Description:
THIS AGREEMENT, made this 29th day of January, 1975, by and between
the participating carriers listed in Exhibit A, attached hereto and made a part
hereof, and represented by the National Carriers' Conference Committee, and the
employees of such carriers shown thereon and represented by the United Transportation
Union, witnesseth: IT IS HEREBY AGREED: ARTICLE I - GENERAL WAGE INCREASES Section 1 - First General Wage Increase (for other than Dining Car Stewards
and Yardmasters) (a) Effective January 1, 1975, all standard basic daily and mileage
rates of pay of employees represented by the United Transportation Union
in effect on December 31, 1974 shall be increased by an amount equal to 10%. (b) In computing the increase for enginemen under paragraph (a)
above, 10% shall be applied to the standard basic daily rates of pay, and 10%
shall be applied to the standard mileage rates of pay, respectively, applicable
in the following weight-on-drivers brackets, and the amounts so produced shall
be added to each standard basic daily or mileage rate of pay: Passenger - 600,000 and less than 650,000 pounds
Freight - 950,000 and less than 1,000,000 pounds
(through freight rates)
Yard Engineers - Less than 500,000 pounds
Yard Firemen - 250,000 and less than 300,000 pounds
(separate computations covering five-day
rates and other than five-day rates) (c) The standard basic daily and mileage rates of pay produced by
application of the increases provided for in this Section 1 are set forth in
Appendix 1, which is a part of this Agreement. Section 2 - Second General Wage Increase (for others than Dining .Car Stewards
and Yardmasters) Effective October 1, 1975, all standard basic daily and mileage rates
of pay of employees represented by the United Transportation Union in effect on
September 30, 1975, shall be increased by an amount equal to 5 percent, computed
and applied for enginemen in the same manner as the first general wage increase
provided under Section 1 above. The standard basic daily and mileage rates of
pay produced by application of this increase are set forth in Appendix 2, which
is a part of this Agreement. – Section 3 - Third General Wage Increase (for others than Dining Car Stewards
and Yardmasters) Effective April 1, 1976, all standard basic daily and mileage rates
of pay of employees represented by the United Transportation Union in effect on
March 31, 1976, shall be increased by an amount equal to 3 percent, computed
and applied for enginemen in the same manner as the first general wage increase
provided under Section 1 above. The amount of any cost-of-living allowance
which may be in effect will not be included with basic rates in computing the
amount of this increase. The standard basic daily and mileage rates of pay produced
by application of this increase are set forth in Appendix 3, which is a
part of this Agreement. Section 4 - Fourth General Wage Increase (for others than Dining Car Stewards
and Yardmasters) Effective July 1, 1977, all standard basic daily and mileage rates
of pay of employees represented by the United Transportation Union in effect on
June 30, 1977 shall be increased by an amount equal to 4 percent, computed and
applied for enginemen in the same manner as the first general wage increase provided
under Section 1 above. The amount of any cost-of-living allowance which
may remain in effect after a portion of the allowance has been incorporated into
basic rates pursuant to Article II, Section l(d), will not be included with basic
rates in computing the amount of this increase. The standard basic daily and
mileage rates of pay produced by application of this increase will be published
as soon as the amount to be incorporated into basic rates effective June 30,
1977, referred to above, is known. Section 5 - Application of Wage Increases (i) (a) In engine service, all arbitraries, miscellaneous
rates or special allowances, based upon mileage, hourly or daily rates of pay,
as provided in the schedules or wage agreements, shall be increased commensurately
with the wage increases provided for in this Article I. (b) In train and yard ground service, arbitraries,
miscellaneous rates or special allowances, including those expressed in terms of
miles, as provided in the schedules or wage agreements, shall be increased
under this Agreement in the same manner as heretofore increased under previous
wage agreements. (ii) In determining new hourly rates, fractions of a cent will
be disposed of by applying the next higher quarter of a cent. (iii) Daily earnings minima shall be increased by the amount of
the respective daily increase. (iv) Standard monthly rates and money monthly guarantees in
passenger train service shall be thirty times the new standard daily rates.
