Alcatel-Lucent Long-Term Disability Plan Summary Plan Description

56 Pages·2015·0.29 MB·English

Alcatel-Lucent Long-Term Disability Plan
Summary Plan Description —
Represented/Occupational Employees
January 2015

Effective January 1, 2015
This summary plan description is intended for represented/occupational employees under the Alcatel-Lucent Long-Term
Disability Plan. In the case of a discrepancy between this Summary Plan Description and the official plan document for
the Alcatel-Lucent Long-Term Disability Plan, the official plan document shall control.
Administrative Information
Disclaimer
This is a summary of the benefits offered to represented/occupational employees
under the Alcatel-Lucent Long-Term Disability Plan (the “Long-Term Disability Plan”
or the “Plan"). This summary is provided for informational purposes only and is
intended to comply with Department of Labor requirements for Summary Plan
Descriptions (“SPDs”). More detailed information about the Plan is provided in the
official Long-Term Disability Plan document, a copy of which can be obtained by
writing to the Plan Administrator (see Your Rights Under ERISA and Administrative
Information).
This summary is based on Long-Term Disability Plan provisions effective January 1,
2015. If there is any conflict between the information in this SPD and the Long-Term
Disability Plan document, the Long-Term Disability Plan document will govern.
Plan May Be Amended or Terminated
The Company expects to continue the Long-Term Disability Plan but
reserves the right to amend or terminate the Long-Term Disability Plan,
in whole or in part, at any time by the resolution of the Board of
Directors or its properly authorized designee, subject to the terms of
applicable collective bargaining agreements. In addition, the Company
does not guarantee the continuation of any long-term disability benefits
during employment or at or during retirement nor does it guarantee any
specific level of benefits or contributions, subject to the terms of any
applicable bargaining agreement(s).

Questions regarding your benefits should be addressed as indicated in this SPD (see
Important Contacts). Because of the many detailed provisions of the Plan, no one
other than the personnel or entities identified in this SPD (see Important Contacts) is
authorized to advise you as to your benefits. Neither Alcatel-Lucent nor the Plan can
be bound by statements made by unauthorized personnel or entities. In the event of a
conflict between any verbal information provided to you by an authorized resource
and information in the official Long-Term Disability Plan document, the Long-Term
Disability Plan document will govern.
Please note: Participation in the Plan is neither an offer of nor a guarantee of
continued benefits or future employment.

Effective January 1, 2015
This summary plan description is intended for represented/occupational employees under the Alcatel-
Lucent Long-Term Disability Plan. In the case of a discrepancy between this Summary Plan
Description and the official plan document for the Alcatel-Lucent Long-Term Disability Plan, the
official plan document shall control.
Administrative Information

This document is a working summary of the terms of the LTD Plan as of January 1,
2015 applicable to represented/occupational employees, but is not the Plan itself. To
the extent that anything in this summary may be contradicted by the terms of the
Plan, the Plan terms are controlling. You may always request a copy of the full plan
document from the Plan Administrator (see Administrative Information).

Effective January 1, 2015
This summary plan description is intended for represented/occupational employees under the Alcatel-
Lucent Long-Term Disability Plan. In the case of a discrepancy between this Summary Plan
Description and the official plan document for the Alcatel-Lucent Long-Term Disability Plan, the
official plan document shall control.
YOUR BENEFIT PLAN

Alcatel-Lucent USA Inc.

Represented Employees

Disability Income Insurance: Long Term Benefits

Certificate Date: January 1, 2015
Alcatel-Lucent USA Inc.
600 Mountain Avenue, Room 2B410
Murray Hill, NJ 07974

TO OUR EMPLOYEES:

All of us appreciate the protection and security insurance provides.

This certificate describes the benefits that are available to you. We urge you to read it carefully.

Alcatel-Lucent USA Inc.
Metropolitan Life Insurance Company
200 Park Avenue, New York, New York 10166

CERTIFICATE OF INSURANCE

Metropolitan Life Insurance Company (“MetLife”), a stock company, certifies that You are insured for the
benefits described in this certificate, subject to the provisions of this certificate. This certificate is issued to
You under the Group Policy and it includes the terms and provisions of the Group Policy that describe Your
insurance. PLEASE READ THIS CERTIFICATE CAREFULLY.

This certificate is part of the Group Policy. The Group Policy is a contract between MetLife and the
Policyholder and may be changed or ended without Your consent or notice to You.

Policyholder: Alcatel-Lucent USA Inc.

