what happens to your benefits...• issuance of a qualified medical child support order. you must...

Travelers Qualified Status Changes (Rev 7-19) 2

WHAT HAPPENS TO YOUR BENEFITS ................................... 3

IF YOU TAKE A LEAVE OF ABSENCE ..................................... 4

IF YOU DIE WHILE EMPLOYED .............................................. 22

IF YOU RETIRE* ....................................................................... 25

IF YOUR EMPLOYMENT TERMINATES ................................. 29

IF YOU ARE REHIRED AFTER A TERMINATION OF EMPLOYMENT ......................................................................... 32

IF YOUR EMPLOYMENT STATUS CHANGES (BUT REMAIN BENEFIT ELIGIBLE) ................................................. 34

IF YOUR EMPLOYMENT STATUS CHANGES (AND BENEFIT ELIGIBILITY CHANGES) ......................................... 37

IF YOU MAKE AN INTERCOMPANY TRANSFER TO A NEW U.S. CITY ......................................................................... 42

IF YOU MAKE AN INTERCOMPANY TRANSFER FROM A U.S. OFFICE TO AN OFFICE IN ANOTHER COUNTRY ......... 43

IF YOU MAKE AN INTERCOMPANY TRANSFER FROM AN OFFICE IN ANOTHER COUNTRY BACK TO A U.S. OFFICE ..................................................................................... 45

IF YOU BECOME AN OFFSITE OFFICE WORKER, OR RETURN FROM AN OFFSITE OFFICE TO A COMPANY OFFICE ..................................................................................... 47

IF YOU MARRY* ....................................................................... 48

IF YOU ENTER INTO A DOMESTIC PARTNERSHIP* ............. 51

IF YOU DIVORCE, LEGALLY SEPARATE OR FILE A TERMINATION OF DOMESTIC PARTNERSHIP ..................... 55

IF YOU GIVE BIRTH, ADOPT A CHILD, OR GAIN ELIGIBLE FAMILY MEMBERS* ............................................... 59

IF YOUR COVERED FAMILY MEMBER DIES ......................... 62

IF YOUR COVERED FAMILY MEMBER IS NO LONGER ELIGIBLE FOR TRAVELERS COVERAGE ............................. 65

CHANGE IN FAMILY MEMBER’S EMPLOYMENT STATUS* ................................................................................... 67

CHANGE OR LOSS OF COVERAGE UNDER A PLAN MAINTAINED BY YOUR FAMILY MEMBER’S EMPLOYER* ............................................................................. 70

CHANGE IN ELIGIBLE DEPENDENT CARE EXPENSES ....... 73

CHANGE IN LONG-TERM DISABILITY OR LIFE INSURANCE COVERAGE ........................................................ 74

IF YOU WANT TO ENROLL IN EXCHANGE COVERAGE ...... 75

ENROLLMENT IN MEDICARE OR MEDICAID ........................ 76

LOSS OF OTHER HEALTH INSURANCE COVERAGE .......... 77

2019 Employee Benefits Program (U.S.) Qualified Status Changes TABLE OF CONTENTS


WHAT HAPPENS TO YOUR BENEFITS

What happens to your benefits if you become disabled, die, take a leave of absence, leave the company or have another Qualified Status Change? You can find answers to these questions in the pages that follow. For more detailed information about the plans, see the appropriate summary for each plan and/or contact the Employee Services Unit (ESU) via AskESU, [email protected] or 800.441.4378. In general, you must request changes for your coverage within 31 days after the event. Changes are generally effective the day of the event.

Changes can be approved only if the change in benefit coverage is consistent with the Qualified Status Change and if the request is received by the ESU within 31 days of the event. In general, a change in coverage will be considered consistent only if the Qualified Status Change results in the gain or loss of eligibility for benefit coverage under a plan maintained by Travelers or under a plan maintained by your family member’s employer. Certain exceptions may apply. For example, if you elect to make pre-tax contributions to your Health Savings Account (HSA) with Fidelity, you can change that election at any time on a prospective basis because such elections are not subject to any Qualified Status Change rules. See the following pages of this summary for more detail on the Qualified Status Change rules.

Qualified Status Changes

Different Qualified Status Change rules apply to different plans. Please review the relevant section of this summary for the details of how a specific Qualified Status Change event may impact your benefits under a particular plan. In general, examples of Qualified Status Changes include the following:

• Change in legal marital status, such as: marriage, divorce, legal separation, annulment or death of your spouse;

• Change in domestic partnership status, such as: filing a Domestic Partner Affidavit and Agreement or filing a Termination of Domestic Partnership;

• Loss or gain of children, such as: birth, adoption, placement for adoption or death of a child;

• Change in employment status, such as: termination or commencement of employment by you, your spouse or domestic partner or your child;

• Change in work schedule, such as: change in hours of employment, commencement or return from an unpaid leave of absence or a strike or lockout which causes you or your family member to gain or lose eligibility for benefits or to pay more for benefits;

• Change in eligibility status of a child, such as: change in a child’s eligibility under a plan due to attainment of age, student status, disabled status or change in custodial parent;

• Change in the eligibility of you or your family member for Medicare, Medicaid or your state’s Children’s Health Insurance Program (see the Medical summary for more details);

• Change in coverage under a plan maintained by your family member’s employer;

• Change in dependent care expenses for Dependent Care Spending Accounts (see the Flexible Spending Accounts summary for more detail);

• Change in residence or worksite, such as: change in your or your family member’s location of residence or worksite out of a health plan’s coverage area; and

• Issuance of a Qualified Medical Child Support Order.

You must contact the ESU to request a change to your benefits and complete the online enrollment within 31 days after the Qualified Status Change. You must also complete the Benefits Affidavit. If you fail to return the Benefits Affidavit, your benefit changes may be reversed to your previous elections. You may also be required to provide additional documentation supporting your Qualified Status Change, upon request.

Failure to notify ESU within 60 days of loss of eligibility status will result in your or your covered family member’s loss of continuation coverage rights. Travelers will consider a failure to notify Travelers when you or a family member becomes ineligible as an intentional misrepresentation. This may result in a retroactive loss of coverage for you or your family member that is not a rescission.


IF YOU TAKE A LEAVE OF ABSENCE

(Including Disability Leave)

This section of the Qualified Status Changes summary describes what happens to your benefits and your responsibility for paying premiums, when you start a leave, while you are on a leave of absence and when your leave ends. Generally, leaves of absence fall into five (5) types:

• Paid FMLA/STD leave – this may be either paid Family and Medical Leave Act (FMLA) leave that is covered by your paid time off (PTO), or short-term disability leave (and would include any paid parental leave you may be eligible for).

• Unpaid FMLA leave – this may be either unpaid FMLA leave that starts after you have exhausted your PTO, or state paid family leave.

• Extended disability leave – this starts after short-term disability leave ends. In general, any leave of absence due to disability is limited to nine (9) continuous months, starting on the date that you transition to LTD leave or unpaid leave (if not enrolled and determined to be disabled for purposes of the Travelers’ disability leave policy). Even if your leave extends beyond nine (9) months, any coverage that was available during the maximum approved leave period will end. Your extended disability absence coverage may end earlier if you recover, return to work or your employment is terminated during the leave period.

• Unpaid personal leave – in certain limited circumstances, Travelers may approve a personal (non-FMLA, non-disability) unpaid leave of absence. An “appeal” leave (during which you can appeal a determination by MetLife under the short-term disability or long-term disability component of the Disability plan) is considered an unpaid personal leave for benefits purposes.

• Military leave - military leaves of absence generally fall into two (2) types:

o Paid military leave – this is military leave for which you are receiving military differential pay.

o Unpaid military leave – this is military leave that is unpaid because you are not receiving military differential pay.

Review the Travelers’ Military Leave policy for additional information regarding military leave, such as which uniformed services are considered military service, what happens if you do not intend to return to work, the maximum length of service, the time period to return to work with reemployment rights and the effect of dishonorable discharge.

Note: Benefit treatment for administrative paid leaves are handled the same as Paid FMLA/STD leaves. Benefits treatment for administrative unpaid leaves are handled the same as Unpaid FMLA leave.

Change in leave status: If your leave changes from unpaid to paid leave, you can add or change coverage if consistent with the change, but this rule does not apply to your spending accounts.

IMPORTANT: Your request for a change in benefit coverage will be approved only if it is consistent with the Qualified Status Change and received by the ESU within 31 days of the event.

IMPORTANT NOTE ABOUT PREMIUMS: If you are required to pay any premiums while on a leave of absence and you fail to do so within 60 days of the date you are billed for the premium, coverage will end on the last day of the period for which you paid the last required premium. You will receive monthly invoices for these premiums. A termination of coverage for failure to pay premiums is not a rescission.

If You Take A Leave Of Absence (Including Disability Leave) (continued)


Medical, Dental And Vision

When You Start Leave

Paid FMLA/STD leave:

o Your coverage will continue - you cannot elect to change or discontinue coverage.

Unpaid FMLA leave, extended disability leave, unpaid personal leave, military leave:

o You have the choice to continue or discontinue coverage. To stop coverage, you must file a written election to stop coverage within 31 days after your leave starts. Your election to stop coverage generally will be effective on the date you file it (or when your leave starts, if later).

Note: During military leave, you may want to consider discontinuing coverage because government coverage may be available.

During Your Leave

Paid FMLA/STD leave, paid military leave (if coverage continues):

o You must continue to pay premiums. Generally, you pay premiums on a before-tax basis by your paycheck. However, if you do not have a sufficient amount in your paycheck to cover the premium, you will be required to pay the premiums on an after-tax basis by personal check.

o If the Working Spouse Subsidy Reduction applies to you, it will continue, but you may now qualify for the smaller Working Spouse Subsidy Reduction due to a decrease in your income, if you notify Travelers of such decrease within 31 days of the start of your leave.

Unpaid FMLA leave, extended disability leave, unpaid personal leave, unpaid military leave:

o If your coverage continues, you must continue to pay premiums on an after-tax basis by personal check.

o If you are on unpaid personal leave only, the Working Spouse Subsidy Reduction will no longer apply.

o For all other unpaid leaves, if the Working Spouse Subsidy Reduction applies to you, it will continue, but you may now qualify for the smaller Working Spouse Subsidy Reduction due to the decrease in your income, if you notify Travelers of such decrease within 31 days of the start of your leave.

For all leaves:

o If you fail to make a premium payment, coverage will end at the end of the period for which you paid the last required premium. In this case, you are not eligible to enroll during the annual enrollment period.

o If you are on a leave during the annual enrollment period or at the time of a Qualified Status Change, you have the same rights as an active employee to drop, add or change coverage (except if you fail to make a premium payment during your leave). You cannot add or change coverage other than under those circumstances.

When Your Leave Ends

Paid FMLA/STD leave, unpaid FMLA leave, extended disability leave, unpaid personal leave, military leave (if coverage continued):

o Your coverage will continue without interruption, and you may not make a new election upon your return.

Unpaid FMLA leave, extended disability leave, unpaid personal leave, military leave (if coverage ended):

o If your coverage ended at the start of or during your leave, your pre-leave coverage will not be reinstated upon your return.



o You may make a new election within 31 days of your return to work. If no new election is made during this 31-day special election period, you cannot elect coverage for the rest of that plan year unless a Qualified Status Change occurs.

For all leaves:

o If your employment ends during or at the end of your leave, your coverage will end, at the latest, on the last day of the month in which your employment ends.

o If your Working Spouse Subsidy Reduction was discontinued or decreased due to your leave, it will resume and will increase to the reduction in effect prior to your leave, unless your income continues to qualify you for the smaller Working Spouse Subsidy Reduction.

Life/AD&D Insurance



o Your coverage will continue – you cannot elect to discontinue coverage.

Unpaid FMLA leave, extended disability leave, unpaid personal leave, military leave:


During Your Leave

Paid FMLA/STD leave, paid military leave (if coverage continues):

o You must continue to pay premiums. Generally, you pay premiums on an after-tax basis by your paycheck. However, if you do not have a sufficient amount in your paycheck to cover the premium, you will be required to pay the premiums on an after-tax basis by personal check.

o If you are on a leave during the annual enrollment period or at the time of a Qualified Status Change, you have the same rights as an active employee to drop or add coverage (except if you fail to make a premium payment during your leave), subject to all applicable rules, including evidence of insurability and a requirement that you be actively at work for an increase in coverage to become effective. You cannot add or drop coverage other than under those circumstances.

Unpaid FMLA leave, unpaid military leave (if coverage continues):

o You must continue to pay premiums on an after-tax basis by personal check.

o If you are on a leave during the annual enrollment period or at the time of a Qualified Status Change, you have the same rights as an active employee to drop or add coverage (except if you fail to make a premium payment during your leave), subject to all applicable rules, including evidence of insurability and a requirement that you be actively at work for an increase in coverage to become effective. You cannot add or drop coverage other than under those circumstances.

Extended disability leave, unpaid personal leave:

o You must continue to pay premiums on an after-tax basis by personal check.

o If you are on a leave during the annual enrollment period or at the time of a Qualified Status Change, you may drop coverage or decrease your Optional Life/AD&D or Dependent Life/Spouse AD&D coverage.



For all leaves:



For all leaves:

o Your coverage will continue without interruption.

o You may not make a new election upon your return. You cannot elect coverage until the next annual enrollment period (or the occurrence of a Qualified Status Change).

o If your employment ends during or at the end of your leave, your coverage will end, at the latest, on the last day of the month in which your employment ends.

Disability

Coverage under the STD component of the plan continues throughout your paid FMLA/STD leave, unpaid FMLA or military leave until your employment ends (if applicable), but otherwise ends when you start an extended disability leave or unpaid personal leave. Accordingly, the following relates only to the LTD component of the plan.


Paid FMLA/STD leave, extended disability leave:

o Your coverage will continue – you cannot elect to discontinue coverage.

Unpaid FMLA leave, unpaid personal leave, military leave:


During Your Leave

Paid FMLA/STD leave; paid military leave (if coverage continues):

o You must continue to pay premiums if you were required to pay premiums before your leave started (that is, if your base salary is more than $50,000). Generally, you pay premiums on an after-tax basis by your paycheck. However, if you do not have a sufficient amount in your paycheck to cover the premium, you will be required to pay the premiums on an after-tax basis by personal check.

Unpaid FMLA leave, unpaid military leave:

o If your coverage continues, you must continue to pay premiums if you were required to pay premiums before your leave started (that is, if your base salary is more than $50,000). You will be required to pay the premiums on an after-tax basis by personal check.

Extended disability leave:

o Your coverage will continue – you do not pay premiums for the period you are on leave.

Unpaid personal leave:

o If your coverage continues, you must continue to pay premiums, even if your base salary is $50,000 or less. You will be required to pay the premiums on an after-tax basis by personal check.



Paid FMLA/STD leave, unpaid FMLA, military leave, unpaid personal leave:


o If you are on a leave during the annual enrollment period or at the time of a Qualified Status Change, you have the same rights as an active employee to drop or add coverage (except if you fail to make a premium payment during your leave). If your base salary is over $50,000, you may add coverage subject to all applicable rules, including evidence of insurability and a requirement that you be actively at work for added coverage to take effect. You cannot add or drop coverage other than under those circumstances.


Paid FMLA/STD leave; paid military leave (if coverage continued), extended disability leave:

o Your coverage will continue without interruption.

Unpaid FMLA leave, unpaid personal leave, military leave (if coverage ended):

o If your salary is $50,000 or less and your coverage ended at the start of or during your leave, your pre-leave coverage is automatically reinstated without evidence of insurability.

o If your salary is over $50,000 and you did not have coverage before your leave or your coverage did not change during leave, you cannot change coverage when you return to work (your coverage may have changed while you were on leave if you made a new election during an intervening annual enrollment period or as a result of a Qualified Status Change).

o If your salary is over $50,000, and your coverage ended at the start of or during your leave, your pre-leave coverage will not be reinstated upon your return. However, you may elect coverage within 31 days of your return to work. You will be required to submit evidence of insurability in this case, unless you were on unpaid FMLA leave and you return to work within the time required by law. Coverage will start on the later of the day you return to work or the first of the month following the date your application is approved (approval only applies if you were required to submit evidence of insurability). If you do not elect coverage within 31 days of your return to work, your coverage is waived (unless you made a new election during an intervening annual enrollment period or as a result of a Qualified Status Change, and that election becomes effective when you return). You cannot elect coverage for the rest of that plan year unless a Qualified Status Change occurs.