Other than standard monthly rates and money monthly guarantees shall be so
adjusted that differentials existing as of December 31, 1974 shall be preserved. (v) Existing monthly rates and money monthly guarantees
applicable in train service other than passenger will be increased in the
same proportion as the daily rate for the class of service involved is increased. (vi) Existing money differentials above existing standard
daily rates shall 11 be maintained. (vii) In local freight service, the same differential in
excess of through freight rates shall be maintained. (viii) The differential of $4.00 per basic day in freight
and yard service, and 4c per mile for miles in excess of 100 in freight
service, will be maintained for engineers working without firemen on locomotives
on which under the former National Diesel Agreement of 1950 firemen
would have been required. (ix) In computing the increases in rates of pay effective
January 1, 1975 under Section 1 for firemen, conductors, brakemen and flagmen
employed in local freight service, or on road switchers, roustabout runs,
mine runs, or in other miscellaneous service, on runs of 100 miles or less
which are therefore paid on a daily basis without a mileage component, whose
rates had been increased by "an additional $.40" effective July 1, 1968, the
10% increase shall be applied to daily rates in effect December 31,1974,
exclusive of car scale additives, local freight differentia Is, and any other
money differential above existing standard daily rates. For firemen, the
rates applicable in the weight-on-drivers bracket 950,000 and less than
1,000,000 pounds shall be utilized in computing the amount of increase. The
same procedure shall be followed in computing the increases of 5 percent effective
October 1, 1975, 3 percent effective April 1, 1976, and 4 percent
effective July 1, 1977. The rates produced by application of the standard
local freight differentials and the above-referred-to special increase of
"an additional $.40" to standard basic through freight rates of pay are set
forth-In-Appendixes 1, 2 and 3. (x) Other than standard rates: (a) Existing basic daily and mileage rates of pay other
than standard shall be increased, effective as of the effective dates specified
in Sections 1 through 4 hereof, by the same respective percentages as
set forth therein, computed and applied in the same manner as the standard
rates were determined. (b) The differential of $4.00 per basic day in freight
and yard service, and 4c per mile for miles in excess of 100 in freight service,
will be maintained for engineers working without firemen on locomotives
on which under the former National Diesel Agreement of 1950 firemen would have
been required. (c) Daily rates of pay, other than standard, of firemen,
conductors, brakemen and flagmen employed in local freight service, or
on road switchers, roustabout runs, mine runs, or in other miscellaneous service,
on runs of 100 miles or less which are therefore paid on a daily basis
without a mileage component, shall be increased as of the effective dates
specified in Sections 1 through 4 hereof, by the same respective percentages
as set forth therein, computed and applied in the same manner as provided in
paragraph (ix) above. (xi) Wage rates resulting from the increases provided for in
Sections 1, 2, 3 and 4 of this Article I, and in Section l(d) of Article II,
will not be reduced under Article II. Section 6 - General Wage Increases for Dining Car Stewards and Yardmasters Effective January 1, 1975 all basic monthly rates of pay of
dining car stewards and yardmasters represented by the United Transportation
Union in effect on December 31, 1974 shall be increased by 10%. The rates produced by such increase shall be further increased
as follows: Effective October 1,- 1975 5% Effective April 1, 1976 3%
The amount of any cost-of-living allowance
which may be in effect will not be included
with basic rates in computing the amount of
this increase. Effective July 1, 1977 4%
The amount of any cost-of-living allowance
which may remain in effect after a portion
of the allowance has been incorporated into
basic rates pursuant to Article II, Section
l(d), will not be included with basic rates
in computing the amount of this increase. Rates of pay resulting from the increases provided for in this
Section 6, and Section l(d) of Article II, will not be reduced under Article II ARTICLE II - COST-OF-LIVING ADJUSTMENT Section 1 - Amounts and Effective Dates of Cost-of-Living Adjustments (a) Cost-of-living adjustments will be determined from the
