Business Travel Accident Plan



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Transcription:

Business Travel Accident Plan SUMMARY PLAN DESCRIPTION Effective March 1, 2015 Business Travel Accident Plan Summary Plan Description Effective March 1, 2015 1 of 18

Table of Contents Table of Contents... 2 Introduction... 3 Important Contact Information... 4 Important Definitions... 5 Participation... 6 Eligibility... 6 Effective Date... 6 Contributions... 6 Schedule of Coverage... 7 Accidental Death Benefit... 7 Dismemberment and Paralysis Benefit... 7 Severe Burn Benefit... 9 Age Reduction... 9 Permanent and Total Disability... 9 Other Covered Benefits... 10 Your Beneficiary... 11 Limitations and Exclusions... 12 Limitations... 12 Exclusions... 12 Claim Information... 13 Filing a Claim for Benefits... 13 Time for Decision on A Claim... 13 Notification of Denial... 13 Right to Review... 13 Time for Decision on Review... 14 Notification of Determination on Review... 14 When Coverage Terminates... 15 Administrative Information... 16 Your Rights under This Plan... 18 Business Travel Accident Plan Summary Plan Description Effective March 1, 2015 2 of 18

Introduction Many Associates travel at one time or another for their jobs. CarMax provides a Business Travel Accident Insurance Plan (the Plan ), that covers Associates while traveling on business for CarMax (the Company ). The Plan includes both death and dismemberment benefits along with related coverage. The Plan is a component program under the CarMax, Inc. Master Welfare Plan ( Master Welfare Plan ). This document is designed to be an easy-to-read information resource about the Plan. A number of the terms in this document have a special meaning and begin with a capital letter. These terms are defined throughout this document or in the Important Definitions section. You should read this document carefully, share it with your family, and keep it handy for easy reference. This Document and Other Plan Documents This document is the Summary Plan Description ( SPD ). It summarizes the terms of the Plan as of March 1, 2015. In addition to this SPD, the Plan is subject to the terms of the Master Welfare Plan and the terms of any underlying insurance contract through which Plan benefits are provided. If the terms of this SPD conflict with the terms of the Master Welfare Plan or any such insurance contract, the terms of the Master Welfare Plan or the insurance contract will prevail. You may obtain a copy of the Master Welfare Plan or the insurance policy at no charge by sending your written request to the Plan Administrator. Information about this Plan is located on the CarMax website, accessible on the CarMax World or at carmax.com/benefits. The Company reserves the right to revise or terminate the Plan, in whole or in part, at any time and without prior notice to you. The Company also may revise the Plan as necessary to comply with law. Business Travel Accident Plan Summary Plan Description Effective March 1, 2015 3 of 18

Important Contact Information To file a claim for benefits, please contact: CarMax Plan Administrator Attn: Risk Management 12800 Tuckahoe Creek Parkway Richmond, VA 23238 Tel: 1-804-747-0422, x4461 Fax: 1-804-935-4573 Business Travel Accident Plan Summary Plan Description Effective March 1, 2015 4 of 18

Important Definitions Business Travel Business Travel refers to travel occurring while on assignment or at the direction of the Company for the purpose of furthering the business of the Company. Business Travel begins when you leave your residence or place of regular employment for the purpose of going on an assigned business trip, whichever occurs last, and continues until you return to your residence or place of regular employment, whichever occurs first. Business Travel may include a Sojourn or Personal Deviation taken during the course of the trip provided it is within a radius of 250 miles of the covered Associate s destination(s). Coverage may include stops and/or extensions of time spent at the destination(s) provided they do not last longer than a total of 3 days or 25% of the time that would otherwise have been spent; whichever is less. Business Travel does not include the following: (1) travel between your residence and your place of regular employment; (2) periods while you are working at your regular place of employment; or (3) any period during which you are on an authorized leave of absence or vacation. Insured Person An Associate or Eligible Dependent who experiences an accident or event while insured under this Plan. Business Travel Accident Plan Summary Plan Description Effective March 1, 2015 5 of 18

