Welcome
Benefits Proudly Offered to Carney Management Employees
Be fully prepared and confident
with LegalEASE
Learn about legal insurance, a smart option for your protection.
Product Administered By: LegalEASE
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 a LegalEASE insurance plan, 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 insurance plan 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 insurance 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 insurance plan. LegalEASE offers valuable insurance 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.
- 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 only $18.66 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 |
Not Applicable |
Review of Simple Documents - up to 6 Pages |
Covered |
Not Applicable |
Miscellaneous Services |
LegalEASE Plan Coverage Participating Attorney |
LegalEASE Plan Coverage Non-Participating Attorney |
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:
|
Covered |
|
Consumer Dispute |
Covered
Subject to Managed Case Rules*
|
$595 |
Small Claims Court Representation |
Covered up to 2 Hours |
$105 |
Vehicle Repair and Lemon Law Litigation | Covered up to 5 Hours | $300 |
Cell Phone Contract Dispute
|
Covered up to 5 Hours
|
$300 |
Warranty Dispute
|
Covered up to 5 Hours
|
$300 |
Estate Planning |
LegalEASE Plan Coverage Participating Attorney |
LegalEASE Plan Coverage Non-Participating Attorney |
Simple Will or Codicil for:
|
Covered |
$80 |
Complex Will | Covered | $310 |
Living Will and/or Health Care Power of Attorney
|
Covered |
$55 |
Probate of Small Estate |
Covered up to 2 Hours |
$105 |
Home and Residential Matters |
LegalEASE Plan Coverage Participating Attorney |
LegalEASE Plan Coverage Non-Participating Attorney |
Purchase of Primary Residence | Covered | $490 |
Sale of Primary Residence | Covered | $365 |
Refinancing of Primary Residence |
Covered |
$385 |
Neighbor Dispute |
Covered
Subject to Managed Case Rules*
|
$765 |
Tenant Dispute |
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
Subject to Managed Case Rules*
|
$850 |
Bankruptcy (chapter 7 or 13) |
Covered
Subject to Managed Case Rules*
|
$680 |
Foreclosure |
Covered
Subject to Managed Case Rules*
|
$510 |
Tax Audit |
Covered
Subject to Managed Case Rules*
|
$1,385 Maximum
Subject to Managed Case Rules*
|
Family |
LegalEASE Plan Coverage Participating Attorney |
LegalEASE Plan Coverage Non-Participating Attorney |
Separation, Divorce, Civil Annulment
|
Covered up to 10 hours | $340 |
Contested Divorce, as defined |
Covered up to 28.5 Hours
Subject to Managed Case Rules*
|
$1,700 Maximum
Subject to Managed Case Rules*
|
Prenuptial Agreement |
Covered
Subject to Managed Case Rules*
|
$205 |
Name Change | Covered | $255 |
Guardianship/Conservatorship |
Uncontested: Covered
Subject to Managed Case Rules*
Contested: Covered
Subject to Managed Case Rules*
|
$300 $765 |
Uncontested Governmental Agency Adoptions |
Covered
Subject to Managed Case Rules*
|
$340
|
Stepparent Adoptions |
Uncontested: Covered
Subject to Managed Case Rules*
Contested: Covered
Subject to Managed Case Rules*
|
$300 $765
|
Juvenile Court Proceedings |
Covered
Subject to Managed Case Rules*
|
$470 |
School Administrative Proceeding |
Covered
Subject to Managed Case Rules*
|
$425 |
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*
|
Incompetency Defense |
Covered
Subject to Managed Case Rules*
|
$1,700 Maximum
Subject to Managed Case Rules*
|
Criminal Defense |
LegalEASE Plan Coverage Participating Attorney |
LegalEASE Plan Coverage Non-Participating Attorney |
Traffic Ticket |
Covered
Subject to Managed Case Rules*
|
$170 |
Serious Traffic Matters (resulting in suspensioin or revocation of license) |
Covered
Subject to Managed Case Rules*
|
$425 |
Administrative Proceeding (Regarding Suspension or Revocation of License) |
Covered
Subject to Managed Case Rules*
|
$255 |
Additional Benefits |
LegalEASE Plan Coverage Participating Attorney |
LegalEASE Plan Coverage Non-Participating Attorney |
Immigration Assistance | Included | Not Applicable |
Elder Law | Included | Not Applicable |
Financial Advisor |
Included |
Not Applicable |
Mediation |
Included |
Not Applicable |
Identity Theft Assistance |
Included |
Not Applicable |
Limitations may apply.