"Consumer Price Index - United States city average for urban wage earners
and clerical workers - All Items - Unadjusted" (1967 = 100) as published
by the Bureau of Labor Statistics, U. S. Department of Labor, and hereinafter
referred to as the BLS Consumer Price Index. The first cost-of living
adjustment shall be made effective January 1, 1976 based on the
BLS Consumer Price Index for September 1975 as compared with such index
for March 1975. Further cost-of-living adjustments shall be made effective
the first day of each sixth month thereafter based on the BLS
Consumer Price Indexes for the respective months shown in the following
table, as provided in paragraphs (f) and (g): CHART NOT REPRODUCED IN THIS ELECTRONIC DOCUMENT
DOWNLOAD ‘PDF’ FOR COMPLETE CHART (b) While a cost-of-living allowance is in effect, such
cost-of-living allowance will apply to straight-time, overtime, vacations,
and holidays, and to special allowances and arbitraries, in the same
manner as basic wage adjustments have been applied in the past. (c) The amount of the cost-of-living allowance, if any, which
will be effective from one adjustment date to the next may be equal to, or
greater or less than, the cost-of-living allowance in effect in the preceding
adjustment period. (d) (i) Effective December 31, 1976, 75 percent of the cost-of living
allowance then payable will be incorporated into basic rates of pay
for all purposes, and the cost-of-living allowance will be reduced by 75
percent. (ii) Effective June 30, 1977, the remainder of the cost of-living
allowance resulting from application of paragraph (d) (i),
less the amount of any downward adjustment in the cost-of-living
allowance effective January 1, 1977 by reason of a decline in the BLS
Consumer Price Index, will be incorporated into basic rates of pay for
all purposes, and the cost-of-living allowance will be reduced commensurately. (iii) Effective December 31, 1977, 50 percent of the cost of-living
allowance then payable will be incorporated into basic rates
of pay for all purposes, and the cost-of-living allowance will be reduced
by 50 percent. (e) The cumulative amount of the cost-of-living allowance
which may be in effect at any time shall not exceed the maximum amount
shown in the following table: CHART NOT REPRODUCED IN THIS ELECTRONIC DOCUMENT
DOWNLOAD ‘PDF’ FOR COMPLETE CHART (f) (i) The cost-of-living allowance effective January 1, 1976,
July 1, 1976, and January 1, 1977 will be one cent per hour for each full
four-tenths point by which the BLS Consumer Price Index for the respective
month shown in the first column of paragraph (a) exceeds such index for
March 1975, but will not be more than the maximum amount for the respective
date shown in paragraph (e). (ii) In determining the cost-of-living allowance effective
January 1, 1977, there will be deducted from the amount determined under
paragraph (f) (i) above 75 percent of the cost-of-living allowance which
had been payable as of December 31, 1976 prior to application of paragraph
(d) (i). NOTE: As soon as the BLS Consumer Price Index
for March 1975 becomes available, a
table will be prepared showing the
amount of the cost-of-living allowance,
prior to the December 31, 1976 incorporation
into basic rates of 75 percent
of the allowance then payable, for each
BLS Consumer Price Index figure. (g) The cost-of-living allowance effective July 1, 1977
will be the allowance effective January 1, 1977, increased by one cent
per hour for each full three-tenths point by which the BLS Consumer
Price Index for March 1977 exceeds such Index for September 1976. If
the BLS Consumer Price Index for March 1977 is less than such index for
September 1976, the cost-of-living allowance effective July 1, 1977 will
be the allowance effective January 1, 1977, reduced by one cent per hour
for each full three-tenths point by which the BLS Consumer Price Index
for March 1977 is less than such index for September 1976. If the amount
of the cost-of-living allowance which became effective January 1, 1977
was limited by operation of the 45-cent maximum in paragraph (e) above,
the increase or reduction will be applied to the amount of the cost-of living
allowance which would have become effective January 1, 1977 in the
absence of such 45-cent maximum. In any event the cost-of-living allowance
effective July 1, 1977 will not be more than 68 cents per hour less the
entire amount of the allowance payable as of December 31, 1976 which was
incorporated into basic rates pursuant to paragraphs (d) (i) and (d)(ii). NOTE: As soon as the BLS Consumer Price Index for
September 1976 becomes available, a table
