SUMMARY PLAN DESCRIPTION FOR THE
MID-AMERICA APARTMENTS, LP SHORT-TERM DISABILITY PLAN
A COMPONENT OF THE MID-AMERICA APARTMENTS, LP EMPLOYEE WELFARE BENEFITS PLAN
April 1, 2018
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SHORT-TERM DISABILITY PLAN
The Short-Term Disability Plan of Mid-America Apartments, LP (the “STD Plan”) is a short term disability income protection benefit plan sponsored by Mid-America Apartments, LP. (the “Employer”) to provide continued income for a period of time in the event you are unable to work due to a non-occupational Illness or Injury. The STD Plan can help provide continued income to you. As of January 1, 2017, this benefit became a component of the Mid-America Apartments, LP Employee Welfare Benefits Plan and replaces both the Post Apartment Homes, L.P., Short- Term Disability Plan and the Mid-America Apartment Communities, Inc. Group Short Term Disability program. Detailed information about your eligibility for coverage, what benefits are payable, how to file a claim, and other features of this Plan are contained in this document, which is referred to as your “booklet,” “summary plan description” or SPD. If your disability extends beyond the STD benefit period, you may be eligible for Long Term Disability (LTD) benefits under the Mid-America Apartments, LP Employee Welfare Benefits Plan. See the Summary Plan Description or individual booklet for the Long Term Disability Benefit component for further information about the LTD benefit. The Employer pays the full cost of the coverage and pays benefits under the STD Plan from its general assets (this is not an insured benefit and there is no insurance policy). The Employer has engaged the Claims Administrator to provide certain administrative and claims services for the STD Plan, but the Claims Administrator does not insure this Plan. The Employer reserves the right to modify, amend, suspend or terminate, in whole or in part, any of the provisions of this STD Plan at any time for any reason or for no reason. When making a benefit determination under the STD Plan, we have discretionary authority to determine your eligibility for benefits and to interpret and enforce the terms and provisions of the STD Plan. We may delegate some or all of this authority to the Claims Administrator.
“We,” “us,” and “our,” as used in this summary, refer to the Plan Administrator identified in the ERISA Provisions section.
PLAN OUTLINE
Employees Eligible for Coverage
All full-time employees (defined as employees on the Employer’s payroll who are regularly scheduled to work at least 30 hours per week) who are in Active Employment and receive a Form W-2 from the Employer are eligible for coverage under this Plan. Examples of employees who are not eligible for coverage include part-time, temporary, leased employees and seasonal workers.
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Date of Eligibility / Waiting Period
You are eligible for benefits under this STD Plan upon completing the Waiting Period, provided you are a full-time employee and in Active Employment on that date. If you are not in Active Employment on that date, you will become eligible upon your return to full- time Active Employment. Employees who have completed the Waiting Period are referred to as “Eligible Employees”.
The Waiting Period ends on the first day of the month coinciding with or next following 90 days of continuous Active Employment as a full-time employee.
If you are an Eligible Employee (that is, you have satisfied the Waiting Period), you are eligible for the Weekly Benefit if you become Disabled, subject to all the other terms of this STD Plan.
Weekly Benefit
The Weekly Benefit is 60% of an Eligible Employee’s Basic Weekly Earnings, up to a maximum of $2,000 per week, reduced by Other Income and applicable withholding and subject to all the terms of this policy.
Maximum STD Benefit Period
Benefits for an Eligible Employee begin following the expiration of 7 calendar days of Disability (referred to as the “Elimination Period”) and continue for up to a maximum of 26 weeks following the beginning of the Elimination Period.
TERMS YOU SHOULD KNOW
The following terms used in this STD Plan have special meanings, as follows:
“ Active Employment ” means you must be working:
o for your Employer on a full-time basis and paid regular earnings;
o either at your Employer’s usual place of business or at a location to which your Employer’s business requires you to travel;
o performing all of the duties of your regular occupation; and
o not confined in any institution providing care or treatment of physical or mental illness or injury.
