Plan Document Effective January 1, Participants Cummins Inc. US Exempt, Salaried Non-exempt and Hourly Employees

Transcription

1 LIFECHOICES Plan Document Effective January 1, 2011 Participants Cummins Inc. US Exempt, Salaried Non-exempt and Hourly Employees This SPD is a simplified description of the major features of the Plan and each of the Benefit Plans. Special situations which affect a limited number of employees may not be covered in this SPD. Each of the benefits described in this SPD is governed solely by the terms of a separate legal document or contract. If there is a conflict between this SPD and the Plan document controlling the operation of the Plan, the Plan document will govern.

2 TABLE OF CONTENTS Dictionary Terms... 1 Preface... 8 Introduction Eligibility... 9 Enrollment When Coverage Begins... 9 Making Changes Notice of Ineligibility Providing Evidence of Insurability Cost Cost of Coverage Taxes Plan Benefit Basic (Non-Contributory) Life Insurance Benefits for Employee Optional (Contributory) Life Insurance Benefits For Employee Spouse/Domestic Partner Benefits (Voluntary Benefit) Dependent Child or Domestic Partner s Child Benefits (Voluntary Benefit) Former Employee Benefits (Portable Group Life Insurance) Spouse/Domestic Partner of Former Employee Benefits (Portable Group Term Life) Accident Insurance Employee Benefits Accident Insurance Benefit Seatbelt Benefit Maximum Benefit Minimum Benefit When Benefits are Paid Accelerated Living Benefit Option Restrictions and Exclusions Life Insurance Exclusions Accidental Death and Dismemberment Insurance Exclusions Filing a Claim How To File a Claim If a Claim Is Denied Appealing a Denied Claim Salaried Non-exempt and Hourly Employees January 1, 2011

3 Termination and Continuation of Coverage If You Leave the Company If You Retire If the Company Ends the Benefit When Coverage Ends When Coverage Continues For Temporary Leave of Absence, Layoff, Family Medical Leave or Severance Continuation for Disability Administrative Information Right of Recovery Assignment of Benefits Conversion Privileges for Life Insurance Extension of Conversion Period Prior Conversion Limitation Portability For Spouses/Domestic Partners For Dependent Children Naming a Beneficiary Beneficiary Cooperation Plan Information Practices Notice ERISA Rights Future of the Plan Modifications No Guarantee of Employment Plan Sponsor Plan Administrator Employer Identification Number (EIN) Plan Number Plan Year Source of Benefits Funding Agent for Service of Legal Process Contacts Salaried Non-exempt and Hourly Employees January 1, 2011

4 Dictionary Terms The following terms are used throughout the Plan document. In this section, you will find the definitions for these terms to help clarify their meaning and to provide information to better help you understand the provisions of your benefit plans. Accelerated Living Benefit (Living Benefit) Partial payment the Plan pays before you die, under certain circumstances. These advance payments are deducted from the death benefit when you die and are up to 50% of Optional (Contributory) Life Insurance Benefits in force on the date the insured is determined by the Insurance Company to be terminally ill, subject to a Maximum Benefit of $100,000. Accident A sudden, unforeseeable external event that causes you bodily Injury and occurs while your coverage is in force under the Policy. Active Service If you are an employee, you are in active service on a day which is one of the Company s scheduled work days if either of the following conditions is met: You are actively at work. This means you are performing your regular occupation for the Company for all regularly scheduled hours of work either at one of the Company s usual places of business or at some location to which the Company s business requires you to travel; or The day is a scheduled holiday; vacation day or period of Company approved paid leave of absence. You are in active service on a day which is not one of the employer's scheduled work days only if you were in active service on the preceding scheduled work day. A spouse/domestic partner and eligible dependent is considered in active service, or "capable of performing the activities of daily living," if he or she is able to perform all the activities another person of the same age and sex could normally perform and is not: A patient in a hospital or hospice, or receiving outpatient care for chemotherapy or radiation therapy; Confined at home under the care of a physician for sickness or injury; Unable to perform any of the activities of daily living expected of a person of the same age (i.e., mobility, transferring, feeding, dressing or toileting) without human supervision or assistance; nor Receiving disability benefits from any source due to his or her sickness or injury. Affiliate A business concern owned in whole or in part, directly or indirectly, by another business. After-tax Paycheck Deductions Contributions taken from your pay after applicable federal, state and local taxes are withheld. Annual Base Salary Yearly fixed compensation, including shift differential, paid for regular work or services; usually excludes commissions, overtime, bonus or other additional pay. Salaried Non-exempt and Hourly Employees 1 January 1, 2011