will be prepared showing the amount of the
cost-of-living allowance for each BLS
Consumer Price Index figure. (h) Continuance of the cost-of-living adjustment is dependent
upon the availability of the official monthly BLS Consumer Price Index in
its present form and calculated on the same basis as the Index for March
1975, except that, if the Bureau of Labor Statistics, U. S. Department of
Labor, should during the effective period of this Agreement revise or change
the methods or basic data used in calculating the BLS Consumer Price Index
in such a way as to affect the direct comparability of such revised or changed
index with the index for March 1975 or the index for September 1976, then that
Bureau shall be requested to furnish a conversion factor designed to adjust
the revised index to the basis of the index(es) for March 1975 and/or September
1976, described in paragraph (a) of this Section 1. Section 2 - Application of Cost-of-Living Adjustments
In application of the cost-of-living adjustments provided for by
Section 1 of this Article II, the cost-of-living allowance will not become
part of basic rates of pay except as provided in Section l(d). Such allowance
will be applied as follows: (a) For others than dining car stewards and yardmasters, each
one cent per hour of cost-of-living allowance will be treated as an increase
of 8 cents in the basic daily rates of pay produced by application
of Sections 2, 3 and 4 of Article I and by Section l(d) of this
Article II. The cost-of-living allowance will otherwise be applied in
keeping with the provisions of Section 5 of Article I. (b) For dining car stewards, each one cent per hour of cost of-living
allowance will be treated as an increase of $1.80 in the
monthly rates of pay produced by application of Section 6 of Article
I and by Section l(d) of this Article II. (c) For yardmasters, each one cent per hour of cost-of-living
allowance will be treated as an increase of $2.00 in the monthly rates
of pay produced by application of Section 6 of Article I and by Section
l(d) of this Article II. ARTICLE III – HOLIDAYS Section 1. In 1976, Christmas Eve (the day before Christmas is
observed) will be added to the list of paid holidays for employees receiving
holiday pay. Details of the holiday provision will be agreed upon by the
parties by July 1, 1975. Section 2. The National Carriers' Conference Committee, on behalf
of the carriers party to this Agreement, may exercise a national option prior
to January 1, 1976 to substitute Good Friday for the birthday holiday effective
January 1, 1976, for the employees represented by the United Transportation
Union. ARTICLE IV – EMPLOYEE INFORMATION Commencing June 1975, the carriers will provide each General Chairman
with a list of employees who are hired or terminated, their home addresses, and
Social Security numbers if available, otherwise the employees' identification
numbers. This information will be limited to the employees covered by the
collective bargaining agreement of the respective General Chairmen. The data
will be supplied within 30 days after the month in which the employee is hired
or terminated. Where railroads can not meet the 30-day requirement, the matter
will be worked out with the General Chairman. ARTICLE V - HEALTH AND WELFARE BENEFITS Subject to the Letter of Understanding of January 1975 (Attachment
1), the benefits now provided under Group Policy Contract GA-23000 are to be
continued during the three-year period commencing January 1, 1975, the railroads
to pay the premium cost offset by such amounts as may be available from
the Special Account. Details of the agreement covering the foregoing to be
worked out by the parties by July 1, 1975. ARTICLE VI – NATIONAL DENTAL PLAN A National Dental 1 plan will be established to be effective March
1, 1976 with features as described in Memorandum identified as "Description
of National Dental Plan" (Attachment 2). The plan will be established and
administered as follows: (a) The entire cost of the dental plan will be borne by the
railroads. (b) The railroads and the unions will jointly invite insurers
to submit proposals, and will select the insurer which submits the most favorable
proposal to issue an insurance contract to the railroads as the policyholder. (c) The insurer will furnish financial data, statistical and
actuarial reports, and claim experience information to the unions in the
same detail and at the same time that it furnishes such data to the railroads. (d) Any dividends or retroactive rate refunds or credits will be
paid into a special fund established for such purpose, to be held by the insurer.
