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Reynolds American - Health Care Plan
BROWN & WILLIAMSON TOBACCO CORPORATION
HEALTH CARE PLAN
FOR SALARIED EMPLOYEES
(As Amended Through July 29, 2004)
BROWN & WILLIAMSON TOBACCO CORPORATION
HEALTH CARE PLAN
FOR SALARIED EMPLOYEES
(As Amended Through July 29, 2004)
Table of Contents
PREAMBLE 1
ARTICLE 1. Definitions.................................................... 1
1.01 Annual Out-of-Pocket Limit..................................... 1
1.02 Ambulance...................................................... 2
1.03 Bed Patient.................................................... 2
1.04 Benefit Period................................................. 2
1.05 Claims Administrator........................................... 2
1.06 Code........................................................... 2
1.07 Coinsurance.................................................... 2
1.08 Company........................................................ 2
1.09 Continuation Coverage.......................................... 3
1.10 Continued Stay Review.......................................... 3
1.11 Copayment...................................................... 3
1.12 Covered Charges................................................ 3
1.13 Covered Services............................................... 4
1.14 Custodial Care................................................. 4
1.15 Deductible..................................................... 4
1.16 Dental Benefits................................................ 5
1.17 Dentist........................................................ 5
1.18 Dependent...................................................... 5
1.19 Dependent-Participant.......................................... 6
1.20 Effective Date................................................. 6
1.21 Eligible Employee.............................................. 6
1.22 Emergency Care................................................. 7
1.23 Employee....................................................... 7
1.24 Experimental or Investigational................................ 8
1.25 Employee-Participant........................................... 8
1.26 ERISA.......................................................... 8
1.27 Family......................................................... 8
1.28 Flex Plan...................................................... 8
1.29 FMLA........................................................... 9
1.30 Home Health Care Agency........................................ 9
1.31 Hospice Agency................................................. 9
1.32 Hospice Facility............................................... 9
1.33 Hospital or Health Care Facility............................... 9
1.34 Illness........................................................ 9
1.35 Injury......................................................... 10
1.36 Immunization................................................... 10
1.37 Inpatient...................................................... 10
1.38 Maternity...................................................... 10
1.39 Medical Plan................................................... 10
1.40 Medically Necessary............................................ 10
1.41 Mental Health Condition........................................ 11
1.42 Network........................................................ 11
1.43 Network Provider............................................... 11
1.44 Non-Network Provider........................................... 12
1.45 Normal Cost.................................................... 12
1.46 Office Visit................................................... 13
1.47 Outpatient..................................................... 13
1.48 Outpatient Facility............................................ 13
1.49 Participant.................................................... 13
1.50 Physician...................................................... 13
1.51 Plan........................................................... 14
1.52 Plan Administrator or Administrator............................ 14
1.53 Pre-Admission Certification.................................... 14
1.54 Pre-Admission Review........................................... 14
1.55 Primary Residence.............................................. 14
1.56 Provider....................................................... 14
1.57 Psychiatric Facility........................................... 14
1.58 Related Company................................................ 14
1.59 Retirement Plan................................................ 15
1.60 Retired Participant............................................ 15
1.61 Review Deductible.............................................. 15
1.62 Schedule of Benefits........................................... 15
1.63 Schedule of Covered Dental Expenses............................ 16
1.64 Services....................................................... 16
1.65 Skilled Nursing Care........................................... 16
1.66 Skilled Nursing Facility....................................... 16
1.67 Spouse or Surviving Spouse..................................... 16
1.68 Substance Abuse................................................ 17
1.69 Substance Abuse Treatment Facility............................. 17
1.70 Therapy Services............................................... 17
1.71 Treatment Plan................................................. 17
1.72 Urgent Care Facility........................................... 17
1.73 Vision Plan.................................................... 18
1.74 Year of Service................................................ 18
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ARTICLE 2. Eligibility and Participation.................................. 18
