YOUR HR PORTAL YOUR CBS 401(K) PLAN PREPARE. DECIDE. ACT. YOUR CBS PENSION BENEFITS YOUR RETIREMENT PROGRAM A HEALTHY PARTNERSHIP CBS CORPORATION ORIENTATION KIT CBS & YOU Summary Plan Description CBS Group Life Insurance plan Effective as of January 1, 2013
The CBS Group Life Insurance Plan A Component of the CBS Health and Welfare Benefits Plan Summary Plan Description Effective as of January 1, 2013 Because CBS Corporation considers the overall health and welfare of its employees to be extremely important, the CBS Group Life Insurance Plan was designed to protect you and your family against unexpected events by providing you with a variety of insurance benefits. The CBS Group Life Insurance Plan (the Plan ) consists of four components (1) Basic Term Life Insurance ( Basic Life ), (2) Basic Accidental Death & Dismemberment Insurance ( AD&D ), (3) Optional Employee & Spouse Group Universal Life Insurance ( GUL ), and (4) Dependent Term Life Insurance. The Plan is a component of the CBS Health and Welfare Benefits Plan and is defined as a welfare plan under the Employee Retirement Income Security Act of 1974, as amended ( ERISA ). The main features of the Plan are described in this booklet which serves as the Summary Plan Description ( SPD ). For benefits available on or after July 1, 2012, this booklet replaces and supersedes any SPD for the Plan which may have previously been issued to you. The options described in this booklet are offered to eligible actively employed Full-Time Employees and certain disabled employees of the Company. For purposes of the booklet, the terms CBS and Company include CBS Corporation together with all of its divisions and subsidiaries that have elected to participate in the Plan. CBS reserves the right to change or amend the Plan at any time, through the actions of the Plan Administrator. Please note that the Plan does not create an employment contract between you and the Company and does not give you any right of continued employment with the Company. Please note that a Glossary of terms is included at the back of this booklet beginning on 18. Terms that are capitalized in this booklet and not defined in the text are defined in the Glossary. After you have read this information and shared it with your family, you should keep it in a convenient place for future reference. In the Event of a Conflict The CBS & YOU Benefits Center is your primary source of information about the Plan. If you have any questions about: (1) your or a dependent s eligibility for coverage under the Plan, (2) the Plan options available to you or a covered dependent, (3) Plan cost or payment of your Plan premiums, or (4) your rights under ERISA, you should contact the CBS & YOU Benefits Center at 1-800-581-4222. If you have specific questions about Plan coverage for a particular claim you should contact The Prudential Insurance Company of America ( Prudential ) directly. Should there be a discrepancy between the terms of this booklet and the advice you receive from the CBS & YOU Benefits Center, the Claims Administrator, or a representative of the Plan Administrator, the terms herein shall govern. In the event of a conflict between the terms contained in this booklet, including the benefits described in this booklet, and the terms contained in the CBS Health and Welfare Benefits Plan or the Company s contracts and insurance policies with the Prudential which are incorporated by reference in such plan, the terms of the CBS Health and Welfare Benefits Plan and the applicable incorporated contracts and policies will control. The Plan Administrator has delegated authority to the Prudential Insurance Company of America to provide claim processing, claim investigation, claim control and the daily administration of the Plan. 1
This booklet is intended to comply with the disclosure requirements of the regulations issued by the U.S. Department of Labor under ERISA. ERISA requires that you be given a "Summary Plan Description" which describes the Plan and informs you of your rights under it. IMPORTANT INFORMATION FOR RESIDENTS OF CERTAIN STATES: There are state-specific requirements that may change the provisions under the coverage(s) described in this Summary Plan Description. If you live in a state that has such requirements, those requirements will apply to your coverage(s) and are made a part of your Group Insurance Certificate. Prudential has a website that describes these state-specific requirements. You may access the website at www.prudential.com/etonline. When you access the website, you will be asked to enter your state of residence and your Access Code. Your Access Code is 40143. If you are unable to access this website, or you wish to receive a printed copy of these requirements, or you have any questions, call Prudential at 1-866-439-9026. 2
Table of Contents Eligibility... 5 Dependent Eligibility... 5 When Your Coverage Begins... 5 Cost of Coverage... 5 Tax Consequences.... 5 Enrolling in the Plans... 6 Adding a Dependent and/or Increasing Coverage as the Result of a Qualified Change in Circumstance... 6 Changing Coverage... 6 Designation of a Beneficiary... 6 Your Plan Options... 7 Basic Term Life Insurance..... 7 Basic Accidental Death & Dismemberment... 7 Optional Employee & Spouse Group Universal Life.... 7 Cash Accumulation Account Fund... 7 Withdrawals.... 7 Loans... 8 Will Preparation Services..... 8 Age Adjustment... 8 Option to Accelerate Certain Death Benefits Under Universal Life Coverage... 9 Optional Dependent Child Term Life.... 10 Termination of Coverage... 10 Basic Term Life Insurance.... 10 Basic Accidental Death & Dismemberment Insurance.... 11 Group Universal Life (GUL) and Spousal GUL Insurance... 11 Optional Dependent Child Term Life Insurance... 11 Coverage During Leave of Absence... 11 Medical Leave of Absence... 11 Family and Medical Leave Act... 11 Personal Leave of Absence... 11 3
Coverage During Disability... 11 CBS Basic Life Coverage... 11 Basic Accidental Death & Dismemberment Coverage... 11 Group Universal Life (GUL) and Spousal GUL Insurance... 12 Optional Dependent Child Term Life Insurance... 12 Filing a Life Insurance Claim... 12 Administrative Information... 12 Collective Bargaining... 13 Titles or Headings... 13 Clerical Error... 13 Illegality of a Particular Provision... 13 Amendment and Termination... 13 Future of the Plan... 14 Claim Procedures... 14 Determination of Benefits... 14 Appeals of Adverse Determination... 15 Rights and Procedures... 16 Prudent Actions by Plan Fiduciaries... 16 Enforce Your Rights... 16 Assistance with Your Questions... 17 Glossary... 18 4