Withdrawals may be made from such fund only to provide dental care
benefits to employes unless otherwise agreed to. (e) No notices relating to dental benefits or the financing thereof
shall be served prior to January 1, 1977 (not to become effective before
January 1, 1978). If no agreement thereon is reached prior to January 1, 1978
the railroads parties to this agreement will continue payments to the insurer
of the dental plan at the rates previously established as the premium rates
under such plan until the payment rates are changed or modified under the provisions
of the Railway Labor Act, and the policyholder railroads will make
arrangements to provide such benefits as can be financed from such payments. ARTICLE VII - NATIONAL HEALTH LEGISLATION In the event that national health legislation is enacted during
the three-year period commencing January 1, 1975, benefits and payments will
be integrated so as to avoid duplication, and any savings resulting from such
integration will be credited to the Special Account maintained in connection
with the health and welfare plan or to the special fund referred to in
Article VI (d), or will be apportioned between such Account and such fund,
according to the source of such savings. ARTICLE VIII - GENERAL PROVISIONS Section 1 - Court Approval This Agreement is subject to approval of the courts with respect
to participating carriers in the hands of receivers or trustees.* Section 2 - Effect of this Agreement (a) The purpose of this Agreement is to fix the general level
of compensation during the period of the Agreement and is in settlement of
the dispute growing out of notice served upon the carriers listed in Exhibit
A by the United Transportation Union (E-C-T-S) dated on or about July 1, 1974
(Wages) and August 1, 1974 (Health and Welfare). (b) This Agreement shall be construed as a separate agreement by
and on behalf of each of said carriers and their employees represented by the
organization signatory hereto, and shall remain in effect through December 31,
1977 and thereafter until changed or modified in accordance with the provisions
of the Railway Labor Act, as amended. (c) The parties to this Agreement shall not serve nor progress
prior to January 1, 1977 (not to become effective before January 1, 1978) any
notice or proposal for changing any matter contained in: (1) this Agreement, (2) Section 2(c) of Article XV of the Agreement of
January 27, 1972, except that notices may be served regarding
vacations or holidays so long as they do not relate
to length of paid vacations in excess of the maximum
provided in the national agreement, or number of
paid holidays in excess of the maximum provided in the
national agreement, * With respect to the Penn Central Transportation Company, the power
of attorney to the ~national Carriers' Conference Committee was conditioned
upon the right of the trustees to approve the agreement,
and the trustees have so approved. (3) except as hereinafter provided in paragraph (d)
of this Section 2, the following items, which have been
referred to the Standing Committee created by Article XIV
of the Agreement of January 27, 1972: Basis of pay
Car-scale additives
Elimination of arbitraries applicable to road and yard employees
Mileage holddown
Road-yard proposals not disposed of in the January 27, 1972 Agreement
Reduction of work month for dining car stewards
Overtime in passenger service
Time and one-half for working during vacation periods
Sick leave pay
Elimination of hostlers
Paid holidays for employees not now eligible for paid holidays (4) or regarding bereavement or funeral pay
and any pending notices which propose such matters are hereby withdrawn. (d) The parties to this Agreement will continue in effect during
the term of this Agreement the Standing Committee established by Article XIV
of the Agreement of January 27, 1972, including the procedures worked out by
the parties. However, if either party signatory to this Agreement decides
that the Standing Committee procedure should no longer be continued, the
carriers or the union may after December 31, 1975 serve national (but not
local) Section 6 notices on the matters listed in paragraph (c)(3) of this
Section. (e) This Article will not debar management and committees on
individual railroads from agreeing upon any subject of mutual interest. SIGNED AT WASHINGTON, D. C. THIS 29th DAY OF JANUARY, 1975. FOR THE PARTICIPATING CARRIERS LISTED IN EXHIBIT A:
