SECTION 4 - HEALTH AND WELFARE

Article IV - Health and Welfare of the 2002 National Agreement is amended to read as follows:

"ARTICLE IV - HEALTH AND WELFARE

Part A - Plan Changes

Section 1 - Continuation of Health and Welfare Plan

The National Railway Carriers and United Transportation Union Health and Welfare Plan and the Railroad Employees National Health and Welfare Plan (individually and collectively referred to in this Agreement, depending on the context, as "the Plan"), modified as provided in this Article with respect to employees represented by the organization and their eligible dependents, will be continued subject to the provisions of the Railway Labor Act.

(a) All of the benefits as changed herein will be subject to the Plan’s generally applicable limitations, conditions, and exclusions. Existing Plan provisions not specifically amended by this Article shall continue in effect without change.

(b) The Plan’s Comprehensive Health Care Benefit ("CHCB") is amended to include one routine physical examination (including diagnostic testing and immunizations in connection with such examination) each calendar year for covered employees and their eligible dependents. Such CHCB benefit shall cover 100% of the Eligible Expenses involved up to $150, and 75% of such Eligible Expenses in excess of $1 50.

(c) Routine childhood (up to age 18) immunizations, including boosters, for Diphtheria, Pertussis or Tetanus (DPT), measles, mumps, rubella, and polio shall be provided under the CHCB. This benefit is subject to the applicable deductible and percentage of Covered Expenses (Eligible Expenses) payable.

(d) In addition to the Plan’s existing coverage for speech therapy, such therapy will be a Covered Expense (Covered Health Service) under the CHCB and the Plan’s Managed Medical Care Program ("MMCP"), when given to children under three years of age as part of a treatment for infantile autism, development delay, cerebral palsy, hearing impairment, or maj or congenital anomalies that affect speech.

(e) Phenylketonurial blood tests ("PKU") will be a Covered Expense (Covered Health Service) under the MMCP and the CHCB when given to infants under the age of one in a hospital or on an out-patient basis.

(f) The MMCP will continue to require a co-payment with respect to the first office visit by a participant or beneficiary to her obstetrician or gynecologist for treatment of a pregnancy but will not require a co-payment with respect to any subsequent visit to that obstetrician or gynecologist for treatment of the same pregnancy.

(g) The MMCP will not require a co-payment on behalf of a participant or beneficiary with respect to any visit to a physician’s office solely for the administration of an allergy shot.

(h) This Section shall become effective with respect to employees covered by this Agreement as soon as practicable.