Penske Long-Term Disability Summary Plan Description

Transcription

1 Penske Long-Term Disability Summary Plan Description

2 Contents Program Highlights... 1 Coverage Available to You...1 Eligibility and Enrollment... 2 Eligibility... If You Are a New Hire... If You Transfer and Become Eligible...4 Enrollment...4 If You Waive Coverage...4 When Coverage Begins...4 Cost of Coverage...5 How the Program Works... 6 When LTD Benefits Start...6 Qualifying for Benefits Definition of Disability...7 What the Program Pays...7 Temporary Recovery...7 Concurrent Disability...8 Annual Benefits Compensation...8 Other Income Benefits...8 Work Incentive Benefit...11 Rehabilitation Incentive...11 Family Care Expenses...11 Survivor Benefit...13 Duration of LTD Benefits...14 Limitations...15 When LTD Benefits Are Not Paid...16 Your Other Benefits While You Are Receiving LTD Benefits...17 How to File a Claim Right to Recover Overpayments...19 If Your Claim Is Denied...21 When Coverage Ends If You Leave the Company...23 If You are Rehired...23 If You Have a Leave of Absence...23 If You Die While a Plan Participant...23 i

3 For detailed administrative information about your Penske long-term disability benefit (including claims and appeals procedures) and the Employee Retirement Income Security Act of 1974 (ERISA), see Administrative Information. The LTD Summary, in combination with the Administrative Information section, is intended to meet ERISA s Summary Plan Description (SPD) requirements. IMPORTANT INFORMATION FOR RESIDENTS OF CERTAIN STATES: There are state-specific requirements that may change the provisions under the Coverage(s) described. If you live in a state that has such requirements, those requirements will apply to your Coverage(s). Prudential has a website that describes these state-specific requirements. You may access the website at When you access the website, you will be asked to enter your state of residence and your Access Code. Your Access Code is If you are unable to access this website, want to receive a printed copy of these requirements or have any questions, call Prudential at Disclaimer Note The purpose of this Long-Term Disability Benefit Summary is to outline the key features of the LTD benefits available to you. This document is not intended to be construed as a contract, expressed or implied, guaranteeing any benefits of employment. In all cases, the plan documents shall govern in cases or disputes. All benefits and coverages described in this document are subject to the terms of the insurance contract under which the benefits are provided. If there is a conflict between this document and the insurance contract, the insurance contract will govern Penske reserves the right to amend, suspend, discontinue, or terminate all or any part of the plan described herein at any time, for any reason. ii

4 Program Highlights The Penske Long-term Disability (LTD) program provides financial protection for you and your family in the event of your disability. Through the program, you can elect to purchase 50%, 60% or 662/3% LTD insurance coverage for yourself. These coverages are are called LTD 50, LTD 60 and LTD 66. There are several advantages to purchasing LTD coverage through Penske (the Company): The advantage of group rates, The convenience of payroll deductions to pay for your LTD 50, LTD 60 or LTD 66 coverage, and You usually do not need to provide a statement of health if you elect this coverage when you are first eligible. Coverage Available to You If you elect LTD 50, LTD 60 or LTD 66 coverage, you are responsible to pay the premium cost. LTD coverage is not available to your family. The Penske LTD program is underwritten by The Prudential Insurance Company of America (Prudential). 1 MyPenskeHR

5 Eligibility and Enrollment Eligibility You are eligible to enroll in LTD 50 coverage on the first of the month immediately following 60 days of continuous service if you are a Penske associate regularly scheduled to work for 35 or more hours per week. If you are a Penske Logistics associate, You are eligible to enroll in LTD 60 or LTD 66 on the first of the year (January 1) that falls on or immediately follows twelve months of continuous service if you are regularly scheduled to work for 35 hours or more per week in a location established prior to 7/1/2007. Penske Logistics associates hired in new locations as of 7/1/2007 are eligible to enroll in LTD 60 or LTD 66 on the first of the year (January 1) that falls on or immediately follows 24 months of continuous service if you are regularly scheduled to work for 35 hours or more per week. Penske Logistics associates hired in new locations as of 1/1/2012 are eligible to enroll in LTD 60 or LTD 66 on the first of the year (January 1) that falls on or immediately follows 12 months of continuous service if you are regularly scheduled to work for 35 hours or more per week. If you are a Penske Truck Leasing associate, you are eligible to enroll in LTD 60 or LTD 66 on the first of the year (January 1) that falls on or immediately follows twelve months of continuous service if you are regularly scheduled to work for 35 hours or more per week Note that Penske Truck Leasing and Penske Logistics are referred to as Penske in this document. An associate who is covered by a collective bargaining agreement is eligible to participate only if the labor contract incorporates the benefit at issue, and if the associate meets the eligibility and waiting period requirements described above. Seasonal associates and independent contractors are not eligible for coverage in the LTD program, even if the Internal Revenue Service (IRS) or a court considers you to be a regular associate. Temporary associates are eligible to enroll for LTD coverage beginning in 2004 if they were hired prior to July 1, 2003 and have satisfied the eligibility requirements outlined above. 2 MyPenskeHR