For all leaves:

o If your coverage ended during your leave because you failed to pay a premium, you cannot elect coverage until the next annual enrollment period (or the occurrence of a Qualified Status Change).

o If your employment ends during or at the end of your leave, your coverage will end, on the day your employment ends.

Regular Paid Time Off (PTO)

Effect of a Leave on Your Awarded but Unused PTO


o You may have used PTO to cover the elimination period (the first week of absence due to disability) under the STD component of the plan.

Military leave (paid or unpaid):

o It is your choice whether to use your awarded PTO.



Unpaid FMLA leave, unpaid personal leave:

o You are required to use all of your awarded PTO prior to taking unpaid leave. If your unpaid leave consists of state paid family leave only, depending on your work state you may not be required to use PTO prior to paid family leave benefits beginning.


o Your awarded but unused PTO will be paid to you after four (4) weeks of leave. If your leave is less than four (4) weeks, your awarded but unused PTO will remain intact.

Circumstances When Additional PTO Will Be Awarded During Leave Or Upon Return to Work


o PTO is not awarded unless you work under the STD Return to Work Program. In this case, PTO hours are awarded to reflect the hours you work. These PTO hours, which are prorated based on the number of hours you work under the Return to Work Program, will be available for use during your paid leave. When you transition from paid FMLA/STD leave to extended disability leave or when you return to work from paid FMLA/STD leave (as applicable), you will be awarded PTO hours (less any hours awarded due to work under the Return to Work Program) as if you had been working during your leave.

Military leave (paid or unpaid):

o PTO continues to be awarded as if you were working during your leave. PTO carryover caps that normally apply do not apply while you are on military leave. Awarded PTO is paid upon your return to work or if you resign from Travelers before you return from military leave, upon your resignation.


o PTO is not awarded unless you work under the LTD Return to Work Program. In this case, PTO hours are awarded to reflect the hours you work. These PTO hours, which are prorated based on the number of hours you work under the Return to Work Program, will be available for your use during the period you work under the program. Any unused hours will be paid to you after you complete the program if you remain disabled. If you return to work following completion of the program, awarded PTO will be available for your use at that time.

Unpaid FMLA leave:

o PTO is not awarded during this leave. When you return to work from leave, you will be awarded PTO hours as if you had been working during your leave.


o PTO is not awarded during this leave.

This is a general discussion of how PTO interacts with leaves, but it is not all-inclusive. For example, it is does not discuss intermittent leaves. Travelers will comply with the FMLA and all other applicable laws.

Purchased PTO



o Your deductions will continue -- you cannot elect to discontinue deductions at any time during this type of paid leave.



Paid military leave:

o You have the choice to continue or discontinue your deductions. To stop deductions, you must file a written election to stop your deductions within 31 days after your leave starts. Your election will be effective retroactive to the date the leave starts. If you stop deductions, your calendar year-to-date deductions (less any time used) will be refunded.


o Your deductions stop.

During Your Leave


o If you are on leave during an annual enrollment period you can make an election as long as you remain on a paid leave.

Unpaid military leave, unpaid FMLA leave, unpaid personal leave, extended disability leave:

o After four (4) weeks of leave your calendar year-to-date deductions (less any time used) will be refunded and your pre-leave deductions will not be reinstated.

Military leave, unpaid FMLA leave, unpaid personal leave, extended disability leave:

o If you are on a leave during an annual enrollment period, you cannot make a purchased PTO election for the following year.

o If you are on a leave at the end of the calendar year, your unused purchased PTO from the current year will be refunded regardless of the length of your leave. Furthermore, any election for purchased PTO time you made during the annual enrollment period for the following plan year will automatically be cancelled.



o Your return to work does not affect your purchased PTO.


o If your deductions continued, your return to work does not affect your purchased PTO if you return in the same calendar year. Otherwise, your election will be waived in the next calendar year.

o If you discontinued your deductions and you return to work within four (4) weeks from the start of your leave and in the same calendar year, your pre-leave deductions will automatically resume. Any deductions you missed during your leave will be made up from your remaining paychecks in the same calendar year.


o If you return to work within four (4) weeks from the start of your leave and during the same calendar year, your pre-leave deductions will automatically resume. Any deductions you missed during your leave will be made up from your remaining paychecks in the same calendar year.

For all leaves:

o If you return to work after the annual enrollment period but before December 31, you may make a new purchased PTO election for the following plan year only if you request to be enrolled by December 31 of the current calendar year.



Holidays


o Holidays are paid during paid leave. A holiday will be considered a disability day and counted towards the 13-week maximum STD duration (if applicable). You will not be required to use PTO for any holidays that occur during the elimination period. If you are scheduled to work on a holiday, but are on a paid FMLA/STD leave, those holiday hours are not available upon your return to work. If a holiday falls during a period of paid parental leave, you will be paid the holiday and your paid parental leave will not be decreased for that day.


o Holidays are paid during paid military leave. If you are scheduled to work on a holiday, but are on a paid military leave, those holiday hours are not available upon your return to work.

Unpaid FMLA leave, extended disability leave, unpaid military leave:

o Holidays are not paid during unpaid leave, and those missed holidays are not available upon your return to work. However, if you are released to work on a holiday and you work the day after the holiday, you will be paid for the holiday.


o Holidays are not paid during unpaid leave, and those missed holidays are not available upon your return to work.

Spending Accounts

Health Care Spending Account



o Your coverage continues. You cannot elect to discontinue coverage at any time during your leave.

Unpaid FMLA leave, military leave:

o You have the choice to continue or discontinue coverage. To stop coverage, you must file a written election within 31 days after your leave starts. Your election to stop coverage generally will be effective on the date you file it (or when your leave starts, if later).


o Your coverage ends when your leave starts.

Note: During military leave, you may be eligible to take a qualified reservist distribution from your health care spending account if you provide proof of being ordered to active duty for at least 180 days. See the “Qualified Reservist Distributions” section of the Flexible Spending Accounts summary for more information.

During Your Leave


o You must continue to make contributions. Generally, you make contributions on a before-tax basis by your paycheck. As long as your coverage continues, even if you do not make contributions (because your paycheck would not cover the contribution amount), you can continue to be reimbursed for eligible expenses incurred during your leave.




o If you elect to continue coverage while you are on a leave, you must continue to make contributions. Generally, you make contributions on a before-tax basis by your paycheck. As long as your coverage continues, even if you do not make contributions (because your leave is unpaid or your paycheck would not cover the contribution amount), you can continue to be reimbursed for eligible expenses incurred during your leave.


o Because your coverage does not continue while you are on these types of leave, you cannot continue to be reimbursed for any expenses incurred during your leave.

For all leaves:

o If you are on a leave during the annual enrollment period or at the time of a Qualified Status Change, you have the same rights as an active employee to drop, add or change coverage. You cannot add or change coverage other than under those circumstances (for example, you cannot increase contributions merely because your leave changes from unpaid to paid).



o If you return to work directly from paid FMLA/STD leave, your coverage will continue without interruption. You may not make a new election upon your return.


o If your coverage continued during your leave but your contributions stopped, and you return to work during the same calendar year, any missed contributions will be made up from your remaining paychecks during the same calendar year.


o You may make a new election within 31 days of your return to work.

− If you elect an amount greater than your prior election (Your prior election and new election together cannot exceed the annual plan maximum), only claims incurred after your new election are eligible for reimbursement up to the new election amount.

− Claims incurred before your new election are subject to the coverage election amount in effect prior to your new election and must have been incurred while you were contributing to the plan.

− If you elect to decrease your contributions, you may not decrease your annual contribution to an amount less than:

• The amount of contributions you have already made to the plan.

• The total expenses that have already been reimbursed by the plan.

• The plan minimum.

If no new election is made during this 31-day special election period, you cannot elect coverage for the rest of the plan year unless a Qualified Status Change occurs.




o Your pre-leave coverage will not be reinstated upon your return. You may make a new election within 31 days of your return to work.







For all leaves:

o If your participation in the plan ended during your leave, your coverage ends when your contributions stopped. Only claims incurred while you were contributing to the plan will be eligible for consideration. Unless you elect COBRA continuation your deadline for submitting claims is December 31st of the plan year in which your leave began.

o If your employment ends during or at the end of your leave, your coverage will end, at the latest, on the day your employment ends. Unless you elect COBRA continuation your deadline for submitting claims is December 31st of the plan year in which your employment ends.

Dependent Care Spending Account


Paid FMLA/STD leave, unpaid FMLA leave, military leave:



o Your coverage will end when your leave starts.

Note: Reimbursements for dependent care are limited to eligible expenses incurred while you and your spouse (if you are married) are actively working, seeking employment or attending school on a full-time basis. Actively working includes military service. Dependent care claims incurred during the period you or your spouse (if you are married) are on disability or other leave may not be eligible for reimbursement. See the Flexible Spending Accounts summary for more information.

During Your Leave

Paid FMLA/STD leave, paid military leave:

o If coverage continues while you are on a leave, you must continue to pay contributions. Generally, you pay contributions on a before-tax basis by your paycheck. However, if you do not have a sufficient amount in your paycheck to cover the contributions, you will be required to pay the contributions if you return to work during



the same calendar year. As long as your coverage continues, even if you do not pay contributions, you can continue to be reimbursed for eligible expenses incurred during your leave, but not for an amount that exceeds the contributions made.

Unpaid FMLA leave, unpaid military leave:

o If coverage continues while you are on a leave, you will be required to pay missed contributions if you return to work during the same calendar year. As long as your coverage continues, even if you do not pay contributions, you can continue to be reimbursed for eligible expenses incurred during your leave, but not for an amount that exceeds the contributions made.

For all leaves:

o If you are on a leave during the annual enrollment period or at the time of a Qualified Status Change, you have the same rights as an active employee to drop, add or change coverage. You cannot add or change coverage other than under those circumstances.


Paid FMLA/STD, unpaid FMLA leave, military leave:

o If your coverage continued during your leave, but your contributions stopped and you return to work during the same calendar year, any missed contributions will be made up from your remaining paychecks during the same calendar year.

For all leaves:


o You may make a new election within 31 days of your return to work.







If no new election is made during this 31-day special election period, you cannot elect coverage for the rest of the plan year unless a Qualified Status Change occurs.

o If you are newly eligible for coverage upon your return from leave, you may elect coverage within 31 days of your return to work.

o If your participation in the plan ends during your leave, your coverage will end when your contributions stop. The deadline to incur and submit claims is December 31st of the plan year in which your leave began.



o If your employment ends during or at the end of your leave, your coverage will end, at the latest, on the day your employment ends. Your deadline for submitting claims is December 31st of the plan year in which your employment ends.

Health Savings Account (HSA)



o Your HSA plan option remains active at Travelers and the HSA custodian. Therefore, your HSA payroll contributions will continue unchanged.


o Your HSA plan option remains active as long as your medical plan option is not terminated due to non-payment or any other reason. Your HSA payroll contributions will suspend during your unpaid leave. Upon returning to work, your HSA payroll contributions will resume but the per pay period contribution will be recalculated based on your remaining goal balance divided by the remaining pay periods in the calendar year.

o If you wish to continue contributing to your HSA during your unpaid leave contact the HSA custodian regarding contribution methods.


o Your HSA plan option ends when your leave starts. This does not terminate your HSA with the HSA custodian. If you maintain HSA eligibility during your leave, you may continue to make contributions into your account. Contact the HSA custodian regarding contribution methods. Upon return to work, you will be able to re-elect your benefit plan options. If the HSA is re-elected, you must be certain the amount elected does not cause total HSA contributions for the calendar year to exceed the IRS annual maximum.

During Your Leave


o You may continue to make contributions. An HSA payroll contribution change form is available. Contributions cannot be increased to exceed the IRS annual maximum. If you elect to decrease your contributions, the new annual amount cannot be less than the total of the contributions already made. Any change in election is effective the 1st of the month after the form is received.


o Your HSA plan option remains active, assuming your medical plan option has not ended due to non-payment or any other reason. Your HSA payroll contributions will suspend during your unpaid leave. Upon returning to work, your HSA payroll contributions will resume but the per pay period contribution will be recalculated based on your remaining goal balance divided by the remaining pay periods in the calendar year.

o If you wish to continue contributing to your HSA during your unpaid leave, contact the HSA custodian regarding contribution methods.


o Your HSA plan option ends when your leave starts. This does not terminate your HSA with the HSA custodian. If you maintain HSA eligibility during your leave, you may continue to make contributions into your account. Contact the HSA custodian regarding contribution methods. If your HSA eligibility is not maintained during your leave, you will not be able to continue to make contributions. But, you can continue to reimburse yourself for any expenses incurred during your leave from your HSA, if you desire.



For all leaves:

o If you are on a leave during the annual enrollment period or at the time of a Qualified Status Change, you have the same rights as an active employee to drop, add or change coverage. You cannot add or change coverage other than under those circumstances.



o If you return to work directly from paid FMLA/STD leave, your HSA plan option and payroll contributions will continue without interruption.


o If your HSA plan option remained active during your unpaid leave, upon returning to work, your HSA payroll contributions will resume but the per pay period contribution will be recalculated based on your remaining goal balance divided by the remaining pay periods in the calendar year.

o If your HSA plan option ended due to non-payment of your medical plan, upon return to work, you will be able to re-elect your benefit plan options. If the HSA is re-elected, you must be certain the amount elected does not cause total HSA contributions for the calendar year to exceed the IRS annual maximum.


o Your pre-leave HSA plan option will not be automatically reinstated upon your return. However, you may make a new election within 31 days of your return to work. Any change in election is effective the 1st of the month after the election is processed. If the HSA is re-elected, you must be certain the amount elected does not cause total HSA contributions for the calendar year to exceed the IRS annual maximum.

For all leaves:

o If your employment ends during or at the end of your leave, your coverage under the HSA plan option and your HSA payroll contributions will end, at the latest, on the day your employment ends. However, this does not terminate your HSA with the HSA custodian.

Travelers 401(k) Savings Plan



o The deferral percentage you have in effect is applied against the compensation you receive, unless you elect to discontinue contributions by contacting Fidelity. Your deferral percentage is applied to your short-term disability pay. For this purpose only, your short-term disability pay is the gross pay, determined by the company, before any reduction for pay received directly by you from a state fund.


o During paid military leave, your deferral percentage is applied against your military differential pay. For this purpose only, we will treat you as having earnings at the pay rate you had in effect when you went on military leave, adjusted for any scheduled pay raises during the leave.


o 401(k) contributions end with your last paycheck.



During Your Leave

Military leave:

o If you have been called to active military service for a period of more than 30 days, you can request a withdrawal of your entire vested plan balance. If you take a military withdrawal, you will not be able to make 401(k) contributions for military differential or any other pay for a six (6)-month period following the withdrawal. After the six (6)-month suspension period, your pre-tax 401(k) and/or after-tax Roth(k) contributions to the plan will be automatically reinstated at the same level as was in effect before your suspension.

o During military leave, the interest rate on any loan from the plan will not exceed 6%. The term of your loan will be extended by the length of military leave.

o If you are on an unpaid military leave that began on or after April 1, 2014, your obligation to make payments will be suspended. You may elect to continue monthly loan payments by direct debit from your bank account or by certified or cashier’s check. Contact Fidelity at 800.480.9980 and review the loan program document for more information.

o If you are on paid military leave at a rate of pay that is higher than your monthly loan installment, you must continue to make loan payments from your paycheck.

o If you die while on military leave, you will be treated as if you had returned to work on the day before your death, meaning that you will be 100% vested.

Non-military unpaid leave:

o For loans made on or after April 1, 2014, your obligation to make payments will be suspended during your unpaid leave for up to one (1) year. You may elect to continue monthly loan payments by direct debit from your bank account or by certified or cashier’s check. Contact Fidelity at 800.480.9980 and review the loan program document for more information.

o For general purpose loans made after April 1, 2014 (not home loans), the term of your loan will be extended by the length of your unpaid leave; however, your total loan term cannot exceed five (5) years.

