Amendment No. 5 to the Brown & Williamson Tobacco Corporation Health Care Plan for Salaried Employees
This amendment, effective January 1, 2006, updates the Brown & Williamson Tobacco Corporation Health Care Plan for Salaried Employees, now maintained by Reynolds American Inc. It revises the definition of eligible dependents, allowing children of retired participants to regain coverage if they return to full-time student status and extends coverage for children who withdraw from school for medical reasons. The amendment also clarifies Medicare offset provisions and updates network provider information. The changes were authorized by the RAI Employee Benefits Committee and apply to eligible former employees and their dependents.
TO THE
BROWN & WILLIAMSON TOBACCO CORPORATION
HEALTH CARE PLAN
FOR SALARIED EMPLOYEES
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(d) | The Claims Administrator shall determine whether a child is a full-time student. The determination of a childs status as a full-time student shall be based on such verification from the childs school as the Claims Administrator may, in its sole discretion, deem appropriate, subject to the following guidelines: | ||
Verification shall be provided to the Claims Administrator with respect to each regular grading period. For this purpose, regular grading period means two regular terms in an academic year, a fall semester (generally, August December) and a spring semester (generally, January May), or any comparable period as determined by the Claims Administrator. | |||
Verification will be satisfactory only if the student is enrolled as a full-time student as defined by the school (generally, 12+ credit hours) during a regular grading period, except as follows: |
(1) | if a student qualifies as a junior or a senior (as defined by the school) and is enrolled for fewer than 12 credit hours during a regular grading period, the Claims Administrator will take into account special circumstances that account for such occurrence (e.g., the unavailability of required courses; fewer than 12 credit hours required for graduation); or | ||
(2) | in the event a student withdraws from school for personal medical reasons (based on a medical leave verification from the school and if they meet certain requirements determined by the medical program administrator), coverage as a Dependent will continue until the beginning of the next following regular grading period; provided that if such Dependent is not able to re-enroll as a full-time student at the beginning of the next following regular grading period due to a medical reason (based on the written verification of a qualified physician and meeting certain requirements determined by the medical program administrator), such coverage shall be continued until the end of such next following regular grading period. |
(a) | The term Network means certain Providers who have entered into agreements through which their fees and expenses for Covered Services are established, as follows: |
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(1) | Immediately prior to January 1, 2006, the Networks are: Secure Health Plan of Georgia (only for Participants employed at or retirees of the Companys Macon, Georgia, facility); CIGNA (for Participants in Georgia, Tennessee, South Carolina and North Carolina, and, effective May 1, 2001, for Participants in Utah); Private Health Care System (for Participants in all states except Georgia, Tennessee, South Carolina, North Carolina and, prior to May 1, 2001, Utah); and the LifeSource Program for organ and tissue transplants. |
(2) | Effective January 1, 2006, the Networks are: (1) Secure Health Plan of Georgia only for Participants employed at or retirees of the Companys Macon, Georgia facility; (2) Aetna for all Participants in all other facilities, and (3) the applicable Networks transplant program for organ and tissue transplants. |
(a) | The term Retired Participant means an Employee-Participant whose employment with the Company has terminated pursuant to the normal, disability or early retirement provisions of the Retirement Plan applicable to the Participant (except retirements under the Rule of 60 or the Rule of 65 as defined therein), or who is deemed to be a Retired Participant pursuant to Sections 2.08(c), 2.08(d), 2.12, 2.13, 2.14, 2.15 or 2.16 of this Plan; provided that such person is an eligible Employee-Participant in this Plan at the time of employment termination (except as provided in Sections 2.08(c)(2), 2.15 and 2.16). |
(d) | Except as provided in Section 2.08(c), 2.15 or 2.16, effective as of the Closing, the term Retired Participant shall exclude former employees of Brown & Williamson Tobacco Corporation (or a Related Company) who had not met the eligibility |
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requirements of subsection (a) above as of the first to occur of: (1) termination of employment for any reason after Closing, or (2) commencement of regular employment with RAI (as defined in Section 2.01(b)(3)). |
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(A) | If the Petersburg Retiree is less than age 65, the Company shall pay the total Normal Cost of his or her coverage, and the Company shall pay 50% of the total Normal Cost of coverage for each of his or her Dependents-Participants. If the Petersburg Retiree is age 65 or older, he or she shall pay 100% of the total Normal Cost of his or her coverage and 100% of the total Normal Cost of coverage for each of his or her Dependent-Participants. |
(h) | A former Employee-Participant who is eligible for coverage under this Section 2.08 may reject individual coverage under the Plan and continue Dependent coverage only, or vice versa, without regard to the Continuation Coverage provisions of Article 10. If a former Employee-Participant rejects coverage, then Dependent coverage and costs shall be determined under Section 2.08 as if the Employee-Participant were a Retired Participant, except that Sections 2.08(a)(3) and (4) shall apply as if the Retired Participant were deceased on the date he or she rejected coverage. If coverage is rejected, or if a Dependent ceases to be a Participant for any other reason after the Dependents Employee-Participant has become a Retired Participant, the individual shall not again be eligible to become a Participant under this Section 2.08, except as follows: |
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(1) | if an individual rejects coverage under the Plan and enrolls in Medicare Plus Choice, he or she may re-elect coverage under the Plan one time during any calendar year if he or she demonstrates to the Claims Administrator that (i) he or she was continuously enrolled in Medicare Plus Choice from the time coverage was discontinued under the Plan until the re-enrollment, and (ii) he or she has discontinued Medicare Plus Choice upon re-enrollment in the Plan; or | ||
(2) | if a Dependent ceases to be a Participant due to a loss of full-time student status, as provided in Section 1.18(d), and thereafter regains full-time student status, such Dependent shall be eligible to recommence coverage under this Section 2.08, provided the Claims Administrator receives notification within 31 days of the date such Dependents full-time student status is re-established in accordance with Section 1.18(d). |
(6) | The Plan shall cover 100 percent of travel expenses for the recipient and one companion in accordance with this subsection (6), except that the Plan shall not pay more than $10,000 in the aggregate for travel expenses with respect to a transplant. The Plan shall not cover any travel expenses unless (A) the transplant Services are provided at a facility that is a member of the applicable Networks transplant program for organ and tissue transplants and the facility is more than 60 miles from the recipients Principal Residence, and (B) the expenses are approved in advance by the Claims Administrator. The Plan covers travel expenses if, but only if, the Claims Administrator determines the expenses are reasonable for travel to and from the transplant site. Travel expenses include lodging and food, but only while at or traveling to and from the transplant site. The term companion means any individual other than the donor who is actively involved as the recipients care giver, who may be a spouse, family member, guardian or other person. |
(6) | Any Services received as a result of Injury or Illness sustained by a Participant in connection with his or her participation in an insurrection, civil revolution or riot. |
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(26) | Any Services received as a result of Injury or Illness that are furnished, paid for, or for which benefits are provided or required under any law of a government. |
(16) | Services received as a result of Injury or Illness (i) sustained by a Participant in connection with his or her participation in an insurrection, civil revolution or riot or (ii) that are furnished, paid for, or for which benefits are provided or required under any law of a government. |
(b) | This provision shall be applicable to all benefits available under the Plan, except that no coordination of benefits provisions shall apply to the Prescription Drug Plan (other than with respect to care, treatment or Services covered by Medicare Part D, as provided in Section 11.03 below). |
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RAI Employee Benefits Committee | ||||||
By: | /s/ McDara P. Folan, III | |||||
Secretary |
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