Eligibility Who is Eligible You are eligible to participate in the Plan provided that you are a non-union Full-Time staff employee in a group designated by the Company for inclusion in the Plan. For union employees the eligibility requirements are governed by the terms and conditions of their union s collective bargaining agreement with the Company. Dependent Eligibility You have the choice of covering eligible dependents under the Plan. Your eligible dependents are: Your spouse or Same Sex Domestic Partner who is less than age 65 and your dependent children. Either a spouse or a Same Sex Domestic Partner may be a Qualified Dependent under the Plan at any one time, but not both at the same time. Your Child(ren) less than 23 years old (a) Unmarried biological child(ren) (b) Legally adopted children (c) Foster children (d) Step Children (e) Domestic partner or any other unmarried child who depends on you for support and lives with you in a parent/child relationship When Your Coverage Begins If you are an eligible Employee, your coverage under the Plan begins automatically on your first day of Active Work for Basic Life and AD&D coverage. If you elect GUL or Dependent Term Life coverage the amount up to the guaranteed issued amount is effective on your first day of active work. Amounts over the guaranteed issue amount are effective on the date of approval. If you are not considered in Active Work on the date your coverage is scheduled to begin, your coverage does not begin until you return to Active Work. Cost of Coverage Basic Life and AD&D insurance are provided at no cost to you. GUL and Dependent Term Life insurance options require contributions for individual as well as for dependent coverage. These contributions represent the total cost of the coverage and are made by participants via payroll deduction. The amount you are required to pay for the cost of your coverage is determined by several factors: Your annual base salary (or benefit base pay amount) The option you select (e.g., GUL, Dependent Term Life) The amount of coverage you choose Your tobacco use status (for GUL only) Employee contribution amounts may change from year to year, based on changes in the group rates. When you first become eligible for coverage, you will be advised of the contributions required for each of the Plan options. If you are in a collective bargaining unit, the cost of your coverage is pursuant to the bargaining agreement between your union and the Company. Tax Consequences Although basic term life insurance coverage is provided at no cost to you, the IRS requires that the Company tax you on the value of any Company-paid coverage amount over $50,000. The taxable amount will appear on your paycheck and W-2 form. Your premiums for GUL coverage, as well as your Cash Accumulation Account contributions (if elected), will be deducted from your paychecks on an after-tax basis. 5
Enrolling in the Plan You are automatically enrolled in the Basic Life and AD&D coverage. If you are an eligible Employee, at the time your employment begins, you will be provided with information about the Plan s GUL coverage choices so that you may select the option and level of coverage you prefer. Because you are eligible for Plan coverage beginning on the first day of your full-time staff employment, you have 31 days following the date your employment begins to select your GUL option and level of coverage. If you enroll in the Plan within these initial 31 days, your coverage is effective retroactive to the date your employment began. As a new hire, if you elect to enroll in GUL within 31 days from your date of hire you will be able to select up to two times your annual base/benefits pay, and you may select up to $30,000 for your spouse or Same Sex Domestic Partner coverage without providing proof of good health. Elections for this optional benefit may be made at any time throughout the year by contacting the CBS & YOU Benefits Center at 1-800-581-4222. Generally, you may need to provide proof of good health, satisfactory to Prudential, when you enroll or increase the amounts of coverage. If you experience an eligible change in circumstance, you may change your coverage within 31 days without proof of good health, up to certain limits. Adding a Dependent and/or Increasing Coverage as the Result of a Qualified Change in Circumstance If you experience a Life Event that results in your acquiring a new dependent, you are permitted to enroll your new dependent for Plan coverage within 31 days of the date you acquire the new dependent, without showing proof of good health. You are also permitted to increase your GUL coverage up to one times your Benefits Base (not to exceed Plan maximums) without showing proof of good health. If you request a higher face amount of insurance within 31 days of a Life Event, you may increase your face amount of insurance by one times pay without giving Evidence of Insurability. Under the Plan, the following events are considered qualified changes in circumstance that would permit an employee to enroll a dependent within 31 days of the event: Change in marital status; The death of a child; The birth or adoption of a child; The purchase of a home. Changing Coverage You are permitted to decrease or cancel your GUL (including spousal and dependent GUL) coverage at any time throughout the year. The change will become effective on the first day of the month following the date of your request submitted in a format acceptable to Prudential. You are also permitted to apply to increase your coverage at any time; however, you will be required to show proof of good health unless you have a Change in Circumstance. Special exceptions apply to the Evidence of Insurability rules for a Change in Circumstance. Designation of Beneficiary Your beneficiary, for the purpose of the Plan, may be any person or persons, your estate or almost any organization you wish. You should make your beneficiary designation carefully since Plan benefits may be a significant part of your personal estate. You may elect or change your beneficiary at any time as long as an assignment of ownership has not been made. To name a beneficiary or update your current beneficiary designation, you should visit the CBS & YOU Portal at www.cbsandyou.com. You are automatically the beneficiary of any life or accident insurance you elect for your spouse, Same-Sex Domestic Partner, or children. If you die without a designated beneficiary or if your beneficiary dies before you and you do not name someone else the insurance company may pay all or part of your insurance benefits to your survivors in the following order: Your surviving spouse, or if none; Your surviving children equally, or if none; Your surviving parents equally, or if none; Your surviving brothers and sisters equally, or if none; Your estate 6