“ Basic Weekly Earnings ” means your gross weekly earnings from your Employer in effect just prior to your date of Disability. It includes your base salary plus your prior calendar year’s bonuses and commissions and the contributions you make to a Section 125 plan, flexible spending account and qualified deferred compensation plan. It does
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not include income received from overtime pay, any other extra compensation, or income received from sources other than your Employer.
“ Claims Administrator ” means Liberty Life Assurance Company of Boston, 175 Berkeley Street, Boston, MA 02116, telephone number 1-888-408-7300.
“ Complications of pregnancy ” means that part of pregnancy during which abnormal conditions or concurrent disease significantly affect the pregnancy’s usual medical management. A complication may exist during the pregnancy, during the delivery or after the delivery. “ Disability ” and “ Disabled ” means that because of Illness or Injury that commences while you are an Eligible Employee, you cannot perform each of the material duties of your regular occupation.
“ Elimination Period ” means a period of 7 consecutive days of Disability, beginning on the first day of Disability, for which no Weekly Benefit is payable.
“ Employer ” means Mid-America Apartments, LP and includes each division, subsidiary, or affiliated company, including, but not limited to, Mid-America Apartment Communities, Inc.
“ Illness ” means sickness, disease, or other medical conditions including pregnancy and complications of pregnancy.
“ Injury ” means bodily injury resulting directly from a non-occupational accident and independently of all other causes. The Disability resulting from the injury must begin while you are an Eligible Employee for benefits to be payable.
“ Other Income ” means:
o Any amount provided under federal maritime law;
o Any amount you are entitled to, under any group insurance plan of your Employer, that provides disability income benefits;
o Any benefits you or your dependents are eligible to receive because of your disability or age under the United States Social Security Act or similar plan or act. If benefits from these programs are denied for any reason (except your non- insured status), you will be required to appeal the denial to the full extent permitted. You will continue to be considered eligible to receive these benefits until all appeal processes are exhausted;
o Any benefits payable under any state compulsory benefit act or law;
o Any income received from any other formal or informal salary continuation program, except for accumulated sick leave and paid time off applied to
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supplement the difference between your Basic Weekly Earnings and your Weekly Benefit under the leave of absence procedures of the Employer;
o Any severance compensation paid by the Employer; and
o Any earnings you receive for work performed for an employer other than the Employer or from self-employment during the period in which you are eligible for a Weekly Benefit, unless such work has been authorized by the Employer. “ Partial Disability ” or “ Partially Disabled ” means that the Claims Administrator determines that, following a period of Disability for which Weekly Benefits were payable under this STD Plan, you are:
o Unable to perform all of the material duties of your regular occupation;
o You are performing at least one of the material duties of your regular occupation or any occupation on a full-time or part-time basis;
o You have a loss of at least 20% of your Basic Weekly Earnings that is related to the current disability; and
o You are under the regular care of a physician.
“ Physician ” means a person (other than you, your spouse, child, brother, sister or parent, or the child, brother, sister or parent of your spouse) who is:
o Operating within the scope of his/her license; and either
o Licensed to practice medicine and prescribe and administer drugs or to perform surgery; or
o Legally qualified as a medical practitioner and required to be recognized, under the policy for insurance purposes, according to the insurance statues or the insurance regulations of the governing jurisdiction.
“ Weekly Benefit ” means the weekly benefit payable under this STD Plan, subject to reduction for Other Income.
“ You ” and “ Your ” means you, the employee.
DISABILITY BENEFITS
When do disability benefits become payable if I am an Eligible Employee? The Employer will pay the Weekly Benefit after the end of the Elimination Period if you and your doctor provide proof acceptable to the Claims Administrator that you:
1.
are Disabled due to Illness or Injury, and
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2.
are under appropriate treatment and care of a Physician.
You will be required to file a claim with the Claims Administrator to be considered for Weekly Benefits. You will also be required to give the Claims Administrator periodic proof acceptable to it that your Disability continues. Such proof will be provided at your expense. To file a claim, you must call the Claims Administrator at 1-888-408-7300.
When do Weekly Benefits end? The Employer will pay the Weekly Benefit until the earliest of the following dates:
1.
You cease to be Disabled or Partially Disabled;
2. You are no longer under the appropriate treatment and care of a Physician;
3.
