Abington-Jefferson Health

Welcome

Benefits Proudly Offered to Abington-Jefferson Health Employees

Be fully prepared and confident

with LegalGUARD^sm

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

Product Administered By: LegalEASE

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. LegalGUARD provides coverage for your specific legal matter so you won't be caught off guard.

Protect your family’s future, with LegalGUARD.

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 LegalGUARD Plan. LegalGUARD 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 LegalGUARD 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.

Be fully prepared and confident with LegalGUARD.

Nobody likes to be caught off guard, especially when it comes to legal matters. So how can you affordably protect you and your family from those unforeseen events? By becoming a LegalGUARD member for less than a cup of coffee a day, your family and your wallet have the protection of the LegalGUARD Plan. Life can be complicated. Finding a good attorney doesn’t have to be. With LegalGUARD, 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 LegalGUARD member saves you time and costly legal fees. But most importantly, it gives you confidence and provides coverage for common legal matters.

With a LegalGUARD 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

Coverage

The Value of a LegalGUARD Plan.

Being a LegalGUARD 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
Elder Law

LegalGUARD 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 LegalGUARD 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 LegalGUARD Plan is only $13.66 per month, via payroll deduction.

Who's Covered?

The Member’s lawful spouse or same sex partner and children. Eligible Family Members are the Member’s spouse or same sex partner and Member’s unmarried dependent children, including stepchild, legally adopted child, child placed in the home for adoption and foster child, up to age 19, and from age 19 up to 25 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	LegalGUARD Plan Coverage Participating Attorney	LegalGUARD Plan Coverage Non-Participating Attorney
LegalEASE Helpline	Paid in Full	N/A
Initial Law Office Consultation	Paid in Full	$60/consultation
Review of Simple Documents up to 10 Pages	Paid in Full	$60
Financial and Tax Helpline	Paid in Full	N/A
Miscellaneous Law Office Services⁴	LegalGUARD Plan Coverage Participating Attorney	LegalGUARD Plan Coverage Non-Participating Attorney
	25% Discount	N/A
Consumer Matters	LegalGUARD Plan Coverage Participating Attorney	LegalGUARD Plan Coverage Non-Participating Attorney
Document Preparation: Simple Deed Promissory Note Consumer Dispute Correspondence Installment Sales Agreement Simple Affidavit General Power of Attorney Family Member Lease Agreement - Tenant Only Time Share Agreement	Paid in Full	$60 $60 $60 $60 $60 $60/document $40/Family Member document $60 $60
Consumer Dispute	Paid in Full	$60
Small Claims Court Representation	Paid in Full	$120
Life Insurance Claims	Paid in Full	$2,000 maximum Subject to Managed Case Rules
Identity Theft Defense	Paid in Full	$250
Will, Codicil, Power of Attorney, Trust and Probate	LegalGUARD Plan Coverage Participating Attorney	LegalGUARD Plan Coverage Non-Participating Attorney
Will or Codicil for Member Spouse	Paid in Full	$90
Will or Codicil for Family Member⁴	$60 per Will	$60
Complex Will for Member/Spouse	Paid in Full	$150
Living Will or Health Care Power of Attorney	Paid in Full	$40
Living Trust Document	Paid in Full	$240
Probate of Small Estate	Paid in Full	$120
Home and Residential Matters	LegalGUARD Plan Coverage Participating Attorney	LegalGUARD Plan Coverage Non-Participating Attorney
Purchase of Primary Residence	Paid in Full	$420
Sale of Primary Residence	Paid in Full	$240
Refinancing of Primary Residence	Paid in Full	$150
Landlord/tenant disputes	Paid in Full	$2,000 maximum Subject to Managed Case Rules
Financial Matters	LegalGUARD Plan Coverage Participating Attorney	LegalGUARD Plan Coverage Non-Participating Attorney
Debt Collection Defense: Pre-litigation defense	Paid in Full	$120
Debt Collection Defense: Trial defense	Paid in Full	$480 maximum Subject to Managed Case Rules
Bankruptcy, Chapter 7 or 13	Paid in Full	$660 maximum Subject to Managed Case Rules
Foreclosure	Paid in Full	$450 maximum Subject to Managed Case Rules
Tax Audits	Paid in Full	$2,000 maximum Subject to Managed Case Rules
Civil Litigation Defense	LegalGUARD Plan Coverage Participating Attorney	LegalGUARD Plan Coverage Non-Participating Attorney
Civil Litigation Defense	Paid in Full	$2,000 maximum Subject to Managed Case Rules
Traffic Tickets	Paid in Full	$120
Incompetency Defense	Paid in Full	$2,000 maximum Subject to Managed Case Rules
Family Law	LegalGUARD Plan Coverage Participating Attorney	LegalGUARD Plan Coverage Non-Participating Attorney
Uncontested Separation	Paid in Full	$200
Consent/default Divorce	Paid in Full	$400
Uncontested Divorce	Paid in Full	$600
Contested Divorce	Paid in Full	$2,000 maximum Subject to Managed Case Rules
Name Change	Paid in Full	$200
Guardianship/Conservatorship	Paid in Full	$400
Governmental Agency Adoptions	Paid in Full	$300
Stepparent Adoptions	Paid in Full	$400
Juvenile Court Proceedings	Paid in Full	$375
Immigration Assistance	Paid in Full	$300
Criminal Defense	LegalGUARD Plan Coverage Participating Attorney	LegalGUARD Plan Coverage Non-Participating Attorney
Serious Traffic Matters (resulting in suspension or revocation of license)	Paid in Full	$360
Administrative proceeding (regarding suspension or revocation of license)	Paid in Full	$300
Misdemeanor Defense	Paid in Full	$2,000 maximum Subject to Managed Case Rules
Additional Benefits	LegalGUARD Plan Coverage Participating Attorney	LegalGUARD Plan Coverage Non-Participating Attorney
Identity Theft Recovery Assistance²	Included	N/A
Elder Law²	Included	N/A