Participation Eligibility Associate Eligibility All active full-time and part-time Associates of the Company. Dependent Eligibility The Plan also covers the Associate s spouse or Domestic Partner and eligible dependent children if: they are accompanying you or are on their way to join you on a covered business trip; and the trip is authorized by and/or paid for in whole or in part by the Company. To be covered under this Plan, dependent children must be unmarried, under age 19, or under age 23 if he/she is attending an accredited institution of higher learning on a full-time basis. Dependent children may include a natural child, step-child, foster child, or adopted child and must be primarily dependent on the Associate for support and maintenance. Please see the CarMax Domestic Partner Benefits Policy for the definition of Domestic Partner. Effective Date Eligible Associates are automatically enrolled in the Plan on their first day of active employment. Contributions The cost of this Plan is paid for entirely by the Company. Business Travel Accident Plan Summary Plan Description Effective March 1, 2015 6 of 18

Schedule of Coverage Accidental Death Benefit If an injury to an Insured Person results in death within 365 days of the date of the accident that caused the injury, the Plan will pay 100% of the Principal Sum. ASSOCIATES Principal Sum LEGAL SPOUSE or DOMESTIC PARTNER $50,000 EACH DEPENDENT CHILD $25,000 Seat Belt Benefit: ** Air Bag Benefit: *** Three (3) times Annual Earnings* Minimum Benefit: $250,000 Maximum Benefit: $750,000 The lesser of $25,000 or 10% of the insured person s Principal Sum The lesser of $25,000 or 10% of the insured person s Principal Sum * Annual Earnings: Please refer to the definitions below for the specifics on the category into which you fall. Your earnings definition will be based on your category on the effective date of the accident. Salaried Associates: Current Base Annual Salary Hourly Associates: Current Hourly Rate X 2080 Commissioned Associates: If you are covered under a pay plan which includes commissions, the commissions received in the 12 months immediately prior to the accident are included. (Commissions will be averaged and annualized for Associates employed for less than 12 months.) ** Seat Belt Benefit: This additional benefit is payable in the event of accidental death while the insured person is wearing a properly fastened, original, factory-installed seat belt. *** Air Bag Benefit: This additional benefit is payable in the event of accidental death while the insured person is positioned in a seat protected by a properly functioning, original, factory-installed supplemental restraint system that inflates on impact. Dismemberment and Paralysis Benefit If, within 365 days of the date of the accident that causes an injury, such injury to the Insured Person results in any one of the Losses specified below, the Plan will pay the percentage of the Principal Sum shown below for that Loss: Both Hands or Both Feet.. 100% Sight of Both Eyes 100% One Hand and One Foot 100% One Hand and the Sight of One Eye. 100% One Foot and the Sight of One Eye.. 100% Speech and the Hearing in Both Ears... 100% One Hand or One Foot.. 50% Sight of One Eye... 50% Speech or the Hearing in Both Ears 50% Thumb and Index Finger on Same Hand.. 25% Quadriplegia.. 100% Paraplegia.. 75% Hemiplegia. 50% Business Travel Accident Plan Summary Plan Description Effective March 1, 2015 7 of 18

Schedule of Coverage (cont.) Definitions of Loss Loss of a hand or foot means complete severance through or above the wrist or ankle joint. Loss of sight of an eye means total and irrecoverable loss of the entire sight in that eye. Loss of hearing in an ear means total and irrecoverable loss of the entire ability to hear in that ear. Loss of speech means total and irrecoverable loss of the entire ability to speak. Loss of thumb and index finger means complete severance through or above the metacarpophalangeal joint of both digits. Quadriplegia means the complete and irreversible paralysis of both upper and both lower limbs. Paraplegia means the complete and irreversible paralysis of both lower limbs. Hemiplegia means the complete and irreversible paralysis of the upper and lower limbs of the same side of the body. If more than one Loss is sustained as a result of the same accident, only one amount, the largest, will be paid. Home Alteration and Vehicle Modification Benefits If an Insured Person suffers an accidental dismemberment or paralysis as defined above, the plan will cover eligible home alteration and vehicle modification expenses that are incurred within one year after the date of the accident causing such Loss(es), up to a maximum of $25,000 for all such Losses caused by the same accident. Covered Rehabilitative Expense Benefits If an Insured Person suffers an accidental dismemberment or paralysis as defined above, the Plan will cover certain Covered Rehabilitative Expenses incurred due to that injury. The Covered Rehabilitative Expenses must be incurred within two years of the accident causing the injury, up to a maximum of $25,000 for all injuries caused by the same accident. Please contact the Plan Administrator for details on eligible expenses. Exposure and Disappearance If an Insured Person suffers a Loss as described above due to exposure to the elements, the Loss will be covered under the Plan. If the body of an Insured Person has not been found within one year of the disappearance of such person, then it shall be deemed that the Insured Person has suffered an accidental death under this Plan. On-Premises Violent Crime If an Insured Person suffers an injury as a result of a criminal act of violence on Company property, benefits may be payable under this Plan provided the criminal act is not committed by the Insured Person, an immediate family member, another employee of the Company, a former employee of the Company whose employment terminated less than 6 months prior to the incident, or an individual who resides with the Insured Person on a permanent basis. In addition, moving violations are not covered unless purposely directed at the Insured Person. Business Travel Accident Plan Summary Plan Description Effective March 1, 2015 8 of 18

