Northwell Health

Welcome

Benefits Proudly Offered to Northwell Health Employees

Be fully prepared and confident

with LegalEASE

Learn about legal benefits, a smart option for your protection.

LegalEASE can help ease the two biggest stresses -finding and paying for an attorney.

Nobody likes to be caught off guard, especially when it comes to legal matters. Life can be complicated. Finding a good attorney doesn’t have to be. With LegalEASE, it’s easy to choose the best attorney, because you get assistance from highly trained and qualified personal specialists who review the details of local attorneys and help you find your best source for legal advice. Being a LegalEASE member saves you time and costly legal fees. But most importantly, it gives you confidence and provides coverage for common legal matters.

With a LegalEASE plan, you get:

An attorney with expertise specific to your legal matter
Access to a national network of attorneys with exceptional experience that are matched to meet your needs
Coverage for in and out-of-network
Concierge help finding a better attorney and navigating common individual or family legal issues
Hours of financial counseling and coaching

We all make some sort of plan in life. But have you ever considered the possibility of a legal problem?

You've graduated from college and are planning for your future - where to get hired, which company will put you on the path to success. Whether to be single or date or settle down, and with the right person. Legal problems can be unexpected and interrupt your plans. LegalEASE provides coverage for your specific legal matter so you won't be caught off guard.

Protect your family’s future, with LegalEASE.

You work hard to make the right choices for your loved ones, especially when it comes to legal and financial matters. Get the peace of mind you want and the protection you need with a LegalEASE Plan. LegalEASE offers valuable benefits to shield your family and savings from unexpected legal issues.

According to the American Bar Association, more than 70 percent of U.S. households will have the need for a lawyer in the next 12 months. And the same study found most consumers feel uncertain about how to tell a good lawyer from a bad one. With LegalEASE you have access to a national network of credentialed attorneys and the help you need to find the best attorney for your legal matter with its concierge service.

Coverage

The Value of a LegalEASE Insurance Plan.

Being a LegalEASE insurance plan member saves you time and costly legal fees. But most importantly, it gives you confidence and provides coverage for:

Home and Residential
Financial and Money Matters
Consumer
Auto and Driving
Family and Personal
Civil Lawsuits
Estate planning and wills

LegalEASE Insurance Plan Coverage

Benefits are designed to meet the typical needs of an employee and their family. There are no deductibles to worry about for covered services. Benefits cover the attorney’s time. Other costs such as filing fees or court costs are not covered. Listed below are the types of matters that are covered by the LegalEASE insurance plan. This plan offers the convenience of in-network and out-of-network benefits. Many of the below areas are fully covered in-network.

Plan Cost

The LegalEASE insurance plan is $16.97 monthly, via payroll deduction.

Who's covered

The Member’s spouse and Member’s unmarried dependent children, including stepchildren, legally adopted children, children placed in the home for adoption and foster children, up to age 19, and from age 19 up to 26 years if they are enrolled in an accredited school or college as full-time student(s) and are primarily dependent upon the Member for support.