Non-military paid leave:

o If you have an outstanding loan, you must continue to make loan payments from your paycheck during paid leave.

For all leaves:

o You will receive the company match if you are on an approved leave of absence on the last business day of the calendar year. The company match will be calculated based on your contributions from your eligible pay in accordance with plan rules.

o You may initiate a new loan if one is available to you.


Military leave:

o If you return to work from a military leave and have not made the maximum 401(k) contributions permitted under tax law, you have the opportunity to make up the missed contributions. You may make up contributions within five (5) years of your return to work (or three (3) times your period of military leave if shorter). You will also receive the company match with respect to any make up contributions in accordance with plan rules. You will not receive any earnings or losses on the make-up contributions or matching contributions.



o If you are unable to return to work because you die or become disabled while in active military service, you will be entitled to several additional benefits. For this purpose, disability means that you would have been approved for benefits under the long-term disability plan, without regard to the exception under that plan for disabilities caused or contributed to by a war or an act of war, insurrection, rebellion or terrorist act. If you are unable to return to work due to death, you will become 100% vested in all of your accounts.

o If you are unable to return to work either due to death or disability, you will not be able to make up missed contributions as described above because you will not have any pay from which to deduct contributions. In this case, you will be eligible to receive the company match based on imputed contributions, which are calculated by reference to the average rate at which you made contributions over the 12-month period immediately before your leave (or over the full period during which you made contributions, if that period is shorter than 12 months). If you previously received the company match based on contributions you made during your leave, you will receive an additional match based on imputed contributions only if your imputed contributions would have resulted in a larger company matching contribution.


o If your employment ends after your extended disability leave, you will become 100% vested.

For all leaves:

o If your contributions ended at the start of or during your leave, and you return to work, including as part of an approved STD or LTD Return to Work Program, your contributions will be automatically reinstated at your pre-leave deferral rate (pre-tax 401(k) and/or after-tax Roth(k)) (unless you made a new election since your contributions ended).

o If your employment ends during or at the end of your leave, you will be entitled to a distribution after your employment ends.

Travelers Pension Plan

During Your Leave


o You continue to earn cash balance pay credits. Your short-term disability pay is counted for purposes of cash balance pay credits. For this purpose only, your short-term disability pay is the gross pay, determined by the company, before any reduction for pay received directly by you from a state fund.


o Your LTD pay (or any other pay you receive from a third party, including disability pay mandated under a state program) is not counted for pay credit purposes.

Military leave:

o You continue to earn cash balance pay credits. Pay credits are generally based on your average rate of pay in effect during the 12 months immediately before the start of your leave (even if you are receiving military differential pay), adjusted for any scheduled pay raises during the leave.

o You continue to earn credited service during the period of your military leave. The maximum period of military leave is determined by reference to the Travelers’ military leave policy. Your pay under a final average pay formula is generally based on your average rate of pay in effect during the 12 months immediately before the start of your military leave, adjusted for any scheduled pay raises during the leave.

o If you die while on military leave, you will be treated as if you had returned to work on the day before your death, meaning that you will be 100% vested, and which means that your survivor may be entitled to additional benefits based on your “in-service death.”



For all leaves:

o Your vesting service continues while you remain an employee.

o Your cash balance account continues to earn interest credits as long as you remain a participant in the plan.


For all leaves:

o If your employment ends during or at the end of your leave, you will be entitled to a distribution of your vested benefit after your employment ends.

Employee Assistance Program (EAP)

For all leaves:

o You are eligible to use the EAP for the maximum approved leave period, but not beyond that.

Legal Services Plan



o Your coverage will continue—you cannot elect to discontinue coverage.

Unpaid FMLA leave, extended disability leave, unpaid personal leave:

o You have the choice to continue or discontinue coverage. To stop coverage, you must file a written election to stop coverage within 31 days after your leave starts. Your election to stop coverage generally will be effective on the date you file it (or when your leave starts, if later). If you discontinue coverage, any legal matters in progress will be completed. No new matters may be opened under the plan.

Paid and Unpaid Military leave:

o Your coverage will continue—you cannot elect to discontinue coverage at the start of your leave.

During Your Leave


o If your coverage continues, you must continue to pay premiums for your coverage. Generally, you pay premiums on an after-tax basis through payroll deductions.

Unpaid FMLA leave, extended disability leave, unpaid personal leave:

o If your coverage continues, you must continue to pay premiums for your coverage on an after-tax basis by personal check.

Paid and Unpaid Military leave:

o The premium is waived while on active duty.

For all leaves (except military leave):

o If you fail to make a premium payment, coverage will end at the period for which you paid the last required premium.



o If you are on a leave during the annual enrollment period or at the time of a Qualified Status Change, you have the same rights as an active employee to drop or add coverage. You cannot drop or add coverage other than under those circumstances.


For all leaves:

o When you return to work you may not enroll in this plan until the next annual enrollment period or as a result of a Qualified Status Change.

o If your employment ends during or at the end of your leave, your coverage will end on the day in which your employment ends. Any legal matters in progress will be completed. No new matters may be opened under the plan. Contact ARAG directly at 800.247.4184 for individual continuation options or see the Legal Services Plan summary.

Educational Assistance

For all leaves (except military leave):

o You are not eligible to be reimbursed for any course you begin while you are on leave. However, you may be eligible to receive reimbursement for a course you completed or an approved course you began before the start of the leave.

Military leave:

o If you are on a military leave and unable to complete an approved course, you are eligible to be reimbursed for any such course.

Excess Liability


Paid leaves:

o Your coverage will continue – you cannot elect to discontinue coverage at the start of the leave.

Unpaid leaves:

o Your coverage will continue, but if you are unable to return to work within four (4) weeks of beginning your unpaid leave of absence, your coverage in the program will end at the end of the period for which you paid the last required premium, unless you contact the Signature B&B Companies directly to continue payments. For individual continuation options contact Kathryn Riffle at [email protected] or 516-823-3131”).

During Your Leave

Paid leaves:

o You must continue to pay premiums for your coverage. Generally, you pay premiums on an after-tax basis through payroll deductions. If you fail to make a premium payment, coverage will end at the end of the period for which you paid the last required premium.

Unpaid leaves:

o If you are unable to return to work within four (4) weeks of beginning your unpaid leave of absence, your coverage in the program will end at end of the period for which you paid the last required premium, unless you contact the Signature B&B Companies directly to continue payments. For individual continuation options. contact Kathryn Riffle at [email protected] or 516-823-3131”).



For all leaves:

o If you are on a leave during the annual enrollment period, you have the same rights as an active employee to drop, add or change coverage.


Paid leaves:

o If coverage continued during your entire paid leave, your coverage will continue without interruption.

o If your coverage ended during your paid leave because you failed to pay a premium, you will be eligible to add coverage by completing the Excess Liability Coverage Election Form and submitting it to the address on the form. You will receive an invoice once your completed Excess Liability Insurance Coverage Election Form is received and processed. The payment that will be due will be the monthly rate multiplied by the number of full months remaining in the current calendar year. After this initial payment, payments for subsequent calendar years will automatically be payroll deducted.

Unpaid leaves:

o If coverage continued during your entire unpaid leave lasting less than four (4) weeks, your coverage will continue without interruption.

o If your coverage ended because your unpaid leave lasted longer than four (4) weeks and you did not choose to continue payments directly with the Signature B&B Companies, upon your return to active status, you will be eligible to add coverage by completing the Excess Liability Coverage Election Form and submitting it to the address on the form. You will receive an invoice once your completed Excess Liability Insurance Coverage Election Form is received and processed. The payment that will be due will be the monthly rate multiplied by the number of full months remaining in the current calendar year. After this initial payment, payments for subsequent calendar years will automatically be payroll deducted.

For all leaves:

o If your employment ends during or at the end of your leave, your coverage will end on the date your employment is terminated.

IMPORTANT: Your request for a change in benefit coverage will only be approved if it is consistent with the Qualified Status Change and received by the ESU within 31 days of the event.

If you return from a leave of absence after the annual enrollment period in which you first elect Medical or Dental coverage and/or a Flexible Spending account but before the following plan year begins, you may elect to have coverage become effective on the first day of the following plan year instead of effective the date of your return to work.

The rules in this section apply to you. If your eligible family member is a service member on military leave, he or she might have certain rights to reinstated coverage. Please contact the ESU via AskESU, [email protected] or 800.441.4378 for more information.


IF YOU DIE WHILE EMPLOYED

Medical

• Coverage for your family members will terminate at the end of the month of your death.

• Your spouse and children may elect and pay for COBRA continuation coverage if they were covered at the time of your death. Your domestic partner may elect and pay for continuation coverage if he or she was covered at the time of your death. If your family members affirmatively elect continuation coverage, Travelers will pay the continuation premiums for the first six (6) months following your death. After the first six (6) months, your family members must pay their own premiums in order to be eligible for continuation coverage.

• Your family members must request continuation coverage within 60 days after the date of your death or within 60 days after the date they receive the notice of their right to continuation coverage, whichever is later. See the COBRA summary for more information.

• If you are retirement eligible at death and you are eligible for special retiree coverage, your surviving family members may elect coverage as described in the Retiree Medical summary.

Dental And Vision

• Coverage for your family members will terminate at the end of the month of your death.

• Your spouse and dependents may elect and pay for COBRA continuation coverage if they were covered at the time of your death. Your domestic partner may elect and pay for continuation coverage if he or she was covered at the time of your death. If your family members affirmatively elect continuation coverage, Travelers will pay the continuation premiums for the first six (6) months following your death. After the first six (6) months, your family members must pay their own premiums in order to be eligible for continuation coverage.

• Your family members must request continuation coverage within 60 days after the date of your death or within 60 days after the date they receive the notice of their right to continuation coverage, whichever is later. See the COBRA summary for more information.

Employee Life/AD&D Insurance

• Your beneficiary(ies) will receive a benefit based on the coverage you selected.

Dependent Life/Spouse AD&D Coverage

• Life coverage terminates at the end of the month of your death.

• Life coverage may be converted to an individual policy within 31 days of the termination of coverage. If notice of the option to convert is given more than 15 days after the termination of coverage, coverage may be converted within 15 days of the notice. However, coverage must be converted at the latest within 91 days of the termination of coverage. AD&D coverage cannot be converted.

Disability

• Your coverage terminates for all plans.

Paid Time Off (PTO)

• Your estate receives payment for any unused awarded regular and/or unused purchased PTO time.

Spending Accounts


• Coverage ends on the date of your death.

If You Die While Employed (continued)


• Your family members may discontinue contributions or continue contributions for the remainder of the year on an after-tax basis through COBRA.

• Your family members must request COBRA within 60 days after the date of death or within 60 days after the date they receive the notice of their right to continue spending account coverage, whichever is later. See the COBRA summary for more information.

• Your family members may continue to submit claims against your account balance for eligible expenses incurred while you or your family members were contributing to the account. The deadline for incurring and submitting claims is December 31st of the calendar year in which your death occurred.

• If your family members elected to continue coverage via COBRA and make post tax contributions to your account through the end of the calendar year, they may continue to incur and submit claims for eligible expenses through the grace period.


• Your contributions stop.

• Reimbursements for dependent care are limited to eligible expenses incurred during the calendar year in which your death occurred. Claims must be submitted by December 31st of the calendar year in which your death occurred.


• Your coverage under the HSA plan option and your HSA payroll contributions will end on the day of your death. However, this does not terminate your HSA with the HSA custodian.

• Your designated beneficiary can contact Fidelity for account information. www.fidelity.com or 1-800-544-3716.


• You will receive a match based on your contributions in the year of your death. Company matching contributions are generally credited to your account in the January or February following the calendar year of your death.

• You become 100% vested in your 401(k) Savings Plan accounts.

• Your outstanding loan balance, if any, becomes taxable income to your estate unless your beneficiary chooses to repay the loan.

• If your account balance is $5,000 or less, your designated beneficiary receives your account balance in a lump sum.

• If your account balance is more than $5,000, your designated beneficiary may elect to take an immediate distribution or to defer payment to no later than the end of the year following the year of death, unless your beneficiary timely requests an extension. See the 401(k) Savings Plan summary for more information.

• If you have not designated a beneficiary before your death, or if your designated beneficiary dies before you, the survivor benefit is payable to your spouse or domestic partner. If you do not have a spouse or domestic partner, or your spouse or domestic partner does not survive you, your benefits will be paid to your estate. Please see the 401(k) Savings Plan summary for definitions of spouse and domestic partner.

• If your beneficiary is your spouse, he or she can roll the payment over to an IRA or to an eligible employer plan.

• If your beneficiary is not your spouse, he or she can roll the payment over to an inherited IRA. (An estate beneficiary is not eligible to make such a rollover.) Important deadlines apply. See the 401(k) Savings Plan summary for more information.

If You Die While Employed (continued)



• Your vested cash balance accounts (if any) will be distributed to your designated beneficiary.

• If you have not designated a beneficiary before your death, or if your designated beneficiary dies before you, your vested cash balance account is payable to your spouse or domestic partner. If you do not have a spouse or domestic partner, or your spouse or domestic partner does not survive you, your benefits will be paid to your estate. Please see the Pension summary for definitions of spouse and domestic partner.

• Distributions are payable as soon as practicable following your death. If you have a spouse, he or she must have consented to the designation of another beneficiary. Distributions of your vested cash balance account to your spouse, if more than $5,000, are generally available to commence at any time after your death and prior to the date you would have reached age 65. If you were over age 65 at your death, distributions to your spouse will commence as soon as practicable following your death.

• A standard set of payment options are available. However, if the benefit is $5,000 or less, it will be paid as soon as practicable in a lump sum.

• If your beneficiary is your spouse, he or she can roll the payment over to an IRA or to an eligible employer plan.

• If your beneficiary is not your spouse, he or she can roll the payment over to an inherited IRA. (An estate beneficiary is not eligible to make such a rollover.) Important deadlines apply. See the Pension summary for more information.

• For death benefit rules under a grandfathered traditional or cash balance pension formula see the Pension Appendices summary.


• Coverage for your family members continues for six (6) months.

Legal Services Plan

• Coverage for your family members continues until the end of the calendar year of your death at no charge.

Excess Liability

• Your coverage will end on the date of your death. Contact Kathryn Riffle at [email protected] or 516-823-3131 for individual continuation options.

• Surviving Spouses are not eligible to continue coverage under the Travelers plan.

Survivor Support

• Your surviving spouse or domestic partner or other survivor may want to take advantage of the Survivor Support financial planning benefit through Ayco. A Survivor Support representative will contact your survivor to describe the program, which is paid by Travelers. See the Other Benefits summary for more information.


IF YOU RETIRE*

* Retirement generally means a termination of employment after (1) you have attained age 55 and completed at least 10 years of service (as defined under the Travelers Pension Plan), (2) you have attained age 62 and completed at least one (1) year of service, or (3) you have attained age 65.

Medical At retirement, you will be in one (1) of these categories:

• Special retiree medical plan participants – in general, these participants receive continued access to medical coverage with Travelers, and receive a company contribution towards such coverage. Some may also be eligible for continued access to group dental coverage. If you fail to pay your premiums within 60 days of the date you are billed, your coverage will be terminated effective as of the last day of the last period for which you paid your premiums.

• Access-only participants – in general, these participants receive continued access to medical coverage with Travelers, but must pay the full cost of such coverage. If you fail to pay your premiums within 60 days of the date you are billed, your coverage will be terminated effective as of the last day of the last period for which you paid your premiums.

• Non-access participants – in general, medical coverage for these participants ends at the end of the month in which they retire. If you are in this group and you are eligible, you will be offered COBRA continuation coverage. See the COBRA summary for more information.

See the Retiree Medical summary for details of eligibility and benefits for each category. Travelers reserves the right to modify, suspend or terminate the Medical plan and the Retiree Medical plan, in whole or in part, at any time and for any reason, even for retirees. The benefits provided by the plan and/or any component plan are not “vested” benefits. Travelers does not promise the continuation of any benefit nor does it promise any specific level of benefits, or cost for such benefits, at or during retirement.

Dental And Vision

• Coverage ends at the end of the month in which you retire.

• Special retiree medical plan participants may be eligible for continued access to group dental coverage.