Schedule of Coverage (cont.) Severe Burn Benefit If an Insured Person suffers an injury that is a Severe Burn (full thickness or third-degree burn), the following benefits are payable under the Plan: Specified Body Area Maximum % of Principal Sum* Face and Neck and Head 99% Hand and Forearm Below Elbow Joint (either arm) 22.5% Upper Arm below Shoulder Joint to Elbow Joint (either arm).. 13.5% Torso Below Neck to Shoulder Joints and Hip Joints (front or back) 36% Thigh Below Hip Joint to Knee Joint (either leg). 9% Foot and Lower Leg Below Knee Joint (either leg). 27% If less than 100% of the body surface listed above is severely burned, than the percentage of the benefit payable (as listed above) will be reduced at a corresponding percentage. If more than one of the Insured Person s specified body areas is severely burned as a result of the same accident, the benefit payable is the lesser of: (1) the sum of the benefit amounts calculated separately, according to the above rules, with respect to each such specified body area; or (2) 100% of the Principal Sum. Age Reduction Beginning at age 70, the Principal Sum (benefit) is subject to reduction according to the following schedule: Age on Date of Accident 70 74 65% 75 79 45% 80 84 30% 85 and older 15% Permanent and Total Disability Percentage of Benefit Otherwise Payable If, as the result of an Injury, an Insured Person becomes Permanently and Totally Disabled within 365 days of the accident that caused the Injury, the Plan will pay 100% of the Principal Sum at the end of 12 consecutive months of such Permanent and Total Disability. Permanent and Total Disability means that the Insured Person is permanently unable to perform the material and substantial duties of any occupation for which he or she is qualified by reason of education, experience or training. This provision is not applicable to Insured Persons Age 70 or older on the date of accident. Business Travel Accident Plan Summary Plan Description Effective March 1, 2015 9 of 18

Schedule of Coverage (cont.) Other Covered Benefits Bereavement and Trauma Counseling If an Insured Person suffers an injury or death covered under this Plan, the injured person or immediate family member(s) may be eligible for coverage of medically necessary bereavement and trauma counseling expenses provided services are incurred within one year of the date of accident, up to a maximum of $100 per session for up to 10 sessions. Coma Benefits If a covered injury renders an Insured Person comatose within 90 days of the date of the accident that caused the injury and if the coma continues for a period of 30 consecutive days, a monthly benefit of 1% of the Principal Sum will be paid. No benefit is provided for the first 30 days of the coma. Such payments will cease at the earliest of 1) the injured person ceasing to be in a coma due to the injury; 2) the date the Insured Person dies; or 3) the date the total amount of monthly coma benefits paid for all injuries caused by the same accident equals 100% of the Principal Sum. Emergency Evacuation If an Insured Person suffers an injury or emergency sickness that warrants his or her Emergency Evacuation while he or she is outside a 100 mile radius from his or her current place of primary residence, up to a maximum of $100,000 for all Emergency Evacuations due to all injuries from the same accident or sicknesses from the same or related cause will be covered by the Plan. All requests for Emergency Evacuation coverage must be coordinated through the CarMax Plan Administrator and the insurance company. Repatriation of Remains Benefit If an Insured Person suffers loss of life due to injury while outside a 100 mile radius from his or her current place of primary residence, the Plan will pay for covered expenses reasonably incurred to return his or her body to his or her current place of primary residence up to a maximum of $25,000. All requests for Repatriation of Remains coverage must be coordinated through the CarMax Plan Administrator and the insurance company. Business Travel Accident Plan Summary Plan Description Effective March 1, 2015 10 of 18