6 If You Are a New Hire You are eligible to enroll in LTD 50 coverage on the first of the month immediately following 60 days of continuous service if you are a Penske associate regularly scheduled to work for 35 or more hours per week. If you are a Penske Logistics associate, You are eligible to enroll in LTD 60 or LTD 66 on the first of the year (January 1) that falls on or immediately follows twelve months of continuous service if you are regularly scheduled to work for 35 hours or more per week in a location established prior to 7/1/2007. Penske Logistics associates hired in new locations as of 7/1/2007 are eligible to enroll in LTD 60 or LTD 66 on the first of the year (January 1) that falls on or immediately follows 24 months of continuous service if you are regularly scheduled to work for 35 hours or more per week. Penske Logistics associates hired in new locations as of 1/1/2012 are eligible to enroll in LTD 60 or LTD 66 on the first of the year (January 1) that falls on or immediately follows 12 months of continuous service if you are regularly scheduled to work for 35 hours or more per week. 3 MyPenskeHR

7 If you are a Penske Truck Leasing associate, you are eligible to enroll in LTD 60 or LTD 66 on the first of the year (January 1) that falls on or immediately follows twelve months of continuous service if you are regularly scheduled to work for 35 hours or more per week If You Transfer and Become Eligible If you transfer from a non-eligible position to an eligible position during the year, you are eligible for LTD 50, LTD 60 or LTD 66 coverage on the first day of the month immediately following your transfer, provided that you have worked for Penske for 60 continuous days. If EOI is required, and you are approved for LTD coverage, your coverage is effective on the date determined by the insurance company. Enrollment You must enroll within 31 days after you initially become eligible for LTD 50 coverage. Note that you can only enroll for LTD 60 and LTD 66 coverage during Annual Enrollment. If you are a current associate, you may enroll for coverage, change your coverage level, or waive coverage during Annual Enrollment, which is held in the fall for the following year. You may not enroll or change your coverage during the year, except when you initially become eligible. If EOI is required, and you are approved for LTD coverage, your coverage is effective on the date determined by the insurance company. Evidence of Insurability If you increase your LTD coverage at any time after your initial new hire enrollment, you will be required to provide evidence of insurability (EOI) to Prudential to be approved for that increased LTD option. EOI is considered met when Prudential decides the evidence is satisfactory and you are actively at work. EOI is required as follows: If You Waive Coverage You may elect to waive LTD 50, LTD 60 or LTD 66 coverage. If you waive LTD coverage as a new hire or during Annual Enrollment, you must wait until Annual Enrollment in the fall to enroll. When Coverage Begins Coverage begins on the first day you are eligible, provided that: You have completed the LTD enrollment form authorizing the payroll deduction for LTD coverage prior to your eligibility date, and Penske approves your enrollment. If you enroll for LTD 50 coverage as a new hire, your coverage is effective on the first of the month immediately following 60 days of continuous service. If you enroll for LTD 50, LTD 60 or LTD 66 coverage during Annual Enrollment, your elections are effective January 1 of the following year. 4 MyPenskeHR

8 Your benefit elections remain in effect until December 31 of each year unless you experience a qualified status change. Note that the insurance company will require you to provide a statement of health if you are electing any LTD coverage after having previously waived LTD coverage. If you are not in active service on the date your LTD benefits would otherwise be effective, coverage will be effective on the date you return to active service in an eligible class. Cost of Coverage You pay the full cost for any LTD 50, LTD 60 or LTD 66 coverage that you elect. Your contributions will be deducted from your paycheck on an after-tax basis. This means that contributions are deducted from your paycheck after federal, Social Security, and, in most areas, state and local income taxes have been withheld. 5 MyPenskeHR

