DENSO Health & Welfare Plan

Transcription

1 DENSO Health & Welfare Plan Attachment E: Employee Assistance Program Booklet Although this booklet references DENSO International America, Inc., the benefits and related effective dates, provisions, conditions, limitations and exclusions are identical for the following DENSO Group Companies: American Industrial Manufacturing Services, Inc. (AIMS) DENSO Manufacturing Arkansas, Inc. (DMAR) DENSO Manufacturing Athens Tennessee, Inc. (DMAT) DENSO Manufacturing Michigan, Inc. (DMMI) DENSO Manufacturing Tennessee, Inc. (DMTN) DENSO Sales California, Inc. (DSCA) DENSO Wireless Systems America, Inc. (DWAM) Effective: January 1, 2013

2 DENSO Health and Welfare Plan EMPLOYEE ASSISTANCE PROGRAM Table of Contents Page Introduction... 1 Eligibility... 1 Definitions... 2 Associate... 2 Company... 2 Dependent... 2 Domestic Partner... 2 EAP Administrator... 2 Participating Employer... 3 Spouse... 3 Covered Benefits... 3 EAP Consultations... 3 In Person Sessions... 3 Critical Incident Management Services... 3 Resources and Personalized Research Referrals... 3 Resources and Assistance... 4 Financial Services... 4 Enhanced Legal Service... 4 Impairment/Translation... 4 General Information... 4 How to Access EAP Benefit... 5 Telephone Access... 5 Online Access... 5 Claims and Appeals... 5 ERISA Welfare Plan... 6 Administrative Information... 6

3 INTRODUCTION This Program Booklet describes the Employee Assistance Program ( EAP ) benefits under the DENSO Health and Welfare Plan ( Plan ), as in effect on January 1, The EAP benefits are designed to provide benefits in addition to those provided through the Blue Cross Blue Shield of Michigan-administered self-insured medical benefit provisions of the Plan. This EAP Program Booklet is an attachment to, and is a part of, the basic Plan and Summary Plan Description document. Together, this Program Booklet and the basic Plan and Summary Plan Description document contain important information on your rights and obligations. Some of the words in this booklet are Capitalized. This means they have a special definition - see the "Definitions" section. Where the definition provided in this document conflicts with that in the basic Plan and Summary Plan Description document, the definition in this document will apply. This Program is designed to provide eligible Associates and their eligible Dependents with access to certain benefits pertaining to work and family issues. The EAP benefits under the Plan are paid through an insurance-type arrangement, purchased by the Plan. Ceridian LifeWorks is the provider of these benefits. Formal claims and appeals concerning eligibility and concerning benefits will be processed by Ceridian LifeWorks, the EAP Administrator. The Plan Sponsor reserves the right to change or end the EAP benefits under the Plan at any time with respect to any individual, in their sole discretion. If the EAP benefits under the Plan end, no benefits will be paid for services provided after the date of termination. Your local Human Resources representative and the Plan Administrator are available to answer your questions about your available benefits, can assist you in filing formal claims and appeals for benefits not approved by the EAP Administrator, and collecting the benefits to which you are entitled. We know you will appreciate the value and convenience which the EAP benefit coverage under the Plan provides. ELIGIBILITY The EAP benefits are available only to eligible individuals. Eligible individuals include Associates, Spouses, Domestic Partners, and Dependents. Enrollment in EAP benefits is automatic, as of the Associate s first day of employment. 1

4 DEFINITIONS Associate an individual classified by the Company as a common law employee (such as by reporting wage payments on Form W-2), a former employee participating under a COBRA election, and excluding temporary, student, intern, contingent or leased employees, regardless of any later classification or reclassification of the employment status of any individual. Company DENSO International America, Inc. ( DIAM ) or any Participating Employer, as to their respective Associates. Dependent an individual who is: your Spouse your or your Spouse's unmarried child who is under age 19, including a natural child, stepchild, a legally adopted child, a child placed for adoption or a child for whom you or your Spouse are the legal guardian; an unmarried child of any age who is or becomes disabled prior to age 26 and who is primarily financially dependent upon you; or your or your Spouse s child age 19 or older and under age 26 who does not have access to similar coverage through the individual s employer. Domestic Partner an individual of the same or opposite sex with whom you have established a domestic partnership as described below. A Domestic Partnership is a relationship between an Associate who is a resident of the State of California and one other person of the same or opposite sex. Both persons must: not be so closely related that marriage would otherwise be prohibited in the State of California; not be legally married to, or the Domestic Partner of, another person under either statutory or common law; be at least 18 years old; live together and share the common necessities of life; be mentally competent to enter into a contract; and be financially interdependent. For opposite gender couples, one partner must be at least age 62 and at least one partner must be eligible for Social Security Benefits. Both partners must file a valid Declaration of Domestic Partnership with the California Secretary of State, and a copy of the filing must be provided. Please see the Human Resources Department for details regarding enrolling a Domestic Partner. EAP Administrator Ceridian LifeWorks. 2

