Short Term Disability Coverage

Transcription

1 Short Term Disability Coverage Highlights Turner offers Short Term Disability coverage that provides salary and benefit continuation when you are unable to perform your job due to medical, mental, or other physical conditions, including pregnancy. Plan Overview Who is eligible? When are you eligible? Do you need to enroll? Who pays the cost? You, if you are a regular, salaried Turner employee who is regularly scheduled to work at least 20 hours per week. After 3 months of service with Turner. No Turner pays the cost of your Short Term Disability coverage. Please refer to the Administrative Information section of this Summary Plan Description for additional information on claims procedures, plan administration, your rights under the plan, and Turner s rights under the plan, including the ability to amend or terminate the plan or any component of it at any time in accordance with applicable law and the discretion to interpret all plan documents and make factual determinations. If there is a conflict between this Summary Plan Description and the official plan documents, the plan documents will govern. The Benefits If you are eligible, after you have been absent for 5 continuous work days, you may receive up to 3 months of salary continuation, as long as you are disabled, according to the payment schedule shown in the following table: Your Service With Turner Up to 3 months Benefit Payable No benefit 3 months or more 100% of base pay, 1 week for each full year of Turner service, with a minimum available benefit period of 2 weeks Then 50% of base pay for any remaining weeks not paid at 100%, up to a total of 3 months of salary continuation Example Eric has completed 9 months of service with Turner. If he qualifies for a Short Term Disability leave of absence, he will receive 100% of his base pay for 2 weeks after satisfying the benefit waiting period of 5 continuous days. If he is still unable to perform his job and continues to qualify for Short Term Disability, he will be eligible to receive a benefit of 50% of his base pay each week for up to 3 months. Bill has completed 20 years of service with Turner. If he qualifies for a Short Term Disability leave of absence, he will receive 100% of his base pay each week for up to 3 months. Integration With Other Benefit Plans The amount of your benefit is reduced by any statutory disability income payable to you during the same period, such as state income programs, Social Security, or W orkers Compensation. At no time will you receive more than 100% of your regular base salary during your period of disability. Turner Benefits

2 Receiving Benefits To be eligible to receive benefits, you must be under the care of a doctor for a medical, mental, or other physical condition that prevents you from working. The Plan Administrator must certify your inability to perform your job duties. Turner has the right to require you to obtain a second opinion from a health care provider chosen by the company. In case of a dispute, a third opinion may become necessary. The company will pay the expense of a second and/or third opinion, if required. If You Return to Work and Later Become Disabled Again If you return to work for less than 6 months following a Short Term Disability leave of absence and then become disabled again, the subsequent disability will be considered part of the prior period of disability, regardless of the cause. If the new period of absence is due to the same illness or injury, your Short Term Disability benefits begin where they left off after the last period of absence. If the new disability period is due to a different cause, there is a 5-day waiting period. Short Term Disability benefits then begin where they left off after the last period of absence. The benefits are paid retroactively to the first day of the absence. If you return to work for at least 6 months and then become disabled again, a new waiting period of 5 consecutive work days of absence must be completed and a new period of disability begins. Deductions for Withholding Taxes and Benefit Premiums Applicable taxes will be deducted from Short Term Disability income benefits. If you are enrolled in other benefit programs, deductions are also made for your share of the premiums for those programs. Disabilities Not Covered You will not receive Short Term Disability benefits if your disability: Occurs before you are eligible to participate or begin participating in Short Term disability coverage Results from attempted suicide Results from intentional self-inflicted injury that is inflicted while sane or insane Does not require the continuous care of a doctor Results in absences that are not medically necessary Results from insurrection, rebellion, or your participation in a riot or civil commotion Results from a sickness or injury caused by war or an act of war, declared or undeclared Results from a sickness or injury that occurred while you were committing or attempting to commit an offense punishable by confinement in jail or imprisonment, even if you are not prosecuted Occurs after you have left employment with Turner or are on a Military, Personal or Unpaid Medical leave of absence How to Use the Benefits 1. Notify the Plan Administrator and your Supervisor/Human Resources Representative at least 30 days before you intend to take a leave of absence or as soon as possible. You will receive a Leave of Absence packet from the Administrator containing FMLA information and paperwork for you to complete. Your Short Term Disability will begin after you miss 5 consecutive workdays. 2. Return the completed paperwork to the Plan Administrator as soon as possible. Keep a copy of the completed paperwork for your records. 3. Pay any monthly benefit premiums that are due: If you are on a paid leave of absence these deductions will continue to be taken from your paycheck. If you are on an unpaid leave of absence you will be required to make monthly premium payments. To assist you with this process, the Benefits Service Center will send coupons to your home address. If you have any Turner Benefits

