Benefits Proudly Offered to Riverside Healthcare 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 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.

The Value of a LegalEASE Plan.

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

LegalEASE 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 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 $15.72 per month or $7.26* per pay period, via payroll deduction.

*Based on a 26 pay-period deduction schedule.

Who's Covered? 

The Member’s Covered Spouse or Domestic Partner and the Member’s and Covered Spouse’s unmarried dependent children, including stepchildren, legally adopted children, children placed in the home for adoption and foster children, up to age 25, and from age 19 up to 25 years if they are enrolled in an accredited school or college as full-time student(s), and are primarily dependent upon the Member for support.

 

Schedule of Benefits
Advice and Consultation	LegalEASE Plan Coverage Participating Attorney	LegalEASE  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 Law Office Services	LegalEASE Plan Coverage Participating Attorney	LegalEASE  Coverage Non-Participating Attorney
Discounted Legal Services for any non-excluded legal matter	25% discount on Plan Attorney's Hourly Rates	Not Applicable
Consumer Matters	LegalEASE Plan Coverage Participating Attorney	LegalEASE  Coverage Non-Participating Attorney
DOCUMENT PREPARATION Simple Deed Promissory Note Consumer Dispute Correspondence Installment Sales Agreement Simple Affidavit General Power of Attorney: Family Member Lease Agreement - Tenant only Time Share Agreement	Covered	$65 $60 $60 $60 $60 $60 $60/Family Member Document $65 $60
Life Insurance Claims	Covered Subject to Managed Case Rules*	$2,000 Maximum Subject to Managed Case Rules*
Consumer Dispute	Covered	$595
Small Claims Court Representation	Covered Up To 2 Hours with remainder at 25% discount	$120
Estate Planning	LegalEASE Plan Coverage Participating Attorney	LegalEASE  Coverage Non-Participating Attorney
Will or Codicil	Covered	$90
Living Will/Health Care or Advance Directive	Covered	$55
Health Care or Medical Power of Attorney	Covered	$55
Probate of Small Estate	Covered Up To 2 Hours with remainder at 25% discount	$120
Elder Matters	LegalEASE Plan Coverage Participating Attorney	LegalEASE  Coverage Non-Participating Attorney
Elder Parent Will Preparation	Covered	$80
Elder Parent Living Will/Health Care or Advance Directive	Covered	$55
Elder Parent Durable Financial Power of Attorney	Member co-pay $45 per document	Not Applicable
Elder Parent Health Care or Medical Power of Attorney	Member co-pay $45 per document	Not Applicable
Home and Residential Matters	LegalEASE Plan Coverage Participating Attorney	LegalEASE  Coverage Non-Participating Attorney
Purchase Of Primary Residence	Covered	$490
Sale Of Primary Residence	Covered	$365
Tenant Disputes	Covered Subject to Managed Case Rules*	$2,000 Maximum Subject to Managed Case Rules*
Financial Matters	LegalEASE Plan Coverage Participating Attorney	LegalEASE  Coverage Non-Participating Attorney
Debt Collection Defense Pre-litigation Defense Activities	Covered	$425
Debt Collection Defense Trial Defense	Covered	$850
Tax Audits	Covered Subject to Managed Case Rules*	$2,000 Maximum Subject to Managed Case Rules*
Civil	LegalEASE Plan Coverage Participating Attorney	LegalEASE  Coverage Non-Participating Attorney
Civil Litigation Defense	Covered Subject to Managed Case Rules*	$2,000 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
Family	LegalEASE Plan Coverage Participating Attorney	LegalEASE  Coverage Non-Participating Attorney
Uncontested Separation	Covered Up To 10 Hours with remainder at 25% discount	$595
Consent/Default Divorce	Covered Up To 10 Hours with remainder at 25% discount	$595
Uncontested Divorce	Covered Up To 10 Hours with remainder at 25% discount	$595
Contested Divorce (As Defined)	Covered Up To 28.5 Hours with remainder at 25% discount	$2,000 Maximum Subject to Managed Case Rules*
Post-Divorce Proceedings, as defined	Covered Up To 28.5 Hours with remainder at 25% discount	$2,000 Maximum Subject to Managed Case Rules*
Name Change	Covered	$255
Uncontested  Guardianship/Conservatorship	Covered	$400
Uncontested Governmental Agency Adoptions	Covered	$365
Uncontested Stepparent Adoptions	Covered	$400
Criminal Defense	LegalEASE Plan Coverage Participating Attorney	LegalEASE  Coverage Non-Participating Attorney
Administrative Proceeding (Regarding Suspension or Revocation Of License)	Covered	$255
Additional Benefits	LegalEASE Plan Coverage Participating Attorney	LegalEASE  Coverage Non-Participating Attorney
Financial Advisor	Included	Not Applicable
Identity Theft Assistance	Included	Not Applicable

