Care Assistance Plan may be limited. Ifyou’re married:

• And file your personal income taxes separately from yourspouse, your annual contribution is limited to $2,500 each(instead of $5,000 total) for you and your spouse

• And file a joint income tax return and your spousealso contributes to a Dependent Care AssistancePlan, the combined limit for the family is $5,000 percalendar year

• And your spouse is disabled or a full-time student, spe-cial limits apply; check with the Internal Revenue Ser-vice at 1-800-829-3676, consult IRS Publication 503and talk to your tax advisor

In any event, you may not contribute more than 50% ofyour earnings or 100% of those of your spouse, which-ever is less.

If you’re not married, your maximum contribution is$5,000 annually.

Eligible expensesThe IRS requires that dependent care expenses meetcertain criteria to be eligible for reimbursement from aDependent Care Assistance Plan.

Working or looking for workTo be work related, a dependent must receive care when:• You’re at work and• If you’re married, your spouse must be:

— At work or— Searching for work or— In school as a full-time student or— Mentally or physically disabled and unable to pro-

vide the care

Services may be provided either inside or outside yourhome by a licensed day care or elder care center,babysitter or companion, including relatives, but excludingyour dependent children under age 19 and relatives youclaim as exemptions on your federal income tax return.

Whether your expenses allow you to work or look for workdepends on the facts. For example, the cost of a babysitterwhile you and your spouse go out to eat isn’t normally awork-related expense. Expenses aren’t considered workrelated merely because you had them while you were work-ing. They must enable you to be gainfully employed. Forexample, you aren’t gainfully employed if you do unpaidvolunteer work or volunteer work for a nominal salary.

Work for part of yearIf you work for only part of the year, you must figure yourexpenses only for the periods worked.

Payments while you’re out sickAmounts you pay for child and dependent care whileyou’re off work because of illness don’t count as work-related expenses.


Detail summary of eligible expensesThe following is a summary of dependent care expensesthat generally would be deductible on your federal incometax return and, therefore, are reimbursable through theDependent Care Assistance Plan. It’s important to notethat you can’t claim a deduction on your tax return forexpenses reimbursed through the Dependent Care Assis-tance Plan. See IRS Publication 503 for an explanation ofeligible and ineligible expenses. This publication changesannually, and some of the expenses listed below may notbe reimbursable in future years. You can obtain a copy ofthe current complete list at your local IRS office, by call-ing the IRS toll free at 1-800-829-3676, or by viewing theirwebsite at www.irs.gov.

Care of a qualifying personTo be work related, your expenses must be to providecare for a qualifying person. You don’t have to choose theleast expensive way of providing the care.

Expenses for household services qualify if part of theservices is for the care of qualifying persons. See the“Household Services” explanation.

Expenses are for the care of a qualifying person only iftheir main purpose is the person’s well being and protec-tion. Expenses for care do not include amounts you payfor food, clothing, and entertainment. However, if theseamounts are incident to and can’t be separated from thecost of caring for the qualifying person, you can count thetotal cost.

SchoolingYou can count the total cost of sending your child toschool if:• Your child is in a grade level below first grade and• The amount you pay for schooling is incident to and

can’t be separated from the cost of care

You can use the total cost of schooling before first gradeonly if the cost of schooling can’t be separated from thecost of the child’s care. If your child is in the first grade orhigher, or if the cost of schooling can be separated, youmust take the total cost and separate the cost of care andthe cost of schooling. You can count only the cost of carein figuring your contributions.

Example 1You take your three-year-old child to a nursery school thatprovides lunch and educational activities as a part of itspre-school child care service. You can count the total costin figuring your contributions.

Example 2Your five-year-old child goes to kindergarten in the morn-ing. In the afternoon, she attends an after-school day careprogram at the same school. Your total cost for sendingher to the school is $3,000, of which $1,800 is for theafter-school program. Only the $1,800 qualifies for figur-ing your contributions.

Example 3You place your ten-year-old child in a boarding school soyou can work full time. Only the part of the boarding schoolexpense that’s for the care of your child is a work-relatedexpense. You can’t count any part of the amount you paythe school for you child’s education.

Care outside your homeYou can count the cost of care provided outside your homeif the care is for your dependent under age 13, or anyother qualifying person who regularly spends at least eighthours each day in your household.

• Dependent care center — you can count care providedoutside your home by a dependent care center if thecenter complies with all applicable state and localregulations: a dependent care center is a place thatprovides care for more than six persons (other thanpersons who live there) and receives a fee, payment,or grant for providing services for any of those persons,even if the center is not run for profit.

• Camp — the cost of sending your child to an overnightcamp is not considered a work-related expense

TransportationThe cost of getting a qualifying person from your home tothe care location and back or from the care location toschool and back isn’t considered a work-related expense.This includes the cost of bus, subway, taxi, or private car.Also, if you pay the transportation cost for the care pro-vider to come to your home, you can’t count this cost asa work-related expense.

Household servicesExpenses you pay for household services meet the work-related expense test if they’re at least partly for the well-being and protection of a qualifying person. Householdservices are ordinary and usual services done in andaround your home that are necessary to run your home.They include the services of a housekeeper, maid, or cook.However, they don’t include the services of a chauffeur,bartender, or gardener.


Expenses partly work relatedIf part of an expense is work related (for either householdservice or the care of a qualifying person) and part is forother purposes, you have to separate the expense. To fig-ure your credit, count only the part that’s work related.However, you don’t have to separate the expense if only asmall part is for other purposes.

ExampleYou pay a housekeeper to care for your nine-year-oldand 15-year-old children so you can work. The house-keeper spends most of the time doing normal house-hold work and spends 30 minutes a day driving you toand from work. You can treat the entire expense of thehousekeeper as work related because the time spentdriving is minimal. You don’t have to separate the ex-penses between the two children because the house-hold expense is partly for the care of your nine-year-oldchild, who is a qualifying person.

