Short Term Disability Plan - My Lowe's Life

Short Term Disability InsuranceThe Short Term Disability Plan provides eligible employees with short term income protection for absencesdue to nonwork related disability. Coverage is automatic after satisfaction of the service requirement, sothere is no enrollment requirement.The following sections summarize the Short Term Disability Plan. Please review these provisions andretain this booklet for future reference. Key terms used in this text are specifically defined at the back ofthis section.In This SectionDescription of Insurance .......................................................................................................................................................................... 2Benefit Cost ............................................................................................................................................................................................. 2The Benefit .............................................................................................................................................................................................. 2Preexisting Condition .............................................................................................................................................................................. 2Other Income Benefits ............................................................................................................................................................................. 2Definition of Disability ............................................................................................................................................................................ 3Partial Disability Benefit Payment ........................................................................................................................................................... 3Proof of Disability ................................................................................................................................................................................... 3Successive Periods of Disability .............................................................................................................................................................. 3General Exclusions .................................................................................................................................................................................. 3When Benefits End .................................................................................................................................................................................. 4Filing Claims ........................................................................................................................................................................................... 4Definitions ............................................................................................................................................................................................... 51

Description of InsuranceThe Short Term Disability Plan is insured by Liberty LifeAssurance Company of Boston (Liberty).Liberty certifies that under and subject to the terms andconditions of the group policy issued to Lowe’s by Liberty,Liberty will provide coverage for each employee who hassatisfied or satisfies in the future the eligibility provisions of theShort Term Disability Plan. For eligibility information , pleasesee Plan Overview.NOTE: The following Short Term Disability Plan descriptionapplies to all Lowe’s full-time, regular employees. Pleasecontact the Lowe’s Group Benefits Department at1-800-400-4104 for more information. Employees at worklocations in New York and Hawaii should file their claim forbenefits through Liberty Mutual, and Liberty Mutual willhandle your State’s disability benefit filing and coordinate theoffset from your Short Term Disability Plan benefit. Employeesat work locations in California, New Jersey and Rhode Islandshould file for disability benefits with their State’s disabilityprogram and Liberty Mutual will coordinate the benefit offsetfrom your Short Term Disability Plan benefit.To contact Liberty’s Customer Service, call toll-free:1-877-225-1740Benefit CostLowe’s pays the full cost of the Short Term Disability Plan .There is no cost to the employee.You will begin receiving benefits under the Short TermDisability Plan after you have satisfied the elimination period.The elimination period is a waiting period that begins on thefirst day of your disability and continues until the later of:• The 15 th day of continuous absence; or• The first day after any sick pay available to the employeehas been exhausted.STD Plan benefits are payable for up to 11 weeks. If you havemore than two weeks of sick pay, any sick pay beyond the twoweeks will reduce your STD benefit period maximum of 11weeks. In no case will combined sick pay and STD benefitsexceed 13 weeks from the start of the absence.Preexisting Condition“Preexisting Condition” means a condition resulting from anInjury or Sickness for which you received a diagnosis ortreatment within three months prior to your effective date ofcoverage.The Short Term Disability Plan will not cover any disabilitythat is caused or contributed to by, a Preexisting Condition, andthat begins in the first 12 months immediately after youreffective date of coverage.Other Income BenefitsThe STD benefit will be reduced by other income benefitsreceived. Other income benefits include earnings from anyform of employment including severance, unemploymentbenefits, retirement benefits, Social Security benefits for youand your family, and any other government program benefits.The BenefitThe amount of the Short Term Disability Plan (STD) benefitis:• For regular, full time hourly employees, 60% of your predisabilityWeekly Earnings to a maximum benefit of$4,615 per week, less other income benefits; or• For regular, full time salaried employees, 80% of your predisabilityWeekly Earnings to a maximum benefit of$6,153 per week, less other income benefits.2

