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GM Retiree Guide


  • pg 1
 2004        Health Care
          Resource Guide
              For GM Salaried Retirees
               and Surviving Spouses

   Enroll for Health Care 2004
October 27 – November 7, 2003
                                             About This Guide
    What’s Inside                            This Health Care Resource Guide contains
    3        Your Health… You’re in the
             Driver’s Seat
                                             details you can use as a reference to help in your
                                             decision making. It concentrates on important
                                             items to consider about health care and your
    5        Adding Quality to Your Health
             Care Decisions

                                             Further information about the GM Salaried
    8        Information About Medicare      Health Care Program is available in the booklet
                                             titled Your Benefits in Retirement (2000). You can
    9        Medical Options
                                             access Your Benefits in Retirement online at
                                             http://retiree.gm.com. You also can request a
    13       Extended Care Coverage (ECC)
                                             printed copy by calling the National Benefit
    15       Dental Options                  Center at 1-800-828-9236 (1-800-872-8682 TTY).

    17       Vision Options                  If you choose not to make any changes,
                                             your elections currently in effect will
    19       How to Verify Dependent
                                             continue for the 2004 plan year with the
                                             applicable 2004 monthly contributions,
                                             if available and you remain eligible.
    24       Ayco Financial Planning

                                                 GM is committed…
                                                 To improving the quality of health care and the
    Enrollment Period                            quality of life for GM retirees and their families.
    October 27 – November 7,
                                                 We work year-round to maintain quality health
                                                 care options in the face of increasing costs. Your
    Access www.retiree.enroll.gm.com             medical options and coverages continue to be
    or call 1-800-462-5184 during the            among the best in the nation.
    enrollment period if you want to:

    ■   Change your coverage elections
    ■   Verify your dependents

Your Health...You’re in the Driver’s Seat
During the annual enrollment you have an           Your Health Care Resources
opportunity to re-evaluate your health care
options and decide whether any changes may         The online enrollment web site
improve the care that you receive. Ask yourself    (www.retiree.enroll.gm.com) includes:
if you are making the best choices for you and
                                                   ■   Details about what's new
your family, and consider how these choices
may affect your out-of-pocket costs and the        ■   Direct access to health plan comparisons and
way in which you want to receive care.                 quality information
GM is constantly striving to improve the quality   ■   Your personalized health care options and
and delivery of health care while developing           2004 monthly contribution amounts
tools to help you — the consumer — make
informed decisions. Take the time to carefully     ■   An online enrollment application to verify your
review your enrollment materials and refer             dependents and make changes to your elections
to the other resources that GM provides.           ■   Additional information to help you through the
The more you understand in terms of quality,           enrollment process
cost and coverage, the better your ability to
make well-informed health care decisions           You can use the Internet to gather GM-specific
and enroll in the options that will best meet      information that can help you make informed health
the needs of you and your family.                  care decisions. The http://retiree.gm.com web site
                                                   provides retirees and surviving spouses with easy
In addition to determining which plan is right
                                                   access to useful information and links to other
for you, also consider how you can become
a better health care consumer throughout           resources.
the year.
                                                   LifeSteps — LifeSteps can help you assess how
                                                   healthy and fit you are, as well as learn about
                                                   personal health and safety issues. The confidential
                                                   LifeSteps Health Risk Appraisal (HRA) helps you
                                                   evaluate your health status and develop
                                                   plans to maintain and improve it. If you would like
                                                   to fill out an HRA, visit www.lifesteps.com.

                                                   Quality Information — You can use the quality
                                                   information (provided in the health plan summaries
                                                   through www.retiree.enroll.gm.com and in
                                                   Your Personal Enrollment Information) to compare
                                                   the quality of your health care choices. Each HMO
                                                   plan is evaluated in five categories — Access and
                                                   Service, Doctor Communication and Service, Staying
                                                   Healthy, Getting Better/Living with Illness and
    Four Steps to Safer Health Care                          Generic Drugs — Safe, Effective,
    Did you know that up to 98,000 Americans die in
    hospitals each year as a result of preventable           When considering a product, most consumers
    medical errors? Here are four simple things you can      weigh cost with quality to determine the best
    do to help reduce the risk of medical errors in your     value for their money. Many health care consumers
    health care:                                             choose pricier, well-known brand-name drugs over
                                                             the less expensive generic equivalent — assuming
    ■   Choosing your doctor is the first step in            that higher cost equals higher quality. But, this is
        improving your safety in health care. One of         not the case when it comes to prescription drugs.
        the best ways to evaluate doctors who
                                                             Generic drugs cost 25 to 80 percent less than
        participate with your plan is to be sure they are
                                                             brand-name drugs, but offer an equally effective
        board certified. That means the doctor has
                                                             treatment. The Food and Drug Administration
        completed a prescribed period of residency in a      (FDA) regulates generic drugs, putting them
        specialty, passed oral and written exams and         through many rigorous tests to make sure
        handled a minimum number of cases. Board             they are interchangeable with their brand-name
        certification is no guarantee of quality, but        counterparts. For a generic drug to be determined
        doctors who pass their boards meet standards         equally effective by the FDA, it must:
        above those required for a medical license.
        To find out if a doctor is board certified,          ■   Have the same active ingredients, dosage form
        visit www.abms.org, call 1-866-275-2267 or               (e.g., tablet or capsule) and strength as the
        look it up in the Directory of Medical Specialists       brand-name drug
        (usually available at local libraries).
                                                             ■   Act on the body in the same way and to the
        Hospital affiliations. The ideal doctor is               same degree as the brand-name drug
        probably affiliated with a well-equipped
        hospital, either as a staff member or as an          ■   Be approved as safe and effective
        attending physician. Without this arrangement,       ■   Follow the same strict manufacturing guidelines
        you will have to see another doctor to be
                                                                 as the brand-name drug
        admitted into the hospital. You can gather
        information about professional qualifications        ■   Have the same patient information inserts as
        and practice arrangements by asking the doctor’s         the brand-name drug
        office staff or by checking the Directory of
        Medical Specialists.
    ■   If you need surgery, consider an                          Prescription Drug Reminder
        experienced hospital where the procedure                  For the Basic Medical Plan (BMP),
        you need is performed frequently. Don’t                   Enhanced Medical Plan (EMP), Preferred
        forget to predetermine service with your health           Provider Organizations (PPOs) and
        plan, if required.                                        Activecare — if there is a generic
    ■   Speak up if you have questions or                         equivalent available for a covered, brand-
        concerns. You have every right to ask questions           name medication, the Program pays at the
        about your condition and treatment options.               generic level. This means that if you
        If you are not sure, ask for a second opinion.            receive the brand-name medication, you
    ■   When your doctor writes a prescription,                   are responsible for the generic copayment
        make sure you can read it. If you cannot read             plus the difference in cost between the
4       your doctor’s handwriting, your pharmacist might          generic and the brand-name drug.
        not be able to read it either.
Adding Quality to                                   Here’s what the stars tell you:
                                                    ★★★★★ Plan performance is considerably
Your Health Care                                          better than average
Decisions                                                        Plan performance is better than
Choosing a health plan is an important decision.    ★★★          Plan performance is average
You have to think about the services you and        ★★           Plan performance is worse than
your family need, the costs you can afford and                   average
how easy it will be to obtain care when you         ★            Plan performance is considerably
need it. You also need to think about the quality                worse than average
of the care you will receive. It is important to
compare quality because some health plans,          Look for HMOs with the most stars in the
doctors and hospitals do a better job than          categories that are most important to you and your
others. GM is offering you access to some of        family.
the best health care organizations in the nation
— but even among these organizations,               A Close-up Look at What’s
differences in quality exist. That is why GM        Measured
has joined forces with other auto companies         Access and Service
and selected health care purchasers to create       More stars mean that more individuals:
better ways to measure the quality of health        ■ Receive care quickly
plans — and report the results to you.              ■ Receive helpful, informative customer service
                                                    ■ Have their complaints handled well by the health
The quality report card in Your Personal
Enrollment Information and on the enrollment
web site compares HMOs offered by GM. In            ■ Give their health plan high ratings