Schedule of Benefits
Advice and Consultation	LegalEASE Plan Coverage Participating Attorney	LegalEASE Plan Coverage Non-Participating Attorney
LegalEASE Helpline	Covered	Not Applicable
Initial Law Office Consultation (One hour per calendar quarter)	Covered	$60/consultation
Review of Simple Documents - up to 6 Pages	Covered	$60
Miscellaneous Services	LegalEASE Plan Coverage Participating Attorney	LegalEASE Plan Coverage Non-Participating Attorney
Discounted Legal Services for any non-excluded legal matter	25% discount on Participating Attorney’s hourly rates	Not Applicable
Consumer Matters	LegalEASE Plan Coverage Participating Attorney	LegalEASE Plan Coverage Non-Participating Attorney
Document Preparation: Simple Deed Promissory Note Consumer Dispute Correspondence Installment Sales Agreement Simple Affidavit General Power of Attorney: Member & Family Member Lease Agreement - Tenant only Time Share Agreement	Covered	$65 $55 $55 $55 $55 $55 $65 $55
Consumer Dispute	Covered	$600
Small Claims Court Reprsentation	Covered up to 2 hours with remainder at 25% discount	$105
Identity Theft Defense	Covered	$850
Estate Planning	LegalEASE Plan Coverage Participating Attorney	LegalEASE Plan Coverage Non-Participating Attorney
Simple Will or Codicil for: Member Spouse Family Member	Covered	$80
Living Will/Health Care or Advance Directivel	Covered	$55
Health Care or Medical Power of Attorney	Covered	$55
Revocable or Irrevocable Living Trust Document	Covered	$310
Probate of Small Estate	Covered up to 2 hours with remainder at 25% discount	$120
Elder Matters	LegalEASE Plan Coverage Participating Attorney	LegalEASE Plan Coverage Non-Participating Attorney
Elder Parent Will Preparation	Covered	$80
Elder Parent Living Will/Health Care or Advance Directive	Covered	$55
Elder Parent Durable Financial Power of Attorney	Member co-pay $45 per document	Not Applicable
Elder Parent Health Care or Medical Power of Attorney	Member co-pay $45 per document	Not Applicable
Home and Residential Matters	LegalEASE Plan Coverage Participating Attorney	LegalEASE Plan Coverage Non-Participating Attorney
Purchase of Primary Residence	Covered	$500
Sale of Primary Residence	Covered	$365
Refinancing of Primary Residence	Covered	$385
Tenant disputes	Covered Subject to Managed Case Rules*	$1,700 maximum Subject to Managed Case Rules*
Financial Matters	LegalEASE Plan Coverage Participating Attorney	LegalEASE Plan Coverage Non-Participating Attorney
Debt Collection Defense: Pre-Litigation Defense	Covered	$425
Debt Collection Defense: Trial Defense	Covered	$850
Bankruptcy (chapter 7 or 13)	Covered	$935
Foreclosure	Covered	$680
Tax Audit	Covered Subject to Managed Case Rules*	$1,700 maximum Subject to Managed Case Rules*
Family	LegalEASE Plan Coverage Participating Attorney	LegalEASE Plan Coverage Non-Participating Attorney
Separation, Divorce, Civil Annulment Uncontested Separation Consent/default Divorce Uncontested Divorce	Covered up to 10 hours with remainder at 25% discount	$595
Contested Divorce	Covered Subject up to 28.5 hours with remainder at 25% discount	$1,700 maximum Subject to Managed Case Rules*
Post-Divorce Proceedings, as defined	Covered Subject up to 28.5 hours with remainder at 25% discount	$1,700 maximum Subject to Managed Case Rules*
Prenuptial Agreement	Covered	$680
Name Change	Covered	$255
Uncontested Guardianship/Conservatorship	Covered	$365
Uncontested Governmental Agency Adoptions	Covered	$365
Uncontested Stepparent Adoptions	Covered	$365
Juvenile Court Proceedings	Covered	$470
Civil	LegalEASE Plan Coverage Participating Attorney	LegalEASE Plan Coverage Non-Participating Attorney
Civil Litigation Defense	Covered Subject to Managed Case Rules*	$1,700 maximum Subject to Managed Case Rules*
Discounted Contingency Fees	10% discount on state maximum, or a maximum of 29% pretrial, 36% at trial, or 40% in an appeal	Not Applicable
Mediation	10% discount on Mediator’s hourly rates	Not Applicable
Criminal Defense	LegalEASE Plan Coverage Participating Attorney	LegalEASE Plan Coverage Non-Participating Attorney
Traffic Ticket Defense	Covered	$425
Serious Traffic Matter (resulting in suspension or revocation of license)	Covered	$425
Administrative Proceeding (resulting in Suspension or Revocation of License)	Covered	$255
Additional Benefits	LegalEASE Plan Coverage Participating Attorney	LegalEASE Plan Coverage Non-Participating Attorney
Financial Advisor	Included	Not Applicable
Identity Theft Assistance	Included	Not Applicable

Limitations apply.