Your Plan Options Basic Term Life Insurance: Basic Life pays a benefit to your beneficiary when you die, whatever the cause of your death. The Company pays the full cost of the Basic Life premium for eligible Employees. You will automatically be enrolled for Basic Life coverage equal to one times your annual Benefits Base pay up to a $3 million maximum. Accidental Death & Dismemberment: AD&D insurance pays a benefit to your beneficiary should you die as the result of a covered accident or from an injury resulting from a covered accident, or pays you in case of accidental dismemberment. The Company pays the full cost of this coverage for eligible Employees. You will automatically be enrolled in the AD&D insurance coverage equal to one times your annual Benefits Base pay up to a $3 million maximum. Optional Employee & Spouse Group Universal Life: The GUL provides you with the option of purchasing additional life insurance protection at group insurance rates. You and your spouse or Same-Sex Domestic Partner* may elect to purchase the following: Employee GUL coverage : Up to 8 times Benefits Base pay (up to a maximum of $5 million) Spouse or Same Sex Domestic Partner* coverage : $10,000 increments (up to $250,000 maximum) * Same Sex Domestic Partners may not be eligible in all states. Cash Accumulation Account Fund (Fund) Provided that you are enrolled in the GUL benefit, you may also elect to contribute to a Cash Accumulation Account Fund (the Fund ). This account allows you to purchase life insurance protection for yourself while still earning competitive interest rates on your fund contributions. A minimal charge to cover taxes attributable to premiums will be deducted from your fund contributions. Your spouse or Same Sex Domestic Partner may also contribute to the Fund once he or she is enrolled for GUL coverage. At any time the amount of your Fund, or your Fund for your spouse or Same Sex Domestic Partner, is the net amount of: (1) your contributions under GUL coverage, including any of the additional provisions that may be a part of the GUL coverage, received by Prudential; plus (2) interest; minus (3) Monthly Deductions; minus (4) any fund charges, including fees for withdrawals or loans; minus (5) any amounts which have been withdrawn. Interest determined by Prudential at a rate not less than 4% per year will be credited on a person's fund. Prudential will credit interest on the person's Fund from the date Prudential receives the contribution. Withdrawals You may withdraw all or part of your Fund, or your Fund for your spouse or Same Sex Domestic Partner, upon written request, subject to a fee set by Prudential. The fee will not exceed $20. However, you may not withdraw that part of the Fund equal to the balance of any loan on the Fund and the interest charged to it. If only part of a Fund is withdrawn, the amount withdrawn must be at least $200. Prudential may defer a withdrawal for not more than six months. 7
Loans You may borrow that part of your Fund, or the Fund of your spouse or Same Sex Domestic Partner, equal to (1) minus (2): (1) 90% of the amount of your fund, or your Fund for your spouse or Same Sex Domestic Partner. (2) one Monthly Deduction. The loan amount may not be less than $200. Each loan is subject to a fee set by Prudential. The fee will not exceed $20. Prudential may defer a loan for not more than six months. You may take only one loan per calendar year from each Fund and can have only one loan in effect at any time from each Fund. Interest on a loan balance will be charged daily at a yearly rate not to exceed 2% plus the rate that interest is credited to the Fund. Interest is due: on each anniversary of the Included Employer s inclusion date; when the loan or part of it is paid back; and when the loan becomes due and payable. Interest not paid when due is added to the loan balance. A loan and the interest charged to it will be due and payable from a person's Fund: (3) when all of the person s face amount of insurance under the GUL coverage ends; or (4) when the person dies; or (5) any time the loan balance plus interest charged to it equals the amount of the person's Fund. When the amount credited to a person s Fund is reduced to zero because the loan balance plus interest equals the amount of a person's Fund, the person's GUL coverage, including any of the additional provisions that may be a part of the GUL coverage, will continue until the date on which Prudential would make the next Monthly Deduction. If, on that date, the amount credited to a person's Fund is less than the amount required for that Monthly Deduction, the person s GUL coverage, including any of the additional provisions that may be a part of the GUL coverage, is in default, and a grace period will begin. You may pay back all or part of a loan at any time. At your request, a loan may be cancelled, or reduced by no less than $200, by deducting the amount needed from the Fund from which it was borrowed. The balance and interest for any loan due at a person's death will be deducted from the death benefit to be paid. Will Preparation Services Any employee who participates in the GUL program also has access to will preparation services through ComPsych Corporation. ComPsych offers the ease and simplicity of online legal document preparation right on your personal computer. If you participate in the GUL program, you will have the ability to create a simple will online at no cost. Additionally, other legal documents, such as living trusts, prenuptial agreements, legal name changes, and divorce agreements, may also be created online at a discounted purchase price. Age Adjustment Because a covered person s age is used to determine your contributions for the GUL coverage, including any of the additional provisions that may be a part of that coverage, and the age used is found to be in error, Prudential will adjust the amount of any death benefit payable. The death benefit will be increased or decreased to reflect the benefit that the contributions you made would have provided at the correct age. Refer to the Group Insurance Certificate for more information. 8