Your Beneficiary In case of your death, the benefit is payable to your designated beneficiary as described below. In case of other Loss, the benefit is payable to you. Your beneficiary for this Plan is (are) the named beneficiary(s) so named under the CarMax, Inc. Associate Life Insurance Plan, a component program under the Master Welfare Plan, if such beneficiary survives you. You may choose to make a specific beneficiary designation under this Plan by completing a beneficiary designation form for this Plan and filing the signed form with the Company. If no beneficiary is named or if no designated beneficiary survives you, benefits will be paid, in equal shares, to the first surviving class in the following order: Surviving spouse Surviving child(ren) Surviving parent(s) Surviving sister(s) and brother(s) Your estate Business Travel Accident Plan Summary Plan Description Effective March 1, 2015 11 of 18

Limitations and Exclusions Limitations If you suffer more than one Loss due to any one accident, payment will be made only for that Loss for which the greatest benefit is payable. Payment will be made for the specific Loss resulting from the accident without considering any previous Loss. Should more than one individual Insured Person under this Plan suffer Loss as a result of the same accident or event, no more than a total of $5,000,000 will be payable to all such persons covered by the Plan. In such case, the individual maximum amount otherwise payable for each Insured Person will be reduced by an equal reduction percentage so as to not exceed the applicable aggregate benefit limit. Exclusions There is no coverage under this Plan for a Loss caused by or resulting from the following: suicide or any attempt at suicide or intentionally self-inflicted injury or any attempt at intentionally selfinflicted injury. travel or flight in or on any vehicle used for aerial navigation unless specifically provided by the insurance policy (for example, business travel on commercial airlines is specifically covered under the insurance policy). declared or undeclared war, or any act of declared or undeclared war, unless specifically provided by the insurance policy. See War Risk, below, for additional information. sickness, disease, mental incapacity or bodily infirmity whether the Loss results directly or indirectly from any of these. infections of any kind regardless of how contracted, except bacterial infections that are directly caused by botulism, ptomaine poisoning or an accidental cut or wound independent and in the absence of any underlying sickness, disease or condition including but not limited to diabetes. full-time active duty in the armed forces, National Guard or organized reserve corps of any country or international authority, except that a Loss caused while on short-term National Guard or reserve duty for regularly scheduled training purposes is not excluded. being under the influence of intoxicants while operating any vehicles or means of transportation or conveyance. being under the influence of drugs unless taken under the advice of and as specified by a Physician. the commission of or attempt to commit a crime. the medical or surgical treatment of sickness, disease, mental incapacity or bodily infirmity whether the Loss results directly or indirectly from the treatment. stroke or cerebrovascular accident or event; cardiovascular accident or event; myocardial infarction or heart attack; coronary thrombosis; or aneurysm. War Risk The Plan excludes coverage for any Loss caused in whole or in part by, or resulting in whole or in part from declared or undeclared war, or any act of declared or undeclared war, unless specifically provided by the insurance policy. However, this exclusion is waived subject to the following restrictions: The waiver only applies with respect to accidents that occur within, or in the airspace above, the geographic limits or territorial waters of a Designated War Risk Territory. The waiver does not apply with respect to any part of a Principal Sum amount in excess of $750,000. Designated War Risk Territories means Worldwide. A Designated War Risk Territory does not include Afghanistan, Chechnya, Iran, Iraq, Israel, Pakistan, Somalia, the United States of America, or the Insured person s country of permanent residence. The terms and conditions of War Risk Coverage, including, but not limited to, the definition of the Designated War Risk Territories, may change at any time to reflect the conditions that, in the opinion of the insurance company, constitute a change in the war risk exposure. To the extent covered above, coverage is only applicable to Business Travel. Sojourn and Personal Deviation related travel are not eligible Business Travel for this provision of the Plan. Business Travel Accident Plan Summary Plan Description Effective March 1, 2015 12 of 18