¹Some Limitations May Apply.

²Additional Benefits

Managed Case Rules require the following:

Member and/or Family Member must secure a confirmation letter from the Member Service Center prior to proceeding with an attorney.
The attorney must provide a written estimate of fees reflecting his or her best judgment as to the likely conduct of the case.
We will set a maximum attorney fee that takes into account 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 the responsibility of the Member and/or Family Member.

Definitions

“PLAN ATTORNEY” - means an attorney associated with a private law firm, who is licensed to practice law in the Member’s state. These attorneys have been contracted to provide legal advice and simple service by telephone to Members.

“ADMINISTRATOR” - means LegalPlans USA, L.L.C; or its subsidiary.

“CLIENT CENTER” - means the service location established to help make full use of the Policy.

“COMPLEX WILL” - means the Member has a significant net worth and will benefit from tax planning, or the estate is subject to current state or federal estate taxation; the Member owns a business that will continue in operation after death; the Member wants to put restrictions on what heirs may do with the property; the Member wants 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 wants 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; the Member thinks that someone will challenge the will; and/or the Member wants to exclude any lawful dependents.

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

“FAMILY MEMBER” - means the Member’s lawful spouse or same sex partner and children. Eligible Family Members are the Member’s spouse or same sex partner and Member’s unmarried dependent children, including stepchild, legally adopted child, child placed in the home for adoption and foster child, up to age 19, and from age 19 up to 25 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.

“MEMBER” - refers to the individual who is associated with the Policyholder and who has paid or a premium has been paid on their behalf and who meets the eligibility requirements for Covered Services in the Policy.

“NON-PARTICIPATING ATTORNEY” - means an attorney not retained by Administrator who is selected and paid by the Member to provide services covered under the Policy up to the maximum amount as shown in the Schedule of Benefits.

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

“PARTICIPATING ATTORNEY” - means an attorney retained by the Administrator to provide covered legal services at the amount shown in the Schedule of Benefits.

“PLAN SPONSOR” - means an organization other than the Policyholder or the Member’s employer which makes coverage hereunder available.

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

“WE”, “US”, “OUR” AND “COMPANY” - means the name of the underwriter indicated on the declarations page of this Policy.

Covered Services

In consideration of payment and receipt by Us of the applicable premium, all Covered Services are available to a Member and the Member’s spouse and eligible dependents. Except as noted below, the following Covered Services are provided to the Member when the Member uses a Participating Attorney. The Schedule of Benefits chart shows the reimbursement schedule when the Member uses a Non-Participating Attorney.