* Managed Case Rules

In cases requiring more attorney time than covered by the standard Participating Attorney maximum fee, Managed Case Rules may be used to approve additional coverage beyond the standard Participating Attorney maximum fees. They are also used to ensure that Non-Participating Attorney fees are reasonable and customary. Managed Case Rules provide protection for You by limiting or preventing additional charges that You would otherwise be responsible for. Managed Case Rules may be enacted prior to or after the initial consultation. Managed Case Rules require the following:

You should contact the Member Service Center prior to proceeding with an attorney. If You understand from the attorney that there may be additional charges beyond the covered charges under the Policy call the Member Service Center. If You do not contact the Member Service Center prior to proceeding with the attorney, then You may be responsible for those additional charges beyond the covered charges under the Policy, even on a Paid In Full benefit.

If it is determined that the complexity of the case may require additional hours beyond the standard Participating Attorney maximum, or that the Non-Participating Attorney charges are higher than reasonable and customary fees, the attorney must provide a written estimate of fees reflecting his or her best judgment as to the likely cost of legal services based on the expected conduct of the case.

We will set a maximum attorney fee that takes into consideration the reasonable level of reimbursement of the proceeding and the proposed litigation strategy. Fees as a result of services in excess of the maximum attorney fee are Your responsibility.

Exclusions

The following benefits are excluded:

(a) Appellate court proceedings.

(b) Class actions.

(d) Malpractice proceedings.

(e) Actions in which punitive damages are being sought.

(f) Derivative actions and amicus curiae filings.

(g) The preparation and filing of:

(1) individual, partnership or estate tax returns,

(2) appellate or administrative proceedings related to tax returns,

(3) litigation before the U.S. Tax Court, U.S. Court of Claims or any other federal, state or other courts with respect to tax matters.

(h) Legal services that are fully paid for or provided at no cost by any governmental agency, organization or insurance company.

(i) Matters that the attorney deems frivolous, spurious, harassing, or unethical or otherwise prohibited by the Model Rules of Professional Conduct of the state in which the attorney is licensed.

(j) Costs associated with covered legal services. This includes, but not limited to, the following:

all fines, court costs, penalties, sanctions, expert witness fees, bonds, bail bonds, attorney fees awarded as part of a judgment, exhibits, deposition costs, filing fees, transcripts, postage, telephone, photocopying, recording fees, messengers, judgments, jury fees, court reporter fees, investigative costs, mediator or arbitrator fees. This also includes all other incidental and out-of-pocket legal and litigation costs.

(k) Any services on behalf of a Covered Family Member against Your interests.

(l) Any dispute or proceeding against the following persons or entities, their officers, directors, employees, or agents:

(1) any person or entity involved in the sale, marketing, administration or other processes related to the Policy;

(2) Legal Plan Administrator or its subsidiaries;

(3) Claims Administrator or its subsidiaries;

(4) Policyholder;

(5) Your employer;

(6) Virginia Surety Company, Inc. and it’s parents, subsidiaries or any affiliated or successor company, plan underwriter or reinsurer;

(7) Plan Sponsor; or any Participating and/or Non-Participating Attorney

if the dispute or proceeding pertains to services provided under the Policy.

(m) The Policy does not allow benefits listed under the Covered Services section to be combined for one legal matter.

(n) Where there are specific hours or dollar amounts provided in the Policy, or where a maximum is set under the Managed Case Rules, You will be responsible for all attorney fees incurred which exceed the maximum. Additional exclusions related to each benefit are included in the Covered Services.

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(o) Matters relating to: securities, trademark or patent matters; business or commercial interests, including, but not limited to the following:

(1) professional, partnership and/or corporate matters;

(2) matters arising out of Your/Covered Family Member’s role as an officer or director of an organization;

(3) matters involving the law or laws of jurisdictions other than the United States and its territories, except as specifically described under Covered Services;

(4) any matters involving a government (domestic or foreign) entity or agency except as specifically described under Covered Services;

(5) farm related issues.

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(o) Matters involving commercial or rental property transactions, including the purchase, sale or lease of investment or income-producing property. A multi-family residence, whether or not used by You/Covered Family Member as the primary residence, is deemed an investment or income-producing property.

