Long Term Disability Income Plan Summary Plan Description
The following information comprises the Summary Plan Description to our employees under the Employees’ Retirement Income Security Act of 1974 often referred to as ERISA.
This Welfare Benefit Plan is administered by Rhodes College, 2000 North Parkway, Memphis, TN 38112 whose Internal Revenue Service Employer Identification Number is EIN620476301. The Plan Number is 501. The Plan year is July through June. This is an insurer administration plan. Information regarding Plan eligibility, enrollment, cost, and the procedure for applying for benefits is contained in this section. The Certificate of Coverage includes a description of benefits under the Plan and the conditions under which these benefits are available to insured individuals.
Employees Eligible for the Plan
All active full-time faculty and staff are eligible.
Date Eligible for Insurance
Each employee becomes eligible the first day of the month following the date of employment with Rhodes. If an employee is absent from work on the day he or she would otherwise become eligible, the employee will become eligible on the day he or she returns to work.
Enrolling in the Plan
An employee will become insured on the first day of the month following hire date. No medical examination is necessary.
Applications, Requests, and Questions Directed to the Plan Administrator
Applications, requests, and questions regarding enrollment, participation, or other administrative matters and service of legal process on issues arising from such questions, should be directed to the Plan Administrator, Chief Human Resources Officer, Rhodes College, 2000 North Parkway, Memphis, TN 38112, (901) 843-3750.
If a written application or request pertaining to enrollment, participation, or administration of the Plan is denied by the Administrator, the Administrator shall, within a reasonable time, provide a written denial to the participant.
It will include the specific reasons for denial, the provisions of the Plan upon which the denial is based, a description of any material needed to complete the application or request (if appropriate) and why it is necessary, and instructions on review procedures. When the Administrator requires additional time to respond because of special circumstances, an extension of up to 90 days may be obtained by notifying the participant that a decision will be delayed, what circumstances have caused the delay and when a decision can be expected. The Administrator will inform the participant of the delay within 90 days of the date the application or request was submitted.
A participant may request in writing a review of a denied request or application, and may review pertinent documents and submit issues and comments in writing to the Administrator. The Administrator shall provide in writing to the participant a decision upon such request for review within 60 days of receipt of the request. When special circumstances require an extension, the Administrator may obtain an extension of up to 60 days by notifying the participant why the decision on the review will be delayed and when a decision can be expected.
The Cost of the Plan
Rhodes currently pays the entire cost of this Plan. Periodically, generally near the end of a plan year, the insurance company reviews the adequacy of premiums charged for the Plan and advises the College whether existing premium rates will be continued or whether adjustments will be made for the coming year.
After six months of total disability and approval by the insurance company, the disabled employee receives monthly income (offset by Social Security and Workers’ Compensation benefits) equivalent to 60% of regular monthly salary with a maximum total benefit of $7,500 per month. When an individual begins receiving total disability income protection payments from the insurance company, the College will no longer continue to provide fringe benefits and the employment relationship is terminated.
Applying for Benefits
The appropriate forms for applying for benefits, and assistance in the completion of these forms, may be obtained from Human Resources.
Notice and proof of claim should be made promptly. Details on the applicable time limits for submitting benefit applications may be found in the Certificate of Coverage which each insured employee receives, as well as in the Group Policy maintained in the office of the Plan Administrator. Upon receipt by the insurance company of the application for benefits and supporting documentation, valid claims will be paid promptly.
If a claim is denied, the insurance company shall within a reasonable period of time (not exceeding 90 days) provide a written denial to the participant. It will include specific reasons for denial, the provisions of the insurance contract on which the denial is based, and how to apply for a review of the denied claim. When appropriate, it will also include a description of any material which is needed to complete or perfect a claim and why such material is necessary. A participant may request in writing a review of a claim denied by the insurance company and may review pertinent documents and submit issues and comments in writing to the insurance company. The insurance company shall provide in writing to the participant a decision upon such request for review of a denied claim within 60 days of receipt of the request.
If special circumstances require a delay on the initial decision on a claim or a review of a denied claim, the insurance company will notify the participant within 90 days of the date the claim was initially submitted or within 60 days of the date a review was requested. The notice will explain the reasons for the delay and when a decision can be expected. In no event will a decision be provided later than 90 days after the notice is sent for an initial decision on a claim or more than 60 days after the notice is sent for a review of a denied claim.
Currently the insurance company is UNUM. Requests for information concerning the UNUM Group Total Disability Insurance contract terms, condition, and interpretations thereof, claims thereunder, any requests for review of such claims, and service of legal process may be directed in writing to UNUM, Suite 1700 - Benefits, 3 Ravina Drive, Atlanta, GA 30346.
For a statement of ERISA rights see ERISA.
Continuation of Medical Benefits Coverage
When an individual begins receiving total disability income protection payments from the insurance company, the College will no longer continue to provide medical benefits coverage and the employment relationship is terminated. Even though an employee will no longer be covered by the College, the employee has the option of COBRA benefits (refer to “COBRA” in this chapter).
Amendment to Group Long Term Total Disability Benefits Insurance Plan
Rhodes College shall be the Administrator for this Plan, and as such, shall have the authority to control and manage the operation and administration of the Plan, subject to the provisions of the Group Insurance Policy. The Administrator has designated in writing the Chief Human Resources Officer to carry out duties under the Plan.
The Board of Trustees reserves the right to modify or discontinue the Plan at any time. Such modification or discontinuance must be effected in accordance with the terms of the group insurance contract.