EXHIBIT 10(c)
TRW
EXECUTIVE HEALTH CARE PLAN
EHCP 8/95
TRW EXECUTIVE HEALTH CARE PLAN (EHCP) - ------------------------------------------------------------------------------
TABLE OF CONTENTS Introduction................................................1
Who Is Eligible.............................................1
Contributions...............................................1
Eligible Dependents.........................................1
Comprehensive Health Care Expense Benefits..................2
Covered Health Care Expenses................................2
Examples of Health Care Expenses Covered by the Plan........3
Examples of Health Care Expenses to be Approved in Advance..3
Examples of Health Care Expenses Not Covered by the Plan....4
Definitions.................................................5
Payment of Claims and Recordkeeping.........................6
Coordination of Benefits Provision..........................6
Reimbursement From a Third Party............................7
When Your Health Care Coverage Terminates...................7
After Health Care Coverage Terminates.......................7
Continuation of Coverage--COBRA.............................8
Cost of COBRA Coverage......................................8
Duration of COBRA Coverage..................................8
TRW Retirement Medical Plan.................................8
Additional Information......................................9
Plan Administration.........................................9
Employee Rights............................................11
Appendix...................................................12
TRW EXECUTIVE HEALTH CARE PLAN (EHCP) - --------------------------------------------------------------------------------
INTRODUCTION The TRW Executive Health Care Plan ("Plan") is a plan which provides payment for a wide range of health care expenses.
To encourage good health, the Plan covers the expenses for physical examinations, as well as other preventive care. A simplified claim reimbursement procedure is also a major feature of the Plan.
TRW reserves the right to modify or terminate the Plan at its discretion at any time.
The elections you make when enrolled must remain in effect until the end of the plan year (calendar year), unless you have an eligible change in life status. Even then, the only changes allowed are those consistent with your change in life status or as required to add a dependent as a result of a Qualified Medical Child Support Order. Please see allowable life status changes listed in the ChoicePlus Employee Benefits Book applicable for your unit.
WHO IS ELIGIBLE You are eligible for the benefits of the Plan as of the date you have been designated as a member of the Special Executive Group by the Chief Executive Office. Your eligible dependents will be covered on the date your coverage begins or the date he or she becomes a dependent, or is first enrolled, whichever is latest. Your eligibility for benefits from any other TRW health insurance plan will cease when you become a member of the Plan.
CONTRIBUTIONS All participants are required to contribute to the cost of the Plan. Your contribution will be determined by TRW and will be based on the number of dependents you elect to include in the Plan. IRS regulations require that your contribution be made on an "after-tax" basis. The amount of the contribution will be reviewed annually.
ELIGIBLE DEPENDENTS Dependents eligible for benefits are:
- - your legal spouse;
- - your unmarried child up to age 19 or age 25, if a full-time student;
(If the dependent is on an internship through the school and is not
over age 25, the employee may continue to cover the dependent through
the end of the internship or age 25.)
- - your child regardless of age if incapable of self-sustaining employment,
because of mental or physical disability.
The term "child" also includes your legally adopted child or one placed with you for adoption, foster child, stepchild, or any other child living with you in a regular parent-child relationship. To qualify as a dependent for purposes of the Plan, each child must also qualify as a "Dependent" under Section 152(a) of the Internal Revenue Code. Where this summary of the Plan refers to a dependent below, it means a person who is eligible to be and has been enrolled in the Plan.
Dependents not enrolled when first eligible may be added in accordance with the Life Status Change Rules described in the "Life Status Change" section of the ChoicePlus Employee Benefits Book.
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TRW EXECUTIVE HEALTH CARE PLAN (EHCP) - --------------------------------------------------------------------------------
COMPREHENSIVE HEALTH CARE EXPENSE BENEFITS Full reimbursement will be made for covered medical, dental and vision expenses incurred by you or your eligible dependents while covered by the Plan.
Reimbursement will be made regardless of where the expenses are incurred- - -whether in or out of the hospital--as long as they are incurred in connection with health care (see "Definitions" page 5). Except as described in the section entitled "After Health Care Coverage Terminates" (page 7), all expenses must be incurred while you or your dependents are covered by the Plan.