some markets, the report card also includes
                                                    Doctor Communication and Service
limited quality information for PPOs, the Basic     More stars mean that more individuals:
Medical Plan and the Enhanced Medical Plan.
                                                    ■ Have doctors who listen and communicate well

Benchmark HMO                                       ■ Receive courteous, helpful service from the
                                                      doctor’s staff
This measure is specific to GM. “YES” means
                                                    ■ Give high ratings to their personal doctor,
that the HMO meets the highest quality, service
and cost standards GM has set for the HMOs            specialists and overall care
offered. High quality health care does not always   Staying Healthy
mean higher cost. If you select a benchmark         More stars mean that more individuals receive
HMO, your monthly contributions will be the         appropriate:
lowest required for any HMO offered.                ■ Screenings for breast cancer and cervical cancer
                                                    ■ Childhood and adolescent immunizations
What’s In the Stars?
                                                    ■ Prenatal care and check-ups after childbirth
In each quality category, an average health plan
earns three stars. Plans earn more stars if they    ■ Well-child visits and adolescent well-care visits

are better than the average plan in the report
card and fewer stars if they are worse.
    Getting Better/Living with Illness                   Where the Information Comes From
    More stars mean that more individuals receive:       Information for the report card comes from survey
    ■ Appropriate treatment after a heart attack         responses of individuals enrolled in HMOs, visits to
    ■ Timely follow-up after being in the hospital for   HMOs and data on the care provided. The information
      mental illness                                     is audited, scored and reported by independent
                                                         organizations — not by the health plans or GM.
    ■ Exams when they have diabetes

    Each HMO plan is eligible to receive one of the
    following accreditation outcomes from the National       Important Notes
    Committee for Quality Assurance (NCQA):
                                                             ■   GM does not endorse or
    ■ Excellent — Achieves the highest range of
                                                                 recommend any particular HMO.
       national or regional performance
                                                                 Some options (BMP, EMP and PPOs)
    ■ Commendable — Meets or exceeds all
                                                                 have not been rated in some
                                                                 categories because there is not an
    ■ Accredited — Meets most requirements                       existing process for gathering
    ■ Provisional — Meets some, but not all                      necessary data.
       requirements                                          ■   The measurements referred to are
    ■ Not Accredited — Did not apply, failed to                  based on existing data and may
       receive or is currently under review for                  not necessarily represent the quality
       accreditation                                             of care you will receive in the future,
    Note: PPOs are accredited by the American                    nor do the measurements represent
    Accreditation Health Care Commission/URAC and                the quality of care you will receive for
    are only eligible to receive an outcome of                   any particular service from any
    “Accredited” or “Not Accredited.” The other three            particular HMO.
    accreditation outcomes do not apply.                     ■   Remember — the choice of a
                                                                 medical plan is a personal one.
                                                                 You are solely responsible for your
                                                                 selection. If you have any questions
                                                                 about a particular HMO, you should
                                                                 contact that HMO directly.
                                                             ■   HMOs and PPOs may not be
                                                                 available in all geographic
                                                                 locations due to issues such as cost,
                                                                 quality and access.

Quick Checks for Quality                           When choosing a treatment, make sure you
Look for a plan that:
                                                   ■ What your diagnosis is
■ Has been rated highly by its members on the
  things that are important to you                 ■ Whether treatment is needed at this time
■ Does a good job of helping people stay           ■ What your treatment options are
  well and get better                              ■ Whether the treatment options are based
■ Is accredited, if that is important to you         on the latest scientific evidence
■ Has the doctors and hospitals you want or need   ■ The benefits and risks of each treatment
■ Provides the benefits you need                   ■ The cost of each treatment
■ Provides services where and when you
                                                   Look for a hospital that:
  need them
                                                   ■ Is covered by your health plan
■ Meets your budget
                                                   ■ Is accredited by the Joint Commission on
Look for a doctor who:                               Accreditation of Healthcare Organizations
■ Participates with your health plan               ■ Is rated highly by State or consumer or
                                                     other groups
■ Is rated to give quality care
                                                   ■ Is one where your doctor has privileges,
■ Has the training and background that
                                                     if that is important to you
  meet your needs
                                                   ■ Has experience with your medical condition
■ Takes steps to prevent illness — for example,
  talks to you about quitting smoking              ■ Has had success with your medical condition
■ Has privileges at the hospital of your choice    ■ Checks and works to improve its own
                                                     quality of care
■ Encourages you to ask questions
■ Listens to you                                   Look for long-term care that:
■ Explains things clearly                          ■ Has been found by State agencies, accreditors
■ Treats you with respect                            or others to provide quality care
                                                   ■ Has the services you need
                                                   ■ Has staff that meet your needs
                                                   ■ Meets your budget
    Quality health care means that health                   — U.S. Department of Health and Human Services
    organizations, doctors and other
    professionals are striving to do the right
    things at the right time in the right
    amount for the right people. It also           Quality vs. Cost