FOR THE EMPLOYEES REPRESENTED BY THE UNITED TRANSPORTATION UNION:
INDEX TO RATE TABLES
RATE CHARTS NOT REPRODUCED IN THIS ELECTRONIC DOCUMENT
DOWNLOAD ‘PDF’ FOR COMPLETE CHARTS EXHIBIT A
RAILROADS REPRESENTED BY THE NATIONAL CARRIERS' CONFERENCE COMMITTEE IN CONNECTION
WITH NOTICES, DATED ON OR ABOUT JULY 1,1974, SERVED UPON VARIOUS RAILROADS BY THE
GENERAL CHAIRMEN, OR OTHER RECOGNIZED REPRESENTATIVES, OF THE UNITED TRANSPORTATION
UNION (E), (C), (T) AND (5), OF DESIRE TO REVISE AGREEMENTS TO THE EXTENT INDICATED IN
ATTACHMENT 1 THERETO, AND IN CONNECTION WITH NOTICES, DATED ON OR ABOUT AUGUST 1,
1974, SERVED BY THE GENERAL CHAIRMEN, OR OTHER RECOGNIZED REPRESENTATIVES,
OF THE UNITED TRANSPORTATION UNION (E), (C), (T) AND (5) PERTAINING
TO II>SPITAL, SURGICAL AND MEDICAL BENEFITS (INCLUDING DENTAL BENEFITS) AND GROUP
LIFE INSURANCE, AS SET FORTH IN ATTACHMENT "A" THERETO. Subject to indicated footnotes, this authorization is co-extensive
with notices filed and with provisions of current schedule agreements
applicable to employees represented by the United Transportation
Union (E), (C), (T) and/or (S), as indicated by "X" inserted
in the appropriate column(s) below: RAILROADS AND CRAFT NOTATIONS NOT REPRODUCED IN THIS ELECTRONIC DOCUMENT
DOWNLOAD ‘PDF’ FOR COMPLETE CHART ATTACHMENT 1
NATIONAL RAILWAY LABOR CONFERENCE
January 29, 1975
Messrs. C. J. Chamberlain, President
Brotherhood of Railroad Signalmen
601 West Golf Road
Mount Prospect, Illinois 60056
H. C. Crotty, President
Brotherhood of Maintenance of Way Employes
12050 Woodward Avenue
Detroit, Michigan 48203
Al H. Chesser, President
United Transportation Union
14600 Detroit Avenue
Cleveland, Ohio 44107
J. W. O'Brien, General Vice President
Sheet Metal Workers' International Association
1750 New York Avenue, N. W.
Washington, D. C. 20006
Gentlemen: As I indicated during our recent discussions respecting health
and welfare and related matters, while the carriers are prepared to continue
the present benefits provided under Group Policy Contract GA-23000
for a three-year period commencing January 1, 1975, that willingness is
conditioned upon the policyholder labor organizations' agreeing to certain
changes designed to avoid unnecessary expense without affecting the benefits
to the employees or participation of the organizations in the administration
of this program. The changes are: 1. Agreement by the organizations to expeditious use of the
amounts in the Special Account to offset premium payments,
with the objective of maintaining the necessary balance
in the Account consistent with the assurance of continued
Medicare premium payments. 2. Agreement in principle to adoption of a premium-plus account
approach to funding GA-23000, provided that
further thorough exploration confirms the advice given
us jointly by Travelers that the interests of the Policyholder
will not be adversely affected. 3. Inclusion of a subrogation provision similar to that
included in the supplemental sickness benefits agreements
between the carriers and the Signalmen's, Sheet
Metal Workers' and Maintenance of Way organizations. What we have in mind, as a typical case, is this: An employee is injured on duty. He sues the employer for
$10,000, and includes in his claim $1,000 of medical expenses
which have already been paid under GA-23000. If
he wins the suit, he should collect $9,000, not $10,000,
for otherwise he would be collecting twice for the same
thing. Our understanding is that, in light of the terms agreed to
by the carriers in our Memorandum of Understanding dated January 21,
1975, on behalf of your organizations you do not object to these changes,
but that you do not purport to speak for any other organizations. If you concur, would you please sign below. Yours very truly,
William H. Dempsey ATTACHMENT 2
DESCRIPTION OF NATIONAL DENTAL PLAN
EFFECTIVE DATE March 1, 1976
ELIGIBILITY
Employee - An employee of a railroad who is eligible for employee or dependent coverage
under GA-23000, provided he has completed one year of service with the railroad.
Dependent - For other than orthodontia, the spouse and children of a covered
employee, as they are defined in GA-23000 (i.e. unmarried children under age 19,
between 19 and 25 if in school, or over 19 if physically or mentally incapacitated).