• If eligible, you and your family members will be offered COBRA continuation coverage if covered at the time of your retirement. You and your family members must request continuation coverage within 60 days after your retirement date or within 60 days after the date you receive the notice of your right to continuation coverage, whichever is later. See the COBRA summary for more information.


• Your Basic Life/AD&D coverage terminates at the end of the month in which you retire.

• See the Retiree Life Addendum to the Life and AD&D summary for details of eligibility, coverage options and costs. Travelers reserves the right to modify, suspend or terminate the Life plan in whole or in part, at any time and for any reason, even for retirees. The benefits provided by the plan and/or any component plan are not “vested” benefits. Travelers does not promise the continuation of any benefit nor does it promise any specific level of benefits, or cost for such benefits, at or during retirement.

• You may convert your Basic Life and/or Optional Life coverage (no AD&D) to an individual policy within 31 days of the termination of coverage. If you are given notice of your option to convert more than 15 days after the termination of coverage, you may convert to an individual policy within 15 days of the date of the notice. However, the latest you can convert is within 91 days of the termination of coverage.

• You may port your Optional Life/AD&D coverage to another group term policy within 31 days of the termination of coverage. If you are given notice of your option to port more than 15 but within 90 days after the termination of coverage, you may port to another group term policy within 45 days of the date of the notice.

If You Retire* (continued)



• If you are a Minnesota resident, you may continue your Basic Life/AD&D coverage in the Travelers plan until you obtain other group life insurance coverage or for 18 months, whichever occurs first. You pay the full cost for this continued coverage. Travelers will notify you of your Minnesota life insurance continuation coverage rights within two weeks of the termination of your employment. You must elect and remit your initial premium for continued coverage within 60 days of the date your coverage terminates or the day you receive notification of your right to continue coverage, whichever is later. When this continued coverage ends, you may be eligible to convert your Basic Life coverage (no AD&D) to an individual policy.

Dependent Life/Spouse AD&D Insurance

• See the Retiree Life Addendum to the Life and AD&D summary for details of eligibility, coverage options and cost. Travelers reserves the right to modify, suspend or terminate the Life plan in whole or in part, at any time and for any reason, even for retirees. The benefits provided by the plan and/or any component plan are not “vested” benefits. Travelers does not promise the continuation of any benefit nor does it promise any specific level of benefits, or cost for such benefits, at or during retirement.

• You may convert your Dependent Life coverage (no AD&D) to an individual policy within 31 days of the termination of coverage. If you are given notice of your option to convert more than 15 days after the termination of coverage, you may convert to an individual policy within 15 days of the date of the notice. However, the latest you can convert is within 91 days of the termination of coverage.

• If you are a Minnesota resident, you may continue your Dependent Life/Spouse AD&D coverage in the Travelers plan until you obtain other group life insurance coverage or for 18 months, whichever occurs first. You pay the full cost for this continued coverage. Travelers will notify you of your Minnesota life insurance continuation coverage rights within two weeks of the termination of your employment. You must elect and remit your initial premium for continued coverage within 60 days of the date your coverage terminates or the day you receive notification of your right to continue coverage, whichever is later. When this continued coverage ends, you may be eligible to convert your Dependent Life coverage (no AD&D) to an individual policy.

Disability

• Your coverage terminates for all plans at retirement.

Paid Time Off (PTO)

• You receive payment for any unused awarded regular PTO and/or unused purchased PTO time.

Spending Accounts


• You may discontinue contributions or continue contributions for the remainder of the calendar year on an after-tax basis via COBRA continuation. See the COBRA summary for more information.

• You may continue to submit claims against your account balance for eligible expenses incurred while you were still contributing to the account. The deadline for submitting claims is December 31st of the calendar year in which your retirement occurred.

• If you elect to continue coverage via COBRA and make post tax contributions to your account through the end of the calendar year, you may continue to incur and submit claims for eligible expenses through the grace period.






• You may continue to submit claims against your account balance for eligible expenses incurred while you were contributing to the account. Claims must be submitted by December 31st of the calendar year in which your retirement occurred.


• Your coverage under the HSA plan option and your HSA payroll contributions will end on the day you retire. However, this does not terminate your HSA with the HSA custodian.

• Contact Fidelity for account information www.fidelity.com or 1-800-544-3716.


• Your deferrals to the plan will stop.

• You will receive a company matching contribution for the year in which you retire. Company matching contributions are generally credited to your account in the January or February following the plan year in which you retire.

• If you have an outstanding loan, you may continue to make monthly payments on your loan by arranging with Fidelity to have the payments deducted from your bank account. Your loan will become due and payable in full in the event that you receive a full distribution from your account before your loan is otherwise repaid. If the loan is not repaid, the outstanding loan balance will be defaulted. Regular income taxes are due on the defaulted amount, and a 10% penalty for early distributions may also apply

• If your vested account balance is $1,000 or less, your account will automatically be distributed to you as a lump sum with applicable taxes withheld. If your vested account balance is between $1,000 and $5,000 your benefit will be automatically rolled over to an IRA established in your name as provided in the 401(k) Savings Plan summary.

• If your vested account balance is more than $5,000, you can request a distribution at any time or you can leave your money in the plan. Payments must start by April 1 of the year following the year in which you attain age 70½.

• You automatically become 100% vested in your plan accounts if you retire after reaching age 62, regardless of your years of service.


• You may elect to receive your benefit in a lump sum or in one of several other payment forms. Any election that you make is irrevocable once payments to you begin. If you do not select a payment form and you have a spouse, you will receive a 50% joint and survivor annuity. Otherwise, you will generally receive a life annuity.

• If your vested benefit is $5,000 or less, your benefit will be automatically rolled over to an IRA established in your name as provided in the Pension Plan summary.

• If your vested benefit is more than $5,000, you can request a distribution at any time or you can leave your benefit in the plan. Payments must start by April 1 of the year following the year in which you attain age 70½ (or, if your employment terminates after you attain age 70½, April 1 of the calendar year following your termination of employment).





• Your coverage stops on your retirement date.

Legal Services Plan

• Your coverage stops on your retirement date. Any legal matters in progress will be completed. No new matters may be opened under the plan. Contact ARAG directly at 800.247.4184 for individual continuation options or see the Legal Services Plan summary.

Excess Liability

• Your coverage will end on your retirement date, but you can continue coverage through direct payment to the Signature B&B Companies. Contact Stephanie Albert at [email protected] or 516.872.2300, extension 3131 for individual continuation options. Contact Kathryn Riffle at [email protected] or 516-823-3131”).


IF YOUR EMPLOYMENT TERMINATES


• Your coverage stops at the end of the month in which you terminate employment.

• Your final premium contribution will be deducted from your final paycheck.

• You, your spouse, and your children may elect and pay for COBRA continuation coverage if covered at the time of your termination of employment. Your domestic partner may elect and pay for continuation coverage if covered at the time of your termination of employment.

• If you or your family members want continuation coverage, you or your family member must request it within 60 days after the date of your termination of employment or within 60 days after the date you receive the notice of your right to continuation coverage, whichever is later. See the COBRA summary for more information.




• If you die within 31 days of the termination of your coverage, a life benefit will be paid to your beneficiary(ies).

• You may convert your Basic Life and /or Optional Life coverage (no AD&D) to an individual policy within 31 days of the termination of coverage. If you are given notice of your option to convert more than 15 days after the termination of coverage, you may convert to an individual policy within 15 days of the date of the notice. However, the latest you can convert is within 91 days of the termination of coverage.

• You may port your Optional Life/AD&D coverage to another group term policy within 31 days of the termination of coverage. If you are given notice of your option to port more than 15 but within 90 days after the termination of coverage, you may port to another group term policy within 45 days of the date of the notice.





• Dependent life coverage can be converted to an individual policy within 31 days of the termination of coverage. If you are given notice of your option to convert more than 15 days after the termination of coverage, you may convert to an individual policy within 15 days of the date of the notice. However, the latest you can convert is within 91 days of the termination of coverage.


If Your Employment Terminates (continued)


Disability

• Your coverage ends for both the STD and LTD components on your termination date. However, if you are approved for STD benefits at the time of your termination, your STD benefit ends, but you may be eligible for LTD benefits.

• You may be eligible to convert from a group LTD policy to an individual policy if you have been enrolled in the LTD component for at least 12 consecutive months.

• Application for conversion to an individual policy must be made and received by MetLife within 31 days of your termination date or the application will be rejected.

Paid Time Off (PTO)

• Your unused awarded regular PTO or unused purchased PTO time is added to your final paycheck.

• Regular or purchased PTO time used in excess of that already awarded or purchased may be deducted from your final paycheck.

• If you make an election in the year end PTO Purchase Cash Out system, your election may be removed and included with your final paycheck.

• Any non-approved disability benefits and overpaid wages may be recovered from your unused awarded PTO time.

Spending Accounts


• You may discontinue contributions or continue contributions for the remainder of the calendar year on an after-tax basis via COBRA continuation. See the COBRA summary for more information.

• If you elect to continue contributions via COBRA for the remainder of the plan year, you are eligible to submit expenses incurred for the entire plan year. You will have access to the grace period if you fully fund your account and are enrolled in the plan as a COBRA participant on December 31st.

• If you do not elect COBRA continuation, you may continue to submit claims against your account balance for eligible expenses incurred while you were still contributing to your account. The deadline for submitting claims is December 31st of the plan year in which your employment terminated.



• You may continue to submit claims against your account balance for eligible expenses incurred while you were contributing to the account. The deadline for submitting claims is December 31st of the plan year in which your employment terminated.


• Your coverage under the HSA plan option and your HSA payroll contributions will end on your last day of employment. However, this does not terminate your HSA with the HSA custodian.

• Contact Fidelity for account information at www.fidelity.com or 1-800-544-3716.



If Your Employment Terminates (continued)


• You will not receive a matching contribution unless you terminated employment under a limited set of circumstances (you were employed on the last business day of the year or your employment terminated due to disability, retirement or death).

• You are always 100% vested in your own contributions under the Travelers 401(k) Savings Plan. You are vested in Travelers company matching and special contributions after three (3) years of service. You may be vested in certain predecessor matching contributions based on the vesting schedule in place at the time the contributions were made. Vesting service for matching and special contributions stops at termination.

• If your vested account balance is $1,000 or less, your account will automatically be distributed to you as a lump sum with applicable taxes withheld. If your vested account balance is between $1,000 and $5,000 your benefit will be automatically rolled over to an IRA established in your name as provided in the 401(k) Savings Plan summary.

• If your vested account balance is more than $5,000, you can request a distribution at any time or you can leave your money in the plan. Payments must start by April 1 of the year following the year in which you attain age 70½.

• If you have an outstanding loan, you may continue to make monthly payments on your loan by arranging with Fidelity to have the payments deducted from your bank account. Your loan will become due and payable in full in the event that you receive a full distribution from your account before your loan is otherwise repaid. If the loan is not repaid, the outstanding loan balance will be defaulted. Regular income taxes are due on the defaulted amount, and a 10% penalty for early distributions may also apply.


• You become vested in your pension benefits after three (3) years of service.

• You may elect to receive your benefit in a lump sum or in one of several other payment forms. Any election that you make is irrevocable once payments to you begin. If you do not select a payment form and you have a spouse, you will receive a 50% joint and survivor annuity. Otherwise, you will generally receive a life annuity.

• If your vested benefit is $5,000 or less, your benefit will be automatically rolled over to an IRA established in your name as provided in the Pension Plan summary.

• If your vested benefit is more than $5,000, you can request a distribution at any time or you can leave your benefit in the plan. Payments must start by April 1 of the year following the year in which you attain age 70½ (or, if your employment terminates after you attain age 70½, April 1 of the calendar year following your termination of employment).


• Your coverage stops at termination.

Legal Services Plan

• Your coverage stops at termination. Any legal matters in progress will be completed. No new matters may be opened under the plan. Contact ARAG directly at 800.247.4184 for individual continuation options or see the Legal Services Plan summary.

Excess Liability

• Your coverage will end on the date your employment is terminated.

Special Rule If Employment Terminates Within Eight (8) Days

• If your employment terminates within the first eight (8) calendar days of your initial hire date (or your date of rehire), refer to the individual summaries for Medical, Dental, Vision, Life and AD&D and Disability for special coverage rules.


IF YOU ARE REHIRED AFTER A TERMINATION OF EMPLOYMENT

Medical, Health Savings Account (HSA), Dental, Vision, Employee Life/AD&D, Dependent Life/ Spouse AD&D And Disability Insurance

• If you are rehired in the same year and within 30 days after your termination of employment, your prior elections will be automatically reinstated when you return to work.

• If you are rehired more than 30 days after your termination of employment or in the next calendar year, your prior elections will not be reinstated. However, you will be treated as a new employee upon rehire, so you may make new elections within 31 days of your date of rehire. If you do not make any new elections during this 31-day election period, the same default benefit elections that apply to newly hired employees will be applied to you until and unless you make a new election at a subsequent annual enrollment period (or the occurrence of a Qualified Status Change). Refer to the individual summaries for Medical, Dental, Vision, Life and AD&D and Disability to see if default benefit elections apply to new employees.

Paid Time Off (PTO)

• When you are rehired, your service date may be adjusted. PTO time will be awarded to you based on the PTO schedule using your adjusted Service Date.

• PTO time will be awarded during the year in which you are rehired from the date you return to work. If you are rehired in the same year that you terminated employment, your annual PTO time for that year will be reduced by the amount of PTO time that you previously used or that was paid out at your prior termination of employment.

Purchased PTO

• Your prior purchased PTO election will not be reinstated. However, you may make a new purchased PTO election during the next annual enrollment period.

Spending Accounts

• If you are rehired in the same year and within 30 days after your termination of employment, your prior election will be automatically reinstated when you return to work. Your deductions for the remainder of the year will be recalculated accordingly.

• If you are rehired more than 30 days after your termination of employment or in the next calendar year, your prior election will not be reinstated. Therefore, if you want coverage, you must make a new election within 31 days of your date of rehire. If you elect an amount greater than your prior election (your prior election and new election cannot exceed the plan maximum), only claims incurred after your new election are eligible for reimbursement up to the new election amount. Claims incurred before your new election are subject to the prior coverage election amount.

• If you elect an amount less than your prior election in the same plan year, you may not elect an amount less than:

o The amount of contributions you have already made during the plan year.

o The total expenses that have already been reimbursed by the plan.

o The plan minimum.

If no new election is made during this 31-day election period, you cannot elect coverage until the next annual enrollment period (or the occurrence of a Qualified Status Change).


• You may begin making contributions when you return to work. You will be automatically enrolled in the plan 40 days after your rehire date, unless you either enroll on your own or opt out by contacting Fidelity.

If You Are Rehired After A Termination Of Employment (continued)


• Your prior vesting service will be restored if you previously made 401(k) contributions to the plan. You may be required to provide proof of your prior participation.

• The portion of your account that you forfeited after you terminated employment may be restored if you return to work within five (5) years of your termination of employment and you repay your prior distribution (if any) within five (5) years after your return to work.


• Your prior vesting and credited service will be restored if you return to work within five (5) years after your termination of employment or if your benefits were vested when you terminated employment.

• Refer to the Pension summary for details regarding the formula you will participate in after your rehire and the treatment of the benefit you previously earned under the plan.


• You again become eligible for the EAP.

Legal Services Plan

• You may commence participation in the Legal Services Plan.

• You pay your premiums via your paycheck on an after-tax basis.

Excess Liability

• You may commence participation in the Excess Liability plan, but if you enroll at any time other than during an annual enrollment period, you must complete the Excess Liability Insurance Coverage Election Form and submit it to the address on the form. You will receive an invoice once your completed Excess Liability Insurance Coverage Election Form is received and processed. The payment that will be due will be the monthly rate multiplied by the number of full months remaining in the current calendar year. After this initial payment, payments for subsequent calendar years will automatically be payroll deducted.