9 How the Program Works If you become disabled and cannot work, knowing that you have a steady income provided through the Penske LTD program is important to your financial security and peace of mind. You also may purchase LTD 60 or LTD 66 coverage. The following chart shows your LTD 50 benefit, LTD 60 benefit and the LTD 66 benefit: Benefit Benefit Amount Cost LTD 50 50% of your monthly compensation You pay the entire cost on an after-tax basis. LTD 60 60% of your monthly compensation You pay the entire cost on an after-tax basis. LTD /3% of your monthly compensation You pay the entire cost on an after-tax basis. Important Notes: The maximum monthly benefit amount (for LTD 50, LTD 60 or LTD 66) is $10,000. The minimum monthly benefit amount (for LTD 50, LTD 60 or LTD 66) is $50. Disability benefits are paid monthly, based on a 30-day period, and will be prorated if payable for any period of less than a month. When LTD Benefits Start Benefits begin after you have been disabled for the 180-day waiting or the end of the STD period whichever occurs last provided your disability qualifies under the LTD program and that the insurance company has approved your claim for benefits. The elimination period is the period of time during which no benefits are payable and it begins on the day you become disabled. You must be under the continuous care of a doctor during your elimination period. You may temporarily recover (for 30 days) from your disability during your elimination period. If you again become disabled due to the same or a related condition, you may not have to begin a new elimination period. Note that either Company-paid Salary Continuation or Company-paid Short-Term Disability benefits cover all associates for the first 26 weeks of a non-work related disability. For more information about Salary Continuation or Short-Term Disability, call the MyPenskeHR at MyPenskeHR

10 Qualifying for Benefits Definition of Disability To qualify for LTD benefits, you must be disabled. Disabled means that, due to sickness, pregnancy or accidental injury, you are receiving appropriate care and treatment from a doctor on a continuing basis, and: During your elimination period and the next 24-month period, you are unable to earn more than 80% of your predisability earnings or indexed predisability earnings at your own occupation for any employer in your local economy, or After the 24-month period, you are unable to earn more than 60% of your indexed predisability earnings from any employer in your local economy at any gainful occupation for which you are reasonably qualified taking into account your training, education, experience and predisability earnings. Gainful Occupation is defined as an occupation, including self-employment, that is or can be expected to provide the employee with an income within 12 months of returning to work, that exceeds 60% of indexed monthly earnings if the employee is working. Your loss of earnings must be a direct result of your sickness, pregnancy or accidental injury. Economic factors such as, but not limited to, recession, job obsolescence, paycuts and job-sharing will not be considered in determining if you meet the loss of earnings test. For an associate whose occupation requires a license, loss of license for any reason does not, in itself, constitute disability. What the Program Pays The LTD program provides you with a benefit of 50%, 60% or 662/3% of your annual benefits compensation up to a maximum monthly benefit of $10,000. Note that benefits you receive from the LTD program are offset by any other benefits you are eligible to receive because of your disability. For more information, see Other Income Benefits beginning on page 6. How Benefits Are Paid LTD benefits are paid directly to you on a monthly basis. Benefits for a period of less than one month are prorated. Temporary Recovery Once LTD benefits become payable, you may temporarily recover from your disability. If you become disabled again due to the same condition (the period of time between the prior disability and current disability cannot be more than six months), you may not have to begin a new elimination period. After you have satisfied your elimination period, a period of temporary recovery is your return to work for less than six months for each period of temporary recovery. 7 MyPenskeHR

