The amount of Life Insurance will be raised to the next
multiple of $1,000, if not already such a multiple. In no event will the amount of Life
Insurance exceed $400,000.
Except, if you are an Employee who is Totally Disabled on March 1, 1993
and your insurance is not being continued under the prior carrier's plan, the
amount of Life Insurance for you prior to your return to Active Work
will be equal to the same amount of Life Insurance in effect for you on
February 28, 1993 under the policy this policy replaces.
Changes in the Amounts For Which You Are
Insured...will be made when your Annual Wage or attained age changes.
The amounts will be adjusted automatically to reflect the change, on
the effective date of the change, except as follows:
- 1.
- If you are not Actively At Work on the effective
date of the change in your Annual Wage, the adjustment will take effect on the date
you have completed 5 full consecutive days of Active Work.
- 2.
- If UCAR makes a retroactive change in your Annual Wage, no retroactive adjustment
will be made in the amounts.
- B.
- The Amount of Life Insurance That Can Be Accelerated...can equal up to 100% of the amount
of Life Insurance for which you are insured, subject to the other limits in the "ACCELERATED DEATH BENEFIT".
PART 4: TYPES OF BENEFITS - LIFE INSURANCE BENEFITS
The Death Benefit...will be equal to the
amount set forth in "PART 3: SCHEDULE OF BENEFIT AMOUNTS, (A) The Amount of Life Insurance."
PART 5: PAYMENT IN THE EVENT OF DEATH
The Benefits Are Payable...to your Beneficiary.
The Beneficiary is any person or institution whom you have named, (other than UCAR) in
form satisfactory to TIAA, to receive the benefits at your death. You may
designate different classes of Beneficiaries such as primary (first) and contingent
(secondary). These classes set the order of payment. A class may contain more than one
person. Benefits will be paid in equal shares to the then living persons
in the class with the highest priority.
For example, if you die with your spouse named as primary Beneficiary and "children" as
equal contingent Beneficiaries, your spouse would receive all of the benefits if he or
she survived you. But if your spouse did not survive you, then your surviving children
would receive equal shares of the benefits.
"Children" or "My Children"...are terms which may be used to name a class of
or Beneficiaries, either primary or contingent. Unless you specify otherwise, these terms
will mean: all children born of your marriage or marriages; and any children legally
adopted by you. The term "children" also has the same inclusive meaning when used to name
as Beneficiaries the children of: a spouse, a child, a brother or a sister.
If No Beneficiaries Are Named...or are
alive at your death, the benefits will be paid to:
- 1.
- the executor or administrator of your estate; or
- 2.
- at TIAA's option, any one or more of these surviving relatives: a spouse, a
child, a parent, a brother or a sister.
You May Change The Beneficiary...at any time by written notice in form
satisfactory to TIAA, if the right to do so has not been assigned. Once recorded by or on
behalf of TIAA, the change will take effect as of the date you signed the notice. Until
the notice is recorded, TIAA will not be liable for any action taken in good faith
contrary to directions contained in the notice. If you change the Beneficiary, any
choice of method of payment for benefits payable under the group policy is
revoked.
The Methods of Payment...for other than a one sum payment
may be made by you or, after your death, by a Beneficiary other than your estate. When
TIAA receives satisfactory proof of your death, the benefits provided under the group
policy will be payable in one sum unless some other method of payment is (or
was) requested in writing and approved by TIAA. Amounts and terms of other than one sum
payments will be those normally offered by TIAA for group life insurance
at the time of the request.
TIAA may, at its option, pay up to $5,000 of the benefits to any person who incurs expenses for
your final illness or burial. Such payment will be proper and the
Beneficiary will receive any remaining benefits.
PART 6: WHEN INSURANCE CEASES
Your Insurance Will Cease...on the earliest of the following events:
- 1.
- the date the group policy terminates; or
- 2.
- the date the group policy is changed to terminate insurance on the class of Employees
to which you belong; or
- 3.
- the date you stop Active Work in an eligible class.
Except when employment terminates due to a reduction in staff, life insurance may be
continued to the end of two months; or
- 4.