IF YOUR EMPLOYMENT STATUS CHANGES (BUT REMAIN BENEFIT ELIGIBLE)

Full-time to part-time (but you remain benefit eligible*) or Part-time (benefit eligible*) to full-time * Benefit eligible for this purpose means that you are regularly scheduled to work at least 20 hours per week (or 50%

of the equivalent full-time schedule if your office’s standard workweek is less than 40 hours)

Medical

• If your hours decrease to part-time and if you are currently enrolled, you may change your medical plan option (BCBS, Choice Plus, etc.). If the Working Spouse Subsidy Reduction applies to you, it will continue, but you may now qualify for the smaller Working Spouse Subsidy Reduction due to the decrease in your income, if you notify Travelers of the change in your income within 31 days of the change in your employment status. The same would be true if your hours do not decrease, but you simply experience a reduction in pay.

• If your hours increase to full-time, you may add coverage or if you are currently enrolled, you may change your medical plan option (BCBS, Choice Plus, etc.). If the Working Spouse Subsidy Reduction applies to you, it will continue, but you now may no longer qualify for the smaller Working Spouse Subsidy Reduction due to the increase in your income; if this is the case, you must notify Travelers of the change in your income within 31 days of the change in your employment status. The same would be true if your hours do not increase, but you simply experience an increase in pay.

If you do not notify Travelers of such change and Travelers determines that solely based on the increase in your pay, you will no longer qualify for the smaller Working Spouse Subsidy Reduction, your payroll deductions will be adjusted automatically to reflect the change in the amount of your premiums.

• In general, you cannot discontinue your coverage or change your coverage level (employee only, employee and spouse, etc.) unless you are enrolled in the Health Plan 200 option. However, if you were in an employment category where you were expected to average at least 30 hours per week and then your employment changes to a category where you are expected to work less than 30 hours per week, but that change doesn’t cause you to lose eligibility for coverage, you may still discontinue your coverage if you represent that you and your family members are enrolling in another plan that provides minimum essential coverage that is effective no later than the first day of the second month following the month that includes the date you have revoked coverage under this plan.

• If you are adding coverage, your coverage will be effective on the date of the employment status change. If your election is received on or before the date of your employment status change, premiums will be deducted on a before-tax basis. If your election is received after the date of your employment status change and within 31 days of your employment status change, premiums will be deducted on an after-tax basis for the period between your employment status change and the date your election is received. (Thereafter, premiums will be deducted on a before-tax basis.)

• Part-time employees are required to pay a greater portion of the total cost of their coverage than full-time employees. Your payroll deductions will be adjusted automatically to reflect the change in the amount of your premiums.

• If you have been covering your spouse or domestic partner who also works at Travelers under your medical coverage because you have the higher annual salary and a change in your employment status or pay causes your spouse or domestic partner to now have a higher annual salary, you must transfer medical coverage to your spouse or domestic partner.

Dental And Vision

• If your hours decrease to part time, you may discontinue coverage or change your coverage level (employee only, employee and spouse, etc.).

Employee Life/AD&D

• No change is allowed.

• Your coverage amount and your premiums will be automatically adjusted to your new salary.

If Your Employment Status Changes (But Remain Benefit Eligible) (continued)




Disability


• Your coverage amount will be automatically adjusted to your new salary. You may be required to begin paying long-term disability premiums (if your new base salary is greater than $50,000).

Paid Time Off (PTO)

• Your regular PTO will increase or decrease on a pro rata basis. For example, if you work 50% of the normal schedule, 50% of the number of regular PTO hours will be awarded to you.

Purchased PTO

• You can continue the election you had in place prior to your change in status; OR

• Waive purchased PTO and receive a cashout of year-to-date unused purchased time.

• If you do not elect to waive your purchased PTO, you will default to the election in place prior to your change in status.

• If your employment status changes, the cost will continue to be based on your pay as of December 31st of the prior year when you initially elected to purchase PTO.

If your employment status changes after the annual enrollment period but by January 1 of the following plan year, you may elect to change your purchased PTO election by contacting the ESU by December 31.

Spending Accounts





• You may increase or decrease your contributions (subject to the plan minimums and maximums) only if the change in hours corresponds to an increase or decrease in eligible dependent care expenses. Also, you may not decrease your contribution to an amount less than what you have contributed to the plan at the time the change is processed.


• You remain eligible.


• Your HSA plan option remains active at Travelers and the HSA custodian. Therefore, your HSA payroll contributions will continue unchanged.

• You may make changes to your contribution amount by submitting the Health Savings Account (HSA) Contribution Change Form.

If Your Employment Status Changes (But Remain Benefit Eligible) (continued)



• Regardless of whether you are a full-time or part-time employee, you generally remain eligible for participation in the Travelers 401(k) Savings Plan if you are an eligible employee of a participating affiliate.


Full-time to part-time**

• The plan will determine the number of hours you worked as of the date of your employment status change; if you were not already participating, you will enter the plan on the January 1 or July 1 following the first year in which you complete 1,000 hours of service.

Part-time** to full-time

• If you had more than one (1) year of continuous service as a part-time employee, you will become eligible on the first day of the month following the date your employment status changed. Otherwise, you will become eligible the first day of the month coincident with or next following the anniversary of your hire date.

** Part-time for this purpose is defined as being scheduled to work less than 40 hours per week, or the full-time equivalent if your office’s standard workweek is less than 40 hours.

Legal Services Plan


Excess Liability

• You remain eligible and may continue your current coverage.

If you have a qualifying event after the annual enrollment period in which you first elect Medical or Dental coverage and/or a Flexible Spending account but before the following plan year begins, you may elect to have coverage become effective on the first day of the following plan year instead of effective the date of the qualifying event.


IF YOUR EMPLOYMENT STATUS CHANGES (AND BENEFIT ELIGIBILITY CHANGES)

Full-time or part-time (benefit eligible*) to part-time (not benefit eligible*) or Part-time (not benefit eligible*) to full-time or part-time (benefit eligible*) * Benefit eligible for this purpose means that you are regularly scheduled to work at least 20 hours per week (or 50%

of the equivalent full-time schedule if your office’s standard workweek is less than 40 hours)

Medical

• If your regularly scheduled hours decrease so that you are no longer benefit eligible, you are no longer eligible to participate. Your coverage ends at the end of the month in which your reduction in hours occurred. You, your spouse and your children may elect and pay for COBRA continuation coverage if you, your spouse and your children were covered at the time of your employment status change. Your domestic partner may elect and pay for continuation coverage if he or she was covered at the time of your employment status change.

• You must request your continuation coverage within 60 days of the date of the qualifying event or within 60 days of the date you receive notice of your right to continuation coverage, whichever is later. See the COBRA summary for more information.

• If your regularly scheduled hours increase so that you become benefit eligible, you may add coverage. If you are adding coverage, your coverage will be effective on the date of the employment status change. If your election is received on or before the date of your employment status change, premiums will be deducted on a before-tax basis. If your election is received after the date of your employment status change and within 31 days of your employment status change, premiums will be deducted on an after-tax basis for the period between your employment status change and the date your election is received. (Thereafter, premiums will be deducted on a before-tax basis.)

• Your new election must be received within 31 days of the date of the employment status change. If you fail to make an election within 31 days and you are benefits eligible, your coverage will default to the High Deductible + HSA Plan with employee only coverage.

Dental And Vision

• If your regularly scheduled hours decrease so that you are no longer benefit eligible, you are no longer eligible to participate. Your coverage ends at the end of the month in which your reduction in hours occurred. You, your spouse and your dependents may elect and pay for COBRA continuation coverage if you, your spouse and your dependents were covered at the time of your employment status change. Your domestic partner may elect and pay for continuation coverage if he or she was covered at the time of your employment status change.

• You must request your continuation coverage within 60 days of the date of the qualifying event or within 60 days of the date you receive notice of your right to continue coverage, whichever is later. See the COBRA summary for more information.

• If your regularly scheduled hours increase so that you become benefit eligible, you may add coverage. If you are adding coverage, your coverage will be effective on the date of the employment status change. If your election is received on or before the date of your employment status change, premiums will be deducted on a before-tax basis. If your election is received after the date of your employment status change and within 31 days of your employment status change, premiums will be deducted on an after-tax basis for the period between your employment status change and the date your election is received. (Thereafter, premiums will be deducted on a before-tax basis.)

• Your new election must be received within 31 days of the date of the qualifying event. If you fail to make an election within 31 days and you are benefits eligible, your coverage will default to “waive.”

If Your Employment Status Changes (And Benefit Eligibility Changes) (continued)


Employee Life/AD&D

If your regularly scheduled hours decrease so that you are no longer benefit eligible, then:

• You will no longer be eligible for the Employee Life/AD&D plan. Your coverage will terminate at the end of the month in which the status change occurred.

• You may convert your Basic Life and/or Optional Life coverage (no AD&D) to an individual policy within 31 days of the termination of coverage. If you are given notice of your option to convert more than 15 days after the termination of coverage, you may convert to an individual policy within 15 days of the date of the notice. However, the latest you can convert is within 91 days of the termination of coverage.

• You may port your Optional Life/AD&D coverage to another group term policy. You must apply for portability within 31 days of the termination of coverage. If you are given notice of your option to port more than 15 but within 90 days after the termination of coverage, you may port to another group term policy within 45 days of the date of the notice.


If your regularly scheduled hours increase so that you become benefit eligible, then:

• You will automatically receive Basic Life/AD&D.

• You may add Optional Life/AD&D coverage. You must submit medical evidence of insurability if you elect coverage exceeding the lesser of four (4) times salary or $2,600,000.

• Your Optional Life/AD&D election must be received within 31 days of the date of the employment status change or your election will default to “waive.”


If your regularly scheduled hours decrease so that you are no longer benefit eligible, then:

• You will no longer be eligible for Dependent Life/Spouse AD&D coverage. Coverage will terminate at the end of the month in which the status change occurred.

• You may elect to convert Dependent Life coverage (no AD&D) to an individual policy within 31 days of the termination of coverage. If you are given notice of your option to convert more than 15 days after the termination of coverage, you may convert to an individual policy within 15 days of the date of the notice. However, the latest you can convert is within 91 days of the termination of coverage.


If your regularly scheduled hours increase so that you become benefit eligible, then:

• You may add Dependent Life/Spouse AD&D coverage for your spouse or domestic partner.



• You must submit medical evidence of insurability if you elect over $40,000 of Dependent Life coverage.

• You may add Dependent Life coverage for your child(ren) without submitting any evidence of insurability.

Disability

• If your regularly scheduled hours decrease so that you are no longer benefit eligible, you will no longer be eligible for STD or LTD coverage. You may be able to convert your LTD coverage within 31 days of your loss of eligibility.

• If your regularly scheduled hours increase so that you become benefit eligible, you will be automatically enrolled in the STD component of the plan. In addition, you will be eligible for LTD coverage. If your new base salary is $50,000 or less, you will automatically receive LTD coverage. If your new base salary is more than $50,000, you must decide whether to enroll. Your new election for LTD coverage must be received within 31 days of the date of the employment status change or you will default to “60% LTD coverage.”

Paid Time Off (PTO)

• If your regularly scheduled hours decrease so that you are no longer benefit eligible, PTO is no longer awarded to you and you will receive a cashout of year-to-date awarded regular PTO and purchased PTO time in excess of the time you already used.

• If your regularly scheduled hours increase so that you become benefit eligible, you will be eligible for regular PTO (prorated). For example, if you work 50% of the normal schedule, 50% of PTO time will be awarded to you. You will be able to elect purchased PTO time based on your scheduled hours and salary at the next annual enrollment period.

Purchased PTO

Benefit Eligible to Not Benefit Eligible

• Your purchased PTO ends.

• Any unused purchased PTO will be paid to you in the next available paycheck.

Not Benefit Eligible to Benefit Eligible

• You can enroll in purchased PTO in the next annual enrollment period.

• If your employment status changes after the annual enrollment period but before January 1 of the following plan year, you may elect purchased PTO by contacting the ESU by December 31.

Spending Accounts


• If your regularly scheduled hours decrease so that you are no longer benefit eligible, you are no longer eligible to contribute to your Health Care Spending Account on a before-tax basis.

• You may continue contributions for the remainder of the year on an after-tax basis via COBRA continuation. If you elect to continue coverage via COBRA and make post tax contributions to your account through the end of the calendar year, you may continue to submit claims for eligible expenses through the grace period.

• If you do not elect to continue coverage via COBRA, you may submit claims against your account balance for eligible expenses incurred while you were contributing to your account. The deadline for submitting claims is December 31st.

• If your regularly scheduled hours increase so that you become benefit eligible, you may elect to make contributions on a before-tax basis. Your election must be received within 31 days of the employment status change or you will default to electing no contributions.




• If your regularly scheduled hours decrease so that you are no longer benefit eligible, your contributions stop.

• You may continue to submit claims against your account balance for eligible expenses incurred while you were contributing to the account. The deadline for submitting claims is December 31st.

• If your regularly scheduled hours increase so that you become benefit eligible, you may elect to make contributions.


If your regularly scheduled hours decrease so that you are no longer benefit eligible, your HSA payroll contributions will end. Contact Fidelity with regard to your HSA account balance.

If your regularly scheduled hours increase so that you become benefit eligible, you may begin contributions to the HSA if you enroll in the High Deductible + HSA medical plan option.




• Regardless of whether you are a full-time or part-time employee, you generally are immediately eligible for participation in the Travelers 401(k) Savings Plan if you are an eligible employee of Travelers or a participating affiliate.


Full-time to part-time**

• The plan will determine the number of hours you worked as of the date of your employment status change; if you were not already participating, you will enter the plan on the January 1 or July 1 following the first year in which you complete 1,000 hours of service.

Part-time** to full-time

• If you had more than one (1) year of continuous service as a part-time employee, you will become eligible on the first day of the month following the date your employment status changed. Otherwise, you will become eligible the first day of the month coincident with or next following the anniversary of your hire date.

** Part-time for this purpose is defined as being scheduled to work less than 40 hours per week, or the full-time equivalent if your office’s standard workweek is less than 40 hours.

Legal Services Plan

• If your regularly scheduled hours decrease so that you are no longer benefit eligible, you will no longer be eligible for the Legal Services Plan and your coverage ends on the date your status changes. Any legal matters in progress will be completed. No new matters may be opened under the plan. Contact ARAG directly at 800.247.4184 for individual continuation options or see the Legal Services Plan summary.

• If your regularly scheduled hours increase so that you become benefit eligible, you may add the Legal Services Plan.

Excess Liability

• If your regularly scheduled hours decrease so that you are no longer benefit eligible, you will no longer be eligible for Excess Liability coverage.



• Your coverage will end at the end of the period for which you paid the last required premium.




IF YOU MAKE AN INTERCOMPANY TRANSFER TO A NEW U.S. CITY

Medical

• If enrolled in the Blue Cross Blue Shield, United Healthcare Choice Plus, Out of Area or Health Plan 200 option and the options available to you in your new location are different, you may change to any medical option that is available in your new location. In some cases you may change plan options if there is a significant change in network providers or facilities in your new location.

• If enrolled in the High Deductible + HSA Plan option, no change is allowed.

• You may not change the coverage level or add coverage in your new location if you waived coverage in your previous location.

• If you had medical coverage prior to your transfer, you will automatically continue in the plan you had prior to your transfer with the same coverage level (e.g., employee only, employee + spouse) you had prior to your transfer. If you wish to enroll in any options that are newly available to you in your new location, you must do so within 31 days of your transfer date.

• If you make a timely election to change your medical option, the change will be effective on the date of your transfer.

Dental, Vision, Employee Life/AD&D Insurance, Dependent Life/Spouse AD&D Coverage, Disability, Spending Accounts, Legal Services Plan And Excess Liability




• You may make a change to your HSA contribution amount by submitting the Health Savings Account (HSA) Contribution Change Form.

Paid Time Off (PTO)

• If you transfer to or from a state with a different carryover schedule for PTO, you will be awarded PTO based on the new state’s rules on the first of the month following your transfer. If your transfer is effective the first of the month, the change in awarded PTO will be effective on your transfer date.

• If you make an intercompany transfer out of California, Montana, or Nebraska and your PTO carryover exceeds the amount permitted to be carried over in your new location, your carryover PTO in excess of 40 hours, less what you have used in the calendar year of the transfer, will be paid to you. Any PTO time awarded in the current year will be unchanged.



IF YOU MAKE AN INTERCOMPANY TRANSFER FROM A U.S. OFFICE TO AN OFFICE IN ANOTHER COUNTRY

This section applies only if you are an “expatriate,” which means that you are a citizen of the United States who is transferred to a position where you are working outside of the United States.