Claim Information Filing a Claim for Benefits Written notice of claim must be given to the Company within 20 days after the covered Loss or accident occurs or as soon thereafter as reasonably possible. Written notice of claim should be sent to: CarMax, Inc. Attn: Risk Management Department 12800 Tuckahoe Creek Parkway Richmond, VA 23238 The Company will send claims forms to you within 15 days after receiving notice of the claim. Written proof of Loss must be furnished to the Company within 90 days after the date of the Loss. As the Plan Administrator, CarMax will file the claim with the Insurance Company. You may designate in writing, on a form provided by the Plan Administrator, an authorized representative to act on your behalf in pursuing your claim for benefits. Time for Decision on A Claim If you have submitted a claim for benefits and your claim is denied, in whole or in part, you will receive written notice of the denial within 90 days after receipt of your claim, or within 180 days after such receipt if special circumstances require an extension of time. If special circumstances require an extension of time, you will be furnished written notice prior to the end of the initial 90-day period. The notice of extension will explain the special circumstances requiring an extension of time and the date by which the Plan Administrator expects to render a decision. Notification of Denial The written notice of denial will contain the following: the specific reason or reasons for denial; a reference to specific provisions on which the denial is based; a description of any additional material or information necessary for the claimant to perfect the claim, and an explanation of why the material or information is necessary; and an explanation of the claims review procedure and the time limits applicable to such procedures, including a statement of your right to bring a civil action under ERISA Section 502(a) following a denial upon review of the claim. Right to Review Review may be requested at any time within 60 days following the date you received written notice of the denial. A failure to file a request for review within 60 days will constitute a waiver of your right to have the denial of your claim reviewed. Review Procedures Your petition for review should be made in writing to the Insurance Company at the address below and should state your name and address, the fact that you are disputing the denial of a claim, the date of the initial notice of denial, and the reason(s), in clear and concise terms, for disputing the denial. AIG Life Insurance Company 600 King Street Wilmington, DE 19801 Group Policy # GTP 9065285 During the review process, the Insurance Company will: provide, upon request and free of charge, reasonable access to and copies of all documents, records and other information relevant to the claim; Business Travel Accident Plan Summary Plan Description Effective March 1, 2015 13 of 18

Claim Information (cont.) permit you to submit written comments, documents, records and other information relating to the claim; and provide a review that takes into account all comments, documents, records and other information submitted by you, without regard to whether such information was submitted or considered in the initial determination. Time for Decision on Review Unless special circumstances require an extension of time for processing, you will be notified of the decision on review within 60 days after receipt of your written petition for review. If an extension is necessary due to special circumstances, you will be given a written notice of the required extension prior to the expiration of the initial 60-day period. The notice will indicate the circumstances requiring the extension and the date by which the Insurance Company expects to render a decision. The extension may be for up to 60 additional days. Notification of Determination on Review If your claim is denied upon review, the written notice will contain the following information: the specific reason for the decision and specific reference to the provisions of the Plan on which the decision is based; a statement that you are entitled to receive, upon request and free of charge, copies of all documents, records and other information relevant to the claim for benefits; and a statement explaining your right to bring a civil action under Section 502(a) of ERISA following the denial. In addition to the procedures described above for filing a claim for benefits under the Plan, certain special rules apply if you are filing a claim for a Plan benefit on account of your disability. If your claim relates to a disability benefit, the following special rules will apply to your claim: The 90-day period for a written decision on the initial claim (subject to the additional 90-day extension) is reduced to 45 days (subject to a maximum of two 30-day extensions). In addition to the information described above that must be contained in any written denial of a claim or appeal, the written denial will contain the following: - a description of any internal rule or guideline relied upon in making the determination (or a statement that such rule or guideline will be provided upon request and free of charge); and - (b) if the decision was based on medical necessity, experimental treatment or a similar limit, a description of the scientific or clinical judgment for the determination (or a statement that such explanation will be provided upon request and free of charge). The 60-day period in which you must file your request for review upon denial of your initial claim is increased to 180 days. The review will not afford deference to the initial claim denial, and will be conducted by a fiduciary of the Plan other than the one who made the initial decision or a subordinate of that person. In addition, if the review depends on a medical judgment, the Plan fiduciary will consult appropriate medical professionals, other than those who were consulted in the initial determination or their subordinates, and will disclose the identity of such medical professionals, upon request. The 60-day period for the written decision upon review of a claim (subject to the additional 60-day extension) is reduced to 45 days (subject to a 45-day extension). Business Travel Accident Plan Summary Plan Description Effective March 1, 2015 14 of 18

When Coverage Terminates (cont.) When Coverage Terminates This coverage terminates on the earliest of the following dates: The date this policy is terminated. The date you cease to be an active full-time or part-time Associate. Business Travel Accident Plan Summary Plan Description Effective March 1, 2015 15 of 18