Advice and Consultation

LegalEASE Helpline:

Advice and consultation by toll-free telephone with a Plan Attorney. Services are available during normal business hours (EST) or in an emergency, on a 24-hour basis. Calls can relate to any personal legal matter, civil or criminal, except those specifically excluded.

Financial and Tax Helpline:

Consultation by toll-free telephone during normal business hours (EST). Calls can relate to investment strategies, debt matters, taxes or any personal financial planning question.

Initial Law Office Consultation

Up to the maximum as shown in the Schedule of Benefits for office consultations with a Participating Attorney on any personal legal problem, civil or criminal, except those specifically excluded. See Miscellaneous Law Office Services.

Miscellaneous Law Office Services

Benefits not specifically covered or excluded hereunder to be provided at an amount shown in the Schedule of Benefits.

Review of Simple Document

The Plan Attorney will verbally explain the meaning or impact of any form or document, or make suggestions for changes to a form or document being drafted of up to the maximum number of pages as shown in the Schedule of Benefits. This benefit does not include a written analysis of any form or document.

OnLine Legal Access

Internet access to legal information and documents for many common legal situations. This feature is designed for Members and/or Family Members who wish to independently research legal issues either before or after contacting an Plan Attorney. OnLine Legal Access can be activated through the internet by contacting the following website: www.legalaccessplans.com.

Document Preparation

Preparation of any of the following documents: simple deed (excluding those reviewed or prepared under the real estate benefit), promissory note, consumer dispute correspondence, installment sales agreement, general power of attorney, lease agreement (tenant only), time share agreement, and simple affidavit.

Life Insurance Claims

Assistance to Members in securing life insurance proceeds (not including life insurance provided as an employee benefit) when a Member and/or Family Member is a beneficiary of a life insurance policy.

Consumer Dispute

Consultation or representation in a dispute relating to consumer goods and services (not involving real estate construction, landlord/tenant disputes or renovation).

Small Claims Court Representation

Consultation and/or representation for a consumer dispute filed in small claims court.

Identity Theft Defense

Services providing members with consultations with an attorney regarding potential creditor actions resulting from identity theft, and attorney services as needed to contact creditors, credit bureaus and financial institutions. It also provides defense services for specific creditor actions over disputed accounts as set forth in the Debt Collection Defense coverage. In addition, it provides members with online help and information about Identity Theft and prevention. Also includes support counseling for members for the purpose of assisting with Identity Theft restoration.

Will and Codicil Preparation

Simple will and/or complex will-Paid in Full for members and/or spouse. Preparation of one simple will or codicil (an amendment to an existing will) for the Member and spouse or same-sex partner only, including the preparation of a simple testamentary support trust for the dependent children:

Simple Will Preparation:

Plan Attorney shall prepare a simple will or codicil for Member and Family Member and discuss the legal requirements for signing the will. A simple will or codicil may be prepared for Family Member at an additional cost as shown in the Schedule of Benefits.

Complex Will Preparation:

Plan Attorney shall prepare a complex will or codicil for Member and or spouse only. Other covered family members will receive a 25% discount on said services.

Living Will and/or Health Care Power of Attorney

Preparation of living will and/or health care power of attorney for Member and/or Family Member as authorized by state law. A living will expresses an individual’s wishes as to the use or withdrawal of life support systems. A health care power of attorney appoints another to make medical decisions if the individual is unable to do so him/her self.

Living Trust Document

Preparation of living trust documents. This benefit does not include services related to transactions to fund the trust or transfer assets into it.

Probate of Small Estate

The service of an attorney for the probate of a small estate (an estate that is not subject to current state or federal estate taxation) up to the maximum as shown in Schedule of Benefits.

Real Estate Sale, Purchase or Refinancing of Primary Residence

The services of an attorney for the purchase, sale, or refinancing of a Member’s primary residence (where Member has resided or intends to reside for twenty-seven (27) weeks or more per year). This service includes the review or preparation of closing documents and/or attendance by the Member’s attorney at closing in situations when it is customary to do so. This benefit does not include services performed by or for a title company, or 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.

Landlord/Tenant Disputes

Representation of the Member and/or Family Member as a tenant in a dispute with his/her landlord.