The end of the maximum benefit period under the STD Plan;
4. You fail to give any required proof of continued Disability or Partial Disability or to provide any other requested information on a timely basis;
5. You fail to comply with a request to be examined by an independent Physician;
6.
You make a material misrepresentation to obtain benefits;
7. You cease to be classified as an Eligible Employee eligible for an STD Plan benefit by the Employer; or
8.
The date of your death.
How is the Weekly Benefit calculated? If you are Disabled, your Weekly Benefit will equal 60% of your Basic Weekly Earnings, reduced by Other Income, up to a maximum of $2,000 per week. Benefits payable for less than one week will be paid to you at the rate of 1/7th of the Weekly Benefit amount for each day of Disability. The Weekly Benefit will be reduced by all applicable withholding and deductions, including but not limited to tax withholding and deductions for contributions for benefits for which you are eligible (this excludes the 401(k) plan). Benefits for Partial Disability are explained below. What happens if I return to work and become Disabled again? If you are Disabled, return to work, and become Disabled again due to the same or a related cause, the second disability will be considered a continuation of the first period of disability as long as you had returned to work for fourteen calendar days or less. If your second Disability is unrelated to the first, or if you have returned to work for more than fourteen calendar days on a full-time basis, the second period of Disability will be considered a separate claim and a new Elimination Period must be satisfied before benefits will become payable.
What happens if I am Partially Disabled?
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If you are Partially Disabled, your Weekly Benefit will be calculated as described in this section and not as described above. Benefits for a Partial Disability are payable only following a period of a related, total Disability. The Weekly Benefit for a period of Partial Disability is determined as follows:
1. subtract the earnings received while Partially Disabled from your Basic Weekly Earnings (this amount is referred to as your “lost earnings”);
2.
multiply your lost earnings by 75%, and then
3.
deduct Other Income from the amount obtained in Step 2.
However, in no event will the Weekly Benefit be more than the amount that would be payable under this STD Plan if you had remained Disabled and not returned to work.
GENERAL EXCLUSIONS
What disabilities are not covered? Benefits will not be paid for any Disability due to:
1. intentionally self-inflicted injuries or attempted suicide, while sane or insane;
2.
participation in a felony or as a result of such participation;
3. military service of any country which is at war or due to war or act of war, unless you are either a United States expatriate or on temporary assignment in a war area on employer business;
4. a vague or undefinable condition (such as “tiredness” or “pain”), for which your doctor cannot provide a medical diagnosis;
5. cosmetic surgery, except surgery made necessary by accidental injury incurred while eligible for short-term disability benefits;
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occupational illness or injury; or
7. for any day in which you are confined in a penal or correctional institution for conviction of a criminal or public offense.
TERMINATION
When does coverage under this STD Plan terminate? You will cease to be covered under this policy on the earliest of the following dates:
1.
your Employer ceases to provide these STD benefits;
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2. you cease to be an Eligible Employee (such as, but not limited to, due to cessation of full-time employment or lay off);
3.
the date of your death; or
4.
you make a material misrepresentation to obtain benefits.
CLAIMS, SUBROGATION AND REIMBURSEMENT RIGHTS
When must you submit a claim? You must give the Claims Administrator proof of claim no later than 30 days after your Disability starts. You must give the Claims Administrator proof of continued Disability and regular treatment by a Physician within two weeks of the date such proof is requested. When are claims paid? When the Claims Administrator receives satisfactory proof of claim, and your claim for Disability benefits is approved, benefits will begin on the following regularly scheduled payroll date.
To whom are benefits paid? All benefits are payable to you. There are no survivor benefits.
What constitutes proof of claim? In order for a claim to be processed, the Claims Administrator must receive your application for benefits, as well as sufficient medical evidence in support of your claim. Such evidence may consist of records from your Physician, narrative reports, x-rays and any other medical records, as well as evidence that you continue to be under the appropriate care and treatment of a Physician. The Employer may require that you see a doctor selected by the Claims Administrator for an independent evaluation. Approval of a claim for benefits and the continuation of benefits are subject to your cooperation in submitting to such an examination.
