Voluntary Accidental Death & Dismemberment Reference Manual for Danaher Corporation Metropolitan Life Insurance Company New York, NY 10010 L0109284T(exp0902)MLIC-LD 1
Voluntary Accidental Death and Dismemberment (AD&D) AD&D insurance provides full-time financial protection for associates 24 hours a day, 365 days a year from accidents on or off the job, including travel by public or private transportation. This coverage provides benefits for accidental death as well as for paralysis or loss of limb, speech, hearing or eyesight resulting from an accident. If an insured associate suffers a fatal accident, benefits will be paid to the associate's beneficiary. Beneficiaries for AD&D are the same as for Basic Life Insurance. The following coverage is available: 1 to 5 times basic annual salary to maximum of $1,000,000 Important For benefits to be paid, the loss must occur within 365 days of the date of the accident and be a direct result of bodily injury sustained from that accident, independent of all other causes. Special Benefits THE SEAT BELT BENEFIT: Payable if the associate should die from injuries sustained in an accident while driving or riding in a private passenger car and wearing a properly fastened seat belt. The benefit is an additional 10% of the Principal Amount, but not less than $1,000 or more than $25,000. THE HOSPITALIZATION BENEFIT: Provides a monthly income to help defray hospitalization costs resulting from an accident. If the insured is confined to a hospital for more than four days and then remains hospitalized, the Hospitalization Benefit will pay a monthly amount equal to 1% of the Principal Amount to a maximum of $2,500 per month, with a maximum duration of twelve months. 2
What Does VAD&D Insurance Cover? FOR THE LOSS OF: Life Two or more members One Member Thumb and index finger on same hand Hearing in both ears Speech Hearing in both ears and Speech COVERED LOSSES ALSO INCLUDE: Quadriplegia Paraplegia Hemiplegia THE AMOUNT PAYABLE IS: Principal Amount Principal Amount 25% of Principal Amount Principal Amount Principal Amount TERMS YOU SHOULD KNOW: Member Quadriplegia Paraplegia A hand, foot, or the sight in one eye Total paralysis of both upper and lower limbs Total paralysis of both lower limbs Hemiplegia Total paralysis of upper and lower limbs on one side of the body If more than one of the above losses occurs as a direct result of an accident, the insured will receive only one benefit amount, but it will be the largest to which he or she is entitled. For example, if the insured should suffer the loss of sight in one eye and quadriplegia, he/she will be entitled to the Principal Amount 3
What Is Not Covered? VAD&D insurance does not include payment for any loss which in any way results from or is caused by or contributed to by: physical or mental illness, diagnosis of or treatment for the illness; an infection, unless caused by an external wound accidentally sustained; suicide or attempted suicide; injuring oneself on purpose; the use of any drug or medicine; a war, or a warlike action in times of peace, including terrorist acts; committing or trying to commit a felony or other serious crime or assault; any poison or gas voluntarily taken, administered or absorbed; service in the armed forces of any country or international authority except the United States National Guard; Operating, learning to operate or serving as a member of a crew of an aircraft; While in any aircraft under any military authority (other than the Military Airlift Command); While in any aircraft being used for a test or experimental purposes; While in any aircraft used or designed for use beyond the Earth's atmosphere; While in any aircraft for the purpose of descent from such aircraft while in flight (except for self-preservation); or driving a vehicle while intoxicated as defined by laws of the jurisdiction in which the vehicle was being operated. Certain exclusions and limitations may be subject to state specific requirements. MetLife s VAD&D plan provides ACCIDENT insurance only. It pays benefits for bodily injury. It does not provide coverage for sickness. Coverage is provided under a group insurance policy (Policy Form GPNP99) issued to Danaher Corporation by MetLife. Voluntary Accidental Death and Dismemberment (VAD&D) terminates when an associate s employment ceases, when an associate s VAD&D contributions cease, or upon termination of the group contract by Danaher Corporation upon prior written notice to MetLife. The group policy may be discontinued by MetLife for nonpayment of premium or if participation requirements are not met. 4