    means that the treatment they provide
                                                   In comparing HMOs, higher HMO costs do
    helps ensure the best possible results.
                                                   not necessarily mean higher quality. In fact,
    With quality care, people feel better,
                                                   those HMOs with the best performance on
    function better and enjoy a better
                                                   the selected quality measures AND greatest
    quality of life.
                                                   cost effectiveness generally have the lowest
                                                   monthly contributions.
    Information About                                       Did You Know?
                                                            GM currently pays a significant portion
    Medicare                                                of your health care costs while you are
                                                            receiving benefits through Medicare.
    ■   Refer to the Medicare & You handbook that           For example, GM pays:
        the government provides to all 39 million
        Medicare beneficiaries.                             ■   Covered prescription expenses less your
                                                                GM copayment and other cost sharing
    ■   Call toll-free 1-800-MEDICARE to speak with
        an operator or listen to pre-recorded answers       ■   Covered vision and dental expenses less your
        to frequently asked questions. TTY service is           GM copayment
        available for the hearing impaired at
                                                            ■   Your Medicare Part B premium (reimbursed in
                                                                your monthly retirement check, subject to
    ■   Visit the Medicare web site at                          Program eligibility)
                                                            ■   The difference, subject to cost sharing, between
                                                                what Medicare pays and what your GM medical
    Additional Resources
                                                                option covers; for example — the Medicare Part
    ■   Visit the Access America for Seniors                    A deductible for hospitalization
        web site at www.seniors.gov for access to
        government services and information designed
        for senior citizens. The web site is sponsored by
        10 government agencies, including the Federal            Important!
        agency that runs Medicare.                              If you elect a GM-offered Medicare HMO for
    ■   Call toll-free 1-800-677-1116 to reach the              the first time, you must complete and return
        Eldercare Locator, a public service of the              the government application form included
        Administration on Aging, U.S. Department of             with your confirmation statement. If you fail
        Health and Human Services. The service links you        to return this form, you will be placed in
        with the information and referral networks of           the Enhanced Medical Plan.
        state and local area agencies on aging.

Medical Options                                     A Comment About
OPTIONS                                             Contributions

■   Basic Medical Plan (BMP)                        Whether or not you change your health
                                                    care elections, the monthly contributions
■   Enhanced Medical Plan (EMP)                     for any and all coverages may change from
                                                    year to year. General Motors shares year-
Where available:                                    to-year increases in the cost of health care
■   Preferred Provider Organizations (PPOs)         coverage with you. Annual cost increases
    (Not available to retirees, surviving spouses   are based on business conditions and could
    and dependents enrolled in Medicare)            vary from year-to-year.

■   Health Maintenance Organizations (HMOs)         You authorize and direct GM to deduct the
■   Activecare                                      required contributions for health care
                                                    coverage from your monthly retirement
■   Waive medical coverage                          benefits when you:

                                                    ■   Enroll and confirm elections over the
CONTRIBUTIONS                                           telephone system or via the online
                                                        enrollment web site, or
See the enrollment web site
(www.retiree.enroll.gm.com) or Your                 ■   Complete and sign the authorization form
Personal Enrollment Information for the 2004            when you retire
monthly contributions for each medical
option. These contributions vary by the family      Your authorization applies for as long as
status category that you elect for 2004. They       you have health care coverage — even
do not include the cost of covering any             though the required contribution amount
Sponsored Dependents for medical                    may change. However, you may revoke your
coverage. The 2004 contributions for                authorization to deduct contributions from
Sponsored Dependent medical coverage                your retirement benefits at any time.
will be available in late December by
contacting the National Benefit Center at           To revoke your authorization, write to
www.gmnbc.com or 1-800-828-9236.                    the Plan Administrator at the National
                                                    Benefit Center, P.O. Box 14692, Lexington,
Monthly contributions for HMOs reflect the          KY 40512-4692. If you do this, you must
individual plan’s performance on selected quality   arrange for timely payment of monthly
measures and financial performance. Those           contributions or your action may result in
HMOs with the best performance on the               your elected coverage changing to options
selected quality indicators and greatest            that do not require monthly contributions.
cost-effectiveness have the lowest
     ELECTION RULES                                               If you waive medical to be covered as a
     The family status you elect for medical will also            dependent under any non-GM plan, you do not
     apply to Extended Care Coverage, dental and                  have GM health care coverage. (See page 13 for
     vision if you elect them.                                    effect of waiver on ECC.)

        Defining Your Medical Options
        HMOs — are health care plans that coordinate your care. An HMO provides care through a network
        of doctors, hospitals, health care centers, laboratories, pharmacies and other health care providers.
        Because of their focus on keeping you healthy, HMOs offer a variety of preventive care, wellness and
        disease management programs. To help coordinate your care, you choose a doctor from the HMO’s
        network. This doctor is usually a family practitioner, internist or pediatrician. If you enroll in an HMO,
        you must use network providers for all of your covered health care — except in an emergency.
        Traditional/Indemnity Plans — BMP and EMP — are health care plans that let you get care from
        any doctor or facility for appropriate covered expenses. You pay a percentage of the cost of all of the
        services that you receive after satisfying your annual deductible (up to your annual out-of-pocket
        maximum). With a Traditional plan, you decide which doctors to see and you coordinate your overall
        care. You must call Health International at 1-877-299-4635 for a predetermination of specified
        health care services.
        PPOs — are health care plans that blend aspects of an HMO and a Traditional/Indemnity plan. Your
        care is provided through a network of doctors and facilities — but you can go outside this network if
        you wish. You pay a percentage of the cost for all services you receive after satisfying your annual
        deductible. If you use a network provider, you pay less for your care as your copay percent is lower
        and the provider charges are generally lower. You must call Health International at 1-877-299-4635
        for a predetermination of specified health care services.
        Activecare — unique health care plans that put an emphasis on personal attention and high quality
        care. They focus on helping you maintain and improve your health by encouraging a strong
        physician-patient relationship. Activecare promotes involvement in your health care decisions,
        while providing many of the benefits of coordinated care. Activecare provides benefits generally at
        the HMO level of coverage, with no deductibles for in-network care. This includes hospital care,
        doctor's office visits, preventive services and prescription drug coverage for care provided in the
        Activecare network. If you obtain care outside the Activecare network, you still receive coverage
        similar to the GM Enhanced Medical Plan (with deductible plus 20% coinsurance). Activecare is
        available in the Greater Ann Arbor, Michigan and Dayton, Ohio service areas.

