summary of the
JPMorgan Chase Group
Personal Excess Liability
Insurance Plan. This
applicable insurance
contracts, if any. If there
is a discrepancy
between the applicable
insurance contracts and
The Group Personal Excess Liability
Insurance Plan
Effective 1/1/19
The JPMorgan Chase Group Personal Excess Liability Insurance Plan is not a
About this Summary
This section is a
plan governed by the Employee Retirement Income Security Act, and is
therefore not governed by the rules and procedures of ERISA. This document
is a description of the Group Personnel Excess Liability Insurance Plan for
summary does not
include all of the details
informational purposes only. The Plan provides additional liability protection for
contained in the
up to $10 million in coverage for damages and costs you or a covered family
member might have to pay, beyond the limits of liability provided by your
primary auto, homeowners, renters, recreational vehicle, motorcycle and
watercraft insurance policies. Examples of situations this coverage could
this summary, the
insurance contracts will
potentially address are:
control.
Serious auto and boat accidents;
Youthful driver claims;
Swimming pool accidents;
“Slip and fall” accidents on your property;
Snowmobile claims;
Service on a homeowner’s condominium or cooperative association, if not for profit; and
Service as a director or officer for a non-profit organization for which you do not receive any pay.
This section of the Guide will provide you with a better understanding of how coverage under the Group
Personal Excess Liability Insurance Plan works, including how and when benefits are paid.
Be sure to see important additional information about the Plan, in the sections titled About This Guide,
What Happens If… and Plan Administration.
Effective 1/1/19 The Group Personal Excess Liability Insurance Plan 285
Questions?
If you still have questions after reviewing this Guide, there are a number of resources that can provide answers. As a
first stop for the Personal Excess Liability Insurance Plan, contact the claims administrator:
Arthur J. Gallagher
Risk Management Services
(866) 631-4630
Representatives are available from 9 a.m. to 5 p.m., Eastern Time, Monday through Friday.
For additional resources, consult the Contacts section.
The JPMorgan Chase U.S. Benefits Program is available to most employees on a U.S. payroll who are regularly
scheduled to work 20 hours or more a week and who are employed by JPMorgan Chase & Co. or one of its
subsidiaries to the extent that such subsidiary has adopted the JPMorgan Chase U.S. Benefits Program. This
information does not include all of the details contained in the applicable insurance contracts, plan documents, and
trust agreements. If there is any discrepancy between this information and the governing documents, the governing
documents will control. Because most benefits under the Group Personal Excess Liability Insurance Plan are
provided by insurance, the terms of the policy or insurance certificate will control eligibility for benefits. If there is a
discrepancy between this description and the policy or certificate, the policy or certificate will control. JPMorgan
Chase & Co. expressly reserves the right to amend, modify, reduce, change, or terminate its benefits and plans at
any time. The JPMorgan Chase U.S. Benefits Program does not create a contract or guarantee of employment
between JPMorgan Chase and any individual. JPMorgan Chase or you may terminate the employment relationship at
any time.
Effective 1/1/19 The Group Personal Excess Liability Insurance Plan 286
Table of Contents Page
Personal Excess Liability Highlights .....................................................................................288
Participating in the Plan ......................................................................................................... 289
Who’s Eligible? .................................................................................................................................. 289
Who’s Not Eligible? ........................................................................................................................... 289
When You Become Eligible .............................................................................................................. 289
Who’s Covered? ................................................................................................................................ 289
Additional Covered Persons ........................................................................................................... 289
Cost of Coverage ............................................................................................................................... 290
How to Enroll...................................................................................................................................... 290
Enrolling if You Are an Employee ................................................................................................... 290
Enrolling if You Are a Newly Hired Employee ................................................................................ 290
Enrolling if You Are a Newly Eligible Employee ............................................................................. 291
If You Do Not Enroll........................................................................................................................... 291
When Coverage Begins..................................................................................................................... 291
No Midyear Changes ......................................................................................................................... 291
When Coverage Ends ........................................................................................................................ 292
How the Plan Works ................................................................................................................ 292
Required Underlying Insurance .............................................................................................293
Additional Features................................................................................................................. 294
Uninsured/Underinsured Motorist Protection ................................................................................ 294
Defense Coverages ........................................................................................................................... 294
Shadow Defense Coverage .............................................................................................................. 294
Identity Fraud ..................................................................................................................................... 295
Kidnap Expenses ............................................................................................................................... 295
Reputational Injury ............................................................................................................................ 295
What’s Not Covered ................................................................................................................ 296
Filing a Claim........................................................................................................................... 298
Defined Terms ......................................................................................................................... 298
Effective 1/1/19 The Group Personal Excess Liability Insurance Plan 287
Personal Excess Liability Highlights
Benefits of
The Group Personal Excess Liability Insurance Plan provides additional liability protection for
Participating
damages and costs arising from bodily injury or personal injury to others, or for damage to the
property of others.