11 During a temporary recovery, you will not qualify for any change in coverage caused by a change in any of the following: The rate of earnings used to determine your predisability earnings, or The terms, provisions, or conditions of the LTD Plan. If your recovery lasts longer than the allowable temporary recovery period and if you again become disabled, you will have to begin a new elimination period. Concurrent Disability If a new disability occurs while monthly benefits are payable, it will be treated as part of the same period of disability. Monthly benefits will continue while you remain disabled. They will be subject to both of the following: The maximum benefit duration, and Limitations and exclusions that apply to the new cause of disability. Annual Benefits Compensation Annual benefits compensation is the sum of your base pay, bonuses, and commissions (before your disability) but does not include overtime pay or other extra compensation. Base pay for the current year will be based on your annualized base wage as of June 30 of the prior year (before your disability). Commissions for the current year will be based on commissions paid out prior to January 1 of the prior year. For example, commissions paid in 2004 are used when determining annual benefits compensation for associates who become disabled in Bonuses for the current year will be based on the bonus paid in March of the prior year. If you are classified as a truck driver, annual benefits compensation is based on the median compensation for all Company truck drivers. This amount will be adjusted annually. You will be notified of such adjustments during Annual Enrollment. Other Income Benefits Your LTD benefit will be reduced by other income benefits you may receive because of your disability. For the purposes of this section, dependents include any person who receives (or is assumed to receive) benefits under any applicable law because of your entitlement to benefits. Federal Social Security Act, Railroad Retirement Act, Canada Pension Plan, or any provincial pension or disability plan, or the Canada Old Age Security Act Benefits that you receive, are entitled to receive or would have been eligible to receive upon making timely application because of your disability or retirement will be counted, and Benefits available with respect to your spouse and dependents (regardless of marital status or their place of residence) because of your disability or retirement will be counted. If you are divorced or legally separated, benefits paid directly to your dependents and not taken into constructive receipt by you will not be counted. 8 MyPenskeHR

12 Estimated Social Security Benefits Your monthly benefit may be reduced by any Social Security disability benefits you may be eligible to receive. Your monthly benefit will not be reduced by estimated Social Security disability benefits during the first 24 months of monthly benefit payments if, prior to the end of the six-month period following the date you became disabled: You provide proof that you have applied for Social Security disability benefits, You have signed the reimbursement agreement which confirms that you will repay all overpayments, and You have signed the form authorizing the Social Security Administration to release information on awards directly to Prudential. If you have not received approval or final denial of your claim from the Social Security Administration by the end of this 24-month period, Prudential will begin reducing your monthly benefit by an estimate of Social Security disability benefits. For purposes of this section, final denial of your claim means that you have received a Notice of Denial of Benefits from an administrative law judge. In any case, when you do receive approval or final denial of your claim from the Social Security Administration: Your monthly benefit will be adjusted, and You must promptly refund to Prudential an amount equal to all overpayments. If you do not promptly make such a refund to Prudential, they may reduce or offset any future benefits payable to you, including the minimum benefit. Social Security Adjustment Example Here is an example of how the Social Security adjustment might impact an associate with LTD 60 coverage and annual benefits compensation of $32,000: Monthly LTD benefit (before reduction for Social Security benefit) $1,600 Social Security benefit $700 Maximum LTD benefit from the program $900 Note that the total amount the associate receives is still $1,600. However, the associate will receive $900 through the LTD program and $700 from Social Security. For more information on Social Security disability benefits, call the Social Security Administration at or visit the Social Security Administration website at Group Insurance Policies Group insurance policies will be counted if Penske contributes towards them or makes payroll deductions for any of the following: Other group health insurance policies will be counted to the extent that they provide benefits for loss of time from work due to disability, and A group life policy that provides installment payments for permanent total disability will be counted. Work Earnings, Rehabilitation Incentive, and Family Care Expenses will not be used to reduce your monthly benefit except as described in the Work Incentive Benefit section on page 9. 9 MyPenskeHR

13 Penske s Defined Benefit Retirement Plans Defined Benefit Retirement Plans will be counted if you: Receive as disability payments under your Penske s Defined Benefit Retirement Plan, Voluntarily elect to receive as retirement or early retirement payments under your Penske s Defined Benefit Retirement Plan, or Receive as retirement payments when you reach normal retirement age, as defined in your Penske s Defined Benefit Retirement Plan. Disability payments under a retirement plan will be those benefits which are paid due to disability and do not reduce the retirement benefits which would have been paid if the disability had not occurred. Retirement payments will be those benefits which are paid based on your Penske s contribution to the retirement plan. Disability benefits which reduce the retirement benefits under the plan will also be considered as a retirement benefit. Amounts received do not include amounts rolled over or transferred to any eligible retirement plan. Prudential will use the definition of eligible retirement plan as defined in Section 402 of the Internal Revenue Code including any future amendments which affect the definition Penske s Defined Benefit Retirement Plans refer to defined benefit plans that provide retirement benefits to associates and that are not funded wholly by associate contributions. The term shall not include the following, regardless of the source of contributions: Profit sharing plans, Non-qualified plans of deferred compensation, or Plans under IRC Section 401(k). No-fault Auto Laws Only the basic reparations portion for loss of income of a law providing for payments without determining fault in connection with automobile accidents will be counted. Supplemental disability benefits you buy under a no-fault law will not be counted. Loss of time disability income payments under any "automobile liability insurance policy issued in accordance with the Pennsylvania Motor Vehicle Financial Responsibility Law" will be offset. Other Programs or Plans including: Loss of time disability payments under state compulsory benefit programs will be counted Any other group disability income plan, fund, or other arrangement, no matter what called, if Penske contributes toward it or makes payroll deductions for it, will be counted, or Any sick pay or other salary continuation, other then vacation pay, paid to you by Penske will be counted Workers Compensation or a Similar Law Periodic benefits and substitutes and exchanges for periodic benefits will be counted. Occupational Disease Laws 10 MyPenskeHR

