Life Insurance Benefits and Accidental Death & Dismemberment

43 Pages·2005·0.13 MB·English

LIFE INSURANCE BENEFITS
FOR U.S. EMPLOYEES AND RETIREES

And

ACCIDENTAL DEATH and
DISMEMBERMENT INSURANCE BENEFITS
FOR U.S. EMPLOYEES

Under the

NATIONAL RAILWAY CARRIERS
and UNITED TRANSPORTATION UNION (NRC/UTU)
HEALTH and WELFARE PLAN
TABLE OF CONTENTS

Page

I. INTRODUCTION...........................................................................1
II. DEFINITIONS ............................................................................10
III. EFFECTIVE DATE OF COVERAGE ........................................14
IV. LIFE INSURANCE UNDER THE PLAN ...................................16
V. RIGHT TO CONVERT TO A PERSONAL
POLICY OF LIFE INSURANCE ................................................17
VI. ACCIDENTAL DEATH AND DISMEMBERMENT
INSURANCE UNDER THE PLAN.............................................21
VII. WHEN COVERAGE ENDS .......................................................23
VIII. CONDITIONS UNDER WHICH ACTIVE
EMPLOYMENT IS DEEMED TO CONTINUE .........................25
IX. BENEFICIARY ...........................................................................31
X. REVIEW OF CLAIMS ................................................................34
XI. FUTURE OF THE PLAN ...........................................................38
XII. ERISA INFORMATION ..............................................................39
XIII. STATEMENT OF ERISA RIGHTS ............................................42
I
Introduction

This booklet describes the life insurance and accidental death
and dismemberment insurance benefits that are available to
U.S. employees and the life insurance benefit that is available to
retirees under the National Railway Carriers and United
Transportation Union (NRC/UTU) Health and Welfare Plan. We
urge you to read it carefully, and to keep it in a safe place. Your
Beneficiary should know where it is kept.
The NRC/UTU Health and Welfare Plan B which we refer to in
this booklet as the "Plan" B also provides health benefits. Those
benefits are described in a separate booklet entitled "NATIONAL
RAILWAY CARRIERS and UNITED TRANSPORTATION
UNION HEALTH AND WELFARE PLAN."
The Plan is maintained pursuant to collective bargaining
agreements between the United Transportation Union ("the
UTU") and contain freight railroads; including the Burlington
Northern Santa Fe, Conrail, CSX, Kansas City Southern, Norfolk
Southern, and Union Pacific, along with their wholly-owned
subsidiaries. For those employees and retirees eligible for
coverage under it, the Plan replaces coverage under The
Railroad Employees National Health and Welfare Plan.
This booklet does not constitute a legal contract. The benefits it
describes are provided pursuant to an insurance policy. If there
are any differences between this booklet and the insurance
policy, the policy will govern.