For orthodontia. unmarried children under age 19. INDIVIDUAL TERMINATION OF INSURANCE Upon termination of railroad service; i.e., no special extensions such as those
for furloughed or disabled employees as provided under GA-23000. BENEFITS FOR OTHER THAN ORTHODONTIA What is Payable - The plan pays the dentist's charges for covered expenses on
the following basis: 75% Group A - Preventive and Basic Services and Emergency Visits
50% Group B - Prosthetic Services, including Crowns and Gold Restorations Deductible - $50 per individual for each calendar year. Maximum - The maximum benefit for each calendar year is $500. This maximum applies
separately to each insured family member. What Dental Expenses are Covered - The plan covers charges up to those made by
most dentists in the area for the services and supplies described in the following
section. What Dental Services are Covered - The plan covers the following services and
supplies, for which a charge is made by a dentist or physician, that are required
in connection with the dental care and treatment of any disease or defect. In
addition, the plan covers certain preventive services. GROUP A - Preventive and Basic Services and Emergency Visits 1. Oral Examinations and Prophylaxis
Routine oral examination and prophylaxis (scaling and cleaning of teeth),
but not more than once for each covered person during any period of six
(6) consecutive months. 2. Fluoride Treatment
The plan covers a fluoride treatment once each calendar year for children. 3. Space Maintainers
The plan covers all space maintainers. 4. Emergency Visits
Emergency palliative treatment. 5. X-rays
Dental x-rays, including full mouth x-rays (but not more than once in any
period of thirty-six (36) consecutive months), supplementary bitewing x-rays
(but not more than once in any period of six (6) consecutive months)
and such other dental x-rays as are required in connection with the diagnosis
of a specific condition requiring treatment. 6. Extractions
The plan covers all extractions. Allowances for extraction include routine
post-operative care. 7. Oral Surgery
The plan covers all necessary oral surgery. Allowances include routine
post-operative care. 8. Fillings
The plan covers amalgam, acrylic, synthetic porcelain and composite fillings
that are necessary to restore the structure of teeth that have been broken
down by decay. 9. General Anesthetic
The plan covers a separate charge for general anesthetic in conjunction with
oral surgery and periodontics. 10. Treatment of Gum Disease
The plan covers necessary periodontic treatment of the gums and supporting
structure of the teeth. 11. Endodontic Treatment
The plan covers endodontic treatment, including root canal therapy. 12. Drugs
The plan covers charges for injectable antibiotics administered by a dentist
or physician. 13. Repair and Rebasing
Repair or recementing of crowns, inlays, onlays, bridgework or dentures;
or relining or rebasing of dentures more than six (6) months after the
installation of an initial or replacement denture, but not more than one
relining or rebasing in any period of thirty-six (36) consecutive months.
If the plan pays for a new denture it will not also cover the repair or
rebasing of the old denture. GROUP B - Prosthetic Services 1. Initial Installation
The plan covers initial installation of fixed bridgework, including inlays
and crowns used as abutments, and partial or full removable dentures (including
any adjustments during the six (6) month period following installation). 2. Replacement of Existing Prosthetic Appliances
The plan covers replacement of an existing partial or full removable
denture or fixed bridgework by a new denture or by new bridgework, or
the addition of teeth to an existing partial removable denture or to
bridgework, but only if satisfactory evidence is presented that: (a) The replacement or addition of teeth is required to replace one
or more teeth extracted after the existing denture or bridgework
was installed, or (b) The existing denture or bridgework cannot be made serviceable and
is more than 5 years old, or (c) The existing denture is an immediate temporary denture which cannot
be made permanent and replacement by a permanent denture takes
place within twelve (12) months from the date of initial installation
of the immediate temporary denture. When a permanent
denture replaces an immediate temporary denture for which benefits
were provided under this plan, the allowance for both appliances
will be limited to the maximum benefit for a permanent denture. 3. Crowns and Gold Restorations
The plan covers crowns, inlays, onlays and gold fillings that are
necessary to restore the structure of teeth that have been broken down
by decay, provided the tooth cannot be reconstructed by an amalgam,
acrylic, synthetic porcelain or composite filling. Benefit Determination - The plan covers treatment performed while insured.
Treatment will be considered to have been performed when the service is actually
rendered, except as specified for the following procedures: (a) Dentures, Full or Partial - when the impression is taken for the appliances. (b) Fixed bridgework, crowns and gold restorations - when the tooth is first
prepared. (c) Endodontics, including root canal therapy - when the tooth is opened.
Extended Benefits - For the procedures listed under Benefit Determination,
benefit payments will be made for treatment performed while insured with respect
to services rendered within 30 days following termination of insurance.