5 Annual Open Enrollment The period of time each year designated by the Company when you may generally make changes to your benefit elections, if allowed by the Plan. You must enroll in the Plan in order to have coverage. You may choose coverage for yourself and your dependents within 31 days from your date of hire or within 31 days of the date you first become eligible for coverage. If you do not enroll within this 31 day period, or if you waive coverage and later decide you want to add this coverage, you may enroll during the next open enrollment period. If you experience a Qualifying Life Event, you may make your election within 31 days of the event. Any changes you request during open enrollment will become effective January 1 st of the following Plan year and will remain in effect for the entire calendar year, unless you have a Qualifying Life Event, or your coverage otherwise ends. Appeal An inquiry for reconsideration of a denied claim. The Insurance Company will review the appeal request and determine if the claim's previous denial should be upheld or overturned. Certain inquiries are governed by requirements set forth by the Employee Retirement Income Security Act of 1974 (ERISA), including how inquiries are submitted and responded to, relevant time frames and responsibilities of the claimant and the Insurance Company. Automatic Benefits The benefits you initially receive from the Company that you do not need to formally enroll in. Note: Any Plan option that requires a contribution from the employee does require enrollment. Automatic Increase Your Optional (Contributory) Life Benefit is based on your Annual Base Salary. Your benefit will increase automatically in accordance with salary increases up to the Maximum Benefit Amount subject to the following conditions: You are in active service on the effective date of the increase. If you are not in active service on the date of the increase, the benefit will not increase until you return to active service; Your total benefit does not exceed the Guarantee Issue Amount. If your Voluntary benefit is less than or equal to the Guarantee Issue Amount and with the Automatic Increase, your benefit amount exceeds the Guarantee Issue Amount, Evidence of Insurability will be required for the amount in excess of the Guarantee Issue Amount. The effective date of the Automatic Increase Amount is the later of the date your salary increased or the date the Insurance Company approves your Evidence of Insurability. Basic Life Insurance Basic Life Insurance is called "term life" insurance because it provides insurance coverage only during the period of time you are employed by the Company. With term life insurance you do not build a cash reserve for the future. Beneficiary The person entitled to benefits if you or a covered person dies. You or the covered person names or designates the beneficiary. If there is no named beneficiary or surviving beneficiary, death benefits will be paid to the first surviving of the following living relatives: spouse; child or children; mother or father; brothers or sisters; or to the executors or administrators of the s estate. If benefits are paid to the estate, the Insurance Company may pay up to $1,000 to a relative by blood or marriage who is deemed equitably entitled. Benefits paid under the Accelerated Living Benefit are payable to the employee, if living, otherwise as noted above. Salaried Non-exempt and Hourly Employees 2 January 1, 2011

6 Bonus In most cases, a cash payment made periodically based on your individual performance and/or the Company's performance. Change in Status (also see Life Status Change and Qualifying Life Event) Company The association or organization you work for and that provides your benefit program. Cummins Inc. and its affiliates and subsidiaries such as Fleetguard, Nelson, Power Generation, etc. Company Contribution Money the Company contributes to the Plan on your behalf. Dependent Child or Domestic Partner s Child You or your spouse/domestic partner's unmarried child if he or she or she meets the following requirements: A child from live birth to 26 years; A child who is primarily supported by you and incapable of self-sustaining employment due to a mental or physical handicap. You may be required to provide proof of the initial dependency and dependence may be required from time to time by the Insurance Company; A child legally born to or adopted by you (includes a child prior to the finalization of adoption); A child living with you, financially dependent on you, and born to or legally adopted by your spouse/domestic partner; A child for whom you and/or your spouse/domestic partner is the legal guardian (including a grandchild or foster child); A step-child born to your spouse/domestic partner who is living with you and financially dependent upon you; A child or grandchild residing with you and who is financially dependent on you for whom you are the court-appointed legal guardian; A child for whom the court has issued a Qualified Medical Child Support Order (QMCSO); and A child stillborn during the third trimester. Stillborn is an unintended death of the child during the third trimester; the third trimester is the period beginning as of the 28 th week of pregnancy until birth. Dependent or Domestic Partner s Handicapped Child Coverage is available for physically or mentally handicapped unmarried children as long as they are primarily dependent upon you for support. The child also has to be incapable of selfsustaining employment by reason of the physical or mental handicap. Verification will be needed to determine if the child will be eligible. Please call the CBS Benefits Contact Center for instructions on the verification process. If your handicapped child is already 26 or older when you apply for child coverage, you should call the CBS Benefits Contact Center for instructions on the verification process. Child life insurance claims will not be paid for handicapped children age 26 or older unless you have received approval. Disabled You are disabled if, because of injury or sickness, you are unable to perform all the material duties of any occupation for which you are or may reasonably become qualified based on your education, training or experience. Salaried Non-exempt and Hourly Employees 3 January 1, 2011

7 Domestic Partner A person of the same or opposite sex who shares your permanent residence, has resided with you for at least 6 months and is expected to reside with you indefinitely, has agreed with you in writing to assume financial responsibility for the welfare of each other, has signed an Enrollment and Affidavit of Domestic Partnership, or other similar document as required by the Company, has signed a Domestic Partner declaration with you if you reside in a jurisdiction that provides for Domestic Partner declarations, neither of you has signed a Domestic Partner declaration with another person within the last 6 months, neither of you is less than 18 years of age nor more than 70 years of age, neither of you is currently legally married to any other person, and neither of you is a blood relative any closer than would prohibit legal marriage. Effective Date The date you and/or your covered dependents' coverage begin. Employee A person the Company hires to do a job or activities that are controlled by the Company. Family and Medical Leave Act (FMLA) Federal law that provides for leave for an employee's serious health condition, the serious health condition of the employee's spouse, child or parent or the birth, adoption or foster care placement of a child. Forfeit To lose a benefit or have a benefit taken away. Full-time An employee who is scheduled to work a minimum of 20 hour per week. Gross Income (Gross pay, gross salary) Your total earnings before any deductions or taxes are withheld. Hospice Care Home care or inpatient care for a patient with a terminal illness. Installment Monthly, quarterly or yearly payment that continues for a specified period of time. Injury Any accidental loss or bodily harm that results directly or independently from all other causes from an accident. Insurability Requirement (Proof of good health, Evidence of Insurability EOI) An eligible person satisfies the insurability requirement for an amount of coverage on the day the Insurance Company agrees in writing to accept you as insured for that amount. To determine a person's acceptability for coverage, the Insurance Company will require you to provide evidence of good health and may require it be provided at your expense. Insurance Company The LifeChoices program is an insured plan. The Life Insurance Company Of North America, also referred to as CIGNA Group Insurance has issued a Group Policy, FLX , to Trustee Of The National Consumer Insurance Trust of behalf of Cummins Inc. References in this document to the Life Insurance Company Of North America have been changed to the Insurance Company. Salaried Non-exempt and Hourly Employees 4 January 1, 2011

