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EXHIBIT 10.26
ASSUMPTION AGREEMENT
THIS ASSUMPTION AGREEMENT is executed and delivered pursuant to that
certain Agreement and Plan of Merger, dated as of January 28, 2001 (the "Merger
Agreement"), by and among Maxim Integrated Products, Inc., a Delaware
corporation (the "Company"), MI Acquisition Sub, Inc., a Delaware corporation,
and Dallas Semiconductor Corporation, a Delaware corporation ("Dallas
Semiconductor"), pursuant to which Dallas Semiconductor will become a wholly
owned subsidiary of the Company. Pursuant to Section 6.3(c) of the Merger
Agreement, the Company is required to expressly assume the obligations of that
certain Dallas Semiconductor Executives Retiree Medical Plan, effective as of
October 1, 1999, as amended (the "Plan"), a copy of which is attached hereto as
Exhibit A.
For good and valuable consideration, the receipt and sufficiency of
which is hereby acknowledged, in accordance with the provisions of Section 13.11
of the Plan, the Company hereby assumes and agrees to pay, perform, and
discharge in accordance with the terms thereof, all of the duties, liabilities
and obligations of Dallas Semiconductor under the Plan.
This Assumption Agreement shall be binding upon and inure to the benefit
of the parties hereto and their respective successors and assigns.
[REMAINDER OF PAGE INTENTIONALLY LEFT BLANK; SIGNATURE PAGE FOLLOWS]
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IN WITNESS WHEREOF, each party hereto has caused this instrument to be
executed by its duly authorized officer this the 11th day of April, 2001.
MAXIM INTEGRATED PRODUCTS, INC.
By: /s/ Xxxx X. Xxxxxx
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Name: Xxxx X. Xxxxxx
Title: Chief Financial Officer
DALLAS SEMICONDUCTOR CORPORATION
By: /s/ Xxxx X. Xxxx
------------------------------------
Name: Xxxx X. Xxxx
Title: Chief Financial Officer
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Exhibit A
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DALLAS SEMICONDUCTOR CORPORATION
EXECUTIVES RETIREE MEDICAL PLAN
(EFFECTIVE OCTOBER 1, 1999)
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TABLE OF CONTENTS
PAGE
ARTICLE I - INTRODUCTION.....................................................................1
1.1 Purpose of Plan...............................................................1
1.2 Medical Care Plan Status......................................................1
ARTICLE II - DEFINITIONS.....................................................................2
2.1 "Administrator"...............................................................2
2.2 "Board".......................................................................2
2.3 "Board Member"................................................................2
2.4 "Code"........................................................................2
2.5 "Covered Dependent"...........................................................2
2.6 "Creditable Coverage".........................................................2
2.7 "Dependent"...................................................................3
2.8 "Director"....................................................................3
2.9 "Effective Date"..............................................................3
2.10 "Eligible Employee"...........................................................3
2.11 "Eligible Individual".........................................................3
2.12 "Eligible Retiree"............................................................3
2.13 "Employer"....................................................................3
2.14 "Enrollment Date".............................................................3
2.15 "Enrollment Period"...........................................................4
2.16 "ERISA".......................................................................4
2.17 "Excepted Benefits":..........................................................4
2.18 "FMLA"........................................................................5
2.19 "Genetic Information".........................................................5
2.20 "Health Status - Related Factor"..............................................5
2.21 "Late Enrollee"...............................................................5
2.22 "Manager".....................................................................5
2.23 "Military Leave"..............................................................5
2.24 "Officer".....................................................................5
2.25 "Participant".................................................................6
2.26 "Participating Employer"......................................................6
2.27 "Placed for Adoption".........................................................6
2.28 "Plan"........................................................................6
2.29 "Plan Year"...................................................................6
2.30 "Policy"......................................................................6
2.31 "Pre-existing Condition"......................................................6
2.32 "Pre-existing Condition Exclusion"............................................6
2.33 "Qualified Medical Child Support Order".......................................6
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2.34 "Qualified Medical Expense"...................................................6
2.35 "Retirement" and "Retire".....................................................7
2.36 "Sponsor".....................................................................7
2.37 "Spouse"......................................................................7
2.38 "USERRA"......................................................................7
2.39 "Waiting Period"..............................................................7
ARTICLE III - PARTICIPATION..................................................................7
3.1 Eligibility to Participate....................................................7
3.2 Commencement of Participation.................................................8
3.3 Cessation of Participation....................................................8
3.4 USERRA Reinstatement Rules....................................................9
3.5 FMLA Compliance...............................................................9
3.6 Reinstatement of Former Participant..........................................10
3.7 No Eligibility Discrimination Due to Health..................................10
3.8 Special Enrollments..........................................................10
ARTICLE IV - ELECTION TO RECEIVE MEDICAL CARE BENEFITS......................................11
4.1 Election of Benefit Options..................................................11
4.2 Election Procedure...........................................................12
4.3 No Premium Discrimination Due to Health......................................12
ARTICLE V - MEDICAL CARE BENEFITS...........................................................12
5.1 Benefits.....................................................................12
5.2 Pre-existing Conditions......................................................12
5.3 Notification of Enrollment Rights............................................14
5.4 Newborns' and Mothers' Health Protection Act of 1996.........................14
5.5 Mental Health Parity Act of 1996.............................................14
5.6 Women's Health and Cancer Rights Act of 1998.................................15
ARTICLE VI - PAYMENT OF MEDICAL CARE EXPENSE REIMBURSEMENTS.................................15
6.1 Claims Procedure.............................................................15
6.2 Reimbursement of Expenses....................................................15
ARTICLE VII - COORDINATION OF BENEFITS......................................................15
7.1 Explanation..................................................................15
7.2 Definitions..................................................................16
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7.3 Coordination of Benefits Procedure...........................................16
7.4 Existence of Other Group Plans...............................................18
7.5 Recovery and Payment of Benefits.............................................18
7.6 Coordination with Medicare, Medicaid and CHAMPUS.............................19
7.7 Subrogation..................................................................20
ARTICLE VIII - TERMINATION OF PARTICIPATION.................................................21
8.1 Limitation on Covered Expenses...............................................21
8.2 Date of Policy Coverage Termination..........................................21
ARTICLE IX - CONTINUATION COVERAGE UNDER "COBRA"............................................22
9.1 Special Definitions..........................................................22
9.2 Entitlement to Continuation Coverage.........................................23
9.3 Notice Required..............................................................23
9.4 Election of Continuation Coverage............................................24
9.5 Premiums.....................................................................24
9.6 Period of Continuation Coverage..............................................24
9.7 Expiration of Continuation Coverage..........................................26
ARTICLE X - FUNDING.........................................................................26
ARTICLE XI - ADMINISTRATION.................................................................27
11.1 Named Fiduciary..............................................................27
11.2 Allocation of Fiduciary Responsibilities.....................................27
11.3 Records......................................................................27
11.4 Appointment of Committee.....................................................28
11.5 Actions of Committee.........................................................28
11.6 Other Powers and Duties of the Administrator.................................28
11.7 Indemnification..............................................................29
11.8 Reliance on Tables, Etc......................................................30
11.9 Claims and Review Procedures.................................................30
11.10 Participant's Responsibilities...............................................31
11.11 Missing Persons..............................................................31
11.12 Nondiscriminatory Exercise of Authority......................................31
11.13 Expenses.....................................................................31
ARTICLE XII - AMENDMENT OR TERMINATION OF PLAN..............................................32
12.1 Amendment of Plan............................................................32
12.2 Termination of Plan..........................................................32
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ARTICLE XIII - MISCELLANEOUS................................................................32
13.1 Information to be Furnished..................................................32
13.2 Limitation of Rights.........................................................32
13.3 Benefits Not Solely from Policy..............................................32
13.4 Nonassignability of Rights...................................................33
13.5 No Guarantee of Tax Consequences.............................................33
13.6 Severability.................................................................33
13.7 Construction of Terms........................................................33
13.8 Choice of Law/Jurisdiction and Venue.........................................33
13.9 No Vested Interest...........................................................33
13.10 No Guarantee of Employment...................................................33
13.11 Adoption by Successor Employer or Affiliates.................................34
13.12 Bonding......................................................................34
ARTICLE XIV - QUALIFIED MEDICAL CHILD SUPPORT ORDERS........................................34
14.1 Notification of Receipt of Child Support Order...............................34
14.2 Procedures to Determine if Medical Child Support Order is a Qualified
Medical Child Support Order..................................................35
14.3 Treatment of Alternate Recipient under Qualified Medical Child Support
Order........................................................................36
14.4 Cost of Qualified Medical Child Support Order Benefits.......................36
14.5 Qualified Medical Child Support Order and Medicaid...........................37
14.6 Payments or Reimbursements under a Qualified Medical Child Support
Order........................................................................37
14.7 Alternate Recipient..........................................................37
ARTICLE XV - POLICY.........................................................................37
ARTICLE XVI - PARTICIPATING EMPLOYERS.......................................................37
16.1 Adoption by Other Employers..................................................37
16.2 Requirements of Participating Employers......................................38
16.3 Designation of Agent.........................................................38
16.4 Transfers....................................................................38
16.5 Participating Employer's Contribution........................................38
16.6 Discontinuance of Participation..............................................38
16.7 Administrator's Authority....................................................39
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ARTICLE I
INTRODUCTION
1.1 PURPOSE OF PLAN. The purpose of this Plan is to enable the
Sponsor to provide retiree (and limited other) medical care benefits to (a)
Board Members during the term of their service as a Board Member on behalf of
the Sponsor, and (b) to Board Members and to Eligible Retirees upon their
Retirement from the employment, or service as a Board Member, as applicable, of
the Sponsor or any other Participating Employers. On the Effective Date, the
Plan makes available to Participants the medical insurance described in the
Policy attached as Exhibit A.
Board Members, Officers and Spouses are to get lifetime coverage and
benefits under this Plan. Each other Participant and his spouse are to get
coverage and benefits under the Plan until the covered individual reaches his
(or her, as appropriate) 65th birthday. Covered Dependents (other than a spouse)
of a Participant who is not a Board Member or Officer are to get coverages and
benefits until the Participant's 65th birthday.
The specific medical coverages and benefits available to Participants
are identified in the Policy. In the event a Policy is not in effect at the time
a qualifying expense was incurred, the specific medical coverages and benefits
available at that time will be those identified in the Policy most recently in
effect immediately prior to the date the expense was incurred.
Notwithstanding anything in the Plan to the contrary, the Plan is
intended to provide medical coverage and benefits without regard to whether a
Policy is in effect at a particular time. Except for the coordination of
benefits as required by ARTICLE VII, the benefits and coverages under this Plan
shall not decrease or be reduced in the aggregate or individually by more than
an immaterial amount during the life of this Plan, except as provided in SECTION
12.1 The Sponsor will select and utilize a Policy or Policies that provides
medical coverages and benefits that are not worse than the coverages and
benefits provided by Sponsor to active employees of the Sponsor outside of this
Plan at the time the Policy or Policies were selected, and in the event that it
is determined the Sponsor has attempted to reduce benefits and coverages in an
effort to circumvent the restrictions of this Section and its obligations under
the Plan, notwithstanding anything to the contrary in this Plan, (i) the Plan
shall provide, for the remainder of the Plan's existence, the most valuable
benefits and coverages the Plan provided at any time during the Plan's existence
up to that time, and (ii) the Sponsor shall obtain and maintain insurance
providing coverage and benefits at least as good as those required under this
paragraph.
1.2 MEDICAL CARE PLAN STATUS. This Plan is intended to qualify as a
"medical care plan" under sections 105 and 106 of the Code, and is to be
interpreted in a manner consistent with the requirements of sections 105 and 106
of the Code. It is intended that the value of medical coverage be excluded from
the Participants' income under Code section 106, to the extent applicable.
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The Plan is intended to satisfy all applicable requirements of the Code
and its regulations. This Plan is also intended to satisfy those requirements of
ERISA which are applicable to employee medical plans. Nothing in the Plan shall
be construed as requiring compliance with Code or ERISA provisions that do not
otherwise apply.
ARTICLE II
DEFINITIONS
Whenever used in this document, the following terms have the following
meanings unless a different meaning is clearly required by the context, and
defined terms from the Policy are incorporated in this document by reference,
but only to the extent that such terms are not inconsistent with the following
definitions:
2.1 "ADMINISTRATOR" means the Sponsor, which shall be the plan
administrator within the meaning of ERISA section 3(16).
2.2 "BOARD" means the Board of Directors of the Sponsor.
2.3 "BOARD MEMBER" means each person listed on Exhibit D to the Plan.
2.4 "CODE" means the Internal Revenue Code of 1986, as amended.
2.5 "COVERED DEPENDENT" means an individual who qualifies as a
Dependent or as a Spouse under this Plan and who was enrolled by a Participant
under this Plan when he was a Participant under this Plan.
2.6 "CREDITABLE COVERAGE" means, with respect to an individual,
coverage of the individual under any of the following:
(a) A group health plan;
(b) Health insurance coverage-,
(c) Part A or part B of title XVIII of the Social Security
Act;
(d) Title XIX of the Social Security Act, other than coverage
consisting solely of benefits under section 1928;
(e) Chapter 55 of title 10, United States Code;
(f) A medical care program of the Indian Health Service or of
a tribal organization;
(g) A State health benefits risk pool;
(h) A health plan offered under chapter 99 of title 5, United
States Code;
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(i) A public health plan (as defined in Federal regulations);
(j) A health benefit plan under section 5(e) of the Peace
Corps Act (22 U.S.C. 2504(e); or
(k) A state uninsured children's health insurance program.