CONSIDERATIONS                                          coverage. For these health plans, your cost depends
Medical coverage options differ from each               on whether you choose a generic, preferred brand-
other in:                                               name drug or non-preferred brand-name drug, and
                                                        whether you fill your covered prescription at a
■   The amount you pay through monthly                  network pharmacy, a non-network pharmacy or use
    contributions                                       the home delivery prescription drug program.
■   The amount you pay in deductibles and               If a generic equivalent is available for a
    copayments as you receive covered services and      covered brand-name medication, the Program pays
    have expenses                                       at the generic level. If you receive the brand-name
■   Limits that may be placed on your choice of         medication, you will be responsible for the generic
    providers to receive benefits                       copayment plus the difference in cost between the
                                                        generic and the brand-name drug.
■   The quality of health care services provided
                                                        Your physician can appeal the specific need for
HMO/PPO elections: The level of benefits you            a brand-name drug through the Medco Health
receive will depend in part on whether you use          appeal process. If your physician establishes
participating providers.                                the medical necessity and appropriateness of
                                                        dispensing the brand-name drug rather than the
If you are considering an HMO or PPO and
                                                        generic equivalent, the additional amount will
want to find out if your current physician is part
                                                        be refunded after the applicable brand-name
of the plan’s network, call the plan directly.
                                                        copayment is applied.
Phone numbers are listed on the medical plan
comparison chart in Your Personal Enrollment            For HMO prescription drug coverage details,
Information and the online health plan summaries        access the online health plan summaries or
available through the enrollment web site               refer to the medical plan comparison chart
(www.retiree.enroll.gm.com). Remember, when             through the enrollment web site
you choose an HMO or PPO, you are choosing a            (www.retiree.enroll.gm.com).
plan, not a specific doctor, as doctors may elect to
leave the plan during the year.                         The Basic, Enhanced and PPO options include three
                                                        features for retirees, surviving spouses and eligible
Prescription drug coverage: The Basic Medical           dependents who are not enrolled in Medicare:
Plan, Enhanced Medical Plan, Activecare and PPO
plans all provide the same level of prescription drug   ■   Care Management provides a resource to help
                                                            ensure the medical treatment you receive is
                                                            medically necessary and appropriate through a
    Rx Home Delivery                                        best practices predetermination. You and your
    Enrollees in the Basic Medical Plan, Enhanced           eligible dependents must call Health
    Medical Plan, PPO and Activecare options                International (toll-free at 1-877-299-4635)
    can enjoy the convenience of obtaining home             before any surgery, hospital stay, skilled
    delivery prescription drug refills online at            nursing facility admission or home health
    www.medcohealth.com or by calling                       care service. If you do not call — or if you
    1-800-464-4679. Note: Starting a new                    proceed with services considered inconsistent
    prescription in home delivery requires the              with nationally recognized best practices —
    prescription to be written for up to a                  sanctions of $200 per occurrence (up to $600 per
    90-day supply.                                          year) will apply.
     ■   Disease Management can enhance quality of
         life when you or a family member lives with a        You can access online health plan
         chronic medical condition. Health International      summaries and a chart comparing your
         medical professionals can work with you and          medical options through the enrollment
         your doctor to develop a personalized coordinated    web site (www.retiree.enroll.gm.com).
         plan of care. This feature is voluntary.
     ■   Centers of Excellence offer the
         opportunity to receive care from among the best
         facilities and doctors — nationally recognized for
         improved outcomes in treating specific serious
         medical conditions. Health International medical
         professionals can advise you on local and
         regional facilities. This feature is voluntary.

     If you have coverage under more than one
     health care plan or through Medicare, the
     Program will coordinate medical and ECC plan
     payments with those other plans.


     If You or a Covered Dependent
     Will Turn Age 65 in 2004
     Typically, you become eligible for Medicare
     at age 65. At that time, you should send a copy of
     the Medicare ID card to the Medicare Verification
     Unit at the National Benefit Center, P.O. Box 14685,
     Lexington, KY 40512-4685.

     If you are considering an HMO and you or a
     covered dependent will turn age 65:

     ■   On or before January 31, 2004 — only HMOs
         that accept Medicare-eligible enrollees will be
         listed in your enrollment information.
     ■   After January 31, 2004 — you should check the
         plan summary or call the HMO directly to verify
         whether it accepts Medicare-eligible enrollees.
         If you elect an HMO that does not accept
         Medicare-eligible enrollees, you will be notified
         to change options before Medicare begins.
Extended Care Coverage (ECC)
OPTIONS                                          ELECTION RULES

■   Continue ECC                                 You must elect one of the medical plans to
                                                 elect ECC, which is provided at the same family
■   Waive ECC
                                                 status category as your medical coverage.
If you waive ECC, you are permanently
                                                 If you waive ECC and/or medical coverage,
excluded from future re-enrollment unless
                                                 you will not be able to elect ECC again unless:
you waive medical coverage to be covered as a
dependent of another GM salaried employee or     ■   You waive medical to be covered as a
retiree who has ECC. (See details under              dependent of a GM salaried employee or a
“Election Rules” on this page.)                      GM salaried retiree who has ECC. In such
                                                     cases, you may add ECC coverage at a
Changing your medical plan does not affect
                                                     future date when you again elect GM
your ECC coverage.
                                                     medical coverage.

                                                 If you terminate or drop your ECC coverage,
CONTRIBUTIONS                                    you cannot reinstate it at a later date other than
See the enrollment web site                      as described above.
(www.retiree.enroll.gm.com) or Your              Sponsored Dependents are not eligible
Personal Enrollment Information for the 2004     for ECC.
monthly contributions for ECC. They are
based on the family status you elect for 2004.

      For more details about ECC, you may
      refer to the booklet entitled Your
      Benefits in Retirement (2000).