8 Insured You (employee of the Company) are an insured if you are eligible for insurance under the Policy, insurance is elected for you, the required premium is paid and your coverage is in force under the Policy. Life Insurance Carrier (see Insurance Company) Life Status Change A Life Status Change or Qualifying Life Event or "qualifying event," is an event recognized by the Company s benefits plan as qualifying you to make changes in benefit selections at a time other than an annual open enrollment period. You have 31 days from the date of the Life Status Change to increase your or your spouse s/domestic partner s Optional (Contributory) Life Insurance benefit by one benefit level, as long as the total benefit does not exceed the Guaranteed Issue Amount, without satisfying the Insurability Requirement. You may increase coverage for you and your spouse/domestic partner in excess of the Guaranteed Issue Amount by satisfying the Insurability Requirement. The excess amount is effective on the date the Insurance Company approves the coverage. If you are insured, you may also enroll your newborn dependent child/domestic partner s child without satisfying the Insurability Requirement. You may also reduce your Optional (Contributory) Life Insurance Benefits within 31 days of a Life Status Change. The reduced amount is effective the first of the month following the date the change is received by the Insurance Company. The Life Status Changes are listed below. For more information or if you have questions, please call the CBS Benefits Contact Center. Marriage or acquisition of a new spouse/domestic partner; Divorce, annulment or legal separation from your spouse; Termination of domestic partner relationship; Birth, adoption, or the placement of a child for adoption with you and your spouse/domestic partner; Death of your spouse/domestic partner; Termination of your spouse/domestic partner's employment; A change in the benefit plan available to your spouse/domestic partner; Issuance of a court order or legal decree requiring coverage of a dependent child/domestic partner s child; or A change in employment status for you or your spouse/domestic partner that affects either person s eligibility for benefits. Long-Term Disability A medical condition that lasts for an extended period of time, usually more than 6 months, and makes you unable to perform your job or any other job for which you are suitably trained. Lump Sum Payment A one-time payment of your entire benefit. Military Leave Notwithstanding anything in this Plan to the contrary, with respect to any employee or dependent who loses coverage under this Plan during the employee's absence from employment by reason of military service, no pre-existing condition exclusion or waiting period may be imposed upon the reinstatement of such employee's or dependent's coverage upon reemployment of the employee unless such pre-existing condition exclusion or waiting period would have otherwise applied to such employee or dependent had the employee not been on military leave of absence. Net Pay (take-home pay) The amount of earnings that remain after taxes and payroll deductions are taken. Salaried Non-exempt and Hourly Employees 5 January 1, 2011

9 Non-exempt Employees entitled to overtime pay under the Fair Labor Standards Act of at least one and one-half times regular hourly earnings for all hours worked over 40 hours in a week. Notification Date When you are told about an event related to your benefits. Also, the date you notify the Plan Administrator and/or the Insurance Company of an event that may result in a change in election, such as marriage. Part-Time Employees who are scheduled to work less than their scheduled full work week. Pay Period The period of time an employer pays wages to an employee, such as weekly, biweekly or monthly. Physician A licensed doctor practicing within the scope of his or her license and rendering care and treatment to an insured that is appropriate for the condition and locality. The term does not include you, your spouse/domestic partner, your immediate family (including parents, children, siblings, or spouses of any of the foregoing, whether the relationship derives from blood or marriage), or a person living in your household. Plan Document A legally required document describing your benefits in detail, how the Plan operates, how to file claims, and your rights and responsibilities as a plan participant. Plan Year The 12-month period, or policy or fiscal year on which the Plan's records are kept. Cummins Inc. Benefits Plans generally use the calendar year, January 1 through December 31. Pre-Existing Condition A health problem you had and received treatment for before your current benefit elections took effect. Premium The amount of money you pay each month for your Life Insurance benefit coverage. Pretax (Before-tax) Contributions taken from your paycheck before applicable federal, state, local and other taxes are withheld. Proof of Good Health (Evidence of Insurability - EOI) In some cases, the Insurance Company may require you or a spouse/domestic partner to complete a medical questionnaire and/or have one or more medical tests or a physical exam to receive life insurance coverage in excess of Guaranteed Issue Amount or when applying to reinstate coverage you have previously cancelled. Qualified Domestic Relations Order A judgment, decree or order that relates to child support, alimony payments or marital property rights to a spouse, former spouse, child or other dependent and is made pursuant to a state domestic relations law (including a community property law). It is considered a qualified domestic relations order if it creates or recognizes the existence of an alternate payee's right - or assigns to an alternate payee the right - to receive all or a portion of the benefits payable to a participant under a plan, specifies required information and does not alter the amount or form of plan benefits. Salaried Non-exempt and Hourly Employees 6 January 1, 2011

