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Benefits Proudly Offered to Maimonides Medical Center Employees
Be fully prepared and confident
with LegalEASE
Learn about legal benefits, a smart option for your protection.
LegalEASE can help ease the two biggest stresses -finding and paying for an attorney.
Nobody likes to be caught off guard, especially when it comes to legal matters. Life can be complicated. Finding a good attorney doesn’t have to be. With LegalEASE, it’s easy to choose the best attorney, because you get assistance from highly trained and qualified personal specialists who review the details of local attorneys and help you find your best source for legal advice. Being a LegalEASE member saves you time and costly legal fees. But most importantly, it gives you confidence and provides coverage for common legal matters.
With a LegalEASE plan, you get:
- An attorney with expertise specific to your legal matter
- Access to a national network of attorneys with exceptional experience that are matched to meet your needs
- Coverage for in and out-of-network
- Concierge help finding a better attorney and navigating common individual or family legal issues
- Hours of financial counseling and coaching
We all make some sort of plan in life. But have you ever considered the possibility of a legal problem?
You've graduated from college and are planning for your future - where to get hired, which company will put you on the path to success. Whether to be single or date or settle down, and with the right person. Legal problems can be unexpected and interrupt your plans. LegalEASE provides coverage for your specific legal matter so you won't be caught off guard.
Protect your family’s future, with LegalEASE.
You work hard to make the right choices for your loved ones, especially when it comes to legal and financial matters. Get the peace of mind you want and the protection you need with a LegalEASE Plan. LegalEASE offers valuable benefits to shield your family and savings from unexpected legal issues.
According to the American Bar Association, more than 70 percent of U.S. households will have the need for a lawyer in the next 12 months. And the same study found most consumers feel uncertain about how to tell a good lawyer from a bad one. With LegalEASE you have access to a national network of credentialed attorneys and the help you need to find the best attorney for your legal matter with its concierge service.
Coverage
The Value of a LegalEASE Benefits Plan.
- Home and Residential
- Financial and Money Matters
- Consumer
- Auto and Driving
- Family and Personal
- Civil Lawsuits
- Estate planning and wills
LegalEASE Benefits 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 benefits 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 Plan is $16.92 monthly, via payroll deduction.
Who's Covered?
The Member’s spouse or Domestic Partner 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 year
|
Covered |
Not Applicable |
Review of Simple Documents - up to 6 Pages |
Covered |
Not Applicable |
Miscellaneous Law Office Services |
LegalEASE Plan Coverage Participating Attorney |
LegalEASE Plan Coverage Non-Participating Attorney |
Discounted Legal Services for any non-excluded legal matter |
25% discount on Participating
Attorney’s hourly rates
|
Not Applicable |
Elder Matters |
LegalEASE Plan Coverage Participating Attorney |
LegalEASE Plan Coverage Non-Participating Attorney |
Elder Parent Will Preparation | Covered | $80 |
Elder Parent Living Will/Health Care or Advance Directive | Covered | $55 |
Elder Parent Durable Financial Power of Attorney
|
Member co-pay $45 per document | Not Applicable |
Elder Parent Health Care or Medical Power of Attorney |
Member co-pay $45 per document | Not Applicable |
Consumer Matters |
LegalEASE Plan Coverage Participating Attorney |
LegalEASE Plan Coverage Non-Participating Attorney |
Document Preparation:
|
Covered |
|
Consumer Dispute |
Covered |
$600 |
Small Claims Court Reprsentation |
Covered up to 2 hours with remainder at 25% discount |
$120 |
Estate Planning |
LegalEASE Plan Coverage Participating Attorney |
LegalEASE Plan Coverage Non-Participating Attorney |
Will or Codicil |
Covered |
$80 |
Complex Will | Covered | $310 |
Living Will/Health Care or Advance Directive |
Covered |
$55 |
Health Care or Medical Power of Attorney |
Covered |
$55 |
Revocable or Irrevocable Living Trust Document | Covered | $310 |
Probate of Small Estate |
Covered up to 2 hours with remainder at 25% discount |
$120 |
Residential Matters |
LegalEASE Plan Coverage Participating Attorney |
LegalEASE Plan Coverage Non-Participating Attorney |
Purchase of Primary Residence | Covered | $500 |
Sale of Primary Residence | Covered | $365 |
Refinancing of Primary Residence | Covered | $385 |
Tenant Dispute | Covered | $1,700 maximum subject to Managed Case Rules* |
Financial Matters |
LegalEASE Plan Coverage Participating Attorney |
LegalEASE Plan Coverage Non-Participating Attorney |
Debt Collection Defense
|
Covered |
|