3 questions or need additional information in reference to your coverage, you should contact the Benefits Service Center directly. 4. Provide a telephone number where the Plan Administrator and your Supervisor/Human Resources Representative can reach you. You must keep this contact number current throughout your leave period. 5. Keep all parties informed of any status changes. 6. Follow the steps outlined in the Long Term Disability section (page 111) if your leave is due to illness or injury and results in Long Term Disability. 7. If applicable, file a claim for dismemberment benefits under the Accidental Death and Dismemberment (AD&D) program. If you have AD&D coverage and your disability is due to the loss of a limb, eyesight or other covered loss, you may qualify for a benefit under that program. Contact the Benefits Service Center to report a claim. 8. Provide Turner with any documents that would help to recover payment from a third party, if applicable. Turner has the right to recover short term disability payments when a third party is found to be responsible for your disability. For example, you could be in an automobile accident caused by another person and the courts could find that person responsible for your disability. 9. Notify the Plan Administrator and your Supervisor/Human Resources Representative when you plan to return to work. 10. Contact your Plan Administrator if you have questions about your Short Term Disability benefit. What Else You Should Know Enrollment You are automatically enrolled in coverage when you become eligible. For more information about eligibility and enrollment, see Your Benefits Program, beginning on page 1. When Coverage Begins If you meet eligibility requirements, coverage becomes effective after 3 months of service with Turner. Cost Turner pays the cost of your Short Term Disability coverage. When Turner May Recover Payment In some situations, a third party, such as another person or insurance company, may be legally responsible for your disability. This might happen, for example, in an automobile accident. When this occurs, Turner is entitled to be reimbursed for all disability income benefits that have been paid under the program. Turner may take any actions necessary to enforce its rights to be reimbursed. When you accept payment from the Turner Short Term Disability Program, you agree to provide any documents that would help Turner to recover Short Term Disability payments it has made on your behalf. The legal term for Turner s right of recovery is subrogation. In situations where Turner has a subrogation interest, you may be asked to sign certain documents acknowledging Turner s rights. Turner is entitled to subrogation even if you fail to sign the requested documents. Proof of Disability You are required to provide proof of your disability and that you are receiving regular medical treatment from a doctor to be eligible to receive benefits. Proof must be provided to the Plan Administrator and your local Human Resources Representative upon request and at your own expense unless the charges are covered under the Medical Plan or HMO. In addition, Turner reserves the right to require you to have an independent medical examination from time to time, to verify a continued disability. Turner will choose the examiner and schedule the appointment. The program pays the cost of this examination and the results of the independent medical examination will be binding. Failure to appear for an independent examination will cause your benefits to be terminated. Periods of disability are considered separate periods when: They are not caused by the same (or a related) illness or injury and you have returned to Active W ork, or Turner Benefits