14 Maritime Maintenance & Cure Unemployment Insurance Law or Program Exceptions to Other Income Benefits Other income benefits will not include: Group credit or mortgage disability insurance benefits, or Early retirement benefits not taken into constructive receipt, or Individual insurance policies. Work Incentive Benefit If you are disabled and your monthly disability earnings are 20% or more of your indexed monthly earnings, due to the same sickness or injury, Prudential will figure your payment as follows: During the first 24months of payments, while working, your monthly payment will not be reduced as long as disability earnings plus the gross disability payment does not exceed 100% of indexed monthly earnings. 1. Add your monthly disability earnings to your gross disability payment. 2. Compare the answer in item one to your indexed monthly earnings. If the answer from item one is less than or equal to 100% of your indexed monthly earnings, Prudential will not further reduce your monthly payment. If the answer from item one is more than 100% of your indexed monthly earnings, Prudential will subtract the amount over 100% from your monthly payment. After 24 months of payments, while working, you will receive payments based on the percentage of income you are losing due to your disability. 1. Subtract your disability earnings from your indexed monthly earnings. 2. Divide the answer in item one by your indexed monthly earnings. This is your percentage of lost earnings. 3. Multiply your monthly payment by the answer in item two. This is the amount Prudential will pay you each month. Rehabilitation Incentive While disabled, your monthly benefit, before reduction for other income benefits, is increased by 10% for up to 12 months when you participate in a rehabilitation program approved by Prudential. Family Care Expenses Day Care Prudential will send you a day care payment each month up to the maximum period of day care payment while you are: Receiving long term disability benefits under the plan, and 11 MyPenskeHR

15 Participating in a rehabilitation program that has been approved by Prudential. Your maximum period of day care payment is 12 months. 12 MyPenskeHR

16 The monthly day care payment is equal to the amount of your eligible day care expenses up to the maximum monthly day care amount. Your maximum monthly day care amount is equal to $500 times the number of eligible children. Eligible children are children age 12 or under who live with the employee. Children include legally adopted children, stepchildren and foster children. Spouse and Elder Care Prudential will send you a spouse and elder care payment each month up to the maximum period of spouse and elder care payment while you are: Receiving long term disability benefits under the plan; and Participating in a rehabilitation program that has been approved by Prudential. Your maximum period of spouse and elder care payment is 12 months. The monthly spouse and elder care payment is equal to the amount of your eligible spouse and elder care expenses up to the maximum monthly spouse and elder care amount. Your maximum monthly spouse and elder care amount is equal to $500 times the number of eligible family members. Eligible family members include the employee's spouse, employee's parents or grandchildren who live with the employee, and spouse's parents and grandparents who live with employee. Survivor Benefit If you die while you are receiving LTD benefit payments, your spouse or unmarried children under age 25 may be eligible for a lump sum survivor benefit. The amount of this benefit is equal to three times the monthly benefit before reductions for other income benefits. The amount of this benefit is reduced by any overpayment that Prudential is entitled to recover. Prudential will pay the survivor benefit, if the following conditions are met: You have completed your elimination period of 180 or more consecutive days, You are eligible to receive a monthly benefit at the time of death, Proof of your death is provided to Prudential. An eligible survivor is one of the following: Your surviving spouse, or If there is no surviving spouse, your unmarried children or your spouse s unmarried children under age 25. The term children also includes adopted children and children placed for adoption until legal adoption. Payment will be divided into equal shares among the eligible children. Prudential will pay a survivor benefit to your eligible survivor on the date one month after the last monthly benefit payment was made before your death. However, if there is no eligible survivor on the date payment is due to be paid, Prudential will pay the benefit to the estate. 13 MyPenskeHR