Bankruptcy (Chapter 7 or 13) |
Covered | $935 |
Foreclosure |
Covered | $680 |
Tax Audit |
Covered subject to Managed Case Rules* | $1,700 maximum subject to Managed Case Rules* |
Family |
LegalEASE Plan Coverage Participating Attorney |
LegalEASE Plan Coverage Non-Participating Attorney |
Separation, Divorce, Civil Annulment
|
Covered up to10 hours with remainder at 25% discount | $595 |
Contested Divorce, as defined | Covered up to 28.5 hours with remainder at 25% discount | $1,700 maximum subject to Managed Case Rules* |
Post-Divorce Proceedings, as defined | Covered to 28.5 hours with remainder at 25% discount | $1,700 maximum subject to Managed Case Rules* |
Prenuptial Agreement | Covered | $680 |
Name Change | Covered | $255 |
Guardianship/Conservatorship |
Uncontested: Covered
|
$365
|
Governmental Agency Adoptions |
Uncontested: Covered
|
$365
|
Stepparent Adoptions |
Uncontested: Covered
|
$365
|
Juvenile Court Proceedings |
Covered |
$470 |
Civil |
LegalEASE Plan Coverage Participating Attorney |
LegalEASE Plan Coverage Non-Participating Attorney |
Civil Litigation Defense |
Covered |
$1,700 maximum subject to Managed Case Rules* |
Discounted Contingency Fees | 10% discount on state maximum, or a maximum of 29% pre-trial, 36% at trial, or 40% in an appeal | Not Applicable |
Mediation | 10% discount on Mediator’s hourly rates | Not Applicable |
Traffic and Administrative Matters |
LegalEASE Plan Coverage Participating Attorney |
LegalEASE Plan Coverage Non-Participating Attorney |
Traffic Ticket | Covered | $215 |
Serious Traffic Matters (resulting in suspension or revocation of license) |
Covered |
$425 |
Administrative Proceeding (resulting in Suspension or Revocation of License) |
Covered |
$255 |
Additional Benefits |
LegalEASE Plan Coverage Participating Attorney |
LegalEASE Plan Coverage Non-Participating Attorney |
Financial Advisor | Included | Not Applicable |
Identity Theft Assistance | Included | Not Applicable |
Limitations apply.
* Managed Case Rules
Exclusions
Definitions
DEFINITIONS
“CLAIMS ADMINISTRATOR” - means LegalEASE; or its subsidiary.
“COMPLEX WILL” – means:
(a) You have a significant net worth and will benefit from tax planning, or
(b) the estate is subject to current state or federal estate taxation; or
(c) You own a business that will continue in operation after death; or
(d) You want to put restrictions on what heirs may do with the property; or
(e) You want to leave money to someone in a trust because the person cannot manage his or her own affairs (such as a mentally handicapped child), or
(f) You want the property to be managed by a trustee for a period of time past the child’s age of majority, to age 25 or 30, for example; or
(g) You think that someone will challenge the will; or
(h) You want to exclude any lawful dependents.
The inclusion of a pour-over provision in a will does not, by itself, make a will complex.
VSC_LP_B1_DEF_CW (202103)
“CONTESTED DIVORCE” - refers to a divorce proceeding that:
(a) requires more than 5 hours of attorney time, and
(b) involves disputed issues and
(c) both parties are represented by an attorney.
VSC_LP_B1_DEF_CD (202103)
“COVERED FAMILY MEMBER” - means Your spouse and Your unmarried dependent children, including stepchildren, legally adopted children, children placed in the home for adoption and foster children, up to age 19, and from age 19 up to 26 years if they are enrolled in an accredited school or college as full-time student(s) and are primarily dependent upon You for support.
VSC_LP_B1_DEF_CFM-STD (202103)
“COVERED SPOUSE” - means Your lawful spouse or Domestic Partner at the time the coverage is in effect.
VSC_LP_B1_DEF_CS-2 (202103)
“DOMESTIC PARTNER” – means Your domestic/civil union partner as defined by the jurisdiction in which You primarily resides.
VSC_LP_B1_DEF_DP (202103)
“DURABLE FINANCIAL POWER OF ATTORNEY” –a legal document that allows an individual to appoint another person to manage the individual’s finances in the event that he/she is unable to do so him/her self.
VSC_LP_B1_DEF_DFPOA (202103)
“EFFECTIVE DATE” - means the date Your coverage hereunder begins.
“ELIGIBLE PARENT” – means Your or Covered Spouse’s parents, regardless of age. It includes, biological parents, step-parents and adoptive parents.
VSC_LP_B1_DEF_EP (202103)
“HEALTH CARE OR MEDICAL POWER OF ATTORNEY” – A legal document that allows an individual to appoint another person to make medical decisions in the event the individual is unable to do so him/her self.
VSC_LP_B1_DEF_HCPOA (202103)
“LEGAL PLAN ADMINISTRATOR” – LegalEASE,
(a) its affiliates, officers, directors, employees, and/or
(b) agents, including third party organizations and their affiliates, officers, directors, employees, and/or
(c) agents, hired by LegalEASE to perform services under the Policy.
“LIVING WILL/HEALTH CARE OR ADVANCE DIRECTIVE” – A legal document that outlines an individual’s preferences for medical treatment. This document takes effect when the individual becomes incapacitated and can no longer express his or her wishes.