Such term does not include coverage consisting solely of coverage of
Excepted Benefits.
2.7 "DEPENDENT" means any person who is a dependent of a Participant
(including, without limitation, a Participant's spouse on the date of his
Retirement) and who satisfies the definition of "dependent" in the Policy in
effect on the date of the Participant's Retirement, or if none, in the last
Policy in effect immediately prior to the Participant's Retirement.
2.8 "DIRECTOR" means the title awarded by an Employer to employees
(who are not members of the Board) in certain job classifications as specified
on its books and records.
2.9 "EFFECTIVE DATE" means October 1, 1999, the effective date of the
Plan, except where expressly stated otherwise in this document.
2.10 "ELIGIBLE EMPLOYEE" means (i) each Officer of the Sponsor on the
Effective Date, (ii) each common-law employee of an Employer who was designated
on the books and records of the Employer as a "functionally equivalent" officer
on the Effective Date and who shared in the contribution made on June 12, 1998,
to the Dallas Semiconductor Corporation Executive Deferred Compensation Plan,
(iii) each common-law employee of an Employer, on the Effective Date, who, on
the Effective Date (or within the five (5) calendar year period preceding the
Effective Date), also held the title of Director or was the Sponsor's corporate
controller, and (iv) each common-law employee of an Employer, on the Effective
Date, who, on the Effective Date, held the position of Manager and was required
to report for operating purposes directly to the Sponsor's President and Chief
Executive Officer. Each person who was an Eligible Employee on the Effective
Date is listed on either Exhibit C or Exhibit F to the Plan.
2.11 "ELIGIBLE INDIVIDUAL" means a Board Member or an Eligible
Retiree, as appropriate, who has satisfied (i) the requirements of Article III
to be eligible to participate in the Plan, and (ii) the eligibility requirements
stated in the Policy.
2.12 "ELIGIBLE RETIREE" means an Eligible Employee who has Retired
after the Effective Date.
2.13 "EMPLOYER" means the Sponsor and each Participating Employer
which shall adopt this Plan under Article XVI.
2.14 "ENROLLMENT DATE" means the earlier of (i) the last day of an
Enrollment Period during which an Eligible Individual did not elect under
SECTION 3.2 to not be a Participant, or (ii) the first day of the period that
must pass under ARTICLE III, if any, before an Eligible Employee, Board Member
or Dependent, as appropriate, is eligible to be covered for benefits under the
Plan.
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2.15 "ENROLLMENT PERIOD" means (i) in the case of an Eligible Retiree,
the thirty (30) day period occurring after the Eligible Retiree's Retirement
during which an Eligible Retiree may refuse in writing under Section 3.2 to
participate under the Plan, and (ii) in the case of a Board Member, the thirty
(30) day period occurring immediately after the Effective Date.
2.16 "ERISA" means the Employee Retirement Income Security Act of
1974, as amended.
2.17 "EXCEPTED BENEFITS" means the following:
(a) benefits not subject to the requirements regarding
Creditable Coverage:
(1) coverage only for accident or disability income
insurance or any combination thereof,
(2) coverage issued as a supplement to liability
insurance;
(3) liability insurance, including general liability
insurance and automobile liability insurance;
(4) workers' compensation or similar insurance,
(5) automobile medical payment insurance;
(6) credit-only insurance;
(7) coverage for on-site medical clinics; and
(8) other similar insurance coverage, specified in
regulations, under which benefits for medical care
are secondary or incidental to other insurance
benefits.
(b) If offered separately:
(1) limited scope dental or vision benefits;
(2) benefits for long-term care, nursing home care,
home health care, community based care, or any
combination thereof,
(3) other similar limited benefits as specified in
regulations.
(c) If offered as independent non-coordinated benefits
(separate consent or policy, no coordination of benefits
with any other plan sponsored by the employer):
(1) coverage for a specified disease or illness;
(2) hospital indemnity or other fixed indemnity
insurance.
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(d) If offered as separate insurance policy, Medicare
supplemental health insurance and similar supplemental
coverage.
2.18 "FMLA" means the Family and Medical Leave Act of 1993, as
amended.
2.19 "GENETIC INFORMATION" means information about genes, gene
products, and inherited characteristics that may derive from the individual or a
family member. This includes information regarding carrier status and
information derived from laboratory tests that identify mutations in specific
genes or chromosomes, physical medical examinations, family histories, and
direct analysis of genes or chromosomes.
2.20 "HEALTH STATUS - RELATED FACTOR" means the following factors:
(a) health status,
(b) medical condition (include both physical and mental
illnesses),
(c) claims experience,
(d) receipt of health care,
(e) medical history,
(f) Genetic Information,
(g) evidence of insurability (including conditions arising out
of acts of domestic violence), and
(h) disability.
2.21 "LATE ENROLLEE" means a Participant or Covered Dependent who
enrolled under this Plan other than during his first Enrollment Period or a
Special Enrollment Period.
2.22 "MANAGER" means the title awarded by an Employer to employees in
certain job classifications as specified on its books and records.
2.23 "MILITARY LEAVE" means the absence due to the performance of duty
on a voluntary or involuntary basis under competent authority in (i) the Armed
Forces, (ii) the Army National Guard and the Air National Guard when engaged in
active duty for training, inactive duty training, or full-time National Guard
duty, (iii) the commissioned corps of the Public Health Service, and (iv) other
categories of persons designated by the President in time of war or emergency
for a period of up to thirty (30) days during which a person who previously
qualified as an employee is not employed on a full-time basis solely because the
person is engaged in active military service for the United States government.
2.24 "OFFICER" means each person listed on Exhibit C to the Plan.
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2.25 "PARTICIPANT" means any Eligible Individual who has elected to
participate in the Plan in accordance with ARTICLE III.
2.26 "PARTICIPATING EMPLOYER" means any entity which has adopted this
Plan pursuant to ARTICLE XVI.
2.27 "PLACED FOR ADOPTION" means the assumption and retention by an
Eligible Employee of a legal obligation for the total or partial support of an
individual in anticipation of adoption of a child prior to the date on which
such child attains age eighteen (18). A child's status as having been Placed for
Adoption ends on the date that the Eligible Employee's legal obligation
described in this Section ends.
2.28 "PLAN" means the Dallas Semiconductor Corporation Executives
Retiree Medical Plan, as set forth in this document, and any and all amendments,
schedules and supplements to this document.
2.29 "PLAN YEAR" means the period beginning on the Effective Date and
ending on the following December 31 and, thereafter, the fiscal year beginning
on each January 1 (starting on January 1, 2000) and ending on the following
December 31.
2.30 "POLICY" means the fully-insured medical insurance policy or
policies described on Exhibit A attached to this Plan, as such Exhibit A existed
on the Effective Date or as it may be amended in the future.
2.31 "PRE-EXISTING CONDITION" means a condition (whether physical or
mental), regardless of the cause of the condition, for which medical advice,
diagnosis, care or treatment was recommended or received within the six (6)
month period ending on the Enrollment Date.
2.32 "PRE-EXISTING CONDITION EXCLUSION" means with respect to
coverage, a limitation or exclusion of benefits relating to a condition based on
the fact that the condition was present before the date of enrollment for such
coverage, whether or not any medical advice, diagnosis, care or treatment was
recommended or received before such date. Genetic Information is not a
Pre-existing Condition in the absence of a diagnosis of the condition related to
such information.
2.33 "QUALIFIED MEDICAL CHILD SUPPORT ORDER" means any judgment,
decree, order (including a settlement agreement), administrative notice or
National Medical Support Notice (defined in section 609(a)(5)(C) of ERISA) which
satisfies the requirements set forth in ARTICLE XIV.
2.34 "QUALIFIED MEDICAL EXPENSE" means an expense incurred by a
Participant, by the Participant's spouse or by a Dependent of such Participant
for medical care as defined in Code section 213, including, without limitation,
amounts paid for hospital bills and doctor bills, but only to the extent that
(i) the Participant or other person is not reimbursed for the expense through
insurance or otherwise, other than under the Plan, and (ii) the expense is not
taken into account as a deduction by the Participant on his Internal Revenue
Service Form 1040; provided, however, that notwithstanding anything in this
document to the contrary, a Qualified Medical
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Expense shall be limited to only those expenses covered under the Policy, if a
Policy is in effect, and if no Policy is in effect so that the expense is
covered by Policy, to only those expenses covered under the Policy last in
effect immediately prior to the date the expense was incurred.
2.35 "RETIREMENT" and "RETIRE" mean (i) an Eligible Employee's
termination of employment with an Employer, voluntarily or involuntarily, after
the Effective Date when the Eligible Employee has at least (10) ten years of
employment by the Sponsor or its affiliates and has reached the age of at least
fifty (50) and (ii) an Officer's termination of employment with an Employer,
voluntarily or involuntarily, after the Effective Date when the Officer has at
least ten (10) years of employment by, and five (5) years as an Officer of, the
Sponsor or its affiliates. A Board Member shall be deemed to be Retired for
purposes of only this Plan on the Effective Date of the Plan.
2.36 "SPONSOR" means Dallas Semiconductor Corporation, a Delaware
corporation, or any successor or assign which shall adopt the Plan. Throughout
the Plan, a purposeful distinction is drawn between the Sponsor and the
Employers. The powers and responsibilities assigned to the Sponsor by the Plan
shall apply exclusively to the Sponsor, unless specifically delegated in writing
by the Sponsor.
2.37 "SPOUSE" means the wife of an Officer or of a Board Member on the
date of his Retirement. Each person who was a Spouse on the Effective Date is
listed on Exhibit E, but being listed on Exhibit E does not make an individual a
Spouse for purposes of this Plan.
2.38 "USERRA" means the Uniformed Services Employment and Reemployment
Rights Act of 1994, as amended.
2.39 "WAITING PERIOD" means with respect to a group health plan and an
individual who is a potential Participant or beneficiary in the plan, the period
that must pass with respect to the individual before the individual is eligible
to be covered for benefits under the terms of the plan. Any period of time
before a Late Enrollee enrolls under a Special Enrollment Period is not a
Waiting Period.
Special definitions used only for particular purposes are found in
ARTICLE VII and ARTICLE IX.
ARTICLE III
PARTICIPATION
3.1 ELIGIBILITY TO PARTICIPATE. Eligible Employees and Board Members
shall become Eligible Individuals on the Effective Date. No other individual may
become a Participant (or an Eligible Individual) under the Plan.
The Policy in effect on the date of a Participant's Retirement
determines (i) the Plan's Eligible Individuals, (ii) the Plan's Spouses and
(iii) those Dependents, if any, of an Eligible Individual who will be eligible
to be covered under its terms. When an Eligible Individual's
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eligible Dependents satisfy the eligibility requirements of the Policy in effect
on the date of a Participant's Retirement, those eligible Dependents shall also
be eligible to participate at that time under the Plan. If, at the date of a
Participant's Retirement, no Policy is then in effect, the Participant's
eligible Dependents shall be determined under the terms of the Policy last in
effect with respect to the Plan.
3.2 COMMENCEMENT OF PARTICIPATION. An Eligible Individual shall
become a Participant automatically when he becomes an Eligible Individual unless
he refuses in writing in a form acceptable to the Administrator that is received
by the Administrator before the Eligible Individual's Enrollment Date.
3.3 CESSATION OF PARTICIPATION. Subject to Section 12.2, a Board
Member and an Officer shall be a Participant and receive coverage under this
Plan for his life.
A Participant (other than a Board Member or an Officer) shall be a
Participant and receive coverage under the Plan until his 65th birthday and such
a Participant's spouse shall be a Covered Dependent and receive coverage under
the Plan until her 65th birthday; provided, however, that notwithstanding
anything in this Plan to the contrary, a Participant (other than a Board Member
or an Officer) shall also cease to be a Participant (and his spouse shall also
cease to be a Covered Dependent) as of the earliest of
(a) the date on which the Plan terminates as provided in
Section 12.2;
(b) the date on which the Participant (other than a Board
Member or an Officer) or his spouse fails to satisfy the
eligibility criteria of the Plan; or
(c) the date on which his election to receive medical care
under this Plan terminates or expires according to its
written terms.
Subject to Section 12.2, a Spouse shall receive coverage under the Plan
for her life.
A Covered Dependent (other than a Spouse and the spouse of a Participant
who is neither a Board Member nor an Officer) shall receive coverage under the
Plan until his or her Participant reaches his 65th birthday; provided, however,
that notwithstanding anything in this Plan to the contrary, a Covered Dependent
(other than a Spouse and the spouse of a Participant who is neither a Board
Member nor an Officer) shall also cease to be a Covered Dependent as of the
earliest of:
(a) the date on which the Plan terminates as provided in
Section 12.2;
(b) the date on which the Covered Dependent fails to satisfy
the eligibility criteria of the Plan; or
(c) the date on which his election to receive medical care
under this Plan terminates or expires according to its
written terms.
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3.4 USERRA REINSTATEMENT RULES.
(a) This Plan shall provide any health benefits otherwise
available to Eligible Employees, if any, in accordance
with USERRA and this Section, effective with respect to
Military Leaves that began on or after October 13, 1994.
(b) The maximum period of Plan coverage available to an
Eligible Employee and his Dependents under this Section
will not exceed the lesser of (i) eighteen months or (ii)
the period ending on the day after the date upon which the
person fails to apply for a return to a position of
employment under section 4312(a) of USERRA. The period of
Plan coverage available under this Section shall begin on
the date on which the person's qualifying absence begins.