For information about Plan benefits or how to file a claim,
call Metropolitan toll-free at 1-800-310-7770.
Schedule of Benefits
The life insurance and accidental death and dismemberment
insurance benefits under the Plan are provided through Group
Policy No. 105147 issued to the Plan by Metropolitan Life
Insurance Company. The Group Policy provides the following
benefits, subject to the remaining provisions of this booklet.
BENEFITS FOR ELIGIBLE EMPLOYEES
The following insurance benefits are payable to Eligible
Employees effective July 1, 2004:
Amount
LIFE INSURANCE ......................................................................$20,000
ACCIDENTAL DEATH AND
DISMEMBERMENT INSURANCE...................................Up to $ 16,000
BENEFITS FOR RETIRED EMPLOYEES
LIFE INSURANCE.........................................................................$ 2,000
Conversion Of Life Insurance Benefits To Personal
Policy
If your life insurance coverage under the Plan ceases, you may
be permitted to purchase a personal policy of life insurance from
Metropolitan Life Insurance Company, without having to give
proof of good health. Certain restrictions will apply, though. See
Section V of this booklet.
No Cash Value or Assignment
The life insurance and accidental death and dismemberment
insurance provided under the Plan do not at any time provide
paid-up insurance, or loan or cash values. Nor may you assign
your insurance benefits to anyone else.
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Life And AD&D Insurance Under The Former Policy
Contract
Group Policy No. 105147 issued by Metropolitan Life Insurance
Company became effective on January 1, 2002. Eligible
Employees and retirees who are covered under this Plan and
who were eligible for benefits prior to January 1, 2002 were
covered under a different policy issued by Minnesota Life
Insurance Company. That policy provided the same benefits and
level of benefits as the Metropolitan policy provided at the time it
was issued. Now, the Metropolitan policy provides for the
benefits described in this booklet, which for Eligible Employees
are greater than they were before.
Eligibility
Because certain employees sometimes work in train service and
sometimes in engine service, the Plan has been designed to
avoid duplication of benefits. The Plan provides that the
following employees of railroads participating in it are eligible for
life and AD&D insurance coverage under the Plan (provided
they meet the other criteria in the definition of Eligible
Employee):
• Employees who, as of the last Friday in August of the prior
calendar year, are listed in UnitedHealthcare’s records as
working under a UTU collective bargaining agreement;
• Employees hired after the last Friday in August of the prior
calendar year under a UTU agreement, provided they did
not first work under a collective bargaining agreement with
the Brotherhood of Locomotive Engineers and Trainmen
("BLET").
• Employees moving after the last Friday in August of the prior
calendar year, to a position covered by a UTU agreement,
provided that as of the date of the move they had not last
worked under a BLET agreement.
For employees, eligibility for coverage under the Metropolitan
policy begins when the employee becomes an Eligible
Employee and ends when the employee is no longer an
Eligible Employee.
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Employees not eligible for coverage under the Plan during a
given calendar year because of being listed in
UnitedHealthcare's records as working under a BLET
agreement as of the last Friday in August of the prior calendar
year will not become eligible for coverage at any time during
such given calendar year, even if they subsequently work under
a UTU agreement. These employees may continue to be eligible
for coverage under The Railroad Employees National Health
and Welfare Plan.
NOTE: For these purposes, an employee should be listed in
UnitedHealthcare's records as working under a UTU agreement
as of the last Friday in August of any given calendar year only if,
during the twelve-month period ending on June 30 of such
calendar year, the employee's earnings from train and engine
service under a UTU agreement were greater than his or her
earnings from train and engine service under a BLET
agreement. Similarly, an employee should be listed in
UnitedHealthcare's records as working under a BLET
agreement as of the last Friday in August of any given calendar
year only if, during the twelve-month period ending on June 30
of such calendar year, the employee's earnings from train and
engine service under a BLET agreement were greater than his
or her earnings from train and engine service under a UTU
agreement.
The Plan also provides that the following retired employees of
railroads participating in it are eligible for life insurance coverage
under the Plan (provided they meet the other criteria in the
definition of Retired Employees):
$ Employees who retired on or before September 1, 1999, and
who had last worked under a collective bargaining
agreement between a Participating Employer and the UTU;
$ Employees who retired after September 1, 1999, and before
January 1, 2000, and who, as of September 1, 1999, last
worked under a collective bargaining agreement between a
Participating Employer and the UTU, or who transferred after
September 1, 1999 to a position covered by a collective
bargaining agreement between a Participating Employer and
the UTU, provided that as of that date they had not last
worked under a BLET agreement;
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$ Employees who retired on or after January 1, 2000, and who
were covered under this Plan as Eligible Employees for
health care benefits and for life and AD&D insurance
benefits when they last worked.
For Retired Employees, eligibility for coverage under the
Metropolitan policy will be January 1, 2002, if you were already
retired as of that date.
If you become a Retired Employee on or after January 1, 2002,
your life insurance as a Retired Employee will become effective
on the date immediately following the date your coverage as an
Eligible Employee ceases.
Retired Employees who are not eligible for coverage under the
Plan as Eligible Employees during a given calendar year
because of being listed in UnitedHealthcare's records as working
under a BLET agreement as of the last Friday in August of the
prior calendar year will not become eligible for coverage at
anytime during such given calendar year, even if they last
worked under a UTU agreement before their retirement. These
Retired Employees may continue to be eligible for coverage
under The Railroad Employees National Health and Welfare
Plan.
You and your beneficiary are not entitled to receive the benefits
under this Plan and under The Railroad Employees National
Health and Welfare Plan. Accordingly, if your beneficiary
receives life insurance benefits under The Railroad Employees
National Health and Welfare Plan on account of your death, your
beneficiary will not be permitted to receive life insurance benefits
under this Plan on account of your death. Similarly, if you or
your beneficiary receives AD&D insurance benefits under The
Railroad Employees National Health and Welfare Plan on
account of injuries you sustained in an accident, you and your
beneficiary will not be permitted to receive AD&D insurance
benefits under this Plan for injuries you sustained in the same
accident. If your beneficiary receives life insurance benefits
under this Plan on account of your death, your beneficiary will
be deemed to have waived any right to life insurance benefits
under The Railroad Employees National Health and Welfare
Plan on account of your death. Similarly, if you or your
beneficiary receives AD&D insurance benefits under this Plan
on account of injuries you sustained in an accident, you and
your beneficiary will be deemed to have waived any right to
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AD&D insurance benefits under The Railroad Employees
National Health and Welfare Plan for injuries you sustained in
the same accident.
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II
Definitions