Definition of DisabilityIf, as a result of a nonoccupational Sickness or Injury, you areunable to perform the material and substantial duties of yourown job on a full-time or part-time basis, you are considereddisabled or partially disabled.With respect to partial disability, you are considered partiallydisabled if you can perform one or more, but not all, of theduties for your job or all the duties of another job, and areearning between 20% and 80% of your pre-disability earnings.Partial Disability BenefitPaymentTo figure the amount of your weekly STD benefit the formula(A divided by B) x C will be used.A. Your pre-disability weekly earnings minus your partialdisability earnings. This represents the amount of lostearnings.B. Your pre-disability weekly earnings.C. The weekly benefit.Proof of DisabilityWhen Liberty receives proof that you are disabled due to anInjury or Sickness that requires the regular attendance of aphysician, Liberty will pay the weekly benefit. The benefit willbe paid for the period of disability if you provide proof ofcontinued disability, receive regular care from a physician, andreceive appropriate available treatment. The proof must be in aformat satisfactory to Liberty and obtained and provided atyour expense.“Appropriate available treatment” means care or services thatare acknowledged by physicians to cure, correct, limit, treat, ormanage the disabling condition, and are accessible within yourgeographical region. The services must be provided by aphysician who is licensed and qualified in a discipline suitableto treat the disabling Injury or Sickness. A physician does notinclude any family member or domestic partner.Short Term Disability InsuranceSuccessive Periods ofDisabilityA successive period of disability will be treated as part of theprior disability if, after receiving disability benefits under thispolicy, you return to your own job for less than two continuousweeks, and then become disabled again for the same or arelated disability. To qualify for the successive periods ofdisability benefit, you must experience more than a 20% loss ofmonthly earnings.If you return to your own job for two continuous weeks ormore, the successive period of disability will be treated as anew period of disability. You must complete anotherelimination period to be eligible for STD benefits. If youbecome eligible for any other group short term disabilitycoverage, this provision will cease to apply.General ExclusionsThe Short Term Disability Plan will not pay for any disabilitydue to:• An occupational Injury or Sickness for which you receiveor are entitled to receive benefits under workers’compensation law;• War, declared or undeclared, or any act of war;• Intentionally self-inflicted injuries, while sane or insane;• Active participation in a riot;• The committing of, or attempting to commit, a felony ormisdemeanor;• Cosmetic surgery, unless such surgery is in connectionwith an injury or sickness; or• A gender change, including, but not limited to, anyoperation, drug therapy, or any other procedure related to agender change.3

When Benefits EndThe weekly benefit will end on the earliest of the following:• The date you fail to provide proof of continued disability;• The date you are no longer under the regular care of aphysician, refuse to be examined, refuse to seekappropriate available treatment, or fail to provideinformation or documents needed to determine whetherbenefits are payable;• The date you refuse a full-time or part-time job withLowe’s where work modifications or accommodationshave been made to allow you to perform the duties of yourjob;• The date your current partial disability earnings exceed80% of your weekly earnings;• The end of the maximum benefit period;• The date you are no longer disabled; or• The date you die.In addition, coverage will not continue beyond the end of thesix-month period in which a leave of absence begins, or beyond12 weeks for a temporary layoff due to lack of work.PortabilityYour coverage under the Short Term Disability Plan will end atthe termination of your employment with Lowe’s, includingretirement, or loss of eligibility due to your change inemployment classification from full-time regular status.Coverage under the Short Term Disability Plan is notportable.Filing ClaimsYou should submit your claim for Short Term Disabilitybenefits as soon as you think that your absence from work mayextend beyond 14 days. You may also submit your claim twoweeks in advance of a planned disability absence such aschildbirth or prescheduled surgery. You should also notify yourHR Manager that you will be missing work.You can submit your claim through a toll-free number providedby Liberty, at 1-877-225-1740, or by submitting it online at theMyLiberty Claim web site, accessible via the employee portalat www.myloweslife.com (My Lowe’s Life > My Work/Life >Work Life Related Quick Links > STD/LTD/FMLA LeaveReporting > Submit Claim, Leave, or EOI > I Agree to TheseTerms of Use > Claim or Leave Submission).Please note that Liberty requires your doctor to provideinformation about your medical condition. If Liberty cannotobtain this information, your STD benefits may be denied. Youare responsible for signing an authorization for your physiciansto release medical information to Liberty and for making sureyour physicians provide Liberty with proof of your disability. Ifmedical documentation is not received within 14 business daysfrom the receipt of your claim, processing of your claim will besuspended.You will receive a claim number when you report your claim toLiberty’s toll-free number. Have a pen and paper ready torecord this number. In order to report your claim, you willneed:• Your name and Social Security number;• Your complete address and phone number; and• Your last day worked and first day absent from workbecause of your injury or sickness.You will be asked additional questions about yourself and yourphysician or medical care provider and your medical condition.After your claim is submitted, a case manager from Liberty willbe assigned to your claim. The case manager will be yourprimary contact throughout the duration of your claim, and canbe reached by calling 1-877-225-1740.You can also check the status of a claim at the MyLibertyClaimweb site, accessible via the employee portal atwww.myloweslife.com (My Lowe’s Life > My Work/Life >Work Life Related Quick Links > STD/LTD/FMLA LeaveReporting > Check status of a Claim or Leave request).If there is a change in your medical condition that would allowyou to return to work earlier than expected, contact your HRManager and your Liberty case manager.If you develop additional medical complications and need to beout longer than expected, you will be required to provideobjective medical information that supports your continueddisability.4

DefinitionsInjury: Bodily impairment resulting directly from an accidentand independently of all other causes.Short Term Disability InsuranceSickness: Illness, disease, or pregnancy or complications ofpregnancy.Weekly Earnings: For hourly and salaried employees, thebasic weekly rate of pay immediately prior to your disability, asverified by Lowe’s. Normal base pay does not includeovertime, bonuses, and incentive pay, or non-cashcompensation.5