An expense or charge will be deemed incurred as of the date the service is rendered or the supply is furnished.
Services rendered after the termination of coverage will not be paid.
COVERED HEALTH CARE EXPENSES Covered Health Care Expenses are the reasonable charges incurred in connection with the medical, dental, and vision care of you or your eligible dependent, and must be those which would qualify as a tax deduction. Covered Health Care Expenses, therefore, are those which are Reasonably Necessary and if not reimbursed, could be deducted by you (or you and your spouse in a joint return) when computing your taxable income under Section 213 of the Internal Revenue Code. The provision of Section 213 which limits deductible expenses to an amount measured against adjusted gross income does not apply.
Covered Health Care Expenses include, but are not limited to, the following expenses for services and supplies:
- - Room, board, and other medical services and supplies furnished by a
hospital or other institution qualified to provide medical care.
- - Services of any legally qualified doctor of medicine (M.D.), doctor of
osteopathy (D.O.), doctor of podiatry (D.P.M.), doctor of chiropracty
(D.C.), doctor of optometry (O.D.), doctor of chiropody (D.P.M. - D.S. C.),
dentist (D.D.S. or D.M.D.), Christian Science practitioner listed in the
Christian Science Journal (C.S.), registered nurse (R.N.), licensed
practical or vocational nurse under the direction of an R.N. (L.P.N. or
L.V.N.), midwife, physician's assistant certified by the National
Commission on Certification of Physicians' Assistants (P.A.), audiologist,
occupational therapist, physical therapist, psychologist, respiratory
therapist, social worker, or speech therapist.
- - Necessary transportation to and from an area or facility where the services
or supplies covered hereunder may be obtained, including transportation by
personal automobile.
- - Drugs or medicines prescribed by a physician.
- - Purchase or rental of medical or surgical supplies, aids, and prosthetic
appliances, including eyeglasses, hearing aids, or dental prosthetic
appliances.
Examples of health care expenses that must be approved in advance are shown on page 3. Examples of health care expenses covered and NOT covered are shown on pages 3 and 4.
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TRW EXECUTIVE HEALTH CARE PLAN (EHCP) - --------------------------------------------------------------------------------
EXAMPLES OF HEALTH CARE EXPENSES COVERED BY THE PLAN
- - AMBULANCE SERVICES
- - DIAGNOSTIC & PREVENTATIVE SERVICES
- Allergy & Dermatology Tests
- Immunization & Inoculations
- Physical Examinations -
- X-ray & Laboratory Examinations
- - DRUGS & SUPPLIES
- Crutches
- Eyeglasses
- Hearing Aids
- Hospital Beds
- Prescription Drugs
- Prostheses
- Wheelchairs
- HOSPITAL SERVICES
- Emergency Care
- Inpatient Care
- Outpatient Care
- - NURSING SERVICES
- Licensed Vocational Nurses
- Practical Nurses
- Registered Nurses
- - PHYSICAL THERAPY
- - PROFESSIONAL SERVICES
- Chiropodists
- Chiropractors
- Christian Science Practitioners
- Dentists
- Optometrists
- Osteopaths
- Physicians
- Podiatrists
- Psychiatrists
- Psychologists
EXAMPLES OF HEALTH CARE EXPENSES TO BE APPROVED IN ADVANCE Since reimbursement is made only when the expense is both reasonable and tax deductible, you should request approval from The Prudential Insurance Company (216-668-6662) for any unusual expense prior to the date it is incurred. Some examples of expenses that must be approved in advance are:
- - Charges made by suppliers other than:
- licensed medical practitioners,
- licensed medical care institutions, or
- providers of medically-related services and supplies. - - Charges representing, in whole or in part, expenses of a capital nature. - - Charges for medically necessary cosmetic procedures, including surgery. - - Charges which appear to have been made for purely custodial care. - - Charges for the use of scheduled airline and any other transportation
expense except:
- Those representing reimbursement for the reasonable use of a personal
auto at the prevailing rate per mile, as defined by the IRS for
medical transportation.
- Those representing the actual cost of any mode of necessary emergency
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