- the date that ends the period for which you made the last required premium
contribution, if any.
If you are no longer actively at work due to a leave of
absence or other absence, ask your Plan Administrator when your insurance ceases. Your
Plan Administrator is listed in "PART 11: ERISA".
CONVERSION OF LIFE INSURANCE
When Your Life Insurance Ceases...under the group policy,
you may purchase an individual policy of life insurance without providing proof of good
health as follows:
- 1.
- When your employment terminates or you stop Active Work in an eligible class;
the amount of Life Insurance you will be permitted to purchase under an individual policy may not
be more than the amount of Life Insurance for which you were insured under the group
policy when coverage ceased; or
- 2.
- When the group policy terminates or is changed so that the class to which you belong
is no longer eligible for insurance; the amount of Life Insurance you will be permitted to
purchase under an individual policy may not be more than:
- (a) the amount of Life Insurance for which you were
insured under the group policy when coverage ceased;
- less
- (b) the amount of any group life insurance for which you are then eligible or become
eligible within 31 days after the date coverage ceased under the group policy.
When Your Life Insurance Reduces as Your Attained Age Changes...you may
purchase an individual policy of life insurance as if employment had terminated on the
date the reduction took effect. The amount of life insurance you will be permitted to
purchase under an individual policy will be the amount by which Life Insurance under the
group policy was reduced.
An Individual Policy...will be issued under these
additional requirements and terms:
- 1.
- You must make application for an individual policy
and pay the first premium for that policy within 31 days after the date your
insurance ceases under the group policy; and
- 2.
- The individual policy may be on any one of the life
insurance forms that TIAA then makes available, except one for term insurance, or one
having disability or other supplementary benefits. At your option, however, single premium
term insurance for one year may precede insurance under the individual policy; and
- 3.
- The premium payable will be based on the rates in use by TIAA on the date the
individual policy takes effect. The rates will be based on the policy chosen, and your
attained age and class of risk; and
- 4.
- The individual policy will take effect on the thirty-second day after the termination
of your insurance under the group policy.
If You Die During The Conversion Period...TIAA will pay
the amount of Life Insurance that could have been converted. Such amount will be paid to
the Beneficiary named under the group policy, if you died before applying for an
individual policy of life insurance. If, however, you died after applying for an
individual policy, such amount will be paid to the Beneficiary named on the application
for the individual policy.
PART 7: REQUESTING INFORMATION AND APPLYING FOR BENEFITS
Requesting Information: The Plan Administrator will answer
any written question or request that you (or your beneficiary who is receiving benefits)
have about enrollment, participation or other administrative matters. You will receive a
written explanation within a reasonable period of time (not more than 90 days after the
Plan Administrator receives your written question or request).
If your request is denied, the explanation will include
the reasons for the denial, a description of any materials necessary to complete the request,
and an explanation of why this material is necessary. And, it will tell you how to apply for
a review if you are not satisfied with the explanation.
- A.
- Applying for Review: If your request is denied or
you are not satisfied with the response, you may ask for a review. Write directly to the
Plan Administrator within 60 days of receiving your answer. You or your duly authorized
representative may examine any documents pertaining to your question or request. You
are encouraged to submit issues and comments to the Plan Administrator. You will receive a
decision in writing on the review within a reasonable time (not more than 60 days).
- B.
- Delays: If special circumstances require a delay on a
request or question, the Plan Administrator will notify you. The notice will explain reasons for
the delay and when you can expect a decision. If it is a delay on the initial request or
question, the Plan Administrator will inform you not more than 90 days after the day the request
was submitted and will send a decision not more than 90 days after the notice of the delay. If
the delay is on a request for review, the Plan Administrator will notify you of the delay not more
than 60 days after the request date and will send a decision not more than 60 days after the
notice.
- C.
- Service of Legal Process: Service of legal process
on any administrative matter should be directed to the Plan Administrator.
Applying for Benefits: An application for benefits
and all documents to support the application, should be filed promptly. The Plan
Administrator can supply the application and help you or your beneficiary complete it.
The Plan Administrator will send the application for benefits to TIAA.