This insurance covers what you or a covered family member may be liable for beyond the
limits of liability provided by your primary auto, homeowners, renters, recreational vehicle,
motorcycle or watercraft insurance policies.
Your Choices
You can choose from among the following options:
$2 million in coverage
$5 million in coverage
$10 million in coverage
Additional
Additional features include:
Features
Uninsured/Underinsured Motorist Protection — $2 million in coverage
Identity Fraud — $25,000 in coverage
Kidnap Expense — $100,000 in coverage
Reputational Injury — $25,000 in coverage
Who’s Covered?
If you enroll for coverage, the Plan provides coverage for you and all of the dependents who
are eligible and qualify for the JPMorgan Chase Medical Plan (your spouse or domestic
partner and your children under age 26). For more details, see “Your Eligible Dependents” in
the Health Care Participation section.
Costs
You pay the full cost of any group personal excess liability insurance you choose on an
after-tax basis. There is a flat rate for coverage based on the coverage level you elect — your
cost per pay period is the same regardless of how many dependents you cover.
Enrolling and
Changing
Coverage
Enrolling: You can only enroll for coverage during Annual Benefits Enrollment or when you
first become eligible (generally, as a newly hired employee or due to a work status change).
Changing Coverage: You cannot drop coverage during the plan year. You can only make
changes to your coverage during Annual Benefits Enrollment (usually held in the fall of each
year for the following year’s participation). Midyear changes due to a Qualified Status
Change (QSC) are not permitted under this Plan. When you enroll, your participation is in
effect through December 31 and you may not stop participating unless you are no longer
eligible due to a work status change.
Required
Underlying
Insurance
The Plan is designed to provide protection in case of liabilities beyond the limits of liability
provided by your primary auto, homeowners, renters, recreational vehicle, motorcycle or
watercraft insurance policies. This primary coverage is called the underlying coverage. You
are required to have primary insurance in place that meets the specifications noted in
“Required Underlying Insurance” on page 293.
Claims
The claims administrator is Arthur J. Gallagher Risk Management Services.
Administrator
Plan benefits are provided through insurance offered by The Chubb Insurance Company.
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Participating in the Plan
Who’s Eligible?
In general, you are eligible to participate if you are:
Employed by JPMorgan Chase & Co., or one of its subsidiaries that has adopted the Plan, on a U.S.
payroll and you are subject to FICA taxes;
Paid hourly, salary, draw, commissions, or production overrides; and
Regularly scheduled to work 20 or more hours per week.
Who’s Not Eligible?
An individual who does not meet the criteria under “Who’s Eligible?” as well as an individual classified or
employed in a work status other than as a common law salaried employee by his or her employer is not
eligible for the Plan regardless of whether an administrative or judicial proceeding subsequently
determines this individual to have instead been a common law salaried employee. Examples of such
individuals include an:
Independent contractor/agent (or its employee);
Intern; and/or
Occasional/seasonal, leased, or temporary employee
When You Become Eligible
Employees are eligible to participate in the Group Legal Plan as follows:
If you are a full-time employee (regularly scheduled to work 40 hours per week), you are eligible to join
the Plan on the first of the month after your date of hire.
If you are a part-time employee (regularly scheduled to work at least 20 but less than 40 hours per
week), you are eligible to join the Plan on the first of the month after 60 days from your date of hire.
Who’s Covered?
If you, the JPMorgan Chase employee, enroll in the Plan, the Plan automatically covers you, your
spouse/domestic partner, and all eligible children that are eligible and qualify for coverage under the
Medical Plan. For details about your eligible dependents, please see “Your Eligible Dependents” in the
Health Care Participation section.
Please Note: Even if underlying personal liability (homeowners) and automobile personal liability
coverage is not in the employee’s name, group personal excess coverage will be extended to a spouse or
a domestic partner since he or she is considered a family member.
Additional Covered Persons
If you enroll, in addition to you and the dependents noted above, under “Who’s Covered,” include:
Your family members (a family member is your spouse or domestic partner or other relative who lives
with you, or any other person under age 26 who lives with you and who is in your care or your
relative’s care);
Any person using a vehicle or watercraft covered under this Plan with permission from you or a family
member with respect to their legal responsibility arising out of its use;
Any other person who is a covered person under your required primary underlying insurance;
Any person or organization with respect to their legal responsibility for covered acts or omissions of
you or a family member; or
Any combination of the above.
