THE CATHOLIC UNIVERSITY OF AMERICA
EMPLOYEE ASSISTANCE PLAN
SUMMARY PLAN DESCRIPTION
TABLE OF CONTENTS
Name of Plan
Name and Business Address of Employer
Employer's Taxpayer Identification Number
Plan Number
Type of Administration
Discretion of the Plan Administrator
Insurance Issuer's Name and Business Address
Plan Year
Service of Legal Process
Type of Plan
Eligibility
Participation
Summary of Available Benefits
Claims Procedure
Termination or Amendment of Plan
No Continued Employment
Your Rights Under ERISA
Further Information
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GENERAL INFORMATION ABOUT THE PLAN
Name of Plan
The Catholic University of America Employee Assistance Plan.
Name and Business Address of Employer
The Catholic University of America
Cardinal Station
Washington, D.C. 20064
Employer's Taxpayer Identification Number
53-0196583
Plan Numbers
Plan Number: 506
Type of Administration
The Plans are administered by the Plan Administrator. Benefits are provided
through insurance contracts. To the extent that any benefits are not provided through
insurance contracts, they are paid from the Employer's general assets.
Discretion of the Plan Administrator
In carrying out its duties under the Plan, the Plan Administrator has discretionary
authority to exercise all powers and to make all determinations, consistent with the terms of
the Plan, in all matters entrusted to it. The Plan Administrator's determinations shall be
given deference and shall be final and binding on all interested parties.
Insurance Issuer's Name and Business Address
LifeEra, Inc., 7632 SW Durham Road, Suite 300, Portland, OR 97224-7584 (800860-6933) is the provider and insurer of your benefits under this Plan. The Plan's benefits
are fully guaranteed under the policies of insurance issued by this company. If another
insurance issuer replaces this insurer or the fully guaranteed nature of your benefits change,
a notice communicating the new information will be delivered to you (and any such notice is
hereby incorporated herein by reference).
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Plan Year
The Plan Year is the period beginning each January 1 and ending each December 31
during which the Plan is in effect.
Name and Address
Dr. Julie Englund
Vice President for Finance and Treasurer
260 Leahy Hall, The Catholic University of America,
620 Michigan Avenue, NE,
Washington, DC. 20064
Service of Legal Process
Craig Parker, Esquire
General Counsel
Room 280 Leahy Hall
Office of General Counsel
The Catholic University of America
Washington, D.C. 20064
Type of Plan
This Plan is a form of employee welfare benefit plan.
Eligibility
All full time and regular part time employees of the Employer are eligible to
participate in this Plan.
Participation
Each Eligible Employee will become a Participant on the date the Eligible
Employee commences employment. A Participant will cease to be a Participant as of the
earlier of (a) the date on which the Plan terminates or (b) the date on which Eligible
Employee’s employment ceases. A former Participant will become a Participant again if
the Eligible Employee is rehired by the Employer.
Summary of Available Benefits
The Company has entered into a contract with LifeEra, Inc. for the purpose of
providing benefits under this Plan. Pursuant to the contract, the third party provider will
provide, by way of telephone consultations initiated by the Participant, education,
information, problem assessment, assistance, crisis management and referral
recommendations for a Participant’s personal problems including, but not limited to,
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marital/family relations, dependent care and adult care, financial and/or non-employment
related legal issues, chemical or alcohol dependency, illnesses and work related
problems. The University’s obligation under the plan is simply to provide the services of
the LifeEra, Inc.
Benefits available under the Plan must be consistent with, and limited in
accordance with, ethical and religious principles of the Roman Catholic Church.
There will be no cost to Participant for the telephone counseling service of
LifeEra. LifeEra may refer Participants to others for additional services; if it does so, the
cost of those additional services will be the responsibility of the Participant and not the
responsibility of the University.
The Plan benefits hereunder are also available to Participants’ spouses and
dependents.
The Plan will not disclose any protected health information (PHI) as defined in 45
CFR §160.103 to the Plan Sponsor without a written authorization from the employee or
as is stated in the balance of this paragraph. All counseling will be confidential to the
limits permitted by law, provided, however, that if the third party provider believes there
is a threat of death or serious bodily harm to the individual seeking counseling or to
others, the third party provider may advise the University or law enforcement authorities
as the third party provider, in its uncontrolled discretion, deems necessary and
appropriate.
LifeEra will be unable to provide legal consultation relating to existing or
potential lawsuits against the University or against the University’s health plans.
Claims Procedure
In order to receive Plan benefits, you must follow the procedures established by
LifeEra or the Plan Administrator.
If a request for Plan benefits is denied, a Participant, a beneficiary or a duly
authorized representative of either may file a claim for Plan benefits to which the claimant
believes he or she is entitled. The claim must be in writing and must be delivered or mailed
to the Plan Administrator (or insurer, if applicable).
The Plan Administrator must notify the claimant in writing of its decision to grant or
deny a claim, in whole or in part, usually within 90 days after receiving the claim. If, due to
special circumstances, the Plan Administrator (or insurer, if applicable) needs additional
time to process a claim, the claimant will be notified in writing, within 90 days after the Plan
Administrator (or insurer, if applicable) receives the claim, of those special circumstances
and of when the Plan Administrator expects to make its decision. Under no circumstances
may the Plan Administrator (or insurer, if applicable) extend the time for making its
decision beyond 180 days after receiving a claim.