Debt Collection Defense

The defense of any dispute involving personal (non-business related) debt. This benefit includes correspondence, negotiating with creditors to arrange a repayment schedule, assistance in limiting harassment by bill collectors, and negotiating settlement after a complaint is filed. This service does not include defense against execution of a court-ordered judgment or efforts to vacate or set aside a judgment.

Bankruptcy

Representation on behalf of the Member or Family Member for personal (non-business related) bankruptcy protection under Chapter 7 or 13 of the Internal Revenue Code.

Foreclosure

Defense of the Member in an action to foreclose on the Member’s primary residence (where Member has resided or intends to reside twenty-seven (27) weeks or more per year.)

Tax Audits

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

Separation, Divorce, Annulment

Contested and Uncontested Divorce-Paid in Full. Legal representation of the Member only for separation, divorce, civil annulment, consent or default divorce.

Name Change

Services required to accomplish a legal name change for a Member or Family Member.

Guardianship/Conservatorship

Services required to establish a Member and/or Family Member as the guardian(s) or conservator(s) of another. This benefit does include contested matters.

Adoption

Uncontested and contested adoptions - Paid in Full. Legal representation for a Member and/or Family Member for a governmental agency or stepparent adoption. This benefit does not include: (1) fees for a court-appointed attorney for the child; or (2) adoptions(s) made through any agency other than a governmental agency.

Juvenile Court Matters

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

Immigration Assistance

Advice and consultation, preparation of affidavits and powers of attorney, review of any immigration documents and lend help to members who are preparing for immigration hearings.

Civil Litigation Defense

Services related to the representation of a Member and/or Family Member who is a named defendant in a civil lawsuit (non-business related), up to and including the trial thereof. This benefit does not include: (1) any debt collection or family law matters; (2) lawsuits normally handled on a contingent fee basis; or (3) matters for which the Member has or is required by law to have insurance.

Traffic Tickets

This service covers representation of the Participant in defense of any traffic ticket except driving under influence or vehicular homicide, including court hearings, negotiation with the prosecutor, trial, and counseling and preparing member for self-representation at any hearings if chosen.

Incompetency Defense

Services covering members in the defense of any incompetency action, including court hearings when there is a proceeding to find the Participant incompetent.

Serious Traffic Matters

Services related to the representation of a Member and/or Family Member who is charged by governing authorities with moving traffic violation(s) and conviction could result in suspension or revocation of Member’s and/or Family Member’s drivers’ license.

Administrative Proceeding

Services related to the representation of a Member and/or Family Member in an administrative proceeding relating to the suspension or revocation of driving privileges.

Misdemeanor Defense

Defense of a Member and/or Family Member in connection with criminal misdemeanor charges (not associated with any felony charge). This benefit does not include defense of moving traffic violations.

Identity Theft Recovery Assistance

Coverage includes a basic Identity Theft Help Line Service for covered members.

Advice and Consultation
1. Free ½ hour telephonic consultations (4 per year) with a Trained Identity Theft Recovery Specialist (consultations can also be online – member’s choice)
2. Online Assistance in understanding identity theft prevention
3. Unlimited access to complete identity theft legal issue law libraries
Additional Benefits
1. Personal Recovery Kit – designed to walk a victim of identity theft step-by-step through the process of recovery (designed to be utilized in conjunction with the free consultations with the Recovery Specialist).
2. Free Simple Recovery Letter preparation by plan attorney – a plan attorney will draft the simple affidavits to submit to specific agencies and organizations needed to establish the theft of your identity and prevent further loss of your identity and credit rating.
3. Free Review of necessary recovery legal documents (up to 6 pages each)

Elder Law Services

Your benefits package includes Elder Law Services as described below. These benefits are in addition to plan services described in your Certificate of Coverage.