Effective 1/1/19 The Group Personal Excess Liability Insurance Plan 289
Cost of Coverage
You pay the entire cost of coverage under the Plan with after-tax contributions. Your per-pay-period cost
depends on your pay schedule frequency and the coverage level you choose.
There is a flat rate for coverage under this Plan, based on the level of coverage you choose. You can
choose from among the following coverage levels:
$2 million;
$5 million; or
$10 million.
Your cost per-pay-period is the same regardless of how many dependents are covered.
How to Enroll
You can only enroll for coverage when you first become eligible (generally, as a newly hired employee) or
during Annual Benefits Enrollment. Unlike other JPMorgan Chase benefits, you cannot enroll, change, or
cancel your coverage during the year, even if you have a Qualified Status Change (QSC). Participation in
the Plan is optional. You must enroll to have coverage.
If you want to enroll, the process varies, depending on whether you are a:
Current, eligible employee, enrolling during Annual Benefits Enrollment;
Newly hired employee; or
Newly eligible employee (because of a change in work status).
Enrolling if You Are an Employee
You’ll receive information on Plan benefits as well as instructions on enrolling during Annual Benefits
Enrollment. You make your elections through the Benefits Web Center on My Health or through the
accessHR Contact Center.
Elections you make during Annual Benefits Enrollment are effective the following January 1.
You need to consider your choice carefully and enroll for the coverage that best meets your needs. You
can't change or cancel your choice during the year, even if you have a Qualified Status Change (QSC).
If you're already participating in the Plan and do not cancel coverage during Annual Benefits Enrollment,
you'll continue with the same coverage you had before Annual Benefits Enrollment. However, you'll be
subject to any changes in the Plan and coverage costs effective with the new plan year.
Enrolling if You Are a Newly Hired Employee
If you’ve just joined JPMorgan Chase and are enrolling for the first time, you need to make your choices
through the Benefits Web Center on My Health or through the accessHR Contact Center.
You will need to enroll within 31 days of your date of hire if you are a full-time employee, and within 31
days prior to becoming eligible if you are a part-time employee, as explained below.
If you are a full-time employee (regularly scheduled to work 40 hours per week), you may
receive information regarding benefits enrollment after accepting a position with JPMorgan Chase but
before your hire date. Your coverage will begin on the first of the month following your hire date, as
long as you enroll prior to your hire date or within 31 days after your hire date.
If you are a part-time employee (regularly scheduled to work at least 20 but less than 40 hours
per week), you are eligible for coverage on the first of the month after 60 days from your date of hire.
You will receive your enrollment materials within 31 days before becoming eligible for coverage. You
need to enroll within 31 days before your eligibility date.
You can access your benefits enrollment materials online at My Health > New Hire Information.
Effective 1/1/19 The Group Personal Excess Liability Insurance Plan 290
Enrolling if You Are a Newly Eligible Employee
If you’re enrolling during the year because you’re a newly eligible employee due to a work status change,
you’ll have 31 days from the date of the change in work status to make your new choices through the
Benefits Web Center on My Health > My Resources or through the accessHR Contact Center.
If You Do Not Enroll
If You Are an Employee
If you're already participating in the Plan and do not cancel coverage during Annual Benefits Enrollment,
you'll generally keep the same coverage you had before Annual Benefits Enrollment. However, you'll be
subject to any changes in the Plan and coverage costs effective with the new plan year.
If You Are a Newly Hired or Newly Eligible Employee
If you’re a newly hired or newly eligible employee and do not actively enroll before the end of the
designated 31-day enrollment period, you won’t be able to enroll in the Group Personal Excess Liability
Insurance until the next Annual Benefits Enrollment.
When Coverage Begins
If You Are an Employee
If you enroll during Annual Benefits Enrollment, your coverage will be effective January 1 and you will
continue to participate for the full calendar year (January through December). If you go on a leave of
absence and not receiving payroll deductions, your participation will continue as long as you continue to
pay applicable premiums.
If You Are a Newly Hired or Newly Eligible Employee
If you enroll, coverage will be effective on the first of the month following your hire date if you are a full-
time employee. If you are a part-time employee, coverage will be effective the first day of the month
following 60 days from your date of hire.
You will continue to participate from the effective date through the end of the calendar year. If you go on a
leave of absence and not receiving payroll deductions, your participation will continue as long as you
continue to pay applicable premiums.
Your Insurance Certificate
Following your coverage effective date, you will receive an individual certificate of insurance directly from Arthur J.
Gallagher Risk Management Services. This will be your proof of coverage under the Group Personal Excess Liability
Insurance Plan. Please retain this certificate for your records.