VSC_LP_B1_DEF_LW (202103)
“MEMBER” - refers to the individual who
(a) is associated with the Policyholder and/or Plan Sponsor,
(b) has either paid a premium or had a premium paid on his or her behalf, and
(c) meets the eligibility requirements for Covered Services as defined by the Policyholder.
“MEMBER SERVICE CENTER” - means the service location established to assist You/Covered Family Members in making full use of the coverage.
“NON-PARTICIPATING ATTORNEY” - means an attorney not contracted by the Legal Plan Administrator who:
· is selected and
· paid by the You
to provide covered legal services.
Covered legal services are provided up to the maximum amount shown under the Non-Participating Attorney column of the Schedule.
“PAID IN FULL” - means complete payment in full to a Participating Attorney for covered legal services.
“PARTICIPATING ATTORNEY” - means an attorney contracted by the Legal Plan Administrator to provide covered legal services. Covered legal services are provided up to the amount shown under the Participating Attorney column of the Schedule.
“PLAN SPONSOR” - means an organization other than the Policyholder or the Your employer that makes coverage hereunder available.
“POLICY” - means the Group Legal Expense Insurance Policy and the Certificate of Coverage.
“POLICYHOLDER” - means the organization named in the declarations page.
“SURFACE WEB” – means the portion of the World Wide Web that is readily available to the general public and searchable via standard web search engines.
VSC_LP_B1_DEF_SW (202103)
“WE”, “US”, “OUR” AND “COMPANY” - means Virginia Surety Company, Inc.
“YOU” AND “YOUR” – means Member.
VSC_LP_B1 (202103)
COVERED SERVICES
In consideration of payment and receipt by Us of the applicable premium, all Covered Services are available to You and all Covered Family Members, except as specifically noted below. The following Covered Services are provided when You use a Participating Attorney. The Schedule chart shows the reimbursement schedule when You use a Non-Participating Attorney.
VSC_LP_C1 (202103)
Advice and Consultation
LegalEASE Helpline:
Advice and consultation by telephone with a Participating Attorney. Services are available during normal business hours. Calls can relate to any personal legal matter, except those specifically excluded.
VSC_LP_C1_CS_M_000-2 (202103)
Initial Law Office Consultation:
Office consultations with an attorney on any personal legal problem, except those specifically excluded.
VSC_LP_C1_CS_M_001 (202103)
Review of Simple Documents:
This benefit includes:
(a) attorney review,
(b) verbal explanations of the meaning or impact of any form or document, or
(c) suggestions for changes to a form or proposed document being drafted
of up to the maximum number of pages as shown in the Schedule.
This benefit does not include a written analysis of any form or document.
VSC_LP_C1_CS_M_002 (202103)
Miscellaneous Law Office Services
Discounted Legal Services for any Non-Excluded Legal Matter:
This benefit will cover any legal services to:
(a) review and/or prepare documents, or
(b) any other service required on any legal matters not listed as a Covered Service or Exclusion.
This benefit may be used to extend the coverage for any other service shown in the Schedule beyond the limits of coverage.
VSC_LP_C1_CS_M_004 (202103)
Consumer Matters
Document Preparation:
Preparation of any of the following documents:
VSC_LP_C1_CS_M_005 (202103)
· Simple Deed (excluding those reviewed or prepared under the real estate benefit) This benefit is limited to one use per year per Member/Covered Family Member.
VSC_LP_C1_CS_M_210-2 (202103)
· Promissory Note: This benefit is limited to one per year per Member/Covered Family Member.
VSC_LP_C1_CS_M_220-2 (202103)
· Consumer Dispute Correspondence: This benefit is limited to one use per year per Member/Covered Family Member.
VSC_LP_C1_CS_M_230-2 (202103)
· Installment Sales Agreement: This benefit is limited to one use per year per Member/Covered Family Member.
VSC_LP_C1_CS_M_240-2 (202103)
· Simple Affidavit: This benefit is limited to one use per year per Member/Covered Family Member.
VSC_LP_C1_CS_M_250-2 (202103)
· General Power of Attorney: This benefit is limited to one use per year per Member/Covered Family Member and can be used for a General, Limited, and/or Durable Financial Power of Attorney.
VSC_LP_C1_CS_M_310-2 (202103)
· Lease Agreement (for You/Covered Family Member as a tenant only). This benefit is limited to one use per year per Member/Covered Family Member.
VSC_LP_C1_CS_M_320-2 (202103)
· Time Share Agreement: This benefit is limited to one use per year per Member/Covered Family Member.
VSC_LP_C1_CS_M_330-2 (202103)
Consumer Dispute:
Consultation or representation in a dispute relating to consumer goods and services (not directly or indirectly related to
(a) real estate construction or renovation, or
(b) landlord/tenant disputes).
This benefit is limited to one use per year.
VSC_LP_C1_CS_M_360-4 (202103)
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.