Administrative Information Name of the Plan CarMax, Inc. Business Travel Accident Plan, a component program under the CarMax, Inc. Master Welfare Plan Plan Sponsor and Policy Holder CarMax, Inc. 12800 Tuckahoe Creek Parkway Richmond, VA 23238 Telephone: 1-804-747-0422 Employer Identification Number: 54-1821055 Plan Administrator CarMax, Inc. Benefits Administrative Committee 12800 Tuckahoe Creek Parkway Richmond, VA 23238 Telephone: 1-804-747-0422 The Plan is administered on behalf of the Company by the Benefits Administrative Committee (the Committee), which is the Plan Administrator for ERISA purposes. The Committee has the authority to amend the Plan in all respects at any time for any reason; provided, however, that any amendment that is financially material to the Company or the Company s shareholders must be approved by the Company s Board of Directors. The Company s Board of Directors has the authority to terminate the Plan at any time for any reason. Plan Insurer AIG Life Insurance Company 600 King Street Wilmington, DE 19801 Group Policy # GTP 9065285 Funding The Plan is funded by the Company through a fully-insured insurance contract. Plan Year The Plan Year begins on August 2 and ends on August 2 of the following year. Type of Administration The Plan Insurer has discretion to interpret the terms of the Plan and to decide factual and other questions relating to the Plan and the Plan benefits, including, without limitation, factual questions relating to eligibility for, entitlement to, and payment of benefits. The Plan Insurer s reasonable interpretations of the Plan and factual determinations concerning benefit issues are binding on participants and beneficiaries. Agent for Service of Legal Processes CarMax, Inc. 12800 Tuckahoe Creek Parkway Richmond, VA 23238 Attn: Corporate Secretary Business Travel Accident Plan Summary Plan Description Effective March 1, 2015 16 of 18

Administrative Information (cont.) Plan Number 508 Plan Records and Documents This document describes the major provisions of the Plan. It is not a full statement of the Plan covering all details. These are contained in the contract issued by the Plan Insurer and the Master Welfare Plan, which govern the operation of the Plan. Future of this Plan CarMax reserves the right to terminate the Plan at any time. Any covered claims or expenses that were incurred prior to the termination of the Plan shall be covered to the extent provided in the Plan. Any claims or expenses incurred after the Plan is terminated will not be covered. The Plan Sponsor also reserves the right to suspend, withdraw, amend, or change the Plan in whole or in part at any time. For example, this means that Plan limits or the types of coverage available under the Plan may change. Any covered claims or expenses that were incurred prior to such suspension, withdrawal, amendment or change shall be covered to the extent provided in the Plan at the time of the Loss. Any claims or expenses that were incurred after such suspension, withdrawal, amendment or change and are not covered by the Plan as changed, shall not be covered. Other In the event the relevant facts about your enrollment are inaccurate or administrative errors occur, an adjustment will be made. Additional contributions from you or a refund to you may be required to correct the situation. In any event, the terms of the Plan and/or Company policies will prevail. The benefits described in this document do not constitute or imply employment contracts or any other contractual obligations between the Company and its Associates and/or other individuals eligible to participate in this Plan. CarMax retains the right to modify or terminate this Plan or any of these benefits without the consent of or notice to Participants, Associates or other individuals eligible to participate in this Plan. The Company maintains this Plan by choice, not obligation. Business Travel Accident Plan Summary Plan Description Effective March 1, 2015 17 of 18

Your Rights under This Plan As a Participant in this Plan, you are entitled to certain rights and protections under the Employee Retirement Income Security Act of 1974 (ERISA). ERISA provides that you are 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, all documents governing the Plan 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 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 this Plan. The people who operate this 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, or any other person, may fire you or otherwise discriminate against you in any way to prevent you from obtaining a Plan benefit or exercising your rights under ERISA. Enforce Your Rights If your claim for a 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 your 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 requested materials, unless the materials were not sent because of reasons beyond the control of the Plan Administrator. If you have a claim for benefits that is denied or ignored, in whole or in part, and you have exhausted the Plan s internal claims and appeals procedures described in this SPD, you may file suit in Federal court. In addition, if you disagree with the Plan s decision or lack thereof concerning the qualified status of a domestic relations order or 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 from the U.S. Department of Labor or 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 the 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 help 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, D.C. 20210. You may also obtain certain publications about your rights and responsibilities under ERISA by calling the publications hot-line of the Employee Benefits Security Administration or by visiting www.dol.gov/ebsa. Business Travel Accident Plan Summary Plan Description Effective March 1, 2015 18 of 18