     Extended Care Coverage supplements your                 Long-Term Care (LTC)
     medical coverage when certain services are              Insurance: A Reminder
     required. It covers:                                    If you currently have LTC Insurance
                                                             through John Hancock, you do not
     ■   Hospital, skilled care or home health care
                                                             need to re-enroll to continue coverage.
         services that exceed medical plan limits
     ■ Custodial  care, which is not covered by              To purchase LTC Insurance, you or
         the medical plan                                    your spouse can apply for coverage at
                                                             any time through John Hancock. Your
     ECC has no deductible or copayment. The                 parents and/or parents-in-law also may
     plan pays benefits up to an annual maximum of           apply. You cannot purchase this
     $50,000 per covered person.                             coverage through the health care
                                                             enrollment system.
     ECC pays:
                                                             For information on how to enroll,
     ■   A reasonable and customary rate for approved        call John Hancock — Monday through
         hospital or skilled nursing facility stays beyond   Friday between 8:30 am and 4:30 pm
         the medical plan’s limits; skilled care at an       Eastern time.
         approved nursing facility; and home health
                                                             ■   1-800-200-6773
         care — skilled only or a mixture with unskilled
         — that exceeds medical plan coverage                ■   1-800-255-1808 (TTY)
     ■   Up to $35 a day for unskilled care at a
         hospital, skilled nursing facility or licensed
         nursing home, or received through a home
         health care agency or by a privately contracted
         qualified nurse professional approved by the
         ECC carrier

Dental Options
OPTIONS                                             CONSIDERATIONS

■   Traditional Dental Plan (MetLife)               Similar to HMOs, Alternative Dental Plans
                                                    (ADPs) require the use of network providers for
■   Alternative Dental Plans (where available)
                                                    you to receive benefits. Call the plan directly for
■   Waive dental coverage                           a list of participating dentists. If you elect the
                                                    Traditional Dental Plan, you can choose to see
                                                    any dentist and receive covered benefits.
CONTRIBUTIONS                                       However, you can lower your out-of-pocket
See the enrollment web site                         costs by using a dentist in MetLife’s
(www.retiree.enroll.gm.com) or Your                 Preferred Dentist Provider (PDP) network.
Personal Enrollment Information booklet for the     The PDP network operates “silently” within the
2004 monthly contributions for each option.         Traditional Dental Plan and does not require
Contributions vary by your family status election   special enrollment. Use of a PDP dentist is
for 2004.                                           voluntary, but it can save both you and GM
                                                    money. Examples of cost-saving opportunities
                                                    common to the MetLife Traditional Dental Plan
                                                    are found on page 16.

Sponsored dependents are not eligible               Both types of dental plans cover similar
for dental coverage.                                services. The Traditional Dental Plan payments
                                                    generally are based on reasonable and customary
                                                    charge standards, while ADP payments typically
                                                    are based on a fee schedule determined by the
      Note: The names of the Alternative            dental plan.
      Dental Plans may be similar to your
      other options — make sure you are             The Traditional Dental Plan and Alternative
      electing the plan that you want.              Dental Plans (if any) available in your area are
                                                    summarized in the online health plan summaries
                                                    available through the enrollment web site
                                                    (www.retiree.enroll.gm.com). If you are
                                                    enrolled in MetLife’s Traditional Dental Plan, you
                                                    can find information on available benefits,
                                                    eligibility and status of your claims online at
                                                    www.gmnbc.com (select “MyBenefits”).

                                                    This Program coordinates payment with
                                                    benefits from other dental plans.

                                                    Changing your medical option does not
                                                    affect your dental coverage.
     Save Money on Traditional Dental Costs by Using a PDP Provider
     Here are some examples of cost-saving opportunities common to the MetLife Traditional Dental Plan.
     (Note: For purposes of illustration, these examples assume the provider charge equals R&C *.)

     1. Periodic Oral Exam plus Cleaning (Plan pays 100%)
                   Traditional Dentist (non-PDP)                      PDP Dentist                    Total Savings
      Provider Traditional        Plan          You         PDP           Plan          You        You         GM
      Charge      R&C*            Pays          Pay        Fee**          Pays          Pay        Save       Saves

        $95.00      $95.00       $95.00        $00.00      $65.00        $65.00        $00.00      $00.00     $30.00
                               (100% x $95)                            (100% x $65)

     2. Crowns (Plan pays 90%; You pay 10%)
                   Traditional Dentist (non-PDP)                      PDP Dentist                    Total Savings
      Provider Traditional        Plan          You         PDP           Plan          You        You         GM
      Charge      R&C*            Pays          Pay        Fee**          Pays          Pay        Save       Saves

       $700.00     $700.00      $630.00        $70.00     $475.00       $427.50        $47.50      $22.50     $202.50
                               (90% x $700)                            (90% x $475)

     3. Complete Denture — Upper (Plan pays 50%; You pay 50%)
                   Traditional Dentist (non-PDP)                      PDP Dentist                    Total Savings
      Provider Traditional        Plan          You         PDP           Plan          You        You         GM
      Charge      R&C*            Pays          Pay        Fee**          Pays          Pay        Save       Saves

       $979.00     $979.00      $489.50       $489.50     $679.00       $339.50       $339.50     $150.00     $150.00
                               (50% x $979)                            (50% x $679)

     4. Orthodontia Services (Plan pays 50%, up to $1,800 lifetime maximum)
                   Traditional Dentist (non-PDP)                      PDP Dentist                    Total Savings
      Provider Traditional        Plan          You         PDP           Plan          You        You         GM
      Charge      R&C*            Pays          Pay        Fee**          Pays          Pay        Save       Saves

      $4,760.00    $4,760.00     $1,800       $2,960.00   $3,350.00     $1,675.00     $1,675.00   $1,285.00   $125.00
                                 ($1,800                                  (50%
                                maximum)                                x $3,350)