2.01 Eligibility and Participation.................................. 18
2.02 Dependents..................................................... 19
2.03 Cessation of Participation..................................... 20
2.04 Right to Conversion Coverage................................... 21
2.05 HMO Options.................................................... 21
2.06 Enrollment; Contributions...................................... 22
2.07 Employee Assistance Program.................................... 22
2.08 Effect of Retirement........................................... 22
2.09 BATUS Retail Merger............................................ 31
2.10 Qualified Medical Child Support Orders......................... 31
2.11 American Tobacco Plan.......................................... 33
2.12 Medical Rule of 70 Coverage.................................... 34
2.13 Medical Rule of 70 Coverage - (Post-September 30, 2003
Restructuring).............................................. 35
2.14 Medical Rule of 70 Coverage - (Special Severance
Pay Plan -- B&W/RJR Business Combination)................. 36
2.15 Medical Rule of 70 (Contingent Coverage for Certain
Former B&W Employees)....................................... 38
2.16 Medical Rule of 70 Coverage (BATIC Employees).................. 40
ARTICLE 3. Medical Plan................................................... 41
3.01 In General..................................................... 41
3.02 Schedule of Benefits........................................... 42
3.03 Ambulance Services............................................. 49
3.04 Dental Services................................................ 50
3.05 Durable Medical Equipment...................................... 50
3.06 Home Health Care............................................... 51
3.07 Hospice Care................................................... 52
3.08 Hospital Confinement Limitations............................... 54
3.09 Hospital Inpatient Care........................................ 54
3.10 Infertility Diagnosis.......................................... 55
3.11 Mental Health Conditions....................................... 55
3.12 Obstetrical Care............................................... 56
3.13 Organ and Tissue Transplants................................... 56
3.14 Other Covered Services......................................... 58
3.15 Physician Services............................................. 60
3.16 Prosthetic Devices............................................. 61
3.17 Skilled Nursing Facility....................................... 61
3.18 Substance Abuse Conditions..................................... 61
3.19 Temporomandibular or Craniomandibular Joint Dysfunction........ 62
3.20 Therapy Services............................................... 62
3.21 Wellness Program............................................... 62
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ARTICLE 4. Deductibles and Annual Out-of Pocket Limit..................... 64
4.01 Deductibles.................................................... 64
4.02 Annual Out-of-Pocket Limit..................................... 64
ARTICLE 5. Exclusions..................................................... 65
5.01 Exclusions..................................................... 65
ARTICLE 6. Pre-admission Review, Continued Stay Review and Medical
Case Management............................................. 69
6.01 Pre-Admission and Continued Stay Review........................ 69
6.02 Medical Case Management........................................ 70
ARTICLE 7. Prescription Drug Plan......................................... 71
7.01 Prescription Drugs............................................. 71
7.02 Pre-Authorization.............................................. 73
7.03 Definitions.................................................... 73
7.04 Prescription Drug Limitations.................................. 73
ARTICLE 8. Dental Plan.................................................... 74
8.01 Dental Plan Options; Eligibility............................... 74
8.02 Deductible..................................................... 75
8.03 Limitations.................................................... 75
8.04 Cessation of Participation..................................... 75
8.05 Dental Expenses Not Subject to Deductible...................... 75
8.06 Dental Expenses Subject to Deductible.......................... 76
8.07 Orthodontics................................................... 78
8.08 Schedule of Covered Dental Expenses............................ 78
8.09 Predetermination of Dental Benefit Coverage.................... 78
8.10 Dentally Necessary............................................. 79
8.11 Exclusions..................................................... 79
ARTICLE 9. Vision Plan.................................................... 81
9.01 Vision Care Benefits........................................... 81
9.02 Exclusions..................................................... 82
ARTICLE 10. Continuation Coverage......................................... 83
10.01 In General..................................................... 83
10.02 Qualifying Event............................................... 84
10.03 Qualified Beneficiary.......................................... 85
10.04 Newborn and Adopted Children................................... 85
10.05 Period of Coverage............................................. 86
10.06 Premium Requirements........................................... 87
10.07 Insurability and Conversion Option............................. 87
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10.08 Qualified Beneficiary's Election............................... 87
10.09 Notices........................................................ 88