Option to Accelerate Certain Death Benefits Under Universal Life Coverage For You and Your Dependent Spouse or Same Sex Domestic Partner These provisions change the GUL coverage to provide an option to accelerate payment of portions of your or your dependent spouse s or Same Sex Domestic Partner s face amount of insurance and fund parts of the death benefit. You should know that election of this option may affect other benefits or entitlements for which a person may be eligible. It may also affect a person s income tax liability. Read this information carefully: (1) If you elect this option, the amount of GUL coverage for the person is reduced by the Terminal Illness Proceeds described below. (2) Any payment made under this option may be taxable. You are advised to seek the help of a professional tax advisor for assistance with any questions that you may have. (3) If you elect this option, eligibility for Medicaid or other government programs may be affected. As used here: Face Amount" means a person s face amount of insurance under the GUL coverage on the day Prudential receives proof that the person is Terminally Ill. Fund Amount" means the amount of a person s fund part of the GUL coverage on the day Prudential receives proof that the person is Terminally Ill. Terminally Ill" means having a life expectancy that is 12 months or less. Terminal Illness Proceeds" mean the amount of the Universal Life Death Benefit placed under this option for a person. The Terminal Illness Proceeds are equal to: - a portion of a person s Face Amount, as determined under (1) below; plus - a portion of a person s Fund Amount, as determined under (2) below. (1) You must elect the portion of a person s Face Amount that you want to place under this option. You may elect up to 50% of the person s Face Amount. However, such portion may be reduced if, within 12 months after the date Prudential receives proof that a person is Terminally Ill, an Amount Limitation would have applied to the person s Face Amount. In that case, the portion of the person s Face Amount placed under this option will not exceed the person s Face Amount after applying the Limitation. Based on your election and any Amount Limitation that may apply, Prudential will determine the Accelerated Payment Factor. The Accelerated Payment Factor is equal to: a) the portion of a person s Face Amount that is placed under this option; over b) the person s total Face Amount. (2) The portion of a person s Fund Amount that will be placed under this option is equal to: a) the person s total Fund Amount times the Accelerated Payment Factor; minus b) any outstanding loan balance, plus any interest due on the loan, times the Accelerated Payment Factor. Changes Made in the Coverage: If a person is Terminally Ill while a Covered Person under the GUL coverage or while death benefit protection is being extended for the person under the coverage, you may elect to have the person s Terminal Illness Proceeds placed under this option. That election is subject to the Conditions" set forth below. The face amount of insurance and fund parts under the GUL coverage are affected as described in the Effect on Coverage" section. Contributions are affected as described in the Effect on Contributions" section. 9
Conditions: Your right to be paid under this option is subject to these terms: (1) You may elect this option for a person only once during the time the person is a Covered Person. (2) You must choose this option in writing in a form that satisfies Prudential. (3) You must furnish proof that satisfies Prudential that the person s life expectancy is 12 months or less, including a certification by a Doctor. (4) The Universal Life Coverage on the person must not be assigned. (5) Terminal Illness Proceeds will be made available to you on a voluntary basis only. Therefore, you are not eligible for this option if: a) law requires using this option to meet the claims of creditors, whether in bankruptcy or otherwise; or b) a government agency requires using this option in order to apply for, get or keep a government benefit or entitlement. (6) Once you elect this option for a person, you may no longer: a) increase the person s face amount of insurance under the GUL coverage; b) make a lump sum contribution to the fund for the person, except for the required Monthly Deduction; or c) increase the amount of contributions to the fund for the person, except to the extent an increase is needed to reflect an increase in the Monthly Deduction. Effect on Coverage: When you elect this option, the total amount of GUL coverage otherwise payable on a person s death, including any amount under an extended death benefit, will be reduced by the Terminal Illness Proceeds. Also, any amount a person could otherwise have converted to an individual contract will be reduced by the Terminal Illness Proceeds. Prudential reserves the right to make a distribution from a person s Fund Amount when benefits under this option are paid. Any such distribution will be made only to the extent needed to continue to qualify the GUL coverage as life insurance under the Internal Revenue Code. Effect on Contributions: The amount of your contribution for a person will be adjusted based on the amount of the person s GUL coverage remaining in force. Method of Payment: If you elect this option, Prudential will pay the Terminal Illness Proceeds to you in one sum when it receives proof that a person is Terminally Ill. When Prudential pays an accelerated death benefit under this option, Prudential will send you a statement that shows the effect of the payment on the person s amount of GUL coverage and on your contribution for the person s GUL coverage. Optional Dependent Child Term Life You are able to purchase group term life insurance protection for your unmarried dependent children. Your dependent children are eligible for this coverage up to age 23, provided they are not working on a full-time basis. The age 23 limit does not apply to a child who: (a) is considered mentally or physically incapable of earning a living. Prudential must receive proof of this within the next 31 days; and (b) otherwise meets the definition of a qualified dependent. You may purchase dependent coverage in the following increments: $1,000, $2,000, $4,000, $10,000, and $20,000. Each eligible dependent is insured for the coverage amount you elect. Once you no longer have any dependents who meet the eligibility requirements, you must call the CBS & YOU Benefits Center at Mercer to cancel your coverage. Dependent child term life insurance is not subject to any Evidence of Insurability requirements. You may enroll in this benefit at any time. All inquiries regarding the dependent child term life insurance program should be directed to Mercer via the CBS & YOU Benefits Center at 1-800-581-4222. Termination of Coverage Basic Term Life Insurance Under the Plan, the term life insurance you had as an Employee will remain in force until the thirty-first day after you cease to be insured for the Basic Life; and the fifteenth day after you have been given written notice of the conversion privilege. In no event may you convert the insurance to an individual contract if you do not apply for the contract and pay the first premium prior to the ninety-second day after you cease to be insured for the Employee 10
