Long-Term Disability (LTD) Coverage

Benefit Reductions

If you receive income from other sources while you are disabled, your benefits may be reduced.

The LTD Plan begins to pay benefits if you are totally disabled as defined by the plan when your STD Plan benefits end, or 90 days after your disability began (whichever is later). In some cases, you can receive disability payments even if you work while you are disabled.

How Much the Plan Pays

The LTD benefits you receive are based on your monthly earnings before your disability began. The plan offers two levels of coverage:

• Basic LTD Plan paid by employer — 40% of monthly earnings to a maximum benefit of $5,000 per month.
• Buy-Up LTD Plan paid by you — 60% of monthly earnings to a maximum benefit of $7,500 per month.

Your benefits may be reduced by the amount of other income replacement benefits you receive for the same disability.

For more information on the way benefits may be reduced, see “Other Sources of Income” on the following page.

Once your coverage begins, any increased or additional coverage due to a change in your weekly or monthly earnings or due to a plan change requested by MPTN will take effect immediately if you are actively employed or on a covered leave of absence. If you are not actively employed due to illness or injury, any increased or additional coverage will begin on the date you return to active employment.

If you become totally disabled while you are on a covered leave of absence, the plan administrator will use your monthly earnings from MPTN in effect on the day before the date your absence began. For more information about leaves of absence, contact Human Resources.

Benefits are paid as explained in “Receiving LTD Benefits — How Long LTD Benefits Continue” within this section, as long as you remain totally disabled as defined by the LTD Plan. See the Terms to Know section for the definition of “totally disabled.”

Taxes on LTD Benefits

The benefits you receive from the Basic LTD Plan generally are taxable. This means that income and Social Security (FICA) taxes should be withheld from your benefits payment.

With the buy-up LTD option, you pay the premium for benefits coverage of 20% of your monthly earnings, and MPTN pays for the 40% basic benefit. Because you pay for your portion on an after-tax basis, the benefits you receive from that portion generally are not subject to income and Social Security (FICA) taxes.

Time Limits on LTD Claims

To initiate your LTD claim, you must call the plan administrator within 10 days of the first day you are totally disabled. You must also send written proof of your claim, as described below, no later than 90 days after the 90-day elimination period. If it is impossible to give proof within 90 days, you must send such proof no later than one year after the time that proof is otherwise required. There is an exception to this time limit if you are legally incapacitated.

For more information on how to submit a claim, contact Human Resources or the plan administrator.

LTD Benefit Example

This example shows how your monthly benefit is calculated. All amounts used are before taxes and any other deductions. Assume that your monthly earnings are $5,000.

Other Sources of Income

You may still receive income from other sources while you are totally disabled. Depending on the source of income, your benefits may be reduced. However, the minimum monthly LTD benefit is the greater of:

• $100, or
• 10% of the gross monthly benefit.

For a list of income that does not reduce your LTD benefits, and for information on how benefit reductions are managed, see “How Your Benefits Are Reduced” within this section.

Filing a Claim

Call the plan administrator
toll-free at 1-855-212-7102 or 1-866-562-8421 (Espanol), Monday through Friday, 8 a.m. to 8 p.m., Eastern Time,
to begin filing a claim.

Income that Reduces Your LTD Benefits

Income from the following sources will be subtracted from your gross LTD benefit:

• The amount that you receive or are entitled to receive under:
  • a Workers’ Compensation law,
  • an occupational disease law, or
  • any other act or law with similar intent.
• The amount that you receive or are entitled to receive as disability income payments under any:
  • state compulsory benefit act or law,
  • other group insurance plan, or
  • governmental retirement system as a result of your job with MPTN.
• The amount that you receive under:
  • an accumulated sick leave plan,
  • The Jones Act (Title 46, U.S.C. Section 688), or
  • the mandatory portion of any “no fault” motor vehicle plan.
• The amount that you, your spouse and your children receive or are entitled to receive as disability payments because of your disability under:
  • the U.S. Social Security Act, or
  • any similar plan or act.
• The amount that you receive as retirement payments or the amount your spouse and children receive as retirement payments because you are receiving retirement payments under:
  • the U.S. Social Security Act, or
  • any similar plan or act.