ARTICLE 11. Coordination of Benefits and Subrogation...................... 89
11.01 Coordination of Benefits....................................... 89
11.02 "Primary-Secondary" Payment Rule............................... 89
11.03 Medicare Eligibility........................................... 91
11.04 Other Insurance or Health Plans................................ 91
11.05 Amounts Reduced Due to Application of Rules.................... 91
11.06 Third-Party Liability.......................................... 91
11.07 Subrogation and Reimbursement.................................. 91
11.08 Excess Payments................................................ 93
ARTICLE 12. General Provisions............................................ 93
12.01 Rights and Benefits Not Assignable............................. 93
12.02 Care Rendered Outside the U.S.................................. 94
12.03 Filing Deadlines............................................... 94
12.04 Forfeiture of Unclaimed Benefits............................... 94
12.05 Family and Medical Leave Act................................... 94
12.06 Independent Agents............................................. 95
12.07 Military Service............................................... 95
12.08 Privacy Standards.............................................. 95
ARTICLE 13. Plan Administration........................................... 97
13.01 Named Fiduciary................................................ 97
13.02 Allocation of Fiduciary and Other Responsibilities............. 97
13.03 Quorum and Voting; Procedures.................................. 97
13.04 Service in Multiple Capacities................................. 98
13.05 Powers and Authority........................................... 98
13.06 Powers of Plan Administrator................................... 98
13.07 Powers of Benefit Finance Committee............................ 99
13.08 Advisors...................................................... 99
13.09 Powers not Exclusive........................................... 99
13.10 Limitation of Liability; Indemnity............................. 99
ARTICLE 14. Amendment and Termination..................................... 100
14.01 Amendment and Termination...................................... 100
ARTICLE 15. Funding....................................................... 100
15.01 Trust Agreement and Other Funding.............................. 100
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EXHIBIT A SPECIAL PROVISIONS APPLICABLE TO CERTAIN EMPLOYEES
WHO INCUR A "RESTRUCTURING TERMINATION"..................... 1
SCHEDULE A - EFFECTIVE JANUARY 1, 2004 SCHEDULE OF BASIC PLAN
DENTAL BENEFITS BASED ON CODE OF DENTAL PROCEDURES
AND NOMENCLATURE PREPARED BY COUNCIL ON DENTAL
CARE PROGRAMS OF ADA...................................... 1
SCHEDULE B SCHEDULE OF OPTIONAL PLAN DENTAL BENEFITS...................... 1
* * * * *
vi
BROWN & WILLIAMSON TOBACCO CORPORATION
HEALTH CARE PLAN
FOR SALARIED EMPLOYEES
(As Amended Through July 29, 2004)
PREAMBLE
BROWN & WILLIAMSON TOBACCO CORPORATION (the "Company") adopted the Brown & Williamson Tobacco Corporation Comprehensive Health Care Plan and Separate Options for Salaried Employees (the "Prior Plan"), effective as of July 1, 1988, to provide health care benefits to Eligible Employees of Brown & Williamson Tobacco Corporation, BATUS Inc., Brown & Williamson Industries, Inc., and effective as of December 1, 1988, B.A.T Capital Corporation, and their eligible dependents. Effective the close of business, December 31, 1990, health care plans of certain companies previously included within a controlled group of corporations with the Company were merged into this Plan for administrative purposes, as set forth herein.
Effective January 1, 1992, the Company amended and restated in its entirety the Prior Plan under the name of the Brown & Williamson Tobacco Corporation Health Care Plan for Salaried Employees (the "Plan") which incorporated into a single plan document all plans providing self-insured health care benefits to salaried employees of the Company and their eligible dependents. In particular, effective as of such date, the Brown & Williamson Tobacco Corporation Health Care, Dental and Vision Plan for Salaried Employees, as then in effect, was merged with this Plan. Effective August 6, 2002, the ATCO Plan (as defined in Section 2.11) was merged into this Plan.
The Plan, as restated January 1, 1992, and as amended through December 16, 2002, was again restated to consolidate all amendments previously adopted, and to incorporate certain technical and compliance revisions not previously incorporated into the Plan, with effect from January 1, 2002 (except and to the extent otherwise specifically noted in the Plan), which restatement was approved and executed by an officer of this Company thereunto duly authorized, under date of September 11, 2003.
The Plan, as restated effective January 1, 2002, and as amended through March 8, 2004, was further amended by resolution of the Board of Directors of the Company adopted July 29, 2004. As so amended the Plan reads as follows:
ARTICLE 1.
Definitions
1.01 Annual Out-of-Pocket Limit. The term "Annual Out-of-Pocket Limit" means
the specific amount of specified Covered Charges paid by a Participant in a
Benefit Period that is set
forth in Section 4.02. The calculation of the Annual Out-of-Pocket Limit
shall not include any of the following: Copayments; Review Deductibles; any
charges resulting from a reduction in benefits due to a Participant's
failure to comply with the requirements of Section 6.01; or other charges
and expenses not covered by the Plan, such as charges in excess of
reasonable and customary fees, charges in excess of Plan maximums, and
charges for non-Covered Services.