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If, within 90 days after filing a claim, the Plan Administrator (or insurer, if
applicable) does not furnish the claimant with a notice of its decision or a notice that special
circumstances require more time for processing the claim, the claimant may act as though
the claim has been denied and may request a review of the denial of the claim.
If the Plan Administrator (or insurer, if applicable) denies a claim, it must provide to
the claimant, in writing:
(a)
The specific reasons for denial;
(b)
A reference to the Plan provision or insurance contract provision upon which
denial is based;
(c)
A description of any additional information or material that the claimant
must provide in order to perfect the claim;
(d)
An explanation of why additional material or information is necessary; and
(e)
Notice that the claimant has a right to request a review of the claim denial
and information on the steps to be taken if the claimant wishes to request a review of the
claim denial.
A request for review of a denied claim must be made in writing to the Plan
Administrator (or insurer, if applicable) within 60 days after receiving notice of denial. As
part of the review procedure, the claimant has the right to review pertinent documents and to
submit to the Plan Administrator (or insurer, if applicable) in writing issues and comments.
The decision upon review will be made within 60 days after the Plan Administrator's (or
insurer's, if applicable) receipt of a request for review, unless special circumstances require
an extension of time for processing, in which case a decision will be rendered not later than
120 days after receipt of a request for review. The Plan Administrator (or insurer, if
applicable) will give the claimant, in writing, a notice of (1) its decision, (2) the specific
reasons for the decision, and (3) the relevant Plan provisions or insurance contract
provisions on which its decision is based. If the decision is not furnished within that time,
the claim will be considered denied upon review. The decision of the Plan Administrator
(or insurer, if applicable) will be final and binding upon both parties.
Termination or Amendment of Plan
The Employer expects to maintain the Plan indefinitely as a permanent program of
employee benefits. However, the Employer has the right, in its sole discretion, to terminate
or amend any provision of the Plan at any time. In the event of the dissolution, merger,
consolidation or reorganization of the Employer, the Plan automatically will terminate as to
the Employer unless it is continued by the successor to the Employer.
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Participants in the Plan (including retirees, if any) have no Plan benefits after a Plan
termination or a partial Plan termination affecting them, except with respect to covered
events giving rise to benefits and occurring prior to the date of Plan termination or partial
termination and except as otherwise expressly provided, in writing, by the Employer.
No Continued Employment
No provisions of the Plan or this Summary shall give any employee any rights of
continued employment with the Employer or shall in any way prohibit changes in the terms
of employment of any employee covered by the Plan.
Your Rights Under ERISA
As a participant in the Plan, you are entitled to the following rights and protections
under the Employee Retirement Income Security Act of 1974 ("ERISA"):
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You can examine, free of charge, at the Plan Administrator's office and at
other locations, all of the Plan documents, including insurance contracts, if
any, collective bargaining agreements and copies of all documents filed by
the Plan with the U.S. Department of Labor, such as detailed annual reports.
●
You can obtain copies of all Plan documents by writing to the Plan
Administrator. You may have to pay a reasonable charge to cover the cost
of photocopying.
●
In some cases, the law may require the Plan Administrator to provide you
with a summary of the Plan's annual financial report.
In addition to creating rights for Plan participants, ERISA imposes duties upon the
people who operate the Plan. These people are called fiduciaries and have a duty to act
prudently and in the interest of you and other Plan participants and beneficiaries.
No one, including the Employer or any other person, may fire you or otherwise
discriminate against you in any way to prevent you from obtaining a benefit under a Plan or
exercising your rights under ERISA. As described above, if your claim for a Plan benefit is
denied, in whole or in part, you must receive a written explanation of the reason for the
denial, and you have the right to have the Plan review and reconsider your claim.
Under ERISA, there are steps you can take to enforce the preceding rights. For
instance, if you make a written request for materials from the Plan and do not receive them
within 30 days, you may file suit in federal court. In such a case, the court may require the
Plan Administrator to provide the materials and pay you up to $100 a day until you receive
the materials, unless the materials were not sent because of reasons beyond the control of the
Plan Administrator. If you have a claim for benefits which is denied after review and
reconsideration by the Plan or is ignored, in whole or in part, you may file suit in a state or
federal court.
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If it should happen that Plan fiduciaries misuse Plan funds, if any, or if you are
discriminated against for asserting your rights, you may seek assistance from the U.S.
Department of Labor, or you may file suit in a federal court. The court will decide who
should pay court costs and legal fees. If you are successful, the court may order the person
you have sued to pay these costs and fees. If you lose, the court may order you to pay these
costs and fees, for example, if it finds your claim is frivolous.
If you have any questions about the Plan, you should contact the Plan Administrator.
If you have any questions about this statement or your rights under ERISA, you should
contact the nearest office of the Pension and Welfare Benefits Administration, U.S.
Department of Labor, listed in your telephone directory or the Division of Technical
Assistance and Inquiries, Pension and Welfare Benefits Administration, U.S. Department of
Labor, 200 Constitution Avenue, N.W., Washington, D.C. 20210.
Further Information
If you have further questions regarding the Plan or this Summary Plan Description,
please contact the Plan Administrator at (202) 319-5050. Copies of all Plan documents are
on file with the Plan Administrator and, upon reasonable request, are available to
participants and their beneficiaries for examination during regular business hours.
05075 Employee Assistance Plan SPD 9/19/05
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