No Midyear Changes
When you enroll, your participation is in effect through December 31 and you may not stop participating
unless you are no longer eligible due to a termination or work status change. If your work status changes
and you are then scheduled to work fewer than 20 hours per week, your Plan coverage will end on the
date of the work status change.
Midyear changes are not permitted under this Plan, even if you have a Qualified Status Change (QSC)
that allows you to change other JPMorgan Chase benefits.
You can only make changes to your coverage during Annual Benefits Enrollment (usually held in the fall
of each year for the following year’s participation).
Effective 1/1/19 The Group Personal Excess Liability Insurance Plan 291
When Coverage Ends
Group legal coverage ends on your last day of active employment. Your coverage can also end when:
You stop paying applicable premiums or in any other way become ineligible to participate in the plan;
or
After you have been receiving long-term disability benefits for 24 months.
Continuing Coverage After It Ends
You cannot convert or port your coverage, but you are eligible to continue your current coverage through
the end of the calendar year in which you leave, provided that you pay the balance of the policy in full
directly to Arthur J. Gallagher Risk Management Services.
If your coverage ends because you leave JPMorgan Chase, Arthur J. Gallagher & Co., the plan
administrator, will contact you with instructions for continuing your coverage and paying the balance. If
your payment is not received within 31 days, your policy will be canceled effective as of your termination
date. You may not continue to participate in the program after the end of the policy year in which you
were an active employee.
How the Plan Works
The JPMorgan Chase Group Personal Excess Liability Insurance Plan provides additional liability
protection for damages and costs for which you or a covered family member are liable, beyond the limits
of liability provided by your primary auto, homeowners, renters, recreational vehicle, motorcycle, and
watercraft insurance policies. If you enroll, you can choose from three levels of coverage:
$2 million in coverage
$5 million in coverage
$10 million in coverage
Coverage under this type of plan is always in excess of any other collectible insurance and is also known
as an “umbrella policy.” The Plan generally covers damages a covered person is legally obligated to pay
for personal injury or property damage, in excess of damages covered by the underlying insurance. The
Plan also covers some liability exposures that may be excluded by your underlying policies. These
exposures have no required underlying limits and are covered from the first dollar of loss, unless the Plan
states otherwise.
For example, in the case of a car accident, your primary auto insurance policy would provide the first level
of coverage and the JPMorgan Chase Group Personal Excess Liability Insurance Plan would be available
once the primary limits are exhausted. However, if you already have a personal excess liability policy, that
policy would act as the second level of coverage and then the JPMorgan Chase Group Personal Excess
Liability Insurance Plan would be the final level of coverage after all other policy limits are reached.
The Chubb Insurance Company will pay on the participant’s behalf up to that amount for covered
damages from any one occurrence, regardless of how many claims, homes, vehicles, watercraft, or
people are involved in the occurrence. Any costs The Chubb Insurance Company pays for legal expenses
are in addition to the amount of coverage.
In case of an accident or occurrence, you must notify The Chubb Insurance Company as soon as
reasonably possible.
Effective 1/1/19 The Group Personal Excess Liability Insurance Plan 292
Required Underlying Insurance
It is a condition of the Group Personal Excess Liability Plan that you and your family members maintain in
full effect primary underlying liability insurance of the types and in at least the amounts shown below. If
you carry less than the minimum required limits, you will be responsible for any “gaps in coverage”
between what is required and the amount of the primary coverage. Unless there is underlying coverage
as stipulated below, rented, borrowed, or furnished vehicles and watercraft are not covered for more than
60 days.
The following chart shows the minimum underlying primary liability policy limits that are required for
coverage under the Plan. It is recommended that you contact your current insurance carrier or
agent to ensure that you meet the limits before enrolling in this Plan.
Coverage Underlying Limits (Per Person/Per Accident)
Personal Liability/
Property Damage
$300,000
Personal Automobile
$250,000/$500,000 of bodily injury and $100,000 of property
Liability
damage; OR
(Registered Vehicle)
$300,000/$300,000 of bodily injury and $100,000 of property
damage; OR
$300,000 single limit each occurrence
Personal Automobile
Liability
(Unregistered Vehicle)
$300,000 bodily injury and property damage each occurrence
Registered Vehicles (less
$250,000/$500,000 of bodily injury and $100,000 of property
than four wheels) and
damage; OR
Motor Homes
$300,000/$300,000 of bodily injury and $100,000 of property
damage; OR
$300,000 single limit each occurrence
Uninsured Motorist/
$250,000/$500,000 of bodily injury and $100,000 of property
Underinsured Motorist
damage; OR
Protection
$300,000/$300,000 of bodily injury and $100,000 of property
damage; OR
$300,000 single limit each occurrence
Watercraft
Less than 26 ft. and 50
engine-rated HP or less
$300,000 each occurrence
26 ft. or longer, or more than
50 engine-rated HP
$500,000 each occurrence
Please Note: If you carry limits that are higher than the minimums required under the Plan, you can
either reduce your underlying limits to the required minimums or keep the higher limits. If you choose to
leave your underlying limits higher than the minimum amounts required, you will have a higher level of
coverage.