17 Payment to a minor child may be made to an adult who submits proof satisfactory to Prudential that he/she has assumed custody and support of the child. Duration of LTD Benefits Your LTD benefits will continue until the earlier of: The end of your maximum LTD benefit period as shown on the chart below, The day your earnings exceed the amount allowable under the program. For the first 24 months of payment, this is 80% of indexed monthly earnings, but after 24 months, the percentage changes to 60%. During the first 24 months of payments, when you are able to work in your regular occupation on a part-time basis but choose not to; after 24 months of payments, when you are able to work in any gainful occupation on a part-time basis but choose not to. The day you are no longer disabled, The day you die, The day you refuse to fully cooperate in all required phases of the rehabilitation plan that Prudential considers appropriate for your situation AND that is approved by an independent doctor. The day you are no longer receiving appropriate care, or The day you fail to cooperate in the administration of your claim. 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. 14 MyPenskeHR

18 Age on Date Disability Starts Maximum Benefit Duration Under age 61 To your normal retirement age*, but no less than 60 months 61 To your normal retirement age*, but no less than 48 months 62 To your normal retirement age*, but no less than 42 months 63 To your normal retirement age*, but no less than 36 months 64 To your normal retirement age*, but no less than 30 months months months months months 69 and over 12 months * Your normal retirement age is your retirement age under the Social Security Act where retirement age depends on your year of birth. Limitations Alcohol, Drug or Substance Abuse or Dependency If you are disabled due to alcohol, drug or substance abuse or dependency, monthly benefits are limited to one period of disability during your lifetime. Self-reported Injuries Disabilities, which as determined by Prudential, are primarily based on self-reported symptoms are limited to 12 months. Pre-Existing Conditions You may be disabled due to a pre-existing condition. No LTD benefits are payable in connection with that disability, unless you have been an active associate covered under the LTD program for 12 consecutive months. A pre-existing condition is an injury, sickness, or pregnancy for which you in the three months before your effective date: Received medical treatment, consultation, care, or services, Took prescription medication or had medications prescribed, or Had symptoms or conditions which would cause a reasonably prudent person to seek diagnosis, care, or treatment. 15 MyPenskeHR

19 If you cannot satisfy the above limitation and you were covered under the plan that this program replaced at the time of transfer, benefits may be payable under the LTD program. Prudential will give consideration towards the continuous time you were covered under the prior plan and this program. If you then satisfy the above limitation, the maximum monthly benefit payable under this program will not exceed the lesser of: The maximum benefit under this program, and The maximum benefit under the prior plan. Pre-existing limitations also apply to any benefit increase. Disabilities Due to Particular Conditions Prudential will continue to send you payments for disabilities due in whole or part to mental illness beyond the 12 month period if you meet one or both of these conditions: 1. If you are confined to a hospital or institution at the end of the 12 month period, Prudential will continue to send you payments during your confinement. If you are still disabled when you are discharged, Prudential will send you payments for a recovery period of up to 90 days. If you become reconfined at any time during the recovery period and remain confined for at least 14 days in a row, Prudential will send payments during that additional confinement and for one additional recovery period up to 90 more days. 2. In addition to item one, if, after the 12 month period for which you have received payments, you continue to be disabled and subsequently become confined to a hospital or institution for at least 14 days in a row, Prudential will send payments during the length of the confinement. Prudential will not pay beyond the limited pay period as indicated above, or the maximum period of payment, whichever occurs first. When LTD Benefits Are Not Paid The LTD program does not cover any disability that results from or is caused by or contributed to: War, declared or undeclared, or any act of war. Active participation in a riot, Intentionally self-inflicted injuries or attempted suicide, or Disabilities as a result of a crime from which the employee has been convicted in a court of state or federal law. 16 MyPenskeHR

20 Your Other Benefits While You Are Receiving LTD Benefits During any certified disability period, you will continue to be eligible for certain benefits through the end of the month following six months from the last day you were actively at work. Approval to receive LTD benefits does not entitle you to any additional period of benefit eligibility. 17 MyPenskeHR