Meals and lodging provided for housekeeperIf you have expenses for food that your housekeeper eatsin your home, count these as work-related expenses. Ifyou have extra expenses for your housekeeper’s lodging,count these as work-related expenses also.

ExampleYou move to an apartment with an extra bedroom for ahousekeeper. You can count the extra rent and utility ex-penses for this bedroom as work related. If your house-keeper moves into an existing bedroom in your home,you can count the extra utility expenses as work related.

Taxes paid on wagesThe taxes you pay on wages for qualifying child anddependent care services are work-related expenses.

Ineligible expensesCertain expenses may not be reimbursed through aDependent Care Assistance Plan. Be careful not toinclude these expenses when you determine yourcontribution amount:• Expenses you incur while away from work due to ill-

ness, leave, or vacation• Payments to a person who could be claimed as a de-

pendent on your tax return or your spouse’s• Payments to your child or stepchild who is under age

19 at the end of the taxable year• Tuition for kindergarten• Caregiver’s transportation expenses• Expenses claimed under the Federal Dependent Care

Tax Credit• Expenses incurred before or after your participation in

the account• Expenses for overnight camp• Health care expenses for dependents• Child support or family maintenance payments• Dependent care expenses that exceed the earned in-

come of the lower-paid spouse

How the account coordinates with the federal tax creditYou can also save taxes on dependent care expenses byclaiming a tax credit on your federal income tax return.Both the tax credit and the Dependent Care AssistancePlan are intended to offer you tax savings. You may notuse both for the same expense. However, you may usethe account for some expenses and the tax credit for otherexpenses, subject to the limits described below. The bet-ter method for you depends on your income, the numberof dependents you have, and other factors.

Every dollar reimbursed through your Dependent CareAssistance Plan reduces, dollar-for-dollar, your maximumeligible expenses under the federal tax credit. That maxi-mum is $3,000 a year if you have one qualifying depen-dent and $6,000 a year if you have two or more qualifyingdependents. So, if you have one qualifying dependent andyou contribute $3,000 or more to a Dependent Care As-sistance Plan, you wouldn’t be able to use the tax creditfor any other eligible expenses.

Consult a professional tax advisor, or refer to IRS publica-tion 503 for a complete discussion of the tax credit. Toorder a copy, call the IRS toll free at 1-800-829-3676.


How do I get reimbursed from the Dependent CareAssistance Plan?

You must submit a claim form for reimbursement ofdependent care expenses.

If you make contributions to a Dependent Care AssistancePlan, funds will be deducted from each paycheck. Yourcontributions will be credited to an account set up in yourname by the Plan Administrator.

When you incur an eligible expense, complete a claim formand send it with your paid receipt or cancelled check to:

Fringe PlusP.O. Box 7955Shawnee Mission, KS 66207-0955

Claims are processed and reimbursement checks are is-sued as they’re processed throughout the month. You’llreceive an Explanation of Benefits (EOB) statement anda new claim form with each reimbursement check.

According to tax law requirements, the rules for reim-bursements from Dependent Care Assistance Plan areas follows:

Dependent care claimsWhen you have eligible dependent care expenses, sim-ply fill out a claim form. You must furnish proof of pay-ment for the services provided, such as canceled checkor signed receipt.

When you file claims against your Dependent Care Assis-tance Plan, you must provide your caregiver’s taxpayeridentification number or social security number, or iden-tify your caregiver as a tax-exempt organization. Claimswill not be reimbursed without this information. The PlanAdministrator will then pay your dependent care claim infull if there are sufficient funds in your account.

If your claim exceeds your present account balance, you’llreceive a check only for the amount presently in your ac-count. The remaining amount will be pended and auto-matically resubmitted for payment when your next payrolldeduction is credited to your account. Assuming morecontributions are credited to your account, you’ll receiveanother reimbursement check.

Submitting your claimYou can request a reimbursement for dependent care ex-penses at any time. There’s no minimum amount. Justrequest a reimbursement by using the specially designedclaim form that’s available by calling 1-888-537-4643. Com-plete the entire form and mail it in for processing alongwith claim documentation.

Dependent care expenses are paid to you on a reimburse-ment basis. With the claim form, you must submit proofthat the expense has already been paid, such as a can-celed check or a signed receipt.

FBD administers dependent care claims. Your reimburse-ment will be processed if you do the following:• Use FBD claim form, complete the Employee’s State-

ment, and sign and date the form; or, use the electronicform available athttp://www.fbdconsult.com/services/fordfsa/index.html

• If not indicated on your receipts, be sure to add thename of the person for whom the services were rendered

• Provide a telephone number where FBD may contactyou for additional information, if needed

• Finally, if you have a question about dependent careexpenses or procedures, simply call FBD for assistance

If you submit a properly completed claim form to FBD,you’ll be reimbursed within three weeks after your claimform is received.

Only services rendered during the plan year are eligiblefor reimbursement. The plan year begins January 1 andends on the following December 31. You have until March31 to submit claims for reimbursement of dependent careexpenses incurred during the prior plan year. Claimspostmarked after March 31 can’t be accepted. Under IRSrules, any unspent dollars remaining in your accountafter that date will be forfeited.

Account statementsYou’ll receive a statement of your Dependent CareAssistance Plan four times per plan year. The statementshows contributions, payments made, and accountbalances. In addition, each time you receive areimbursement, you’ll receive a summary of year-to-dateactivity and a blank claim form.


What situations affect participation?

Some situations could affect your participation in the De-pendent Care Assistance Plan, as summarized here:• You are not eligible for reimbursements of expenses

that were incurred during a period that you were not atwork (i.e., illness, vacation, leaves of absence, etc.)

