Life and Accident Insurance

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1 Life and Accident Insurance Honda offers basic life and accident insurance and business travel insurance benefits for you or your survivors in the event of your accidental death or serious injury. Table of Contents For More Information Administrative details and procedures for appealing a claim can be found in the Administrative Information section. Basic Life and Accident Insurance Who Is Eligible When Coverage Begins Basic Life and Accident Insurance Coverage Naming a Beneficiary Benefits Claims Benefits during a Terminal Illness When Coverage Ends Changing to a Personal Policy Business Travel Insurance Who Is Eligible When Coverage Begins Business Travel Insurance Coverage Benefits Claims When Coverage Ends Life and Accident Insurance HAM/EGA/HNA 51 January 1, 2014

2 Basic Life and Accident Insurance Basic life and accident insurance provides financial protection for your family in the event of your death or serious accidental injury. Highlights Cost Who Is Covered Coverage Begins Benefits Special Features Coverage Ends Administered by Paid for by Honda Regular associates working at least 16 hours per week First day of month after three full months of employment Two times base annual earnings (up to $750,000) if you die; full or partial benefit if you suffer an accidental injury You can request payment of a portion of your basic life insurance benefit if you become terminally ill When your Honda employment or eligibility ends MetLife Who Is Eligible You are eligible for basic life and accident insurance if you: Are a regular associate who routinely works at least 16 hours per week and Have been employed by Honda for three full calendar months You are not eligible if you: Are an active Honda associate who has a regular work schedule of less than 16 hours per week Are a self-employed person who provides services to Honda through an agreement between Honda and you Are employed by or obtain your employment through a company that provides temporary workers to Honda Are a student or temporary associate or Are an associate of an international affiliate on temporary assignment at Honda If you are an associate of a Canadian affiliate on assignment, you are not eligible for basic life insurance. However, associates of a Canadian affiliate on assignment are eligible for accident insurance. When Coverage Begins Basic life and accident insurance coverage begins on the first day of the month after you meet the eligibility criteria described in Who Is Eligible on page 52, provided you are actively at work on that day. Otherwise, coverage will be delayed until you return to active work for one full day. Basic Life and Accident Insurance HAM/EGA/HNA 52 January 1, 2014

3 Basic Life and Accident Insurance Coverage Your coverage amounts under this plan are: Basic life insurance of two times your base annual earnings, up to $750,000 of coverage and Accident insurance of two times your base annual earnings, up to $750,000 of coverage If your base annual earnings are not a multiple of $1,000, they are first rounded up to the next $1,000 multiple for your basic life insurance. If your base annual earnings are not a multiple of $1,000, they are first rounded up to the next $1,000 multiple for your accident insurance. The value of basic life insurance coverage over $50,000 is taxable and is reported on your W-2 form each year. Value means what the Internal Revenue Service determines to be the premium cost. When Coverage Amounts Change Your basic life and accident insurance coverage amounts change: On the date your base annual earnings change, if you are actively at work On the date you return to work for one full day, if your base annual earnings changed while you were disabled or on an approved leave of absence Naming a Beneficiary You name a beneficiary to receive all death benefits payable from the plans by logging in to or calling the Honda Benefits Service Center at You may elect different beneficiaries for each plan. You may name a person (or a legal entity, such as a trust) as your beneficiary. You may change your beneficiary selection at any time by calling the Honda Benefits Service Center or by changing your beneficiary online. Beneficiary selections (or changes) are effective when you make the change through a personal service representative at the Honda Benefits Service Center or when an online selection is saved at Benefits Basic Annual Earnings Base annual earnings means your regular base wage rate, excluding overtime, shift premium, bonus, expense allowances or other special compensation. Benefits are paid if you die or have an accidental loss as listed in the chart below. The coverage amount in effect on the date of death or accidental loss applies. Benefits for loss of life will be paid to your beneficiary. Benefits for all other losses will be paid to you. See How Benefits Are Paid on page 55. Accidental losses must occur within one year of the accident. In the event of multiple accidental losses, the plan will pay up to 100% of the accident coverage. Basic Life and Accident Insurance HAM/EGA/HNA 53 January 1, 2014