10 Qualified Plan A plan that receives certain tax advantages and meets certain government rules. Qualifying Life Event (For additional information see Life Status Change in Dictionary Terms) An event recognized by Section 125 of the IRS tax code that entitles you to make a change in election. Examples of Qualifying Life Events include leaving the Company; a reduction in hours; marriage; birth of your child; your death, divorce or legal separation; your eligibility for Medicare; a dependent child's/domestic partner s child loss of dependent status; or loss of coverage due to your filing for bankruptcy. Regular Employee An exempt or non-exempt employee who works on an ongoing basis instead of a temporary basis. Salaried Employees Employees who receive fixed compensation paid regularly for work or services, regardless of the number of hours worked each week. These employees may also be referred to as "exempt" from overtime. Section 125 A section of the Internal Revenue Code that allows you to pay for certain benefits with pretax dollars, and regulates enrollment and eligibility requirements for these benefits. Sickness A physical or mental illness. Short Term Disability A medical condition that lasts for a period of time, usually less than 6 months, and makes you unable to perform your job. Social Security Benefits A federal program you can apply for that may pay disability benefits to you, your spouse and your dependent child (ren)/domestic partner s child (ren) if you become totally and permanently disabled. Social Security Disability The Social Security Administration has specific definitions that it uses to determine eligibility for Social Security Disability Benefits. In general, they look for medical proof of a disability severe enough to stop you from doing any substantial, gainful work for at least 12 months. Spouse The person you are legally married to on the earlier of your Benefit Commencement Date and the date of death. To the extent permitted by law the term spouse shall refer to a participant's domestic partner. To be eligible, your spouse must be under age 70. Taxable Income Your total earnings that are subject to taxes, like wages, salary, back pay, bonuses, commissions and overtime pay. Terminally Ill (Accelerated Living Benefit) A medical condition from which you are expected to die within 12 months or less. The Terminal Illness Benefit is payable only once in an employee's lifetime. Salaried Non-exempt and Hourly Employees 7 January 1, 2011

11 Termination Date The last day you are scheduled to work. Some Plan document sections may also refer to coverage or benefits termination date, which may be different from your last day of work or your termination of employment date. Total Disability (Totally and permanently disabled) An employee is disabled if, because of injury or sickness, he or she is unable to perform all the material duties of any occupation for which he or she may reasonably become qualified based on education, training or experience. Work-Related Injury or Illness An injury or illness that happens in the course of and because of your daily job duties or responsibilities. Workers' Compensation Every state has a system of providing for the cost of medical care and weekly payments to employees who suffer work-related illnesses or injuries and to dependents of those killed in industry. The employer is required to pay benefits prescribed by law. Voluntary Insurance Employees who are eligible for Basic Life Insurance are eligible to elect LifeChoices Optional (Contributory) Life Insurance Coverage for you, your spouse/domestic partner and your eligible dependent child (ren). Preface This Plan document provides a concise description of LifeChoices Benefits available to you. Every attempt has been made to make it non-technical and understandable. This document is the "Summary Plan Description" (SPD) of the Plan required by the federal law known as ERISA. It is also the official Plan document. This Plan supersedes any previous Plan documents and any provision or practice not consistent with this Plan. The LifeChoices program is an insured plan. The Life Insurance Company of North America (LINA) also referred to as CIGNA Group Insurance, your Life Insurance Carrier has issued a Group Policy, FLX , to Trustee of the National Consumer Insurance Trust on behalf of Cummins Inc. This document is not the insurance policy or contract. It does not waive or alter any of the terms of the Policy. If questions arise, the Policy will govern. You may examine the Policy at the office of the Policyholder or the Administrator. Benefits are determined under the terms of the Plan in effect at the time you become eligible for the benefits in question. The Company reserves the right to suspend, modify or terminate these benefits at any time to the extent permitted by law. This Plan document does not constitute a contract of employment or guarantee any particular benefit. If you have a question as to whether the Plan applies to you, please contact the CBS Benefits Contact Center at (877) Introduction For financial protection for you and your dependents, the Company provides LifeChoices Company-Paid Basic Life and offers LifeChoices Employee Optional (Contributory) Life coverage. This Plan pays death benefit proceeds to your named beneficiary if you die due to an illness or accident. You can elect to buy coverage in addition to the Company-Paid Basic Life benefit. The Plan also offers an Accelerated Living Benefit option that allows you to access funds if you are considered terminally ill. Salaried Non-exempt and Hourly Employees 8 January 1, 2011