     To learn more about your Traditional Dental Plan benefits and locate a PDP dentist, visit
     www.metlife.com or call MetLife at 1-888-224-0240.
      * Reasonable and Customary (“R&C”) charges are based on the lowest of a dentist’s usual, actual and
        community average charge as determined by MetLife. You are responsible for the amount of the fee above
        the R&C charge, if any.
16   ** PDP fee refers to the negotiated fees that participating PDP dentists have agreed to accept as payment in full.
Vision Options                                   The chart on page 18 shows your vision
OPTIONS                                          coverage at-a-glance under the vision
                                                 network. More detailed information is found
■   Vision Plan (Cole Managed Vision)            in the Your Benefits in Retirement (2000) booklet.
■   Waive vision coverage
                                                 This Program coordinates payment with
                                                 benefits from other plans.
                                                 You may be responsible for any costs above the
Monthly contributions for vision coverage vary   reasonable and customary charge (R&C).
by your family status election for 2004:         R&C is based on the actual amount a provider
                                                 charges for services or materials up to a
■   $1 for you only                              reasonable limit set by the carrier.
■   $2 for you and spouse/partner
                                                 Changing your medical option does not
■   $2 for you and children                      affect your vision coverage.
■   $3 for you and family                        The Vision Plan is a traditional plan, which means
                                                 you can choose to see any vision provider and
                                                 receive benefits. Use of a network vision provider
                                                 is voluntary, but it can save both you and GM
Sponsored dependents are not eligible for        money. For network providers in your area,
vision coverage.                                 contact Cole Managed Vision at
                                                 www.colemanagedvision.com or
     Vision Benefits At-A-Glance

                                              Network              Out of
      Benefit             Frequency           Provider             Network              Out of Area*

      Vision Exam         Once each           Covered in full      Enrollees are        Enrollees are
                          calendar year                            reimbursed           reimbursed based
                                                                   based on carrier     on R&C** minus
                                                                   fee schedule         $7 copay

      Frames              Once every two      Covered in full if   Enrollees are        Enrollees are
                          consecutive         selected from        reimbursed           reimbursed based
                          calendar years      designated           based on carrier     on R&C** minus
                                              frame display        fee schedule         $10 copay
                                              (30% discount
                                              available on all
                                              other frames)

      Lenses              Once every          Covered lenses       Enrollees are        Enrollees are
                          calendar year       available at no      reimbursed           reimbursed based
                                              cost (enrollees      based on carrier     on R&C** minus
                                              pay non-covered      fee schedule         $10 copay

      Contact             Once every          Enrollees pay        Enrollees are        Enrollees are
      Lenses              calendar year in    the difference       reimbursed $65       reimbursed $75
                          place of regular    between                                   minus $10 copay
                          lenses              providers charge
                                              and $75

     Note: A vision exam provided by a non-network ophthalmologist results in the enrollee being reimbursed
           based on R&C** minus $7 copay. Frames are covered in full if selected from the discounted frame
           display shown by the network provider. A 30% discount is available on all other frames.

        * Out of Area occurs when there is no network provider within 25 miles of the enrollee’s residence.
       ** R&C stands for reasonable and customary charge.

How to Verify                                           How to Determine if a Dependent
                                                        Is Eligible
Dependent                                               The charts on pages 21–23 walk through the
                                                        eligibility requirements for most dependents.
Information                                             You should review them as you verify the eligibility
                                                        for each dependent. To obtain the eligibility
You should review the accuracy of your dependent
                                                        requirements for domestic partners, contact the
information as listed in Your Personal Enrollment
                                                        National Benefit Center at www.gmnbc.com or
Information and the online enrollment web site
                                                        1-800-828-9236. If you have any questions about
(www.retiree.enroll.gm.com). This list shows
                                                        whether a dependent meets the eligibility criteria,
dependents — including Sponsored Dependents
                                                        call the Enrollment Center at 1-800-462-5184 and
— who are currently covered under your GM
                                                        speak with a Customer Service Consultant.
health care coverage.

When you review the list, check that each
                                                            Note: If you have an ineligible
dependent shown is eligible and that the
                                                            dependent enrolled and claims and/or
information provided is correct.
                                                            expenses are paid, you will need to
■   Do nothing if all of the dependents continue to         make reimbursement for all payments
    meet eligibility requirements, the information is       made for that person from the date he
    correct and you want to keep the same health            or she stopped being eligible for the
    care coverage.                                          Corporation’s health care coverage.

■   Dependent information changes:
    – To cancel dependents who will be
      ineligible effective January 1, 2004,                 Is Your Spouse Eligible?
      use the online enrollment web site                    If you married your current spouse:
      (www.retiree.enroll.gm.com) or call the
      Enrollment Center at 1-800-462-5184. At the           1. Before you retired from GM, your
      same time, you can review your current health            spouse is eligible as a dependent
      care coverage or make changes to your                    with Corporation contributions.
      choices. To cancel dependents who are
                                                            2. After you retired from GM and
      currently not eligible, contact the National
                                                               before July 1, 1988, your spouse
      Benefit Center immediately at
                                                               is eligible as a dependent with
      www.gmnbc.com or 1-800-828-9236.
                                                               Corporation contributions.
    – To correct other dependent information
                                                            3. After you retired from GM and on
      — such as relationship status, date of birth
                                                               or after July 1, 1988, you may
      or spelling of a dependent’s name — or to
                                                               purchase medical coverage for your
      add a dependent, contact the National
                                                               spouse as a Sponsored Dependent.
      Benefit Center at www.gmnbc.com or
      1-800-828-9236.                                       If you are the surviving spouse of a GM
                                                            salaried employee or retiree, you cannot
                                                            add a new spouse to your GM coverage.
     The rules and steps for adding a dependent             DEFINITIONS
     have not changed from last year. You
                                                            These definitions are included to help you
     can access the form to add dependents
                                                            understand terms that appear on the dependent
     by contacting the National Benefit Center at
                                                            eligibility charts on pages 21–23.
     www.gmnbc,com, or by calling 1-800-828-9236
     and accessing the automated voice response             A Qualified Medical Child Support Order
     system — available Monday through Friday               (QMCSO) is a court order that meets the
     between 7 am and 8 pm (Eastern time).                  provisions of Federal law requiring you to provide
                                                            health care coverage for the child identified, if the
     If you do not make changes online or call the
                                                            child meets all tests except for residency and
     Enrollment Center, you will have represented
                                                            dependency. The child must be the child of the
     that your current dependents remain eligible for
                                                            GM retiree.
     coverage and that their information is accurate.
                                                            Children enrolled as of October 31, 1992 under
     Just because a person qualifies as an
                                                            the former “principally supported child or
     exemption for personal income tax purposes
                                                            legal guardianship” provisions are eligible if:
     does not necessarily mean he or she is eligible
     for medical, ECC, dental and vision coverage.          ■   They remained continuously eligible
                                                                and enrolled, and
     If you retired on or after July 1, 1988, you
     can only cover your spouse or children if they         ■   They are legally claimed as an exemption
     were eligible for coverage at the time of your             on your personal Federal income taxes
     retirement. New dependents can receive medical
     coverage as Sponsored Dependents if they are           The Program’s definition of “Totally and
     eligible and you pay the full cost of that coverage.   Permanently Disabled” is having a medically
                                                            determinable physical or mental condition
                                                            that prevents the child from engaging in
        Sponsored Dependents                                substantial gainful activity and which can be
                                                            expected to result in death or be of a long-term
        Sponsored Dependents are not included in
                                                            or indefinite duration.
        your family status election or the medical
        contribution amounts listed in Your Personal
        Enrollment Information and the online
        enrollment web site. You should, however,
        verify the eligibility of your Sponsored                  The following charts are excerpts from
        Dependents. See the chart on page 23.                     the Guide to Dependent Eligibility for
                                                                  the Salaried Health Care Program. You
        Information about medical coverage                        can access this guide online at
        contributions for Sponsored Dependents                    www.gmnbc.com — or request a
        will be available in late December by                     copy by calling the National Benefit
        contacting the National Benefit Center                    Center at 1-800-828-9236.
        at www.gmnbc.com or 1-800-828-9236.
        Sponsored Dependents are not
        eligible for dental, vision or Extended
        Care Coverage.
If You Are a Salaried Retiree and Have Dependent Children
Your children must satisfy each of four tests to be eligible for health care coverage as a dependent. These tests —
relationship, marital status, age and residency — are summarized in the following chart. Start with the top box under
“Relationship” and walk through the chart to determine the eligibility of each child.
  Start here