Exclusions
Network
- 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
- 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.
Definitions
Definitions
“CLAIMS ADMINISTRATOR” - means Co-ordinated Benefit Plans LLC; or its subsidiary.
“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; or the Member owns a business that will continue in operation after death; or the Member wants to put restrictions on what heirs may do with the property; or 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; or the Member thinks that someone will challenge the will; or the Member wants to exclude any lawful dependents.
“CONTESTED DIVORCE” - refers to a divorce proceeding that requires more than 5 hours of attorney time, involves disputed issues and both parties are represented by an attorney.
“COVERED FAMILY MEMBER” – means 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.
“COVERED SPOUSE” - means the Member’s lawful spouse at the time the group policy is in effect.
“EFFECTIVE DATE” - means the date a Member’s coverage hereunder begins.
“INTERNET PURCHASE” - A purchase of goods or services whose purchase value is over $200.00 at the time of purchase by a Member and/or Covered Family Member from a website on the worldwide web.
“LEGAL PLAN ADMINISTRATOR” – LegalEASE, its affiliates, officers, directors, employees, and/or agents, including third party organizations and their affiliates, officers, directors, employees, and/or agents, hired by LegalEASE to perform services under this group policy / Certificate of Coverage.
“MEMBER” - refers to the individual who is associated with the Policyholder and who has paid or a premium has been paid on his/her behalf and who meets the eligibility requirements for Covered Services as defined by the Policyholder.
“MEMBER SERVICE CENTER” - means the service location established to help make full use of the certificate benefits.
“NON-PARTICIPATING ATTORNEY” - means an attorney not retained by Legal Plan Administrator who is selected and paid by the Member to provide services covered under the Certificate of Coverage 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 Legal Plan Administrator to provide covered legal services at the amount shown in the Schedule of Benefits.
“POLICYHOLDER” - means the organization named in the declarations page.
“WE”, “US”, “OUR” AND “COMPANY” - means the name of the underwriter indicated on the first page of this Certificate of Coverage.
Covered Services
In consideration of payment and receipt by Us of the applicable premium, all Covered Services are available to a Member and all Covered Family Members. 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 telephone with a Participating Attorney. Services are available during normal business hours. Calls can relate to any personal legal matter, civil or criminal, except those specifically excluded.
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.
Review of Simple Documents:
The Participating 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.
Miscellaneous Law Office Services
Legal Services for any Non-Excluded Legal Matter:
This benefit will cover any legal services needed by the Member or Covered Family Member for review or preparation of documents, or any other service required on any legal matters not listed as a covered benefit or exclusion under this Policy. This benefit cannot be used to extend the coverage for any other service shown in the Schedule of Benefits beyond the limits of coverage.
Consumer Matters
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.
This benefit is limited to one use per year per document, except general power of attorney, which is limited to one use per year per Covered Family Member.
Consumer Dispute:
Consultation or representation in a dispute relating to consumer goods and services (not involving real estate construction, landlord/tenant disputes or renovation).
This benefit is limited to one use per year.
Small Claims Court Representation:
Consultation and/or representation for a consumer 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.
Vehicle Repair and Lemon Law Litigation:
Services related to the representation of a Member and/or Covered Family Member who is entitled under the applicable state “lemon” law to bring a civil lawsuit (non-business related), up to and including the trial thereof related to a defective car as defined in the applicable state law. This benefit does not include: (1) any lawsuit related to finances or defects that do not specifically fall under the definitions permitted in the applicable state lemon law; (2) lawsuits normally handled on a contingent fee basis; (3) any collection or related defense or action; or (4) matters for which the Member has or is required by law to have insurance.
This benefit is limited to one use per year.
Cell Phone Contract Dispute:
Review of the cell phone contract where the Participating 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 maximum number of pages shown on the Schedule of Benefits.
In the event of a dispute over the terms of the agreement between the cell phone company and the Member or any Covered Family Member, this benefit provides representation in a dispute relating to the cell phone contract if the Member/Covered Family Member is sued or named in a small claims court action. This service covers counseling on prosecuting a small claims court action; helping the Member/Covered Family Member prepare documents; advising on evidence, documentation and witnesses; and preparing the Member/Covered Family Member for trial. The service does not include the Participating Attorney’s attendance or representation at a small claims trial, collection activities after a judgment or any services relating to post-judgment actions
This benefit is limited to one use per year
Warranty Dispute:
Review of the warranty policy or service contract where the Participating 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 up to the maximum number of pages shown on the Schedule of Benefits.
