Fortunately, long-term disabilities are rare. But when they do happen, the result could be financial disaster. This Long-Term Disability plan is offered to protect you and your family against the catastrophic loss that disability can cause. This plan can be a way to provide financial protection in the event of disability.

As a member of the FlexAbility benefits plan you automatically receive core coverage under the long-term disability plan at no cost to you. This plan is meant to protect you against loss of income if you are disabled.

Any payments that are paid under this policy are subject to the actual insurance policy. This section is a summary of information contained in the group insurance certificate. To obtain a copy of the certificate, please contact your local Human Resources department.

If you are unable to return to your job after 90 days of disability, long-term disability (LTD) benefits will replace a portion of your income. (Coverage through time-off programs may replace part of your income before LTD benefits begin.)

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LTD Coverage Benefit

Your LTD benefit is coordinated with other income benefits. This means that the total amount you would receive from the combination of other income benefits and the LTD benefit is 60 percent of your base pay. The most that you can receive from the LTD benefit is 60 percent of your base pay or $5,000 per month, whichever is less, minus other income benefits. The least you can receive per month is the greater of $100 or 10 percent of the monthly benefit before deductions for other income benefits.

"Base pay" means your rate of earnings from your employer just prior to the date the disability begins. It doesn't include commissions, bonuses, overtime, or other compensations.

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Other income benefits

The other income benefits that would reduce your benefits from this plan include:

Payments you receive from:

• Your employer's retirement program
• Retirement benefits for you or your dependents from Social Security or the
• Railroad Retirement Act

Disability income you are eligible for under:

• Any other group insurance plan
• A governmental retirement system that is a result of your job with your employer
• Workers' or Workmen's Compensation law, occupational disease law, or any compulsory benefit act or law
• Social Security or the Railroad Retirement Act

These other payments, except retirement benefits, must be payable as a result of the same disability for which we pay a benefit .

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Payment of LTD Benefit

If you are totally or partially disabled by illness or injury, whether on the job or off, long-term disability benefits begin after you have been disabled for 90 consecutive days. You must notify the Claims Administrator of your disability in order to receive benefits.

As long as you remain disabled and require the care of a physician, monthly benefits are paid according to this schedule.

Benefit payments stop when the maximum benefit period is reached or on the date one of the following conditions is met:

• The date you are no longer disabled
• The date you die
• The date your current earnings exceed 80 percent of your indexed pre-disability earnings

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Defining Disabled

You are considered disabled if because of injury or sickness:

• You cannot perform each of the material duties of your regular occupation;
  

AND

• After benefits have been paid for 24 months, you cannot perform each of the material duties of any gainful occupation for which you are reasonably fitted by training, education, or experience;
  

OR

• While unable to perform all the material duties of your regular occupation on a full-time basis, you are:
  --Performing at least one of the material duties of your regular occupation or another occupation on a part-time or full-time basis;

AND

• --Earning currently at least 20 percent less per month than your indexed pre-disability earnings due to that same injury or sickness.

While you are receiving disability benefits, you may be asked to provide proof of your disability to continue being eligible to receive benefits. You must be under the regular care of a physician during your entire disability, or your benefits will stop.

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Recurrent disability

A recurrent disability is a disability that is related to or due to the same cause as a prior disability for which you received a monthly benefit. A recurrent disability is considered either a continuation of the prior disability or a new disability.

• If you become disabled less than 6 months after you return to your regular occupation on a full-time basis, the disability would be considered as part of the prior disability.
• If you become disabled more than 6 months after you return to your regular occupation on a full-time basis, the disability would be considered a new disability and benefits would begin after you have been disabled for 90 consecutive days.

Benefits payable under the recurrent disability provision are discontinued if benefits are payable under any other group long-term disability policy.

What Is Not Covered

Disabilities that are not covered

Any disabilities due to the following are not covered:

• War, declared or undeclared, or any act of war.
• Intentionally self-inflicted injuries.
• Active participation in a riot.

Pre-existing conditions exclusion

Your long-term disability plan does not cover any disability that begins in the first 12 months after your effective date if it is caused by, contributed to, or results from a preexisting condition.

For this plan, pre-existing condition means a sickness or injury for which you received medical treatment, consultation, care, or services including diagnosis, or for which you took prescribed drugs or medicines in the 3 months prior to your effective date.

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Mental illness limitation

If you have a disability due to mental illness, benefits are paid for a maximum of 24 months. The benefits may be extended if, at the end of the 24-month period, you are in a hospital or institution, or if you continue to be disabled and become confined after the 24-month period for at least 14 days in a row.

Benefits are not paid beyond the maximum benefit period defined by your age at the time of disability.

Filing a Claim

To file a claim, contact Human Resources to obtain Long-Term Disability claim forms. Within 30 days of when the disability started, fill out the forms and return them to your local Human Resources department.

If you notify the department in writing without using the form, be sure to include:

• The date the disability started
• The cause of the disability
• How serious the disability is

You must send your Human Resources department a proof of claim no later than 180 days from the date of the disability.

If Your Claim Is Denied

If you have any questions, contact Human Resources or your Claims Administrator for this plan.

If your claim is denied, either in full or in part, and you do not agree with the reason, you should write to your Claims Administrator within 60 days of receiving the denial. See the additional information sheet provided with this handbook, or your employer's Human Resources department, for the address.

State why you believe the claim should not have been denied, and submit any data, questions, or comments you think are appropriate. You will receive a written response confirming that your appeal is being reviewed. See the additional information sheet provided with this handbook, or your local Human Resources department.

Your Claims Administrator will review your claim and give a final decision on the review no later than 60 days from when they received your request. If there are any special circumstances, you will be notified and the final decision on the review will be made no later than 120 days from when your request for a review was received.

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End of Coverage

Coverage under this plan ends on the earliest of the following dates:

• The date the policy terminates
• The date you are no longer eligible
• The date your employment terminates

If you take a leave of absence or are temporarily laid off, coverage continues through the end of the month following the date in which you begin your layoff or leave of absence. You may be eligible for additional coverage if your leave qualifies under the Family and Medical Leave Act. Contact your Human Resources Department for more information.

If the insurer ends the plan or if your employer ends the insurance contract, coverage would end on the date the plan or insurance contract is ended.

LTD Benefit Claims Administrator

We encourage suggestions from our members. Call or write your Claims Administrator:

UNUM Life Insurance Company of America
101 North Brand Boulevard, Suite 800
Glendale, CA 91203-2622
(800) 424-2008

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