4 Benefit Amount Loss Life Accidental loss of: Life* (subject to review of exclusions) Both hands or both feet Entire sight of both eyes Total paralysis of both upper and lower limbs (quadriplegia) Loss of one arm or one leg Total paralysis of both lower limbs (paraplegia) Total paralysis of upper and lower limbs on one side of body (hemiplegia) Speech or hearing in both ears One hand, one foot or entire sight of one eye Total paralysis of one limb Thumb and index finger of same hand Plan Pays this % of Coverage Amount 100% of life benefit 100% of accident benefit* (in addition to life benefit) 100% of accident benefit 100% of accident benefit 100% of accident benefit 75% of accident benefit 50% of accident benefit 50% of accident benefit 50% of accident benefit 50% of accident benefit 25% of accident benefit 25% of accident benefit * Seat Belt Benefit: An additional 10% up to a $25,000 maximum will be paid if loss of life results from accidental injuries sustained while driving or riding in a private, four-wheel passenger car with a properly fastened seat belt or child restraint. Seat belt use must be certified by an investigating officer and a police report submitted with the claim. This benefit is not payable if the car is commercially licensed or used for commercial purposes or any vehicle used for recreational or professional racing, or if the covered person was driving under the influence of alcohol or drugs. Covered Losses Covered losses listed in Benefit Amount are defined as follows: Loss of hand means removal at or above the wrist joint but below the elbow Loss of a foot means removal at or above the ankle joint but below the knee Loss of sight means permanent and uncorrectable loss of sight in the eye. The visual acuity must be 20/20 0 or worse in the eye or the field of vision must be less than 20 degrees Loss of thumb and index finger on the same hand means that the thumb and index finger are permanently severed through or above the third joint from the tip of the index finger and the second joint from the tip of the thumb Loss of speech and hearing in both ears means a complete, continuous and irrevocable loss that continues for six consecutive months following the accidental injury Loss of use of limbs (paralysis) means loss of use of a limb, without severance and must be certified by a physician as permanent, complete and irreversible Exclusions and Limitations Accident benefits will not be paid for any loss caused by or contributed to by: Physical or mental illness or infirmity, or the diagnosis or treatment of such illness or infirmity Infection, other than infection occurring in an external accidental wound Suicide or attempted suicide (while sane or insane) An intentionally self-inflicted injury Basic Life and Accident Insurance HAM/EGA/HNA 54 January 1, 2014

5 War, whether declared or undeclared; or act of war, insurrection, rebellion or riot Service in the armed forces of any country or international authority Commission of or attempt to commit a criminal act Use of alcohol, intoxicants or drugs, except as prescribed by a physician. An accident in which the blood alcohol level of the operator of a motor vehicle meets or exceeds the level at which intoxication would be presumed under the jurisdiction where the accident occurred will be deemed to be caused by the use of alcohol Air or space travel. This does not apply if a person is a passenger, with no duties at all, on an aircraft being used only to carry passengers (with or without cargo) The injury must not be one which is excluded by the terms of this section. Claims The Honda Benefits Department files all basic life and accident insurance claims on behalf of associates. In the event of your death, a family member or beneficiary should notify Honda or the Honda Benefits Department at Other accidental losses should be reported within 30 days after the date of the accident (or within a reasonable time period). In both cases, acceptable proof of loss needs to be provided to the insurance company before benefits can be paid. If a claim is denied in whole or part, you can appeal in writing to MetLife. See the Administrative Information section. Basic Life and Accident Claim Forms Notify the Benefits Department to file a claim for benefits. Claim forms are submitted directly to the insurance company by the Benefits Department on your behalf. How Benefits Are Paid Both basic life and accident benefits are payable as a single lump sum payment or through an account with checkbook privileges. The Honda Benefits Service Center (call or log in to can give you more details about payment options. If your beneficiary dies before receiving the full benefit amount, the remainder will be paid to the person/entity you designate as a contingent or secondary beneficiary on the beneficiary form or online. If no primary or contingent beneficiary is named or still living at your death, payment will be made to one of the following in this order: If You or Your Beneficiary Have Questions If you or your beneficiary have questions about filing claims or completing forms, contact the Honda Benefits Service Center at or log in to Your surviving spouse (or same gender domestic partner in states that recognize that type of civil union) Your surviving children in equal amounts (payment to a minor child may be made to an adult who has custody and supports the child, or a legal guardian, when appointed) Basic Life and Accident Insurance HAM/EGA/HNA 55 January 1, 2014

6 Your surviving parents in equal amounts Your surviving brother(s)/sister(s) in equal amounts Your estate Benefits during a Terminal Illness If you are terminally ill with a life expectancy of 12 months or less, you can access a portion of your basic life insurance benefit. You can withdraw a lump sum of up to 80% of your basic life insurance amount (two times annual base earnings). The minimum withdrawal is $20,000, while the maximum is $500,000. To apply for this benefit, you need to complete an application and provide physician certification of your life expectancy. Forms are available from and you can return forms to the Honda Benefits Department ( ). The life insurance coverage which remains in force will be reduced by the amount of benefits received. When Coverage Ends Basic life and accident insurance coverage will end on the earliest of the date: Your Honda employment ends Your plan eligibility ends or The plan ends If your employment or eligibility ends, you may change your Honda coverage to a personal policy. Coverage during Disability and Leave of Absence Honda will continue your basic life and accident insurance while: You Are Disabled. Coverage continues until your Honda employment ends You Are on Approved Leave of Absence. Coverage continues until your Honda employment ends. This does not apply to educational or some military leaves of absence Changing to a Personal Policy When your basic life and accident insurance ends, you can change your Honda coverage to a personal policy without providing proof of good health. If you change to a personal policy: MetLife will automatically send you conversion forms after they receive your separation/retirement notification. If you have not received your notification within 21 days of your separation/retirement date, contact MetLife at You will have to pay premiums for your coverage. The first premium will need to be paid before your personal policy can take effect Basic Life and Accident Insurance HAM/EGA/HNA 56 January 1, 2014