In the event of a dispute over the terms of the agreement between the warranty company and the Member or Covered Family Member, this benefit provides representation in a dispute relating to the warranty or service contract if the Member or Covered Family Member is sued or named in a small claims court action. This service covers counseling on prosecuting a small claims court action; helping the Member/Covered Family Member prepare documents; advising on evidence, documentation and witnesses; and preparing the Member/Covered Family Member for trial.
This benefit is limited to one use per year.
Estate Planning
Will or Codicil Preparation:
Preparation of one simple will or codicil (an amendment to an existing will) for the Member and/or Covered Family Member, including the preparation of a simple testamentary support trust for the dependent children:
Simple Will Preparation: Participating Attorney shall prepare a simple will or codicil for Member and/or Covered Family Member and discuss the legal requirements for signing the will.
This benefit is limited to one use per year per Member/Covered Family Member.
Complex Will Preparation: Participating Attorney shall prepare a complex will or codicil for Member or Covered Family Member. This benefit shall be limited to one complex will prepared per year.
Living Will and/or Health Care Power of Attorney:
Preparation of living will and/or health care power of attorney for Member and/or Covered 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/herself.
This benefit is limited to one use per year.
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.
Residential Matters
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.
This benefit is limited to one closing per year.
Tenant Dispute:
Representation of the Member and/or Covered Family Member as a tenant in a dispute with his/her landlord.
This benefit is limited to one use per year.
Neighbor Dispute:
The services of an attorney in a dispute relating to a Member’s neighbor up to the maximum shown in the Schedule of Benefits. Advice and/or preparation and assistance for a dispute filed in court is also covered, although representation in small claims court is not covered.
This benefit is limited to one use per year.
Financial Matters
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.
This benefit is limited to one use per year.
Bankruptcy:
Representation on behalf of the Member and/or Covered Family Member for personal (non-business related) bankruptcy protection under Chapter 7 or 13 of the Internal Revenue Code.
This benefit is limited to one use per year.
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.)
This benefit is limited to one use per year.
Tax Audit:
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.
This benefit is limited to one use per year.
Family Matters
Separation, Divorce, Civil Annulment:
Legal representation of the Member only for up to the maximum shown on the Schedule of Benefits in an uncontested separation, divorce, civil annulment, consent or default 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: (1) services in excess of the maximum shown on the Schedule of Benefits; the Member must pay the attorney’s fee for services in excess of the maximum; or, (2) contested matters in which case the Member must pay the attorney’s fee for services, unless this Policy provides coverage of contested matters and the benefit shall be in accordance with the Schedule of Benefits. A contested separation, divorce or civil annulment requires more than five hours of attorney time, involves disputed issues and both parties are represented by an attorney.
This benefit is limited to one use per year (representation seeking or defending against interim or subsequent-to-decree order shall constitute a separate use) and applies to the Member and Covered Family Members only for actions not involving the Member as an opposing party.
Prenuptial Agreement:
This service covers the preparation of an agreement by a Member and his or her fiancé/partner prior to their marriage or legal union (where allowed by law), outlining how property is to be divided in the event of separation, divorce or death of a spouse. Representation is provided only to the Member. The fiancé/partner must have separate counsel or must waive representation.
This benefit is limited to one use per year
Name Change:
Services required to accomplish a legal name change for a Member and/or Covered Family Member.
This benefit is limited to one use per year.
Guardianship/Conservatorship:
Services required to establish a Member and/or Covered Family Member as the guardian(s) or conservator(s) of another. This benefit does not include fees for a court –appointed attorney for the child/conservatee.
This benefit is limited to one use per year.
Government Agency/Stepparent Adoption:
Legal representation for a Member and/or Covered Family Member of up to the maximum shown in the Schedule of Benefits in a governmental agency or stepparent adoption. An uncontested adoption does not involve significant disputed issues. This benefit does not include: (1) contested termination of parental rights; (2) fees for a court-appointed attorney for the child; or (3) adoptions(s) made through any agency other than a governmental agency. A contested adoption requires more than five hours of attorney time and involves disputed issues.
