BWXT Y•12 - Medical Plan - Other Important Information

Company Right to Reimbursement (Subrogation)
If you or a covered dependent receives benefits for a covered expense and then collects payment for the same expense from a third party by settlement, judgment or otherwise, you or your dependent must reimburse the Company for the amount of benefits paid by the plan or the amount received from the third party, whichever is less. This is called "subrogation.”

As a condition of participation in the medical plan, you and your covered Eligible Dependents agree to cooperate with the plan fully to permit the plan to recover the amounts it has paid or will pay on you or your covered Eligible Dependents’ behalf for an injury caused by a third party, but not more than these amounts. You or your covered Eligible Dependent may keep the portion of any recovery from or settlement with the third party or its insurer for your out-of-pocket medical expenses not covered by the plan such as copayments and deductibles, and your reasonable attorney’s fees to obtain the recovery.

The plan is entitled to recover these amounts regardless of whether the recovery is designated as compensation for medical expenses. It is your responsibility to notify the Plan Administrator when you or your covered dependent may have an injury which may entitle the plan to assert subrogation rights.

Newborns’ and Mothers’ Health Protection Act of 1996
Group health plans and health insurance issuers generally may not, under federal law, restrict benefits for any hospital length of stay in connection with childbirth for the mother or newborn child to less than 48 hours following a vaginal delivery, or less than 96 hours following a cesarean section. However, federal law generally does not prohibit the mother’s or newborn’s attending provider, after consulting with the mother, from discharging the mother or her newborn earlier than 48 hours (or 96 hours as applicable).

In any case, plans and issuers may not, under federal law, require that a provider obtain authorization from the plan or the insurance issuer for prescribing a length of stay not in excess of 48 hours (or 96 hours).

Dependent Coverage In the Event of Your Death
If you should die while covered under this plan and before age 65, your spouse and Eligible Dependents may elect to continue medical coverage until your spouse reaches age 65.

When plan coverage terminates, your Eligible Dependents will be able to convert their medical insurance to an individual policy.

Continuation of Medical Coverage (COBRA)
You and your covered dependent may continue your medical coverage in certain cases when coverage would otherwise end. Refer to COBRA within the "Administrative Information" section.

Proof of Prior Coverage
After your coverage terminates, a certificate of health insurance coverage will automatically be provided and mailed to your last known address within a reasonable period of time. If applicable, another certificate will be provided after the COBRA continuation coverage ends. In addition, you may request another certificate within 24 months after coverage terminates.

Extended Coverage
If you or your covered dependent is totally disabled at the time your coverage ends, benefits will continue to be payable for medical expenses related to that disability which are incurred during the 12 months after your employment terminates (or until recovery, if sooner). This extended coverage is provided at no cost to you.

Coverage for Reconstructive Surgery Following Mastectomy
When a covered individual receives benefits for a mastectomy and decides to have breast reconstruction, based on consultation between the attending physician and the patient, the health plan must cover:

Conversion Privileges
If you retire before age 65 or have an Eligible Dependent under age 65, you may convert your coverage to an individual policy within 30 days after plan coverage terminates or during the final 180 days of continued contributory COBRA coverage (see the "Administrative Information" section), without taking a medical examination.

To convert your coverage, you must submit the appropriate form to the insurance company. Your cost for this coverage will be based on the insurance company’s regular premium rates for the type of coverage you elect. Your coverage may differ from the coverage provided under this plan.

Conversion of plan coverage is also available to your Eligible Dependents if you die or if your Eligible Dependents no longer meet the plan’s eligibility requirements. Your spouse may also convert coverage in the case of divorce or annulment.

Call the Benefit Plans Office to obtain forms and instructions for converting coverage to an individual policy.