1.02 Ambulance. The term "Ambulance" means an air or ground vehicle designed
and used only for transporting the sick and injured that contains all life
saving equipment and staff required by state and local laws.
1.03 Bed Patient. The term "Bed Patient" means a Participant who must be
confined to a Hospital or other institutional Provider and for whom a room
and board charge is made.
1.04 Benefit Period. The term "Benefit Period" means the period of time against
which certain benefit allowances are measured. Each Benefit Period begins
on the first day of January of each year and ends on the last day of
December of the same year.
1.05 Claims Administrator. The term "Claims Administrator" means a person or
organization designated in accordance with Section 13.06(a)(5) to receive
and administer claims. The Claims Administrator shall have discretionary
authority to determine eligibility for benefits, including the approval and
denial of claims filed by or on behalf of Participants for benefits under
the Plan.
1.06 Code. The word "Code" means the Internal Revenue Code of 1986, as amended
from time to time.
1.07 Coinsurance. The word "Coinsurance" means that percentage of Covered
Charges which is payable by the Plan or a Participant during a Benefit
Period, after any Deductible is paid, as set forth in the Schedule of
Benefits. The calculation of Coinsurance does not include charges and
expenses not covered by the Plan, such as charges in excess of reasonable
and customary fees and charges for non-Covered Services.
1.08 Company.
(a) The word "Company" means:
(1) Effective the date of closing (the "Closing") of the transactions
contemplated by the Business Combination Agreement dated October 27,
2003, between Brown & Williamson Tobacco Corporation and R.J. Reynolds
Tobacco Holdings, Inc. (the "Business Combination"), Reynolds American
Inc., and any successor thereto, and any Related Company that adopts
the Plan (collectively, "RAI"); and
(2) Prior to Closing (as defined in paragraph (1) above), Brown &
Williamson Tobacco Corporation, any successor thereto, and any Related
Company that adopts the Plan.
2
Effective immediately prior to Closing, Brown & Williamson Tobacco
Corporation and each Related Company that had adopted the Plan prior to
Closing shall be deemed to have withdrawn from and shall no longer maintain
the Plan for its employees.
(b) [Reserved].
1.09 Continuation Coverage. The term "Continuation Coverage" means the coverage
which a Participant may elect, at such Participant's sole expense, as
provided in Article 10.
1.10 Continued Stay Review. The terms "Continued Stay Review" means a review in
which the Participant, subsequent to admission to a Hospital and/or
commencement of a course of treatment, receives an assessment by a health
care coordinator and/or a physician-advisor of the Medical Necessity of
such admission and/or course of treatment.
1.11 Copayment. The word "Copayment" means the set dollar amount a Participant
must pay at the time certain Covered Services are rendered by a Network
Provider, which shall not be more than the actual price of the Service. A
separate Copayment is payable for each Network Physician's Office Visit,
each Hospital Emergency Room visit, each Urgent Care Facility visit and
each prescription. Copayments for Prescription Drugs are specified in
Article 7 and Copayments for other Covered Services are specified in the
Schedule of Benefits. Copayments do not count toward the Deductible or the
Annual Out-of Pocket Limit.
1.12 Covered Charges.
(a) The term "Covered Charges" means, (1) with respect to Network Providers,
the negotiated fees that Network Providers have agreed to charge
Participants for Covered Services; (2) with respect to the Basic Dental
Plan, the fees set forth in Schedule A for Covered Services, subject to
Article 8; (3) with respect to the Vision Plan, the fees set forth in
Section 9.01 for Covered Services, subject to Section 9.02; and (4) travel
expenses to the extent covered in Section 3.13.
(b) The term "Covered Charges" means reasonable and customary fees for Covered
Services payable by the Plan (a) to Non-Network Providers in accordance
with column (c) of Section 3.02; (b) to Network and Non-Network Providers
in accordance with column (d) of Section 3.02; and (c) to Providers under
the Optional Dental Plan. The Claims Administrator shall have the sole
authority and discretion to determine the amounts which constitute
reasonable and customary fees. For purposes of this Section 1.12(b), a
reasonable and customary fee is an amount that is equal to the lesser of:
(1) The fee most often charged in the geographical area where the Service
was performed;
(2) The fee most often charged by the Provider for identical Services;
(3) The fee which is recognized as reasonable by a prudent person;
3
(4) The fee determined by comparing charges for similar Services to a
national database adjusted to the geographical area where the Services
or procedures were performed; or
(5) The fee determined by using a national relative value scale. Relative
value scale means a methodology that values medical procedures and
Services relative to each other that includes, but is not limited to,
a scale in terms of difficulty, work, risk, as well as the material
and outside costs of providing the Service, as adjusted to the
geographic area where the Services or procedures were performed.