The Employer or Claims Administrator also may require a signed statement identifying all Other Income benefits.
When may the Employer require repayment of benefits? The Employer has the right to recover any and all payments made due to fraud, any error made in processing the claim and receipt of Other Income. You (or your estate) is required to make these reimbursements in full and your receipt of Weekly Benefits is contingent on your agreeing to so reimburse the Employer. In addition, the Employer may reduce or withhold future benefit payments to recover such overpayments. The Employer also has the right to recover any amount of collection or legal costs incurred in the recovery of such overpayments. What happens if my injury was caused by a third party? The Plan has what is called right of subrogation and a right of reimbursement and recovery. When another party is legally responsible or agrees to compensate you for a disability for which you
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have previously received STD benefits from the Plan, the Plan has the same rights (“right of subrogation”) that you have against the party. For this purpose, a “party” means any individual, entity, person or other party responsible for making any payment to you due to your disability, including uninsured motorist coverage, underinsured motorist coverage, traditional fault-based automobile insurance coverage, no-fault automobile insurance coverage, personal umbrella coverage, workers’ compensation coverage and any first-party insurance coverage. However, a party does not include any individual or supplementary insurance plan, policy or coverage which is maintained by or for the participant that pays indemnity benefits without regard to the amount of medical expenses incurred, or based on a fixed amount per day (or other period) of hospitalization. The Plan expressly rejects and overrides any default rule that the Plan does not have a right of subrogation, recovery or reimbursement until you have been fully compensated. If you enter into litigation or settlement with another party, the Plan’s right of subrogation, recovery and reimbursement will still apply. You will need to provide the Plan or its agents with any relevant information, assistance and documents that help the Plan obtain its subrogation and reimbursement rights. Also, you could be required to sign and deliver to the Plan or its agent’s documents to secure the Plan’s rights, and you will be required to obtain the consent of the Plan or its agents before releasing any party from liability for payment. If you fail to cooperate with the Claims Administrator, you will lose your STD benefits. In addition, the Plan has a right to recover benefits paid to you for which you received compensation from, or on behalf of, a third party responsible for the injury resulting in the disability. Finally, you have the obligation to repay the Plan to the extent that you receive any compensation, direct or otherwise, by or on behalf of the person at fault from all recovery amounts, regardless of how they are characterized. These rights provide the Plan with a first priority claim and these rights apply without regard to any equitable defenses that you assert or may be entitled to assert, including without limitation any defense of unjust enrichment. ERISA preempts any state or local law, or any regulation issued thereunder, which prohibits or attempts to limit these rights.
To secure the rights of the Plan under this section, you:
Grant to the Plan a first-priority lien against the proceeds of any such settlement, verdict, or other amounts received by the Participant to the extent of all benefits provided in an effort to make the Plan whole;
Assign to the Plan any benefits you may have under any automobile policy or other coverage.
What are the time limits for legal proceedings? All administrative claim and appeal procedures offered by the Plan must be completed before you begin any legal action regarding your claim. If, after you have exhausted the claims procedures, you want to bring legal action, you must do so within the earliest of the following: (A) one year
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following the date of the decision on the final appeal under the STD Plan or (B) two years after the claim arose.
What happens if my claim is denied? The Plan Administrator (or its delegate) has the exclusive discretionary authority to construe and to interpret the STD Plan, to decide all questions of eligibility for benefits and to determine the amount of such STD benefits, and its decisions on such matters are final and conclusive. Benefits under the STD Plan will be paid only if the Plan Administrator (or its delegate) decides in its discretion that the applicant is entitled to them. Any interpretation or determination made pursuant to such discretionary authority will be upheld on judicial review, unless it is shown that the interpretation or determination was an abuse of discretion.
The term Plan Administrator, as used below in describing the STD Plan’s claims and appeals process, includes the delegate of the Plan Administrator, the Claims Administrator.
