Sometimes, to describe a benefit plan accurately, some technical terms must be used. This Glossary contains brief definitions to help you understand the terms used throughout this book.

Annual Pension Benefit
Amount of pension benefit provided under the plan formula.

Average Straight-Time Monthly Earnings
The average of your highest earnings for three years during the last ten years just before you retire.

Beneficiary
The person, organization or trust that you name to receive any life, pension plan or savings program benefits if you die.

Birthing Center
An institution which is constituted, licensed and operated in accordance with the laws of legally authorized agencies to furnish room and board, services of qualified nurses and a certified nurse midwife to expectant mothers. One or more nurses must be on duty at all times. To qualify as a Birthing Center, an institution must:

• have available at all times, under an established agreement, the services of a physician
• maintain daily medical records on all patients

and

• have agreements with hospitals that will accept patients requiring inpatient hospital care at once.

Child
For medical and dental coverage
Your own child, your legally adopted child (or an individual who is lawfully placed with you for legal adoption) or a child of the person who is recognized under applicable law as your spouse (your stepchild who resides with you full-time in your home), and an eligible foster child (an individual who is lawfully placed with you by an authorized placement agency or by judgment, decree or other order of any court of competent jurisdiction) who in each case:

• resides with you for more than one-half of the year (or would so reside but for a handicap, disability, illness or school),except for a stepchild who resides with you full-time
• you provide more than 50% of the child’s support on a calendar year basis

and

• you certify in writing (as a condition of your employment) that you provide more than 50% of the child’s support on a calendar year basis.

A child who is an alternate recipient under a Qualified Medical Child Support Order will be considered a “Child” for purposes of eligibility for medical or dental coverage regardless of whether such individual otherwise meets the definition of a Child. Such individual will be subject to the conditions of eligibility set forth in the definition of an Eligible Dependent.

COBRA
Consolidated Omnibus Budget Reconciliation Act of 1985; this federal law allows you and your Eligible Dependents to continue health care coverages under certain circumstances when coverage would otherwise end.

Coinsurance
The percentage of the charges you are required to pay under the plan.

Company
UT-Battelle, LLC
BWXT-Y12, LLC

Company Service
The total elapsed time between the date you begin employment with the Company and your last day at work. Your Company Service is used or all pension calculations except to determine your eligibility for a vested pension plan benefit.

Conversion Privilege
Your right to convert a group medical or life insurance policy into an individual policy.

Copayment
The amount you and your enrolled dependents are required to pay for the services received — in addition to any Coinsurance or Deductible. Deductibles are not reduced by Copayments.

Crown
A restoration which replaces enamel, covering the entire crown of a tooth, usually made of porcelain or acrylic.

Deductible
The Deductible is the amount you and your enrolled dependents are required to pay each year for covered expenses before the plan pays, and is in addition to any Coinsurance or Copayments.

Dependent Child
For the pension plan
Your natural or adopted child, stepchild or foster child who is under age 23 and who qualifies as your dependent child for federal income tax purposes.

Dependent Parent
For the pension plan
Your natural parent or stepparent who qualifies as your dependent for federal income tax purposes.

Durable Medical Equipment
Any equipment which can withstand repeated use and is medically essential to treat an injury or sickness.

Early Retirement
Retirement prior to reaching age 65.

Elective Surgery
A surgical procedure which is not considered emergency in nature and which may be avoided without undue risk to the patient.

Eligible Dependents
For medical and dental coverage
Your Eligible Dependents are:

• the person who is recognized under applicable law as your spouse
• a Child who is not recognized under applicable law as the spouse of another person and who is less than 24 years old

The term “Child” is defined on page 2 of the Glossary.

Eligible Earnings
Your straight-time earnings divided by straight-time hours then multiplied by scheduled hours.

Emergency
A serious accident or sudden illness that is life-threatening or could result in a long-term medical problem, such as uncontrolled bleeding, seizure or chest pain.

Emergency Admission
Any hospital admission for an inpatient stay for a condition which:

• has a sudden and unexpected onset

and

• requires prompt care to protect life, relieve severe pain or diagnose and treat symptoms which, with delay, could result in serious injury.

ERISA
The Employee Retirement Income Security Act of 1974, as it may be amended from time to time.