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(p) Any employment-related matter. This includes, but is not limited to the following:

(1) any dispute involving

• Your employer or its affiliates,

• their officers or directors,

• Your employee benefit plans,

• credit unions,

• programs or arrangements sponsored by an employer, or

(2) cases involving:

• workers’ compensation,

• unemployment compensation,

• sex harassment, and

• age discrimination.

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(q) Except for consultation, the Policy will not provide benefits in connection with pre-existing matters. Pre-existing matters include any matter where You/Covered Family Member are on notice:

(1) as to a pending legal dispute or

(2) has previously contacted an attorney.

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Definitions

Definitions

“CLAIMS ADMINISTRATOR” - means LegalEASE; or its subsidiary.

“COMPLEX WILL” – means:

(a) You have a significant net worth and will benefit from tax planning, or

(b) the estate is subject to current state or federal estate taxation; or

(d) You want to put restrictions on what heirs may do with the property; or

(e) You want to leave money to someone in a trust because the person cannot manage his or her own affairs (such as a mentally handicapped child), or

(f) You want the property to be managed by a trustee for a period of time past the child’s age of majority, to age 25 or 30, for example; or

(g) You think that someone will challenge the will; or

(h) You want to exclude any lawful dependents.

The inclusion of a pour-over provision in a will does not, by itself, make a will complex.

“COVERED FAMILY MEMBER” - means Your spouse and Your unmarried dependent children, including stepchildren, legally adopted children, children placed in the home for adoption and foster children, up to age 19, and from age 19 up to 26 years if they are enrolled in an accredited school or college as full-time student(s) and are primarily dependent upon You for support.

“EFFECTIVE DATE” - means the date Your coverage hereunder begins.

“ELIGIBLE PARENT” – means Your or Covered Spouse’s parents, regardless of age. It includes, biological parents, step-parents and adoptive parents.

“HEALTH CARE COVERAGE” – means Your coverage under any health care or health insurance policy. It also means any policy that covers as its primary function any aspect of an individual’s health.

“HEALTH CARE OR MEDICAL POWER OF ATTORNEY” – A legal document that allows an individual to appoint another person to make medical decisions in the event the individual is unable to do so him/her self.

“LEGAL PLAN ADMINISTRATOR” – LegalEASE,

(a) its affiliates, officers, directors, employees, and/or

(b) agents, including third party organizations and their affiliates, officers, directors, employees, and/or

“LIVING WILL/HEALTH CARE OR ADVANCE DIRECTIVE” – A legal document that outlines an individual’s preferences for medical treatment. This document takes effect when the individual becomes incapacitated and can no longer express his or her wishes.

“MEMBER” - refers to the individual who

(a) is associated with the Policyholder and/or Plan Sponsor,

(b) has either paid a premium or had a premium paid on his or her behalf, and

“MEMBER SERVICE CENTER” - means the service location established to assist You/Covered Family Members in making full use of the coverage.

“NON-PARTICIPATING ATTORNEY” - means an attorney not contracted by the Legal Plan Administrator who:

is selected and
paid by the You

to provide covered legal services.

Covered legal services are provided up to the maximum amount shown under the Non-Participating Attorney column of the Schedule.

“PAID IN FULL” - means complete payment in full to a Participating Attorney for covered legal services.

“PARTICIPATING ATTORNEY” - means an attorney contracted by the Legal Plan Administrator to provide covered legal services. Covered legal services are provided up to the amount shown under the Participating Attorney column of the Schedule.

“PLAN SPONSOR” - means an organization other than the Policyholder or the Your employer that makes coverage hereunder available.

“POLICY” - means the Group Legal Expense Insurance Policy and the Certificate of Coverage.

“POLICYHOLDER” - means the organization named in the declarations page.

“YOU” AND “YOUR” – means Member.

“WAITING PERIOD” – means the period after the Effective Date during which certain benefits as shown in the Schedule may not be used. This includes any matter that arises prior to the end of the Waiting Period.

“WE”, “US”, “OUR” AND “COMPANY” - means Virginia Surety Company, Inc.