  Relationship                    Marital Status                         Age                        Residency
Is this your or your              Is the child married?          Is the child under age          Does the child reside       As a retiree, was your
spouse’s child by birth                                          19 or is the child’s            with you as a member        relationship to or legal
or legal adoption?         Yes                            No     19th birthday this        Yes   of your household?      Yes responsibility for the   Yes
                                                                 year?                           (A child temporarily        child established on or
                                                                                                 away from home              after July 1, 1988 and
                                                                                                 while attending             after retirement?
                                                                                                 school will qualify.)

      No                                      Yes                      No                             No                             No

Is this a child in the                                           Is the child (1) under        Are you legally               The child is eligible
process of adoption                                              age 25 or is this the         responsible for the           for enrollment,
who resides with you                                             calendar year of the          health care expenses          with Corporation
and for whom you                                                 25th birthday, and        Yes of the child per a        Yes contributions, under
have physical custody                                            (2)* did/will the child       divorce decree or per         the Salaried Health
or who is under age 18                                           maintain status as a          a QMCSO?                      Care Program.
and has been “placed”                                            full-time student for
for adoption with you                                            at least one term                    No
(meaning you have                                                during the calendar
assumed and retain                                               year?                         Is this a child for
legal obligation for                                                                           whom you are legally
partial or total support                                               No                      responsible for
of the child)?                                                                                 providing health care
                                                                 Does the child qualify    Yes per a paternity order     Yes
                                                                 as Totally and                or court order (other
                                                                 Permanently Disabled          than a QMCSO) and
                                                                 under Program                 for whom you claim a
Is this a child who was
                                                                 provisions?                   Federal income tax
enrolled under the
“guardianship” or                                                                              exemption?
“principally supported                                                 No
child” provisions as of                                                                               No
10/31/92, has been          Yes
                                                                 This child is not
continuously eligible
                                                                 eligible for coverage
and enrolled since
                                                                 as a dependent child.
then and for whom you
                                                                 However, the child
claim a Federal income
                            No                                   may be eligible as a
tax exemption?
                                                                 Sponsored Dependent.

                                                                                             See page 20 for definitions of “Qualified
                                                                                             Medical Child Support Order (QMCSO)”
                                                                                             and “Totally and Permanently Disabled,”
                                                                                             and the chart on page 23 for Sponsored
               *Such children, age 24 or older, must also qualify as
                                                                                             Dependent eligibility.
                your dependents under Section 152 of the Internal
                Revenue Code.
     If You Are a Surviving Spouse of a Salaried Employee or Retiree
     Check the following chart to determine if your children will remain eligible for health care coverage
     during 2004.

        Start here

      Is this a child who                                              Does the individual             This individual is
      was enrolled or                                                  continue to meet all            eligible to have health
      eligible to be enrolled                                          Program eligibility             care coverage
      at the time of the                      Yes                      criteria (personal        Yes   continued.
      employee’s or retiree’s                                          relationship, marital
      death?                                                           status, age and

      Is this a child of the
      employee or retiree
      and the surviving
      spouse and conceived                                  Yes
      prior to but born after
      the death of the
      employee or retiree?


      Is this individual a            Has the individual
      Sponsored                       been continuously
      Dependent?                      enrolled as of the
                                Yes   date of the                 No
                                      employee’s or retiree’s

                                                                       This individual is not
                                                                       eligible to have health
                                                                       care coverage

                                                                            Surviving spouses can only elect coverage
                                                                            for “you only” or “you and children.”

                                                                            A surviving spouse may not:

                                                                            ■   Enroll a new spouse
                                                                            ■   Enroll new children or stepchildren
                                                                            ■   Enroll or re-enroll a Sponsored Dependent
     To Determine if a Dependent Qualifies as a Sponsored Dependent
     The following chart walks through the requirements for a Sponsored Dependent of a salaried retiree or employee.
     Review it to verify that your current Sponsored Dependents remain eligible. Also, dependents who are not eligible
     for coverage as your dependents may qualify as Sponsored Dependents.
        Start here

      Is this your spouse
      acquired after
      retirement and on or
      after July 1, 1988?