Fixed Bridgework
Permanently inserted artificial teeth joined to inlayed or crowned natural teeth on either side called abutments. A fixed bridgework for anterior teeth often requires two abutments on either side.

Full Denture
Upper or lower; artificial teeth in replacement of all teeth in an arch.

Home Health Aide
A person who is trained to assist a person with daily living in his or her home after surgery or injury and who reports to and is under the direct supervision of a home health care agency. A home health aide can assist with persona hygiene, changing dressings and mobility.

Home Health Services
Skilled health care services that the insurance company has determined are medically appropriate to provide in the home.

Hospice Facility
An institution or part of one which primarily provides care for terminally ill patients and fulfills any licensing requirements of the state or locality in which it operates.

Hospice Program
A coordinated, interdisciplinary program of care designed to meet the physical, psychological, spiritual, and social needs of dying persons and their families. A hospice program may also provide palliative and supportive medical, nursing and other health services through home or inpatient care during the terminal illness.

Hospice Care Services
Any services provided by a hospital, skilled nursing facility, home health agency, hospice, or any other licensed facility or agency under a hospice program.

Hospital
A Hospital is an institution constituted, licensed and operated in accordance with the laws pertaining to hospitals, which maintains on its premises all the facilities needed to diagnose and treat injury and sickness. It is an institution which qualifies as a hospital, a psychiatric hospital or a tuberculosis hospital as a provider of services under Medicare and is accredited by the Joint Commission on the Accreditation of Hospitals.

A Hospital can specialize in treatment of mental illness, alcoholism, drug addiction, or other related illness. It can also provide residential treatment programs, but only if it is constituted, licensed and operated in accordance with the laws of legally authorized agencies responsible for medical institutions. It provides all treatment for a fee, by or under the supervision of physicians on an inpatient basis with continuous 24-hour nursing service by qualified nurses.

Any institution which is exclusively a place for rest, a place for the aged or a nursing home, will not be considered a Hospital.

Hour of Work
Each hour of work for the Company for which you are paid, including straight-time, overtime, holidays, and jury duty. However, vacations, personal leave and time off for union business are not included in calculating your hours of work.

Indemnity Plan
A medical plan in which you can use any provider you choose.

Informal Caregiver
For long term care
A person providing custodial (personal) care, who is not a nurse or therapist or whose services are not provided and supervised by a home health care agency, nursing home, assisted living facility, hospice, or adult day care center or care management organization. Members of the covered person’s immediate family may qualify as informal caregivers.

In-Network Benefits
Health care services or items provided by your primary care physician, or authorized services or items provided by another participating provider.

Lifetime Maximum
The maximum amount of eligible benefits a plan will pay for an individual during his or her lifetime.

Limb
An arm or a leg.

Major Medical Medicare Supplement Plan
A medical plan available to retirees who are age 65 or over and enrolled in Medicare Part A and Part B. The plan is designed to provide coverage for certain eligible expenses for which no Medicare benefits or limited Medicare benefits are payable.

Member Services
The network manager’s customer service unit. You can call Member Services any time you have a question about the Point-of-Service Plans.

Mental Health Provider
The company responsible for authorizing mental health and alcohol/drug abuse treatment for Point-of-Service Plan participants.

Myofunctional Therapy
Correcting and/or retraining of the muscles in order to correct an orthodontic disorder.

Necessary Services and Supplies
Any services or supplies, other than bed and board, that are necessary for your treatment and are administered during hospital confinement. Necessary Services and Supplies will also include professional ambulance service to or from the nearest hospital where the necessary medical treatment can be provided, and any charges for the administration of anesthetics during hospital confinement. Necessary services do not include special nursing, dental or medical services.

Network
A group of health care providers who have agreed to provide care for prenegotiated rates, s well as to comply with quality assurance procedures and patient service standards.

Network Manager
The health plan that sets up and manages a network of providers and administers out-of-network benefits, too. The Point-of-Service Pans’ network manager is CIGNA HealthCare.

Network Pharmacy
A pharmacy that has contracted with the pharmacy benefit management company to provide prescription drugs under a contracted arrangement for discounted costs.
 

Normal Retirement
Retirement at age 65.