(c) Covered Charges are subject to all provisions of the Plan, including
limitations and exclusions. The Plan shall treat a Covered Charge as
incurred on the date the Covered Service was provided. No fee, expense or
other charge shall be a Covered Charge unless it is incurred by a
Participant for Covered Services.
1.13 Covered Services.
(a) The term "Covered Services" means, the Services specifically described in
the provisions setting forth the Plan's benefits, subject to subsection
(b).
(b) Except as expressly provided otherwise in Sections 3.07, 3.14(c), 3.14(j)
and 3.21, a Service shall not be a "Covered Service" under the Plan unless
(1) the Service is incurred by a Participant due to Injury or Illness; (2)
the Service is expressly covered by the Plan; (3) the Claims Administrator
determines that the Service is Medically Necessary (or dentally necessary
as to the Dental Plan); (4) the Service is consistent with the condition
for which the Participant is being treated; and (5) the Service is ordered
or provided by a Physician. Covered Services are subject to Articles 5 and
6 and the other limits, exclusions, terms and conditions set forth in the
Plans.
1.14 Custodial Care. The term "Custodial Care" means care which is not
primarily provided for its therapeutic value in the treatment of an Illness
or Injury, but which is minimal, ambulatory, or part-time care Services, or
Services designed to assist in the activities of daily living. Custodial
Care includes, but is not limited to, help with walking, dressing, bathing,
eating, toileting, preparing special diets, taking medication and
supervision over self administration of medications not requiring constant
attention of trained medical personnel, without regard to whether a
Physician has prescribed, recommended or performed such Services.
1.15 Deductible. The word "Deductible" means, with respect to the Medical Plan,
the dollar amount of Covered Charges specified in Section 4.01 that must be
paid by a Participant before the Plan will pay any Covered Charge during a
Benefit Period. The word "Deductible" means, with respect to the Dental
Plan, the dollar amount of Covered Charges specified in Section 8.02 that
must be paid by a Participant before the Plan will pay any Covered Charges
listed in Sections 8.06 and 8.07. The calculation of a Participant's
Deductible shall not include any Copayments, Review Deductibles, or other
charges and expenses not covered by the Plan, such as charges in excess of
reasonable
4
and customary fees and charges for non-Covered Services. The calculation of
a Participant's Medical Plan Deductible shall not include any Dental Plan
Deductible paid by the Participant, and the calculation of a Participant's
Dental Plan Deductible shall not include any Medical Plan Deductible paid
by the Participant.
1.16 Dental Benefits. The term "Dental Benefits" means those benefits
specifically provided under the Dental Plan set forth at Article 8, subject
to all terms and conditions contained herein.
1.17 Dentist. The word "Dentist" means a Doctor of Dental Surgery (DDS), Doctor
of Dental Medicine (DDM), or Doctor of Dental Science (DS) who is duly
licensed by the applicable licensing authority.
1.18 Dependent.
(a) The word "Dependent" means an Employee-Participant's, or a Retired
Participant's (subject to Section 2.08), spouse, any unmarried child under
age 21, any unmarried child under age 25 who attends school as a full-time
student, and any eligible unmarried handicapped child. Notwithstanding any
other provision of this Section 1.18, an individual shall be classified as
a Dependent if and only if that individual is a dependent of the
Employee-Participant within the meaning of section 152 of the Code, except
that this sentence shall not apply to any child for whom the
Employee-Participant or the spouse-Participant has a legal obligation,
under a divorce decree or other court order, to provide health care
expenses. The term "child" includes a natural child, a stepchild and a
legally adopted child. Subject to the above age restrictions, the term
"child" also includes a child for whom legal guardianship (which includes
the obligation to provide health care expenses) has been awarded to the
Employee-Participant, and any child for whom the Employee-Participant or
the spouse-Participant has a legal obligation, under a divorce decree or
other court order, to provide health care expenses. A child will be
considered handicapped if, but only if, the Claims Administrator determines
that he or she satisfies each of the following requirements: (1) the child
is not able to earn his or her own living because of a mental or physical
disability that is expected to continue indefinitely; (2) such disability
commenced while the child was a Dependent-Participant and prior to the
child's attaining age 21, or age 25 if he or she attends school as a
full-time student; and (3) the child depends on the Employee-Participant
for more than 50 percent of his or her support. A child shall not be
eligible for Dependent coverage if the child is married. The Plan may
require proof of a child's marital status and handicapped status from time
to time.