Group Policy Number: 93587-4-G

Type of Insurance: Disability Income Insurance: Long Term Benefits

MetLife Toll Free Number(s): 1-800-300-4296
For Claim Information

THIS CERTIFICATE ONLY DESCRIBES DISABILITY INSURANCE.

THE BENEFITS OF THE POLICY PROVIDING YOU COVERAGE ARE GOVERNED PRIMARILY BY THE
LAWS OF A STATE OTHER THAN FLORIDA.

THE GROUP INSURANCE POLICY PROVIDING COVERAGE UNDER THIS CERTIFICATE WAS ISSUED
IN A JURISDICTION OTHER THAN MARYLAND AND MAY NOT PROVIDE ALL THE BENEFITS
REQUIRED BY MARYLAND LAW.

WE ARE REQUIRED BY STATE LAW TO INCLUDE THE NOTICE(S) WHICH APPEAR ON THIS PAGE
AND IN THE NOTICE(S) SECTION WHICH FOLLOWS THIS PAGE. PLEASE READ THE(SE) NOTICE(S)
CAREFULLY.
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For Texas Residents: Para Residentes de Texas:

IMPORTANT NOTICE AVISO IMPORTANTE

To obtain information or make a complaint: Para obtener información o para someter una queja:

You may call MetLife’s toll free telephone number Usted puede llamar al numero de teléfono gratis de
for information or to make a complaint at MetLife para información o para someter una queja al

1-800-300-4296 1-800-300-4296

You may contact the Texas Department of Puede comunicarse con el Departamento de Seguros
Insurance to obtain information on companies, de Texas para obtener información acerca de
coverages, rights or complaints at compañías, coberturas, derechos o quejas al

1-800-252-3439 1-800-252-3439

You may write the Texas Department of Insurance Puede escribir al Departamento de Seguros de Texas
P.O. Box 149104 P.O. Box 149104
Austin, TX 78714-9104 Austin, TX 78714-9104
Fax # [phone] Fax # [phone]
Web: http://www.tdi.state.tx.us Web: http://www.tdi.state.tx.us

Email: [email protected] Email: [email protected]

PREMIUM OR CLAIM DISPUTES: Should You DISPUTAS SOBRE PRIMAS O RECLAMOS: Si
have a dispute concerning Your premium or about tiene una disputa concerniente a su prima o a un
a claim, You should contact MetLife first. If the reclamo, debe comunicarse con MetLife primero. Si
dispute is not resolved, You may contact the Texas no se resuelve la disputa, puede entonces
Department of Insurance. comunicarse con el departamento (TDI).

ATTACH THIS NOTICE TO YOUR CERTIFICATE: UNA ESTE AVISO A SU CERTIFICADO:
This notice is for information only and does not Este aviso es solo para propósito de información y no
become a part or condition of the attached se convierte en parte o condición del documento
document. adjunto.

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NOTICE FOR RESIDENTS OF ALL STATES

WORKERS’ COMPENSATION
This certificate does not replace or affect any requirement for coverage by workers’ compensation insurance.

MANDATORY DISABILITY INCOME BENEFIT LAWS
For Residents of California, Hawaii, New Jersey, New York, Rhode Island and Puerto Rico
This certificate does not affect any requirement for any government mandated temporary disability income
benefits law.
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NOTICE FOR RESIDENTS OF ARKANSAS
If You have a question concerning Your coverage or a claim, first contact the Policyholder or group account
administrator. If, after doing so, You still have a concern, You may call the toll free telephone number shown
on the Certificate Face Page.

If You are still concerned after contacting both the Policyholder and MetLife, You should feel free to contact:

Arkansas Insurance Department
Consumer Services Division
1200 West Third Street
Little Rock, Arkansas 72201
[phone] or [phone]
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NOTICE FOR RESIDENTS OF CALIFORNIA

IMPORTANT NOTICE

TO OBTAIN ADDITIONAL INFORMATION, OR TO MAKE A COMPLAINT, CONTACT THE
POLICYHOLDER OR THE METLIFE CLAIM OFFICE SHOWN ON THE EXPLANATION OF BENEFITS
YOU RECEIVE AFTER FILING A CLAIM.

IF, AFTER CONTACTING THE POLICYHOLDER AND/OR METLIFE, YOU FEEL THAT A SATISFACTORY
SOLUTION HAS NOT BEEN REACHED, YOU MAY FILE A COMPLAINT WITH THE CALIFORNIA
INSURANCE DEPARTMENT AT:

DEPARTMENT OF INSURANCE
300 SOUTH SPRING STREET
LOS ANGELES, CA 90013
1 [phone]

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