(c) Only for purposes of determining eligibility for medical
benefits and only if the Eligible Employee pays all
amounts that the Employer is permitted to charge under
USERRA for coverage while on a qualifying leave, an
Eligible Employee who experiences a reduction in hours or
termination of employment solely due to a Military Leave
shall be deemed to continue to be an employee until the
earliest date that the termination of his Plan benefits is
permitted by USERRA and this Section.
3.5 FMLA COMPLIANCE.
(a) This Plan shall provide any health benefits otherwise
available to Eligible Employees, if any, in accordance
with FMLA for Eligible Employees.
(b) Unless an Eligible Employee chose not to retain health
coverage, the Employer must maintain medical coverage
under the Plan, if any, for such an Eligible Employee on
FMLA leave for the duration of his FMLA leave, at the
level and under the conditions that coverage would have
been provided if the Eligible Employee had continued
working and had not taken a FMLA leave.
(c) An Eligible Employee on FMLA leave shall have the same
opportunity as active employees to change Plan coverage,
such as from single coverage to family coverage on the
birth of a child, as required by FMLA.
(d) The Employer's obligation to continue to maintain health
coverage under FMLA and this Section ends on the earliest
of the following dates:
(1) the date the Eligible Employee informs the Employer
of his intent not to return from a FMLA leave;
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(2) the date the Eligible Employee's employment
relationship would be terminated but for the FMLA
leave (such as during a reduction in force);
(3) the date the Eligible Employee fails to return from
the FMLA leave; or
(4) the date the Eligible Employee fails to pay a
required employee contribution when due.
(e) Former Participants who lose eligibility during a FMLA
leave will have their benefits reinstated upon their
return at the end of the FMLA leave at the same levels as
were provided to them under the Plan when their FMLA leave
began, but subject to any changes in benefit levels that
may have occurred during the leave that affected the
entire work force. Participants returning from FMLA leave
shall not be required to requalify for any benefits.
3.6 REINSTATEMENT OF FORMER PARTICIPANT. A former Participant who
again meets the eligibility requirements under Section 3.1 will receive medical
coverages and benefits under the Plan and become a Participant in this Plan
again on the first day the former Participant satisfies the requirements of
Section 3. 1, unless the former Participant is (i) reinstated as a Participant
in the Plan as provided by Sections 3.4 and 3.5 or (ii) declines participation
as provided under Section 3.2.
3.7 NO ELIGIBILITY DISCRIMINATION DUE TO HEALTH. The Plan shall not
establish rules for eligibility (including continued eligibility) for any
individual under the Plan that are based on one or more Health Status-Related
Factors of the individual or his Dependent.
3.8 SPECIAL ENROLLMENTS.
(a) Notwithstanding any provision to the contrary, an Eligible
Individual or an eligible Dependent of an Eligible
Individual may elect health care coverage under Special
Enrollment, but only if
(1) the Eligible Individual (or the eligible Dependent)
was covered under a group health plan or health
insurance at the time coverage was offered under
this Plan;
(2) the Eligible Individual (or the eligible Dependent)
declined coverage under the Plan in writing for the
stated reason that he had the other health
coverage;
(3) the Eligible Individual (or the eligible Dependent)
has "Exhausted COBRA Coverage" or the other health
coverage (or the individual's former employer's
contribution toward the cost of such coverage) has
terminated; and
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(4) the Eligible Individual (or the eligible Dependent)
requests Special Enrollment under this Section in
writing within thirty (30) days after the date he
or she lost his or her other health coverage.
For purposes of this Plan, a person shall be treated as if
they have "Exhausted COBRA Coverage" if that individual's
COBRA coverage ceased for any reason other than either
failure of the individual to pay premiums on a timely
basis or for cause (such as making a fraudulent claim or
an intentional misrepresentation of a material fact in
connection with the plan). A person has "Exhausted COBRA
Coverage" if the COBRA coverage ceases because either (a)
the employer or other responsible entity fails to remit
the premiums on a timely basis, or (b) the individual no
longer resides in the service area of an HMO or a similar
program (whether or not within the choice of the
individual) and there is no other COBRA coverage available
to the individual.
(b) Special Enrollment must be offered to Dependents if. (a)
the Plan offers Dependent coverage, (b) the Eligible
Individual is a Participant under the Plan or has met the
Waiting Period and is eligible for coverage but for his
failure to enroll during a previous enrollment period, and
(c) the Dependent became a new Dependent as -a result of
marriage, birth, adoption or being Placed for Adoption. A
thirty (30) day Special Enrollment period shall be offered
to such Dependent beginning on the later of (i) the date
Dependent coverage is made available or (ii) the date of
marriage, birth, adoption or being Placed for Adoption, as
the case may be. If a Special Enrollment period is offered
to a new Dependent under the Plan, the Eligible Individual
who has the new Dependent may also enroll under the Plan
during that Special Enrollment period if he is not already
a Participant.
Coverage that is timely elected during a Special Enrollment period shall
be effective (i) if due to loss of coverage, on the first day of the month after
receipt of the completed enrollment request under the Plan, (ii) if due to
birth, on the date of birth, (iii) if due to adoption or being Placed for
Adoption, the date it occurred and (iv) if due to marriage, on the first day of
the month after receipt of the completed enrollment request under the Plan. A
person who enrolls during a Special Enrollment period is not a Late Enrollee.
ARTICLE IV
ELECTION TO RECEIVE MEDICAL CARE BENEFITS
4.1 ELECTION OF BENEFIT OPTIONS. An Eligible Individual shall be
deemed to have elected to receive medical care coverages and benefits under the
Plan as described in the Policy in effect on his Enrollment Date. If no Policy
is in effect on his Enrollment Date, an Eligible Individual will be deemed to
have elected to receive medical coverage and benefits under the
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Plan as described in the Policy in effect immediately prior to his Enrollment
Date. An Eligible Individual who declined participation during an Enrollment
Period will become a Participant in the subsequent Enrollment Period, if any,
during which he does not refuse to become a Participant.
4.2 ELECTION PROCEDURE. An Eligible Individual may decline to
participate in this Plan by filing a properly completed election form with the
Administrator.
4.3 NO PREMIUM DISCRIMINATION DUE TO HEALTH. The Plan shall not
require an individual (as a condition of enrollment or continued enrollment
under the Plan) to pay a premium or otherwise contribute an amount which exceeds
the amount paid by a similarly situated individual solely due to a Health Status
- Related Factor of the individual; provided, however, that the rules regarding
Health Status-Related Factors do not restrict the amount an Employer may charge
for coverage or prevent premium discounts or rebates or modified deductibles and
co-payments in return for adherence to programs of health promotion and disease
prevention.
ARTICLE V
MEDICAL CARE BENEFITS
5.1 BENEFITS. The Administrator shall offer to each Eligible
Individual, at the time he becomes eligible under ARTICLE III and at each
subsequent Enrollment Period applicable to that Eligible Individual, if any, the
opportunity to participate in the Plan. Subject to SECTION 12.1, the specific
coverages and benefits available to Participants are set forth in the Policy or
if there is no Policy, in the Policy last in effect in connection with the Plan.
The benefits and coverages under this Plan shall continue for the lifetime of
each Board Member, each Officer and each Spouse.
5.2 PRE-EXISTING CONDITIONS.
(a) PRE-EXISTING CONDITIONS. The Plan will not pay any
benefits for the care or treatment of pre-existing
conditions (as defined in the Policy) for the period of
time set forth in the Policy; provided, however, that (i)
notwithstanding anything in this Plan or any Policy to the
contrary, a pre-existing condition in the Policy shall not
include any condition that does not fall within the
definition of a Pre-existing Condition, (ii) no
pre-existing condition shall include a condition for which
Genetic Information was used as a basis for asserting the
existence of the condition if there has been no diagnosis
of the condition related to such information, and (iii)
the period during which any exclusion or limitation of
benefits (relating to a condition based on the fact that
the condition was present before a person's Enrollment
Date) in the Plan or the Policy will be enforced shall not
be longer than the excess of twelve (12) months (eighteen
(18) months for a Late Enrollee), beginning on his
Enrollment Date, over the aggregate
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of the periods of Creditable Coverage (if any) applicable
to the Participant as of his Enrollment Date.
For purposes of this subsection, a period of Creditable
Coverage shall not be counted, with respect to enrollment
of an individual under the Plan, if, after such period and
before his Enrollment Date, there was a 63 -day period for
all of which the individual was not credited with
Creditable Coverage. However, any period that an
individual is required to wait before becoming covered
under the Plan pursuant to the Policy or ARTICLE III shall
not be taken into account in determining the continuous
63-day period described in the preceding sentence.
The individual seeking to become a Participant and who
seeks to establish a period of Creditable Coverage must
obtain and provide to the Administrator a written
certification from the prior health insurance plan or the
prior health insurance issuer regarding each period of
Creditable Coverage of the individual under such prior
health insurance plan and COBRA continuation provisions.
Such certification should detail the Waiting Period, if
any, imposed with respect to the individual for any
coverage under such other health insurance plan. If a
written certification cannot be produced, Creditable
Coverage may be demonstrated through the presentation of
other documentation or through other means satisfactory to
the Administrator.
(b) EXCLUSION NOT APPLICABLE TO CERTAIN NEWBORNS. The Plan
shall not impose any pre-existing condition exclusion (as
defined in the Policy) in the case of an individual who,
as of the last day of the thirty (30) day period beginning
with the date of birth, is covered under Creditable
Coverage. However, this exclusion shall no longer apply to
an individual after the end of the first 63-day period
during all of which the individual was not covered under
any Creditable Coverage.
(c) EXCLUSION NOT APPLICABLE TO CERTAIN ADOPTED CHILDREN. The
Plan shall not impose any pre-existing condition exclusion
(as defined in the Policy) in the case of a child who is
adopted or Placed for Adoption before attaining eighteen
(18) years of age and who, as of the last day of the
thirty (30) day period beginning on the date of the
adoption or Placement of Adoption, is covered under
Creditable Coverage. The previous sentence shall not apply
to coverage before the date of such adoption or Placement
for Adoption. However, this exclusion shall no longer
apply to an individual after the end of the first 63-day
period during all of which the individual was not covered
under any Creditable Coverage.
(d) EXCLUSION NOT APPLICABLE TO PREGNANCY. The Plan shall not
impose any exclusion relating to pregnancy as a
pre-existing condition.
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(e) NOTICE OF CREDITABLE COVERAGE. The Administrator or its
designee shall provide written certification of Creditable
Coverage to any individual whose coverage terminates under
the Plan (i) at the time of the Qualifying Event or other
termination of coverage, (ii) at the time COBRA coverage
ceases, and (iii) upon any written request made by an
individual not later than twenty-four (24) months after
his Plan coverage ceased. The written certification will
include (i) the date the certificate is issued, (ii) the
name of the plan that provided the coverage, (iii) the
name of the participant and/or dependents to whom the
certificate applies, (iv) the name, address, and telephone
number of the plan administrator, (v) the telephone number
of the person to contact for additional information, and
(vi) either (a) a statement that the individual has at
least 18 months of Creditable Coverage without a 63-day
break in coverage, or (b) state (A) the Waiting Period (if
any) imposed on the individual for coverage under the
plan, (B) the date coverage began, and (C) the date
coverage ended (or indicate if it is continuing).
(f) NOTICE TO INDIVIDUAL OF PRE-EXISTING CONDITION EXCLUSION.
After the Plan receives a Creditable Coverage certificate
from a prior plan, the Plan will make a determination and
notify individuals within a reasonable period of time
regarding the length of any Pre-Existing Condition
Exclusion period that applies to them. If no Pre-Existing
Condition Exclusion applies to the individual, the Plan
will not send a notice. The notice shall explain the basis
of the Plan's determination, including the source and
substance of any information that the Plan relied on, and
the Plan's appeal procedures.
5.3 NOTIFICATION OF ENROLLMENT RIGHTS. All Eligible Individuals shall
be provided with a notice of his or her enrollment rights in writing at or
before the time the Eligible Individual elects to enroll, and such notification
shall be substantially in the same form as provided in Temp. Treas. Xxx.xx.
54.9801-6T(c) and Interim U.S. Department of Labor Regulations.2590.701-6(c).
5.4 NEWBORNS' AND MOTHERS' HEALTH PROTECTION ACT OF 1996.
Notwithstanding the precertification requirements of the Plan to the contrary,
the Plan shall provide maternity care benefits in accordance with the Newborns'
and Mothers' Health Protection Act of 1996 (the "Newborns' Act"), effective on
the date specified in the Newborns' Act. In accordance with the Newborns' Act,
the Plan shall provide benefits for a minimum of 48 hours of inpatient hospital
stay following a normal vaginal delivery and a minimum of 96 hours of inpatient
hospital stay following caesarean section delivery unless the health care
provider and the mother agree that discharge from the hospital shall occur
earlier.
5.5 MENTAL HEALTH PARITY ACT OF 1996. In accordance with the Mental
Health Parity Act of 1996, the lifetime maximum limit and the annual maximum
limit on mental health benefits under the Plan shall be at least equal to the
lifetime maximum limit and the annual
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maximum limit, respectively, for medical and surgical benefits under the Plan,
unless one or more of the exceptions set forth in the Mental Health Parity Act
of 1996 apply
5.6 WOMEN'S HEALTH AND CANCER RIGHTS ACT OF 1998. Medical and
surgical benefits provided for mastectomies under the Plan will be provided in
accordance with the Women's Health and Cancer Rights Act of 1998 (the "Women's
Health Act"). In accordance with the Women's Health Act, coverage will be
provided for the following:
(a) reconstruction of the breast on which the mastectomy has
been performed;
(b) surgery and reconstruction of the other breast to produce
a symmetrical appearance; and
(c) prostheses and coverage for any complications in all
stages of mastectomy, including lymphedema.