Basic Life. To be eligible for a conversion policy, you must make an application to Prudential within this 31-day conversion period and pay the first premium. You may obtain information on your conversion rights by calling Prudential at 1-800-562-9874. Basic Accidental Death and Dismemberment Insurance All AD&D insurance ends on your termination date. There is no conversion available for AD&D insurance coverage. Group Universal Life (GUL) & Spousal GUL Insurance If you are enrolled for GUL coverage for yourself only or for yourself and your spouse or Same Sex Domestic Partner under the Plan, when you leave the Company, you may take you r GUL coverage with you by converting it to an individual life insurance contract and arranging for a direct billing relationship with Prudential. You will automatically receive information from Prudential concerning your GUL direct billing option approximately 4 weeks following your off-payroll date. If you have any questions about this coverage, contact Prudential at 1-800- 562-9874. Optional Dependent Child Term Life Insurance If you elected to cover your dependent children under the Plan, this coverage ends on your termination date. You may elect to convert your dependent life insurance coverage to an individual policy with Prudential. To do so, you must contact Prudential within 31 days of your termination date to request the appropriate paperwork to convert the insurance. The individual contract must be applied for and the first premium must be paid by the later of: (1) the thirty-first day after you cease to be insured for Dependent Term Life Coverage with respect to the dependent child; and (2) the fifteenth day after you have been given written notice of the conversion privilege. In no event may the insurance be converted to an individual contract if it is not applied for and the first premium paid prior to the ninetysecond day after you cease to be insured for Dependents Term Life Coverage with respect to the dependent child Coverage During a Leave of Absence Medical Leave of Absence: Your Plan coverage continues in effect for the entire duration of a Company-approved medical leave of absence at no cost to you. Family and Medical Leave Act (FMLA): While on FMLA leave of absence your Plan coverage continues for up to 12 weeks at no cost to you. This 12-week period refers to the leave of absence duration provided under federal law (FMLA). If you are eligible for a longer family leave period in accordance with a state law where you reside or work, your GUL coverage continues during the statutory period at no cost to you. Personal Leave of Absence: You can continue your GUL coverage for the duration of your Company-approved personal leave of absence by paying the applicable group premium to the insurance carrier on a monthly basis. Coverage During Disability CBS Basic Life Coverage: The amount of Basic Life insurance coverage in effect on your last day of Active Work will be continued until age 65, or until you are no longer disabled under the terms of the CBS Long Term Disability Plan ( LTD Plan ) as determined by Unum, whichever occurs first. CBS currently pays the full cost of continuing your Basic Life insurance coverage during your disability. If you are already age 65 at the time your CBS Short-Term Disability Plan ( STD Plan ) benefits end, your Basic Life insurance will end at the time your STD Plan benefit payments cease. You have 31 days following the date your coverage ends i.e., the date your STD Plan benefits end, your 65th birthday, or the date your LTD Plan benefits terminate, whichever is earliest - to convert your Basic Life insurance coverage to an individual policy with Prudential without having to provide evidence of your insurability. If you are interested in applying for a conversion policy at that time, contact Prudential at 1-800-562-9874. Basic Accidental Death and Dismemberment Coverage (AD&D): Your AD&D coverage ends at the time you go off-payroll when your STD Plan benefits end. There is no provision for continuing your AD&D coverage beyond this date. 11
GUL Coverage & Spousal GUL Insurance: If you are enrolled for optional life insurance for yourself only or for yourself and your spouse or Same Sex Domestic Partner under the Plan, this insurance is converted to an individual life insurance contract. When your payroll deductions stop (i.e., when your STD Plan benefits end and you go off-payroll), you may transfer your GUL coverage to a direct-billing relationship with Prudential. You should automatically receive information from Prudential concerning your GUL direct-billing option approximately 4 weeks following your last paycheck from CBS. If you have any questions about this coverage, or if you do not receive your direct-billing information on a timely basis, you should contact Prudential at 1-800-562-9874. Optional Dependent Child Term Life Insurance: If you elected to cover your dependent children under the Company s Dependent Life Insurance program, this coverage will end when you go off-payroll at the time your STD Plan benefits end. However, you may elect to convert your dependent life coverage to an individual policy without having to provide proof of your dependents good health. To do so, you must contact Prudential at 1-800-562-9874 within 31 days of your off-payroll date to request the appropriate paperwork to convert the insurance. Filing a Life Insurance Claim You or your family must notify the CBS & YOU Benefits Center at 1-800-581-4222 to begin processing a life insurance claim. Prudential will only mail a package to the designated beneficiary(ies). It is very important to keep your beneficiary designations current. Administrative Information This section is provided in accordance with disclosure requirements of the Employee Retirement Income Security Act of 1974 ( ERISA ). It contains a description of your rights under ERISA. The Company reserves the right to change or amend the Plan, and any feature of the Plan, at any time for any reason. In addition, the Company s benefit plans are not intended in any way to create a contract or guarantee of employment. Plan Name: CBS Group Life Insurance Plan component of the CBS Health and Welfare Benefits Plan Plan Number: 502 Type of Plan: Group Term Life Insurance and Group Universal Life Insurance Plan Sponsor: CBS Corporation Employer Identification Number: 04-2949533 Plan Administrator: The Retirement Committee of CBS Corporation 51 West 52 nd Street New York, NY 10019 Phone: 212-975-3324 Plan Year Ends: December 31 st Plan Benefits Provided by: The Prudential Insurance Company of America 751 Broad Street Newark, New Jersey 07102 12