• Generally if you’re married, both you and your spousemust be at work in order to receive eligible dependentcare expenses

• If you’re on unpaid leave of absence, you’re not eligibleto continue participation in the Dependent CareAssistance Plan while on leave, nor would you receiveany reimbursement for eligible work-related expensesduring the period of your leave

• If you return from your unpaid leave of absence withinthe same plan year, your spending account payrolldeductions resume

• If you return from your unpaid leave of absence in adifferent plan year, you may make a new spendingaccount election after you return to work

• Your participation in the Dependent Care AssistancePlan ends with your termination and can’t be continued;you may be reimbursed up to the balance in youraccount for expenses incurred prior to termination

Where to call for informationIf you have questions about the Dependent CareAssistance Plan, call Fringe Plus at 1-888-537-4643.Normal business hours are from 8:30 a.m. to 6:30 p.m.Eastern time, Monday through Friday.

Index 273

ADMINISTRATIVE AND ERISA INFORMATION Agent for Service of Legal Process ............................................................................................................... 254Assistance with your questions...................................................................................................................... 261Continuation of health care coverage ............................................................................................................. 262Continue group health plan coverage ............................................................................................................. 260Covered employees ....................................................................................................................................... 254Employee eligibility ........................................................................................................................................ 262Employer number ........................................................................................................................................... 254Enforce your rights ......................................................................................................................................... 261Future changes in FMLA procedures .............................................................................................................. 262Job restoration ............................................................................................................................................... 262Leave entitlement .......................................................................................................................................... 261Notice and certification .................................................................................................................................. 262Plan Administrator .......................................................................................................................................... 254Plan filing and funding information ................................................................................................................. 255Plan Sponsor ................................................................................................................................................. 254Plan termination ............................................................................................................................................. 254Plan Year ....................................................................................................................................................... 254Prudent actions by Plan fiduciaries ................................................................................................................ 260Receive information about your plan and benefits .......................................................................................... 260Vacations and FMLA leaves ........................................................................................................................... 262

DEPENDENT CARE ASSISTANCE Account statements ...................................................................................................................................... 270Care of a qualifying person ............................................................................................................................ 268Care outside your home ................................................................................................................................. 268Cost ............................................................................................................................................................... 265Dependent care assistance plan .................................................................................................................... 264Dependent care claims .................................................................................................................................. 270Dependent care spending accounts ............................................................................................................... 266Detail summary of eligible expenses .............................................................................................................. 268Eligible expenses ........................................................................................................................................... 267Eligibility ........................................................................................................................................................ 265Enrollment ..................................................................................................................................................... 265Expenses partly work related ......................................................................................................................... 269Household services ....................................................................................................................................... 268How the account coordinates with the federal tax credit ................................................................................. 269Ineligible expenses ........................................................................................................................................ 269Maximum contribution limits .......................................................................................................................... 267Meals and lodging provided for housekeeper .................................................................................................. 269Payments while you’re out sick...................................................................................................................... 267Qualified dependents ..................................................................................................................................... 265Schooling ....................................................................................................................................................... 268Submitting your claim .................................................................................................................................... 270Tax advantages ............................................................................................................................................. 266Taxes paid on wages ..................................................................................................................................... 269Transportation ................................................................................................................................................ 268Using spending accounts ............................................................................................................................... 266When account participation is effective .......................................................................................................... 265Where to call for information .......................................................................................................................... 271Work for part of year ...................................................................................................................................... 267Working or looking for work ............................................................................................................................ 267

INDEX

274 Index

GUARANTEED INCOME STREAM (GIS) BENEFIT PROGRAM Administrative procedures ............................................................................................................................. 186Continuing eligibility ....................................................................................................................................... 182 If you are disabled ...................................................................................................................................... 182Continuing your insurance coverage............................................................................................................... 185Eligibility for Insurance benefits ..................................................................................................................... 185GIS Income Benefit calculation...................................................................................................................... 183 Example ..................................................................................................................................................... 183GIS Income Benefit offset ............................................................................................................................. 184 Example ..................................................................................................................................................... 184Hospital-Surgical-Medical Insurance coverage ............................................................................................... 185 Example ..................................................................................................................................................... 185If you are disabled ......................................................................................................................................... 182Income Benefit payments .............................................................................................................................. 185Life Insurance coverage ................................................................................................................................. 185Maximum income benefit ............................................................................................................................... 183Other eligibility requirements .......................................................................................................................... 181Overpayments of benefits .............................................................................................................................. 187If you are disabled ......................................................................................................................................... 188Qualifying layoffs ........................................................................................................................................... 180Suspension of GIS benefits ........................................................................................................................... 188Termination of GIS benefits ........................................................................................................................... 190

HEALTH CARE PLANOverview BCBS National PPO Plan ................................................................................................................................. 8DHMO (Dental Health Maintenance Organization) .............................................................................................. 9

HMO (Health Maintenance Organization) ........................................................................................................... 8 PPO (Preferred Provider Organization) .............................................................................................................. 9 Traditional Dental Plan ...................................................................................................................................... 9UNICARE Traditional Medical Plan .................................................................................................................... 8

Dental CoverageCovered under an alternative dental plan ......................................................................................................... 58Covered services ............................................................................................................................................. 54Dental services not covered ............................................................................................................................. 58Enhanced Traditional Dental Plan .................................................................................................................... 56 Predetermination ........................................................................................................................................... 56 Finding a DenteMax network dentist ............................................................................................................. 56How does Dental coverage work? .................................................................................................................... 54Orthodontia ...................................................................................................................................................... 57Services covered at 100% ............................................................................................................................................................ 55

90% ........................................................................................................................................................... 55 50% ........................................................................................................................................................... 55

Services covered under Hospital-Surgical-Medical coverage ............................................................................ 55Treatment plan / predetermination .................................................................................................................... 57