This benefit is limited to one use per year.
Juvenile Court Matters:
Services related to the representation of the dependent child of a Member and/or Covered Family Member in any juvenile court proceeding, provided the child’s interest is not in conflict with the Member’s 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.
School Administrative Proceeding:
Services needed for a dependent child of a Member and/or Covered Family Member for consultations, and review or help with preparation of documents prior to the representation of the dependent child in any school administrative proceeding (not including expulsion), provided the child’s interest is not in conflict with the Member’s and/or Covered Family Member’s interest. This benefit does not cover any matter that falls outside the jurisdiction of the school in which the child is officially enrolled.
This benefit is limited to one use per year
Civil Litigation Defense
Civil Litigation Defense:
Services related to the representation of a Member and/or Covered 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/Covered Family Member has or is required by law to have insurance.
This benefit is limited to one use per year.
Incompetency Defense:
Services related to the representation of a Member in the defense of any incompetency action, including court hearings when there is a proceeding to find the Member incompetent.
This benefit is limited to one use per year.
Criminal Defense
Traffic Tickets:
Services related to the representation of the Member and/or Covered Family Member 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. This benefit does not cover violations related to a commercial driver’s license. This benefit is limited to one use per year.
Serious Traffic Matters:
Services related to the representation of a Member and/or Covered 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 Covered Family Member’s drivers’ license. This benefit does not cover violations related to a commercial driver’s license.
This benefit is limited to one use per year.
Administrative Proceeding:
Services related to the representation of a Member and/or Covered Family Member in an administrative proceeding relating to the suspension or 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.
COVERED SERVICES ENDORSEMENT
The Effective Date of this endorsement is the Effective Date of the Policy/Certificate to which this endorsement is attached. This endorsement is made a part of the Policy/Certificate to which it is attached. This endorsement is subject to all of the provisions
and limitations of the Policy/Certificate. If there is a conflict between the Policy/Certificate and the endorsement, the terms of the endorsement will govern.
The following is a list of Covered Services available, in addition to the services described in your Policy/Certificate of Coverage.
FINANCIAL ADVISOR
Financial Helpline
Consultation with legal or financial professionals by toll-free telephone during normal business hours. Calls can relate to investment strategies, debt matters, or any personal financial planning question.
ELDER LAW
Eligibility of Parents
Parents of the Member and the Member’s Spouse, regardless of age, are eligible for benefits under the Elder Law coverage described herein. Benefits cover Biological Parents, Step-Parents and Adoptive Parents.
Elder Law Benefits
Advice and Consultation
Legal Helpline:
Member/Eligible Parent 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.
Financial Helpline:
Member/Eligible Parent 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
Document Preparation
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.
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.
Power of Attorney Preparation:
Eligible Parents, as defined above, may request one POA per year at no charge. Plan Attorney will prepare the document as authorized by state law and discuss the legal requirements for signing the POA.
Additional Documents
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.
MEDIATION
Consultation Services:
Members receive one free thirty minute consultation with a licensed mediator every quarter. Topics include: domestic disputes, divorce or child custody proceedings, consumer problems, medical bill, warranties, loan disputes, auto accidents.
Mediation Counseling Assistance:
Assistance is available to assist Members with understanding mediation and alternative dispute resolution. Examples of some topics are; charting projected lawsuit expenses, understanding when mediation might work, managing legal expenses in mediation, educational tools to make an informed decision, and advice on selecting mediator or other options. These services are designed to help Members deal with the increase in resolution pace.
Discounted Mediation Services:
Member receives a 10% discount on Participating Attorney’s normal mediation fees. This includes hourly rates and flat fees.
However, this does not apply to contingency fees.
IDENTITY THEFT PREVENTION/RECOVERY ASSISTANCE
Coverage includes a basic Identity Theft HelpLine Service as well as a comprehensive Online Identity Theft Prevention and Assistance Service for Member, and Covered Family Members.
Advice and Consultation
Telephone consultations (6 per year) with a Trained Identity Theft Recovery Specialist
Additional Benefits
a) 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 consultations with the Recovery Specialist).
b) 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.
c) Review of necessary recovery legal documents (up to 6 pages each)
d) Up to $25,000 Expense Reimbursement for Identity Theft Losses That Cannot Be Recovered. Reimbursement policy provided by 3rd party Insurance Company.