ARTICLE VI
PAYMENT OF MEDICAL CARE EXPENSE REIMBURSEMENTS
6.1 CLAIMS PROCEDURE. Participants and Covered Dependents seeking
benefits under the Plan shall follow the claims procedures established by the
Policy under which they are covered, if any, at the time and the procedures set
forth in SECTION 11.9. Notwithstanding the claim filing procedures established
by this Plan or the applicable Policy, the Health Care Financing Administration
shall have three years from the date a claim is filed to seek recovery of a
mistaken payment when this Plan should have paid as the "Primary Plan" and
Medicare should have paid as the "Secondary Plan" pursuant to ARTICLE VII.
6.2 REIMBURSEMENT OF EXPENSES. All Qualified Medical Expenses of a
Participant or Covered Dependent that are covered under the Policy shall be
reimbursed as set forth in the Policy.
ARTICLE VII
COORDINATION OF BENEFITS
7.1 EXPLANATION. When a Participant is covered under this Plan and by
one or more other Group Plans, the benefits of this Plan shall be coordinated
and determined in accordance with the provisions of this Article. This Article
is intended to prevent the payment of medical benefits which exceed expenses.
Determination of benefits shall be made in relation to the services furnished to
a Participant during any one calendar year.
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7.2 DEFINITIONS. The following definitions apply to this Article.
(a) "Group Plan" means any group or group-type arrangement of
coverage whether insured or uninsured which provides
health benefits or services to a Participant (including
the Policy under this Plan), either by indemnity or
prepaid services, by means of (i) group or blanket
insurance, (ii) franchise insurance that terminates upon
cessation of employment, (iii) group hospital or medical
service plans and other group prepayment coverage, or (iv)
any coverage under labor-management trusteed arrangements,
union medical arrangements, employer organization
arrangements, government benefit arrangements or
government programs (excluding Medicare).
(b) "Allowable Expenses" means any necessary, reasonable, and
customary item of expense for health care when the item of
expense is covered at least in part by one or more Group
Plans covering the Participant for whom claim is made. An
Allowable Expense does not include (i) differences between
the cost of an average semiprivate hospital room and a
private hospital room unless the private hospital room is
medically necessary (as defined in the Policy), or (ii)
the amount of any reduction in benefits because a
Participant does not comply with the Group Plat)
provisions.
(c) "Primary Plan" means the Group Plan whose benefits for a
Participant's health care coverage must be determined
without consideration of the existence of any other plan.
(d) "Secondary Plan" means a Group Plan which is not a Primary
Plan. If a Participant is covered by more than one
Secondary Plan, the order of benefit determination rules
decide the order in which their benefits are determined in
relation to each other.
7.3 COORDINATION OF BENEFITS PROCEDURE. Without regard to what is
stated in the Policy, this Plan determines its order of benefits using the first
of the following rules which applies:
(a) The benefits of a Group Plan which covers the Participant
(on whose expenses the claim is based) other than as a
Dependent shall be determined before the benefits of a
Group Plan which covers the Participant as a Dependent.
(b) The benefits of a Group Plan which covers the Participant
(on whose expenses the claim is based) as a Dependent of a
person whose birthday occurs earlier in a calendar year
shall be determined before the benefits of a Group Plan
which covers such Participant as a Dependent of a person
whose birthday occurs later in a calendar year. However,
if either Group Plan does not have the provisions of this
subsection (b) and the omission results either in each
Group Plan determining its benefits before the other,
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or in each Group Plan determining its benefits after the
other, the provisions of this subsection (b) shall not
apply, and the rule set forth in the other Group Plan
shall determine the order of benefits; provided, however,
that notwithstanding anything to the contrary in the Plan,
in the case of a Participant for whom claim is made as a
Dependent child:
(1) When the parents are separated or divorced and the
parent with custody of the child has not remarried,
the benefits of a Group Plan which covers the child
as a Dependent of the parent with custody of the
child will be determined before the benefits of a
Group Plan which covers the child as a Dependent of
the parent without custody.
(2) When the parents are divorced and the parent with
custody of the child has remarried, the benefits of
a Group Plan which covers the child as a Dependent
of the parent with custody shall be determined
before the benefits of a Group Plan which covers
that child as a Dependent of the stepparent, and
the benefits of a Group Plan which covers that
child as a Dependent of the stepparent will be
determined before the benefits of a Group Plan
which covers that child as a Dependent of the
parent without custody.
(3) Notwithstanding subparagraphs (1) and (2) of this
subsection (b), when the parents are divorced or
separated and there is a court decree which would
otherwise establish financial responsibility for
the health care expenses of the child, the benefits
of a Group Plan which covers the child as a
Dependent of the person with such financial
responsibility shall be determined before the
benefits of any other Group Plan which covers the
child as a Dependent.
(c) When subsections (a) and (b) above do not establish an
order of benefits determination, the benefits of a Group
Plan which has covered the Participant (on whose expenses
the claim is based) for the longer period of time shall be
determined before the benefits of a Group Plan which has
covered such Participant for the shorter period of time,
except that:
(1) The benefits of a Group Plan covering the
Participant (on whose expenses the claim is based)
as a laid-off or retired employee or as a Dependent
of such a Participant shall be determined after the
benefits of any other Group Plan covering such
Participant as an employee other than as a laid-off
or retired employee or a dependent of such a
person; and
(2) If either Group Plan does not have a provision
regarding laid-off or retired employees and as a
result each Group Plan determines its
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benefits after the other, the provisions of this
subsection (c) do not apply.
(d) When another Group Plan is a Primary Plan under the order
of benefit determination rules contained in this Article
but such Group Plan contains "excess" or "always
secondary" provisions, the Group Plan which has been in
force for the longest period of time will be the Primary
Plan.
(e) When this Plan is the Secondary Plan, the benefits of the
other Group Plan shall be deducted from the charges for
all items of Allowable Expenses for which any benefit is
provided under this Plan or the other Group Plan and this
Plan will pay the remainder of the charges for such items;
provided, however, that in no event shall the provisions
of this Article be construed to increase the amount of
total benefits which would be available under the Plan in
the absence of another Group Plan.
(f) If this Plan is the Secondary Plan under this Article, but
is unable to determine the benefits of the other Group
Plan, this Plan may estimate in good faith the benefits of
the other Group Plan and provide the benefits of this Plan
on the basis of that estimate. Payment under this
subsection shall constitute full discharge of the
liability of the Plan for the charges involved, subject
only to adjustment in the event the Plan later determines
the actual benefits of the other Group Plan.
7.4 EXISTENCE OF OTHER GROUP PLANS. This Plan assumes no obligation
to discover the existence of another Group Plan or the benefits available under
it if discovered. This Plan will give effect to the provisions of this Article
in accordance with information furnished it by an authoritative source. This
Plan shall, however, be entitled to obtain and to release such information as
reasonably necessary to give effect to these provisions without the consent of
or notice to any person, and any person claiming benefits under this Article
shall, as a condition precedent to his right of recovery, furnish to the Plan
full information concerning the existence of other Group Plans, their benefits,
and any other information as may be necessary to implement this Article.
7.5 RECOVERY AND PAYMENT OF BENEFITS. The Plan shall be entitled at
any time to recover benefits paid in excess of its obligation determined under
the provisions of this Article, irrespective of to whom such benefits were paid,
from an issuer, insurer, provider under the other Group Plan, hospital,
physician or other provider, any person or firm to (or for) whom such payment
was made, or from any combination of such sources.
When benefits have been paid under another Group Plan, the Plan shall
have the right, in its discretion, to pay to the issuer or provider of such
other Group Plan any portion of the benefits available under this Plan which the
Plan may determine to be due in order to give effect to the intent of this
Article and corresponding coordination of benefits provisions in such other
Group Plan. The amount so paid shall be deemed to be benefits provided under
this Plan and to the extent the Plan shall be fully discharged from liability.
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7.6 COORDINATION WITH MEDICARE, MEDICAID AND CHAMPUS. The term "Group
Plan" as used in this Article includes Medicare, Medicaid and CHAMPUS, and the
statutes, regulations, and other laws governing these programs take precedence
over the order of determination set forth in this Plan.
Any Participant eligible for Medicare has the following rights to
coordinate the coverage under this Plan with Medicare coverage and should see
the Administrator to determine what elections may be available with respect to
primary and secondary Medicare coverage and to obtain election forms.
(a) AGE SIXTY-FIVE (65) AND OLDER. Individuals and their
eligible spouses age sixty-five (65) or older are entitled
to receive the same Plan benefits, under the same
conditions, as those Individuals and Covered Dependents
under age sixty-five (65). The Plan is the Primary Plan
and Medicare is the Secondary Plan unless the Participant
elects otherwise, as set forth below.
(b) DISABLED INDIVIDUALS AND COVERED DEPENDENTS. Individuals
and their Covered Dependents who become eligible for
Medicare by reason of disability rather than by age (even
though they are not sixty-five (65) years of age) are
entitled to the same Plan benefits, under the same
conditions, as other Participants. The Plan is the Primary
Plan and Medicare is the Secondary Plan with respect to
these disabled persons.
(c) PARTICIPANTS WITH END STAGE RENAL DISEASE. Participants
who are medically determined to have end stage renal
disease (as defined by Medicare) are entitled to the same
Plan benefits, under the same conditions, as other
Participants for the first thirty (30) month period
following the earlier of (i) initiation of renal dialysis,
or (ii) eligibility for Medicare benefits due to such
condition. The Plan is the Primary Plan and Medicare is
the Secondary Plan with respect to these Participants.
(d) MEDICARE ELECTION NOTICE. Each Individual who is eligible
for Medicare upon attainment of age sixty-five (65) must
complete a Medicare Election Notice Form notifying the
Employer that they want Medicare as the Primary Plan with
this Plan as the Secondary Plan.
If the Individual's spouse is age sixty-five (65) or
older, such spouse will also be subject to the
Individual's election of the Primary Plan.
(e) COORDINATION WITH MEDICARE. Subject to the above
provisions and to the extent permitted by Medicare,
medical benefits payable under this Plan will be
coordinated with Medicare. Such coordination will apply
whether or not the Participant has or has not applied for
or is receiving Medicare.
(f) MEDICAID BENEFICIARY. When enrolling an individual or
making any payments for medical benefits to a Participant
or on a Participant's behalf,
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the Plan shall not take into account the Participant's
eligibility for medical assistance or benefits payable
under a plan under 42 X.X.X.xx. 1396, et seq.
The effective date for this subsection (f) was October 1,
1993.
7.7 SUBROGATION. If a Participant incurs charges for any sickness,
injury or other condition through the acts or omissions of another person or
organization, the Plan shall pay the medical benefits which are medically
necessary and provided by this Plan, subject to the following conditions:
(a) The Participant shall advise the Administrator of any
claim against a third party or insurance carrier within
sixty (60) days of the occurrence of the sickness or
injury, shall provide the Plan with any information
necessary to pursue its rights and shall cooperate with
the Administrator and shall do whatever is necessary to
secure those rights. The Participant agrees to do nothing
which would prejudice those rights;
(b) The Plan shall be subrogated, to the extent of payments
made for medical benefits, to all of the Participant's
rights of recovery of those medical benefits against any
person or organization who, by reason of such person's
acts or omissions, is responsible for the sickness or
injury in question;
(c) It is agreed that if the Participant fails to take the
necessary legal action to recover from a responsible party
within one (1) year after the date of the sickness or
injury, the Plan may proceed in the name of the
Participant against the responsible party and will be
entitled to the recovery of the amount of medical benefits
paid and the expenses for that recovery;
(d) The Plan will have a lien against the proceeds of a
settlement or judgment resulting from a Participant's
claim or suit against a third party in an amount equal to
all sums paid by the Plan with respect to the illness or
injury in question, regardless of whether the proceeds of
such settlement or judgment are designated as payment for
other specified damages. The Employer shall be entitled to
notify third parties, including insurance carriers, of
this lien. The Employer may deduct the amount covered by
the lien from any future claims payable to the Participant
if the lien has not been previously satisfied or the
Participant fails to notify the Employer of payment
received from the third party; and
(e) The Participant must agree in writing, prior to his
entitlement to medical benefits:
(1) To reimburse the Plan for medical benefits paid
under the Plan immediately upon receipt of any
damages collected from a third party, whether
pursuant to judgment, settlement or otherwise, net
of reasonable expenses incurred in collecting such
amount, such as
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reasonable attorneys' fees, and any amounts which
are allocated under the terms of any judgment for
payment of unreimbursed medical expenses;
(2) To execute and deliver such instruments and do
whatever else is reasonably necessary to secure the
Plan's right to reimbursement of medical payments
and to provide the Plan such information as is
necessary to enforce its rights under this
provision;
(3) To agree to a credit against payments to be made
under the Plan in the future equal to the amount of
any damages collected by the Participant from a
third party, less any amount paid to the Plan;
(4) If a covered person fails to comply with these
requirements, he will not be eligible to receive
any further medical benefits under the Plan until
he complies; and
(5) The Plan has the right to intervene at its own
expense in any suit or other proceeding to protect
these reimbursement rights. The Participant is
responsible for all fees and expenses of the
attorney handling his or her claim against the
third party.
