2013 XGS Office SPD.pdf - US Xpress

Eligibility
Any employee of the Company or an affiliated business that has adopted the Plan who is required
to work at least 33 hours per week, and who receives W-2 compensation is eligible to participate
in the Plan. A list of the affiliated business(es) that have adopted the Plan is at the end of this
document. Coverage for benefits under the Plan begins on the first day of the month following
completion of 90 days of employment. The company will honor time worked as a contractor or
temporary worker (for US Xpress) in determining the 1 st of the month following 90 days waiting
period. Employee contributions toward the cost of benefits coverage must begin to be paid one
month in advance of the date that coverage begins, with the first contribution beginning with the
first paycheck on or after the first day of the month following completion of 60 days of
employment. The Company has established a procedure regarding the refund of portions of prepaid
contributions in certain situations minus any amounts owed for taxes or administrative fees
accrued. In certain cases where an individual becomes an employee of the Company (or an
affiliated business that has adopted the Plan) as a result of the Company’s (or affiliated
business’s) acquisition of another business, the employee may be given credit for his or her
service with the acquired business for purposes of determining the effective date of the
employee’s coverage under the Plan. For medical, dental and vision benefits, you may elect to
cover your eligible dependents. Your eligible dependents are the following:
1. Your legal spouse, as determined under the law of the state in which you are a resident.
Domestic partners who are not legal spouses as described above are not eligible for medical
benefits. You will need to provide proof of spousal status.
2. Your or your legal spouse’s biological child, legally adopted child (including children placed
for adoption), step-child, eligible foster children or child for whom you or your legal spouse is
the legal guardian, provided that the child is less than 26 years old and does not have access
to his/her own employer-sponsored health coverage. If you have dependents, you’ll need to
provide proof of dependent status prior to enrolling them. Documentation may include the
appropriate marriage license, birth certificate, or court order. You may also be required to
provide documentation of their continued eligible status from time to time after they are
initially enrolled for coverage.
3. Your or your legal spouse’s child for whom a qualified medical child support order has been
issued.
4. Your or your legal spouse’s unmarried child (as described above) who is, and continues to
be, both (i) incapable of self-sustaining employment by reason of mental retardation or
physical handicap; and (ii) chiefly dependent upon you or your legal spouse for economic
support and maintenance, provided that you furnish proof of such incapacity and dependent
within 30 days of the child’s attainment of the applicable limiting age and subsequently as
may be required. In addition, the child must be a dependent enrolled in the Plan prior to
attaining the applicable limiting age.
Benefit Options
The Benefit Options under the Plan are: medical, dental & vision insurance, short and long-term
disability, AD&D, group term life, dependent care assistance benefits and medical reimbursement
benefits. For all benefits, eligibility begins on the first day of the month following completion of 90
days of full-time (at least 33 hours per week) employment.
Enrollment and Elections
In order to participate in the Plan, you must complete the enrollment process during an enrollment
period. During the enrollment process, you will select the benefits you would like to enroll in and
agree to reduce your pay for each payroll period to pay for your share of the cost of the benefit
elected. Office Employees who elect dependent care assistance and/or medical reimbursement
benefits must indicate the amount they want to contribute to their dependent care and/or medical
reimbursement benefit spending account for the Plan Year.
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