IMMIGRATION ASSISTANCE
Coverage includes immigration services for up to one Eligible Family Member, as described below, per year.
Eligible Family Members
Includes Spouse, children up to any age, parents of Member and Spouse and siblings of Member and Spouse.
Advice and Consultation
Members receive one office consultation per issue with a Participating Attorney on any personal immigration matter.
Review of Immigration Documents
Participating Attorney will review and explain the meaning or impact of any immigration form or document, or make suggestions
for changes to a form or document being drafted that is up to six (6) pages.
Preparation for Hearings
Member will receive up to two hours of general preparation for immigration hearings.
Preparation of Documents
Participating Attorney will prepare necessary affidavits and powers of attorney for the Member or Eligible Family Member at no charge.
Obtaining Benefits
1. 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 the Member Service Center within thirty (30) days following consultation with an attorney may result in a denial of benefits.
2. To obtain benefits under the Managed Case Rules:
Members and/or Covered 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 Covered Family Member.
3. Members actively receiving services must remain enrolled and continue to pay premium hereunder. All benefits will be subject to subrogation and coordination of benefit rules.
4. Upon completion of a Covered Service, the Member and/or Covered Family Member will 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 the Member/ Covered Family Member will be responsible for all legal fees.
5. If the Member and/or Covered 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, proof of payment and supporting documentation sufficient to demonstrate the work completed in the matter within sixty (60) days after incurring the legal fees. Benefits provided to the Member and/or Covered Family Member for Covered Services are subject to the maximum as shown in the Schedule of Benefits.
6. Upon receipt of the submitted claim a satisfaction survey will be sent to the Member. In the event that a survey form is not received, Members may contact the Member Service Center at (888) 416-4313 to request a form.
Complaint Resolution Procedure
If, at any point, a Member has a complaint about the services provided either by the Member Service Center or the Participating Attorney a complaint may be registered by calling (888) 416-4313. The matter will be escalated to the Quality Assurance Team for resolution. In the event that a satisfactory resolution is not reached the Member has the option to file a complaint with the Massachusetts Division of Insurance
Any dispute or controversy arising between the Insurer and any Attorney or Member whose Certificate (group)/Policy (individual) has been canceled or to whom the Insurer has refused to issue a Policy/Certificate or between any Attorney and a Member may request a hearing in writing to the Massachusetts Division of Insurance commissioner within thirty (30) days after such dispute or controversy arises. The commissioner or his designee will hear such party or parties within (30) thirty days after receipt of the written request, and will give written notice of the time and place of the hearing no sooner than fifteen (15) days from the date. The hearing will be an adjudicatory hearing as defined in chapter thirty A. The commissioner or his designee will issue a decision within thirty (30) days after the hearing.
You may contact the Division of Insurance to obtain information on companies, rights or complaints at (877)-563-4467. Or visit the website to obtain a complaint form at http://www.mass.gov/doi.
In addition, a Member may also submit a complaint for review by the Board of Bar Overseers. The Board of Bar Overseers investigates and evaluates complaints against Attorneys. Complaints are initially handled by the Attorney and Consumer Assistance Program (ACAP) of the Office of the Bar Counsel. Complaint forms can be obtained by calling the Attorney and Consumer Assistance Program (ACAP) at (617) 728-8750. Please note that complaints cannot be accepted via electronic mail due to confidentiality requirements. Completed complaint forms, or questions regarding the process, should be directed to following address:
Office of the Bar Counsel
99 High Street
Boston, Massachusetts 02110
(617) 728-8750
Disputes Between Member and Covered Family Member
In the event that the Member and one of the Covered Family Members are involved as adversaries in a dispute that is a Covered Service, only the Member 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.
Exclusions
The following benefits are excluded:
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; any matters involving a government (domestic or foreign) entity or agency except as specifically described under Covered Services; 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 that 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, judgments, 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 Covered 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, marketing, administration or other processes related to the group policy; Legal Plan Administrator or its subsidiaries; Claims Administrator or its subsidiaries; Policyholder; Member’s employer; Nationwide Mutual Insurance Company and 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.
The Certificate of Coverage will not provide benefits in connection with pre-existing matters, which includes any matter where the Member and/or Covered Family Member is on notice as to a pending legal dispute or has previously contacted an attorney, except when prior coverage under another Legal Plan provided by the Policyholder can be demonstrated.