Eligibility of Parents
1. Parents of the Plan Member and the Member’s Spouse, regardless of age, are eligible for benefits under the Elder Law coverage described herein.
2. The benefits specified below extend not only to the Member’s Parents and the Member’s Spouse’s Biological Parents, but their Step-Parents and Adoptive Parents as well.
Benefits for Elder Parents
1. Advice and Consultation
  1. LegalADVISOR Helpline: Member may receive advice and consultation by toll-free telephone with a Plan Attorney. Services are available during normal business hours. Calls can relate to any personal legal matter, civil or criminal.
  2. Financial Helpline: Member will receive consultation by toll-free telephone during normal business hours. Calls can relate to investment strategies, debt matters or any personal financial planning question
2. Simple Wills & Living Wills
  1. Simple Will Preparation: Each Eligible Parent, as defined above, may receive one Simple Will per year at no charge. Plan Attorney will prepare the document and discuss the legal requirements for executing the Will.
    
    Simple Will means the will maker does not have a significant net worth and will not benefit from tax planning, or the estate is not subject to current state or federal estate taxation; the will maker does not own a business that will continue in operation after death; the will maker does not want to put restrictions on what heirs may do with the property; the will maker does not 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 does not 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; the will maker does not think that someone will challenge the will; and/or the will maker does not want to exclude any lawful dependents.
  2. Living Will Preparation: Eligible Parents, as defined above, may request one Living Will per year at no charge. Plan Attorney will prepare the document as authorized by state law and discuss the legal requirements for signing the Living Will. A Living Will expresses an individual’s wishes as to the use or withdrawal of life support systems.
  3. Additional documents may be prepared for a minimal charge:
    1. Additional documents may be prepared for a minimal charge, up to once per year per Eligible Parent, as described above:
      - Healthcare Directive - $45 fee per document
      - Financial Power of Attorney - $45 fee per document
      - Durable Power of Attorney - $45 fee per document
      - Healthcare Durable Power of Attorney - $45 fee per document
        
        Any 3 or more of the above documents may be prepared for a package cost of $115 per set.

Obtaining Policy Benefits

Telephone Advice and Consultation on Legal and Financial Matters

Consultation by toll-free telephone with an attorney. Services are available during normal business hours (EST) Calls can relate to any personal legal matter, civil or criminal, except those specifically excluded herein.

Financial and Tax Helpline:

Consultation by toll-free telephone during normal business hours (EST). Calls can relate to investment strategies, debt matters, taxes or any personal financial planning question.

Claim for Benefits

Members must call the Member Service Center to confirm eligibility and coverage prior to consulting with any attorney. The Member Service Center will assign a Participating Attorney to provide services relative to the matter. Failure to notify Member Service Center within thirty (30) days following consultation with an attorney may result in a denial of benefits.
To obtain benefits under the Managed Case Rules:
- Members and/or Family Member must secure a confirmation letter from the Member Service Center prior to proceeding with an attorney.
- The attorney must provide a written estimate of fees reflecting his or her best judgment as to the likely conduct of the case.
- We will set a maximum attorney fee that takes into account the reasonable level of reimbursement for the proceeding and the proposed litigation strategy. Fees as a result of services in excess of the maximum attorney fee are the responsibility of the Member and/or Family Member.
Members actively receiving services under this Policy must remain enrolled and continue to pay premium hereunder. All Policy benefits will be subject to subrogation and coordination of benefit rules.
Upon completion of a Covered Service, the Member and/or Family Member will be required by the Participating Attorney to sign a confirmation of completion.
If the Member and/or Family Member pays for pre-authorized services provided by a Non-Participating Attorney, the Member must submit a reimbursement form (provided by Member Service Center) accompanied by an original itemized bill within sixty (60) days after incurring the legal fees. Benefits provided to the Member and/or Family Member for Covered Services are subject to the maximum as shown in the Schedule of Benefits.

Disputes between Member and Family Member

In the event that the Member and one of the Family Members are involved as adversaries in a dispute that is a Covered Service, the Policy will cover the Member only.

If two or more Family Members are involved in a ispute that is otherwise covered under the Policy, the Policy will provide no coverage.

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

Exclusions

This Policy excludes benefits for the following:

Appellate court proceedings, class actions, interventions, derivative action and amicus curiae filings.

The preparation and filing of individual, partnership or estate tax returns, appellate or administrative proceedings related to tax returns, 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.

Matters relating to securities, trademark or patent matters; business or commercial interests, including, but not limited to, professional, partnership and/or corporate matters; matters involving the law or laws of jurisdictions other than the United States and its territories and Canada; any matters involving a government (domestic or foreign) entity or agency; farm related issues; matters involving commercial or rental property transactions, including the purchase, sale or lease of investment or income-producing property. A two-family house, whether or not used by the Member as his or her primary residence, is deemed an investment or income-producing property.