INDEX

Index 275

Eligibility for Health Care CoverageAdding dependents .......................................................................................................................................... 16Additional information ...................................................................................................................................... 23Changing medical or dental plans .................................................................................................................... 17Enrolling when first eligible ............................................................................................................................... 16Removing dependents ..................................................................................................................................... 17 Benefit overpayment recovery ...................................................................................................................... 17Your children’s eligibility ................................................................................................................................... 13Your principally supported children’s eligibility .................................................................................................. 14Your same-sex domestic partner’s children’s eligibility ..................................................................................... 15Your same-sex domestic partner’s eligibility .................................................................................................... 12Your sponsored dependent’s eligibility ............................................................................................................. 14Your spouse’s eligibility ................................................................................................................................... 12When coverage begins .................................................................................................................................... 18When coverage ends ....................................................................................................................................... 20When coverage is continued ............................................................................................................................ 20When your children’s eligibility ends ................................................................................................................ 22When your same-sex domestic partner’s eligibility ends .................................................................................. 22When your sponsored dependent’s eligibility ends ........................................................................................... 23When your spouse’s eligibility ends ................................................................................................................. 21

Health Care ClaimsClaims and Appeal Procedures ........................................................................................................................ 77 Appeals ....................................................................................................................................................... 78 Claims .......................................................................................................................................................... 78 HMOs, DHMOs, PPOs, National Foot Care and SVS Vision ....................................................................... 78 Voluntary level of appeal .............................................................................................................................. 78Claims filing ..................................................................................................................................................... 75 BC/BS National PPO Plan ............................................................................................................................ 75 Dental coverage ............................................................................................................................................ 76 Durable Medical Equipment and Prosthetic & Orthotic Appliances ................................................................ 76 Foot Care coverage (Michigan, Illinois, Missouri, and Ohio only) .................................................................. 77 Prescription drug coverage ........................................................................................................................... 76 UNICARE Hospital-Surgical-Medical and Hearing Aid coverage .................................................................... 76 Vision Care coverage.................................................................................................................................... 77Explanation of Benefits .................................................................................................................................... 74Identification card ............................................................................................................................................ 75Standard of review ........................................................................................................................................... 74

INDEX

276 Index

Hospital-Surgical-Medical CoverageAmbulance services ........................................................................................................................................ 31 Emergency transportation ............................................................................................................................. 31 Ground transportation between facilities ....................................................................................................... 31BCBS National PPO Plan ................................................................................................................................ 26 Important notes ............................................................................................................................................ 26 In-Network benefit level ................................................................................................................................ 26 Out-of-Network benefit level .......................................................................................................................... 26 Out-of-Network referrals ................................................................................................................................ 26Case Management feature ............................................................................................................................... 28Complex Care Management ............................................................................................................................. 36Coordinated Care Management ........................................................................................................................ 36Coordinated Home Care ................................................................................................................................... 35Coverage at non-participating hospitals ............................................................................................................ 31Durable Medical Equipment ............................................................................................................................. 37 Customer service information ....................................................................................................................... 37 Out-of-Network services ............................................................................................................................... 37Emergency treatment ....................................................................................................................................... 34Health Maintenance Organizations (HMOs) ...................................................................................................... 43Home care kidney machines ............................................................................................................................ 35Hospice care .................................................................................................................................................... 35Hospital coverage as an inpatient .................................................................................................................... 29Hospital coverage as an outpatient .................................................................................................................. 30Hospital related services .................................................................................................................................. 29If you have Medicare ....................................................................................................................................... 26Infusion therapy ............................................................................................................................................... 35Managed Care Program (MCP) for Mental Health an d Substance Abuse treatment ......................................... 40 Benefits received from non-participating providers ........................................................................................ 41 Benefits received from participating providers ............................................................................................... 41 Facilities ........................................................................................................................................................ 40 Providers ...................................................................................................................................................... 40Mastectomy services....................................................................................................................................... 39Maternity and newborn infant health coverage.................................................................................................. 29Predetermination feature .................................................................................................................................. 27Preferred Provider Organizations (PPOs) ......................................................................................................... 43Prosthetic and Orthotic Appliances .................................................................................................................. 38 Customer service information ....................................................................................................................... 39 Out-of-network services ................................................................................................................................ 39Reasonable and customary charges ................................................................................................................ 27Services not covered ....................................................................................................................................... 42Skilled nursing facility ...................................................................................................................................... 34Surgical and Medical services ......................................................................................................................... 32Voluntary Second Surgical Opinion feature ...................................................................................................... 28

INDEX

Index 277

INDEX

Hearing Aid Coverage Covered expenses .......................................................................................................................................... 68 Digital Hearing Aid National Pilot Program ....................................................................................................... 69

Hearing Aid expenses not covered .................................................................................................................. 70

HIPAA Privacy Practices Complaints ...................................................................................................................................................... 82

Contact information .......................................................................................................................................... 82How Group Health Plans may use or disclose your health information ............................................................. 80No change to plans .......................................................................................................................................... 82Obligations of the Group Health Plans ............................................................................................................. 82Personal or designated representatives ........................................................................................................... 81Your health information rights under HIPAA...................................................................................................... 81

Important Medicare Information Coordination with Medicare Part A ................................................................................................................... 86

Enrollment in Medicare Part A .......................................................................................................................... 86 Enrollment in Medicare Part B ......................................................................................................................... 87

No enrollment in Medicare Part B ................................................................................................................. 89 Spouse and dependent enrollment in Medicare Part B .................................................................................. 89Medicare contact information ........................................................................................................................... 90

Medicare cost ................................................................................................................................................. 85 Medicare Identification card ............................................................................................................................ 87 Medicare Information Table ............................................................................................................................. 91

Special Age 65 benefit ..................................................................................................................................... 88What is Medicare? ........................................................................................................................................... 84Who is eligible for Medicare? ........................................................................................................................... 85