Medical

• If you are currently enrolled, you may change your medical plan option to the BCBS World Wide Plan or UnitedHealthcare Out of Area Plan or discontinue your coverage.

• You may not change the coverage level or add coverage in your new location if you waived coverage in your previous location (unless you are otherwise losing group coverage or experiencing a separate Qualified Status Change event that would allow you to add coverage).

• If you had medical coverage prior to your transfer and you do not make any changes within 31 days of your transfer date, you will automatically continue in the plan you had prior to your transfer with the same coverage level (e.g., employee only, employee + spouse) you had prior to your transfer.


• The Working Spouse Subsidy Reduction will no longer apply.

Dental And Vision

• If you are currently enrolled, you may discontinue your coverage.

• You may not change the coverage level or add coverage in your new location if you waived coverage in your previous location (unless you are otherwise losing group coverage or experiencing a separate Qualified Status Change event that would allow you to add coverage).

• If you had dental or vision coverage prior to your transfer and you do not make any changes within 31 days of your transfer date, you will automatically continue in the plan you had prior to your transfer with the same coverage level (e.g., employee only, employee + spouse) you had prior to your transfer.

Legal Services Plan

• If you are currently enrolled, you may discontinue coverage. Note that the benefits you receive outside the United States are treated as if you are using an out-of-network attorney. For additional information on out-of-network coverage, refer to the Legal Services Plan summary or call ARAG at 800.247.4184.

• You may not add coverage in your new location if you waived coverage in your previous location (unless you are experiencing a separate Qualified Status Change event that would allow you to add coverage).

• If you had legal services coverage prior to your transfer and you do not make any changes within 31 days of your transfer date, you will automatically continue in the plan.

Excess Liability


Employee Life/AD&D Insurance, Dependent Life/Spouse AD&D Coverage, Disability, Spending Accounts And Paid Time Off (PTO)


If You Make An Intercompany Transfer From A U.S. Office To An Office In Another Country (continued)



• Your coverage under the HSA plan option and your HSA payroll contributions will end on the day you transfer to another country. However, this does not terminate your HSA with the HSA custodian.

• Contact Fidelity for account information at www.fidelity.com or 1-800-544-3716.


• You remain eligible, but you will be eligible for the benefits provided to employees in your new country of residence. Contact Harris, Rothenberg International LLC in your new country of residence for more information.


• Regardless of your location, you generally remain eligible for participation in the Travelers 401(k) Savings Plan if you are an eligible employee of a participating affiliate.

• As long as you are employed by an affiliate of Travelers, you will not be entitled to a distribution due to a termination of employment for purposes of the Travelers 401(k) Savings Plan.


• Regardless of your location, you generally remain eligible for participation in the Travelers Pension Plan if you are an eligible employee of a participating affiliate.

• As long as you are employed by an affiliate of Travelers, you will not be entitled to a distribution due to a termination of employment for purposes of the Travelers Pension Plan.



IF YOU MAKE AN INTERCOMPANY TRANSFER FROM AN OFFICE IN ANOTHER COUNTRY BACK TO A U.S. OFFICE

This section applies only if you are an “expatriate,” which means that you are a citizen of the United States who has been transferred to a position where you are working outside of the United States, and you are subsequently transferred back to the United States.

Medical

• If you are currently enrolled, you may change your medical plan option to the BCBS, Choice Plus, or High Deductible + HSA Plan. You may also elect to discontinue your coverage if you are otherwise gaining group coverage (e.g., through a spouse’s employer’s plan) or experiencing a separate Qualified Status Change event that would allow you to drop coverage.

• If you were not previously enrolled in medical coverage, but would like to add coverage upon your transfer back to a U.S. office, you may add coverage upon your transfer back if you are losing group coverage (e.g., through a spouse’s employer’s plan) or experiencing a separate Qualified Status Change event that would allow you to add coverage.

• If you had medical coverage prior to your transfer and you do not make any changes within 31 days of your transfer date, you will automatically continue in the plan you had prior to your transfer with the same coverage level (e.g., employee only, employee + spouse) you had prior to your transfer.


• If you are covering your spouse or domestic partner, the larger Working Spouse Subsidy Reduction will apply unless you designate otherwise.

Dental And Vision

• If you are currently enrolled, you may discontinue your coverage.


• If you had dental or vision coverage prior to your transfer and you do not make any changes within 31 days of your transfer date, you will automatically continue in the plan you had prior to your transfer with the same coverage level (e.g., employee only, employee + spouse) you had prior to your transfer.

Excess Liability


Employee Life/AD&D Insurance, Dependent Life/Spouse AD&D Coverage, Disability, Spending Accounts, Paid Time Off (PTO) And Legal Services Plan



• If you enroll in the High Deductible + HSA medical plan, you may make a contribution election to the HSA.


• You remain eligible, but you will be eligible for the benefits provided to employees in the United States. Contact the EAP at 866.497.0014 for more information.

If You Make An Intercompany Transfer From An Office In Another Country Back To A U.S. Office (continued)



• Regardless of your location, you generally remain eligible for participation in the Travelers 401(k) Savings Plan if you are an eligible employee of a participating affiliate.


• Regardless of your location, you generally remain eligible for participation in the Travelers Pension Plan if you are an eligible employee of a participating affiliate.




IF YOU BECOME AN OFFSITE OFFICE WORKER, OR RETURN FROM AN OFFSITE OFFICE TO A COMPANY OFFICE

Medical

• If enrolled in the Blue Cross Blue Shield, United Healthcare Choice Plus, Out of Area or Health Plan 200 option and the options available to you in your new location are different, you may change to any medical option that is available in your new location.

• If enrolled in the High Deductible + HSA plan option, no change is allowed.


• If you had medical coverage prior to your transfer and you do not enroll in any option available in your new location within 31 days of your transfer date, you will automatically continue in the plan you had prior to your transfer with the same coverage level (e.g., employee only, employee + spouse) you had prior to your transfer.


Dental, Vision, Employee Life/AD&D Insurance, Dependent Life/ Spouse AD&D Coverage, Disability, Spending Accounts, Legal Services Plan And Excess Liability




• You may make changes to your HSA contributions by submitting the Health Savings Account (HSA) Contribution Change Form.

Paid Time Off (PTO)

• If you transfer to or from a state with a different carryover schedule for PTO, you will be awarded PTO based on the new state’s rules on the first of the month following your transfer. If your transfer is effective the first of the month, the change in awarded PTO will be effective on your transfer date.

• If you make an intercompany transfer out of California, Montana, or Nebraska and your PTO carryover exceeds the amount permitted to be carried over in your new location, your carryover PTO in excess of 40 hours, less what you have used in the calendar year of the transfer, will be paid to you.



IF YOU MARRY*

* If you marry, you can use the Life Events application to make your benefit elections. This section discusses your benefits after you marry. If you have a domestic partner, the “If You Enter Into A Domestic Partnership” section discusses your benefits.

Medical

• You may enroll yourself, your spouse and/or newly acquired children, including stepchild(ren) if they meet the definition of child. If you are already in the plan, and you add your spouse and/or eligible children, you can elect to change to any plan option for which you are eligible.

• Coverage begins on the date of your marriage. When you enroll, you must indicate whether your spouse is eligible for active employee group medical coverage from his or her own employer, and if so, whether your combined salaries are more than $60,000, so that the correct Working Spouse Subsidy Reduction amount can be applied.

• If you are eligible for retiree coverage, you may elect coverage for your spouse and children as described in the Retiree Medical summary.

• If your election is received on or before the date of your marriage, premiums will be deducted on a before-tax basis. If your election is received after the date of your marriage and within 31 days of your marriage, premiums will be deducted on an after-tax basis for the period between your marriage date and the date your election is received. (Thereafter, premiums will be deducted on a before-tax basis.)

• You may drop coverage if you will be covered under your spouse’s plan. Your coverage will end on the date of your marriage, unless coverage under your spouse’s plan is not effective immediately.

Dental And Vision

• You may enroll yourself, your spouse and/or newly acquired dependents, including stepchild(ren) if they meet the definition of eligible family member.

• Coverage begins on the date of your marriage.

• If your election is received on or before the date of your marriage, premiums will be deducted on a before-tax basis. If your election is received after the date of your marriage and within 31 days of your marriage, premiums will be deducted on an after-tax basis for the period between your marriage date and the date your election is received. (Thereafter, premiums will be deducted on a before-tax basis.)

• You may drop coverage if you will be covered under your spouse’s plan. Your coverage will end on the date of your marriage, unless coverage under your spouse’s plan is not effective immediately. In this case, call the ESU for more information.


• You may increase or decrease your Employee Optional Life/AD&D coverage. Evidence of insurability will be required for all increases in coverage. Changes will be effective on the later of the date of your marriage or the first of the month following the date evidence of insurability is approved.

• You should consider changing your beneficiary using the Travelers Beneficiary Online application.


• You may add Dependent Life/Spouse AD&D coverage for your spouse. You must submit evidence of insurability if you elect over $40,000 of Spouse Life coverage.

• You may add Dependent Life coverage for your child(ren) without submitting any evidence of insurability.

• Changes will be effective on the later of the date of your marriage or the first of the month following the date evidence of insurability is approved.

If You Marry* (continued)



Disability

• You may elect long-term disability coverage with evidence of insurability or you may drop coverage.

• If you drop coverage, the change will generally be effective the date of your marriage.

• If you drop coverage and later wish to enroll, you must submit evidence of insurability.

Paid Time Off (PTO)


Spending Accounts


• You may begin or increase contributions (up to the plan maximum).

• If you elect an amount greater than your prior election, only claims incurred after your later election are eligible for reimbursement up to the new election amount. Claims incurred before your later election are subject to the coverage election amount in effect prior to your later election.


• You may increase or decrease contributions (subject to plan minimums and maximums) if consistent with a change in eligible dependent care expenses. For instance, if your eligible dependent care expenses increase due to your marriage, you may increase your contributions. If your spouse does not work, you may discontinue contributions. You may not decrease your annual contribution to an amount less than what you have contributed to the plan at the time the change is processed.





• Your spouse will be your beneficiary unless you designate another beneficiary using the online beneficiary tool on Fidelity’s NetBenefits at www.netbenefits.com/Travelers.

• If you designate a beneficiary other than your spouse, he or she must provide written notarized consent to your election.


• Your spouse will be your beneficiary unless you designate another beneficiary using the Travelers Beneficiary Online application.

• If you designate a beneficiary other than your spouse, he or she must waive the preretirement death benefit protection otherwise provided under the plan and provide written notarized consent to your election.

If You Marry* (continued)



• Even if you have designated a beneficiary other than your spouse, pension benefits that commence during your lifetime will be distributed in the form of a qualified joint and survivor annuity unless you elect another form of distribution and your spouse provides a written notarized consent to your election.

• If you are a Legacy St. Paul participant who is retirement eligible and you participate in the Traditional Pension Plan, you may buy up to the 100% preretirement surviving spouse benefit coverage.

Legal Services Plan



• Your election is effective on the date of your marriage.

Excess Liability

You May Elect Excess Liability Coverage

• Your coverage begins on the first day of the month after your acceptance into the program. You will receive an invoice once your completed Excess Liability Insurance Coverage Election Form is received and processed. The payment amount that will be due will be the monthly rate multiplied by the number of full months remaining in the current calendar year. After this initial payment, payments for subsequent calendar years will automatically be payroll deducted.

You May Change Your Excess Liability Coverage Amounts

• Your changes go into effect on the first day of the month after your changes are accepted by the program.

o For a coverage increase, you will receive an invoice once your completed Excess Liability Insurance Coverage Change Form is received and processed. The payment amount that will be due will be the difference in the monthly rate multiplied by the number of full months remaining in the current calendar year. After this initial payment, payments for subsequent calendar years will automatically be payroll deducted at the rate for your new coverage.

o For a coverage reduction, your paycheck deductions will be reduced by the difference of the monthly rates once your completed Excess Liability Insurance Coverage Change Form is received and processed.

You May Cancel Your Excess Liability Coverage


IMPORTANT: Your request for a change in benefit coverage will only be approved if it is consistent with the Qualified Status Change and received by the ESU within 31 days of the event. If you are eligible for retiree coverage, you may elect coverage for your spouse and dependents as described in the Retiree Medical summary.



IF YOU ENTER INTO A DOMESTIC PARTNERSHIP*

* You can make the changes described in this section only within 31 days of first meeting the criteria for your domestic partner to be covered under Travelers plans. You must also file a Domestic Partner Affidavit and Agreement in a form acceptable to Travelers within the 31-day period.

Medical

• You may enroll yourself, your domestic partner and/or newly acquired children if they meet the definition of child. If you are already in the plan, and you add your domestic partner and/or eligible child(ren), you can elect to change to any plan option for which you are eligible.

• Coverage begins on the date your domestic partner first becomes eligible. When you enroll, you must indicate whether your domestic partner is eligible for active employee group medical coverage from his or her own employer, and if so, whether your combined salaries are more than $60,000, so that the correct Working Spouse Subsidy Reduction amount can be applied.

• If you are eligible for retiree coverage, you may elect coverage for your domestic partner and children as described in the Retiree Medical summary.

• If your domestic partner is also your tax dependent, you must complete a Certification of Domestic Partner Tax Status for premiums for your domestic partner’s coverage to be deducted on a before-tax basis. If your election is received at the same time as your Domestic Partner Affidavit and Agreement and your Certification of Domestic Partner Tax Status, premiums will be deducted on a before-tax basis. If your election and your Certification of Domestic Partner Tax Status is received after the date of filing your Domestic Partner Affidavit and Agreement and within 31 days of filing your Domestic Partner Affidavit and Agreement, premiums will be deducted on an after-tax basis for the period between your filing the Domestic Partner Affidavit and Agreement and the date your election and your Certification of Domestic Partner Tax Status is received. Thereafter, premiums will be deducted on a before-tax basis.

• If your domestic partner is not your tax dependent or a Certification of Domestic Partner Tax Status is not received, premiums for your domestic partner will be deducted on an after-tax basis. You will also be taxed on the value of coverage provided by Travelers for your domestic partner.

• You may drop coverage if you will be covered under your domestic partner’s plan. Your coverage will generally end on the date you become covered under your domestic partner’s plan.

Dental And Vision

• You may enroll yourself, your domestic partner and/or newly acquired dependents, if they meet the definition of eligible family member.

• Coverage begins on the date your domestic partner first becomes eligible.

• If your domestic partner is also your tax dependent, you must complete a Certification of Domestic Partner Tax Status for premiums for your domestic partner’s coverage to be deducted on a before-tax basis. If your election is received at the same time as your Domestic Partner Affidavit and Agreement and your Certification of Domestic Partner Tax Status, premiums will be deducted on a before-tax basis. If your election and your Certification of Domestic Partner Tax Status is received after the date of filing your Domestic Partner Affidavit and Agreement and within 31 days of filing your Domestic Partner Affidavit and Agreement, premiums will be deducted on an after-tax basis for the period between your filing the Domestic Partner Affidavit and Agreement and the date your election and your Certification of Domestic Partner Tax Status is received. Thereafter, premiums will be deducted on a before-tax basis.

• If your domestic partner is not your tax dependent or a Certification of Domestic Partner Tax Status is not received, premiums for your domestic partner will be deducted on an after-tax basis. You will also be taxed on the value of coverage provided by Travelers for your domestic partner.

• You may drop coverage if you will be covered under your domestic partner’s plan. Your coverage will generally end on the date you become covered under your domestic partner’s plan. In this case, contact the ESU for more information.

If You Enter Into A Domestic Partnership* (continued)




• You may increase or decrease Employee Optional Life/AD&D coverage. Evidence of insurability will be required for all increases in coverage. Changes will be effective on the later of the date your domestic partner first becomes eligible or the first of the month following the date evidence of insurability is approved.



• You may add Dependent Life/Spouse AD&D coverage for your domestic partner. You must submit evidence of insurability if you elect over $40,000 of Spouse Life coverage.

• You may add Dependent Life coverage for your child(ren) and your domestic partner’s child(ren) without submitting any evidence of insurability.