VSC_LP_C1_CS_M_390-3 (202103)
Estate Planning
Will or Codicil Preparation:
Preparation of one will or codicil (an amendment to an existing will), including the preparation of a simple testamentary support trust for the dependent children:
VSC_LP_C1_CS_M_400A (202103)
Will Preparation: Attorney shall prepare a will or codicil and discuss the legal requirements for signing the will. This benefit does not cover Complex Wills. For a definition of Complex Wills, please see the Definitions section.
This benefit is limited to one use per year per Member/Covered Family Member.
VSC_LP_C1_CS_M_400-2 (202103)
Complex Will Preparation: Attorney shall prepare a Complex Will or codicil.
This benefit shall be limited to one Complex Will prepared per year per Member/Covered Spouse/Covered Family Member.
VSC_LP_C1_CS_M_430-2 (202103)
Living Will/Health Care or Advance Directive/Health Care or Medical Power of Attorney:
This benefit covers the preparation of up to 2 of any of the following documents as defined in the Definitions section per Member/Covered Family Member:
(a) Living Will
(b) Health Care Directive
(c) Advance Directive
(d) Health Care Power of Attorney
(e) Medical Power of Attorney
The titles of the above documents may vary by state. When state law allows the information contained in any two or more of the above mentioned documents to be combined into one document, then the benefit covers the preparation of both documents, and can be combined to increase the total allowed benefit.
This benefit is limited to one use per year per Member/Covered Family Member.
VSC_LP_C1_CS_M_440/450-2 (202103)
Revocable or Irrevocable Living Trust Document:
Preparation of a revocable or irrevocable living trust for You and/or Covered Family Member. This benefit does not include services related to transactions to fund the trust or transfer assets into it. This benefit does not include tax planning or tax advice. This benefit does not include the preparation of:
(a) a charitable or charitable remainder trust;
(b) special needs trust;
(c) tax by-pass or credit shelter trust;
(d) asset protection trust;
(e) insurance trust;
(f) qualified domestic trust (QDOT);
(g) qualified terminable interest property trust (QTIP); or
(h) blind trust.
This benefit is limited to one use per year per Member/Covered Spouse/Covered Family Member.
VSC_LP_C1_CS_M_460-2 (202103)
Probate of Small Estate:
The service of an attorney for the probate of a small estate up to the maximum as shown in the Schedule. The estate must not be subject to current state or federal estate taxation.
VSC_LP_C1_CS_M_470 (202103)
Elder Matters
Elder Parent Will Preparation:
Each Eligible Parent may receive one Simple Will per year at no charge. The attorney will prepare the document and discuss the legal requirements for signing the will. This benefit does not cover Complex Wills. For a definition of Complex Wills, please see the Definitions section.
This benefit is limited to one use per year per Eligible Parent.
VSC_LP_C1_CS_M_401-2 (202103)
Elder Parent Living Will/Health Care or Advance Directive:
Each Eligible Parent may request one Living Will/Health Care or Advance Directive per year at no charge. For a definition of Living Will/Health Care or Advance Directive, please see the Definitions section. The attorney will prepare the documents as authorized by state law and discuss the legal requirements for signing the Living Will/Health Care or Advance Directive. The titles of the above documents may vary by state. When state law allows the information contained in any two or more of these documents to be combined into one document, then the benefit covers the preparation of both documents, and can be combined to increase the total allowed benefit.
This benefit is limited to one document/set of documents per year per Eligible Parent.
VSC_LP_C1_CS_M_441-2 (202103)
Elder Parent Durable Financial Power of Attorney:
Each Eligible Parent may request one Durable Financial Power of Attorney per year at the co-pay rate shown in the Schedule. For a definition of Durable Financial Power of Attorney, please see the Definitions section. The attorney will prepare the documents as authorized by state law and discuss the legal requirements for signing the Durable Financial Power of Attorney. The titles of the above documents may vary by state.
This benefit is limited to one use per year.
VSC_LP_C1_CS_M_311-4 (202103)
Elder Parent Health Care or Medical Power of Attorney:
Each Eligible Parent may request one Health Care or Medical Power of Attorney per year at the co-pay rate shown in the Schedule. For a definition of Health Care or Medical Power of Attorney, please see the Definitions section. The attorney will prepare the documents as authorized by state law and discuss the legal requirements for signing the Health Care or Medical Power of Attorney. The titles of the above documents may vary by state. When state law allows the information contained in any two or more these documents to be combined into one document, then the benefit covers the preparation of only one document and can not be combined to increase the total allowed benefit.
This benefit is limited to one use per year.
VSC_LP_C1_CS_M_451-4 (202103)
Residential Matters
Real Estate Sale, Purchase or Refinancing of Primary Residence:
The services of an attorney for the sale, or purchase or refinancing of a primary residence (where You have resided or intends to reside for twenty-seven (27) weeks or more per year).