Limitations may apply.

 

Exclusions

 

The following benefits are excluded:

 

Appellate court proceedings, class actions, interventions, malpractice proceedings, derivative actions 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 arising out of a Member/Covered Family Member’s role as an officer or director of an organization; matters involving the law or laws of jurisdictions other than the United States and its territories and  except as specifically described under Covered Services; 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 multi-family residence, whether or not used by the Member/Covered Family Member as their 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 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 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, 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, and age discrimination.

 

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 Policy; Legal Plan Administrator or its subsidiaries; Claims Administrator or its subsidiaries; Policyholder; Member’s employer; Virginia Surety Company, Inc. and it’s parents, subsidiaries or any affiliated or successor company, plan underwriter or reinsurer; or any Participating and/or Non-Participating Attorney, if the dispute or proceeding pertains to services provided under the Policy or to any services rendered by any Participating or Non-Participating attorney in any legal matter.

 

Except for consultation, the Policy will not provide benefits in connection with pre-existing matters, which includes any matter where the Member/Covered Family Member is on notice as to a pending legal dispute or has previously contacted an attorney.

 

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

 

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

Definitions

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

GRLE_05_DEF_CA (202208)

“COMPLEX WILL” - means a will for an individual who has a significant net worth and will benefit from tax planning, or the estate is subject to current state or federal estate taxation; or owns a business that will continue in operation after death; or wants to put restrictions on what heirs may do with the property; or wants to leave money to someone in a trust because the person cannot manage their 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 thinks that someone will challenge the will; or wants to exclude any lawful dependents.

GRLE_05_DEF_CW (202208)

“CONTESTED DIVORCE” - refers to a divorce proceeding that requires more than 5 hours of attorney time, and involves disputed issues and both parties are represented by an attorney.

GRLE_05_DEF_CD (202208)

“COVERED FAMILY MEMBER” – means the Member’s Covered Spouse and the Member’s and Covered Spouse’s unmarried dependent children, including stepchildren, legally adopted children, children placed in the home for adoption and foster children, up to age 25, and from age 19 up to 25 years if they are enrolled in an accredited school or college as full-time student(s), and are primarily dependent upon the Member for support.

GRLE_05_DEF_CFM (202208)

“COVERED SPOUSE” - means the Member’s lawful spouse or Domestic or Civil Union Partner at the time the coverage is in effect and for whom the required premium is paid where spouse coverage is option.

GRLE_05_DEF_CS_IL (202208)

“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 they are unable to do so themselves.

GRLE_05_DEF_DFPOA (202208)

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

GRLE_05_DEF_ED (202208)

“ELIGIBLE PARENT” – means the parents of the Member or Covered Spouse who are living in the Member’s home, regardless of age, and includes, biological parents, step-parents and adoptive parents.

GRLE_05_DEF_EP (202208)

“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 themselves.

GRLE_05_DEF_HCPOA (202208)

“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 the Policy.

GRLE_05_DEF_LPA (202208)

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

GRLE_05_DEF_LW (202208)

“MEMBER” - refers to the individual who (a) is associated with the Policyholder, (b) has either paid a premium or had a premium paid on their behalf, and (c) meets the eligibility requirements for Covered Services as defined by the Policyholder.

GRLE_05_DEF_MEM (202208)

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

GRLE_05_DEF_MSC (202208)

“NON-PARTICIPATING ATTORNEY” - means an attorney not contracted by the Legal Plan Administrator who is selected and paid by the Member to provide covered legal services up to the maximum amount shown under the Non-Participating Attorney column of the Schedule of Benefits.