(b) "Dependent" excludes anyone covered as an Employee or Retired Employee.
Effective prior to November 1, 2001, the term "Dependent" excluded anyone
in active military service, subject to Section 12.07. No
Employee-Participant shall be eligible for benefits as a
Dependent-Participant, and no Dependent-Participant shall be eligible for
benefits as an Employee-Participant. No person may be a Dependent of more
than one Employee (except in case of divorce).
5
(c) The term "adopted child" as used in subsection (a) above shall include
dependent children placed with an Employee-Participant for adoption,
irrespective of whether the adoption has become final. For this purpose the
words "placed" or "placement" mean the assignment and retention by the
Employee-Participant of a legal obligation for total or partial support of
such child in anticipation of adoption of such child.
(d) The Claims Administrator shall determine in its sole discretion whether a
child is a full-time student. The determination of a child's status as a
full-time student shall be based on such verification from the child's
school as the Claims Administrator shall deem appropriate, based on the
following guidelines:
Verification shall be provided to the Claims Administrator twice each Plan
Year, but not more than once with respect to the same semester or similar
academic period ("verification period"). Verification will be satisfactory
only if the student is enrolled as a full-time student as defined by the
school (generally, for at least 12 hours of credit during the verification
period), except as follows: If a student qualifies as a junior or a senior
(as defined by the school), the Claims Administrator will take into account
special circumstances resulting in enrollment in fewer than 12 hours in any
verification period such as the unavailability of required courses.
1.19 Dependent-Participant. The term "Dependent-Participant" means a Dependent
who is a Participant.
1.20 Effective Date. The term "Effective Date" means the day, month and year a
given Participant's coverage begins.
1.21 Eligible Employee.
(a) The term "Eligible Employee" means any Employee; provided, however, that an
Employee shall not be eligible during any period in which such Employee is:
(1) employed on a temporary or seasonal basis;
(2) employed on a part-time basis (i.e., the Employee's normal and
customary work week is less than 40 hours per week), except Prime-Time
Employees as defined in Section 1.23(a);
(3) included in a unit subject to collective bargaining unless the
applicable collective bargaining agreement provides otherwise;
(4) a non-resident alien who receives no earned income (within the meaning
of Section 911(d)(2) of the Code) from the Company which constitutes
earned income from a source within the United States (within the
meaning of Section 861(a)(3) of the Code); or
6
(5) covered by another health care plan of the Company or a Related
Company that provides similar health care coverage, unless and to the
extent the Employee and the Company have agreed otherwise in writing.
(b) The term "Eligible Employee" shall not, except with respect to the Optional
Dental Plan described in Article 8, include any employee whose primary
employment duties with the Company relate to a business operation which,
prior to March 1, 1995, was part of the American Tobacco Company or Golden
Belt Manufacturing Company.
1.22 Emergency Care. The term "Emergency Care" means the first treatment given
in a Hospital emergency room for the treatment of a sudden and, at that
time, unexpected Illness or Injury manifesting itself by acute symptoms of
sufficient severity that the absence of immediate medical attention could
reasonably result in (a) permanently placing the Participant's life in
jeopardy, (b) causing other serious medical consequences, (c) causing
serious impairment to bodily functions, or (d) causing serious and
permanent dysfunction of any body organ or part. The Claims Administrator
shall determine in its sole discretion whether treatment constitutes
Emergency Care, and its decision will be based on the symptoms at the time
of treatment, as documented by the treating Physician. Emergency Care does
not include Ambulance charges.
1.23 Employee.
(a) Subject to subsections (b), (c) and (d) below, the term "Employee" means
any individual who is classified by the Company as an employee of the
Company for federal income tax withholding purposes and is either (1) a
full-time salaried employee, or (2) a Prime-Time Employee. The term "full
time salaried employee" means a salaried employee whose normal and
customary work week is at least 40 hours per week. The term "Prime-Time
Employee" means a part-time employee who works at least 20 hours per week
and who has at least 5 years of prior continuous service with the Company
a...
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