This service includes:
(a) the review and/or preparation of closing documents and/or
(b) attendance by the attorney at closing in situations when it is customary for the attorney to do so.
This benefit does not include:
(a) services performed by or for a title company, or
(b) for an attorney acting on behalf of a lending institution.
Home equity loans and the sale or purchase of rental properties are not included.
This benefit does not include any fees or costs other than those related to the attorney’s review of the purchase/sale documents.
This benefit is limited to one closing per year.
VSC_LP_C1_CS_M_500/530/550-3 (202103)
Tenant Dispute:
Representation of You as a tenant in a dispute with Your landlord. This benefit does not include representation for a tenant in a dispute with other tenants.
This benefit is limited to one use per year.
VSC_LP_C1_CS_M_560-3 (202103)
Financial Matters
Debt Collection Defense:
The defense of any dispute involving personal (non-business related) debt.
This benefit includes:
(a) correspondence,
(b) negotiating with creditors to arrange a repayment schedule,
(c) assistance in limiting harassment by bill collectors, and
(d) negotiating settlement after a complaint is filed.
This service does not include:
(a) defense against execution of a court-ordered judgment or
(b) efforts to vacate or set aside a judgment.
This benefit is limited to one use per year.
VSC_LP_C1_CS_M_600/620-2 (202103)
Bankruptcy:
Representation on Your behalf for personal bankruptcy protection under Chapter 7 or 13 of the Internal Revenue Code. This benefit does not include business related bankruptcy.
This benefit is limited to one use per year.
VSC_LP_C1_CS_M_630-2 (202103)
Foreclosure:
Defense of You in an action to foreclose on Your primary residence (where You have resided or intends to reside twenty-seven (27) weeks or more per year.)
This benefit is limited to one use per year.
VSC_LP_C1_CS_M_640-2 (202103)
Tax Audit:
This benefit includes:
(a) the services of an attorney (but not accounting services) during a personal (non-business related) tax audit required by federal and
(b) state tax authorities and negotiations relating to it.
This benefit does not include a defense against criminal charges nor the defense of civil tax litigation in any tax court.
This benefit is limited to one use per year.
VSC_LP_C1_CS_M_650-2 (202103)
Family Matters
Separation, Divorce, Civil Annulment:
Legal representation of You for up to the maximum shown on the Schedule in an uncontested separation or civil annulment; consent or default divorce, uncontested divorce or Contested Divorce. An uncontested separation, divorce or civil annulment does not involve significant disputed issues and the parties resolve any issues prior to any court supervised proceeding.
A consent or default divorce does not involve any disputed issues and the opposing party is not represented by counsel.
The benefit for uncontested matters does not provide any coverage of an attorney’s fee for:
(a) services in excess of the maximum shown on the Schedule, You must pay the attorney’s fee for services in excess of the maximum; or
(b) contested matters in which case the Member must pay the attorney’s fee for services, unless the coverage includes contested matters and the benefit shall be in accordance with the Schedule.
A contested separation, divorce or civil annulment requires:
(a) more than five hours of attorney time and
(b) involves disputed issues.
This benefit is limited to one use per year (representation seeking or defending against interim order shall constitute a separate use). This benefit applies to the Member and Covered Family Members only for actions not involving the Member as an opposing party.
VSC_LP_C1_CS_M_710/720/730-2 (202103)
Post-Divorce Proceedings:
Legal representation of You for up to the maximum listed on the Schedule in a contested or uncontested post-divorce proceeding. An uncontested post-divorce proceeding does not involve significant disputed issues and the parties resolve any issues prior to any court supervised proceeding.
The benefit for uncontested matters does not provide any coverage of an attorney’s fee for:
(a) services in excess of the maximum listed on the Schedule; You must pay the attorney’s fee for services in excess of the maximum;
(b) contested matters in which case You must pay the attorney’s fee for services, unless the coverage includes contested matters and the benefit shall be in accordance with the Schedule.
A contested post-divorce proceeding requires:
(a) more than five hours of attorney time,
(b) involves disputed issues and
(c) requires that both parties be represented by an attorney.
This benefit includes custody, support, and alimony proceedings.
This benefit is limited to one use per year.
This benefit applies to the Member and Covered Spouse only for actions not involving the Member as an opposing party.
VSC_LP_C1_CS_M_733-2 (202103)
Prenuptial Agreement:
This service covers the preparation of an agreement by You and Your fiancé/partner prior to Your marriage or legal union (where allowed by law), outlining how property is to be divided in the event of:
(a) separation,
(b) divorce or
(c) death of a spouse.
Representation is provided only to You. The fiancé/partner must have separate counsel or must waive representation.
This benefit is limited to one use per year.
VSC_LP_C1_CS_M_705-2 (202103)
Name Change:
Services required to accomplish a legal name change for You/Covered Family Member.
This benefit is limited to one use per year per Member/Covered Family Member.
VSC_LP_C1_CS_M_740-2 (202103)
Uncontested Guardianship/Conservatorship:
Services required to establish You/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 does not include contested matters.