Other Health Care Plan InformationBenefit overpayment recovery ......................................................................................................................... 96Certificate of Creditable Coverage for credit against another plan’s Preexisting Condition Clause .................. 100Coordination with other group health care plans ............................................................................................... 94Coordination with medical coverage through auto insurance ............................................................................. 95Coordination when working over age 65 ........................................................................................................... 95Continuation of coverage under “cash pay” rules .............................................................................................. 96Continuation of coverage under COBRA .......................................................................................................... 97 Additional COBRA information ...................................................................................................................... 99 Continuation of coverage for same-sex domestic partners ............................................................................ 99 Continuation of coverage for children of same-sex domestic partners ........................................................... 99 Effect of Company continuation provisions on COBRA ................................................................................. 98 Other provisions ........................................................................................................................................... 98 Notification of Qualifying Events ................................................................................................................... 97 Qualifying Events — dependent children ....................................................................................................... 97 Qualifying Events — employees ................................................................................................................... 97 Qualifying Events — spouses ....................................................................................................................... 97 Termination of COBRA coverage .................................................................................................................. 98 Your cost ...................................................................................................................................................... 98Conversion to an individual policy .................................................................................................................. 100Subrogation recovery ....................................................................................................................................... 96

278 Index

Pilot ProgramsFoot care program ........................................................................................................................................... 72Pilot programs in effect .................................................................................................................................... 72

Prescription Drug CoverageCovered medications ....................................................................................................................................... 47 Insulin ........................................................................................................................................................... 47 Dosage quantities ......................................................................................................................................... 47Generic prescription drugs ............................................................................................................................... 52How prescription drug coverage works ............................................................................................................. 46Home delivery program (Medco by Mail) .......................................................................................................... 49 To fax your order .......................................................................................................................................... 49 To mail your order ......................................................................................................................................... 49Maintenance drugs .......................................................................................................................................... 50Maintenance drug list ....................................................................................................................................... 51Prescription drug administrator ......................................................................................................................... 48Prescription drug co-payments ......................................................................................................................... 47Prescription drugs not covered ......................................................................................................................... 52Prescriptions filled by a physician or dentist .................................................................................................... 48When you use a non-participating retail pharmacy ........................................................................................... 48When you use a participating retail pharmacy ................................................................................................. 48

Vision Care CoverageAm I covered under the Vision Care program? ................................................................................................. 60Covered expenses - Network provider benefit schedule ................................................................................... 61Emergency services ........................................................................................................................................ 64Expenses covered by a non-network provider if you live more than 25 miles from a network provider .................................................................................................................. 63Expenses covered by a non-network provider if you live within 25 miles of a network provider ...................................................................................................................... 63Expenses not covered under the Vision Care program ..................................................................................... 65Ophthalmologists ............................................................................................................................................. 62Vision Care administrator ................................................................................................................................. 60Vision Care program limitations........................................................................................................................ 64Warranty on lenses and / or frames from a Network provider ........................................................................... 61

INTRODUCTION Benefits service from the NESC ....................................................................................................................... 3

Convenient account access ............................................................................................................................... 3How do you call the NESC? ............................................................................................................................... 3How your benefits work together ........................................................................................................................ 4Your benefit service directory ............................................................................................................................. 3

INDEX

Index 279

LIFE AND DISABILITY INSURANCE PROGRAM Eligibility ........................................................................................................................................................ 102How your benefits are determined .................................................................................................................. 103If your base hourly rate changes .................................................................................................................... 103Naming a beneficiary ..................................................................................................................................... 103When coverages begin ................................................................................................................................... 102When coverages end ..................................................................................................................................... 103Your cost ....................................................................................................................................................... 103How to file your claim..................................................................................................................................... 125Mileage reimbursement for Impartial Medical Examination ............................................................................. 125Notice and proof of claim ............................................................................................................................... 125Other sources of benefits ............................................................................................................................... 124Physical examination ..................................................................................................................................... 125Reinstatement of Accident and Sickness benefits during layoff ..................................................................... 126Subrogation.................................................................................................................................................... 124Successive periods of disability ..................................................................................................................... 123Waiver of benefits .......................................................................................................................................... 125When benefits begin ...................................................................................................................................... 123When benefits end ......................................................................................................................................... 123

Accident and Sickness Benefit Application for Social Security Disability benefits .......................................................................................... 125Benefit amount .............................................................................................................................................. 122Claims processor ........................................................................................................................................... 121Eligibility for benefits ...................................................................................................................................... 121

Accidental Death and Dismemberment Beneficiary .................................................................................................................................................... 107

Benefit amount .............................................................................................................................................. 107How your benefits are paid ............................................................................................................................. 107Maximum benefits ......................................................................................................................................... 107Some losses aren’t covered ........................................................................................................................... 107When coverage ends ..................................................................................................................................... 107

Dependent Group Life Insurance Beneficiary .................................................................................................................................................... 114

Benefit amount .............................................................................................................................................. 113Changing your coverage amounts .................................................................................................................. 113Converting to an individual policy ................................................................................................................... 114Eligibility ........................................................................................................................................................ 112How benefits are paid..................................................................................................................................... 114When coverage begins ................................................................................................................................... 112When coverage ends ..................................................................................................................................... 114Your contributions .......................................................................................................................................... 113Your eligible dependents ................................................................................................................................ 112

INDEX

280 Index

Extended Disability BenefitsBenefit amount .............................................................................................................................................. 126Benefits may be suspended ........................................................................................................................... 129Claims processor ........................................................................................................................................... 126Duration of benefits ........................................................................................................................................ 128Eligibility for benefits ...................................................................................................................................... 126Mileage reimbursement for Impartial Medical examination ............................................................................. 129Offset for benefits from the Ford-UAW Retirement Plan ................................................................................. 128Offset for Social Security Disability Insurance benefits .................................................................................. 128Other sources of benefits ............................................................................................................................... 127Physical examination ..................................................................................................................................... 129Special Medicare benefits .............................................................................................................................. 129Subrogation.................................................................................................................................................... 127Waiver of benefits .......................................................................................................................................... 129