5 Participating Employer any affiliate of DIAM that participates in the Plan as authorized by DIAM. Spouse an individual to whom you are legally married or a Domestic Partner. Note that the IRS has ruled that a Domestic Partner is not a spouse, and the Plan must comply with this ruling for tax and reporting purposes. COVERED BENEFITS EAP Consultations: Access to EAP consultants for information, assessment, shortterm problem resolution, and crisis intervention. In Person Sessions: Assessment and short-term problem resolution assistance from a network of EAP consultants. Eligible individuals who are California or Nevada residents are eligible for up to three sessions per person in any rolling six month period of time. Eligible individuals who are residents of any other state are eligible for up to five sessions per subject matter per year. If you are unable to meet face-to-face for an In Person Session, the In Person Session can be conducted by telephone instead. Critical Incident Management Services: Access to specially-trained EAP consultants regarding emergency or disaster-type incidents in the workplace, such as sudden death, murder, or downsizing. Resources and Personalized Research Referrals: Access to resources and personalized researched referrals in the areas of emotional health, addictions, and workplace issues. The EAP Administrator can provide assistance for many types of personal issues, including: Family/children problems Marital/relationship conflicts and tensions Stress or other emotional difficulties including depression, fears, anxieties and Phobias Grief/loss issues Alcohol or other drug use Interpersonal relationships at work Personal challenges and achievements Work/life balance challenges Addictions including gambling, Internet, etc. By referring you to resources in your area, the EAP Administrator can also provide assistance with other matters, such as: Elder care referrals 3

6 Child care resources Resources and Assistance: Access to general resources and assistance in locating help with matters such as parenting, elder care and aging issues, financial planning, legal needs, and health. Financial Services: Access to consultants for financial information and assistance, consultation with certified financial professionals. No investment advice or loans are available through the EAP Program. Enhanced Legal Service: Access to consultants for legal information and assistance, and access to an initial consultation with network attorneys for up to 30 minutes of consultation per legal issue. No legal advice or representation is provided during initial consultations, and no review of real estate or trust documents is performed as a part of the consultation. After initial attorney consultation, access is provided to discounts off of standard legal fees of attorneys participating in Ceridian LifeWorks network of attorneys. Access is provided to consultation via telephone with staff attorneys for up to 30 minutes per legal issue. These consultations do not provide legal advice or legal representation. Access to resources and personalized researched referrals regarding legal needs, including educational information in print, online, and via audio recording, access to website with educational resources and interactive tools, referral to community resources, case management of consultant-delivered services including follow-up contact with you after the delivery of services. Impairment/Translation: Services may be configured to meet the special needs of hearing, vision, or physically-impaired Associates, as appropriate to the service being delivered. Bilingual or translation services may be available for non-english speaking Associates, with respect to EAP benefits. General Information: Program Benefits are provided through individuals employed by the Provider, and they are not employees of the Company or of the Plan. The EAP Administrator has a contractual relationship with the Plan. You are not required to use the EAP benefit; it is made available to you solely for your convenience. The EAP Administrator does not disclose to the Company the identity of any Associate who use the EAP Administrator s services, although aggregated de-identified statistical information regarding benefit usage may be provided. The fact that these services are made available through the Plan in which your employer participates does not create, and should not be construed as creating, an employer-requirement that you receive counseling, legal, financial, or other services through the EAP. The Company is not a licensed attorney, counselor, or financial planner, and does not employ individuals to provide you with counseling, legal, financial, or other services discussed in this Program Booklet. When you elect to use the EAP, you do so voluntarily, and are free at all times to select a different provider outside of the EAP, in your own discretion and at your own cost. 4