GRLE_05_DEF_NPA (202208)

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

GRLE_05_DEF_PIF (202208)

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

GRLE_05_DEF_PA (202208)

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

GRLE_05_DEF_POL (202208)

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

GRLE_05_DEF_PH (202208)

“PRIMARY RESIDENCE” – means where an individual has resided or intends to reside for twenty-seven (27) weeks or more per year.

GRLE_05_DEF_PR (202208)

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

GRLE_05_DEF_WP (202208)

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

 

 

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

GRLE_06_CS (202109)

 

 

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.

GRLE_06_CS_A_000 (202109)

 

Initial Law Office Consultation:

Up to the maximum as shown in the Schedule of Benefits for office consultations with an attorney on any personal legal problem, civil or criminal, except those specifically excluded.

GRLE_06_CS_A_001 (202109)

 

Review of Simple Documents:

This benefit includes attorney review, verbal explanations of the meaning or impact of any form or document, or suggestions for changes to a form or proposed 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.

GRLE_06_CS_A_002 (202109)

 

 

 

 

 

Discounted Legal Services for any Non-Excluded Legal Matter:

This benefit will cover any legal services to review and/or prepare documents, or any other service required on any legal matters not listed as a Covered Service or Exclusion.

GRLE_06_CS_B_004 (202109)

 

 

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
• Simple Affidavit
• General Power of Attorney
• Lease Agreement (for the Member/Covered Family Member as a tenant only)
• Time Share Agreement

This benefit is limited to one use(s) per year per document per Member/Covered Family Member.

GRLE_06_CS_C_210/220/30/240/250/310/320/330 (202109)

 

Life Insurance Claim:

Assistance in securing life insurance proceeds (not including life insurance policies provided as an employee benefit) when a Member is a beneficiary of a life insurance policy.

This benefit is limited to one use(s) per year.

GRLE_06_CS_C_340 (202109)

 

Consumer Dispute:

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

This benefit is limited to one use(s) per year.

GRLE_06_CS_C_360 (202109)

 

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(s) per year.

GRLE_06_CS_C_390 (202109)

 

 

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, as defined in the Definitions section.

This benefit is limited to one use(s) per year per Member.

This benefit applies to the Member only.

GRLE_06_CS_D_400/430 (202109)

 

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:

 

• Living Will
• Health Care Directive
• Advance Directive
• Health Care Power of Attorney
• Medical Power of Attorney

 

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

This benefit is limited to one document/set of documents per year per Member/Covered Family Member.

GRLE_06_CS_D_440/450 (202109)

 

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.

GRLE_06_CS_D_470 (202109)

 

 

Elder Parent Will Preparation:

Preparation of a Simple Will(s) for the Eligible Parent(s). The attorney will prepare the document and discuss the legal requirements for signing the will. This benefit does not cover Complex Wills, as defined in the Definitions section.

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

GRLE_06_CS_E_401 (202109)

 

Elder Parent Living Will/Health Care or Advance Directive:

Preparation of a Living Will(s)/Health Care or Advance Directive(s), as they are defined in the Definitions section, for the Eligible Parent(s) at no charge. The attorney will prepare the document(s) 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 only one document(s), and cannot be combined to increase the total allowed benefit.

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

GRLE_06_CS_E_441 (202109)

 

Elder Parent Durable Financial Power of Attorney:

Preparation of a Durable Financial Power of Attorney(s), as defined in the Definitions section, for the Eligible Parent(s) at the co-pay rate shown in the Schedule of Benefits. The attorney will prepare the document(s) 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 document/set of documents per year per Eligible Parent.

GRLE_06_CS_E_311 (202109)

 

Elder Parent Health Care or Medical Power of Attorney:

Preparation of a Health Care or Medical Power of Attorney(s), as they are defined in the Definitions section, for the Eligible Parent(s) at the co-pay rate shown in the Schedule of Benefits. The attorney will prepare the document(s) 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(s), and cannot be combined to increase the total allowed benefit.