Life Insurance, AD&D, Safety Belt user or Survivor IncomeReview of denial of the claim by the UAW-Ford Group Life and Disability Appeal Committee ......................... 120Denial of other insurance claims .................................................................................................................... 121

Life Insurance Benefit Benefit amount after age 65 .......................................................................................................................... 105Benefit amount upon death prior to age 65 ..................................................................................................... 104Benefit if you become terminally ill ................................................................................................................ 106Continuing Group Life Insurance amount ........................................................................................................ 105Converting to an individual policy ................................................................................................................... 106Eligibility for benefits ...................................................................................................................................... 104Example ........................................................................................................................................................ 105How your benefits are paid ............................................................................................................................. 106Naming a beneficiary .................................................................................................................................... 106

Other circumstancesAccident or disability ..................................................................................................................................... 137Assigning your benefits .................................................................................................................................. 137Attachment of Survivor Income Benefits ........................................................................................................ 137Claiming Death, Dismemberment or Survivor Income benefits ....................................................................... 133Claiming Disability Benefits ........................................................................................................................... 134Filing claims .................................................................................................................................................. 137If a disability benefit is overpaid ..................................................................................................................... 137If you are laid off ............................................................................................................................................ 130If you have a grievance pending .................................................................................................................... 131If you leave for another reason ....................................................................................................................... 133If you or your beneficiary are incompetent ..................................................................................................... 137If you quit or are discharged .......................................................................................................................... 130If you retire .................................................................................................................................................... 131If you terminate employment between ages 60 and 65 ................................................................................... 131If you’re on a medical leave of absence ......................................................................................................... 131If you’re on a non-medical leave of absence .................................................................................................. 131Naming a beneficiary ..................................................................................................................................... 137Optional Group Life Insurance, Dependent Group Life Insurance and Optional Accident Insurance ................ 133Review of denial by the Plan Administrator .................................................................................................... 135Review of denial of the appeal by the Committee ........................................................................................... 136Summary of administrative information .......................................................................................................... 138Your contributions for continuing coverage .................................................................................................... 132

INDEX

Index 281

Optional Accident InsuranceAmount of Insurance ..................................................................................................................................... 114Changing your coverage amounts .................................................................................................................. 117Comatose Benefit .......................................................................................................................................... 115Common Disaster Benefit .............................................................................................................................. 116Continuation of coverage for surviving spouse ............................................................................................... 116Eligibility ........................................................................................................................................................ 114Examples ...................................................................................................................................................... 117Exclusions ..................................................................................................................................................... 117Loss of life or a bodily injury .......................................................................................................................... 115Naming a beneficiary and how benefits are paid ............................................................................................. 118Paralysis benefits .......................................................................................................................................... 115Repatriation benefit ........................................................................................................................................ 116Seat Belt benefit ............................................................................................................................................ 116Special child care center benefit .................................................................................................................... 116Special education benefit ............................................................................................................................... 115Spousal occupational training expense .......................................................................................................... 116When coverage begins ................................................................................................................................... 114When coverage ends ..................................................................................................................................... 119Your contributions .......................................................................................................................................... 117Your eligible dependents for Family Coverage ................................................................................................ 118

Optional Group Life InsuranceAssignment ................................................................................................................................................... 111Benefit amount .............................................................................................................................................. 110Changing your coverage amounts .................................................................................................................. 110Converting to an individual policy ................................................................................................................... 111Eligibility ........................................................................................................................................................ 109Examples ...................................................................................................................................................... 110How benefits are paid..................................................................................................................................... 111Naming a beneficiary ..................................................................................................................................... 111When coverage begins ................................................................................................................................... 109When coverage ends ..................................................................................................................................... 111Your contributions .......................................................................................................................................... 110

Safety Belt UsersBeneficiary .................................................................................................................................................... 120Benefit amount .............................................................................................................................................. 119Eligibility ........................................................................................................................................................ 119Some deaths aren’t covered .......................................................................................................................... 120When coverage ends ..................................................................................................................................... 120

Survivor Income BenefitsAttachment of benefits .................................................................................................................................. 109Bridge Survivor Income Benefits .................................................................................................................... 108Transition Survivor Income Benefits .............................................................................................................. 108Waiver of benefits .......................................................................................................................................... 109Your eligible survivors .................................................................................................................................... 108

INDEX

282 Index

PROFIT SHARING PLAN Assignment of benefits ................................................................................................................................... 249

Choosing cash ................................................................................................................................................ 247Choosing Ford Money Market Account ............................................................................................................ 248Choosing TESPHE .......................................................................................................................................... 248Determining the Total Profit Share ................................................................................................................... 245Eligible pay ..................................................................................................................................................... 246

Eligibility ......................................................................................................................................................... 244Example .......................................................................................................................................................... 247If you or your beneficiary is incapacitated ....................................................................................................... 249If your claim is denied ..................................................................................................................................... 249If your Profit Share is overpaid ........................................................................................................................ 249If your Profit Share is underpaid ...................................................................................................................... 249Naming a beneficiary ....................................................................................................................................... 249Other excluded pay ......................................................................................................................................... 246Prior year payments ........................................................................................................................................ 249Profits and sales ............................................................................................................................................. 245Special provisions ........................................................................................................................................... 246Transfers ......................................................................................................................................................... 249Union dues ...................................................................................................................................................... 248Your date of participation ................................................................................................................................. 246Your profit share .............................................................................................................................................. 247