If you fail to maintain the required underlying limits for your primary insurance, and there is an occurrence
that would have been covered by such insurance, you will be responsible for the amount of damages up
to the applicable minimum required underlying limits of your required primary insurance.
The Plan will only pay amounts in excess of your required underlying limits.
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Additional Features
Additional features of the Plan include:
Coverage Coverage Amount
Uninsured/Underinsured Motorist Protection $2,000,000
Defense Coverages See details under “Defense Coverages” on page 294
Shadow Defense Coverages $10,000
Identity Fraud $25,000
Kidnap Expense $100,000
Reputational Injury $25,000
Uninsured/Underinsured Motorist Protection
This protection covers bodily injury and property damage, in excess of the underlying insurance or
required primary underlying insurance, whichever is greater, that you are legally entitled to receive from
the owner or operator of an uninsured motorized/underinsured motorized land vehicle. You will be
covered for up to $2 million, regardless of the number of vehicles covered by the required primary
underlying insurance and regardless of the number of claims, vehicles, or people involved in any one
occurrence.
If there is a disagreement around the legal entitlement or the amount covered, either you or The Chubb
Insurance Company can make a written demand for arbitration. Local rules of law as to procedure and
evidence will apply.
Defense Coverages
This coverage offers defense against any suit brought against you to recover damages for personal injury
or property damage that is either covered or not covered by an underlying insurance. The Chubb
Insurance Company will begin defense, at its own expense, once the underlying coverage has been
exhausted.
The Chubb Insurance Company will provide defense at its own expense, even if the suit is groundless,
false or fraudulent, using counsel of its choice. The Chubb Insurance Company may investigate,
negotiate, and settle any such claim or suit at its discretion.
Expenses to be paid include:
All expenses incurred by the insurance company;
All costs taxed against you;
All earnings lost by you at the insurance company’s request, up to $25,000;
Other reasonable expenses incurred by you at the insurance company’s request; and
The cost of bail bonds required of you because of a covered loss.
Shadow Defense Coverage
If you or a family member is being defended by The Chubb Insurance Company in a suit, the insurance
company will pay up to $10,000 for you to have a law firm of your choice review and monitor the defense
being provided. You must obtain prior approval from the insurance company before incurring any fees or
expenses in order for them to be paid. Any recommendation made by your attorney will not be binding on
the insurance company.
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Identity Fraud
Expenses for identity fraud occurrences will be paid by the insurance company up to $25,000 for each
occurrence. Identity fraud is defined by the Plan as the act of knowingly transferring or using, without
lawful authority, your or a family member’s means of identity, which constitutes a violation of federal law
or a crime under any applicable state or local law.
Identity fraud expenses include:
The cost for notarizing affidavits or similar documents to law enforcement agencies, financial
institutions or similar credit grantors, and credit agencies;
The cost for sending certified mail to law enforcement agencies, financial institutions or similar credit
grantors, and credit agencies;
Loan application fees to reapply for loan(s) due to rejection of original application because of incorrect
credit information;
Reasonable attorney fees incurred with prior notice and approval by insurance company for:
the defense of you or a family member against any suit(s) by businesses or their collection
agencies;
the removal of any criminal or civil judgments wrongly entered against you or a family member;
any challenge to the information in your or a family member’s consumer credit report; and
Reasonable fees incurred by an identity fraud mitigation entity with prior notice and approval by the
insurance company to:
provide services for the activities described above;
restore accounts or credit standing with financial institutions or similar credit grantors and credit
agencies; and
monitor for up to one year the effectiveness of the fraud mitigation and detect additional identity
fraud activity after the first identity fraud occurrence.
Kidnap Expenses
You will be covered for up to $100,000 in kidnap expenses incurred by you or a family member as a result
of a kidnap and ransom occurrence. The occurrence must include a demand for ransom payment, which
would be paid by you or a family member in exchange for the release of the kidnapped person(s). Also,
up to $25,000 will be paid to any person for information not otherwise available that would lead to the
arrest and conviction of any person(s) who kidnaps you, a family member, or covered relative. (You, a
family member, or a covered relative who witnessed the occurrence will not be eligible to receive a reward
payment.)