In the event the Plan recovers an amount greater than the medical benefit paid,
the excess over the expenses of recovery will be paid to the Participant. The
Plan reserves the right to compromise the amount of its claim if, in its
opinion, it is appropriate to do so.
The Administrator may, in its sole discretion, elect not to enforce this
provision.
ARTICLE VIII
TERMINATION OF PARTICIPATION
8.1 LIMITATION ON COVERED EXPENSES. In the event that an individual
ceases to be a Participant or Covered Dependent in this Plan for any reason, the
individual (or his estate) shall be entitled to reimbursement only for Qualified
Medical Expenses incurred and submitted for reimbursement (following the date
the expense was incurred) in accordance with the terms of the Policy, but only
if the expense was incurred while the individual was a Participant or Covered
Dependent, and only if the individual (or his estate) applies for such
reimbursement in the time and manner provided in the Policy. Except to the
extent required in Article IX, no such reimbursement shall exceed the coverage
limitations provided by the Policy.
8.2 DATE OF POLICY COVERAGE TERMINATION. Coverage provided by a
Policy shall terminate according to the terms of the Policy unless continued
pursuant to SECTION 3.4, SECTION 3.5, or ARTICLE IX. Termination of a Policy
shall not terminate this Plan or its obligations.
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ARTICLE IX
CONTINUATION COVERAGE UNDER "COBRA"
9.1 SPECIAL DEFINITIONS. For purposes of this Article, the following
terms shall have the meaning given them as follows:
(a) "Qualified Beneficiary" means any individual who was the
spouse of a Participant or the dependent child of a
Participant whose expenses were eligible for reimbursement
under the Plan on the day before a Qualifying Event,
unless that individual was entitled to benefits under
Title XVIII of the Social Security Act on the day before
the Qualifying Event. Notwithstanding anything to the
contrary in the preceding sentence, the term "Qualified
Beneficiary" shall also include a child who is born to, or
Placed for Adoption with the Participant during the COBRA
continuation period as determined under SECTION 9.6.
(1) In the case of a Qualifying Event described in
SECTION 9.1(b)(2), the term "Qualified Beneficiary"
also includes the Participant, unless the
Participant is not an employee or was entitled to
benefits under Title XVIII of the Social Security
Act on the day before the Qualifying Event.
(2) In the case of a Qualifying Event described in
SECTION 9.1(b)(6), the term "Qualified Beneficiary"
includes a Participant who had retired on or before
the date of substantial elimination of coverage
under this Plan and any other individual who on the
day before such Qualifying Event was a beneficiary
under this Plan as a spouse, surviving spouse or
dependent child of the Participant.
(b) "Qualifying Event" means any of the following events which
would result in the loss of coverage under this Plan for a
Qualified Beneficiary:
(1) The death of the Participant,
(2) The termination of the Participant's employment
with an Employer (for reasons other than the
Participant's gross misconduct), the reduction of
hours of the Participant's employment, or a
Participant's notice to the Administrator he will
not return to work from a leave of absence under
FMLA,
(3) The divorce or legal separation of the Participant,
(4) The Participant's becoming entitled to benefits
under Title XVIII of the Social Security Act,
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(5) A dependent child ceasing to be a dependent child
under this Plan, or
(6) A proceeding under Title II of the United States
Code with respect to the Employer from whose
employment the Participant retired at any time.
9.2 ENTITLEMENT TO CONTINUATION COVERAGE.
(a) Notwithstanding any other provision of this Plan, a
Qualified Beneficiary who would otherwise lose coverage
under this Plan as a result of a Qualifying Event is
entitled to elect continuation coverage from the Employer
under this Plan.
(b) The continuation coverage will consist of coverage which,
as of the time the coverage is being provided, is
identical to the coverage provided under the Plan to
similarly situated beneficiaries under the Plan with
respect to whom a Qualifying Event has not occurred. If
coverage under the Plan is modified for any group of
similarly situated beneficiaries, coverage will be
modified in the same manner for the Qualified
Beneficiaries.
(c) The continuation coverage provided in this Article will
not be conditioned upon or discriminate on the basis of
lack of evidence of insurability.
9.3 NOTICE REQUIRED.
(a) At the time that coverage commences under this Plan,
Participants and their spouses, if any, shall be given
written notice of their rights under this Article.
(b) The Employer of any affected Participant shall notify the
Administrator of any Qualifying Event described in SECTION
9.1(b)(1), (2), (4) or (6) within thirty (30) days after
the date of such Qualifying Event.
(c) Each Qualified Beneficiary shall notify the Administrator
of the occurrence of a Qualifying Event described in
SECTION 9.1(b)(3) or (5) within sixty (60) days after the
later of the date of such Qualifying Event or the date as
of which the Qualified Beneficiary would otherwise lose
coverage under the Plan as a result of that Qualifying
Event. If the Qualified Beneficiary fails to notify the
Administrator of such a Qualifying Event within such sixty
(60) day period, such Qualified Beneficiary shall forfeit
his right to elect continuation coverage under this
Article.
(d) Any Qualified Beneficiary who is determined, under Titles
II or XVI of the Social Security Act, to have been
disabled at any time during the first sixty (60) days of
continuation coverage that began as a result of a
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Qualifying Event described in SECTION 9.1(b)(2) shall so
notify the Administrator within sixty (60) days of such
determination; provided, however, that such notice must
occur in any event before the expiration of the initial
eighteen (18) month period following the Qualifying Event.
In addition, such Qualified Beneficiary shall notify the
Administrator within thirty (30) days of any final
determination that he is no longer disabled.
(e) Within fourteen (14) days after the Administrator is
notified of a Qualifying Event, the Administrator shall
notify any Qualified Beneficiary of his or her rights
under this Article. Notice to a Qualified Beneficiary who
is the spouse or former spouse of a Participant will be
treated as notice to all other Qualified Beneficiaries
residing with such spouse at the time such notice is
given.
9.4 ELECTION OF CONTINUATION COVERAGE. Any Qualified Beneficiary who
desires continuation coverage under this Plan must make an election during the
applicable "election period" which begins on the date coverage would otherwise
terminate under the Plan by reason of a Qualifying Event, and ends sixty (60)
days after such date or sixty (60) days after the date the Qualified Beneficiary
receives notice of his or her fight to elect continuation coverage, whichever is
later. Unless specified otherwise in the election, any election by a Participant
or spouse to continue coverage under this Plan shall be deemed to be an election
of continuation coverage on behalf of any other Qualified Beneficiary who would
otherwise lose coverage under the Plan by reason of the same Qualifying Event.
9.5 PREMIUMS. The Qualified Beneficiary may be required to pay
premiums for any period of continuation coverage up to one hundred two percent
(102%) of the applicable premium, as defined under and determined in accordance
with Code section 498013(f)(4) and ERISA section 604; provided, however, that
notwithstanding the foregoing, that a Qualified Beneficiary who is entitled to
extended coverage under SECTION 9.6(a)(1)(A) may be required to pay premiums up
to one hundred fifty percent (150%) of the applicable premium for the coverage
period following the initial eighteen (18) month period. Premiums shall be
payable in monthly installments on the first day of every month; provided,
however, that the premium payment for the period of coverage prior to the date
of the participant's initial election shall not be required prior to forty-five
(45) days after the date of the election.
9.6 PERIOD OF CONTINUATION COVERAGE. Continuation of coverage timely
and properly elected by any Qualified Beneficiary under this Article shall
extend for a period that begins on the date of the Qualifying Event, and ends on
the earliest of the following dates:
(a) Maximum Period.
(1) In the case of a Qualifying Event described in
SECTION 9.1(b)(2), the date which is eighteen (18)
months after the date of the Qualifying Event;
provided, however,
(A) if the Qualified Beneficiary is. determined
to have been disabled at any time during the
first 60 days of continuation
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coverage following the Qualifying Event
under Titles 11 or XVI of the Social
Security Act, and if the Qualified
Beneficiary has timely notified the
Administrator of such determination in
accordance with SECTION 9.3(d), the maximum
period for that Qualified Beneficiary and
the covered members of the Qualified
Beneficiary's family shall end on the
earlier of (i) the date which is 29 months
after the date of the Qualifying Event, or
(ii) the first day of the month commencing
more than thirty (30) days after a final
determination that the Qualified Beneficiary
is no longer disabled;
(B) if another Qualifying Event, other than the
one described in SECTION 9.1(b)(6), occurs
during such eighteen (18) month period, the
date which is thirty-six (36) months after
the date of the original Qualifying Event;
and
(2) In the case of a Qualifying Event described in
Section 9.1(b)(2) that occurs less than 18 months
after the date the Covered Individual became
entitled to benefits under Article XVIII of the
Social Security Act, the period of coverage for
Qualified Beneficiaries other than the Participant
shall not terminate before the date which is
thirty-six (36) months after the date the
Participant became entitled to benefits under Title
XVIII of the Social Security Act, regardless of
whether such entitlement was the sole Qualifying
Event or if entitlement preceded the Qualifying
Event.
(3) In the case of a Qualifying Event described in
SECTION 9.1(b)(6), the date of death of the former
Participant; or if the Qualifying Event occurs
after the death of the former Participant, the date
of death of the surviving spouse of the former
participant; or with regard to the surviving spouse
or dependent children of a former Participant who
dies after the Qualifying Event, the date which is
thirty-six (36) months after the date of the former
Participant's death.
(4) In the case of any other Qualifying Event, the date
which is thirty-six (36) months after the date of
the Qualifying Event;
(b) The date on which the Employer of the Participant ceases
to provide any group health plan to any employee;
(c) If a premium is unpaid when due, the date that is thirty
(30) days after the first day on which the premium is due
under this Plan, or, if later, the date
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on which Participants would lose their coverage under this
Plan due to failure to pay premiums when due;
(d) The first date after a valid COBRA election is made that
the Qualified Beneficiary becomes entitled to benefits
under Title XVIII of the Social Security Act; or
(e) The first date after a valid COBRA election is made that
the Qualified Beneficiary becomes covered under any other
group health plan, as an employee or otherwise; provided,
however, that in order for this to stop a continuation of
coverage period, such other plan may not contain any
exclusion or limitation for pre-existing conditions with
respect to the Qualified Beneficiary, and provided,
however, that for any period commencing after December 31,
1996, the coverage provided under a group health plan with
respect to a Qualified Beneficiary who has continuation
coverage under the Plan shall not be considered to contain
any exclusion or limitation with respect to any
Pre-Existing Condition of that person by reason of the
existence of any limitation or exclusion which does not
apply to (or is satisfied by) such person continuing the
coverage by reason of Chapter 100 of the Code, part 7 of
the subtitle B of Title I of ERISA or Title XXVII of the
Public Health Service.
9.7 EXPIRATION OF CONTINUATION COVERAGE. In the case of any Qualified
Beneficiary whose continuation coverage expires under Section 9.6(a), the
Administrator shall, during the thirty-one (31) day period ending on such
expiration date, provide to the Qualified Beneficiary the option of enrolling in
a conversion plan otherwise generally available to Participants under the Plan,
if any. No conversion coverage shall be available to Participants under this
Plan.
ARTICLE X
FUNDING
Except for Board Members, Officers and Spouses, the Plan shall be funded
solely by contributions from Participants and Covered Dependents. In the case of
a Board Member, an Officer or a Spouse, notwithstanding anything in the Plan or
any other agreement to the contrary, the Sponsor will pay (i) all of the cost of
all of the Plan's benefits and coverages for that individual for that
individual's lifetime and (ii) to the individual, an additional sum in the
amount necessary to reimburse such individual for any federal income tax
liability resulting from (or associated with) the Sponsor's payments to or for
the benefit of the individual under this Plan, so that the benefits and
coverages under this Plan for that individual are provided at no cost to that
individual.
The Employers shall have no obligation, but shall have the right, to
establish a special trust or fund out of which benefits shall be paid. The
Employers shall have no obligation, but shall have the right, to reinsure, or to
purchase any type of additional coverage with respect to
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35
any benefits under the Plan. To the extent the Employer elects to purchase
insurance for any benefits under the Plan, any such benefits shall be the sole
responsibility of the insurer, and the Employer shall have no responsibility for
the payment of such benefits (except for refunding any Participant contributions
that were not remitted to an insurer).
ARTICLE XI
ADMINISTRATION
11.1 NAMED FIDUCIARY. The Named Fiduciaries of the Plan shall be the
Administrator, and any insurer or other persons, to the extent of its or their
discretionary authority with regard to the administration of the Plan. Except as
otherwise provided in the Policy, the Administrator shall have complete
authority to control and manage the operation and administration of the Plan.
The Administrator, subject to the succeeding provisions of this ARTICLE XI, is
authorized to take such actions as may be necessary to carry out the provisions
and purposes of the Plan and shall have the authority to control and manage the
operation and administration of the Plan. In order to effectuate the purposes of
the Plan, the Administrator shall have the discretionary power to construe and
interpret the Plan, to supply any omissions therein, to reconcile and correct
any errors or inconsistencies, to decide any questions in the administration and
application of the Plan, and to make equitable adjustments for any mistakes or
errors made in the administration of the Plan. All such actions or
determinations made by the Named Fiduciaries, and the application of rules and
regulations to a particular case or issue by the Named Fiduciaries, in good
faith, shall not be subject to review by anyone, but shall be final, binding,
and conclusive on all persons ever interested hereunder, subject only to the
claims review procedures set forth in SECTION 11.9. In construing the Plan and
in exercising its power under provisions requiring Administrator approval, the
Administrator shall attempt to ascertain the purpose of the provisions in
question and when such purpose is known or reasonably ascertainable, such
purpose shall be given effect to the extent feasible. Likewise, the
Administrator is authorized to determine all, questions with respect to the
individual rights of the Participants or Beneficiaries under this Plan,
including, but not limited to, all issues with respect to eligibility. The Named
Fiduciary in the exercise of any discretionary powers hereunder, shall exercise
such discretion in a uniform manner with respect to all similarly situated
Participants.