4 You have returned to Active W ork for more than 6 months before the separate period of disability begins. Discontinuation of the Short Term Disability Benefit The W eekly Benefit will cease on the earliest of: 1. The date the Covered Person fails to provide Proof of continued Disability and Regular Attendance of a Physician; 2. the date the Covered Person fails to cooperate in the administration of the claim. Such cooperation includes, but is not limited to, providing any information or documents needed to determine whether benefits are payable or the actual benefit amount due; 3. the date the Covered Person refuses to be examined or evaluated at reasonable intervals; 4. the date the Covered Person returns to work in his Own Job on a part-time basis; 5. the date the Covered Person is no longer Disabled according to this policy; 6. the end of the Maximum Benefit Period; or 7. the date the Covered Person dies. A Covered Person refers to an eligible employee. The Sponsor would be Turner Corporation. Integrated Disability Management Turner has partnered with an Integrated Disability Management (IDM) service to administer Turner s disability and leave of absence programs. If you need a leave of absence due to your disability (or for other reasons), you can call the Benefits Service Center and be connected with the Plan Administrator. The Plan Administrator will work with you to obtain necessary medical certifications, monitor your time away from work, and keep your Human Resources Administrator informed. The Plan Administrator will assist in any transition from Short Term Disability to Long Term Disability. Turner will partner to work with the Plan Administrator to help you return to work when you are ready. Your leave remains subject to Turner s approval. Other Disability Income If you become totally disabled, you may be entitled to benefits from other company and government-sponsored plans. Your Short Term Disability benefit will be reduced by benefits that you and your dependents are eligible to receive from other plans. Other sources of income that may affect the amount you receive under the Short Term Disability Program may include, but are not limited to: W orkers Compensation, Social Security disability income benefits, other group insurance plans, state disability income programs, and money recovered from a third party who is responsible for your expenses. If you work in New York, New Jersey, Rhode Island, or California, you must apply for state disability and advise the Plan Administrator and your local Human Resources Representative of the weekly benefit amount. The state amount paid to you will be coordinated with your Short Term Disability. If you receive other income benefits in a lump sum payment, the amount you receive will be prorated on a monthly basis over the period of time for which the lump sum is given. If no time period is stated, the sum will be prorated on a monthly basis over your expected length of disability as determined by Human Resources. This monthly amount will offset the amount you receive as monthly disability income benefits under the Short Term Disability Program. Turner reserves the right to require you to repay benefits that you receive from Turner in excess of the maximum amount to which you are entitled. If you fail to repay those amounts, Turner reserves the right to deduct those amounts from your regular payroll or any future benefits you may be entitled to under any Turner benefit program or plan. Continuing Health Care and Other Life Insurance Coverages If you are covered under the Medical Plan, the Dental Assistance Plan, the Vision Care Plan, the Personal Legal Plan, Supplemental Life, Dependent Life, and/or Accidental Death and Dismemberment Insurance coverage for you and your dependents continues while you are on a disability leave of absence, as long as you pay the required premiums. If you are receiving Short Term Disability benefits, these premiums will continue to be deducted from your pay, if it is sufficient to cover the full amount of the premiums. If your Short Term Disability payments stop or if your paycheck is not enough to cover the premiums, the Benefits Service Center will contact you regarding premium payments. The premium is due the first of the month in which coverage is to continue. If the premium is not received within 30 days of the due date, your benefit coverage will be terminated effective the first day the premium was not paid. If you return to work, you will be eligible to reinstate your benefit elections within 30 days. Turner Benefits

5 Reinstatement You will have up to 6 months after the onset of your disability to apply for reinstatem ent to your former position. Reinstatement will be contingent on current business conditions. If no positions are available, you will be released for lack of work. Failure to apply for reinstatement will be construed as a termination. Appealing a Claim Denial If your disability claim is denied or your benefit payments are terminated, you will receive a written explanation of the reason for the denial or termination. You have the right to have your claim reviewed and reconsidered. See page 178 for more information on appealing a claim denial. When Coverage Ends Your coverage under the Short Term Disability Program will end at midnight on the date that any of the following events occur: You no longer qualify for disability income benefits and you do not return to Active W ork You or any covered dependent submits or attempts to submit a false, altered, forged, or fraudulent claim or document requesting benefits under any benefit program or plan You file for unemployment While on leave, you become employed by another entity or individual, regardless of the nature of the employment and regardless of whether your employment is full-time or part-time, permanent, or temporary A settlement agreement is made that terminates your benefits under the Short Term Disability Program Your employment with Turner ends Turner no longer offers the Short Term Disability Program Conversion Privilege Short Term Disability coverage cannot be converted to an individual policy. Turner Benefits