This benefit is limited to one use per year.
VSC_LP_C1_CS_M_750-5 (202103)
Uncontested Government Agency/Stepparent Adoption:
Legal representation up to the maximum shown in the Schedule in an uncontested:
(a) governmental agency or
(b) stepparent adoption.
An uncontested adoption does not involve significant disputed issues.
This benefit does not include:
(a) contested termination of parental rights;
(b) fees for a court-appointed attorney for the child; or
(c) adoptions(s) made through any agency other than a governmental agency.
A contested adoption requires:
(a) more than five hours of attorney time and
(b) involves disputed issues.
This benefit is limited to one use per year.
VSC_LP_C1_CS_M_760/770-4 (202103)
Juvenile Court Proceeding:
Services related to the representation of Your/Covered Family Member’s dependent child in any juvenile court proceeding, provided the child’s interest is not in conflict with Your and/or Covered Family Member’s interest. This benefit does not cover any matter that falls outside the jurisdiction of juvenile court.
This benefit is limited to one use per year.
VSC_LP_C1_CS_M_780-2 (202103)
Civil Matters
Civil Litigation Defense:
Services related to representation when You are named as defendant in a filed civil lawsuit (non-business related), up to and including the trial thereof. This benefit does not include: (a) any debt collection or family law matters; (b) lawsuits normally handled on a contingent fee basis; or (c) matters for which You have or are required by law to have insurance.
This benefit is limited to one use per year.
VSC_LP_C1_CS_M_800-2 (202103)
Discounted Contingency Fees:
Participating Attorneys will handle the matter at a maximum percentage of the gross award. It is Your responsibility to pay this fee and all costs.
(a) When state laws set contingency fees: Lesser of 10 % less than state law maximum fee or the Participating Attorney’s usual fee.
(b) When state laws do not set contingency fee: Maximum of 29 % if settled before trial, 36 % if trial is conducted, or 40 % after an appellate brief is filed.
Contingency rate discount applies in those cases where attorneys customarily take a case on a contingency fee, (an agreed upon portion of any recovery), depending on the outcome of the case.
VSC_LP_C1_CS_M_840 (202103)
Mediation:
The services of an attorney for representation at a mediation. This benefit does not include the cost of the mediator’s services.
VSC_LP_C1_CS_M_850 (202103)
Traffic and Administrative Matters
Traffic Ticket:
Services related to representing You in defense of any traffic ticket except driving under influence or vehicular homicide, including:
(a) court hearings,
(b) negotiation with the prosecutor,
(c) trial, and
(d) counseling and preparing You for self-representation at any hearings if chosen.
This benefit does not cover violations related to a commercial driver’s license. This benefit does not apply to Driving Under the Influence (DUI) or Driving While Intoxicated (DWI) violations/citations.
This benefit is limited to one use per year.
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Serious Traffic Matter:
Services related to representing You when You are:
(a) charged by governing authorities with moving traffic violation(s) and
(b) conviction could result in suspension or revocation of a state-issued license permitting a person to drive a motor vehicle.
This benefit does not cover violations related to a commercial driver’s license. This benefit does not apply to Driving Under the Influence (DUI) or Driving While Intoxicated (DWI) violations/citations. This benefit can not include expungements of misdemeanor convictions. This benefit does not include adjustments to probation or parole.
This benefit is limited to one use per year.
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Administrative Proceeding:
Services related to representing You in an administrative proceeding relating to the:
(a) suspension or
(b) revocation
of driving privileges.
This benefit does cover suspension or revocation of a commercial driver’s license.
This benefit is limited to one use per year.
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FINANCIAL ADVISOR
Coverage includes a financial counseling Service for Member, and Covered Family Members.
Financial Helpline
Consultation with legal or financial professionals by toll-free telephone during normal business hours. Calls can relate to investment strategies, debt matters, budgeting or any personal financial planning question.
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 (10 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)
OBTAINING BENEFITS
Claim for Benefits
1. You should call the Member Service Center to confirm the potentially applicable benefit(s) prior to consulting with any attorney. You/Covered Family Member must provide all information requested with respect to the circumstances of an insured event or service provided. The Member Service Center will assign a Participating Attorney to provide services relative to the matter. Failure to notify the Member Service Center within thirty (30) days following consultation with an attorney may result in a denial of benefits, if such failure to provide timely notice has prejudiced Us in any way. Failure to provide notice within thirty (30) days will not invalidate or reduce an otherwise valid claim if it is shown not to be reasonably possible to give such notice within 30 days and that notice was given as soon as reasonably possible thereafter. Coverage applies to covered events which occur while the coverage is in effect. Any covered event which occurs prior to the effective date of coverage will be considered excluded and no benefits will apply.
You may reach the Member Service Center at:
5151 San Felipe, Suite 2300
Houston, TX 77056
888-416-4313
2. To confirm coverage for matters to which Managed Case Rules apply reference Managed Case Rules in the Schedule.
3. Members and/or Covered Family Members who are requesting services must remain enrolled and continue to pay premium hereunder.