11.2 ALLOCATION OF FIDUCIARY RESPONSIBILITIES. The Administrator may
allocate certain of its fiduciary responsibilities among others and/or may
designate other persons to carry out certain of its fiduciary responsibilities
in accordance with and subject to the limitations of ERISA section 405. Any
person or group of persons may serve in more than one fiduciary capacity with
regard to the Plan. The Administrator and any fiduciary designated by the
Administrator may employ one or more persons to render advice concerning their
responsibilities under the Plan.
11.3 RECORDS. The Administrator shall exercise such authority as it
deems appropriate in order to comply with the terms of the Plan relating to the
records of Participants and the amounts which are payable under the Plan. The
Administrator shall make available to each
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Participant such of its records under the Plan as pertain to him for examination
at reasonable times during normal business hours.
11.4 APPOINTMENT OF COMMITTEE. The day-to-day administration of the
Plan shall be handled by a Committee comprised of at least one individual, if
such a Committee is appointed by the Administrator as its agent. If no Committee
is appointed, the Administrator shall be the Committee. Each member of the
Committee shall serve until his successor is appointed by the Administrator or
until he otherwise resigns. All expenses of the Committee shall be paid by the
Sponsor. A member of the Committee who is an employee shall not receive any
additional compensation for his or her services on the Committee, but shall be
reimbursed by the Sponsor for expenses incurred.
11.5 ACTIONS OF COMMITTEE. A majority of the members of the Committee
appointed pursuant to Section 11.4 shall constitute a quorum for the transaction
of business, and shall have full power to act hereunder. Action by the Committee
shall be official if approved by a vote of a majority of the members present at
any official meeting. The Committee may, without a meeting, authorize or approve
any action by written instrument signed by a majority of all of the members. Any
written memorandum signed by the Chairman, any other member of the Committee, or
any other person duly authorized by the Committee to act regarding the subject
matter of the memorandum, shall have the same force and effect as a formal
resolution adopted in open meeting.
A member of the Committee may not vote or decide upon any matter
relating solely to him or vote in any case in which his individual fight or
claim to any benefit under the Plan is specifically involved. If a Committee
member is so disqualified to act and the remaining members then present cannot,
by majority vote, act or decide, the Sponsor will appoint a temporary substitute
member to exercise all of the powers of the disqualified member concerning the
matter in which he is disqualified.
The Committee shall maintain minutes of its meetings and written records
of its actions. Members may participate and hold a meeting of the Committee by
means of telephone conference or similar communications equipment which permits
all persons participating in the meeting to hear each other; however, minutes
and written records must be maintained of such meeting. Participation in such a
meeting constitutes presence in person at such meeting.
11.6 OTHER POWERS AND DUTIES OF THE ADMINISTRATOR. The Administrator,
the Committee and any persons or entities designated by the Administrator,
except as otherwise set forth in the Policy, shall have all powers necessary or
desirable to administer the Plan, including, but not limited to, the following:
(a) in its sole discretion, to construe and interpret the
Plan, reconcile errors and supply omissions in the Plan,
and decide all questions of eligibility;
(b) to prescribe procedures to be followed by Participants in
making elections under the Plan and in filing claims under
the Plan;
(c) to prepare and distribute information explaining the Plan
to Participants;
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(d) to obtain from Participants such information as shall be
necessary for the proper administration of the Plan;
(e) to keep records of elections, claims, and disbursements
for claims under the Plan;
(f) to appoint individuals or committees to assist in the
administration of the Plan and to engage any other agents
it deems advisable, including legal and actuarial counsel;
(g) to purchase any insurance deemed necessary for providing
benefits under the Plan;
(h) to accept, modify, or reject elections under the Plan;
(i) to promulgate election forms and claims forms to be used
by Participants;
(j) to prepare and file any reports or returns regarding the
Plan required by the Code, ERISA, or any other laws;
(k) to determine and announce any Participant contributions
required hereunder;
(l) to determine and enforce any limits on benefits elected
hereunder;
(m) to take such action as may be necessary to cause the
payroll deduction of any Participant contributions
required hereunder;
(n) to, notwithstanding any other provision of the Plan, in
the event the Administrator determines that as a result of
administrative or arithmetic error, it has, with respect
to one or more Individuals, incorrectly determined
eligibility for participation, job classification, or
other items involving or concerning the continued
qualification of the, Plan under the Code, and determines
further that such error has resulted in one or more
Individuals receiving a smaller (or greater) benefit
provided by the Plan than they would have in the absence
of the error, take such steps as shall be necessary or
appropriate to correct such error with respect to the
affected individuals, utilizing whatever method will
result in the least overall cost to the Plan; and
(o) to recover overpayments erroneously made from the Plan to
Participants, Beneficiaries, or others utilizing whatever
method will result in the least overall cost to the Plan.
11.7 INDEMNIFICATION. The Sponsor and the Employers agree to and shall
indemnify and hold harmless each Indemnified Person (as defined in this Section)
from and against any and all claims, losses, damages, causes of action, suits,
and liability of every kind, including all
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38
expenses of litigation, court costs and reasonable attorney's fees, incurred in
connection with the Plan. "Indemnified Person" shall mean each member of the
Committee, and each employee, officer, or director of the Sponsor or of an
Employer acting as a fiduciary of the Plan. Such indemnity shall apply
regardless of whether the claims, losses, damages, causes of action, suits, or
liability arise in whole or in part from the negligence or other fault on the
part of the Indemnified Person, except to the extent there has been a final
adjudication that the claim or liability results from the gross negligence or
willful misconduct of the Indemnified Person.
11.8 RELIANCE ON TABLES, ETC. In administering the Plan, the
Administrator will be entitled, to the extent permitted by law, to rely
conclusively upon all tables, valuations, certificates, opinions and reports
which are furnished by accountants, counsel or other experts employed or engaged
by the Administrator.
11.9 CLAIMS AND REVIEW PROCEDURES.
(a) CLAIMS PROCEDURE. If any person believes he is being
denied any rights or benefits under the Plan, such person
may file a written claim with the Administrator. If the
claim is wholly or partially denied, the Administrator
will notify the claimant of its decision in writing. Such
notification will be written in a manner calculated to be
understood by such person and will contain: (i) specific
reasons for the denial, (ii) specific reference to
pertinent Plan provisions, (iii) a description of any
additional material or information necessary for the
person to perfect his claim and an explanation of why such
material or information is necessary, and (iv) information
as to the steps to be taken if the person wishes to submit
a request for review. Notification of a claim denial will
be given within ninety (90) days after the claim is
received by the Administrator, or within one hundred
eighty (180) days if special circumstances require an
extension of time for processing the claim, in which case
written notice of such extension and the circumstances
shall be given to the claimant within the initial ninety
(90) day period. If the claimant does not receive written
notice that the claim has been denied within the initial
ninety (90) day period, or within the one hundred eighty
(180) day period, if applicable, the claim will be deemed
to have been denied as of the last day of such period, and
such person may request a review of his claim.
(b) REVIEW PROCEDURE. Within sixty (60) days after the date on
which a person receives written notice of a claim denial,
or if applicable, within sixty (60) days after the date on
which such denial is deemed to have occurred, such person
or his duly authorized representative may file a written
request with the Administrator for a review of his denied
claim. The claimant and/or his authorized representative
may inspect pertinent documents and submit written issues
and comments to the Administrator. The Administrator will
notify the claimant of its decision in writing. Such
notification will be written in a manner calculated to be
understood by such person and will contain specific
reasons for the decision, as well as
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39
specific references to pertinent Plan provisions. The
decision on review will be made within sixty (60) days
after the request for review is received by the
Administrator, or within one hundred twenty (120) days if
special circumstances require an extension of time. If
such an extension of time is taken, the Administrator
shall notify the claimant in writing within the initial
sixty (60) day period and shall state the circumstances
and the date on which a decision is expected. If the
claimant does not receive written notice of the decision
within the initial sixty (60) day period, or within the
one hundred twenty (120) day period if applicable, the
claim shall be deemed to have been denied on review.
11.10 PARTICIPANT'S RESPONSIBILITIES. Each Participant shall be
responsible for providing the Administrator and the Sponsor with the
Participant's and his beneficiary's current address. Any notices required or
permitted to be given under this Section shall be deemed given if directed to
such address and mailed by regular United States mail. Neither the Administrator
nor the Sponsor shall have any obligation or duty to locate a Participant or
beneficiary. In the event that a Participant or beneficiary becomes entitled to
a payment under the Plan and such payment is delayed or cannot be made because:
(a) the current address according to Sponsor records is
incorrect;
(b) the Participant or beneficiary fails to respond to the
notice sent to the current address according to Sponsor
records;
(c) of conflicting claims to such payments; or
(d) of any other reason.
The amount of such payment, if and when made, shall be that determined under the
provisions of the Plan without consideration of any interest which may have
accrued.
11.11 MISSING PERSONS. If any amount becomes payable under the Plan to
a Participant or beneficiary and the same shall not have been claimed, or if any
check issued under the Plan remains uncashed, and reasonable care shall have
been exercised by the Administrator in attempting to make such payments, the
amount shall be forfeited within such period as is necessary to prevent escheat
under any applicable law and shall cease to be a liability of the Plan.
11.12 NONDISCRIMINATORY EXERCISE OF AUTHORITY. In the administration of
the Plan, whenever any discretionary action by the Administrator is required,
the Administrator shall exercise its authority in a nondiscriminatory manner in
order that all persons similarly situated will receive substantially the same
treatment.
11.13 EXPENSES. The Employer shall bear all costs and expenses
associated with the administration of this Plan which are not paid by an
established trust, if any.
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ARTICLE XII
AMENDMENT OR TERMINATION OF PLAN
12.1 AMENDMENT OF PLAN. The Sponsor expressly reserves the right to
amend the elections, terms and conditions of the Plan, if necessary; provided,
however, that without the express, prior written consent of each Participant and
Covered Dependent at the time the amendment is signed (or, if earlier, is
effective), no amendment to this Plan shall reduce the coverages available or
benefits payable under the Plan or decrease the individuals who may be
Participants or Covered Dependents under this Plan. Any amendment that is
necessary with respect to the Plan and permitted under this Section shall be
made only by a written instrument signed by the appropriate person or persons
and shall be binding upon and effective with respect to each Employer and its
Participants, Dependents, and Eligible Individuals.
12.2 TERMINATION OF PLAN. The Sponsor may terminate or discontinue
this Plan at any time, if necessary, only by a written instrument signed by its
authorized officer and only with the express, prior written consent of all
Participants and Covered Dependents at the effective date of the termination or
discontinuation. Notwithstanding anything in the Plan to the contrary, coverages
and benefits provided under this Plan are to be continued for the life of each
Board Member, each Officer and each Spouse, and the Plan and the Sponsor's
obligations under the Plan may not be terminated or discontinued without the
express, prior written consent of each Board Member, Officer and Spouse. Upon
termination or discontinuance of the Plan as permitted by this Section, all
elections shall terminate, and reimbursements or payments of Qualified Medical
Expenses shall be made only in accordance with ARTICLE VI.
ARTICLE XIII
MISCELLANEOUS
13.1 INFORMATION TO BE FURNISHED. Participants shall provide the
Employer and Administrator with such information and evidence as may reasonably
be requested from time to time for the purpose of administering the Plan.
13.2 LIMITATION OF RIGHTS. Neither the establishment of the Plan, nor
any amendment of the Plan, nor the payment of any benefits shall be construed as
giving to any Participant or other person any legal or equitable right against
the Employer or Administrator or their respective officers and directors, as an
employee or otherwise, except as expressly provided in this Plan, and in no
event will the terms of employment or service of any Participant or employee be
modified or in any way affected by this Plan.
13.3 BENEFITS NOT SOLELY FROM POLICY. Except as required by law,
applicable regulation or elsewhere in this Plan, the benefits provided under the
Plan shall be paid solely from the Policy so long as there is a Policy. If there
is no Policy, benefits payable under this Plan shall be paid from the general
assets of the Sponsor. Nothing in this Plan shall be construed to
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require (except as required by law and applicable regulation) any Fiduciary or
the Administrator to maintain any fund or segregate any amount for the benefit
of any Participant.
13.4 NONASSIGNABILITY OF RIGHTS. The right of any Participant to
receive any reimbursement under the Plan shall not be alienable by the
Participant by assignment or any other method and shall not be subject to being
taken by his creditors by any process whatsoever, and any attempt to cause such
right to be so subjected will not be recognized, except to such extent as may be
required by law.
13.5 NO GUARANTEE OF TAX CONSEQUENCES. Neither the Employer nor the
Administrator makes any commitment or guarantee that any amounts paid to or for
the benefit of a Participant under ARTICLES V or VI will be excludable from the
Participant's gross income for federal or state income employment tax purposes,
or that any other federal or state tax treatment will apply to or be available
to any Participant. It shall be the obligation of each Participant to determine
whether each payment under ARTICLES V or VI is excludable from the Participant's
gross income for federal and state income and employment tax purposes, and to
notify the Employer if the Participant has reason to believe that any such
payment is not so excludable.