Dental Charges Not Covered - Covered Dental Expenses do not include and no
benefits are payable for: Charges for services for which benefits are otherwise provided under
surgical and major medical coverage under Group Policy Contract GA-23000.
Charges for treatment by other than a legally licensed dentist or physician,
except that scaling or cleaning of teeth and topical application of fluoride
may be performed by a licensed dental hygienist if the treatment is rendered
under the supervision and guidance of the dentist.
Charges for veneers or similar properties of crowns and pontics placed on or
replacing teeth, other than the ten upper and lower anterior teeth.
Charges for services or supplies that are cosmetic in nature, including
charges for personalization or characterization of dentures, specialized
techniques, or precision attachments.
Charges for the replacement of a lost, missing, or stolen prosthetic device.
Charges for appliances or procedures to increase vertical dimension or
occlusion.
Charges for orthodontic diagnostic procedures and treatment, including
appliance therapy, surgical therapy and functional or myofunctional therapy.
Charges for services or supplies which are compensable under a Workmen's
Compensation or Employer's Liability Law.
Charges for services rendered through a medical department, clinic, or
similar facility provided or maintained by the patient's employer.
Charges for services or supplies for which no charge is made that the
employee is legally obligated to pay or for which no charge would be made
in the absence of dental expense coverage.
Charges for services or supplies which do not meet or are not necessary
according to accepted standards of dental practice, including charges for
services or supplies which are experimental in nature.
Charges for services or supplies received as a result of dental disease,
defect or injury due to an act of war, declared or undeclared. - 5 -
Charges for any services to the extent for which benefits are payable
under any health care program supported in whole or in part by funds of
the federal government or any state or political subdivision thereof.
Charges for education or training and supplies used for personal oral
hygiene or dental plaque control, or dietary or nutritional counseling.
Charges for implantology.
Charges for sealants.
Charges for failure to keep a scheduled visit with the dentist or hygienist.
Charges for the completion of any forms. Optional Treatment - Occasionally, a patient may select a more expensive procedure
rather than a suitable alternate procedure. In such case, plan benefits
will be paid on the basis of a less expensive procedure that is consistent with
good dental care. Co-ordination of Benefits - If the individual is eligible to receive dental
benefits under another program, co-ordination of benefits will be applied between
the two with respect to dental charges. BENEFITS FOR ORTHODONTIA What Is Payable –
The plan pays the dentist's charge at
50% of covered orthodontic expenses up
to a lifetime maximum amount payable of
$500 for each child under 19 years of
age. Covered Orthodontic Treatment –
The plan covers orthodontic treatment
that is required to correct malposed
teeth, and which begins while the child
is covered by the plan. Treatment
consists of appliance therapy, surgical
therapy, functional and myofunctional
therapy, and includes related diagnostic
procedures, surgery and extractions performed
by a dentist. Payment Sequence –
The sequence of payments for orthodontic
services is determined in the following
manner. If the dentist estimates that
active treatment will continue for two or
more years, then the total benefit is
divided into eight equal portions. The
first portion will be payable when the
orthodontic appliance is installed and
subsequent installments will be payable at
90 day intervals until the maximum has
been paid or until insurance terminates.
If the estimated course of treatment is
less than two years, the total charge
is divided into portions so as to make
payments at 90 day intervals, beginning
with the date the appliance is inserted. -
Orthodontic benefits will be payable while
treatment continues provided insurance
remains in force with respect to the
individual. Benefits will be payable
provided the individual is covered at the
beginning of the 90 day interval.
Orthodontic coverage will terminate at
the end of the quarter during which the
child attains his 19th birthday.
If an employee's insurance is terminated
and he subsequently again becomes insured,
he will be entitled to any unpaid remainder
of the original payable benefit, as long
as active orthodontic treatment is continued.
Such remainder will be payable at 90 day
intervals calculated in accordance with
the original payment sequence. Orthodontic Charges Not Covered -
Since it is contemplated that this plan
would be written in conjunction with
a plan covering other dental services,
the appropriate exclusions set forth in
the description of such plan would also
apply to this plan. Co-ordination of Benefits -
If the individual is eligible to receive
orthodontic benefits under another program,
co-ordination of benefits will be applied
between the two with respect to
orthodontic charges.
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