When an application for benefits and all supporting
documents are received, TIAA will process the application promptly.
- A.
- Denied Application for Benefits: If TIAA denies an application
for benefits, you or your beneficiary will receive a written denial within a reasonable
period of time (not more than 90 days). TIAA will specify the reason(s) for the denial,
the provision of the contract on which the denial is based, and how to ask for a
review.
- When appropriate, TIAA's letter will also describe any material which might complete or
perfect the application and will explain why the material is needed.
- B.
- Asking for a Review: You or your beneficiary may ask
for a review of a denied application for benefits by writing directly to TIAA within 60
days of receiving the denial. You or your duly authorized representative may examine
documents pertaining to your application. You are encouraged to submit issues and comments
to TIAA. You or your beneficiary will receive a decision of the review within a reasonable
period of time (not more than 60 days).
- C.
- Delays: If special circumstances require a delay in
evaluating an application for benefits TIAA will notify you. The notice will explain the
reason for the delay and when a decision can be expected.
- If it is a delay on an initial application, TIAA will
notify you or your beneficiary not more than 90 days after the day the application was
submitted, and will send a decision not more than 90 days after the notice
of delay. If the delay is on a request for review of a denied
application for benefits, TIAA will notify you or your beneficiary of the
delay not more than 60 days after the request date and will send a decision not more than 60
days after the notice.
TIAA will comply with any shorter time limits which may
be required by the laws or regulations of the state in which the group policy is
issued.
Requests for Information About Your Insurance:
Please direct any written request for information about the TIAA Group Life Insurance Benefits policy, its terms, conditions, interpretations, application
for benefits thereunder, review of an application, and the service of legal process to: Teachers Insurance and Annuity Association, 730 Third
Avenue, New York, New York 10017-3206.
PART 8: ACCELERATED DEATH BENEFIT
The Accelerated Death Benefit...will be provided if you have a
Terminal Illness. You can accelerate the payment of your Life Insurance in advance of
your death, if TIAA receives satisfactory proof that you have a Terminal Illness.
Terminal Illness...is a state of health in which your life
expectancy is twelve months or less.
The Amount of Life Insurance That Can Be Accelerated...can equal up to 100% of the amount of Life Insurance for
which you are insured.
Except, if:
- A.
- the Schedule of Insurance provides for decreasing amounts of Life Insurance; and
- B.
- your amount of Life Insurance would have been reduced within twelve months from the
date TIAA approves your accelerated payment;
- C.
- the amount of the Accelerated Death Benefit will be based on the reduced amount of
Life Insurance.
- The minimum amount of Life Insurance that can be accelerated is the lesser of:
- A.
- 25% of your amount of Life Insurance; or
- B.
- $50,000.
Payment Will Be Made...directly to you in one sum.
Payment Of The Accelerated Death Benefit...is subject to the following conditions:
- A.
- the group policy is in effect; and
- B.
- your Life Insurance is in effect; and
- C.
- you give to TIAA Notice of Claim and Proof of Terminal Illness as set forth
below; and
- D.
- you are living at the time the Accelerated Death Benefit is payable; and
- E.
- you give to TIAA written consent from:
- 1.
- your spouse, as required by TIAA;
- 2.
- any assignee;
- 3.
- any irrevocable beneficiary.
Limitations The Accelerated Death Benefit can be elected
only once and is available only if you, freely and voluntarily choose to elect this
benefit. Thus;
- A.
- if you are required to elect this benefit to satisfy
the claims of any creditor(s) or to satisfy any judgements against you, you are not eligible
for this benefit; or
- B.
- if you are required by any government agency to elect this benefit in order to apply for, receive, or maintain any government sponsored
benefit, entitlement, or any other form of public assistance, you are not eligible for this
benefit.
Notice of Claim and Proof of Terminal Illness TIAA must receive in writing any
notice of claim and proof of Terminal Illness it requires. Proof of Terminal
Illness must be certified by a physician, other than yourself, who is legally licensed to
practice medicine and surgery. All proof must be satisfactory to TIAA.