With respect to all claims for benefits under the STD Plan filed on or after April 1, 2018, the following procedures will apply. For claims for benefits under the STD Plan filed prior to April 1, 2018, the claims procedures set forth in the STD Plan document effective January 1, 2017 will apply. If you have made a claim for STD benefits, including a claim for eligibility under the STD Plan, and your claim is denied, you will receive a written denial notice within 45 days of the date that the claim was received. This notice will be made in a culturally and linguistically appropriate matter and will include –
The specific reason or reasons for the denial;
The specific reference to any provisions of the STD Plan on which the denial is based;
A description of any additional material or information you may submit to perfect your claim and an explanation of why such material or information is necessary;
A description of the STD Plan’s claims review procedure (including the time limits applicable to such process);
Your right to review, upon request and free of charge, relevant documents and other information;
Your right to file suit under ERISA with respect to any adverse determination after appeal of your claim;
A discussion of the decision, including an explanation of the basis for disagreeing with or not following:
- The views you presented to the STD Plan of health care professionals who treated who and vocational professionals who evaluated you;
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- The views of medical or vocational experts whose advice was obtained on behalf of the STD Plan in connection with the adverse determination on your claim, without regard to whether the advice was relied upon in making the benefit determination; and
- Any Social Security Administration disability determination regarding you that you presented to the STD Plan.
If your claim was denied based on a medical necessity or experimental treatment or similar exclusion, an explanation of the scientific or clinical judgment for the determination, applying the terms of the STD Plan to your medical circumstances (or a statement of your right to receive such an explanation upon request); A statement disclosing any internal rule, guidelines, protocol or similar criteria relied on in making the adverse determination, or, alternatively, a statement that such rules, guidelines, protocols, standards or similar criteria do not exist; and A statement that you are entitled to receive, upon request and free of charge, reasonable access to, and copies of, all documents, records, and other information relevant to your claim for benefits. If, for reasons beyond the control of the Plan Administrator, an extension of time is required for processing the claim, you will receive a written notice of the extension, an explanation of the circumstances requiring extension and the expected date of the decision before the end of the 45- day period. The Plan Administrator may only extend the 45-day period twice, each for 30 days at a time. If at any time the Plan Administrator requires additional information in order to determine the claim, you will receive a written notice explaining the unresolved issues that prevent a decision on the claim and a listing of the additional information needed to resolve those issues. You will then have 45 days from the receipt of that notice to provide the additional information to the Plan Administrator, and during the time that a request for information is outstanding, the running of the time period in which your claim must be decided is suspended.
Appeal of a Denied Claim
If your claim has been denied in whole or in part and you would like your claim reconsidered, you must appeal the denial by submitting a written request for review to the Plan Administrator within 180 days of the date that you receive the claim denial notice, or else you will lose your right to appeal your denial. If you do not appeal on time, you will also lose your right to file suit in court, as you will have failed to exhaust your administrative appeal rights, which is generally a prerequisite to bringing suit.
Your right to appeal includes the opportunity for you or your legal representative to:
State the reasons why you feel your claim should not have been denied;
Submit written comments, documents, additional facts and other information supporting your claim;
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Ask additional questions;
Request to receive reasonable access (free of charge) to copies of all documents, records, and other information relevant to your claim; and
Ask for a review that takes into account all comments, documents, records, and other information you have timely submitted, whether or not it was submitted or considered in the initial determination of your claim. The review of your appeal will not give deference to the initial decision on your claim. The individual who decides your appeal will not be the same individual who decided your initial claim denial and will not be that individual’s subordinate. If your appeal is based in whole or in part on a medical judgment, the reviewer will consult with a health care professional who has appropriate training and experience in the field of medicine involved in the medical judgment. The identity of any medical or vocational expert consulted in connection with your appeal will be provided. Before your appeal is decided, the Plan Administrator will provide you, free of charge, with any new or additional evidence considered, relied upon, or generated by the STD Plan, the Plan Administrator, or other person making the benefit determination in connection with the claim, as well as any new or additional rationale. You will be provided this new or additional evidence or rationale as soon as possible to give you a reasonable opportunity to respond before your claim is decided. If your appeal is denied in whole or in part, you will receive a written notice within 45 days of the date that it was received, unless the Plan Administrator determines that special circumstances require an extension of time for processing your claim. If the Plan Administrator determines that an extension of time for processing is required, written notice of the extension will be furnished to you prior to the termination of the initial 45-day period. The extension notice will indicate the special circumstances requiring an extension of time and the date by which the Plan Administrator expects to render the determination on review.