• Changes will be effective on the later of the date your domestic partner first becomes eligible or the first of the month following the date evidence of insurability is approved.

Disability


• If you drop coverage, the change will generally be effective the date your Domestic Partner first becomes eligible.


Paid Time Off (PTO)


Spending Accounts

If your domestic partner is not your tax dependent, no change is allowed.

If your domestic partner is your tax dependent and you have completed a Certification of Domestic Partner Tax Status the following changes are allowed:


• You may begin or increase contributions (up to the plan maximum).



• You may increase or decrease contributions (subject to plan minimums and maximums) if consistent with a change in eligible dependent care expenses. For instance, if your eligible dependent care expenses increase due to the addition of your domestic partner’s child to your family, you may increase your contributions. You may not decrease your annual contribution to an amount less than what you have contributed to the plan at the time the change is processed.








• If you do not have a beneficiary designation on file, your domestic partner will be your beneficiary unless you designate another beneficiary using the online beneficiary tool on Fidelity’s NetBenefits at www.netbenefits.com/Travelers.

• You can name any beneficiary without your domestic partner’s consent.


• If you do not have a beneficiary designation on file, your domestic partner will be your beneficiary unless you designate another beneficiary using the Travelers Beneficiary Online application.

• You can name any beneficiary without your domestic partner’s consent.

• Pension benefits that commence during your lifetime will be distributed in the form of a life annuity unless you elect another form of distribution.

• If you are a Legacy St. Paul participant who is retirement eligible and you participate in the Traditional Pension Plan, you may buy up to the 100% preretirement surviving domestic partner benefit coverage.

Legal Services Plan



• Your election is effective on the date your domestic partner first becomes eligible.

Excess Liability


• Your coverage begins on the first day of the month after your acceptance into the program. You will receive an invoice once your completed Excess Liability Insurance Coverage Election Form is received and processed. The payment amount that will be due will be the monthly rate multiplied by the number of full months remaining in the current calendar year. After this initial payment, payments for subsequent calendar years will automatically be payroll deducted.



o For a coverage increase, you will receive an invoice once your completed Excess Liability Insurance Coverage Change Form is received and processed. The payment amount that will be due will be the




difference in the monthly rate multiplied by the number of full months remaining in the current calendar year. After this initial payment, payments for subsequent calendar years will automatically be payroll deducted at the rate for your new coverage.







IF YOU DIVORCE, LEGALLY SEPARATE OR FILE A TERMINATION OF DOMESTIC PARTNERSHIP

Medical

• You must stop coverage for your spouse or domestic partner; you must stop coverage for your child(ren) if they no longer meet the definition of a child. Coverage terminates at the end of the month in which the event occurs. Premiums are deducted through the end of the month.

• Your request to change coverage must be received within 31 days of the event. If you notify the ESU more than 31 days after the event, your spouse or domestic partner and/or child coverage will be terminated effective at the end of the month in which the event occurred and premiums will not be refunded.

• Your spouse or domestic partner and any children who have lost coverage may elect and pay for COBRA continuation coverage (including continuation coverage for a domestic partner) if covered at the time of the event. See the COBRA summary for more information.

• You, your spouse or domestic partner, and children must notify the ESU of the event within 60 days of the event or your spouse or domestic partner and/or child(ren) will lose eligibility for continuation coverage. Travelers will consider a failure to notify Travelers when a family member becomes ineligible as an intentional misrepresentation. This may result in a retroactive loss of coverage for the family member that is not a rescission.

• If you lose medical coverage under your spouse’s or domestic partner’s plan you may add coverage for you and/or your child(ren), if your child(ren) meet the definition of child. Coverage under the Travelers plan is effective on the date that you lose coverage under your spouse’s or domestic partner’s plan. If your election is received on or before the date of your loss of coverage, premiums will be deducted on a before-tax basis. If your election is received after the date of your loss of coverage and within 31 days of your loss of coverage, premiums will be deducted on an after-tax basis for the period between your loss of coverage date and the date your election is received. (Thereafter, premiums will be deducted on a before-tax basis.) If you are already in the plan, and you add your child(ren), you can elect to change to any plan option for which you are eligible.

• If you are in the High Deductible Plan, you can change to the Blue Cross Blue Shield, United Healthcare Choice Plus or Out of Area Plan (based on your home address).

Dental And Vision

• You must stop coverage for your spouse or domestic partner; you must stop coverage for your child(ren) if they no longer meet the dependent definition of a child. Coverage terminates at the end of the month in which the event occurs. Premiums are deducted through the end of the month.

• Your request to change coverage must be received within 31 days of the event. If you notify the ESU more than 31 days after the event, your spouse or domestic partner and/or dependent coverage will be terminated effective at the end of the month in which the event occurred and premiums will not be refunded.

• Your spouse or domestic partner and any dependents who have lost coverage may elect and pay for COBRA continuation coverage (including continuation coverage for a domestic partner) if covered at the time of the event. See the COBRA summary for more information.

• You or your spouse or domestic partner and dependents must notify the ESU of the event within 60 days of the event or your spouse or domestic partner and/or nondependent child(ren) will lose eligibility for continuation coverage. Travelers will consider a failure to notify Travelers when a family member becomes ineligible as an intentional misrepresentation. This may result in a retroactive loss of coverage for the family member that is not a rescission.

• If you lose dental coverage under your spouse’s or domestic partner’s plan you may add coverage for you and/or your child(ren), if your child(ren) remain your dependents. Coverage under the Travelers plan is effective on the date that you lose coverage under your spouse’s or domestic partner’s plan. If your election is received on or before the date of your loss of coverage, premiums will be deducted on a before-tax basis. If your election is received after the date of your loss of coverage and within 31 days of your loss of coverage, premiums will be deducted on an after-tax basis for

If You Divorce, Legally Separate Or File A Termination Of Domestic Partnership (continued)


the period between your loss of coverage date and the date your election is received. (Thereafter, premiums will be deducted on a before-tax basis.)


• You may increase or decrease Employee Optional Life/AD&D coverage. Evidence of insurability is required for all increases in coverage.

• Changes in coverage will be effective on the later of the end of the month in which the event occurs or the first of the month following the date evidence of insurability is approved.



• You must stop coverage for your spouse or domestic partner; you must stop coverage for your child(ren) if they no longer meet the definition of a child. Coverage terminates the end of the month in which the event occurs. Premiums are deducted through the end of the month.

• Your request to change coverage must be received within 31 days of the event. If you notify the ESU more than 31 days after the event, coverage will still be terminated effective at the end of the month in which the event occurred, but any premiums paid after that date will not be refunded.

• You may elect coverage for your child(ren) if they lose coverage under your spouse’s or domestic partner’s plan. Evidence of insurability is required. Coverage will be effective on the first of the month after evidence of insurability is approved.

Disability

• You may elect long-term disability coverage with evidence of insurability or you may drop coverage. If you drop coverage, that will be effective on the date of the event.

Paid Time Off (PTO)


Spending Accounts


• You may begin, increase or decrease contributions (subject to plan minimums and maximums) if consistent with the event.


• If you elect to decrease your annual contribution, you may not decrease it to an amount less than what you have contributed to the plan or claims paid at the time the change is processed.


• You may begin, increase or decrease contributions (subject to plan minimums and maximums) if consistent with a change in eligible dependent care expenses.

• If you elect to decrease your annual contribution, you may not decrease it to an amount less than what you have contributed to the plan at the time the change is processed.



• Reimbursements for dependent care are limited to eligible expenses incurred while you are actively working, seeking employment or attending school on a full-time basis.





• You should consider changing your beneficiary designation using the online beneficiary tool on Fidelity’s NetBenefits at www.netbenefits.com/Travelers.

• If you change your beneficiary designation before your divorce is final, your spouse must consent to your beneficiary designation.*

• All or a portion of your benefits may be assigned to your former spouse (but not your former domestic partner) through a Qualified Domestic Relations Order (QDRO). To request procedures or model language, contact QDRO Consultants Co. at 800.527.8481.



• If you change your beneficiary designation before your divorce is final, your spouse must consent to your beneficiary designation.*

• All or a portion of your benefit may be assigned to your former spouse (but not your former domestic partner) through a Qualified Domestic Relations Order. To request procedures or model language, contact QDRO Consultants Co. at 800.527.8481.

*If you designated your spouse or domestic partner as beneficiary by relationship to you (“John Smith, my husband”), your former spouse or domestic partner will automatically be removed as your beneficiary upon your divorce or filing of a Termination of Domestic Partnership form. See the 401(k) Savings Plan and the Pension summaries for more information.


• Only you remain eligible to use the EAP in the event of your divorce, legal separation or termination of domestic partnership; your former spouse or domestic partner may not continue to use the program.

Legal Services Plan

• You may commence participation in the Legal Services Plan. You pay your premiums via your paycheck on an after-tax basis.

• You may drop coverage. Coverage terminates at the end of the month in which the event occurs.

Excess Liability


• Your coverage begins on the first day of the month after your acceptance into the program. You will receive an invoice once your completed Excess Liability Insurance Coverage Election Form is received and processed. Payment due will be the monthly rate multiplied by the number of full months remaining in the current calendar year. After this initial payment, payments for following calendar years will automatically be payroll deducted.





o For a coverage increase, you will receive an invoice once your completed Excess Liability Insurance Coverage Change Form is received and processed. The payment amount that will be due will be the difference in the monthly rate multiplied by the number of full months remaining in the current calendar year. After this initial payment, payments for subsequent calendar years will automatically be payroll deducted at the rate for your new coverage.







IF YOU GIVE BIRTH, ADOPT A CHILD, OR GAIN ELIGIBLE FAMILY MEMBERS*

* Employees will be asked to provide documentation supporting legal custody or legal guardianship when adding a sponsored dependent, such as a foster child or a grandchild. Employees who wish to cover only a domestic partner as an eligible family member should refer to the section titled “If You Enter Into A Domestic Partnership” for more details.


• You may enroll yourself, your spouse or domestic partner and/or children and stepchildren. To enroll your domestic partner, you must file a Domestic Partner Affidavit and Agreement in a form acceptable to Travelers. If you cover your domestic partner or his or her children, you pay for their share of the premium on an after-tax basis unless you have certified that your domestic partner qualifies as your dependent for tax purposes on your Certification of Domestic Partner Tax Status form. In certain states, domestic partner coverage is before-tax for state tax purposes. The ESU will notify you if this special treatment applies to you.

• If you are already in the plan and you add your spouse or domestic partner and/or eligible family member(s), you can elect to change to any medical option for which you are eligible.

• Adopted newborn children may be covered at the earliest of documented assumption of legal and financial responsibility for the child by you or leaving the hospital after birth if the child is released into your household under custody.

• All other adopted children may be covered when custody is granted (or, if sooner, when you assume a legal obligation for support of the child in anticipation of adoption).

• If you are adding a spouse or domestic partner, the Working Spouse Subsidy Reduction may apply and you will need to make a designation.






• You may add coverage for your newborn or newly adopted child without submitting evidence of insurability. Coverage will be effective as of the date of birth or date of adoption or placement for adoption.

• You may add or increase coverage for your spouse or domestic partner; you may add coverage for your domestic partner only if you file a Domestic Partner Affidavit and Agreement in a form acceptable to Travelers. You must submit evidence of insurability. Coverage is effective on the first of the month after evidence of insurability is approved.

• You may not increase coverage for your dependents.

• You may not drop or reduce coverage for your dependents, spouse or domestic partner.

Disability

• You may enroll in long-term disability coverage with evidence of insurability.

• You may not drop or waive long-term disability coverage.

If You Give Birth, Adopt A Child, Or Gain Eligible Family Members* (continued)



Paid Time Off (PTO)


Health Care Spending Account & Dependent Care Spending Account

• You may start or increase contributions (subject to plan maximums). If you elect an amount greater than your prior election, only claims incurred after your later election are eligible for reimbursement up to the new election amount. Claims incurred before your later election are subject to the coverage election amount in effect prior to your later election.





• You should consider changing your beneficiary designation by using the online beneficiary tool on Fidelity’s NetBenefits at www.netbenefits.com/Travelers.

• If your spouse is not your sole primary beneficiary, your spouse must provide written notarized consent to your election.



• If your spouse is not your sole primary beneficiary, your spouse must waive the preretirement survivor benefits otherwise provided and give written notarized consent to your election.


• Contact the EAP for parenting and child care information.

Legal Services Plan

• You may commence participation in the Legal Services Plan. To start coverage, you must file a written election within 31 days of the event. Coverage is effective as of the date of birth, date of adoption or date of placement for adoption.


Excess Liability



If You Give Birth, Adopt A Child, Or Gain Eligible Family Members* (continued)





o For a coverage increase, you will receive an invoice once your completed Excess Liability Insurance Coverage Change Form is received and processed. Payment due will be the difference in the monthly rate multiplied by the number of full months remaining in the current calendar year. After this initial payment, payments for following calendar years will automatically be payroll deducted at the rate for your new coverage.

o For coverage reduction, your paycheck deductions will be reduced by the difference of the monthly rates once your completed Excess Liability Insurance Coverage Change Form is received and processed.



IMPORTANT: Your request to add your newborn, newly adopted child or child newly placed for adoption to medical coverage will be approved if it is received by the ESU within 90 days of the date of birth or adoption. Your request for any other change in benefit coverage will be approved only if it is consistent with the Qualified Status Change and received by the ESU within 31 days of the event. If you are on a leave of absence following the birth or adoption of a child, you may have more time to make an election; however, the effective date of that later election would not be the date of birth or adoption. Please review the section of this summary titled “If You Take A Leave of Absence” for more information. If you are eligible for retiree coverage, you may elect coverage for your family members as described in the Retiree Medical summary. If you give birth or adopt a child after the annual enrollment period in which you first elect Medical or Dental coverage and/or a Flexible Spending account but before the following plan year begins, you may elect to have coverage for the newborn or adopted child become effective on the first day of the following plan year instead of effective the date of birth or adoption.

If you give birth (not adoption or other events), you can use the Life Events application.

If you adopt a child (not give birth or other events), you may be eligible to receive reimbursement for eligible adoption expenses incurred on or after January 1, 2016 through the Adoption Assistance program as described in the Other Benefits summary.


IF YOUR COVERED FAMILY MEMBER DIES

Medical

• Your coverage for your deceased spouse, domestic partner; or child will end

• Your request to change coverage must be received within 31 days of the death.

• If you lose medical coverage under your spouse’s or domestic partner’s plan you may add coverage for you and/or your child(ren), if your child(ren) meet the definition of child. Coverage under the Travelers plan is effective on the date that you lose coverage under your spouse’s or domestic partner’s plan. If your election is received on or before the date of your loss of coverage, premiums will be deducted on a before-tax basis. If your election is received after the date of your loss of coverage and within 31 days of your loss of coverage, premiums will be deducted on an after-tax basis for the period between your loss of coverage date and the date your election is received. (Thereafter, premiums will be deducted on a before-tax basis.)

• If you are already in the plan, and you add your child(ren), you can elect to change to any plan option for which you are eligible.

• If you are in the High Deductible + HSA Plan, you can change to the Blue Cross Blue Shield, United Healthcare Choice Plus or Out of Area Plan (based on your home address).

Dental And Vision

• Your coverage for your deceased spouse, domestic partner; or child will end.

• Your request to change coverage must be received within 31 days of the death.

• If you lose dental or vision coverage under your spouse’s or domestic partner’s plan you may add coverage for you and/or your child(ren), if your child(ren) remain your dependents. Coverage under the Travelers plan is effective on the date that you lose coverage under your spouse’s or domestic partner’s plan. If your election is received on or before the date of your loss of coverage, premiums will be deducted on a before-tax basis. If your election is received after the date of your loss of coverage and within 31 days of your loss of coverage, premiums will be deducted on an after-tax basis for the period between your loss of coverage date and the date your election is received. (Thereafter, premiums will be deducted on a before-tax basis.)






• Coverage for your deceased spouse or domestic partner or child will end. You should contact the ESU to start the claim process.

• Your request to change coverage must be received within 31 days of the event.

• You may elect coverage for your child(ren) if they lose coverage under your spouse’s or domestic partner’s plan. Evidence of insurability is required. Coverage will be effective on the first of the month after evidence of insurability is approved.

