COLBY COLLEGE Office of Personnel Services

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STAFF HANDBOOK

COLBY COLLEGE
SUMMARY PLAN DESCRIPTION

COLBY COLLEGE GROUP LIFE INSURANCE PLAN

I. PLAN INFORMATION

(1) Name of Plan: Colby College Group Life Insurance Plan

(2) Name and address of Plan sponsor: President and Trustees of Colby College, 5500 Mayflower Hill, Waterville, Maine 04901-8855

(3) Employer Identification Number of Plan sponsor: 01-0211497

(4) Plan number: 505

(5) Type of plan: Group life insurance and accidental death insurance plan

(6) Plan year: January 1 through December 31

(7) Type of administration: Administered under contracts by The Hartford and Life Insurance Company of North America.

(8) Name, business address and business telephone number of Plan Administrator:
Director of Personnel, Colby College, 5500 Mayflower Hill, Waterville, Maine 04901-8855 (207) 872-3181

(9) Name and address of agent for service of legal process:
Director of Personnel, Colby College, 5500 Mayflower Hill, Waterville, Maine 04901

(10) Eligibility requirements and description of benefits: as set forth in the accompanying "Group Life Insurance Certificate."

(11) Circumstances which may result in disqualification or ineligibility, denial, loss, forfeiture or suspension of benefits: as set forth in the accompanying "Group Life Insurance Certificate."

(12) Source of contributions: Employer and employee contributions as set forth in the Colby College Staff Handbook and the Colby College Faculty Handbook, which are both available in the Personnel Office.

(13) Reservation of Rights: As sponsor of the Plan, Colby College reserves the right to amend or modify the eligibility requirements, or the level of benefits, and to make any other changes, including termination of the Plan, in its health plan policies at any time and for any reason whatsoever. No vested rights of any nature are provided by the Plan.

II. CLAIMS AND APPEALS PROCEDURE

If you believe you are being denied any rights or benefits under the Plan, you may file a claim in writing with the Administrator of the Plan. If your claim is wholly or partially denied, the Administrator will notify you in writing, giving the reasons for the decision, including specific reference to pertinent Plan provisions, and advising you of your right to request a review of your claim. If notification of the denial of your claim is not made within 90 days after the claim is received by the Administrator (or within 180 days, if special circumstances exist requiring additional time, and if within 90 days after the claim you are informed of such special circumstances and of the amount of additional time needed), the claim can be considered denied and you may request a review of your claim.

A request for review must be made in writing to the Administrator within 60 days after you receive notice of denial. The decision on review will be made within 60 days (or, if the Administrator elects to hold a hearing or other special circumstances exist, within 120 days) after your request for review is received. The decision on review will be in writing and will include specific reasons for the decision, including specific references to pertinent Plan provisions. The Administrator may establish rules and regulations as it may deem necessary or desirable to carry out its duties under this procedure and may make such references, transcripts and reports as it may deem appropriate under the circumstances.

III. STATEMENT OF ERISA RIGHTS

As a participant in the Plan you are entitled to certain rights and protections under the Employee Retirement Income Security Act of 1974 ("ERISA"). ERISA provides that all Plan participants shall be entitled to:

Examine, without charge, at the Administrator's office and at otherspecified locations, all Plan documents, including copies of any document filed by the Plan with the U.S. Department of Labor, such as detailed annual reports and Plan descriptions.

Obtain copies of all Plan documents and other Plan information upon written request to the Administrator. The Administrator may make a reasonable charge for the copies,

Receive a summary of the Plan's annual financial report. The Administrator is required by law to furnish each participant with a copy of this summary annual report.

In addition to creating rights for Plan participants, ERISA imposes duties upon the people who are responsible for the operation of the Plan. The people who operate your Plan, called "fiduciaries" of the Plan, have a duty to do so prudently and in the interest of you and other Plan participants and beneficiaries. No one, including your employer, your union, or any other person, may fire you or otherwise discriminate against exercising your rights under ERISA. If your claim for a benefit is denied in whole or in part, you must receive a written explanation of the reason for the denial. You have the right to have the Administrator review and reconsider your claim.

Under ERISA, there are steps you can take to enforce the above rights. For instance, if you request materials from the Plan and do not receive them within 30 days, you may file suit in a federal court. In such a case, the court may require the Administrator to provide the materials and pay you up to $100 a day until you receive the materials, unless the materials were not sent because of reasons beyond the control of the Administrator. If you have a claim for benefits which is denied or ignored, in whole or in part, you may file suit in a state or federal court. If it should happen that Plan fiduciaries misuse the Plan's money, or if you are discriminated against for asserting your rights, you may seek assistance from the U.S. Department of Labor, or you may file suit in a federal court. The court will decide who should pay court costs and legal fees. If you are successful, the court may order the person you have sued to pay these costs and fees. If you lose, the court may order you to pay these costs and fees, for example, if it finds your claim is frivolous.

If you have any questions about your Plan, you should contact the Administrator. If you have any questions about this statement or about your rights under ERISA, you should contact the nearest Area Office of the U.S. Labor-Management Services Administration, Department of Labor.

IV. POWERS OF THE ADMINISTRATOR

The Administrator shall have the discretion, to the fullest extent permitted by law, to determine all matters relating to eligibility, coverage or benefits under the Plan. The Administrator shall also have the discretion to decide all matters relating to the interpretation and operation of the Plan. Any determination by the Administrator shall be final and binding, in the absence of clear and convincing evidence that the Administrator acted arbitrarily and capriciously.

Your Right to Additional Information

You have the right to receive a copy of the full annual report, or any part thereof, including insurance information, on request. To obtain a copy of the full annual report, or any part thereof, write or call the Office of Personnel Services, Colby College, Mayflower Hill, Waterville, ME 04901, (207) 872-3181. The charge to cover copying costs will be $0.10 per page for the full annual report, or for any part thereof.

You also have the legally protected right to examine the annual report at the main office of the plan, Personnel Services, Colby College, Mayflower Hill, Waterville, ME 04901 and at the U.S. Department of Labor in Washington, D.C., or to obtain a copy from the U.S. Department of Labor upon payment of copying costs. Requests to the Department of Labor should be addressed to: Public Disclosure Room, N-4677, Pension and Welfare Benefit Programs, Frances Perkins Department of Labor Building, 200 Constitution Avenue, N.W. Washington, D.C. 20216.

May 2000

 

 

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© Colby College   Office of Human Resources   5500 Mayflower Hill Drive   Waterville, Maine 04901-8855
T: 207-859-5500   F: 207-859-5505   hsbumps@colby.edu

Last Modified: 07/31/03 11:30:54 AM