Only income that is payable as a result of the same disability will be subtracted from your gross disability benefit. Once the plan administrator has subtracted such income from your gross disability benefit, your benefit will not be reduced further due to an increase — such as a cost of living increase — from that source.

If Your Disability Earnings Fluctuate

If your disability earnings fluctuate widely from month to month on a regular basis, your disability earnings may be averaged over the most recent three months to determine if your claim should continue. If your disability earnings are averaged, your claim will not be terminated unless:

• during the first 24 months of disability payments, the average of your disability earnings from the last three months exceeds 80% of monthly earnings, or
• beyond 24 months of disability payments, the average of your disability earnings from the last three months exceeds the gross disability payment.

You will not receive a monthly payment for any month during which disability earnings exceed the amount allowable under the plan.

When LTD Benefits Begin

You must be totally disabled continuously through the “elimination period” before you are eligible to receive benefits. For purposes of the LTD Plan, the elimination period ends on the later of:

• 90 days after your disability began, or
• the date any benefits you are receiving under the MPTN STD Plan end.

The plan administrator will treat your disability as continuous if your disability stops for 30 days or less during the elimination period. The days that you are not totally disabled will not count toward your elimination period.

Any days that you are able to work while you are disabled will count toward your elimination period.

If You Are Disabled and Working

If you are continuously totally disabled and are able to work, you may have “disability earnings” from rehabilitative, transitional or part-time work. Your monthly disability earnings may affect your LTD benefits.

If you work during the first 12 months of benefits, your monthly benefits will not be reduced as long as disability earnings plus the gross disability payment do not exceed 100% of pre-disability monthly earnings.

If your monthly disability earnings are from 20% to 80% of your pre-disability monthly earnings, your monthly disability earnings are added to your gross disability benefit.

• If the amount is less than or equal to 100% of your pre-disability monthly earnings, your monthly benefit will not be reduced.
• If the amount is more than 100% of your pre-disability monthly earnings, the difference will be subtracted from your monthly benefit.

If you work after receiving 12 months of benefits, your benefits will be based on the percentage of income you are losing due to your disability.

To calculate this percentage:

• Subtract your disability earnings from your pre-disability monthly earnings.
• Divide this amount by your pre-disability monthly earnings. This is your percentage of lost earnings.
• Multiply your monthly benefits by this percentage.

This is the amount you will receive each month.

During the first 24 months of disability benefits, if your monthly disability earnings exceed 80% of your pre-disability monthly earnings, benefit payments will end.

After 24 months of disability benefits, if your monthly disability earnings exceed your gross disability benefit, benefit payments will end.

Your monthly benefit will be adjusted as described above based on your quarterly disability earnings. You may be required to send proof of your monthly disability earnings to the plan administrator at least quarterly, including appropriate financial records that are necessary to substantiate your income.

Payment of LTD Benefits

If you are absent due to an illness, injury or hospitalization that lasts more than 90 consecutive working days, you need to call the plan administrator to file a claim for LTD benefits. If you are already receiving STD benefits, the plan administrator will automatically submit your claim for LTD benefits once your STD benefits end. If you are receiving Workers’ Compensation benefits, MPTN will automatically submit your claim to the plan administrator for LTD benefits.

You must notify the plan administrator immediately when you return to work in any capacity.

Proof of Your Disability

After you file a claim, you will need to provide proof of your disability, at your own expense, including all the following information:

• Evidence that you are under the regular care of a doctor,
• The appropriate documentation of your monthly earnings, such as a pay stub,
• The date your disability began,
• The cause of your disability,
• The extent of your disability, including any restrictions and limitations that prevent you from performing your regular job, and
• The name and address of any hospital or institution where you received treatment, including all attending physicians.

You may be required to be examined by a doctor, another medical practitioner, a vocational expert, or all three. The plan administrator will choose the health care provider and pay for the examination. An examination can be required as often as it is reasonable to do so. You may also be required to be interviewed by an authorized plan administrator representative.