      Is this your parent or    Yes   Can and do you legally Yes        Is the individual a        Yes    Was this individual   Yes   This individual is
      your spouse’s parent?           claim an exemption                U.S. citizen?                     previously enrolled         eligible for employee
            No                        for this individual                                                 as a Sponsored              or retiree-paid
                                      under Section 151 on                                                Dependent?                  Sponsored Dependent
      Is this an unmarried            your Federal income                                                                             health care coverage,
      child?                          tax return?                                                                                     but reenrollment
           Yes                                                                                                                        requires a six-month
                                                                                                                                      waiting period from
      Is this your child                                                                                                              the date the
      acquired after                                                                                                                  application is
      retirement and on or                                                                                                            received. Dental,
      after July 1, 1988?                                                                                                             Vision and Extended
            No                              No               Yes               No                Yes           No                     Care Coverage are not
      Does this child live
      with you (or, if not
      living with you, whose
      health care expenses
      are your responsibility   Yes
      due to a QMCSO) and
      is the child ineligible         Are you legally                   Has this individual                                           This individual is
      for coverage due to             responsible for this              been in the U.S. one                                          eligible for employee
      his/her age?                    individual’s health               year and is the                                               or retiree-paid
                                      care per a QMCSO?                 individual entitled to                                        Sponsored Dependent
No          No                                                          remain indefinitely?                                          health care coverage.
                                                                                                                                      Dental, Vision and
      Is this a minor living                                                                                                          Extended Care
      with you whose                                                                                                                  Coverage are not
      parents are both                                                                                                                available.
      deceased and are you
      or your spouse the
      guardian pursuant to
      a court order?
                                            No                                No
      Is this a minor child                                                                              Remember
      living with you who is
      the child of an           Yes                                                                      You pay the full cost of medical
      individual who is                                                                                  coverage for a Sponsored Dependent.
      covered under the
      Program as your
                                                                                                         Do not include any Sponsored
      dependent child?                                                                                   Dependents when selecting your
            No                        This individual is not eligible for health care                    family status for health care coverage.
                                      coverage as a Sponsored Dependent.

     Ayco Financial                                         Life doesn’t stop with retirement, and neither does
     Planning                                               the need to plan. That’s why it’s important to obtain
                                                            personalized, objective financial planning advice.
     The Ayco Company (a wholly owned subsidiary of
     the Goldman Sachs Group, Inc.) is widely recognized    The Personal Finance Program for Retirees provides
     as one of the nation’s foremost fee-based (i.e.,       access to an experienced, objective financial
     objective) financial counseling firms, and provides    planner via the toll-free Ayco AnswerLine® service
     comprehensive financial planning services at over      as well as the interactive power of the Ayco
     300 major corporations. Ayco’s financial planners      Financial Network (www.aycofn.com), a
     are not salespeople, and its services are not sales    password-protected, member-only web site that
     programs. Most of Ayco’s financial planners hold       acts as your financial mentor and record-keeper.
     credentials such as a law or MBA degree — or a         Through The Ayco AnswerLine®, you can get
     CPA or CFP certificate. All are required to hold       personalized, professional advice on planning
     NASD securities licenses, and all participate in       issues of specific interest to retirees, like setting
     Ayco’s internal training and continuing education      up an estate plan, reallocating your portfolio
     programs.                                              or increasing your cash flow. Personalized, topic-
                                                            specific reports provide an objective assessment
     OPTIONS                                                of your current financial situation.
     ■   No coverage                                        Aycofn.com provides “do-it-yourselfers” with the
     ■   Money in Motion® Personal Finance Program          tools they need to assess their financial health and
         for Retirees                                       prioritize while guiding them through the steps they
                                                            need to take. It allows users to keep a secure, easily
     Note: Financial planning is only available             updateable record of their progress and features a
     directly through Ayco. You cannot purchase             variety of financial modeling tools. You can model
     this service through the enrollment system.            multiple scenarios as life events occur and access
                                                            Ayco’s online reference library for information
                                                            on cash flow, debt management, investments,
     CONTRIBUTIONS                                          estate planning, insurance, tax planning and key
     Refer to Your Personal Enrollment Information or       life events.
     the online personal benefit information for pricing.
                                                            Using Aycofn.com in conjunction with an
     Additionally, please note that you will be paying
                                                            AnswerLine planner can help you make better-
     Ayco directly for enrolling in this service.
                                                            informed decisions and avoid costly mistakes in
                                                            today’s complex financial environment.

     Financial planning is available in the U.S. and
     Puerto Rico.

What the Personal Finance Program includes:           CONSIDERATIONS

■   “Welcome Letter” and brief confidential           This service is designed to be meaningful to
    questionnaire that helps Ayco understand your     all enrollees, at any stage of their lives.
    planning needs
                                                      The service includes five hours of telephone
■   Personalized financial counseling via The Ayco    access to Ayco financial planners familiar
    AnswerLine® service (up to five hours annually)   with GM’s benefit plans. Ayco’s consultants will
■   Ayco’s Updates newsletters (10 issues)            provide information on a broad range of topics
                                                      including tax withholding, investment allocation,
■   The Ayco-Approved List of Mutual Funds            life insurance analysis and estate planning.
■   Access to personalized Focus Reports
■   Unlimited access to the Ayco Financial
    Network                                               For More Information
                                                          and to Enroll
■   The Investing In Your Future guidebook, a
                                                          Call Ayco’s Customer Service Line
    comprehensive planning reference
                                                          anytime throughout the year at
                                                          1-800-437-6383, Monday through Friday,
                                                          9:00 am to 5:00 pm Eastern time
                                                          (1-518-464-2488 if calling from outside
                                                          of the United States).
     In Closing…                                               Right to Amend
     Remember that choices and flexibility are what            General Motors reserves the right to amend,
     annual enrollment is all about. GM provides you           modify, suspend or terminate any of its benefit
     with a range of options for your health care so that      plans or programs by the action of its Board of
     you can choose what you feel is most appropriate for      Directors, or individual or other committee
     you and your family. We continually strive to offer you   expressly authorized by the Board to take such
     the best possible choices, and provide information        action. The benefits to which a retiree or
     and resources you can use in making your health care      surviving spouse is entitled are determined
     decisions. We do this to encourage you to take a look     solely by the provisions of the applicable benefit
     at your health care needs each year, consider how         program. Absent an express delegation of
     things in your life may have changed and decide           authority from the Board of Directors, no one has
     whether a change to your coverage election makes          the authority to commit the Corporation to any
     sense. Remember… you’re in the driver’s seat when         benefit or benefit provisions not provided for
     it comes to your health care.                             under the applicable benefit program, or to
                                                               change the eligibility criteria or any other
                                                               provisions of such program.

                                                               General Motors also reserves the right to
                                                               construe and interpret these benefit programs.
          Enrollment Period                                    Each benefit program also has an appeal
          October 27 – November 7,                             procedure which serves as the exclusive manner
          2003                                                 for resolution of all disputes concerning the
          Access www.retiree.enroll.gm.com                     interpretation or application of the program.
          or call 1-800-462-5184 during the                    The decision on appeal is final and binding.
          enrollment period if you want to:

          ■   Change your coverage elections
          ■   Verify your dependents

26                                                                                      September 2003

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