Types of Proof TIAA may require as part of the proof of
Terminal Illness; statements of treating physicians; copies of test reports or
examinations; x-rays; hospital records; medical examinations by impartial
specialists at TIAA's expense; and investigations conducted by TIAA or outside
agencies.
Effects On Other Group Policy ProvisionsElection of
the Accelerated Death Benefit will affect the following group policy provisions
as set forth below.
- A.
- The Death Benefit: The amount of this benefit as set
forth in PART 3 under "(A) The Amount of Life Insurance" will be reduced by the amount
of the Accelerated Death Benefit.
- B.
- Conversion of Life Insurance: If insurance ceases, and you
have accelerated the payment of any or all of your Life Insurance, the amount that can
be converted will be based on the amount remaining in effect.
- C.
- Premium Payments: All future premiums will be
waived for any amount of life insurance remaining in effect after you are paid an
Accelerated Death Benefit.
Important Information
The receipt of Accelerated Death Benefits may affect eligibility for Medicaid or other government
benefits or entitlements. In addition, receipt of Accelerated Death Benefits may be taxable. You should seek assistance from
your personal tax advisor.
There is no separate premium cost for the Accelerated Death Benefit and no discount or lien
associated with acceleration of the life insurance benefit.
PART 9: GENERAL PROVISIONS
Misstatement of Age:If your age has been misstated, TIAA will change the amount of
benefits to that of the correct age. A premium change will also be made
so that premiums will be paid for the correct age.
Assignment: You may assign your Life
Insurance Benefit provided under the group policy. No assignment
will bind TIAA unless it is in writing and until it is filed at TIAA's
home office. Once recorded, it will take effect as of the date it
was signed if TIAA receives it before the benefit is paid or any
other action is taken by TIAA. TIAA is not responsible for whether
any assignment is valid. You may not assign insurance as collateral
security.
Overpayment of Benefits: Any overpayment of benefits must be repaid
to TIAA. To recoup the amount overpaid, TIAA, at its option will:
- 1.
- require that the amount be repaid to TIAA in one sum; or
- 2.
- withhold the amount from any future benefits payable to you or your Beneficiary
under the group policy; or
- 3.
- take any legal action it deems necessary.
The Group Policy: TIAA and UCAR may
agree to terminate or change any part of the group policy without your
consent. Such termination or change will not affect Life Insurance that is
continued under the following provisions, if any, on the date of such
termination or change: "Waiver of Life Insurance Premium Benefit" and
"Death During The Conversion Period."
Also, the group policy will terminate due to
non-payment of premiums by UCAR in accordance with the terms of the group policy. And,
TIAA may terminate the group policy as of any date set forth below by giving
notice in writing which is mailed to UCAR at least ninety days before this date:
- 1.
- The date of the group policy's anniversary; or
- 2.
- Any premium due date, if on a prior premium due date
the participation requirements set forth in the group policy have not
been met.
Service of Process: TIAA will accept
service of process in any action or suit against it on the group policy in
any court of competent jurisdiction in the United States, Puerto
Rico or Canada, if such service is properly made. TIAA will also accept
such process sent to it by registered mail if the plaintiff is a resident
of the state, district, territory, or province in which the action or suit
is brought. This provision does not waive any of TIAA's rights,
including the right to remove an action or a suit to another court.
Incontestability
After your insurance has been in force for 2 years, no statement made by you as to your insurability will be used to contest the validity
of your insurance with respect to which the statement was made, nor unless the statement:
(1) is in writing; and
(2) is signed by you; and
(3) a copy is, or has been, given to you or to the Beneficiary.
PART 10: DEFINITIONS
Where Used In This Certificate, The
Following Terms Have The Meaning Set Forth Below:
Active Work or Actively At Work...is performing for wages that are paid
regularly by UCAR, the material and substantial duties of your occupation at the usual place of work or at any alternate place of
work required by UCAR.
Annual Wage...is your basic annual wage payable by
UCAR. It excludes overtime pay, bonuses, and other types of extra
compensation.
Total Disability or Totally Disabled...is being
unable due to sickness, bodily injury or pregnancy to perform any
occupation for which you are suited by education, training or experience.