4. Upon completion of a Covered Service, You/Covered Family Member may be required by the Participating Attorney to sign a confirmation of completion. Failure to sign the confirmation may result in denial of the claim and You/Covered Family Member will be responsible for all legal fees.
5. If You/Covered Family Member pay for pre-authorized services provided by a Non-Participating Attorney, You must:
(a) submit a reimbursement form (provided by Member Service Center) accompanied by an original itemized bill,
(b) proof of payment and
(c) supporting documentation
sufficient to demonstrate the work completed in the matter within sixty (60) days after incurring the legal fees. Benefits provided to You/Covered Family Member for Covered Services are subject to the maximum as shown in the Schedule.
6. Payment by Us for Covered Services does not preclude the attorney (whether Participating or Non-Participating) from seeking and recovering attorney’s fees from an opposing party, where authorized by:
(a) law,
(b) court rule, or
(c) contract
at the attorney’s customary or prevailing rate.
If You/Covered Family Member receive reimbursement of attorney’s fees, then You/Covered Family Member agree to reimburse Us for payments issued.
Disputes Between Member and Covered Family Member
In the event that Your and one of the Covered Family Members are involved as adversaries in a dispute that is a Covered Service, only You will be covered.
If two or more Covered Family Members are involved in a dispute that is otherwise covered, no coverage will be provided.
If two Members are involved as adversaries in a dispute that is a Covered Service, separate coverage for each Member will be provided.
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EXCLUSIONS
The following benefits are excluded:
(a) Appellate court proceedings.
(b) Class actions.
(c) Interventions.
(d) Malpractice proceedings.
(e) Actions in which punitive damages are being sought.
(f) Derivative actions and amicus curiae filings.
(g) The preparation and filing of:
(1) individual, partnership or estate tax returns,
(2) appellate or administrative proceedings related to tax returns,
(3) litigation before the U.S. Tax Court, U.S. Court of Claims or any other federal, state or other courts with respect to tax matters.
(h) Legal services that are fully paid for or provided at no cost by any governmental agency, organization or insurance company.
(i) Matters that the attorney deems frivolous, spurious, harassing, or unethical or otherwise prohibited by the Model Rules of Professional Conduct of the state in which the attorney is licensed.
(j) Costs associated with covered legal services. This includes, but not limited to, the following:
all fines, court costs, penalties, sanctions, expert witness fees, bonds, bail bonds, attorney fees awarded as part of a judgment, exhibits, deposition costs, filing fees, transcripts, postage, telephone, photocopying, recording fees, messengers, judgments, jury fees, court reporter fees, investigative costs, mediator or arbitrator fees. This also includes all other incidental and out-of-pocket legal and litigation costs.
(k) Any services on behalf of a Covered Family Member against Your interests.
(l) Any dispute or proceeding against the following persons or entities, their officers, directors, employees, or agents:
(1) any person or entity involved in the sale, marketing, administration or other processes related to the Policy;
(2) Legal Plan Administrator or its subsidiaries;
(3) Claims Administrator or its subsidiaries;
(4) Policyholder;
(5) Your employer;
(6) Virginia Surety Company, Inc. and it’s parents, subsidiaries or any affiliated or successor company, plan underwriter or reinsurer;
(7) Plan Sponsor; or any Participating and/or Non-Participating Attorney
if the dispute or proceeding pertains to services provided under the Policy.
(m) The Policy does not allow benefits listed under the Covered Services section to be combined for one legal matter.
(n) Where there are specific hours or dollar amounts provided in the Policy, or where a maximum is set under the Managed Case Rules, You will be responsible for all attorney fees incurred which exceed the maximum. Additional exclusions related to each benefit are included in the Covered Services.
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(o) Matters relating to: securities, trademark or patent matters; business or commercial interests, including, but not limited to the following:
(1) professional, partnership and/or corporate matters;
(2) matters arising out of Your/Covered Family Member’s role as an officer or director of an organization;
(3) matters involving the law or laws of jurisdictions other than the United States and its territories, except as specifically described under Covered Services;
(4) any matters involving a government (domestic or foreign) entity or agency except as specifically described under Covered Services;
(5) farm related issues.
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(o) Matters involving commercial or rental property transactions, including the purchase, sale or lease of investment or income-producing property. A multi-family residence, whether or not used by You/Covered Family Member as the primary residence, is deemed an investment or income-producing property.
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(p) Any employment-related matter. This includes, but is not limited to the following:
(1) any dispute involving
· Your employer or its affiliates,
· their officers or directors,
· Your employee benefit plans,
· credit unions,
· programs or arrangements sponsored by an employer, or
(2) cases involving:
· workers’ compensation,
· unemployment compensation,
· sex harassment, and
· age discrimination.