A notice that your request on appeal is denied will be culturally and linguistically appropriate and will contain the following information:
the specific reason(s) for the determination;
a reference to the specific STD Plan provision(s) on which the determination is based;
a statement that you are entitled to receive upon request, and without charge, reasonable access to or copies of all documents, records or other information relevant to the determination.
A discussion of the decision, including an explanation of the basis for disagreeing with or not following:
- The views you presented to the STD Plan of health care professionals who treated who and vocational professionals who evaluated you;
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- The views of medical or vocational experts whose advice was obtained on behalf of the STD Plan in connection with the adverse determination on your claim, without regard to whether the advice was relied upon in making the benefit determination; and
- Any Social Security Administration disability determination regarding you that you presented to the STD Plan.
if your appeal was denied based on a medical necessity or experimental treatment or similar exclusion, an explanation of the scientific or clinical judgment for the determination, applying the terms of the Plan to your medical circumstances (or a statement of your right to receive such an explanation upon request); a statement disclosing any internal rule, guidelines, protocol or similar criterion relied on in making the adverse determination or, alternatively, a statement that such rules, guidelines, protocols, standards or other similar criteria do not exist; and a statement describing your right to bring a civil suit under ERISA Section 502(a), including a description of the contractual limitations period described under “ What are the time limits for legal proceedings ?,” above, and the calendar date on which your right to bring an action on the denial of your claim for benefits under the STD Plan expires.
Exhaustion of Administrative Remedies
Before filing any claim or action in court or in another tribunal with respect to the STD Plan, you must first fully exhaust all of your actual or potential rights under the claims procedures provided above by filing an initial claim and then seeking a timely appeal of any denial. This relates to claims for benefits under the STD Plan and to any other issue, matter, or dispute with respect to the STD Plan (including any eligibility, interpretation or amendment issue). This exhaustion requirement will apply even if the Plan Administrator has not previously defined or established specific claims procedures that directly apply to the submission and consideration of a particular issue, matter or dispute. After you have filed your initial claim, the Plan Administrator will inform you of any specific claims procedures that will apply to your particular issue, matter or dispute, or it will apply the claims procedures above that apply to claims for benefits.
ERISA PROVISIONS
NAME OF PLAN The Short-Term Disability Plan of Mid-America Apartments, LP, a component of the Mid- America Apartments, LP Employee Welfare Benefits Plan
NAME AND ADDRESS OF EMPLOYER/PLAN SPONSOR Mid-America Apartments, LP 6815 Poplar Avenue, Suite 500 Germantown, Tennessee 38138
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PLAN ADMINISTRATOR NAME, ADDRESS, AND TELEPHONE NUMBER Mid-America Apartments, LP 6815 Poplar Avenue, Suite 500 Germantown, Tennessee 38138
PLAN IDENTIFICATION NUMBER Mid-America Apartments, LP Employee Welfare Benefits Plan Employer IRS Identification #: 62-1543816 Plan #: 510
TYPE OF WELFARE PLAN The Plan is a welfare benefit plan that provides self-insured short-term disability benefits.
PLAN YEAR January 1 – December 31
TYPE OF ADMINISTRATION The Plan is administered by the Plan Administrator. The Plan Administrator is the “named fiduciary” for the Plan and has full discretion to exercise its duties hereunder. The Plan Administrator may adopt rules and procedures as to how the Plan operates and has authority to exercise discretion in performing its duties. The Plan Administrator retains all fiduciary responsibilities with respect to the Plan except to the extent the Plan Administrator has delegated or allocated to other persons or entities one or more fiduciary responsibilities with respect to the Plan, such as to the Claims Administrator, or as otherwise provided by applicable law. The Employer may, from time to time in their sole discretion, contract with outside parties to arrange for the provision of certain administrative services with respect to the Plan. In that regard, the Claims Administrator has been retained to provide certain administrative claims services for the Plan. The Claims Administrator has full discretion in providing these services, including deciding claims and appeals under the Plan.
