Schedule of Benefits for Retired Employees
and Dependents Eligible for Medicare

This Plan only pays the portion of your medical expenses not covered under Medicare up to the amounts listed below. Although Medicare revises the amount of benefits they pay each year, this Plan does not change its benefit level.

Medicare Supplemental Benefit

 Amount Paid by Medicare in 2006 Amount Paid by Participant in 2006 Amount Paid by Plan

Medicare Part B
Medicare Part B Deductible 0% 0% 100%
Medicare Part B Expenses After Deductible 80% 0% 20%

Medicare Part A
First 60 Days Amounts over $952 $648 $304
61st Day Through 90th Day Amounts over
$238 per Day		 $162
per Day		 $76
per Day
91st Day Until End of Lifetime Reserve Amounts over
$476 per Day		 $324
per Day		 $152
per Day
After Lifetime Reserve is Exhausted 0% 20% 80%
Medicare Part B Deductible 0% 0% 100%
Medicare Part B Expenses After Deductible 80% 0% 20%

Skilled Nursing Facility
First 20 Days 100% 0% 0%
21st Day Through 100th Day Amounts over
$119 per Day		 $45
per Day		 $74
per Day
Maximum payable by the Plan
per Sickness or Accident		 $1,000,000

Employee Assistance Plan (EAP)

Initial Counseling with EAP Staff

Up to Three Sessions
Covered at No Charge

Prescription Drug Benefits Co-Pay Percentage
(if greater than minimum co-pay amounts)                                 20%

Minimum Co-Pay Amount

Retail
  (34 day supply)

Mail
 (90 day supply)
Generic $5 $10
Brand Preferred $15 $30
Brand Non-Preferred $30 $60
Specialty Drug Co-Pay Percentage 20%
Out-of-Pocket Maximum per year
for Specialty and Prescription Drugs
Excluding Prescription Narcotics
(narcotic agonists)		 $5,000
The Participant co-payment for prescription narcotics (narcotic agonists)
is always 20% and is not subject to any Out-of-Pocket Maximum