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

GRLE_06_CS_E_451 (202109)

 

Real Estate Sale or Purchase of Primary Residence:

The services of an attorney for the sale or purchase of a Primary Residence. This service includes the review and/or preparation of closing documents and/or attendance by the attorney at closing in situations when it is customary for the attorney 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(s) per year.

GRLE_06_CS_F_500/530/550 (202109)

 

Landlord Dispute with Tenant:

This benefit covers the Member where they are a landlord, but where the regular business or livelihood of the Member is that other than a landlord, for matters involving evictions, leases, or disputes with a residential tenant. The service includes advice and representation if a lawsuit is filed up to the maximum shown on the Schedule of Benefits. This benefit does not include representation for a tenant in disputes with other tenants or for a tenant acting in their capacity as sublessee or sublessor. If a lawsuit is required in order for the landlord to recover their damages, then representation will be provided up to the maximum shown in the Schedule of Benefits and the Member will be responsible for paying all fees for any additional services required.

This benefit is limited to one use(s) per year.

GRLE_06_CS_F_580 (202109)

 

 

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(s) per year.

GRLE_06_CS_G_600/620 (202109)

 

Tax Audit:

Includes the services of an attorney (but not accounting services) during a personal (non-business related) tax audit 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(s) per year.

GRLE_06_CS_G_650 (202109)

 

 

Separation, Divorce, Civil Annulment:

Legal representation of the Member for up to the maximum shown on the Schedule of Benefits 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: (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 the coverage includes 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, and involves disputed issues and requires that both parties be represented by an attorney.

This benefit is limited to one use(s) per year (representation seeking or defending against interim order shall constitute a separate use). This benefit applies to the Member only and Covered Family Members only for actions not involving the Member as an opposing party.

GRLE_06_CS_H_710/720/730 (202109)

 

Post-Divorce Proceedings:

Legal representation of the Member for up to the maximum listed on the Schedule of Benefits 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: (1) services in excess of the maximum listed on the Schedule of Benefits; the Member must pay the attorney’s fee for services in excess of the maximum; (2) 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 of Benefits. A contested post-divorce proceeding requires more than five hours of attorney time, involves disputed issues and requires that both parties be represented by an attorney. This benefit includes custody, support, and alimony proceedings.

This benefit is limited to one use(s) per year. This benefit applies to the Member only and Covered Spouse only for actions not involving the Member as an opposing party.

GRLE_06_CS_H_733 (202109)

 

Name Change:

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

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

GRLE_06_CS_H_740 (202109)

 

Uncontested Guardianship/Conservatorship:

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

This benefit is limited to one use(s) per year.

GRLE_06_CS_H_750 (202109)

 

Uncontested Government Agency/Stepparent Adoption:

Legal representation 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. If the amount of an attorney’s time for uncontested adoption exceeds the maximum shown in the Schedule of Benefits, or if the adoption becomes contested, then coverage will terminate and the Member will be responsible for any additional legal fees.

This benefit is limited to one use(s) per year.

GRLE_06_CS_H_760/770 (202109)

 

Juvenile Court Proceeding:

Services related to the representation of the dependent child of a Member/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(s) per year.

GRLE_06_CS_H_780 (202109)

 

 

 

Civil Litigation Defense:

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

This benefit is limited to one use(s) per year.

GRLE_06_CS_I_800 (202109)

 

Discounted Contingency Fees:

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

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

GRLE_06_CS_I_840 (202109)

 

Mediation:

The services of an attorney for representation at a court-required mediation. This benefit does not include the cost of the mediator’s services.

This benefit is limited to one use(s) per year.

GRLE_06_CS_I_850 (202109)

 

 

Administrative Proceeding:

Services related to the representation of a 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(s) per year.

Obtaining Benefits

Claim for Benefits

 

1.   Members should call the Member Service Center to confirm the potentially applicable benefit(s) prior to consulting with any attorney. The Member/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. If a Member/Covered Family Member has a Non-Participating Attorney they would prefer to work with, they must notify the representative of their intention to use a Non-Participating Attorney for a Covered Service. The Member Service Center will provide a claim form within fifteen (15) days of notice. The Legal Plan Administrator may elect to offer to negotiate with the attorney on their behalf, but cannot guarantee the Non-Participating Attorney will accept the Plan Discounted Rate. Failure to submit a claim to the Member Service Center within sixty (60) days or as soon as reasonably possible following consultation with an attorney may result in a denial of benefits.