Where there are specific hours or dollar amounts provide in this Certificate of Coverage, or where a maximum is set under the Managed Case Rules, the Member will be responsible for all attorney fees incurred over the maximum. Additional exclusions related to each benefit are included in the Covered Services.
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.
The Member shall authorize the Participating Attorney to provide the Legal Plan Administrator with information and supporting documentation on the number and type of services provided to the Member.
By using legal services benefits that are provided under the group policy / Certificate of Coverage, the Members agree that neither We, nor the Policyholder, nor any other person involved in the marketing or administration of the group policy, shall have any liability for the acts, errors or omissions of an attorney providing services, in whole or in part.
Participating Attorney Grievance Procedure
Members may contact the Member Service Center at (888) 416-4313 during normal business hours for assistance in resolving any issue with a Participating Attorney, including but not limited to billing or fee issues, responsiveness, courteousness or capability. The Member Service Center will gather information about the complaint, contact the Participating Attorney, if appropriate, and attempt to work out a resolution between the Member and the Participating Attorney. Members also have the option of requesting a different Participating Attorney or utilizing the services of a Non-Participating Attorney if no resolution can be reached.
Attorneys are subject to the Rules of Professional Conduct in the state in which they are admitted to practice law. Each state has a governing body that is responsible for seeing that the Rules of Professional Conduct are observed. A grievance may be filed with the governing body in the state where the attorney is licensed. Members may contact the Member Service Center for assistance in locating the contact information for the governing body in the relevant state.
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. The Member’s reimbursement will be based on the reimbursement schedule as shown in the Schedule of Benefits. Reimbursement for a Non-Participating Attorney will not be less than the negotiated amount for a Participating Attorney. If a Member already has an attorney at the time he/she becomes a Member, the Legal Plan Administrator can offer to negotiate with the attorney on behalf of the Member, but will not guarantee the Plan Discounted Rate will be accepted by the attorney or offered by the Legal Plan Administrator.
Legal Terminology
The Member or Covered Family Member may call the Member Service Center to obtain a definition or explanation of any term used herein.
Coverage Territory
The coverage territory includes the United States and United States territories.
Premium Refund Provision
In the event that the premium mode is other than monthly and the group policy is terminated or the Member elects to terminate the coverage, a pro-rata premium refund will be made in accordance with the insurance laws of the Policyholder’s state.
Termination and Cancellation of Coverage
Coverage provided to the Member shall terminate upon the first of the following to occur:
a. Cancellation or termination of the group policy;
b. If applicable, the Member fails to re-enroll;
c. The Member is no longer associated with Policyholder; or
d. The last day of the period for which premium was paid on behalf of a Member, if a premium is not paid when due, subject to the Grace Period provision.
Coverage provided to a Covered Family Member of a Member shall terminate upon the first of the following to occur:
a. The Member’s coverage is cancelled or terminated; or
b. The family member ceases to qualify as a Covered Family Member as defined.
When coverage for a Member and/or Covered Family Member terminates and a matter is unresolved when coverage terminated, then any further legal work between said Member and/or Covered Family Member and the Participating Attorney shall be outside the scope and coverage of the group policy / Certificate of Coverage. The Participating Attorney shall not be obligated to provide any benefits 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 Covered Family Member and the attorney. If such an agreement is not entered into, then the Participating Attorney may withdraw from any further representation in accordance with applicable law and State Bar standards.
Premium Remittance
The Policyholder shall remit premium to the Company no later than the 10th calendar day following the month for which Policy coverage is provided. The premium will be remitted by an employer payroll deduction.
Grace Period
The Policy provides the Policyholder a grace period of thirty-one (31) days after the premium due date to remit the premium that is due and unpaid on behalf of a covered Member. During the grace period, the 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. The Policyholder shall remain liable for the pro-rata portion of all premiums that accrue for the period this Policy is in effect.
Portability
The Member may continue this insurance by electing the option of portability when the Member no longer qualifies as an employee of the Policyholder or as a Member of the group to which the group policy is issued. The Member must apply for portability within sixty (60) days of this disqualifying event and make arrangements for premium payment. Portability coverage will take effect, subject to payment of the initial premium, as of the date the Member’s coverage under the group policy terminates. Credit will be given for any applicable Waiting Period based upon the number of months coverage was in force for the Member under the group policy.
Conformed to Statute
Any terms of the group policy / Certificate of Coverage that 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 group policy / Certificate of Coverage are not assignable.
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