PPO
BLUE ADVANTAGE
HMO
Q&A
NESC
Dental
HUMANA HMO
Contract
Medical Leave
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BCBS PPO Medical

Here are a few good reasons and example of why you should choose a network provider:

Your out-of-pocket costs are less because network physicians accept Blue Cross and Blue Shield’s payment as payment
in full, less any UAW CONTRACTUAL Co-pay's, Deductibles or Co-insurance. Network physicians have signed
agreements with Blue Cross Blue Shield to accept our approved amount as payment in full for covered services.  This
also applies to any services not covered by our contract. Refer to the Allowed amount on your Explanation of Benefits or
E.O.B. This amount will indicate the contractual rate for services.
Medical Care or office visits are covered with a $20 Co-Pay

Let's assume the LAB amount is $92.00 as indicated in the Charged amount column and the Allowed amount column
indicates $58.00, you would not be responsible for the difference of $34.00 for a In-Network Provider.
EXAMPLE OF EOB
PATIENT: NORMA RAE                PROVIDER: COMMUNITY CARE CENTER
CLAIM: 0000111122222
DATE                                         CHARGED    ALLOWED      CO-PAY           AMOUNT PAID
11/13/12    LAB                   $92.00             $58.00                                                    $58.00

Network physicians must accept Blue Cross Blue Shield’s payment as payment in full. This means you are not
responsible for any charges over what Blue Cross Blue Shield reimburses the provider. It is in you best interest to take
control of your health care and apply a consistent PROACTIVE approach to all of your benefits.
Renee Robertson-Hood           
UAW Benefit Representative
E-Mail: rbraithw@ford.com

Plant: (708) 757-5700
Prompt #6 Hourly Benefits

Toll Free Plant: (800) 346-8759        
Prompt #6 Hourly Benefits

Plant Fax: (708) 756-6618
SVS Vision Benefit or 1-800-225-3095
Durable Medical Equipment or 1-800-831-0999 to find a provider
BCBS PPO 1-7-12
www.myfordbenefits.com  or 1-800-248-4444
Active Benefits
Dental Coverage SPD   8-19-11
Please fill out the form below if you want to receive Benefits Bulletins,
the information entered goes straight to Renee only and will be kept private.
Leave Name, E-Mail address and indicate if you are Active or Retired.
$20.00 co pay
for office visits
starts 1/1/2012
Plan will terminate
on 2-29-2012 go to
www.myfordbenefits
 to make a new plan
election
Optional Life insurance 1-800-843-8184
Unicare 3200 Greenfield Road, Dearborn, MI 48123
ATTN: Mary Candroski OPT LIFE