Covered Services

In consideration of payment and receipt by Us of the applicable premium, all Covered Services are available to You and all Covered Family Members, except as specifically noted below. The following Covered Services are provided when You use a Participating Attorney. The Schedule chart shows the reimbursement schedule when You use a Non-Participating Attorney.

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Advice and Consultation

LegalEASE Helpline:

Advice and consultation by telephone with a Participating Attorney. Services are available during normal business hours. Calls can relate to any personal legal matter, except those specifically excluded.

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Initial Law Office Consultation:

Office consultations with an attorney on any personal legal problem, except those specifically excluded.

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Review of Simple Documents:

This benefit includes:

(a) attorney review,

(b) verbal explanations of the meaning or impact of any form or document, or

of up to the maximum number of pages as shown in the Schedule.

This benefit does not include a written analysis of any form or document.

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Miscellaneous Law Office Services

Discounted Legal Services for any Non-Excluded Legal Matter:

This benefit will cover any legal services to

(a) review and/or prepare documents, or

(b) any other service required on any legal matters not listed as a Covered Service or Exclusion.

This benefit may not be used to extend the coverage for any other service shown in the Schedule beyond the limits of coverage.

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Consumer Matters

Document Preparation:

Preparation of any of the following documents:

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Simple Deed (excluding those reviewed or prepared under the real estate benefit) This benefit is limited to one use per year.

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Promissory Note: This benefit is limited to one use per year.

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Consumer Dispute Correspondence: This benefit is limited to one use per year.

VSC_LP_C1_CS_M_230-3 (202103)

Installment Sales Agreement: This benefit is limited to one use per year.

VSC_LP_C1_CS_M_240-3 (202103)

Simple Affidavit: This benefit is limited to one use per year.

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General Power of Attorney: This benefit is limited to one use per year and can be used for either a General, Limited, or Durable Financial Power of Attorney.

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Lease Agreement (for You/Covered Family Member as a tenant only). This benefit is limited to one use per year.

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Time Share Agreement: This benefit is limited to one use per year.

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Consumer Dispute:

Consultation or representation in a dispute relating to consumer goods and services (not directly or indirectly related to

(a) real estate construction or renovation, or

(b) landlord/tenant disputes).

This benefit is limited to one use per year.

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Small Claims Court Representation:

Consultation and/or representation for a dispute filed in small claims court. (Attorney may not be permitted to attend court hearings in some jurisdictions).

This benefit is limited to one use per year.

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Identity Theft Defense:

Services related to Your representation regarding potential creditor actions resulting from identity theft, and attorney services as needed to contact:

(a) creditors,

(b) credit bureaus and

It also provides defense services for specific creditor actions over disputed accounts.

This benefit is limited to one use per year.

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Estate Planning

Will Preparation: Attorney shall prepare a will or codicil and discuss the legal requirements for signing the will. This benefit does not cover Complex Wills. For a definition of Complex Wills, please see the Definitions section.

This benefit is limited to one use per year per Member/Covered Family Member.

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Living Will/Health Care or Advance Directive/Health Care or Medical Power of Attorney:

This benefit covers the preparation of up to 2 of any of the following documents as defined in the Definitions section per Member/Covered Family Member:

(a) Living Will

(b) Health Care Directive

(d) Health Care Power of Attorney

(e) Medical Power of Attorney

The titles of the above documents may vary by state. When state law allows the information contained in any two or more of the above mentioned documents to be combined into one document, then the benefit covers the preparation of only one document and cannot be combined to increase the total allowed benefit.

This benefit is limited to one use per year.

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Revocable or Irrevocable Living Trust Document:

Preparation of a revocable or irrevocable living trust for You and/or Covered Family Member. This benefit does not include services related to transactions to fund the trust or transfer assets into it. This benefit does not include tax planning or tax advice.

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Probate of Small Estate:

The service of an attorney for the probate of a small estate up to the maximum as shown in the Schedule. The estate must not be subject to current state or federal estate taxation.

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Elder Matters

Elder Parent Will Preparation:

Each Eligible Parent may receive one Simple Will per year at no charge. The attorney will prepare the document and discuss the legal requirements for signing the will. This benefit does not cover Complex Wills. For a definition of Complex Wills, please see the Definitions section.