Plan Benefits Provided by The Prudential Insurance Company of America, 751 Broad Street, Newark, New Jersey 07102 The Prudential Insurance Company of America provides insured benefits under your Plan. For all purposes of the Plan, the Company acts on its own behalf or as an agent of its employees. Under no circumstances will the Company be deemed the agent of The Prudential Insurance Company of America, absent a written authorization of such status executed between the Company and The Prudential Insurance Company of America. Nothing in these documents shall, of themselves, be deemed to be such written execution. The Prudential Insurance Company of America as Claims Administrator has the sole discretion to interpret the terms of the Plan, to make factual findings, and to determine eligibility for benefits. The decision of the Claims Administrator shall not be overturned unless arbitrary and capricious. Collective Bargaining The benefits provided by the Plan provided for certain union employees are provided pursuant to applicable union bargaining agreements. Copies of agreements covering union employees are available from the bargaining agent or from the Plan Administrator. The Plan Administrator may charge for copying costs. A complete list of unions eligible to participate in the Plan is available from the Plan Administrator. Titles or Headings Where titles or headings precede explanatory text throughout this document, such titles or headings are intended for reference only. They are not intended and will not be construed to be a substantive part of the document and will not affect the validity, construction or effect of the Plan s provisions. Clerical Error If a clerical error or other mistake occurs, that error does not create a right to benefits. These errors include, but are not limited to, providing misinformation on eligibility or benefit coverage or entitlements. It is your responsibility to confirm the accuracy of statements made by the Plan Sponsor, the Plan Administrator or our designees, including the Claims Administrator, in accordance with the terms of this document. Illegality of a Particular Provision The illegality of any particular provision of this document will not affect the other provisions, but this booklet will be construed in all respects as if such invalid provision were omitted. Amendment and Termination The Plan Sponsor reserves the right in its sole discretion, as permitted by law, without the approval of Participants or their enrolled dependents and at any time or from time to time to change, interpret or modify the Plan and to withdraw or add benefits to the Plan. The Plan Administrator reserves the right to remove or change any insurance company, service Provider, claims processor, or third party administrator at any time and from time to time. The Plan Administrator also reserves the right to terminate any part of or all of the Plan, including any benefit component and/or insurance contract providing benefits under the Plan, or may terminate any contract with an insurance company, service Provider, claims processor, or third party administrator at any time or from time to time. Any provision of the Plan which is in conflict with the requirements of federal statutes or regulations is hereby amended to conform to the minimum requirements of such statutes and regulations. Any change or amendment to or termination of the Plan, its benefits or its terms and conditions, in whole or in part, shall be made solely in a written amendment (in the case of a change or amendment) or in a written resolution (in the case of a termination), whether prospective or retroactive, to the Plan, in accordance with the procedures established by the Plan 13
Administrator. Participants will receive notice of any material modification to the Plan within the prescribed timeframe under ERISA. No one has the authority to make any oral modification to the Plan. The Plan Administrator may, in certain circumstances for purposes of overall cost savings or efficiency and in its sole discretion, provide coverage for services, which would otherwise not be covered. The fact that the Plan Administrator does so in any particular case shall not in any way be deemed to require it to do so in other similar cases. Future of the Plan Benefits under the Plan and its components are paid for on a year-to-year basis. CBS reserves the right to amend, modify, or terminate the Plan at any time. CBS s decision to amend, modify, or terminate the Plan may be due to changes in federal or state laws governing welfare benefits, the requirements of the Internal Revenue Code or ERISA or any other reason. The Plan administrator may amend, modify or terminate this Plan in writing. If CBS decides to amend, modify, or terminate the Plan, it may, at its discretion, decide to set up a different plan or plans. If a Plan amendment results in a material reduction in covered services or benefits, the Plan Administrator will provide notice within 60 days of the adoption of the amendment. If the Plan is terminated, any benefits then due and payable will be determined by the provisions of the master contracts. The benefits under this Plan are not vested. Claim Procedures 1. Determination of Benefits Prudential shall notify you of the claim determination within 45 days of the receipt of your claim. This period may be extended by 30 days if such an extension is necessary due to matters beyond the control of the plan. A written notice of the extension, the reason for the extension and the date by which the plan expects to decide your claim, shall be furnished to you within the initial 45-day period. This period may be extended for an additional 30 days beyond the original 30-day extension if necessary due to matters beyond the control of the plan. A written notice of the additional extension, the reason for the additional extension and the date by which the plan expects to decide on your claim, shall be furnished to you within the first 30-day extension period if an additional extension of time is needed. However, if a period of time is extended due to your failure to submit information necessary to decide the claim, the period for making the benefit determination by Prudential will be tolled (i.e., suspended) from