TRAVEL ASSISTANCE SERVICES (From AD&D) Through a marketing agreement between MetLife and AXA Assistance USA, Inc., participants in the Personal AD&D or Voluntary AD&D policy can gain access to doctors, hospitals and pharmacies through AXA Assistance USA, Inc.'s emergency medical travel assistance program when faced with an emergency while traveling internationally or domestically 100 miles or more away from home. Consider these features: Medical travel assistance services for you and your Family (regardless of the VAD&D option you choose) including access to AXA Assistance USA, Inc.'s global network of alarm centers, with operational capabilities in over 210 countries and jurisdictions, a medical network with more than 10,250 physicians, and relationships with more than 8,600 hospitals and clinics worldwide; Alarm Centers are staffed with trained multi-lingual personnel, including nurses and doctors, to advise and assist you quickly and professionally in a medical emergency. If an associate enrolls in MetLife s Voluntary AD&D plan he or she will have the added benefit of medical travel assistance services with access to: Medical Consultation and Evaluation - A participant s call to the Alarm Center is evaluated by medical staff and referred to English speaking doctors and/or hospitals. Hospital Admission Guarantee - AXA Assistance USA, Inc. will guarantee the participant s or their dependent's hospital admission if the patient is outside the United States by validating their health coverage. Emergency Evacuation - Whenever adequate medical facilities are not available locally, AXA Assistance USA, Inc. will use whatever mode of transport, equipment and personnel necessary to evacuate the participant or their family member to the nearest facility capable of providing proper care. Critical Care Monitoring - AXA Assistance USA, Inc.'s team of doctors, nurses and other medically trained personnel will stay in regular communication with the attending physician and/or hospital and relay information to the participant s family and employer. Medically Supervised Repatriation - If the participant or their dependent is ready to be discharged from the hospital but still in need of medical assistance, AXA Assistance USA, Inc. will repatriate them to a rehabilitation facility or home and, if necessary, will provide a medical or nonmedical escort. 5
Dispatch Prescription Medication - If the participant s dependent forgets or loses their medication, AXA Assistance USA, Inc. will arrange for replacement medication. If the medication is not available locally, AXA Assistance USA, Inc. will dispatch the prescription medicine when possible and legally permissible, upon request of the attending physician. Other Assistance Services - Emergency Message Transmission, Transportation to Join Patient, Care for Minor Children, Return of Mortal Remains, as well as Emergency Legal Referrals, Interpreter Referrals, pre-trip information and lost luggage assistance are all available with the AXA Assistance USA, Inc. card. Unlike the Voluntary AD&D insurance benefits underwritten by MetLife that provide accident only insurance coverage, the travel assistance services offered through AXA Assistance USA, Inc. are available in the case of an accident or illness. A complete description of these and other services will be provided to the participant when he or she receives his/her AXA Assistance USA, Inc. identification card. Exclusions AXA Assistance USA, Inc. is available for participants in traveling status. Whenever a trip exceeds 90 or 120 days, the participant is no longer in traveling status and no longer requires or is eligible for AXA Assistance USA, Inc. services. AXA Assistance USA, Inc. will not evacuate or repatriate participants without medical authorization; with mild lesions, simple injuries such as sprains, simple fractures, or mild sickness which can be treated by local doctors and do not prevent the member from continuing his trip or returning home; with infections under treatment and not yet healed. AXA Assistance USA, Inc. will exclude the above services when travel is undertaken for the specific purpose of securing medical treatment; if injuries are resulting from attempt at suicide; suicide; participating in acts of war or insurrections; commission of an unlawful act; use of drugs unless prescribed by a physician; mental or nervous disorder unless hospitalized. 6
AXA Assistance USA, Inc. Summary of Services Provided EMERGENCY MEDICAL TRAVEL ASSISTANCE SERVICES ARE AVAILABLE TO THE ASSOCIATE S ELIGIBLE FAMILY MEMBERS EVEN IF THE ASSOCIATE ELECTS VAD&D ONLY FOR HIMSELF OR HERSELF. THESE SERVICES ARE AVAILABLE EVEN IF THE ASSOCIATE IS NOT TRAVELING WITH SUCH FAMILY MEMBERS. Services: Medical Assistance Services Medical consultation and evaluation Medical referrals (directing care as appropriate) Pre-admission review and hospital admission guarantees Critical care monitoring Local case management Emergency evacuation Discharge planning Medically supervised repatriation Dispatch of prescribed medication Services: Personal Assistance Services Transportation of a family member to join patient Care/Transportation of minor children Emergency message transmission Return of mortal remains Emergency Legal referrals Pre-departure Health/Medical Advice Services: Management Services 24 Hour care Direction out-of-area Urgent consultation International reasonable and customary charge monitoring Translation/Interpretation of foreign hospital bills Provider payment in local currency 7
Voluntary Accidental Death & Dismemberment Summary of Benefits INSURANCE Voluntary Accidental Death & Dismemberment COVERAGE AMOUNT: 1 to 5 times basic annual salary up to a maximum of $1,000,000 RATES: Associate Only Coverage $0.037/$1,000 SCHEDULE OF LOSSES: VAD&D BENEFITS: Please Refer to Section 1 for Further Details Please Refer to Section 1 for Further Details Seat Belt Benefit Associate Only Hospitalization Benefit Associate Only VAD&D EXCLUSIONS: Please Refer to Section 1 for Further Details 8