CLAIMS ADMINISTRATOR Liberty Life Assurance Company of Boston
175 Berkeley Street Boston, MA 02116 1-888-408-7300
AGENT FOR SERVICE OF LEGAL PROCESS ON THE PLAN Service of legal process may be made upon the Plan Administrator, sent to the Attention of EVP and Chief Human Resources Officer.
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FUNDING AND CONTRIBUTIONS The Employer pays the full cost of the benefits provided under the Plan. All benefits provided under the Plan are funded by the Employer out of its general assets. No insurance policies are used to provide benefits under the Plan and no employee contributions are required or permitted. EMPLOYER’S RIGHT TO AMEND THE PLAN The Employer reserves the right, in its sole and absolute discretion, to amend, modify, or terminate, in whole or in part, any or all of the provisions of the Plan, at any time and for any reason or no reason. Distribution of an updated SPD is proof of such amendment without further action needed. YOUR RIGHTS UNDER ERISA As a participant in the Plan, you are entitled to certain rights and protections under the Employee Retirement Income Security Act of 1974 (ERISA). ERISA provides that all Plan participants shall be entitled to:
Receive Information About Your Plan and Benefits
Examine, without charge, at the Plan Administrator’s office and at other specified locations, all documents governing the Plan, including insurance contracts and a copy of the latest annual report (Form 5500 Series) filed by the Plan with the U.S. Department of Labor and available at the Public Disclosure Room of the Employee Benefits Security Administration. Obtain, upon written request to the Plan Administrator, copies of documents governing the operation of the Plan, including insurance contracts and copies of the latest annual report (Form 5500 Series) and updated summary plan description. The Plan Administrator may make a reasonable charge for the copies.
Receive a summary of the Plan’s annual financial report. The Plan Administrator is required by law to furnish each participant with a copy of this summary annual report.
Prudent Actions by Plan Fiduciaries
In addition to creating rights for Plan participants, ERISA imposes duties upon the people who are responsible for the operation of the employee benefit plan. The people who operate your Plan, called “fiduciaries” of the Plan, have a duty to do so prudently and in the interest of you and other Plan participants and beneficiaries. No one, including your employer or any other person, may fire you or otherwise discriminate against you in any way to prevent you from obtaining a benefit or exercising your rights under ERISA.
Enforce Your Rights
If your claim for a benefit is denied or ignored, in whole or in part, you have a right to know why this was done, to obtain copies of documents relating to the decision without charge, and to appeal any denial, all within certain time schedules. Under ERISA, there are steps you can take to enforce the above rights. For instance, if you request a copy of plan documents or the latest annual report from the Plan and do not receive them within 30 days, you may file suit in a federal court. In such a case, the court may require the Plan
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Administrator to provide the materials and pay you up to $110 a day until you receive the materials, unless the materials were not sent because of reasons beyond the control of the Plan Administrator.
If you have a claim for benefits that is denied or ignored, in whole or in part, you may file suit in federal court. If it should happen that Plan fiduciaries misuse the Plan’s money, or if you are discriminated against for asserting your rights, you may seek assistance from the U.S. Department of Labor, or you may file suit in a federal court. The court will decide who should pay court costs and legal fees. If you are successful, the court may order the person you have sued to pay these costs and fees. If you lose, the court may order you to pay these costs and fees, if, for example, it finds your claim is frivolous. In no event will you be allowed to file suit in court until you have exhausted the administrative remedies available under the Plan, including following the appropriate claims procedure as described above.
Assistance with Your Questions
If you have any questions about your Plan, you should contact the Plan Administrator. If you have any questions about this statement or about your rights under ERISA, or if you need assistance in obtaining documents from the Plan Administrator, you should contact the nearest office of the Employee Benefits Security Administration, U.S. Department of Labor, listed in your telephone directory or the Division of Technical Assistance and Inquiries, Employee Benefits Security Administration, U.S. Department of Labor, 200 Constitution Avenue N.W., Washington, D.C. 20210. You may also obtain certain publications about your rights and responsibilities under ERISA by calling the publications hotline of the Employee Benefits Security Administration.
The Short Term Disability Plan is adopted effective as of April 1, 2018.
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