the date on which the notification of the extension is sent to you until the date on which you respond to the request for additional information. If your claim for benefits is denied, in whole or in part, you or your authorized representative will receive a written notice from Prudential of your denial. The notice will be written in a manner calculated to be understood by you and shall include: (a) (b) (c) (d) the specific reason(s) for the denial, references to the specific plan provisions on which the benefit determination was based, a description of any additional material or information necessary for you to perfect a claim and an explanation of why such information is necessary, a description of Prudential s appeals procedures and applicable time limits, including a statement of your right to bring a civil action under section 502(a) of ERISA following your appeals, and (e) if an adverse benefit determination is based on a medical necessity or experimental treatment or similar exclusion or limit, an explanation of the scientific or clinical judgment for the determination will be provided free of charge upon request. 14
2. Appeals of Adverse Determination If your claim for benefits is denied or if you do not receive a response to your claim within the appropriate time frame (in which case the claim for benefits is deemed to have been denied), you or your representative may appeal your denied claim in writing to Prudential within 180 days of the receipt of the written notice of denial or 180 days from the date such claim is deemed denied. You may submit with your appeal any written comments, documents, records and any other information relating to your claim. Upon your request, you will also have access to, and the right to obtain copies of, all documents, records and information relevant to your claim free of charge. A full review of the information in the claim file and any new information submitted to support the appeal will be conducted by Prudential, utilizing individuals not involved in the initial benefit determination. This review will not afford any deference to the initial benefit determination. Prudential shall make a determination on your claim appeal within 45 days of the receipt of your appeal request. This period may be extended by up to an additional 45 days if Prudential determines that special circumstances require an extension of time. A written notice of the extension, the reason for the extension and the date that Prudential expects to render a decision shall be furnished to you within the initial 45-day period. However, if the period of time is extended due to your failure to submit information necessary to decide the appeal, the period for making the benefit determination will be tolled (i.e., suspended) from the date on which the notification of the extension is sent to you until the date on which you respond to the request for additional information. If the claim on appeal is denied in whole or in part, you will receive a written notification from Prudential of the denial. The notice will be written in a manner calculated to be understood by the applicant and shall include: (a) (b) (c) (d) (e) (f) the specific reason(s) for the adverse determination, references to the specific plan provisions on which the determination was based, a statement that you are entitled to receive upon request and free of charge reasonable access to, and make copies of, all records, documents and other information relevant to your benefit claim upon request, a description of Prudential s review procedures and applicable time limits, a statement that you have the right to obtain upon request and free of charge, a copy of internal rules or guidelines relied upon in making this determination, and a statement describing any appeals procedures offered by the plan, and your right to bring a civil suit under ERISA. If a decision on appeal is not furnished to you within the time frames mentioned above, the claim shall be deemed denied on appeal. If the appeal of your benefit claim is denied or if you do not receive a response to your appeal within the appropriate time frame (in which case the appeal is deemed to have been denied), you or your representative may make a second, voluntary appeal of your denial in writing to Prudential within 180 days of the receipt of the written notice of denial or 180 days from the date such claim is deemed denied. You may submit with your second appeal any written comments, documents, records and any other information relating to your claim. Upon your request, you will also have access to, and the right to obtain copies of, all documents, records and information relevant to your claim free of charge. Prudential shall make a determination on your second claim appeal within 45 days of the receipt of your appeal request. This period may be extended by up to an additional 45 days if Prudential determines that special circumstances require an extension of time. A written notice of the extension, the reason for the extension and the date by which Prudential expects to render a decision shall be furnished to you within the initial 45-day period. However, if the period of time is extended due to your failure to submit information necessary to decide the appeal, the period for making the benefit determination will be tolled from the date on which the notification of the extension is sent to you until the date on which you respond to the request for additional information. 15
Your decision to submit a benefit dispute to this voluntary second level of appeal has no effect on your right to any other benefits under this plan. If you elect to initiate a lawsuit without submitting to a second level of appeal, the plan waives any right to assert that you failed to exhaust administrative remedies. If you elect to submit the dispute to the second level of appeal, the plan agrees that any statute of limitations or other defense based on timeliness is tolled during the time that the appeal is pending. If the claim on appeal is denied in whole or in part for a second time, you will receive a written notification from Prudential of the denial. The notice will be written in a manner calculated to be understood by the applicant and shall include the same information that was included in the first adverse determination letter. If a decision on appeal is not furnished to you within the time frames mentioned above, the claim shall be deemed denied on appeal. Rights and Protections As a participant in this plan, you are entitled to certain rights and protections under the Employee Retirement Income Security Act of 1974 (ERISA), as amended. ERISA provides that all plan participants shall be entitled to: Receive Information about Your Plan and Benefits Examine, without charge, at the plan administrator s office and at other specified locations, such as worksites and union halls, all documents governing the plan, including insurance contracts and collective bargaining agreements, 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 Employee Benefits Security Administration. Obtain, upon written request to the plan administrator, copies of documents governing the operation of the plan, including insurance contracts and collective bargaining agreements, and copies of the latest annual report (Form 5500 Series) and updated summary plan description. The plan administrator may make a reasonable charge for the copies. 