12 You will need to satisfy the requirements described in this Plan document to receive coverage under LifeChoices. Eligibility Eligible Employees Company Paid Basic Life Insurance and LifeChoices Employee Optional (Contributory) Life You must be an active, full-time or part-time salaried or hourly non-exempt benefits-eligible employee working a minimum of 20 hours per week. Refer to the Dictionary Terms section for a list of definitions for employee types. You may be eligible to continue your participation in the Cummins Inc. LifeChoices Plan if you are receiving compensation through a disability plan or a Paid Leave Policy. Enrollment When Coverage Begins Your LifeChoices Company-Paid Basic Life coverage will start on your first day of work. If you enroll in LifeChoices Employee Optional (Contributory) Life coverage within 31 days, your coverage will become effective on your first day of work (subject to any Evidence of Insurability requirements that may apply). If you have a qualified Life Status Change in your family, you may increase your Optional (Contributory) Life Insurance Benefit by one benefit bevel, as long as the total benefit does not exceed the Guaranteed Issue Amount, without satisfying the Insurability Requirement. You must complete this election within 31 days of the Life Status Change. Please refer to the Making Changes section for more information on Life Status Changes. If you are not actively at work (in active service) on the day coverage is to begin, your coverage will start when you are actively at work. If you are hospitalized on the day coverage is to begin, your coverage will start when you are actively at work. Please see the definition of Active Service in the Dictionary Terms to understand what this means. Your spouse/domestic partner is eligible to be insured for Voluntary Spouse/Domestic Partner coverage on the date you are eligible or the date he or she becomes your spouse/domestic partner, if later. Coverage must be elected within 31 days of becoming eligible or if you have a Life Status Change. Elections made in excess of the Guaranteed Issue Amount will require satisfying the Insurability Requirement. Your dependent child (ren)/domestic partner s child(ren) are eligible on the date you are eligible or the date the child becomes a dependent child, if later. Coverage elected within 31 days for you or your spouse/domestic partner up to the Guarantee Issue Amount will be effective on the latest of the policy effective date, the date you authorize a payroll deduction, or the date the Company or Insurance Company receives the completed form. Coverage requiring evidence of good health will be effective on the date the Insurance Company approves the coverage in writing. If coverage for a dependent child is in force and you acquire another dependent child, coverage for that child is effective on the date he or she qualifies as a dependent child. Note that your spouse/domestic partner must qualify under the second part of the Active Service definition for coverage to start for him or her. The active service requirement applies even for amounts of coverage that do not require Evidence of Insurability. Salaried Non-exempt and Hourly Employees 9 January 1, 2011

13 Making Changes The following is a list of events that are each considered to be a qualified change in family status for the LifeChoices Employee Optional (Contributory) Life Plan. For a complete list of events, or for more information or answers to questions, contact the CBS Benefits Contact Center. A change in employment status for you or your spouse/domestic partner that affects either person s eligibility for benefits; A change in the benefit plan available to your spouse/domestic partner; Birth, adoption, or the placement of a child for adoption with you and your spouse/domestic partner; Death of your spouse/domestic partner or covered dependent child; Divorce, annulment or legal separation from your spouse; Termination of your domestic partner relationship; Issuance of a court order or legal decree requiring coverage of a dependent child; Marriage or acquisition of a new spouse/domestic partner; Termination of your spouse's /domestic partner's employment. Changes you make to your LifeChoices Employee Optional (Contributory) Life coverage within 31 days of a qualified Life Status Change, become effective the date of the status/life event (subject to any Evidence of insurability requirements that may apply). Notice of Ineligibility You must notify Cummins Inc. if you experience a change that will affect your dependent's eligibility for benefits under the Plan. If your spouse/domestic partner is employed by Cummins Inc. and is enrolled for employee coverage under this Plan, you may not cover that person as a dependent. In addition, only one of you may cover your dependent children. You both cannot cover your child at the same time for Optional (Contributory) Life Insurance. Providing Evidence of Insurability Providing Evidence of Insurability (EOI) is not required for your participation in LifeChoices Company-Paid Basic Life and the LifeChoices Employee Optional (Contributory) plans if you enroll within 31 days of when you are first eligible for amounts up to the Guaranteed Issue Amount (e.g., the lesser of 1x, 2x, or 3x earnings or $300,000). Providing EOI for your dependents is also not required for amounts up to the Guaranteed Issue Amount if you enroll them within 31 days of when they are first eligible (e.g., spouse/domestic partner in increments of $10,000 or $25,000; for children EOI is never required). At subsequent annual open enrollments, or within 31 days of a qualifying event, you may increase your or your dependent s election by one benefit bevel as long as the benefit level does not exceed the Guaranteed Issue Amount., All coverage amounts in excess of the Guaranteed Issue Amount will require EOI for you or your spouse/domestic partner. However, if you decline coverage when you or your spouse/domestic partner are first eligible, or have canceled your coverage or your spouse/domestic partner s coverage and later wish to re-enroll at annual open enrollment, or you enroll for any amounts greater than the Guaranteed Issue Amounts of Optional Life or spouse/domestic partner coverage at any time, you will be asked to provide EOI. If you enroll for Contributory Life or Accidental Death coverage for you or your family members at any other time, you will be asked to provide EOI for that person. The Insurance Company will mail you a letter and a Term Life Insurance Change Form (EOI form) for the person who is requesting coverage or an increase which could be yourself, and/or your spouse/domestic partner. If you are requesting additional life insurance for your spouse/domestic partner, you will also need to have him/her sign the EOI form. The EOI form will need to be completed in its entirety, signed, dated and received by the Insurance Company within 31 days of the date of the letter you received. The Insurance Company will review the EOI form and will notify you if additional information is necessary. Please note that some or all of your elected coverage is subject to review and will not be in effect until approved by the Insurance Company. The Insurance Company will notify you of the approval or denial. Salaried Non-exempt and Hourly Employees 10 January 1, 2011