7 Your personal policy will be limited to the amount of Honda coverage you had on the last day it was effective. Other limitations may apply if coverage ended because the plan ended If you die within the 31 days after Honda coverage ends, the insurance company will pay your beneficiary the amount of insurance that would have been available to you under a personal policy subject to plan exclusions. This benefit is payable even if you do not apply for a personal policy Please consult the full certificates of coverage for complete details. Basic Life and Accident Insurance HAM/EGA/HNA 57 January 1, 2014

8 Business Travel Insurance Business travel insurance provides financial protection for your family in the event of an injury or death while you are traveling on company business. Highlights Cost Who Is Covered Coverage Begins Pays Benefits of Coverage Ends Administered by Paid for by Honda Regular associates working at least 16 hours per week On your date of hire Five times base earnings, up to $500,000, depending on type of loss When your Honda employment or eligibility ends Cigna Who Is Eligible You are eligible for business travel insurance if you are a regular associate who routinely works at least 16 hours per week. You are not eligible if you: Are an active Honda associate who has a regular work schedule of less than 16 hours per week Are a self-employed person who provides services to Honda through an agreement between Honda and you Are employed by or obtain your employment through a company that provides temporary workers to Honda or Are a student or temporary associate When Coverage Begins Participation in the plan begins on your hire date. Business Travel Insurance Coverage You are automatically protected by the business travel insurance plan, at no cost to you. The plan protects you worldwide, 24 hours a day, while traveling on official Honda business. Plan coverage does not include commuting to your scheduled assigned work location or other personal travel before, during or after work hours. For an associate who is on a temporary assignment for more than 14 days, coverage for business travel commuting to/from the temporary assignment would not be covered. Base Annual Earnings Base earnings means your regular base wage rate, excluding overtime, shift premium, bonus, expense allowances or other special compensation. Business Travel Insurance HAM/EGA/HNA 58 January 1, 2014

9 Coverage begins when you depart on your trip from your home or work location and ends when you return to either location. The coverage amount is five times base annual earnings up to $500,000 based on the type of loss. Benefits Plan benefits are paid in a single lump sum if a loss occurs within one year of, and as the result of, an accident. Benefit Amounts Accidental loss of life 100% Loss of both hands, both feet or entire sight of both eyes 100% Total paralysis of both upper and lower limbs (quadriplegia) 100% Loss of one hand or one foot 50% Loss of entire sight of one eye 50% Loss of speech or hearing in both ears 50% Loss of one arm or one leg 50% Total paralysis of both lower limbs (paraplegia) 50% Total paralysis of upper and lower limbs on one side of body (hemiplegia) 50% The maximum benefit payable for all losses resulting from one accident is $500,000. Business travel insurance benefits are payable in addition to all other insurance coverage and in no way affect your coverage under workers compensation insurance. Your beneficiary for business travel insurance is automatically the same beneficiary you named for your basic life insurance. Covered Losses The plan covers travel on any type of transportation including automobile (your own, rented or companyowned, or another person s), taxi, bus, streetcar, train and ship. The plan covers injuries sustained while a passenger in an aircraft that has a current and valid air-worthiness certificate and is piloted by a person holding a valid and current certificate of competency rating authorizing him or her to pilot the aircraft. This includes any transport type of aircraft operated by the Military Airlift Command of the United States or a similar air transport service of any duly constituted government authority of any other recognized country. Should more than one associate be injured or killed in the same accident, the maximum benefit payable to all associates (or beneficiaries) involved is limited to $5 million. If total losses are over $5 million, the benefit payable to each associate (or beneficiary) is pro-rated based on the individual loss for each associate as it relates to the total loss. Exclusions and Limitations The plan does not cover you as a pilot or crew member in any civilian aircraft. Business Travel Insurance HAM/EGA/HNA 59 January 1, 2014

10 Claims The Honda Benefits Department files all business travel insurance claims on behalf of associates. In the event of your death, a family member or beneficiary should notify Honda or the Honda Benefits Department at Other accidental losses should be reported within 30 days after the date of the accident (or within a reasonable period of time). In both cases, acceptable proof of loss needs to be provided to the insurance company before benefits can be paid. Important Note! You, a family member or your beneficiary must provide acceptable proof of loss to Cigna before benefits can be paid. The claims payer is Cigna. If a claim is appealed in whole or part, you can appeal in writing to Cigna. See the Administrative Information section. When Coverage Ends Your coverage will end on the earliest of the date: Your Honda employment ends Your plan eligibility ends or The plan ends Business Travel Insurance HAM/EGA/HNA 60 January 1, 2014

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