RETIREMENT PLANApplying for benefits ........................................................................................................................................ 164Assignment of benefits and deductions ........................................................................................................... 164Benefit amount ................................................................................................................................................ 158Break in seniority ............................................................................................................................................ 144Decision of the Retirement Board .................................................................................................................... 168Denial of a claim ............................................................................................................................................. 166Example .......................................................................................................................................................... 145If you die ......................................................................................................................................................... 164If you leave the Company................................................................................................................................ 164If you or your spouse is incapacitated ............................................................................................................. 164Limitations period ............................................................................................................................................ 168Optional forms of survivorship coverage.......................................................................................................... 159Optional 50% Surviving Beneficiary benefit ..................................................................................................... 159Optional 100% Surviving Beneficiary benefit ................................................................................................... 159Other conditions for which you may receive service credits ............................................................................ 144Payment of small amounts .............................................................................................................................. 164Pre-Retirement Survivorship coverage ............................................................................................................ 158Review of denial of the claim (other than disability) to the Board of Administration .......................................... 167Review of denial of disability pension claim to the Board of Administration ...................................................... 167Special Disability Survivorship coverage ......................................................................................................... 158Survivorship coverage ..................................................................................................................................... 157The Pension Benefit Guaranty Corporation (PBGC) ......................................................................................... 165When payments begin ..................................................................................................................................... 158

INDEX

Index 283

Deferred Vested benefitBenefit amount ................................................................................................................................................ 160Early receipt of deferred vested benefit ........................................................................................................... 160Eligibility ......................................................................................................................................................... 160ERISA service ................................................................................................................................................. 161Survivorship coverage ..................................................................................................................................... 161

Disability retirementBenefit amount ................................................................................................................................................ 153Definition of disability ...................................................................................................................................... 153Eligibility ......................................................................................................................................................... 153Example of monthly disability retirement benefits payable at or after age 55 with less than 30 years of ................ credited service ............................................................................................................................................ 155Example of monthly disability retirement benefits payable before age 55 with less than 30 years of credited service .......................................................................................................................................... 155If you return to work ........................................................................................................................................ 154How long do payments continue? .................................................................................................................... 154Maximum monthly benefit ............................................................................................................................... 154Supplemental allowance .................................................................................................................................. 154Temporary benefit ............................................................................................................................................ 153Your Life Income benefit .................................................................................................................................. 153

Normal retirementBenefit amount ................................................................................................................................................ 146Eligibility ......................................................................................................................................................... 146Example of monthly normal retirement benefits ............................................................................................... 146If you return to work ........................................................................................................................................ 146Your Life Income benefit .................................................................................................................................. 146

Regular early retirementBenefit amount ................................................................................................................................................ 147Discharged employees .................................................................................................................................... 148Eligibility ......................................................................................................................................................... 147Example of monthly regular early retirement benefits payable before age 62 with less than 30 years of credited service ......................................................................................................................... 149Example of monthly regular early retirement benefits payable before age 62 with more than 30 years of credited service ......................................................................................................................... 150Example of monthly regular early retirement benefits payable after age 62 ...................................................... 150If you have at least 30 years of credited service, you are eligible to receive an early retirement supplement .................................................................................................................................. 148If you return to work ........................................................................................................................................ 149Maximum monthly benefit ............................................................................................................................... 149Supplemental allowance .................................................................................................................................. 148Your Life Income benefit .................................................................................................................................. 147Your reduced Life Income Benefit may be restored ......................................................................................... 147

INDEX

284 Index

SPECIAL EARLY RETIREMENTBenefit amount ................................................................................................................................................ 151Eligibility ......................................................................................................................................................... 151Example of monthly special early retirement benefits payable before age 62 with less than 30 years of credited service ......................................................................................................................... 152If you return to work ........................................................................................................................................ 152Maximum monthly benefit ............................................................................................................................... 152Supplemental allowance .................................................................................................................................. 151Temporary benefit ............................................................................................................................................ 151Your Life Income Benefit ................................................................................................................................. 151

SUPPLEMENTAL UNEMPLOYMENT BENEFIT (SUB) PLANAppeal procedures .......................................................................................................................................... 178Application for Enhanced Moving Allowance .................................................................................................... 178Benefit overpayments ..................................................................................................................................... 172Eligibility requirements .................................................................................................................................... 170Enhanced moving allowance ........................................................................................................................... 177Example .......................................................................................................................................................... 172If you exhaust your state unemployment compensation .................................................................................. 171If the Plan terminates ...................................................................................................................................... 178Information to be provided ............................................................................................................................... 173Maximum benefits ........................................................................................................................................... 172Moving Allowance limitations ........................................................................................................................... 178Overview ......................................................................................................................................................... 170Reduced benefit .............................................................................................................................................. 172State unemployment compensation (UC) benefits ........................................................................................... 170Weekly Regular Benefits calculation ............................................................................................................... 172When to apply ................................................................................................................................................. 173

Automatic Short Week BenefitsApplying for benefits ........................................................................................................................................ 174Eligibility requirements .................................................................................................................................... 174Example .......................................................................................................................................................... 174

INDEX

Index 285

Separation payments Effect of Separation Payment on seniority .................................................................................................... 176Eligibility requirements ................................................................................................................................... 175If you are rehired ............................................................................................................................................ 176Payment amount ........................................................................................................................................... 175To receive a Separation Payment .................................................................................................................. 175

TTTTTaaaaax-Efx-Efx-Efx-Efx-Efficient Savings Plan Fficient Savings Plan Fficient Savings Plan Fficient Savings Plan Fficient Savings Plan For Hourly Emploor Hourly Emploor Hourly Emploor Hourly Emploor Hourly Employyyyyeeseeseeseesees Account statements ...................................................................................................................................... 206Performance History sheet ............................................................................................................................ 206

Administration and other informationAddress changes ........................................................................................................................................... 234Administration of the TESPHE....................................................................................................................... 232Appeal procedure ........................................................................................................................................... 234Decision of the Committee ............................................................................................................................. 235Employee Stock Ownership Plan (ESOP) ...................................................................................................... 233If a claim is denied ......................................................................................................................................... 234Investment process committee ...................................................................................................................... 233Limitations period ........................................................................................................................................... 235Other information ........................................................................................................................................... 233Review of denial of the claim by the Committee ............................................................................................. 234Tax Reduction Act Stock Ownership Plan ...................................................................................................... 235The Pension Benefit Guaranty Corporation (PBGC) ....................................................................................... 232Trustee and recordkeeper .............................................................................................................................. 235Your rights under the Employee Retirement Income Security Act of 1974 (ERISA), as amended ................... 235