This benefit is limited to one use per year per Eligible Parent.

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Elder Parent Living Will/Health Care or Advance Directive:

Each Eligible Parent may request one Living Will/Health Care or Advance Directive per year at no charge. For a definition of Living Will/Health Care or Advance Directive, please see the Definitions section. The attorney will prepare the documents as authorized by state law and discuss the legal requirements for signing the Living Will/Health Care or Advance Directive. The titles of the above documents may vary by state. When state law allows the information contained in any two or more of these documents to be combined into one document, then the benefit covers the preparation of both documents, and can be combined to increase the total allowed benefit.

This benefit is limited to one document/set of documents per year per Eligible Parent.

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Elder Parent Durable Financial Power of Attorney:

Each Eligible Parent may request one Durable Financial Power of Attorney per year at the co-pay rate shown in the Schedule. For a definition of Durable Financial Power of Attorney, please see the Definitions section. The attorney will prepare the documents as authorized by state law and discuss the legal requirements for signing the Durable Financial Power of Attorney. The titles of the above documents may vary by state.

This benefit is limited to one use per year.

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Elder Parent Health Care or Medical Power of Attorney:

Each Eligible Parent may request one Health Care or Medical Power of Attorney per year at the co-pay rate shown in the Schedule. For a definition of Health Care or Medical Power of Attorney, please see the Definitions section. The attorney will prepare the documents as authorized by state law and discuss the legal requirements for signing the Health Care or Medical Power of Attorney. The titles of the above documents may vary by state. When state law allows the information contained in any two or more these documents to be combined into one document, then the benefit covers the preparation of only one document and can not be combined to increase the total allowed benefit.

This benefit is limited to one use per year.

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Residential Matters

Real Estate Sale, Purchase or Refinancing of Primary Residence:

The services of an attorney for the sale, or purchase or refinancing of a primary residence (where You have resided or intends to reside for twenty-seven (27) weeks or more per year).

This service includes:

(a) the review and/or preparation of closing documents and/or

(b) attendance by the attorney at closing in situations when it is customary for the attorney to do so.

This benefit does not include:

(a) services performed by or for a title company, or

(b) for an attorney acting on behalf of a lending institution.

Home equity loans and the sale or purchase of unimproved or rental properties are not included.

This benefit does not include any fees or costs other than those related to the attorney’s review of the purchase/sale documents.

This benefit is limited to one closing per year.

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Tenant Dispute:

Representation of You as a tenant in a dispute with Your landlord. This benefit does not include:

(a) representation for a tenant in a dispute with other tenants or

(b) for a tenant acting in his/her capacity as sublessee or sublessor.

This benefit is limited to one use per year.

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Financial Matters

Debt Collection Defense:

The defense of any dispute involving personal (non-business related) debt.

This benefit includes:

(a) correspondence,

(b) negotiating with creditors to arrange a repayment schedule,

(d) negotiating settlement after a complaint is filed.

This service does not include:

(a) defense against execution of a court-ordered judgment or

(b) efforts to vacate or set aside a judgment.

This benefit is limited to one use per year.

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Bankruptcy:

Representation on Your behalf for personal bankruptcy protection under Chapter 7 or 13 of the Internal Revenue Code. This benefit does not include business related bankruptcy.

This benefit is limited to one use per year.

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Foreclosure:

Defense of You in an action to foreclose on Your primary residence (where You have resided or intends to reside twenty-seven (27) weeks or more per year.)

This benefit is limited to one use per year.

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Tax Audit:

This benefit includes:

(a) the services of an attorney (but not accounting services) during a personal (non-business related) tax audit required by federal and

(b) state tax authorities and negotiations relating to it.

This benefit does not include a defense against criminal charges nor the defense of civil tax litigation in any tax court.

This benefit is limited to one use per year.

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Family Matters

Separation, Divorce, Civil Annulment:

Legal representation of You for up to the maximum shown on the Schedule in an uncontested separation or civil annulment; consent or default divorce, uncontested divorce or Contested Divorce. An uncontested separation, divorce or civil annulment does not involve significant disputed issues and the parties resolve any issues prior to any court supervised proceeding.