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 upon the people who are responsible for the operation of the employee benefit 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. 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 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. 16
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 Employee Benefits Security Administration, U.S. Department of Labor, listed in your telephone directory or the Division of Technical Assistance and Inquiries, Employee Benefits Security Administration, U.S. Department of Labor, 200 Constitution Avenue N.W., Washington, DC 20210. You may also obtain certain publications about your rights and responsibilities under ERISA by calling the publications hotline of the Employee Benefits Security Administration. 17
GLOSSARY Active Work/Active Work Requirement: A requirement that you be actively at work on a full-time basis at the Employer's place of business, or at any other place that the Employer's business requires you to go. You are considered actively at work during normal vacation if you were actively at work on your last regular scheduled workday. Benefits Base: Salaried employees Account Executives who earn salary and commissions Commission-only Account Executives Staff Talent employees on contract (union and nonunion) Current Base salary Base salary in Company records on your date of hire, plus projected commissions for the year Projected commissions for the year Current Benefits Base salary Claims Administrator: The Prudential Insurance Company of America Contract Year: A period of one year measured from the Contract Date and from each successive Contract Anniversary. Coverage: A part of the Certificate and/or Booklet consisting of: (1) A benefit page labeled as a Coverage in its title. (2) Any page or pages that continue the same kind of benefits. (3) A Schedule of Benefits entry and other benefit pages or forms that by their terms apply to that kind of benefits. Covered Person: Under the Universal Life Coverage, including any of the additional provisions that may be a part of the Universal Life Coverage. An Employee who is insured for Employee Insurance under that Coverage and a Qualified Dependent for whom an Employee is insured for Dependents Insurance under that Coverage. Covered Person under the Coverage: An Employee who is insured for Employee Insurance under that Coverage. Doctor: A licensed practitioner of the healing arts acting within the scope of the license. Dependents Insurance: Insurance on the person of a dependent. Earnings: For Employees classified as Sales Employees - This is your Base Salary and the annualized average commissions earned during the shorter of: (i) the 12 month period just prior to your date of loss; or (ii) your period of employment. Bonuses, overtime pay, Earnings for more than 40 hours per week, and all other benefits are not included. For Employees classified as Talent Employees - This is your Benefit Base Salary. For all other Employees - This is your Base Salary. Bonuses, overtime pay, Earnings for more than 40 hours per week, and all other benefits are not included. Employee: A person employed by the Employer; a proprietor or partner of the Employer. The term also applies to that person for any rights after insurance ends. Employee Insurance: Insurance on the person of an Employee. Employer: Collectively, all employers included under the Group Contract. 18
Full-Time: You are full-time if you are regularly working for the Employer at least the number of hours in the Employer's normal full-time work week for your class, but not less than 30 hours per week. If you are a partner or proprietor of the Employer, that work must be in the conduct of the Employer's business. Included Employer: An Employer who: (1) has made a written request to Prudential to be included under the Group Contract; and (2) has agreed to make required payments to the Contract Holder for the insurance; and (3) has been approved by Prudential for inclusion under the Group Contract. Injury: Injury to the body of a Covered Person. Life Event: Any of the following which constitute a change in family status: (1) Change in marital status or Same Sex Domentic Partnership status; (2) the birth or adoption of a child; (3) the death of a child; (4) the purchase of a home. Monthly Deduction: Each month, Prudential will make a Monthly Deduction from a person's fund. A Monthly Deduction is equal to the sum of (1), (2) and (3) below: (1) The amount required to provide the person's face amount of insurance part of the Universal Life Coverage. But, if the amount of a person's death benefit under Section A above is not determined as the sum of the face amount of insurance plus fund, this item (1) is the amount required to provide the portion of the person's death benefit equal to the total death benefit minus the fund. In no event will this amount be higher than 150% of the applicable amount under the 1980 Commissioners Standard Ordinary Mortality Table (Male, age last birthday). (2) The amount required to provide any of the additional provisions that may be a part of the Universal Life Coverage. (3) The monthly administration fee as set by Prudential from time to time, but not more than $6.00. Prudential: The Prudential Insurance Company of America. Same Sex Domestic Partner: Your Same Sex Domestic Partner is a person who: (1) You report in an affidavit of domestic partnership satisfactory to the Contract Holder; and (2) Resides with you; and (3) Has an intimate and committed relationship with you; and (4) Shares the mutual obligation of support for the basic necessities of life, but is prevented from forming a legal marriage with you; and (5) Is not otherwise a Qualified Dependent under the Program You: An Employee. 19
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