Kidnap expenses include other reasonable costs described in the insurance certificate.
Reputational Injury
This coverage will pay the reasonable and necessary fees or expenses that you or a family member may
incur for services by a reputation management firm to minimize potential injury to your or a family
member’s reputation as a result of personal injury or property damage caused by an occurrence. The
maximum amount of coverage is $25,000 for any one occurrence regardless of the number of claims or
people involved. In order to have expenses paid:
The reputational injury must be reported as soon as reasonably possible, but no later than 30 days
after the occurrence, and
You must obtain approval of the reputation management firm from the insurance company before
incurring any fees or expenses, unless stated otherwise or an exclusion applies. There is no
deductible for this coverage.
Effective 1/1/19 The Group Personal Excess Liability Insurance Plan 295
What’s Not Covered
These are some exclusions that apply to your Group Personal Excess Liability Insurance Coverage,
unless stated otherwise. The following list is a partial list of exclusions under the Plan. The Plan will not
pay benefits for the following:
Damages arising out of the ownership, maintenance, use, loading, unloading, or towing of any aircraft,
except aircraft with crew chartered by you;
Property damages to aircraft rented to, owned by, or in the care, custody, or control of a covered
person;
Damages arising out of the ownership, maintenance, use, loading, unloading, or towing of any
hovercraft;
Property damages to hovercraft rented to, owned by, or in the care, custody, or control of a covered
person;
Damages arising out of the ownership, maintenance or use of any motorized land vehicle:
during any instruction, practice, preparation for, or participation in, any competitive, prearranged or
organized racing, speed contest, rally, gymkhana, sports event, stunting activity, or timed event of
any kind; or
on a racetrack, test track, or other course of any kind.
Damages arising out of the ownership, maintenance or use of any watercraft or aircraft during any
instruction, practice, preparation for, or participation in, any competitive, prearranged or organized
racing, speed contest, rally, sports event, stunting activity, or timed event of any kind. This exclusion
does not apply to you or a family member for sailboat racing, even if the sailboat is equipped with an
auxiliary motor.
Damages arising out of the ownership, maintenance, or use of a motorized land vehicle by any person
who is employed or otherwise engaged in the business of selling, repairing, servicing, storing, parking,
testing, or delivering motorized land vehicles. This exclusion does not apply to you, a family member,
or your employee or an employee of a family member for damages arising out of the ownership,
maintenance, or use of a motorized land vehicle owned by, rented to, or furnished to you or a family
member.
Damages arising out of the ownership, maintenance, or use of a watercraft by any person who is
engaged by or employed by, or is operating a marina, boat repair yard, shipyard, yacht club, boat
sales agency, boat service station, or other similar organization. This exclusion does not apply to
damages arising out of the ownership, maintenance, or use of a watercraft by you, a family member,
or your or a family member’s captain or full-time paid crew member maintaining or using this watercraft
with permission from you or a family member.
Damages owed to any person or organization, other than you or a family member or your or a family
member’s employees, with respect to the loading or unloading of motorized land vehicles or
watercraft.
Damages a covered person is legally:
required to provide; or
voluntarily provided under any:
- workers’ compensation;
- disability benefits;
- unemployment compensation; or
- other similar laws.
Effective 1/1/19 The Group Personal Excess Liability Insurance Plan 296
The Plan does provide coverage in excess over any other insurance for damages you or a family member
are legally required to pay for bodily injury to a domestic employee of a residence covered under the
required primary underlying insurance which are not compensable under workers’ compensation, unless
another exclusion applies.
Damages for any covered person’s actions or failure to act as an officer or member of a board of
directors of any corporation or organization. However, the Plan does cover such damages if you are or
a family member is an officer or member of a board of directors of a:
homeowner, condominium, or cooperative association; or
not−for−profit corporation or organization for which he or she is not compensated;
unless another exclusion applies.
Damages owed to any person for property damage to property owned by any covered person.
Damages owed to any person for property damage to property rented to, occupied by, used by, or in
the care of any covered person, to the extent that the covered person is required by contract to
provide insurance. But the Plan does cover such damages for loss caused by fire, smoke, or explosion
unless another exclusion applies.
Damages arising out of a wrongful employment act. A wrongful employment act means any
employment discrimination, sexual harassment, or wrongful termination of any residential staff actually
or allegedly committed or attempted by a covered person while acting in the capacity as an employer,
that violates applicable employment law of any federal, state, or local statute, regulation, ordinance, or
common law of the United States of America, its territories or possessions, or Puerto Rico.