The following terms used in this booklet have the meanings set
forth below:
"Another Railroad Health and Welfare Plan" means a health
and welfare plan established pursuant to agreement between a
railroad or railroads and a labor organization or labor
organizations other than this Plan and The Railroad Employees
National Health and Welfare Plan.
"Eligible Employee" means you are eligible for coverage if:
• You are a U.S. resident, you are employed by a participating
employer, and you work under a collective bargaining
agreement with either the UTU or the BLET; and
• If you were hired on or after March 1, 2004, at least three full
calendar months have passed since the month in which you
first rendered the Requisite Amount of Compensated
Services for the participating employer by whom you are
now employed. If in the interim you begin working for a
different participating employer, you will not become an
Eligible Employee until three full calendar months have
passed since the month in which you first rendered the
Requisite Amount of Compensated Service for your new
participating employer; and
• you are listed on UnitedHealthcare’s records as of the last
Friday in August of the prior calendar year as working under
a collective bargaining agreement with the UTU;
or
• you were hired after the last Friday in August of the prior
calendar year under a UTU agreement and did not first work
under a collective bargaining agreement with the BLET;
or
• after the last Friday in August of the prior calendar year, you
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moved to a position covered by a UTU agreement and as of
the date of the move you had not last worked under a BLET
agreement.
"Former Policy Contract" means:
a. Group Policy Contract 29415-G issued by Minnesota Life
Insurance Company to the National Railway Carriers and
United Transportation Union Health and Welfare Plan; or
b. Group Policy Contract 1023000-G issued by Metropolitan
Life Insurance Company to The Railroad Employees
National Health and Welfare Plan; or
c. Any other policy issued to The Railroad Employees
National Health and Welfare Plan, the insurance under
which was replaced by the insurance under Group Policy
Contract 1023000-G issued by Metropolitan Life Insurance
Company, and which was defined in Group Policy
Contract 1023000-G as a "Former Policy Contract."
"Group Policy" means Group Policy No. 105147 issued by
Metropolitan Life Insurance Company to the Policyholder for
benefits under this Plan.
"Metropolitan" means the Metropolitan Life Insurance
Company. Metropolitan's home office is located at One
Madison Avenue, New York, New York 10010.
"Participating Employer" means an employer that participates
in the Plan. The employers participating in the Plan include the
Burlington Northern Santa Fe, Conrail, CSX, Kansas City
Southern, Norfolk Southern, and Union Pacific, along with their
wholly-owned subsidiaries.
"Plan" means the National Railway Carriers and United
Transportation Union (NRC/UTU) Health and Welfare Plan.
"Requisite Amount of Compensated Service" means
compensated service rendered on an aggregate of at least
seven (7) calendar days during a calendar month. This seven-
day rule will be applied in accordance with the terms of the
collective bargaining agreement providing for it, including any
side letter to such agreement dealing with application of the rule.
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