7 There is no out-of-pocket expense for you to use EAP benefits. When you are provided a referral from the EAP Administrator, such as to a marriage counselor or a child care provider, your subsequent use of the referred provider s services is not a benefit under the EAP, and you are responsible for all costs associated with those services. Similarly, when you use the services of an attorney who participates in the EAP Administrator s network and provides a discount on regular fees as a result, you are responsible for the attorney s fees and those services are not provided as benefits under the Plan. If counseling is needed, then the provisions of the Medical and Prescription Drug Program of the Plan apply, such as deductibles, in-network limitations, coinsurance and co-pays. It is your responsibility to ensure that any provider you see is in your medical network, even if they are referred by the EAP Administrator. HOW TO ACCESS EAP BENEFITS To receive EAP benefits under the Plan, you should follow these steps. Telephone Access: All EAP benefits may be accessed by contacting the EAP Administrator through one toll-free number, 24 hours a day, 365 days a year: Telephone: (888) TTY/TTD: (800) En Espanol: (888) There is no limit on the number of calls you may make. Translation services are available for approximately 140 different languages, with respect to benefits provided under the EAP. These calls are free and confidential. Online Access: Articles, publications, resource listings, and audio recordings are available through the online website provided by the EAP Administrator. You can also a consultant through the website, and can access interactive financial tools. To access the online services go to: User ID: DENSO Password: EAP Claims and Appeals: All requests for benefits, and all appeals of any eligibility decisions or benefit decisions, are handled by the EAP Administrator. The timeframes and process set forth in the Plan and Summary Plan Description regarding appeals apply, although all request and other documentation should be submitted to the EAP Administrator at the following address: Ceridian LifeWorks 3311 E. Old Shakopee Rd. Minneapolis, MN

8 ERISA WELFARE PLAN The EAP benefits are not designed to be subject to the Employee Retirement Income Security Act of 1974, as amended ( ERISA ). The portions of the ERISA Rights section of the basic Plan and Summary Plan Description document do not apply to EAP benefits. In the event the EAP actually provides medical treatment it will be an employee welfare benefit plan within the meaning of ERISA Section 3(1) to the extent of those benefits. In that event, the provisions of the basic Plan and Summary Plan Description regarding HIPAA rights, COBRA rights, QMCSOs, FMLA, USERRA and other leaves of absences, and Coordination of Benefits will apply to that portion of the EAP. Plan Name DENSO Health and Welfare Plan Plan Number 526 Plan Sponsor DENSO International America, Inc Denso Drive P.O. Box 5047 Southfield, Michigan (248) ADMINISTRATIVE INFORMATION Plan Sponsor s Employer Identification Number Agent for Service of Legal Process Director of Human Resources DENSO International America, Inc Denso Drive Southfield, MI (248)

9 Type of Plan Plan Year The EAP is an employee benefit plan making available the following types of benefits that are not subject to ERISA: resources and referrals regarding financial, legal, personal, and medical issues. In the event that the EAP provides medical treatment, the EAP will be an employee welfare benefit plan within the meaning of ERISA Section 3(1) to the extent of those benefits. January 1 through December 31. Type of Administration The EAP is insurer-administered by the EAP Administrator: Ceridian LifeWorks 3311 E. Old Shakopee Rd. Minneapolis, MN (800) Contributions and Funding Premiums for Program benefits are paid by the Company out of its general assets. The cost of actual benefits provided is paid by Ceridian. Participating Employers The Plan provides benefits to the Associates of the certain affiliates of DIAM. The Participating Employers in the EAP as of January 1, 2010 and their Employer Identification Numbers are: American Industrial Manufacturing Services, Inc Corning Place Murrieta, CA DENSO Manufacturing Arkansas, Inc. 100 Denso Road Osceola, AR

10 DENSO Manufacturing Athens Tennessee, Inc Denso Drive Athens, TN DENSO Manufacturing Michigan, Inc. One Denso Road Battle Creek, MI DENSO Manufacturing Tennessee, Inc Robert C. Jackson Drive Maryville, TN DENSO Sales California, Inc Via Oro Avenue Long Beach, CA DENSO Wireless America, Inc Business Park Drive Vista, CA An updated list of the names, addresses, and phone numbers of the employers participating in the Plan may be obtained, or is available for examination, by Participants and beneficiaries upon written request to the Plan Administrator. NOTE: This document only describes the benefits available to the individuals described in the Eligibility section on page 1 of this document. 8