A consent or default divorce does not involve any disputed issues and the opposing party is not represented by counsel.

The benefit for uncontested matters does not provide any coverage of an attorney’s fee for:

(a) services in excess of the maximum shown on the Schedule, You must pay the attorney’s fee for services in excess of the maximum;

(b) contested matters in which case the Member must pay the attorney’s fee for services, unless the coverage includes contested matters and the benefit shall be in accordance with the Schedule; or

A contested separation, divorce or civil annulment requires:

(a) more than five hours of attorney time and

(b) involves disputed issues and

This benefit is limited to one use per year (representation seeking or defending against interim order shall constitute a separate use).

This benefit applies to the Member and Covered Family Members only for actions not involving the Member as an opposing party.

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Post-Divorce Proceedings:

Legal representation of You for up to the maximum listed on the Schedule in a contested or uncontested post-divorce proceeding. An uncontested post-divorce proceeding does not involve significant disputed issues and the parties resolve any issues prior to any court supervised proceeding.

The benefit for uncontested matters does not provide any coverage of an attorney’s fee for:

(a) services in excess of the maximum listed on the Schedule; You must pay the attorney’s fee for services in excess of the maximum;

(b) contested matters in which case You must pay the attorney’s fee for services, unless the coverage includes contested matters and the benefit shall be in accordance with the Schedule.

A contested post-divorce proceeding requires:

(a) more than five hours of attorney time,

(b) involves disputed issues and

This benefit includes custody, support, and alimony proceedings.

This benefit is limited to one use per year.

This benefit applies to the Member only.

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Prenuptial Agreement:

This service covers the preparation of an agreement by You and Your fiancé/partner prior to Your marriage or legal union (where allowed by law), outlining how property is to be divided in the event of:

(a) separation,

(b) divorce or

Representation is provided only to You. The fiancé/partner must have separate counsel or must waive representation.

This benefit is limited to one use per year.

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Name Change:

Services required to accomplish a legal name change for You/Covered Family Member.

This benefit is limited to one use per year.

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Uncontested Guardianship/Conservatorship:

Services required to establish You/Covered Family Member as the guardian(s) or conservator(s) of a family member of either You or Covered Spouse. This benefit does not include fees for a court-appointed attorney for the child/conservatee. This benefit does not include contested matters.

This benefit is limited to one use per year.

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Uncontested Government Agency/Stepparent Adoption:

Legal representation up to the maximum shown in the Schedule in an uncontested:

(a) governmental agency or

(b) stepparent adoption.

An uncontested adoption does not involve significant disputed issues.

This benefit does not include:

(a) contested termination of parental rights;

(b) fees for a court-appointed attorney for the child; or

A contested adoption requires:

(a) more than five hours of attorney time and

(b) involves disputed issues.

This benefit is limited to one use per year.

VSC_LP_C1_CS_M_760/770-4 (202103)

Juvenile Court Proceeding:

Services related to the representation of Your/Covered Family Member’s dependent child in any juvenile court proceeding, provided the child’s interest is not in conflict with the Your and/or Covered Family Member’s interest. This benefit does not cover any matter that falls outside the jurisdiction of juvenile court or any matter that may be considered a felony.

This benefit is limited to one use per year.

VSC_LP_C1_CS_M_780-3 (202103)

Civil Matters

Civil Litigation Defense:

Services related to representation when You are named as defendant in a filed civil lawsuit (non-business related), up to and including the trial thereof. This benefit does not include: (a) any debt collection or family law matters; (b) lawsuits normally handled on a contingent fee basis; or (c) matters for which You have or are required by law to have insurance.

This benefit is limited to one use per year.

VSC_LP_C1_CS_M_800-2 (202103)

Discounted Contingency Fees:

Participating Attorneys will handle the matter at a maximum percentage of the gross award. It is Your responsibility to pay this fee and all costs.

(a) When state laws set contingency fees: Lesser of 10 % less than state law maximum fee or the Participating Attorney’s usual fee.