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

Matters that the attorney deems frivolous, spurious, harassing, or unethical (collectively referred to as “frivolous”) or otherwise prohibited by the Model Rules of Professional Conduct of the state in which the attorney is licensed.

Costs associated with covered legal services, including but not limited to, all fines, court costs, penalties, sanctions, expert witness fees, bonds, bail bonds, attorney fees, exhibits, deposition costs, filing fees, transcripts, postage, telephone, photocopying, recording fees, messengers, judgements, jury fees, court reporter fees, investigative costs and all other

incidental and out-of-pocket legal and litigation costs.

Any services on behalf of a Family Member against the interests of the Member.

Any employment-related matter. This includes, but is not limited to, any dispute involving the Member’s employer or its affiliates, their officers or directors, the Member’s employee benefit plans, credit unions, programs or arrangements sponsored by an employer, or cases involving workers’ compensation, unemployment compensation, sex harassment, age discrimination, etc.

Any dispute or proceeding against the following persons or entities, their officers, directors, employees, or agents: any person or entity involved in the sale of the group policy; Administrator or its subsidiaries; Policyholder; Member’s employer; Virginia Surety Company, Inc. it’s parents, subsidiaries or any affiliated or successor company, plan underwriter or reinsurer; Plan Sponsor; or any Participating and/or Non-Participating Attorney, if the dispute or proceeding pertains to services provided under the group policy / Certificate of Coverage.

Except regarding LegalEASE Helpline and Financial and Tax Helpline services, benefits will not be provided in connection with pre-existing matters, which includes any matter where the Member and/or Family Member is on notice as to a pending legal dispute or has previously contacted an attorney.

General Provisions

Attorney-Client Relationship

All attorneys are subject to the authority of the State Supreme Court and the State Bar of the state where they are licensed to practice. The Member’s relationship with an attorney is privileged and strictly confidential. We will not interfere in the attorney-client relationship, nor in the attorney’s independent exercise of his or her professional judgment. Attorneys are not certified specialists.

Member shall authorize Participating Attorney to provide the Administrator with anonymous statistical reports on the number and type of services provided to Member.

By using legal services benefits for which are provided under the Policy, the Members agree that neither We, nor the Policyholder, nor any other person involved in the marketing or administration of the Policy, shall have any liability for the acts, errors or omissions of an attorney providing services, in whole or in part, under the Policy.

Non-Participating Attorney Services

If the Member already has an attorney, the Member may prefer to use her/him as a Non-Participating Attorney. To do so, the Member must first contact the Member Service Center and notify the representative of his/her intention to use a Non-Participating Attorney for a Covered Service. The Member Service Center will send the Member a claim form to request reimbursement from the Policy. The Member’s reimbursement will be based on the reimbursement schedule as shown in the Schedule of Benefits.

Legal Terminology

The Member or Family Member may call the Member Service Center to obtain a definition or explanation of any term used herein.

Coverage Period

The coverage period is automatically renewable upon receipt of appropriate premium unless terminated in accordance with the terms hereof.

Coverage Territory

The coverage territory includes the states where the Company employs its employees.

Premium Refund Provision

In the event that the premium mode is other than monthly and the Policy is terminated or the Member elects to terminate the coverage, a prorata premium refund will be made in accordance with the insurance laws of the Policyholder’s state.

Termination and Cancellation of Coverage

Coverage provided to Member shall terminate upon the first of the following to occur:

Cancellation or termination of this Policy;
If applicable, the Member fails to re-enroll;
The Member is no longer associated with Policyholder; or
The Member fails to remit premium when due, subject to the statutory grace period.

Coverage provided to Family Member of a Member shall terminate upon the first of the following to occur:

The Member’s coverage is cancelled or terminated; or
The Family Member ceases to be an eligible Family Member of the Member’s coverage.