21 How to File a Claim You must file a claim in order to receive LTD 50, LTD 60 or LTD 66 benefits. The Plan Administrator has appointed Prudential, as the named fiduciary for adjudicating claims for benefits under the program, and for deciding any appeals of denied claims. Prudential shall have the authority, in its discretion, to interpret the terms of the program, to decide questions of eligibility for coverage or benefits under the program, and to make any related findings of fact. All decisions made by Prudential shall be final and binding on participants and beneficiaries to the full extent permitted by law. For more information, see Administrative Information. Notice of Disability To file a claim, you should: Call the Penske Benefits Center at within 31 days from the date of disability. Claim forms and a return envelope will then be mailed to you. Complete and mail the claim forms in the return envelope to Prudential. The mailing address is: The Prudential Insurance Company of America Disability Management Services PO Box Philadelphia, PA Receive either payment or a letter requesting additional information from the insurance company after it receives notice of your claim. Proof of Claim You must provide proof of claim within three months after the end of your elimination period. No benefits are payable for claims submitted more than one year after the date of disability. However, you can request that benefits be paid for late claims if you can show that: It was not reasonably possible to give written proof of disability during the one year period, and Proof of claim satisfactory to Prudential was provided as soon as was reasonably possible. At your expense, you must provide documented proof of your disability. Proof includes, but is not limited to: The date your disability started, The cause of your disability, and The prognosis of your disability. You will be required to provide signed authorization for Prudential to obtain and release medical and financial information, and any other items Prudential may reasonably require in support of your disability. These will include but are not limited to: Proof of continuing disability, 18 MyPenskeHR

22 Proof you have applied, or are not eligible for other income benefits. If you do not provide proof you have applied for other income benefits, Prudential may reduce your monthly benefit. The reduction will be based on your estimate of what you would be eligible to receive through proper and timely pursuit, Proof that you applied for Social Security disability benefits until denied at the administrative law judge level, and Proof you have applied for Workers Compensation benefits or benefits under a similar law. If you do not provide proof that you have applied for these benefits, Prudential may reduce your monthly benefit. The reduction will be based on our estimate of what you would be eligible to receive through proper and timely pursuit. If you do not provide satisfactory documentation after Prudential asks for it, your claim may be denied. Method of Payment When Prudential determines you are disabled: Monthly benefits are paid one month after you qualify for them. Such benefits will be paid on a monthly basis thereafter. Benefits will be paid to you. However, benefits unpaid at your death will be paid to: Your spouse, if living, otherwise Your children, if living, divided equally, or Your estate. If benefits are payable to your estate, Prudential may pay up to $1,500 to someone related to you by blood or by marriage whom Prudential deems entitled to this amount. Prudential will be discharged to the extent of any payment made in good faith. Monthly benefits due for a period of less than a month will be paid at a daily rate of 1/30th of the monthly benefit payable. Right to Recover Overpayments Prudential has the right to recover from you any amount that they determine to be an overpayment. You have the obligation to refund any such amount. Prudential s rights and your obligations in this regard are also set forth in the reimbursement agreement you are required to sign when you become eligible for benefits under this program. The agreement: Confirms that you will repay all overpayments, and Authorizes Prudential to obtain any information relating to other income benefits. Prudential may recover the overpayment by: Reducing or offsetting any future benefits payable to you or your survivors, Stopping future benefit payments (including minimum benefits) which would otherwise be due under this program. Payment may continue when the overpayment has been recovered, or Demanding an immediate refund of the overpayment from you. 19 MyPenskeHR

23 Legal Actions No legal action of any kind may be filed against Prudential within the 60 days after proof of claim has been given, or more than three years after proof of claim must be filed, unless otherwise provided by federal law. Medical Examinations Prudential has the right to have you examined at reasonable intervals by medical specialists of their choice, at their expense. Failure to attend a medical examination or cooperate with the medical examiner may be cause for denial or suspension of your benefits. Assignment You may not assign your benefits. This means that you may not give or transfer your benefits to anyone else. Workers Compensation This program is not in lieu of, and does not affect any requirement for coverage by Workers Compensation Insurance or any government mandated temporary disability income benefit law. 20 MyPenskeHR