PART 11: EMPLOYEE RETIREMENT INCOME SECURITY ACT (ERISA)
Statement of Your Rights Under ERISA
As a participant in this Life Insurance Plan, you are granted certain rights and protections under the Employee Retirement Income Security
Act of 1974 (ERISA). In accordance with ERISA, you are entitled to:
Receive Information About Your Plan and Benefits
- 1.
- Examine, without charge, at the Plan Administrator's office and at other specified locations, such as worksites and union halls, all
plan documents governing the plan, including insurance contracts and collective bargaining agreements, and a copy of the latest annual report
(Form 5500 Series) filed by the plan with the U.S. Department of Labor and available at the Public Disclosure Room of the Pension and
Welfare Benefit Administration.
- 2.
- Obtain, upon written request to the Plan Administrator, copies of documents governing the operation of the plan, including insurance
contracts and collective bargaining agreements, and copies of the latest annual report (Form 5500 Series) and updated summary plan
description. The Plan Administrator may make a reasonable charge for the copies.
- 3.
- Receive a summary of the plan's annual financial report. The Plan Administrator is required by law to furnish each participant
with a copy of this summary annual report.
Prudent Actions by Plan Fiduciaries
In addition to creating rights for plan participants, ERISA imposes duties upon the people who are responsible for the operation of the employee
benefit plan. The people who operate your plan, called "fiduciaries" of the plan, have a duty to do so prudently and in the interest of you and other
plan participants and beneficiaries. No one, including UCAR, your union, or any other person, may fire you or otherwise discriminate
against you in any way to prevent you from obtaining a welfare benefit or exercising your rights under ERISA.
Enforce Your Rights
If your claim for a welfare benefit is denied or ignored, in whole or in part, you have a right to know why this was done, to obtain copies of
documents relating to the decision without charge, and to appeal any denial, all within certain time schedules.
Under ERISA there are steps you can take to enforce the above rights. For instance, if you request a copy of plan documents or the latest
annual report from the Plan Administrator and do not receive them within 30 days, you may file suit in a Federal court. In such a case, the
court may require the Plan Administrator to provide the materials and pay you up to $110 a day until you receive the materials, unless the materials
were not sent because of reasons beyond the control of the Administrator. If you have a claim for benefits which is denied or ignored, in whole or
in part, you may file suit in a state or Federal court. In addition, if you disagree with the plan's decision or lack thereof concerning the qualified status
of a domestic relations order or a medical child support order, you may file suit in Federal court. If it should happen that plan fiduciaries misuse
the plan's money, or if you are discriminated against for asserting your rights, you may seek assistance from the U.S. Department of Labor, or
you may file suit in a Federal court. The court will decide who should pay court costs and legal fees. If you are successful, the court may order
the person you have sued to pay these costs and fees. If you lose, the court may order you to pay these costs and fees, for example, if it finds
your claim is frivolous.
Assistance With Your Questions
If you have any questions about your plan, you should contact the Plan Administrator. If you have any questions about this statement or about
your rights under ERISA, or if you need assistance in obtaining documents from the Plan Administrator, you should contact the nearest office
of the Pension and Welfare Benefits Administration, U.S. Department of Labor, listed in your telephone directory or the Division of Technical Assistance
and Inquiries, Pension and Welfare Benefits Administration, U.S. Department of Labor, 200 Constitution Avenue N.W., Washington, D.C. 20210. You
may also obtain certain publications about your rights and responsibilities under ERISA by calling the publications hotline of the Pension and Welfare
Benefits Administration.
EMPLOYER NUMBER: 84-0412668
PLAN NUMBER: 501
PLAN EFFECTIVE DATE: March 1, 1993
PLAN ANNIVERSARY: January 1
For information regarding the plan or service of legal process upon the plan, the Plan Administrator should be contacted.
THE PLAN ADMINISTRATOR IS:
University Corporation for Atmospheric Research
1850 Table Mesa Drive
Boulder, Colorado 80307
(303) 497-8715
FOR INFORMATION CONTACT:
University Corporation for Atmospheric Research
1850 Table Mesa Drive
Boulder,Colorado 80307-3000
(303) 497-8715
February 2002
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