When coverage for a Member and/or Family Member terminates and a matter is unresolved when coverage terminated, then any further legal work between said Member and/or Family Member and the Plan Attorney shall be outside the scope and coverage of the Policy. The Plan Attorney shall not be obligated to provide any benefits under the Policy and any further legal services shall be based upon an independent and separate fee agreement entered into, if at all, between the former Member and/or Family Member and the attorney. If such an agreement is not entered into, then the Plan Attorney may withdraw from any further representation in accordance with applicable law and State Bar standards.

After this Policy has been in effect for sixty (60) days or more, it may be cancelled for one of the following reasons:

Nonpayment of premium by Policyholder for covered Members;
Policy is obtained through material misrepresentation;
Policyholder violated the material terms and condition of the Policy;
The risk originally accepted has measurably increased;
Loss of reinsurance by the Company;
Continuation of the Policy would be in violation of the law;
Company elects to discontinue underwriting the Policy for this class of risk.

The Company shall provide written notice of cancellation to the Policyholder at least sixty (60) days prior to the effective date of such cancellation. If the Company cancels for non-payment of premium, the Company shall provide written notice of cancellation to the Policyholder at least ten (10) days prior to the effective date of such cancellation. All notices shall state the reason for cancellation. The Policyholder is responsible for notifying the Members of cancellation.

Premium Remittance

Policyholder shall remit premium to Company no later than the 10th calendar day following the month for which Policy coverage is provided.

Grace Period

The Policy provides Policyholder a grace period of thirty-one (31) days after the premium for covered Members due date to remit the premium that is due and unpaid. During the grace period, this Policy will continue in effect. If the premium for covered Members remains unpaid at the end of the grace period, the Policy will terminate. Termination will be effective at 12:01 a.m. on the thirty-second (32nd) day following the due date for which premium for covered Members remains unpaid. Policyholder shall remain liable for the prorata portion of all premiums that accrue for the period this Policy is in effect.

Amendment of the Policy

The Policy may be amended or changed at any time by the Company upon written notice thereof and signed by a duly authorized representative. No agent, broker or sales representative may make any change in this Policy or waive any of its provisions.

Notice of Policy Provisions

Notice to any agent or knowledge possessed by any agent or by any other person shall not effect a waiver or change any part of the Policy or stop Us from asserting any right under the terms of the Policy; nor shall terms of the Policy be waived or changed except as stated above.

Change in Premium

We shall provide the Policyholder written notice within thirty (30) days prior to the anniversary date of the Policy for any change in premium to be implemented. Any such change shall apply to the Policyholder on the

anniversary date of the Policy. The Policyholder is responsible for notifying the Members of the change in premium.

Arbitration

The issuance of this coverage takes place in and substantially affects interstate commerce. Any dispute,

controversy, or cause of action by the Policyholder and its Members arising out of or relating in any way to, this insurance, or to the sale or solicitation of this insurance, shall be settled by arbitration under the provision of the Federal Arbitration Ace, 9 U.S.C., section 1, et seq. Such arbitration shall be governed by the rules of the American Arbitration Association. The arbitration shall be conducted at our home office or such other location as We and the Policyholder/Member agree. The arbitration panel shall consist of three arbitrators, one selected by Us, one selected by the Policyholder/Member and one selected by the arbitrators previously selected.

If We, a Policyholder/Member, or a third party have any dispute that is directly or indirectly related to a dispute governed by this arbitration provision, the Policyholder/Member and We agree to consolidate all such disputes.

The arbitration shall be binding upon the Policyholder/Member and Us. Any award may not be set aside in

later litigation except upon the limited circumstances set forth in the Federal Arbitration Act. The

Policyholder/Member and We give up the right to seek remedies in Court, including the right to a jury trial. Judgment upon the award rendered may be entered in any Court having jurisdiction thereof. The arbitration

expenses shall be borne by the losing party or in such proportion as the arbitrators shall decide.

Conversion

The Member may continue this insurance by converting to an individual policy subject to state availability when the Member no longer qualifies as an employee of the Policyholder or as a Member of the group to which this Policy is issued. The Member must notify us within thirty-one (31) days of this disqualifying event to make arrangements for premium payment.

Policy Conformed to Statute

Any terms of the Policy which are in conflict with the statutes of the jurisdiction where issued, are amended to conform to the statutes.

Assignment of Benefits

The benefits provided under this Policy are not assignable.