Damages arising out of discrimination due to age, race, color, sex, creed, national origin, or any other
discrimination.
Damages arising out of a willful, malicious, fraudulent, or dishonest act or any act intended by any
covered person to cause personal injury or property damage, even if the injury or damage is of a
different degree or type than actually intended or expected. But the Plan does cover such damages if
the act was intended to protect people or property unless another exclusion applies. An intentional act
is one whose consequences could have been foreseen by a reasonable person.
Damages arising out of any actual, alleged, or threatened:
sexual molestation;
sexual misconduct or harassment; or
abuse.
Damages owed to any person who uses a motorized land vehicle or watercraft without permission
from you or a family member;
Any damages arising out of a covered person’s business pursuits, investment or other for−profit
activities, for the account of a covered person or others, or business property except on a follow form
basis. But the Plan does cover damages arising out of volunteer work for an organized charitable,
religious, or community group, an incidental business away from home, incidental business at home,
incidental business property, incidental farming, or residence premises conditional business liability
unless another exclusion applies. The Plan also covers damages arising out of your or a family
member’s ownership, maintenance, or use of a private passenger motor vehicle in business activities
other than selling, repairing, servicing, storing, parking, testing, or delivering motorized land vehicles.
The list above is a partial list of exclusions under the Plan.
Effective 1/1/19 The Group Personal Excess Liability Insurance Plan 297
Filing a Claim
If you have specific coverage questions or need to file a claim for benefits, you should contact the claims
administrator, Arthur J. Gallagher Risk Management Services, at (866) 631-4630, Monday through Friday,
from 9 a.m. to 5 p.m. Eastern Time, except certain holidays.
It is your responsibility to notify the claims administrator as soon as possible after an occurrence or
wrongful act that may result in a claim.
Defined Terms
As you read this summary of the JPMorgan Chase Group Personal Excess Liability Plan, you’ll come
across some important terms related to the Plan. To help you better understand the Plan, many of those
important terms are defined here.
Bodily Injury
Bodily injury means physical bodily harm, including sickness or disease that results from it,
and required care, loss of services and resulting death.
Covered Person
A covered person includes:
You or a family member;
Any person using a vehicle or watercraft covered under the Plan with permission from you
or a family member with respect to their legal responsibility arising out of its use;
Any other person who is a covered person under your required primary underlying
insurance;
Any person or organization with respect to their legal responsibility for covered acts or
omissions of you or a family member; or
Any combination of the above.
Damages
Damages means the sum that is paid or is payable to satisfy a claim settled by The Chubb
Insurance Company or resolved by judicial procedure or by a compromise agreed to in
writing.
Follow Form
Follow Form means that The Chubb Insurance Company covers damages to the extent they
are both covered under the required primary underlying insurance and not excluded under the
Plan. The amount of coverage, defense coverages, cancellation and “other insurance”
provisions of the Plan supersede and replace the similar provisions contained in such other
policies. When the Group Personal Excess Liability Plan is called upon to pay losses in
excess of required primary underlying policies exhausted by payment of claims, The Chubb
Insurance Company will not provide broader coverage than provided by such policies. When
no primary underlying coverage exists, the extent of coverage provided on a follow form basis
will be determined as if the required primary underlying insurance had been purchased from
the Chubb Insurance Company.
Occurrence
An occurrence is an accident or offense to which this insurance applies and which begins
within the Plan period. Continuous or repeated exposure to substantially the same general
conditions, unless excluded, is considered to be one occurrence.
Personal Injury
A personal injury includes the following injuries, and resulting death:
Bodily injury;
Shock, mental anguish, or mental injury;
False arrest, false imprisonment, or wrongful detention;
Wrongful entry or eviction;
Malicious prosecution or humiliation; and
Libel, slander, defamation of character, or invasion of privacy.
Property
Property damage means physical injury to or destruction of tangible property and the resulting
Damage
loss of its use. Tangible property includes the cost of recreating or replacing stocks, bonds,
deeds, mortgages, bank deposits, and similar instruments, but does not include the value
represented by such instruments. Tangible property does not include the cost of recreating or
replacing any software, data or other information that is in electronic form.
Effective 1/1/19 The Group Personal Excess Liability Insurance Plan 298
Registered
Vehicle
A registered vehicle is any motorized land vehicle not described in “unregistered vehicle.”
Sponsoring
Organization
The sponsoring organization is the entity, corporation, partnership, or sole proprietorship
sponsoring and defining the criteria for qualifications as an insured.
Underlying
Insurance
Underlying insurance includes all liability coverage that applies to the covered damages,
except for other insurance purchased in excess of the Group Personal Excess Liability Plan.