Nurse
A Registered Graduate Nurse, a Licensed Practical Nurse or a Licensed Vocational Nurse. A nurse is a professional who has the right to use the respective title and the respective abbreviation R.N., L.P.N. or L.V.N.

Orthodontic Treatment
Science of the movement of teeth in the correction of malocclusion.

Orthotics
A custom-molded rigid insert that, when placed in the shoe, distributes the patient’s weight equally throughout the foot and leg and relieves the stress from any one particular area.

Out-of-Network Benefits
Care that does not qualify as in-network.

Out-of-Pocket Maximum
The maximum you have to pay for eligible medical expenses in one plan year. Once you reach this amount, the medical plan pays 100% of eligible expenses for the rest of that plan year. All eligible medical expenses count toward the Out-of-Pocket Maximum, except for expenses for prescription drugs, mental health/alcohol and drug abuse treatment, amounts above Reasonable and Customary and any penalties for failing to precertify your hospitalization.

Paralysis
The loss of all practical use of a limb as it relates to the ability to perform the normal functions and activities of everyday life without the use of a prosthesis or any other mechanical device(s).

Partial Denture
An appliance supporting artificial teeth less than the full number of teeth in one jaw.

Periodontal Splinting
Stabilizing or immobilization of periodontically involved teeth. Splinting may be accomplished with acrylic resin bit guards, orthodontic band splints, wire ligation, provisional splints and fixed prosthesis.

Periodontics
The treatment of disease of the gum and tissues surrounding the teeth.

Personal Identification Number (PIN)
The number that allows you to access Savings Program account information through the information line.

Physician
A person who is licensed to prescribe and administer drugs or to perform surgery and who operates within the scope of his or her license.

Point-of-Service Plan
A medical plan through which you may receive care coordinated by a Primary Care Physician (at the highest level of benefits) or by any other physician (at a lower level of benefits).

Precertification
The process used to certify the medical necessity and length of a hospital confinement.

Prescription Drugs
Medication prescribed by a physician for the treatment of an illness or injury.

Primary Care Physician
A physician – generally an internist, general/family practitioner or pediatrician – whom you select to coordinate all your medical care within the Point-of-Service network.

Prosthodontic Services
The making of artificial devices for replacement of missing teeth and structures in the mouth.

Qualifying Life Event
An event described in the “About Your Benefits” section which permits a change in coverage or election on a pre-tax basis.

Reasonable and Customary Charge
For medical coverage
A rate that the insurance company determines is the normal charge made by providers in your geographic area for a similar service or supply. The nature and severity of the injury or sickness will be considered. If the insurance company considers your medical expenses more than Reasonable and Customary, you will be responsible for paying the additional amount. These charges do not count toward your Deductible or Out-of-Pocket Maximum.

For dental coverage
A rate for dental services that is determined by the insurance company by taking into account:

• the usual fees charged by dentists with similar training and experience in your geographic area
• any unusual circumstances or complications that require special skill, experience or additional time.

If the insurance company considers your dental expenses more than Reasonable and Customary, you will be responsible for paying the additional amount. These charges do not count toward your Deductible.

Rollover Contributions
Distributions from another employer’s qualified plan that you deposit into your Savings Program account.

Retiree
A Retiree is a former employee who at the time of termination of employment was eligible to receive a retirement benefit.

Room and Board
All charges commonly made by a hospital for rooms and meals and all general services and activities needed for the care of registered bed patients.

Routine
A situation that does not require immediate attention, such as immunizations or annual exams.

Skilled Nursing Facility
A licensed institution, other than a Hospital, which specializes in physical rehabilitation or provides skilled nursing and medical care on an inpatient basis. The institution must maintain on the premises all facilities necessary for medical treatment. Such treatment is provided for compensation and must be under the supervision of physicians and provide Nurses’ services.

Space Maintainers
Appliances to prevent adjacent teeth from moving into space left by a lost tooth.

Terminally Ill
A medical prognosis of six months or less to live.

Urgent Care
Services for a situation that requires prompt medical attention, but is not life threatening.

Vesting
Ownership interest in your pension plan benefits and Company matching contributions under the Savings Program. You have an irrevocable right to a benefit when you are fully vested.