14 If you have any questions about your completed EOI form contact the Insurance Company of North America at their toll-free number at , Monday through Friday 8:00 a.m. to 6:00 p.m. Eastern Time. We also offer a toll-free line for the hearing impaired at Cost Cost of Coverage The Company pays for your Basic coverage. You pay premiums for your Optional (Contributory) Life Insurance coverage. Your premiums are deducted from your pay on an after-tax basis. Your premiums for the cost of the LifeChoices Employee Optional (Contributory) Life coverage depend on several factors: your age, your tobacco user status and the level of coverage you choose. They are determined at a monthly rate per $1,000 based on the schedule of coverage. These rates are reflected by age groups, and if you are a tobacco user, a slightly different rate schedule will apply. A tobacco user is anyone who has used any type of tobacco products in the past 12 months. Your premiums are reviewed annually and are subject to change. Any adjustments to your premiums will be effective January 1 st ; you will be notified by the Company in advance of any changes during your annual open enrollment. Taxes Your taxes can be affected under certain circumstances. Current federal law requires you to pay income taxes on the value of any provided life insurance coverage over $50,000. This value is referred to as imputed income and will be considered taxable income to you. If this applies to you, this will be automatically calculated and paid through the payroll system. Salaried Non-exempt and Hourly Employees 11 January 1, 2011

15 Plan Benefit Schedule of Benefits Policy Effective Date: January 1, 2001 Revised & Reissued Date: January 1, 2002; January 1, 2007; January 1, 2008, January 1, 2011 Policy Number: FLX Revised January 1, 2011 to FLX Eligibility Waiting Period: There is no eligibility waiting period. Basic (Non-Contributory) Life Insurance Benefits for Employee Basic Employee Benefit: Guaranteed Issue Amount: 1 x your Annual Compensation (see definition), rounded up, if necessary, to the next whole $1, x your Annual Compensation Benefit Level: 1 x your Annual Compensation Optional (Contributory) Life Insurance Benefits for Employee Optional (Contributory) Life Employee Benefit: Guaranteed Issue Amount: Maximum Benefit: 1, 2, 3, 4, 5, 6, 7, or 8 x your Annual Compensation (see definition), rounded up, if necessary, to the next whole $1,000 the lesser of 3 x your Annual Compensation or $300,000 the lesser of 8 x your Annual Compensation or $2,000,000 Benefit Level: 1 x your Annual Compensation Terminal Illness (Accelerated Life) Benefit Maximum Benefit: 50% of Life Benefits up to $100,000 Spouse/Domestic Partner Benefits (Voluntary Benefit) Option 1 $ 10,000 Option 2 $ 25,000 Option 3 $ 50,000 Option 4 $ 100,000 Option 5 $ 125,000 Option 6 $ 150,000 Option 7 $ 200,000 Guaranteed Issue Amount: $ 50,000 Salaried Non-exempt and Hourly Employees 12 January 1, 2011

16 Dependent Child or Domestic Partner s Child Benefits (Voluntary Benefit) Option 1 $ 5,000 Option 2 $ 10,000 Guaranteed Issue Amount: $ 10,000 You may elect one of the options shown above for your spouse/domestic partner. You may elect any one of the options shown above for your eligible, dependent child (ren)/domestic partner s child (ren). Each eligible child will be insured for the amount corresponding to the Dependent Child Option selected. Former Employee Benefits (Portable Group Term Life Insurance) Amount of Life Insurance Maximum Benefit Period: An amount elected subject to the Maximum Benefit Amount for Optional (Contributory) Life Insurance Benefits allowable to you, less any amount of conversion insurance issued under the Conversion Privilege for Life Insurance. To Age 85 for Employees Accelerated Living Benefit Maximum Benefit: 50% of Optional (Contributory) Life up to $100,000 Spouse/Domestic Partner of Former Employee Benefits (Portable Group Term Life) Amount of Life Insurance Maximum Benefit Period: To Age 70 Accident Insurance Employee Benefits An amount elected subject to the Maximum Benefit Amount of Life Insurance amount for Optional (Contributory) Life Insurance Benefits available to a spouse/domestic partner. Basic Benefit Optional Contributory Benefit Other Losses see below for details Same as Basic Life Insurance Benefits Same as Optional (Contributory) Life Insurance Benefits 25% to 100% of Life Benefit Amount for certain losses of limb, sense or paralysis. Salaried Non-exempt and Hourly Employees 13 January 1, 2011