If Your Covered Family Member Dies (continued)


Disability


• If you drop coverage, that will be effective on the date of the event.


Paid Time Off (PTO)


Spending Accounts


• You may begin, increase or decrease contributions (subject to plan minimums and maximums) if consistent with the event.


• If you elect to decrease your annual contribution, you may not decrease it to an amount less than the amount you have contributed to the plan or the amount of claims paid at the time the change is processed.


• You may increase or decrease contributions (subject to plan minimums and maximums) if consistent with a change in eligible dependent care expenses.

• If you elect to decrease your annual contribution, you may not decrease it to an amount less than what you have contributed to the plan at the time the change is processed.

• Reimbursements for dependent care are limited to eligible expenses incurred while you are actively working, seeking employment or attending school on a full-time basis.





• You should consider changing your beneficiary designation using the online beneficiary tool on Fidelity’s NetBenefits at www.netbenefits.com/Travelers.


• You should consider changing your beneficiary designation using the Travelers Beneficiary Online application.



If Your Covered Family Member Dies (continued)


Legal Services Plan

• You may commence participation in the Legal Services Plan. You pay your premiums via your paycheck on an after-tax basis.

• You may drop coverage. If you drop coverage, your coverage terminates at the end of the month in which the event occurs.

Excess Liability









Survivor Support

• You may want to take advantage of the Survivor Support financial planning benefit through Ayco. A Survivor Support representative will contact you to describe the program, which is paid by Travelers. See the Other Benefits summary for more information.




IF YOUR COVERED FAMILY MEMBER IS NO LONGER ELIGIBLE FOR TRAVELERS COVERAGE


• Coverage for your ineligible family member(s) terminates at the end of the month the event occurs.

• You must notify the ESU of your family member’s ineligibility for coverage. For premium refund purposes, the notification must occur within 31 days of loss of eligibility. If you notify the ESU more than 31 days after your family member loses eligibility, their coverage will be terminated effective the end of the month they lost eligibility and premiums will not be refunded.

• Your family member(s) may elect and pay for COBRA continuation coverage (if applicable) (including continuation coverage for a domestic partner). See the COBRA summary for more information.

• For COBRA or continuation coverage eligibility purposes, you or your family member must notify the ESU of the loss of eligibility within 60 days after the loss of eligibility or your family member will lose eligibility for COBRA or continuation coverage. Travelers will consider a failure to notify Travelers when a family member becomes ineligible as an intentional misrepresentation. This may result in a retroactive loss of coverage for the family member that is not a rescission.



Dependent Life/Spouse AD&D

• Coverage for family member(s) who are no longer eligible terminates the end of the month in which the event occurs.

• You must notify the ESU of your family member’s ineligibility for coverage. For premium refund purposes, the notification must occur within 31 days of loss of eligibility. If you notify the ESU more than 31 days after your family member loses eligibility, their coverage will be terminated effective the end of the month they lost eligibility and premiums will not be refunded.

• You may elect to convert the Dependent Life amount to an individual policy within 31 days of the loss of coverage. If you are given notice of your option to convert more than 15 days after the termination of coverage, you may convert to an individual policy within 15 days of the date of the notice. However, the latest you can convert is within 91 days of the termination of coverage.

Disability


Paid Time Off (PTO)


Spending Accounts


• You may reduce the amount of contributions to your Health Care Spending Account. You may not reduce it to less than the amount of claims paid or contributions made or an amount less than the plan minimum.


• You may reduce the amount of contributions to your Dependent Care Spending Account. However, you may not reduce it to less than the amount of contributions made or an amount less than the plan minimum.

If Your Covered Family Member Is No Longer Eligible For Travelers Coverage (continued)





Legal Services Plan

• Coverage for family member(s) who are no longer eligible terminates the end of the month in which the event occurs.

Excess Liability




CHANGE IN FAMILY MEMBER’S EMPLOYMENT STATUS*

* If adding coverage through a Travelers plan, additional documentation may be requested to verify the change event as outlined on the Benefit Affidavit (e.g., COBRA notice or HIPAA notice from family member’s employer, etc.) The special rules in this section for domestic partners do not apply to the Spending Accounts.

In this section, “Family Member Loses Employment” refers to any change in employment status or work schedule, such as a demotion, a decrease in hours of employment, or commencement of an unpaid leave of absence or a strike or lockout, which causes you or your family member to lose eligibility for benefits or to pay more for benefits under a plan maintained by your family member’s employer. In this section, “Family Member Gains Employment” refers to any change in employment status or work schedule, such as a promotion, an increase in hours of employment, return from an unpaid leave of absence or a strike or lockout, which causes you or your family member to gain eligibility for benefits under a plan maintained by your family member’s employer. Please note that if you are covering your spouse or domestic partner under the Travelers medical plan but a change in his or her employment status or pay would cause the Working Spouse Subsidy Reduction applicable to you to change, you must notify Travelers of such change (including any change in your combined salaries) within 31 days of the change in employment status or pay of your spouse or domestic partner.


Family Member Loses Employment:

• You may add coverage for you or your family members if you or your family members lose coverage under a plan maintained by your family member’s employer as a result of a change in employment status, work schedule or other IRS-approved event. Coverage under the Travelers plan is effective on the date that you or your family member lose coverage under the other plan. If your election is received on or before the date of your loss of coverage, premiums will be deducted on a before-tax basis. If your election is received after the date of your loss of coverage and within 31 days of your loss of coverage, premiums will be deducted on an after-tax basis for the period between your loss of coverage date and the date your election is received. (Thereafter, premiums will be deducted on a before-tax basis.) If you are already in the plan and you add your eligible family members, you can elect to change to any plan option for which you are eligible.

Family Member Gains Employment:

• You may drop coverage for you or your family members if you or your family members obtain coverage under a plan maintained by your family member’s employer as a result of a change in employment status, work schedule or other IRS-approved event. If you make a timely election, coverage stops on the date the event occurred.



• You may add or increase Employee Optional Life/AD&D coverage by submitting evidence of insurability if you lose similar coverage under a plan maintained by your family member’s employer as a result of a change in employment status, work schedule or other applicable event. Coverage starts the first of the month after evidence of insurability is approved.


• You may drop coverage if you obtain similar coverage under a plan maintained by your family member’s employer as a result of a change in employment status, work schedule or other applicable event. Coverage terminates at the end of the pay period for which you made your last premium contribution.

Change In Family Member’s Employment Status* (continued)





• You may add coverage for your eligible family members by submitting evidence of insurability if your eligible family members lose similar coverage under a plan maintained by your family member’s employer as a result of a change in employment status, work schedule or other applicable event. Coverage starts the first of the month after evidence of insurability is approved.


• You may drop coverage for your eligible family members if you obtain similar coverage under a plan maintained by your family member’s employer as a result of a change in employment status, work schedule or other applicable event. Coverage terminates at the end of the pay period for which you made your last premium contribution.



• You may start or increase the amount of your contributions (subject to plan maximums) to your Health Care Spending Account if your family members lose coverage under a Health Care Spending Account maintained by your family member’s employer due to a loss of eligibility resulting from a change in employment status, work schedule or other IRS-approved event.


• See later in this summary for changes you can make to your Dependent Care Spending Account.






Disability, Paid Time Off (PTO)

Family Member Loses Employment OR Gains Employment:


Change In Family Member’s Employment Status* (continued)



Legal Services Plan


• You may commence participation in the Legal Services Plan. Your coverage will be effective as of the event date.




Excess Liability












CHANGE OR LOSS OF COVERAGE UNDER A PLAN MAINTAINED BY YOUR FAMILY MEMBER’S EMPLOYER*

* The change in coverage under a plan maintained by your family member’s employer must be on account of (i) an annual enrollment period that occurs at a different time than Travelers’ annual enrollment period, (ii) a change in status which permits your family member to elect to change coverage in accordance with applicable cafeteria plan regulations issued by the IRS or (iii) you lose eligibility under your family member’s plan.. If adding coverage through a Travelers plan, additional documentation may be requested to verify the change event as outlined on the Benefit Affidavit (e.g., COBRA notice or HIPAA notice from family member’s employer, loss of eligibility notice from third party provider such as Medicaid, etc.) The special rules in this section regarding Spending Accounts do not apply to domestic partners.


• You may add coverage for you or your family members if you or your family members lose coverage under a plan maintained by your family member’s employer as a result of a change in employment status, work schedule or other IRS-approved event. For example, this includes losing coverage because you turned age 26 and therefore exceeded the maximum age to be eligible as a dependent child under the plan maintained by your parent’s employer. Coverage under the Travelers plan is effective on the date that you or your family member lose coverage under the other plan. If your election is received on or before the date of your loss of coverage, premiums will be deducted on a before-tax basis. If your election is received after the date of your loss of coverage and within 31 days of your loss of coverage, premiums will be deducted on an after-tax basis for the period between your loss of coverage date and the date your election is received. (Thereafter, premiums will be deducted on a before-tax basis.) If you are already in the plan and you add your eligible family members, you can elect to change to any plan option for which you are eligible.

• You may drop coverage for you or your family member if you or your family member obtains coverage under a plan maintained by your family member’s employer as a result of a change in employment status, work schedule or other IRS-approved event. If you make a timely election, coverage stops on the date the event occurred.


• You may add or increase Employee Optional Life/AD&D coverage by submitting evidence of insurability if you lose similar coverage under a plan maintained by your family member’s employer as a result of a change in employment status, work schedule or other applicable event. Coverage starts the first of the month after evidence of insurability is approved.



• You may add coverage for your eligible family members by submitting evidence of insurability if your eligible family members lose similar coverage under a plan maintained by your family member’s employer as a result of a change in employment status, work schedule or other applicable event. Coverage starts the first of the month after evidence of insurability is approved.

• You may drop coverage for your eligible family members if you obtain similar coverage under a plan maintained by your family member’s employer as a result of a change in employment status, work schedule or other applicable event. Coverage terminates at the end of the pay period for which you made your last premium contribution.


• You may start or increase the amount of your contributions to your Health Care Spending Account if you or your family members lose coverage under a medical plan or Health Care Spending Account maintained by your family member’s employer due to a loss of eligibility resulting from a change in employment status, work schedule or other IRS-approved event. For example, if you lose coverage under your parent’s employer’s medical plan because you turned age 26, you may wish to start or increase the amount of your contributions to your Health Care Spending Account.

Change Or Loss Of Coverage Under A Plan Maintained By Your Family Member’s Employer* (continued)

* The change in coverage under a plan maintained by your family member’s employer must be on account of (i) an annual enrollment period that occurs at a different time than Travelers’ annual enrollment period, (ii) a change in status which permits your family member to elect to change coverage in accordance with applicable cafeteria plan regulations issued by the IRS or (iii) you lose eligibility under your family member’s plan. If adding coverage through a Travelers plan, additional documentation may be requested to verify the change event as outlined on the Benefit Affidavit (e.g., COBRA notice or HIPAA notice from family member’s employer, loss of eligibility notice from third party provider such as Medicaid, etc.) The special rules in this section regarding Spending Accounts do not apply to domestic partners.


• If you elect to increase coverage to an amount greater than your prior election, only claims incurred after your later election are eligible for reimbursement up to the new election amount. Claims incurred before your later election are subject to the coverage election amount in effect prior to your later election.

• You may not reduce the amount of your contributions to your Health Care Spending Account if your spouse becomes covered by a health savings account maintained by your spouse’s employer.

• See later in this summary for changes you can make to your Dependent Care Spending Account.




Disability


Paid Time Off (PTO)


Legal Services Plan

• You may commence participation in the Legal Services Plan. Your coverage will be effective as of the event date.



Excess Liability





o For a coverage increase, you will receive an invoice once your completed Excess Liability Insurance Coverage Change Form is received and processed. Payment due will be the difference in the monthly rate

Change Or Loss Of Coverage Under A Plan Maintained By Your Family Member’s Employer* (continued)

* The change in coverage under a plan maintained by your family member’s employer must be on account of (i) an annual enrollment period that occurs at a different time than Travelers’ annual enrollment period, (ii) a change in status which permits your family member to elect to change coverage in accordance with applicable cafeteria plan regulations issued by the IRS or (iii) you lose eligibility under your family member’s plan. If adding coverage through a Travelers plan, additional documentation may be requested to verify the change event as outlined on the Benefit Affidavit (e.g., COBRA notice or HIPAA notice from family member’s employer, loss of eligibility notice from third party provider such as Medicaid, etc.) The special rules in this section regarding Spending Accounts do not apply to domestic partners.


multiplied by the number of full months remaining in the current calendar year. After this initial payment, payments for following calendar years will automatically be payroll deducted at the rate for your new coverage.





If you have a qualifying event after the annual enrollment period in which you first elect Medical or Dental coverage and/or a Flexible Spending account but before the following plan year begins, you may elect to have Medical, Dental and/or Flexible Spending accounts coverage become effective on the first day of the following plan year instead of effective the date of the qualifying event.


CHANGE IN ELIGIBLE DEPENDENT CARE EXPENSES


• You may increase or decrease your contributions (subject to plan minimums and maximums), under a Dependent Care Spending Account if there is a significant change in your eligible dependent care expenses. However, you may not decrease your annual contribution to an amount less than what you have contributed to the plan at the time the change is processed.

• A significant change in eligible dependent care expenses may result from a change in the cost of the dependent care (such as increase or decrease in the amount charged by your dependent care provider or a change in dependent care providers). Note that you may not increase your contributions as a result of an increase in the amount charged by your dependent care provider if your dependent care provider is a relative. You may, however, change your contributions as a result of a change in dependent care providers even if your new dependent care provider is related to you.

• You may also change your contributions if your dependent care expenses become (or cease to be) “eligible” expenses. Dependent care expenses cease to be “eligible” if your child(ren) no longer qualify as an eligible dependent(s) (e.g., if the child attains age 13 or if the child ceases to be your dependent). In addition, to be eligible, dependent care expenses must be incurred to enable you and your spouse (if any) to work, to seek employment or to attend school on a full-time basis. Thus, dependent care expenses incurred while you or your spouse (if any) are not working or on a leave of absence generally are not eligible for reimbursement. Accordingly, you may elect to discontinue your contributions when you or your spouse stops working or takes a leave of absence and you may elect to begin making contributions when you or your spouse goes to work or returns to work following a leave of absence.



CHANGE IN LONG-TERM DISABILITY OR LIFE INSURANCE COVERAGE

• You may drop your LTD, Optional Life/AD&D or Dependent Life/Spouse AD&D coverage at any time during the year if you obtain an individual policy.

• You must notify the ESU within 31 days of the issue date of the individual policy.

• You may be asked to provide documentation of the individual policy.

• If you drop life or long-term disability coverage and wish to re-enroll at a later date, you will be required to submit evidence of insurability at that time.

• You may not add LTD, Optional Life/AD&D or Dependent Life/Spouse AD&D coverage mid-year if you cancel an individual policy.



IF YOU WANT TO ENROLL IN EXCHANGE COVERAGE

• You may drop medical coverage for yourself and any covered family members if you intend to enroll yourself and any covered family members in a Qualified Health Plan through an Insurance Marketplace during either a Special Enrollment Period or the Insurance Marketplace’s annual open enrollment period and that new coverage is effective no later than the day immediately following the last day of your medical coverage under the Travelers plan.


ENROLLMENT IN MEDICARE OR MEDICAID

If you or a covered family member becomes eligible for and enrolls in Medicare or Medicaid,

• You may drop medical coverage for the individual who enrolls in Medicare or Medicaid.

• You may discontinue coverage or decrease the amount of your contributions to your Health Care Spending Account.

• You may drop dental and vision coverage for the individual who enrolls in Medicare or Medicaid.

• No other changes are allowed.



LOSS OF OTHER HEALTH INSURANCE COVERAGE

If you decline enrollment for yourself and your family members because of other health insurance coverage,

• You may enroll yourself and your family members in medical coverage after eligibility for your other coverage ends as a result of the termination of the other health insurance coverage (including an individual health insurance policy) for any reason other than failure to pay premiums on a timely basis or termination of such coverage for cause (such as making a fraudulent claim or intentional misrepresentation of a material fact in connection with such coverage).

• No other changes are allowed.


US.123501205.02

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