Macalester College Business Accident Insurance Plans

Transcription

1 MACALESTER COLLEGE BUSINESS TRAVEL ACCIDENT INSURANCE PLAN SUMMARY PLAN DESCRIPTION Introduction The Macalester College Business Travel Accident Insurance Plan (the Plan ) provides benefits to eligible employees for a covered injury or death occurring while the employee is traveling on behalf of Macalester College (the College ). This Summary Plan Description ( SPD ) describes how the Plan operates and the basic features of the Plan, as in effect on September 1, This SPD is only a summary of the key parts of the Plan, and a brief description of your rights as a participant. It is not a part of the official plan documents. If there is any conflict between this summary and the official plan documents, or in the event that this SPD omits or does not fully describe a particular plan provision, the plan documents will govern. Copies of the Plan and relating documents are available for your inspection at the College during normal business hours. It is important that you read this entire document. Reading only portions of this document may be confusing and misleading. 1. WHAT IS THE PURPOSE OF THE PLAN? The purpose of the Plan is to provide business travel accident insurance benefits to eligible employees (or their beneficiaries) for covered injury or death occurring while the employee is traveling on behalf of the College. 2. WHO IS COVERED UNDER THE PLAN? You are covered under the Plan if you are a faculty or staff employee of the College. However, to be eligible for Plan benefits, you must experience a covered injury or death while traveling on the business of the College. 3. WHAT DOES THE TERM ON THE BUSINESS OF THE COLLEGE MEAN? The term on the business of the College means you are on a trip at the College s direction to further the College s business. All trips must be authorized by the College. A covered trip will begin when you leave your home, place of regular employment, or other place. Such trip will end when you return to your home or place of regular employment, whichever first occurs, or when you make a personal deviation. A personal deviation means an activity that is not reasonably related to your business, and not incidental to the business trip.

2 Your travel to and from work, bona fide leaves of absence, vacations and other personal deviations are not considered to be on the business of the College. 4. WHAT IS A COVERED INJURY OR DEATH? A covered injury or death is a loss of life, limb or sight resulting directly from an accident occurring while you were on a trip on the business of the College. To be a covered injury or death, the accident must occur while you are covered by the Plan and the loss of life, limb or sight must occur within one year of the accident. The Plan does not cover any loss as a result of sickness. In addition, aircraft coverage under the Plan is limited to riding as a passenger and not as a pilot or member of the crew. 5. WHAT BENEFITS ARE PROVIDED UNDER THE PLAN? The Plan provides benefits through a blanket insurance policy, currently issued by The Life Insurance Company of North America. Generally, the Plan pays the following benefits: $100,000 for a covered death or the loss of two or more members, $50,000 for the covered loss of one member, and $25,000 for the covered loss of a thumb and index finger on the same hand. A member means a hand, foot or eye. Loss of a hand or foot means complete severance through or above the wrist or ankle joint. Loss of an eye means the total, irrecoverable loss of sight in the eye. The maximum benefit under the Plan is $100, to an individual. (However, the aggregate maximum payment under the Plan for a single accident is $500,000.00, regardless of the number of eligible employees involved.) If you suffer more than one loss from an accident, the Plan will only pay the loss with the larger benefit. Additional details of the coverage are explained in the master blanket policy available from the College Human Resources Department. 6. UNDER WHAT CIRCUMSTANCES MAY I LOSE COVERAGE UNDER THE PLAN? You may lose coverage under the Plan if any of the following events occur: (a) the College terminates the blanket insurance policy; (b) the College modifies the coverage under the policy to terminate insurance on the class of employees to which you belong; or (c) you terminate active service with the College. -2-

3 7. HOW IS A CLAIM FOR BENEFITS MADE UNDER THE PLAN? The College has claim forms for the Plan. These forms may be obtained from the College Human Resources Department. The completed form should be returned to the Human Resources Department, who will forward the form to the insurance carrier. You must follow the directions on the claim form to make sure your rights are protected. Claims are processed under the claims procedure published by the insurance company. 8. MAY THE PLAN BE CHANGED OR TERMINATED? Yes. The College reserves the right at any time and from time to time to terminate, modify or amend, in whole or in part, any or all provisions of the Plan, provided, however, that no amendment shall eliminate coverage for eligible losses already incurred prior to the date the amendment or modification was approved. 9. INFORMATION CONCERNING PLAN ADMINISTRATION: a. Plan Name: Macalester College Business Travel Accident Insurance Plan. b. Name and Address of Employer: Macalester College 1600 Grand Avenue St. Paul, MN Telephone: (651) c. Plan Number: 504 d. Employer Identification Number: e. Type of Administration: Insurer administration. f. Plan Administrator: The Plan Administrator is: Macalester College Office of the Treasurer 1600 Grand Avenue St. Paul, MN g. Agent for Service of Legal Process: The agent for service of legal process is the Treasurer of the College, at the address listed above. h. Funding Medium: Benefits are provided under a group insurance contract issued by the Life Insurance Company of North America to the College. Premium payments on the group contract are made by the College. No benefits are provided by the College under this Plan except as may be paid by the insurance company. -3-

4 i. Plan Year: January 1 through December Employee Retirement Income Security Act (ERISA) Statement of Rights: 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 1. 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 Pension and Welfare Plan Administration. 2. 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 Administrator may make a reasonable charge for the copies. 3. 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 on the people who are responsible for the operation of the 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, your union, or any other person, may fire you or otherwise discriminate against you in any way to prevent you from obtaining a welfare benefit or exercising your rights under ERISA. Enforce Your Rights If your claim for a welfare 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 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 Administrator. If you have a claim for benefits which is denied or ignored, in whole or in part, you may file suit in a state or Federal court. In addition, if you disagree with the Plan s decision or lack thereof concerning the qualified status of a medical child support order, 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 -4-

5 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, for example, if it finds your claim is frivolous. 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 Pension and Welfare Benefits Administration, U.S. Department of Labor, listed in your telephone directory or the Division of Technical Assistance and Inquiries, Pension and Welfare Benefits Administration, U.S. Department of Labor, 200 Constitution Avenue N.W., Washington, D.C You may also obtain certain publications about your rights and responsibilities under ERISA by calling the publications hotline of the Pension and Welfare Benefits Administration. M1: Revised 6/04-5-