AppendixHow the Catch-Up Contribution feature works and important information to consider ...................................... 237If you would like to take advantage of the Catch-Up Contribution feature ....................................................... 237Managing your account .................................................................................................................................. 240

Assets paid automatically from the PlanAccounts valued at less than $3,500 ............................................................................................................. 220After termination of employment .................................................................................................................... 220Direct rollover ................................................................................................................................................. 221Dividends on stock in the Ford Stock Fund.................................................................................................... 220How distributions are paid .............................................................................................................................. 221If you die ........................................................................................................................................................ 221Loans unpaid at termination of employment ................................................................................................... 221

Assets paid from the PlanAfter-tax contributions .................................................................................................................................... 217Direct rollover ................................................................................................................................................. 219Hardship withdrawals before you reach age 59½ ............................................................................................ 217How withdrawals are paid ............................................................................................................................... 219Making a withdrawal ....................................................................................................................................... 219Participants who are not active employees .................................................................................................... 218Pre-tax contributions ...................................................................................................................................... 217Systematic withdrawal with a series of payments from your account ............................................................. 218Withdrawals after you reach age 59½ ............................................................................................................ 217

INDEX

286 Index

Borrow from the PlanApplying for a loan ......................................................................................................................................... 216Eligible assets ............................................................................................................................................... 215Examples ...................................................................................................................................................... 217Interest charges ............................................................................................................................................. 215Investment of Loan Repayments ................................................................................................................... 217Know the facts before you act ....................................................................................................................... 215Loan repayments ........................................................................................................................................... 216

Circumstances affecting Plan benefitsAssignment of benefits; liens......................................................................................................................... 229Changes in laws and regulations .................................................................................................................... 228General information ........................................................................................................................................ 231If you or your beneficiary is incapacitated ...................................................................................................... 228In case of divorce or legal separation ............................................................................................................. 229Leaves of absence and layoff ........................................................................................................................ 231Life events affecting TESPHE ....................................................................................................................... 230Naming a beneficiary ..................................................................................................................................... 228Transfer of benefits ........................................................................................................................................ 229

Exchanging AssetsExchange privileges ...................................................................................................................................... 214Exchange privileges regarding the Ford Stock Fund ...................................................................................... 214Making an exchange ...................................................................................................................................... 213Short-term redemption fees ............................................................................................................................ 214Trading restrictions ........................................................................................................................................ 214

Contributions made into your accountAdditional Pre-tax Catch-Up Contributions from eligible pay ........................................................................... 208After-tax contributions from eligible pay ......................................................................................................... 208Combination of Pre-tax contributions and After-tax contributions .................................................................... 208Contribution Spillover election ........................................................................................................................ 208Here’s how it works ........................................................................................................................................ 208Pre-tax contributions from eligible pay ........................................................................................................... 208

Fidelity Service CenterConvenient account access ........................................................................................................................... 227Ensuring accuracy ......................................................................................................................................... 228Establishing Your PIN .................................................................................................................................... 227How to access your account .......................................................................................................................... 227If you have questions..................................................................................................................................... 228Transaction deadlines .................................................................................................................................... 227

Investment OptionsAvailable investment options ......................................................................................................................... 211Changes in investment elections ................................................................................................................... 212Investing your contributions ........................................................................................................................... 212Making an investment option selection .......................................................................................................... 213Responsibility of members ............................................................................................................................. 212

INDEX

Index 287

Money contributed to the PlanContributions following qualified Military Service ............................................................................................ 210Limits on TESPHE contributions .................................................................................................................... 210Payroll contributions ...................................................................................................................................... 209Profit Sharing payments ................................................................................................................................ 209Rollover from prior employer’s plan ................................................................................................................ 209Rollover from subsidiary plan ......................................................................................................................... 209

ParticipationElecting or changing your savings contributions ............................................................................................ 207Eligibility ........................................................................................................................................................ 207How to enroll .................................................................................................................................................. 207

Tax consequencesDirect Rollover ............................................................................................................................................... 223How to obtain additional information from the IRS .......................................................................................... 226Income Tax Withholding: ................................................................................................................................ 224If you choose a Direct Rollover: ..................................................................................................................... 222If you choose to have a TESPHE payment that is eligible for rollover paid to you ......................................... 222Payments that can and cannot be rolled over ................................................................................................ 222Payment Paid to You ..................................................................................................................................... 224Surviving spouses, alternate payees, and other beneficiaries ........................................................................ 226Your right to waive the 30-day notice ............................................................................................................. 222

UUUUUAAAAAW-FW-FW-FW-FW-Fororororord Legal Serd Legal Serd Legal Serd Legal Serd Legal Services Planvices Planvices Planvices Planvices PlanCoordination of benefits ................................................................................................................................... 199Eligibility ......................................................................................................................................................... 194Family Planning matters .................................................................................................................................. 197If the Plan is terminated .................................................................................................................................. 199If you are dissatisfied with work performed ...................................................................................................... 199If you do not live near a Plan office ................................................................................................................. 198If you live near a Plan office ............................................................................................................................ 198Legal matters arising from U.S. and Canadian laws are covered ..................................................................... 199No assignment of benefits ............................................................................................................................... 199Plan administration .......................................................................................................................................... 195Plan cost ......................................................................................................................................................... 195Some things to keep in mind ........................................................................................................................... 198When coverage begins .................................................................................................................................... 195When coverage ends ....................................................................................................................................... 195When coverage is continued ........................................................................................................................... 195

INDEX