Executive Medical Health Plan

Exhibit 10 (iii) 52. SUMMARY OF YOUR COVERAGE EXECUTIVE SUPPLEMENTAL HEALTH The Executive Medical Health Plan is designed to supplement the medical, dental, and vision plans offered to IT Employees through the Benefits by Design Flexible Benefit Programs. Eligibility Those eligible to participate in Executive Medical Program are full-time, active, Corporate Officers, Vice Presidents and certain other Senior Level Managers who must also be eligible for and enrolled in Medical and Dental/Vision Plan Choice " B" in the Benefits by Design Flexible Benefit Programs. Eligibility for Executive Supplemental Health Coverage is not automatic. Eligibility must be recommended by the Chief Executive Officer and/or Company President and approved by the Senior Vice President of Human Resources. Those Executives participating in this program may also choose to cover their legally married spouse and/or children, step-children, and/or foster children under age 19 and primarily dependent upon you for support, or up to age 24 if they are fulltime students, provided you have also enrolled these same dependents for coverage as your dependents in Medical and Dental/Vision Plan Choice " B " in the Benefits by Design Flexible Benefit Program. You may not, in any event, cover a dependent under the Executive Supplemental Health Plan whom you have not elected to cover as your dependent under Medical and Dental/Vision Plan Choice " B" in the Benefits by Design Flexible Benefit Program herein referred to as the Core Plan. You are required to notify IT Corporation when your dependent children reach age 19, or when dependent children older than 19 who are full-time students cease to be full-time students or reach age 24. In these cases, your dependents will not longer be eligible to be covered as your dependents under the Executive Supplemental Health Plan. However, you will be given the opportunity to continue coverage under COBRA for these children at your own expense. However, so we can offer you this option, you must notify us within 30 days of the event causing your dependent to be ineligible as your dependent. Maximum Benefits The annual maximum benefit for you and all covered eligible dependents is 10% of your gross annual base salary as of January 1st of each year in which you are eligible to participate in the Executive Medical Program, or $10,000, applied on a calendar year basis- whichever is less. Taxability These benefits are provided to you as a non-taxed benefit. Covered Expenses As a general rule, expenses that can be included as a Medical or Dental Expense in completing an individual income tax return as defined by IRS Publication 502 can be submitted for payment or reimbursement under the Executive Supplemental Health Plan. These expenses include, but are not necessarily limited to: b7 Deductibles/Co-payments Amounts applied toward Plan Choice " B" deductibles for covered participants for medical or dental coverage. Co-payments that you make for covered plan participants toward vision care or that are paid to the mail-order drug program. b7 Co-Insurance Amounts are covered health care expenses under the Benefits by Design Flexible Benefit Programs, but are considered to be the patient' s share (20%) of covered charges. b7 COBRA Premiums The Executive Supplemental Health Plan will reimburse you for COBRA premiums you pay for coverage under your prior employer' s plan or for your over-age dependent(s) under the IT plan. For example, if you continue COBRA coverage under your prior employer' s plan because the IT core plan will not cover pre-existing conditions, you can submit proof of your COBRA premium payments for reimbursement under the Executive Supplemental Health Plan. Additionally, if you pay for COBRA coverage under the IT core plan for a child who reaches the limiting age under the plan but continues to be your dependent for tax purposes, you can submit proof of such COBRA premium payments for reimbursement under the Executive Supplemental Health Plan. b7 Above Reasonable and Customary Reasonable and Customary charges are determined by the health plan administrator and represent nationwide statistics indicating a fee that is reasonable for the diagnosis for procedure and is an amount at or below a level customarily charged by 90% of providers of the same discipline and within the same geographical location. Most providers' fees are within a range considered reasonable and customary. However, we recognize that some providers do charge a premium for their services. This amount sometimes exceeds the maximum benefit allowance. Amounts that exceed the reasonable and customary maximum allowance are payable under your Executive Supplemental Health Benefits. b7 Charges That Exceed Core Plan Maximums (IT' s Your Choice Plan Option " B " ) The Benefits by Design Flexible Benefit Programs contain plan features or benefits with specific limitations or payment maximums. These include, but are not limited to: annual maximums for dental care; lifetime maximums for orthodontic procedures; per visit and number of visit limitations for home health, treatment of spinal conditions, and outpatient mental health/chemical dependency treatment. Annual and Lifetime Maximums also apply to mental health/chemical dependency benefits. The vision plan also limits the cost and timeframes for which you are eligible to receive examinations, frames, lenses, and contact lenses (please refer to your Summary Plan Description for a complete list of specific details). Covered Plan participants' submitted charges exceeding the Core Plan Annual Maximums are payable under the Executive Supplemental Health Plan up to your benefit maximum of 10% of your base salary or $10,000, whichever is less. b7 Medically Necessary Expenses which are not Covered under other Plans The Executive Supplemental Health Plan reimburses for expenses which are medically necessary but are either not covered or are specifically excluded under the IT Flexible Benefit Programs. However, the Exec ...