17 Accident Insurance Benefit An employee s Accident Benefit will be the same amount as his/her Basic Life Insurance and Optional (Contributory) Life Insurance benefit. This benefit will be paid according to the Schedule of Losses. If more than one loss results from the same accident, the greatest benefit amount will be paid. The loss must be a result of bodily injuries caused directly by an accident (and from no other causes), and must occur within 365 days of the accident. Schedule of Losses and Percent of Benefit Paid 100% Benefit: Life, Two Members, Quadriplegia, or Speech and Hearing (both ears) 50% Benefit: One member, Paraplegia, Hemiplegia, Speech, or Hearing (both ears) 25% Benefit: Thumb and Index Finger of the Same Hand Member means a hand, foot or the entire sight of an eye. Loss of a hand means complete severance through or above the wrist or ankle joint. Loss of sight means total, permanent loss of sight of the eye. The loss must be irrecoverable by natural, surgical, or artificial means. Loss of speech means total, permanent and irrecoverable loss of audible communication. Loss of hearing means total and permanent loss of hearing in both ears which cannot be corrected by any means. Loss of a thumb and index finger means complete severance through or above the joints between the fingers and the hand. Quadriplegia means total paralysis of both upper and lower limbs. Paraplegia means total paralysis of upper and lower limbs on one side of the body. Severance means the complete separation and dismemberment of the part from the body. Paralysis means loss of use, without severance, of a limb. The loss must be determined by a physician to be complete and not reversible. Seatbelt Benefit The Seatbelt Benefit is the lesser of 10% of the insured's Accident Insurance Benefits in force on the date of the accident or $10,000. This benefit is subject to the following: You die as a result of an accident while you are covered under the plan; You were driving or riding as a passenger in a private passenger car equipped with seatbelts and the seatbelt was in use and properly fastened at the time of the accident. An official report of the use and position of the seatbelt must be certified in the official report of the accident. If an official report is not available or it is unclear if you were wearing a seatbelt, a limited Seatbelt Benefit of $1,000 will be payable. If a seatbelt was not in use or if the accident occurs while you are participating in a race, speed or endurance test, the benefit will not be paid. Note: Accident Insurance Benefits do not apply to your spouse/domestic partner and dependent child (ren)/ domestic partner s child (ren). Maximum Benefit You are eligible for a maximum of up to $2,000,000 in coverage under the LifeChoices Employee Optional (Contributory) Plan. Minimum Benefit The minimum death benefit the LifeChoices Company-Paid Basic Life Plan will pay is one times Annual Base Salary and, for those who choose it, the minimum the LifeChoices Employee Optional (Contributory) plan will pay is one times the insured's Annual Base Salary. When Benefits are Paid The Plan will pay a benefit to your beneficiary (ies) when you die while covered by the Plan. You may also receive a Living Benefit if you are considered terminally ill. LifeChoices Company-Paid Basic Life and LifeChoices Employee Optional (Contributory) Life payments are not offset by any other Company-provided survivor benefits. Salaried Non-exempt and Hourly Employees 14 January 1, 2011

18 Accelerated Living Benefit Option This benefit can help you if you are considered terminally ill. The Living Benefit option gives you access to funds so you can afford appropriate care without exhausting your assets or estate. For the purpose of determining the existence of a terminal illness, the Insurance Company will require the Employee submit the following proof: A written diagnosis and prognosis by two Physicians licensed to practice in the United States; and Supportive evidence satisfactory to the Insurance Company, including but not limited to radiological, histological or laboratory reports documenting the terminal illness. If you meet the Insurance Company s criteria you may receive this benefit if a doctor certifies that you have less than 12 months to live. The payment may not be considered taxable income. The maximum amount you can receive is 50% of the Optional (Contributory) Life coverage amount up to $100,000. The money will be paid to you the insured employee. Payment of this benefit reduces the amount of benefit payable to your beneficiary upon your death only by the amount you have already received. Restrictions and Exclusions Life Insurance Exclusions If an insured commits suicide, while sane or insane, within 2 years from the date the insured's insurance under the Policy becomes effective, Optional (Contributory) Life Insurance benefits will be limited to a refund of the premiums paid on the insured's behalf. The suicide exclusion applies from the effective date of any additional benefits or increases in life insurance benefits. If a dependent child/domestic partner s child commits suicide and is survived by other dependent children covered under your certificate, no refund of premiums will be paid. Accidental Death and Dismemberment Insurance Exclusions The Insurance Company will not pay Accident Insurance Benefits for a loss which in any way results from any of the following circumstances: Suicide, attempted suicide or intentionally self-inflicted Injury, while sane or insane (except in Missouri, this applies only while sane); Sickness, disease or bodily infirmity; medical or surgical treatment; or bacterial or viral infection, no matter how contracted (This does not include bacterial infection that is the natural and foreseeable result of an accidental bodily Injury or accidental food poisoning.); Full-time active duty for more than 30 days in any Armed Forces. (If you send proof of service, the Insurance Company will refund any premiums paid for coverage during this time. Reserve or National Guard active duty or training is not excluded unless it extends beyond 31 days.); Commission of a felony; Voluntary self-administration of any drug or chemical substance not prescribed by, and taken according to the directions of a doctor (Accidental ingestion of a poisonous substance is not excluded.); War or an act of war, whether or not declared; or Travel or flight in, or getting in or out of: an aircraft being used for test or experiment; an aircraft the insured is flying, is learning to fly, or is part of the crew of; a military aircraft, other than transport aircraft flown by the U.S. Air Mobility Command (AMC) or a similar air transport service of another country; an aircraft owned or leased by or for the Employer, its subsidiaries or affiliates, or the insured or a member of his or her household; an aircraft that does not have a valid FAA normal or transport type certificate of airworthiness; or an aircraft that is not flown by a pilot with a valid license. Salaried Non-exempt and Hourly Employees 15 January 1, 2011