13.6 SEVERABILITY. If any provision of this Plan is held invalid,
unenforceable or inconsistent with any law, regulation or requirement for a
medical plan governed by Code sections 104 or 105 or ERISA, its invalidity,
unenforceability or inconsistency shall not affect any other provision of the
Plan, and the Plan shall be construed and enforced as if such provision were not
a part of the Plan.
13.7 CONSTRUCTION OF TERMS. Words of gender shall include persons and
entities of any gender, the plural shall include the singular and the singular
shall include the plural. Section headings exist for reference purposes only and
shall not be construed as part of the Plan.
13.8 CHOICE OF LAW/JURISDICTION AND VENUE. THIS PLAN SHALL BE
CONSTRUED, ADMINISTERED, AND GOVERNED IN ALL RESPECTS (i) UNDER APPLICABLE
FEDERAL LAW, INCLUDING, WITHOUT LIMITATION, THE PROVISIONS OF ERISA AND THE CODE
AND RELEVANT INTERPRETATIONS OF BOTH, AND (ii) TO THE EXTENT NOT PREEMPTED BY
FEDERAL LAW, UNDER THE LAWS OF THE STATE OF TEXAS. EXCLUSIVE JURISDICTION AND
VENUE OF ALL DISPUTES ARISING OUT OF OR RELATING TO THIS PLAN SHALL BE IN ANY
COURT OF APPROPRIATE JURISDICTION IN DALLAS COUNTY, TEXAS. THE PROVISIONS OF
THIS SECTION SHALL SURVIVE AND REMAIN IN EFFECT UNTIL ALL OBLIGATIONS ARE
SATISFIED, NOTWITHSTANDING ANY TERMINATION OF THE PLAN.
13.9 NO VESTED INTEREST. Except for the right to receive any benefit
payable under the Plan in regard to a previously incurred claim, no person shall
have any right, title, or interest in or to the assets of any Employer because
of the Plan.
13.10 NO GUARANTEE OF EMPLOYMENT. Nothing in this Plan shall be
construed as a (i) contract of employment between an Employer and any
Individual, (ii) guarantee that any
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Individual will be continued in the employment or service of an Employer, or
(iii) limitation on the right of an Employer to discharge any of its employees
with or without cause.
13.11 ADOPTION BY SUCCESSOR EMPLOYER OR AFFILIATES. In the event of the
reorganization, purchase, merger, dissolution, or reconstitution, whether direct
or indirect, of the Sponsor, any successor entity shall be required to adopt and
continue the Plan; in which event, the Plan shall continue without any gap or
lapse in coverage or benefits. Failure of the Sponsor to obtain such assumption
and agreement prior to the effectiveness of any such succession shall be a
breach of this agreement and shall entitle the Participants and Covered
Dependents at that time to a lump sum payment from the Sponsor as liquidated
damages that will be an amount equal to the sum of (i) the total value of the
coverages and benefits under the Plan to such individual and (ii) the cost to
obtain identical (or better) replacement coverage for Plan coverage for such
individual.
The Sponsor shall pay to each Participant and Covered Dependent all
legal fees and expenses incurred by that individual, if any, in seeking to
obtain or enforce any right, coverage or benefit provided by this Agreement. An
individual entitled to a payment under this Section shall not be required to
mitigate the amount of a payment due to him under this Section, and
notwithstanding anything in the Plan to the contrary, payments due under this
Section shall not be reduced by any coverage or benefits received by a payment's
recipient from any other source. Throughout the Plan, a purposeful distinction
is drawn between the Sponsor and the Employers. The powers and responsibilities
assigned to the Sponsor by the Plan shall apply exclusively to the Sponsor.
13.12 BONDING. Every Fiduciary, except a bank or an insurance company,
unless exempted by ERISA and its regulations, shall be bonded in an amount not
less than 10% of the amount of the funds such Fiduciary handles; provided,
however, that the minimum bond shall be $1,000 and the maximum bond, $500,000.
The amount of funds handled shall be determined at the beginning of each Plan
Year by the amount of funds handled by such person, group, or class to be
covered and their predecessors, if any, during the preceding Plan Year, or if
there is no preceding Plan Year, then by the amount of the funds to be handled
during the then current year. The bond shall provide protection to the Plan
against any loss by reason of acts of fraud or dishonesty by a Fiduciary alone
or in connivance with others. The surety shall be a corporate surety company (as
such term is used in section 412(a)(2) of ERISA), and the bond shall be in a
form approved by the Secretary of Labor. Notwithstanding anything in the Plan to
the contrary, the cost of such bonds shall be an expense of and may, at the
election of the Administrator, be paid by the Employer.
ARTICLE XIV
QUALIFIED MEDICAL CHILD SUPPORT ORDERS
14.1 NOTIFICATION OF RECEIPT OF CHILD SUPPORT ORDER. Upon receipt by
the Administrator of a medical child support order, an administrative notice, or
a National Medical Support Notice as set forth in ERISA, the Administrator shall
tell the Participant and the
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potential alternate recipient of the medical child support order, administrative
notice or National Medical Support Notice that it has received the medical child
support order, administrative notice, or National Medical Support Notice within
fifteen (15) days of the Administrator's receipt of the medical child support
order, administrative notice, or National Medical Support Notice. The
notification shall also describe the procedures for determining whether the
medical child support order, administrative notice, or National Medical Support
Notice is a "Qualified Medical Child Support Order"as defined in section 609 of
ERISA. The procedures shall permit a potential alternate recipient to designate
a representative to receive copies of notices with respect to a medical child
support order, administrative notice, or National Medical Support Notice.
The Administrator shall determine if the medical child support order,
the administrative notice or the National Medical Support Notice is a Qualified
Medical Child Support Order within sixty (60) days of receipt of such order or
notice, unless circumstances cause a delay. If a delay is required, the
potential alternate recipient shall be notified of any such delay in writing.
14.2 PROCEDURES TO DETERMINE IF MEDICAL CHILD SUPPORT ORDER IS A
QUALIFIED MEDICAL CHILD SUPPORT ORDER. The Administrator shall review the
medical child support order, the administrative notice, or the National Medical
Support Notice (or request legal counsel to review the medical child support
order, administrative notice or National Medical Support Notice) and verify that
the following items are appropriately addressed in the medical child support
order, administrative notice, or National Medical Support Notice:
(a) The medical child support order, administrative notice or
National Medical Support Notice must create or recognize
the existence of an alternate recipient's right to receive
benefits for which the Participant or beneficiary is
eligible under the Plan or to assign those rights;
(b) The medical child support order, administrative notice or
National Medical Support Notice must identify the parties
responsible for paying for the benefits that are the
subject of the order, notice or National Medical Support
Notice;
(c) The medical child support order, administrative notice, or
National Medical Support Notice must clearly specify the
name and last known mailing address of each alternate
recipient covered by the order, administrative notice or
National Medical Support Notice or must provide the name
and address of any state official or political subdivision
that will be substituted for that of the alternate
recipient. Payment made to any such selected official
shall be treated as payment made to the alternate
recipient;
(d) The medical child support order, administrative notice, or
National Medical Support Notice must specify in a
reasonable description the type of coverage to be provided
by the Plan to each alternate recipient or the manner in
which the type of coverage is to be determined;
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44
(e) The medical child support order, administrative notice or
National Medical Support Notice must specify the period to
which the order, administrative notice or National Medical
Support Notice applies;
(f) The medical child support order, administrative notice, or
National Medical Support Notice must not require the Plan
to provide any type or form of benefit not otherwise
provided under the Plan; and
(g) The medical child support order, administrative notice or
National Medical Support Notice must clearly be an order,
administrative notice, judgment, decree, approval of a
settlement or a National Medical Support Notice.
If the Administrator determines the medical child support order,
administrative notice or National Medical Support Notice satisfies all of the
above requirements, the medical child support order, administrative notice or
National Medical Support Notice shall, subject to SECTION 14.4, be a Qualified
Medical Child Support Order, and the Administrator shall notify, in writing,
each of the alternate recipient(s) or the alternate recipient(s)' selected
official or political subdivision, if applicable, and the Participant or
beneficiary related to such alternate recipient(s) that the order,
administrative notice, or National Medical Support Notice is a Qualified Medical
Child Support Order. The Administrator shall also notify the Participant that he
must execute a new enrollment form to cover the cost of such coverage or
otherwise notify the party responsible for paying for the coverage of their
obligations with respect to payment for the coverage. If the Administrator
determines that the order or administrative notice, or National Medical Support
Notice is not a Qualified Medical Child Support Order, the Administrator shall
notify, in writing, each of the proposed alternate recipient(s) or the alternate
recipient(s)' selected official or political subdivision, if applicable, and the
related Participant or beneficiary that the order, administrative notice, or
National Medical Support Notice is not a Qualified Medical Child Support Order,
why the order, administrative notice or National Medical Support Notice failed
to qualify as such and their rights, if any, to appeal such decision.
14.3 TREATMENT OF ALTERNATE RECIPIENT UNDER QUALIFIED MEDICAL CHILD
SUPPORT ORDER. The Administrator shall treat each alternate recipient under a
Qualified Medical Child Support Order as a Participant under the Plan, but only
for purposes of the reporting and disclosure requirements imposed by ERISA.
14.4 COST OF QUALIFIED MEDICAL CHILD SUPPORT ORDER BENEFITS. The cost
of the coverage provided under the Qualified Medical Child Support Order shall
be paid by the party designated as responsible for paying for such coverage in
the order, administrative notice or National Medical Support Notice.
In the event a medical child support order, administrative notice, or
National Medical Support Notice does not specify the party responsible for
payment for the alternate recipient's coverage under the medical child support
order, administrative notice, or National Medical Support Notice, the
Administrator shall either deny the medical child support order's,
administrative notice's, or National Medical Support Notice's qualified status
and send copies of
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45
the Qualified Medical Child Support Order procedures to the parties, or file an
appropriate pleading in either the Federal district court or in the domestic
relations court requesting revisions of the issued order, administrative notice
or National Medical Support Notice in such a manner as to qualify the order,
administrative notice, or National Medical Support Notice as a Qualified Medical
Child Support Order.
14.5 QUALIFIED MEDICAL CHILD SUPPORT ORDER AND MEDICAID. The
Administrator shall not consider the alternate recipient's eligibility for
Medicaid when enrolling the alternate recipient in the Plan. The Plan shall
comply with the alternate recipient's assignment rights under Medicaid, if any.
14.6 PAYMENTS OR REIMBURSEMENTS UNDER A QUALIFIED MEDICAL CHILD
SUPPORT ORDER. The Administrator is permitted to pay or reimburse the alternate
recipient, the alternate recipient's custodial parent, or any state official or
political subdivision selected by the alternate recipient to receive payments
for any benefit payments due under the Plan to or on behalf of the alternate
recipient.
14.7 ALTERNATE RECIPIENT. "Alternate recipient" means the individual
designated as the person entitled to receive health care coverage under the
Qualified Medical Child Support Order.
ARTICLE XV
POLICY
The Policy set forth on Exhibit A to this Plan is incorporated by this
reference as part of the Plan document. Any amendment or replacement of any of
the documents comprising the Policy may be certified by a duty authorized
officer of the Sponsor, and may be updated as required, without any need to
amend this document. But, to the extent any part of the Policy conflicts with or
contradicts the provisions of this document, this document shall govern in
determining (i) the rights of Participants, their Covered Dependents and, if
any, their other covered beneficiaries, and (ii) the obligations of the
Employers, Administrator, and any Fiduciary to Participants, Covered Dependents
and, if any, other covered beneficiaries.
ARTICLE XVI
PARTICIPATING EMPLOYERS
16.1 ADOPTION BY OTHER EMPLOYERS. Notwithstanding anything in this
document to the contrary, with the written consent of the Sponsor, any other
corporation or entity, whether an affiliate or subsidiary or not, may adopt this
Plan and become a Participating Employer, by a properly executed document
evidencing said intent and will of such Participating Employer. Participating
Employers who have adopted the Plan are listed on Exhibit B to this Plan, as it
may be amended from time to time.
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46
16.2 REQUIREMENTS OF PARTICIPATING EMPLOYERS.
(a) The transfer of any Participant from or to an Employer
participating in this Plan, whether he be an employee of
the Sponsor or a Participating Employer, shall not affect
such Participant's rights under the Plan, and his length
of participation in the Plan shall continue to his credit.
(b) Any expenses of the Plan which are to be paid by the
Employer or borne by the Plan shall be paid by each
Participating Employer in the same proportion that the
total number of all Participants employed by such Employer
bears to the total number of all Participants.
16.3 DESIGNATION OF AGENT. Each Participating Employer shall be deemed
to be a part of this Plan-, provided, however, that with respect to all of its
relations with the Administrator for the purpose of this Plan, each
Participating Employer shall be deemed to have designated irrevocably the
Sponsor as its agent.
16.4 TRANSFERS. It is anticipated that an Individual who is an
employee may be transferred between Participating Employers, and in the event of
any such transfer, the employee involved shall carry with him his accumulated
service and eligibility. No such transfer shall effect a termination of
employment under this Plan, and the Participating Employer to which the employee
is transferred shall become obligated under this Plan with respect to such
employee in the same manner as was the Participating Employer from whom the
employee was transferred.