Entire Contract

This Policy, including the application and endorsements, if any, constitutes the entire contract of insurance.

Network

About the Network of Attorneys

When going in for surgery, you don’t want a surgeon that has a poor track record or only a couple years experience. We feel that a legal need is just as important.

Help Focus Infrastructure

When it comes to finding an attorney, an employee can waste days looking for the right one, even with a legal plan. Our process has a Help Focus Infrastructure. We focus on our relationships with our Providers to help us help your employees, faster. Our Attorney Match Technology and dialogue with attorneys and members ensures the right help the first time. Matching an employee to the right help expedites solutions while saving time and stress.

Standards and Qualifications

The credentialing standards that we utilize to vet our providers is the most stringent in the country. We focus on years of experience, as well as insurance and discipline, as well as penalty of perjury submissions with extensive back ground checks.

Under the Provider Network, your employees will receive legal help from professionals with many of these service characteristics:

Experience in the Legal Matter Needed
Quality Time Spent in Consultations
Years of Legal Training and Experience
Up-to-date Legal Training Each Year
Lawyers Who are Service-Oriented
Lawyers Who Have a Solid Local Reputation in their Communities
Exceptional Backgrounds
Years of Courtroom and Trial Experience

Provider Standards of Care

The Network Provider shall strive to provide the highest quality of legal representation and service to Plan Members.

Plan Providers agree to the following:

To comply at all times with the Rules of Civil Procedure and Criminal Procedure and the Rules of Professional Conduct applicable to the jurisdiction.
To return member's calls promptly, within one business day, and communicate with members such that a member and the member's family do not voice substantiated concerns over promptness or frequency of your or your firm's communication.
To not enter continuances, adjournments, or the like without the member's comfort and consent.
To not arrange for substitutions or stand-ins unless the member has been previously advised and that the member understands that you remain responsible for the case and to contact you if there is any concern or if proceedings do not go as planned.
To always respect a member, their needs and family.
To maintain a professional office, in staffing and appearance.
To fully explain yourself such that a member has an understanding for the reasons behind your recommendations and suggestions, even if a member may not hire your firm.
To not complete any additional work that will result in a fee to the member, where not covered by the member's plan, until a fee arrangement is fully understood by the member and there is a written agreement.
To help each member individually and ensure that everything you do is in the interest of the member.
To notify LegalEASE if there is or may be the possibility of a conflict of interest or violation of ethical codes.
To notify LegalEASE if there may be a misunderstanding or potential service issue where there may be a complaint without breaking any client confidences.
To direct any grievances or concerns, such as process procedure or billing, to Legal Access and not a member.
To not refer any member to another attorney without the knowledge and consent of Legal Access if you cannot assist.
To take responsibility and uphold the highest standards of customer service delivered by any and all firm staff or employees that have interaction with members.
To communicate and cooperate with LegalEASE on any concern, inquiry or issue and return any communication from Legal Access within one business day.

About

We are here to serve you...

We believe people deserve to have a sense of safety and security, a peace of mind, when it comes to being protected in legal matters that they may not be the experts in. To have access to legal professionals that can ease and solve their legal burdens. We are here to serve you.

How we do it is by providing an in-depth pool of resources to accommodate all your legal needs. Legal Access and LegalEASE have broad experiences with employees in small, medium and large companies in the public and private sectors, local, state and federal government offices, unions, employee assistance plans, work-life companies, and organizations, when it comes to solving your legal matters.

What we do is provide value by creating unparalleled access to a network of skilled attorneys to cover your legal needs with options in convenient plans. We are a diversified employee benefits company engaged in administration, network development, technology management and insurance, based in Houston, Texas. Since 1971, we have grown from five attorneys in Los Angeles providing services to a modest amount of companies into a company with the strongest attorney network across America. We provide assistance to members over half of a million times each year throughout the United States and the world.

Legal Access Companies consists of several companies and brands to best meet customer needs, including but not limited to: Legal Plans USA, Legal Access Plans, LegalEASE, and LAMG. Legal Access Plans has a wide array of products across several market segements, including worksite, employee assistance and worklife. LegalEASE is the group's primary insurance brand and focuses primarily in the worksite market. LegalEASE products are underwritten and presented by Virginia Surety Company, part of the Warranty Group.