19 Filing a Claim How to file a Claim Upon your death or terminal illness, your beneficiary should contact the CBS Benefits Contact Center. You or your beneficiary will be provided with required forms and deadlines from the CBS Benefits Contact Center. You or your beneficiary will need to file a claim form and submit proof of death or terminal illness to receive benefits. You or your Beneficiary should contact Cummins, the CBS Benefits Contact Center within 31 days of the loss. The CBS Benefits Contact Center Representative will provide assistance in filing the notice of claim with the Insurance Company within 31 days of the loss. Written proof of loss must be provided to the Insurance Company within 90 days of the date of loss. Proof of loss must not be given to the Insurance Company more than one year after the 90 day period. The Insurance Company has 90 days to review the claim and respond. If additional information is required, your beneficiary will receive a request specifying the nature of the information needed. Once the claim is approved, your beneficiary will have a choice to receive payment as monthly installments, an interest bearing checking account, a lump sum check payable to the beneficiaries or, if the benefit is less than $5,000, payment will be made in a lump sum amount. If applicable, you will receive living benefit option payments. Acceptable proof of death includes the following where applicable (for more information, contact the CBS Benefits Contact Center with your questions or to get a claim form and instructions): A birth certificate (if applicable); A certified copy of the death certificate; (required) A funeral home assignment (if applicable); A marriage certificate (if applicable); or An accident report (if applicable). Acceptable proof of terminal illness requires submission of medical statements from at least two unaffiliated examining and/or treating Physicians licensed to practice in the United States stating their medical opinion that the insured employee is terminally ill with 12 months or less to live. Supportive evidence satisfactory to the Insurance Company, including but not limited to radiological, histological or laboratory reports documenting the terminal illness will be required. Forms are available from the CBS Benefits Contact Center for these claims. Note: Spouse/domestic partner or dependent child (ren)/domestic partner s child (ren) coverage continues with premium payments for 6 months after the employee s death. If a Claim is Denied If your claim for benefits is denied, you or your Beneficiary will be notified in writing of the reason for the denial. The notices for both LifeChoices Company-Paid Basic Life (Employee only) and LifeChoices Employee Optional (Contributory) Life will include: A description of any additional materials or information necessary to complete your claim; An explanation of how, when, and where to appeal your denied claim; Reference to applicable provisions of the Plan document or other relevant material on which the denial is based; and The specific reason for the denial. If you or your beneficiary disagrees with the decision and have not received an adequate explanation concerning the claim for benefit under the Plan, you or your beneficiary has a legal right to appeal the denial or partial denial of the claim. Salaried Non-exempt and Hourly Employees 16 January 1, 2011

20 Appealing a Denied Claim Whenever a claim is denied, you have the right to appeal the decision. You (or your duly authorized representative) must make a written request for appeal to the Insurance Company within 60 days (180 days in the case of any claim for disability benefits) from the date you receive the denial. If you do not make this request within that time, you will have waived your right to appeal. To appeal the denial, your beneficiary should send a written request to the Insurance Company requesting a claim review. The appeal should include: The specific reasons why you think the claim should be reconsidered and approved; Any additional documentation that supports the approval of the claim; A reference to specific plan document provisions or other relevant material on which your appeal is based; and A copy of the denial. Your beneficiary must make this request within 60 days after receiving the original claim decision. The Insurance Company will respond within 60 days from the date it receives the request, but special circumstances may cause the review to take longer (45 days in the case of any claim for disability benefits).you or your beneficiary will be notified if a 60 days extension of the response time will be required and the reason for the extension. Once your request has been received by the Insurance Company, a prompt and complete review of your claim must take place. This review will give no deference to the original claim decision, and will not be made by the person who made the initial claim decision. During the review, you (or your duly authorized representative) have the right to review any documents that have a bearing on the claim, including the documents which establish and control the Plan. Any medical or vocational experts consulted by the Insurance Company will be identified. You may also submit issues and comments that you feel might affect the outcome of the review. If your beneficiary again disagrees with the Insurance Company s decision, your beneficiary may follow up with an additional request for appeal. When you or your beneficiary is notified of the final decision, the notice will provide the reason for the decision and the specific Plan provisions on which it is based. Also, if your survivors question your beneficiary on record, they can ask for a review. Your survivors should send a request for a review to the CBS Benefits Contact Center and should state why they question the beneficiary on record. You or your beneficiary may have additional rights under ERISA. However, applicable law and the Plan's provisions require your beneficiary to pursue all your claim and appeal rights on a timely basis before seeking any other legal recourse regarding claims for benefits. Termination and Continuation of Coverage If you Leave the Company Your LifeChoices coverage ends on your date of termination from the Company. Under some circumstances, you may be eligible to convert your LifeChoices coverage to an individual policy upon termination. Refer to the Conversion Privilege for Life Insurance section for more information. You may also apply to continue all or part of your LifeChoices Employee Optional (Contributory) Life as special Portable Group Term Life insurance at special portable group rates. Salaried Non-exempt and Hourly Employees 17 January 1, 2011