(b) When state laws do not set contingency fee: Maximum of 29 % if settled before trial, 36 % if trial is conducted, or 40 % after an appellate brief is filed.

Contingency rate discount applies in those cases where attorneys customarily take a case on a contingency fee, (an agreed upon portion of any recovery), depending on the outcome of the case.

VSC_LP_C1_CS_M_840 (202103)

Mediation:

This benefit does not include the cost of the mediator’s services.

This benefit is limited to one use per year.

This benefit applies to the Member only.

VSC_LP_C1_CS_M_850-2 (202103)

Traffic and Administrative Matters

Traffic Ticket:

Services related to representing You in defense of any traffic ticket except driving under influence or vehicular homicide, including:

(a) court hearings,

(b) negotiation with the prosecutor,

(d) counseling and preparing You for self-representation at any hearings if chosen.

This benefit does not cover violations related to a commercial driver’s license. This benefit does not apply to Driving Under the Influence (DUI) or Driving While Intoxicated (DWI) violations/citations.

This benefit is limited to one use per year.

VSC_LP_C1_CS_M_810-3 (202103)

Serious Traffic Matter:

Services related to representing You when You are:

(a) charged by governing authorities with moving traffic violation(s) and

(b) conviction could result in suspension or revocation of a state-issued license permitting a person to drive a motor vehicle.

This benefit does cover violations related to a commercial driver’s license. This benefit does not apply to Driving Under the Influence (DUI) or Driving While Intoxicated (DWI) violations/citations. This benefit cannot include expungements of misdemeanor convictions. This benefit does not include adjustments to probation or parole.

This benefit is limited to one use per year.

VSC_LP_C1_CS_M_900-2 (202103)

Administrative Proceeding:

Services related to representing You in an administrative proceeding relating to the:

(a) suspension or

(b) revocation

of driving privileges.

This benefit does not cover suspension or revocation of a commercial driver’s license.

This benefit is limited to one use per year.

VSC_LP_C1_CS_M_910-4 (202103)

Obtaining Benefits

Claim for Benefits

1. You should call the Member Service Center to confirm the potentially applicable benefit(s) prior to consulting with any attorney. You/Covered Family Member must provide all information requested with respect to the circumstances of an insured event or service provided. The Member Service Center will assign a Participating Attorney to provide services relative to the matter. Failure to notify the Member Service Center within thirty (30) days following consultation with an attorney may result in a denial of benefits.

2. To confirm coverage for matters to which Managed Case Rules apply reference Managed Case Rules in the Schedule.

3. Members and/or Covered Family Members who are requesting services must remain enrolled and continue to pay premium hereunder.

4. Upon completion of a Covered Service, You/Covered Family Member may be required by the Participating Attorney to sign a confirmation of completion. Failure to sign the confirmation may result in denial of the claim and You/Covered Family Member will be responsible for all legal fees.

5. If You/Covered Family Member pay for pre-authorized services provided by a Non-Participating Attorney, You must:

(a) submit a reimbursement form (provided by Member Service Center) accompanied by an original itemized bill,

(b) proof of payment and

sufficient to demonstrate the work completed in the matter within sixty (60) days after incurring the legal fees. Benefits provided to You/Covered Family Member for Covered Services are subject to the maximum as shown in the Schedule.

6. Payment by Us for Covered Services does not preclude the attorney (whether Participating or Non-Participating) from seeking and recovering attorney’s fees from an opposing party, where authorized by:

(a) law,

(b) court rule, or

at the attorney’s customary or prevailing rate.

If You/Covered Family Member receive reimbursement of attorney’s fees, then You/Covered Family Member agree to reimburse Us for payments issued.

Disputes Between Member and Covered Family Member

In the event that Your and one of the Covered Family Members are involved as adversaries in a dispute that is a Covered Service, only You will be covered.

If two or more Covered Family Members are involved in a dispute that is otherwise covered, no coverage will be provided.

If two Members are involved as adversaries in a dispute that is a Covered Service, separate coverage for each Member will be provided.

VSC_LP_D1 (202103)