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(q) Except for consultation, the Policy will not provide benefits in connection with pre-existing matters. Pre-existing matters include any matter where You/Covered Family Member are on notice:
(1) as to a pending legal dispute or
(2) has previously contacted an attorney
except when prior coverage under another Legal Plan provided by the Policyholder can be demonstrated.
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GENERAL PROVISIONS
Attorney-Client Relationship
All attorneys are subject to the authority of the state Supreme Court and the state bar association of the state(s) where they are licensed to practice. You have the unrestricted right to choose an attorney. Your relationship with an attorney is privileged and strictly confidential. We will not interfere in:
(a) the attorney-client relationship or
(b) in the attorney’s independent exercise of his or her professional judgment.
Participating Attorneys are not certified specialists. Participating Attorneys are not agents or employees of either the Legal Plan Administrator or Us.
You shall authorize the Participating Attorney to provide the Legal Plan Administrator with:
(a) information and
(b) supporting documentation
on the number and type of services provided to You.
By using legal services benefits that are provided under the Policy, You agree that neither:
(a) We,
(b) the Policyholder,
(c) nor any other person
involved in the marketing or administration of the Policy, shall have any liability for the:
(a) acts,
(b) errors or omissions
of an attorney providing services, in whole or in part.
Non-Participating Attorney Services
If You already have an attorney, You may prefer to use her/him as a Non-Participating Attorney. To do so, You must first contact the Member Service Center and notify the representative of Your intention to use a Non-Participating Attorney for a Covered Service. The Member Service Center will send You a claim form which must be completed and returned in order to request reimbursement. Your reimbursement will be based on the reimbursement schedule shown under the Non-Participating Attorney column of the Schedule. If You have a Non-Participating Attorney You would prefer to work with, the Legal Plan Administrator may elect to offer to negotiate with the attorney on Your behalf but cannot guarantee the Non-Participating Attorney will accept the Plan Discounted Rate.
Subrogation and Coordination of Benefits
All benefits will be subject to subrogation and coordination of benefit rules. For the purpose of subrogation, We may require You/Covered Family Member to assign all rights of recovery of legal fees to the extent that payment is made by Us. If an assignment is sought, You/Covered Family Member must cooperate in providing the assignment.
The Policy coordinates benefits as follows: when a claim is made, the primary plan pays its regular benefit first. A plan is primary when it:
1. covers Policyholder’s employee as insured rather than as a dependent
2. covers a child as dependent of the parent whose birthday occurs earliest in the calendar year, except when:
(a) parents are separated or divorced and parent with custody is not remarried: benefit of parent with custody is primary
(b) parents are divorced and parent with custody is remarried, the order of determination is:
(i) parent with custody
(ii) step-parent
(iii) parent without custody
(c) a court decree establishes financial responsibility for a child’s legal expenses: then that parent’s plan is primary
If none of the above applies, the plan that has covered the insured the longest is primary, except if the insured is laid off or retired.
If You are entitled to receive legal services or reimbursement for legal services from any other person or organization, Our coverage will be excess.
Payment by Us for legal services under the Policy does not preclude Your attorney from seeking and recovering attorney fees from an opposing party, where authorized by law, court rule or contract, at the attorney’s usual and customary or prevailing rate. If You receive reimbursement of attorney’s fees, then You will reimburse Us for payments made under the Policy.
Legal Terminology
You or Covered Family Member may call the Member Service Center to obtain a definition or explanation of any term used herein.
Premium Refund Provision
In the event that:
(a) the premium mode is other than monthly and
(b) the Group Policy is terminated or
(c) You elect 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 Member fails to remit premium when due, subject to the statutory grace period.
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 in the Definitions section.
Illegal Activity, Misrepresentation and Fraud
No misrepresentation shall avoid any contract of insurance or defeat recovery, thereunder, unless such misrepresentation was material. No misrepresentation shall be deemed material unless knowledge by the insurer of the facts misrepresented would have led to a refusal by the insurer to make such contract. We will not provide coverage if doing so would be in violation of any United States economic or trade sanction.
Conformed to Statute
Any terms herein that conflict with the statutes of the jurisdiction where issued are amended to conform to the statutes.
Assignment of Benefits
The benefits provided herein are not assignable.
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Coverage Territory
The coverage territory includes the United States and United States territories
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Portability
You may continue this insurance by electing the option of portability when You no longer qualify as
(a) an employee of the Policyholder or
(b) as a Member of the group
to which the Group Policy is issued.
You 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 Your coverage under the Group Policy terminates.
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Grievances
Should You have a dispute concerning Your coverage, payment or about a reimbursement, You should first contact LegalEASE Member Service Center at 888-416-4313. If the dispute is not resolved, You may contact Virginia Surety Company at 1-800-209-6206.
Nothing in this plan shall be construed to prevent You from making a complaint to the appropriate Appellate Division or other body designated by the Appellate Division to investigate complaints in accordance with Judiciary Law section 90, or to the appropriate disciplinary body in the state where the legal service is being provided.
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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.
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.