16.5 PARTICIPATING EMPLOYER'S CONTRIBUTION. All contributions made by
a Participating Employer, as provided for in this Plan, shall be determined
separately by each Participating Employer and shall be paid for the exclusive
benefit of the employees of such Participating Employer and the Beneficiaries of
such employees, subject to all the terms and conditions of this Plan. On the
basis of the information furnished by the Employers to the Administrator, the
Administrator shall keep separate books and records concerning the Plan affairs
of each Participating Employer and as to the accounts and credits of the
employees of each Participating Employer. The Administrator may, but need not,
register contracts so as to evidence that a particular Participating Employer is
the interested Employer, but in the event of an employee transfer from one
Participating Employer to another, the employing Employer shall immediately
notify the Administrator.
16.6 DISCONTINUANCE OF PARTICIPATION. Any Participating Employer shall
be permitted to discontinue or revoke its participation in the Plan. At the time
of any such discontinuance or revocation, satisfactory evidence of such action
and of any applicable conditions imposed shall be delivered to the
Administrator. The Administrator shall thereafter transfer, deliver and assign
the contracts and other assets allocable to the Participants of such
Participating Employer to such new Administrator as shall have been designated
by such Participating Employer, in the event that it has established a separate
medical care plan for its employees. If no successor is designated, the
Administrator shall retain such assets for the employees of said Participating
Employer. In no such event shall any part of the corpus or income of the Trust
as it relates to
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such Participating Employer be used for or diverted for purposes other than for
the exclusive benefit of the employees of such Participating Employer.
16.7 ADMINISTRATOR'S AUTHORITY. The Administrator shall have authority
to make any and all necessary rules or regulations, binding upon all
Participating Employers and all Participants, to effectuate the purpose of this
Article.
IN WITNESS WHEREOF, the Corporation has caused this Plan to be executed
in its name and on its behalf this 23rd day of June, 2000 authorized
representative.
"SPONSOR"
DALLAS SEMICONDUCTOR CORPORATION
By: /s/ Xxxx X. Xxxx
------------------------------------
Title: V. P. Finance & CFO
39
48
EXHIBIT A
POLICY
40
49
EXHIBIT B
PARTICIPATING EMPLOYERS
41
50
EXHIBIT C
OFFICERS
X. X. Xxxxxxx
Xxxx X. Xxx
Xxxxxxx X. Xxxxx
Xxxx X. Xxxx
Xxxx Xxx Xxxxxxx
42
51
EXHIBIT D
BOARD MEMBERS
Xxxxxxx X. Xxxx
Xxxxxx X. Xxxxxxx
Xxxxxxx X. Xxxxxxx
Adm. X.X. Xxxxxxx, Xx.
43
52
EXHIBIT E
SPOUSES
Xxxxx X. Xxxxxxx
Xxxxx X. Xxxxxxx
Xxxxxxx Xxxxxxxx
Xxxxx X. Xxxx
Xxxx X. Xxx
Xxxxx X. Xxxxxxx
Xxxxxxxxx X. Xxx Xxxxxxx
44
53
EXHIBIT F
ELIGIBLE EMPLOYEES
(OTHER THAN OFFICERS)
Xxxx Xxxxx
Xxxxxx X. Xxxxx
G. Xxxxxx Xxxxxxx
Xxxxx X. Xxxxxxx
Met Xxxx
Xxxxxxx X. Xxxxx
Xxx Xxxx
Xxxxxxx X. Xxxxxx
Xxx Xxxxxxxxxx, III
Xxxxx X. Xxxx
Xxxxx X. Xxxxxxx
Xxx Xxxxx
Xxxxxxx X. Xxxx
Xxx Xxxxxxxxx
Xxxxxx X. Xxx
Xxxx X. Xxxxxx, III
Xxxxx Xxxxxxxxxx
Xxxxxxx X. Xxxxxxx
Xxx Xxxxxx
Xxxxx X. Xxxxxx
Xxxx Xxx
Xxxxx Xxxxxxxxxxxx
Xxxxxxx X. Xxxxx
Gay X. Xxxxxxx
Xxxxx X. Xxxxxxxx
45
54
AMENDMENT ONE TO
THE DALLAS SEMICONDUCTOR CORPORATION
EXECUTIVES RETIREE MEDICAL PLAN
Amendment made to the Dallas Semiconductor Corporation Executives
Retiree Medical Plan, Effective October 1, 1999 (the "Plan"), by Dallas
Semiconductor Corporation (the "Corporation").
W I T N E S S E T H
WHEREAS, the Corporation sponsors the Plan to provide retiree (and
limited other) medical care benefits to board members, officers, certain other
eligible retirees, and the eligible spouses of board members and officers; and
WHEREAS, the Corporation desires to amend the Plan to permit the spouse
of Xxxxxxx Xxxx, Xxxxx Xxxxx, to participate in the Plan, effective June 24,
2000, the date of their marriage; and
WHEREAS, by the terms of Section 12.1 of the Plan, the Plan may be
amended by the Corporation.
NOW, THEREFORE, effective June 24, 2000, the Plan is hereby amended as
follows:
1. Section 2.37 is deleted in its entirety and the following is
substituted in its place:
"2.37 'SPOUSE' means the wife of an Officer or of a Board
Member on the date of his Retirement, and in the case of only
Xxxxxxx Xxxx, means Xxxxx Xxxxx, effective June 24, 2000. Xxxxx
Xxxxx, effective June 24, 2000 and each person who was a spouse
of an Officer or of a Board Member on the Effective Date are
listed on Exhibit E, but being listed on Exhibit E does not make
an individual a Spouse for purposes of this Plan."
2. Existing Exhibit E to the Plan is deleted in its entirety, and
the attached Exhibit E is substituted in its place.
55
IN WITNESS WHEREOF, the Corporation, has caused this instrument to be
executed by its duly authorized officer on this 23rd day of June, 2000, to be
effective June 24, 2000.
DALLAS SEMICONDUCTOR CORPORATION
BY: /S/ XXXX X. XXXX
----------------------------------------
Title: Vice President - Finance and Chief
Financial Officer
2
56
EXHIBIT E
SPOUSES
Xxxxx X. Xxxxxxx
Xxxxx X. Xxxxxxx
Xxxxxxx Xxxxxxxx
Xxxxx X. Xxxx
Xxxx X. Xxx
Xxxxx X. Xxxxxxx
Xxxxxxxxx X. Xxx Xxxxxxx
Xxxxx Xxxxx
3
57
AMENDMENT TWO TO
THE DALLAS SEMICONDUCTOR CORPORATION
EXECUTIVES RETIREE MEDICAL PLAN
Amendment made to the Dallas Semiconductor Corporation Executives
Retiree Medical Plan, effective October 1, 1999 (the "Plan"), by Dallas
Semiconductor Corporation (the "Corporation").
W I T N E S S E T H
WHEREAS, the Corporation sponsors the Plan to provide retiree (and
limited other) medical care benefits to board members, officers, certain other
eligible retirees, and the eligible spouses of board members and officers; and
WHEREAS, the Corporation desires to amend the Plan to clarify that the
Plan will not impose a pre-existing condition limitation; and
WHEREAS, by the terms of SECTION 12.1 of the Plan, the Plan may be
amended by the Corporation.
NOW, THEREFORE, effective October 1, 1999, the Plan is hereby amended as
follows:
1. SECTION 2.34 is deleted in its entirety, and the following is
substituted in its place:
"2.34 `QUALIFIED MEDICAL EXPENSE' means an expense incurred by a
Participant, by the Participant's spouse or by a Dependent of
such Participant for medical care as defined in Code section 213,
including, without limitation, amounts paid for hospital bills
and doctor bills, but only to the extent that (i) the participant
or other person is not reimbursed for the expense through
insurance or otherwise, other than under the Plan, and (ii) the
expense is not taken into account as a deduction by the
Participant on his Internal Revenue Service Form 1040."
2. The second sentence of SECTION 5.1 is deleted in its entirety,
and the following is substituted in its place:
"Subject to SECTIONS 5.2(A) and 12.1, the specific coverages and
benefits available to Participants are set forth in the Policy or
if there is no Policy, in the Policy last in effect in connection
with the Plan."
3. SECTION 5.2(A) is deleted in its entirety, and the following is
substituted in its place:
"5.2 PRE-EXISTING CONDITIONS.
58
(a) PRE-EXISTING CONDITIONS. Notwithstanding anything in the
Plan or any Policy to the contrary, the Plan shall not
impose any type of pre-existing condition exclusion.
Notwithstanding anything in any Policy to the contrary, a
pre-existing condition in a Policy shall not include any
condition that does not fall within the definition of a
Pre-existing Condition, no pre-existing condition shall
include a condition for which Genetic Information was used
as a basis for asserting the existence of the condition if
there has been no diagnosis of the condition related to
such information, and the period during which any
exclusion or limitation of benefits (relating to a
condition based on the fact that the condition was present
before a person's Enrollment Date) in the Policy would be
enforced (if the Plan allowed pre-existing condition
exclusions) for no longer than the excess of twelve (12)
months (eighteen (18) months for a Late Enrollee),
beginning on his Enrollment Date, over the aggregate of
the periods of Creditable Coverage (if any) applicable to
the Participant as of his Enrollment Date."
5. The last sentence of SECTION 8.1 is amended to delete the words
"coverage limitations" in that sentence and to substitute "coverage maximums" in
their place.
IN WITNESS WHEREOF, the Corporation has caused this instrument to
be executed by its duly authorized officer effective October 1, 1999.
DALLAS SEMICONDUCTOR CORPORATION
By: /s/ Xxxx X. Xxxx
------------------------------------
Title:
---------------------------------
2
59
AMENDMENT THREE TO
THE DALLAS SEMICONDUCTOR CORPORATION
EXECUTIVES RETIREE MEDICAL PLAN
Amendment made to the Dallas Semiconductor Corporation Executives
Retiree Medical Plan, effective October 1, 1999 (the "Plan"), by Dallas
Semiconductor Corporation (the "Corporation").
W I T N E S S E T H
WHEREAS, the Corporation sponsors the Plan to provide retiree (and
limited other) medical care benefits to board members, officers, certain other
eligible retirees, and the eligible spouses of board members and officers; and
WHEREAS, the Corporation desires to amend the Plan to permit three
Directors appointed after October 19, 1999, Xxxxxxx X. Xxxx, Xxxx X. Xxxxx and
Xxxxx X. Xxxxxx, to participate in the Plan, effective on the date each was
appointed as a Director; and
WHEREAS, by the terms of Section 12.1 of the Plan, the Plan may be
amended by the Corporation.
NOW, THEREFORE, effective as provided below, the Plan is amended as
follows:
1. SECTION 2.10 is deleted in its entirety, effective October 9,
2000, and the following is substituted in its place:
"ELIGIBLE EMPLOYEE" means (i) each Officer of the Sponsor
on the Effective Date, (ii) each common-law employee of an
Employer who was designated on the books and records of the
Employer as a "functionally equivalent" officer on the Effective
Date and who shared in the contribution made on June 12, 1998, to
the Dallas Semiconductor Corporation Executive Deferred
Compensation Plan, (iii) each common-law employee of an Employer,
on the Effective Date, who, on the Effective Date (or within the
five (5) calendar year period preceding the Effective Date), also
held the title of Director or was the Sponsor's corporate
controller, (iv) effective October 9, 2000, Xxxxx X. Xxxxxx, Xxxx
X. Xxxxx and Xxxxxxx X. Xxxx, and (v) each common-law employee of
an Employer, on the Effective Date, who, on the Effective Date,
held the position of Manager and was required to report for
operating purposes directly to the Sponsor's President and Chief
Executive Officer. Each person who was an Eligible Employee on
the Effective Date or become an Eligible Employee as a result of
an amendment to the Plan after the Effective Date is listed on
either Exhibit C or Exhibit F to the Plan."
1
60
2. Effective October 9, 2000, existing Exhibit F is deleted in its
entirety, and the attached Exhibit F is substituted in its place.
IN WITNESS WHEREOF, the Corporation, has caused this instrument to be
executed by its duly authorized officer on this 10th day of April, 2001.
DALLAS SEMICONDUCTOR CORPORATION
By: /s/ Xxxx X. Xxxx
------------------------------------
Name: Xxxx X. Xxxx
Title: Chief Financial Officer
2
61
EXHIBIT F
ELIGIBLE EMPLOYEES
(OTHER THAN OFFICERS)
(EFFECTIVE OCTOBER 9, 2000)
Xxxx Xxxxx
Xxxxxx X. Xxxxx
G. Xxxxxx Xxxxxxx
Xxxxx X. Xxxxxx
Xxxxx X. Xxxxxxx
Xxx Xxxx
Xxxxxxx X. Xxxxx
Xxx Xxxx
Xxxx X. Xxxxx
Xxxxxxx X. Xxxxxx
Xxx Xxxxxxxxxx, III
Xxxxx X. Xxxx
Xxxxx X. Xxxxxxx
Xxx Xxxxx
Xxxxxxx X. Xxxx
Xxxx Xxxx
Xxx Xxxxxxxxx
Xxxxxx X. Xxx
3
62
Xxxx X. Xxxxxx, III
Xxxxx Xxxxxxxxxx
Xxxxxxx X. Xxxxxxx
Xxx Xxxxxx
Xxxxx X. Xxxxxx
Xxxx Xxx
Xxxxx Xxxxxxxxxxxx
Xxxxxxx X. Xxxxx
Gay X. Xxxxxxx
Xxxxx X. Xxxxxxxx
4
