EX-101 INSTANCE DOCUMENT
EX-10.16 15 v59597exv10w16.htm EX-10.16 exv10w16
Exhibit 10.16
Northrop Grumman Legacy Officers Plan* Matrix Plan Year July 1, 2011 June 30, 2012
Plan Features | Benefit | ||||
Eligibility | Employee + Spouse & Children and or Adult Children up to age 26 | ||||
Medical Plan | Premium PPO Plan administered by Anthem Blue Cross | ||||
Coverage | 100% coverage, for all eligible plan expenses | ||||
Annual Deductible | No annual deductible | ||||
Co-payment/Co-Insurance | No co-payment/co-Insurance | ||||
Preventive Care Coverage | No limits as long as procedures fall under Anthems Guidelines | ||||
Prescription Drug Coverage | Covered under Medical Plan | ||||
Annual Deductible | No annual deductible | ||||
Coverage retail 30 day supply | 100% coverage, when network pharmacy utilized | ||||
Coverage mail order 90 day supply | 100% coverage, when network pharmacy utilized | ||||
Vision Coverage | $500 maximum reimbursement per person, per plan year, for exams, glasses, contact lenses | ||||
Hearing Coverage | Up to two hearing aids per person, per plan year | ||||
Acupuncture and Acupressure | 20 visits (combined) per person, per plan year | ||||
Chiropractic Care | 40 visits per person, per plan year (in and out of network) | ||||
Physical Therapy | 50 visits per person, per plan year (in and out of network) | ||||
Speech Therapy | 50 visits per person, per plan year (in and out of network) | ||||
Occupational Therapy | 50 visits per person, per plan year (in and out of network) | ||||
Mental Health Coverage | Mental health is 100% covered (in and out of network); Office visits unlimited. Inpatient treatment based on mental health, substance abuse or detox treatment will allow a combined total of 30 days coverage with pre-authorization or utilization review and includes out-of-network providers. | ||||
Health Plan Lifetime Maximums | No Lifetime Maximums for essential medical, prescription drug or mental health benefits | ||||
Dental Plan | Premium PPO Plan administered by Delta Dental | ||||
Annual Maximum | $4,000 per person per plan year | ||||
Coverage | 100% coverage, for all eligible plan expenses up to annual maximum, including Orthodontics | ||||
Annual Deductible | No annual deductible | ||||
Co-payment/Co-Insurance | No co-payment/co-Insurance | ||||
Eligibility | Employee only | ||||
Life Insurance Coverage | Company-paid basic life insurance 3x annual base salary up to a maximum of 2 million | ||||
Accidental Death & Dismemberment Coverage | Company-paid basic accidental death & dismemberment insurance 6 x Annual base salary up to a maximum of $1 million | ||||
Long-Term Disability (LTD) | Company-paid basic LTD benefit of 75% of monthly base salary, up to a maximum monthly benefit $25,000 | ||||
* | Executive Health Plan was frozen to new participants on July 1, 2009 and renamed Legacy Officers Plan effective July 1, 2010 |