24 If Your Claim Is Denied If your claim for benefits is denied or if you do not receive a response to your claim within the appropriate time frame (in which case the claim for benefits is deemed to have been denied), you or your representative may appeal your denied claim in writing to Prudential within 180 days of the receipt of the written notice of denial or 180 days from the date such claim is deemed denied. You may submit with your appeal any written comments, documents, records and any other information relating to your claim. Upon your request, you will also have access to, and the right to obtain copies of, all documents, records and information relevant to your claim free of charge. A full review of the information in the claim file and any new information submitted to support the appeal will be conducted by Prudential, utilizing individuals not involved in the initial benefit determination. This review will not afford any deference to the initial benefit determination. Prudential shall make a determination on your claim appeal within 45 days of the receipt of your appeal request. This period may be extended by up to an additional 45 days if Prudential determines that special circumstances require an extension of time. A written notice of the extension, the reason for the extension and the date that Prudential expects to render a decision shall be furnished to you within the initial 45-day period. However, if the period of time is extended due to your failure to submit information necessary to decide the appeal, the period for making the benefit determination will be tolled (i.e., suspended) from the date on which the notification of the extension is sent to you until the date on which you respond to the request for additional information. If the claim on appeal is denied in whole or in part, you will receive a written notification from Prudential of the denial. The notice will be written in a manner calculated to be understood by the applicant and shall include: The specific reason(s) for the adverse determination, References to the specific plan provisions on which the determination was based, A statement that you are entitled to receive upon request and free of charge reasonable access to, and make copies of, all records, documents and other information relevant to your benefit claim upon request, A description of Prudential s review procedures and applicable time limits, A statement that you have the right to obtain upon request and free of charge, a copy of internal rules or guidelines relied upon in making this determination, and A statement describing any appeals procedures offered by the plan, and your right to bring a civil suit under ERISA. If a decision on appeal is not furnished to you within the time frames mentioned above, the claim shall be deemed denied on appeal. If the appeal of your benefit claim is denied or if you do not receive a response to your appeal within the appropriate time frame (in which case the appeal is deemed to have been denied), you or your representative may make a second, voluntary appeal of your denial in writing to Prudential within 180 days of the receipt of the written notice of denial or 180 days from the date such claim is deemed denied. You may submit with your second appeal any written comments, documents, records and any other information relating to your claim. Upon your request, you will also have 21 MyPenskeHR

25 access to, and the right to obtain copies of, all documents, records and information relevant to your claim free of charge. Prudential shall make a determination on your second claim appeal within 45 days of the receipt of your appeal request. This period may be extended by up to an additional 45 days if Prudential determines that special circumstances require an extension of time. A written notice of the extension, the reason for the extension and the date by which Prudential expects to render a decision shall be furnished to you within the initial 45-day period. However, if the period of time is extended due to your failure to submit information necessary to decide the appeal, the period for making the benefit determination will be tolled from the date on which the notification of the extension is sent to you until the date on which you respond to the request for additional information. Your decision to submit a benefit dispute to this voluntary second level of appeal has no effect on your right to any other benefits under this plan. If you elect to initiate a lawsuit without submitting to a second level of appeal, the plan waives any right to assert that you failed to exhaust administrative remedies. If you elect to submit the dispute to the second level of appeal, the plan agrees that any statute of limitations or other defense based on timeliness is tolled during the time that the appeal is pending. If the claim on appeal is denied in whole or in part for a second time, you will receive a written notification from Prudential of the denial. The notice will be written in a manner calculated to be understood by the applicant and shall include the same information that was included in the first adverse determination letter. If a decision on appeal is not furnished to you within the time frames mentioned above, the claim shall be deemed denied on appeal. 22 MyPenskeHR

26 When Coverage Ends Your LTD 50, LTD 60 or LTD 66 coverage will end on the earliest of the following dates: The date you are eligible for coverage under a plan intended to replace this coverage, The date the policy is terminated, The date on which you are no longer eligible for coverage, For coverage requiring associate contributions, the date coinciding with the end of the last period for which required premiums are paid, The date on which you are no longer an active associate. If You Leave the Company Your coverage ends on the date you are no longer an active associate. Note that if you are already out on an approved disability prior to being terminated, you are still covered under the LTD program. If You are Rehired If you are rehired by Penske within 12 months from the date you left the Company, the benefit elections you had before leaving will begin again on the first of the month after your rehire date. Otherwise, you are considered a new hire and you will need to enroll for all your benefits. If You Have a Leave of Absence Your LTD coverage ends at the end of the month following the month in which the commencement of a leave of absence that is not due to medical reasons or protected under the Family and Medical Leave Act (FMLA). For example, if your leave begins in February, LTD coverage ends on February 28. For more information about FMLA, see Administrative Information. If You Die While a Plan Participant Your coverage ends if you die while a plan participant. If you are receiving LTD benefits at the time of your death, your family may be eligible to receive a survivor benefit. For more information, see Survivor Benefit on page 10. October MyPenskeHR