 

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

3.   The Member must remain enrolled and continue to pay premium hereunder for services to be requested.

 

4.   Upon completion of a Covered Service, the Member/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 the Member/Covered Family Member will be responsible for all legal fees.

 

5.   If the Member/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 are subject to the maximum as shown in the Schedule of Benefits.

 

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 law, court rule, or contract, at the attorney’s customary or prevailing rate. If the Member/Covered Family Member receives reimbursement of attorney’s fees, then the Member/Covered Family Member agrees to reimburse Us for payments issued.

 

Disputes Between Members or Covered Family Members

 

In the event that the Member and their Covered Family Member(s) 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 or more Members are involved as adversaries in a dispute that is a Covered Service, separate coverage for each Member will be provided.

Exclusions

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. The Member/Covered Family Member has the unrestricted right to choose an attorney. The Member’s/Covered Family Member’s relationship with an attorney is privileged and strictly confidential. We will not interfere in the attorney-client relationship or in the attorney’s independent exercise of their professional judgment. Participating Attorneys are not certified specialists. Participating Attorneys are not agents or employees of either the Legal Plan Administrator or Us.

The Member/Covered Family 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.

 

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

 

Non-Participating Attorney Services

If the Member/Covered Family Member already has an attorney, they may prefer to use them as a Non-Participating Attorney. To do so, the Member must first contact the Member Service Center and notify the representative of their intention to use a Non-Participating Attorney for a Covered Service. The Member Service Center will send the Member a claim form which must be completed and returned in order to request reimbursement. The Member’s reimbursement will be based on the reimbursement schedule shown under the Non-Participating Attorney column of the Schedule of Benefits. If a Member/Covered Family Member has a Non-Participating Attorney they would prefer to work with, the Legal Plan Administrator may elect to offer to negotiate with the attorney on their 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 the Member/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, the Member/Covered Family Member must cooperate in providing the assignment.

 

Legal Terminology

The 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.

 

Secondary Coverage

If the Member/Covered Family Member is entitled to receive legal services or reimbursement for legal services from any other person or organization, the coverage available under the Policy would be considered excess as defined in the National Association of Insurance Commissioners Model Coordination of Benefits Provisions.

 

Termination and Cancellation of Coverage

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

 

1. Cancellation or termination of the Group Policy;
2. If applicable, the Member fails to re-enroll;
3. The Member is no longer associated with Policyholder; or
4. 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 at time family member ceases to qualify as a Covered Family Member as defined in the Definitions section.

 

Coverage provided to an Eligible Parent of a Member shall terminate at time family member ceases to qualify as an Eligible Parent as defined in the Definitions section.

 

When coverage for a Member/Covered Family Member terminates and a matter is unresolved when coverage terminated, then any further legal work between said Member/Covered Family Member and the Participating Attorney shall be outside the scope and coverage of the Policy. The Participating Attorney shall not be obligated to provide any benefits under the Policy and any further legal services shall be based upon an independent and separate fee agreement entered into, if at all, between the former Member/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.

 

Illegal Activity, Misrepresentation and Fraud

We will not provide coverage if the Member/Covered Family Member has intentionally concealed or misrepresented any material fact or circumstances or been involved in any illegal activity related to the Policy or claim. We will not provide coverage if doing so would be in violation of any United States economic or trade sanction.

 

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.

 

Waiver of Premium

Upon the death of the Member, coverage for the surviving Covered Family Members continues for the remainder of the current Group Policy term. We waive further premium payments during this time.

 

Upon the Member being called to active duty for a period of more than thirty (30) consecutive days for the purposes of military service or of responding to a declared national emergency, coverage for the Covered Family Members will continue, without the payment of premium, for the length of the Member’s absence and for so long as the Member remains eligible for benefits through the Policyholder.

 

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.

 

• 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.