If you do not have such a medical examination or interview, the plan administrator may deny your claim for benefits.

If you are not satisfied with the outcome of your claim for disability benefits, you may appeal the decision. For more information on how to appeal a claim decision, see “Claims Review and Appeals Procedures” in the Rules and Regulations section.

Receiving LTD Benefits

After you complete the elimination period and your LTD claim is approved, you may receive monthly payments for up to 24 months, provided you continue to meet the definition of disability. If you are totally disabled for less than one month, you will receive one-thirtieth (1/30) of your payment for each day of disability.

LTD benefits will continue after the initial 24-month period if:

• you are working in any occupation and continue to have a 20% or more loss in monthly earnings due to the same illness or injury, or
• you are not working and, due to the same illness or injury, are unable to perform the duties of any gainful occupation for which you are reasonably suited by education, training, or experience.

A gainful occupation means an occupation that is or can be expected to provide an income at least equal to your gross disability payment within 12 months of your return to work.

How Long LTD Benefits Continue

The maximum length of time you receive benefits is based on your age when the disability occurs, as follows:

Your LTD benefits end on the earliest of the following dates:

• During the first 24 months of benefits, the date you are able to return to work in your regular occupation on a part-time basis but you choose not to,
• After 24 months of benefits, the date you are able to work in any gainful occupation on a part-time basis but you choose not to,
• The end of the maximum period of payment,
• The date you are no longer totally disabled under the terms of the plan,
• The date you fail to submit proof of continuing disability,
• The date your disability earnings exceed the amount allowable under the plan, or
• The date you die.

Limitations for Certain Disabilities

Benefits for disabilities due to mental illness, alcoholism, or drug abuse are limited to a maximum benefit period of 24 months.

You may receive benefits beyond the 24-month period if you meet one or both of the following conditions:

• If you are confined to a hospital or institution at the end of the 24-month period, you will continue to receive benefits during your confinement.
  • If you are still totally disabled when you are discharged, you will continue to receive benefits for a recovery period of up to 90 days.
  • If you return to the hospital or institution at any time during the recovery period and remain confined for at least 14 days in a row, you will continue to receive benefits during that additional confinement and for one additional recovery period up to 90 more days.
• After the 24-month period for which you have received payment, if you continue to be totally disabled and subsequently are admitted to a hospital or institution for at least 14 days in a row, you will receive benefits during the length of your stay in the hospital or institution.

You will not receive benefits past the limited period as indicated above or the maximum period of payment, whichever occurs first.

The mental illness limitation will not be applied to dementia if it is a result of one or more of the following:

• Stroke,
• Trauma,
• Viral infection,
• Alzheimer’s disease, or
• Other conditions not listed that are not usually treated by a mental health provider or other qualified provider using psychotherapy, psychotropic drugs, or other similar methods of treatment.

Recurring Disabilities

If your disability returns, it will be treated as part of your prior claim and you will not have to complete another elimination period if:

• you were continuously insured under the plan for the period between your prior claim and your recurring disability, and
• your recurring disability occurs within six months of the end of your prior claim.

Your recurrent claim will be subject to the same terms of the LTD Plan as your prior claim.

Any disability that occurs after six months from the date your prior claim ended will be treated as a new claim. The new claim will be subject to all of the policy provisions, including the elimination period.

If you become entitled to payments under any other group Long-Term Disability Plan, you will not be eligible for payments under the MPTN Plan.

Survivor Benefit

In the event of your death, the plan administrator will pay a lump-sum benefit equal to three months of your gross disability payment to your eligible survivor. This benefit will be paid if, on the date of your death:

• your disability had continued for 180 or more consecutive days, and
• you were receiving or were entitled to receive payments under the plan.

The survivor benefit will be subtracted from any overpayment that may have been made on your claim for LTD benefits.

If you have no eligible survivors, payment will be made to your estate, unless there is none. In that case, no payment will be made.