Unregistered
Vehicle
An unregistered vehicle includes the following:
Any motorized land vehicle not designed for or required to be registered for use on public
roads;
Any motorized land vehicle in dead storage at your residence;
Any motorized land vehicle used solely on and to service your residence premises;
Any motorized land vehicle used to assist the disabled that is not designed for or required
to be registered for use on public roads; and
Golf carts.
Effective 1/1/19 The Group Personal Excess Liability Insurance Plan 299
Your JPMC Benefits Guide
Effective 1/1/19
JPMorgan Chase is committed to providing a comprehensive set of benefits
choices to meet different employee needs and lifestyles. In return, we ask our
employees to take an active role in designing a personal strategy to help meet
their short-term and long-term health care and insurance and retirement
savings objectives.
This
Guide
provides a detailed summary of the Health Care and Insurance
Plans for Active Employees of the JPMorgan Chase U.S. Benefits Program. To
access the Retirement Savings Plans, you must be on the website at
www.jpmcbenefitsguide.com and click on the “Retirement Savings” item in the
black horizontal menu bar at the top of the web page. For the plans that are subject to the provisions of
the Employee Retirement Income Security Act of 1974 (ERISA), this Guide serves as the summary plan
description for those plans. For most of these plans, this Guide is also the plan document.
Print and Web
Versions
This Guide is available
as a website, at
www.jpmcbenefitsguide.
com.
The website includes
links to PDF versions of
each section, through
the “Print a Section”
page, in case you want
to download a section to
read it offline.
How This Guide Is Organized
Most of the sections of this Guide describe the details of each benefit plan. Those sections include:
Health Care Benefits, which includes the Medical, Dental, and Vision Plans;
Spending Accounts;
Life and Accident Insurance;
Disability Coverage, which includes the Short-Term and Long-Term Disability Plans;
Other Benefits, which includes the Health & Wellness Centers Plan, the Group Legal Services Plan,
the Group Personnel Excess Liability Plan, the Back-Up Child Care Plan, the Expatriate Medical and
Dental Plans and the Hawaii Medical Plan.
Effective 1/1/19 Your JPMC Benefits Guide 1
Effective 1/1/19 Your JPMC Benefits Guide 2
Other sections of the Guide cover information that applies to all or most of the
benefit plans. These sections are separated from the specific plan details to
minimize repetition and to keep related information together. These sections
include:
What Happens If …, which describes how different life events and situations
can affect your benefits or provide you with opportunities to adjust your
benefits coverage;
Plan Administration, which provides administrative details such as plan
numbers and statements of your rights, including your right to appeal, which
is required by law; and
Contacts, with a full list of contact details for all of the plans.
The section About This Guide provides additional legal information, including
information about the role this Guide serves as summary plan descriptions
(“SPDs”) of the benefit plans.
Questions?
If you still have questions after reviewing this Guide, there are a number of resources that can provide answers. As a
first stop, consult the Contacts section.
The JPMorgan Chase U.S. Benefits Program is available to most employees on a U.S. payroll who are regularly
scheduled to work 20 hours or more a week and who are employed by JPMorgan Chase & Co. or one of its
subsidiaries to the extent that such subsidiary has adopted the JPMorgan Chase U.S. Benefits Program. This
information does not include all of the details contained in the applicable insurance contracts, plan documents and
trust agreements. If there is any discrepancy between this information and the governing documents, the governing
documents will control. JPMorgan Chase & Co. expressly reserves the right to amend, modify, reduce, change or
terminate its benefits plans at any time. The JPMorgan Chase U.S. Benefits Program does not create a contract or
guarantee of employment between JPMorgan Chase and any individual. JPMorgan Chase or you may terminate the
employment relationship at any time.
Retirement Savings
The 401(k) Savings Plan
and the Retirement
(Pension) Plan summary
plan descriptions are
available at
www.jpmcbenefitsguide.
com, as PDFs. The
SPDs for those plans are
complete in the PDFs,
and do not rely on the
any of the other sections
of this Guide.
Table of Contents Page
Your JPMC Benefits Guide......................................................................................................... 1
About This Guide ........................................................................................................................ 4
What Happens If …......................................................................................................................7
Health Care Benefits ................................................................................................................. 28
Health Care Participation .................................................................................................................... 29
The Medical Plan .................................................................................................................................. 49
The Dental Plan .................................................................................................................................. 112
The Vision Plan .................................................................................................................................. 132
The Spending Accounts .........................................................................................................143
Disability Coverage ................................................................................................................. 183
The Short-Term Disability Plan ........................................................................................................ 184
The Long-Term Disability Plan ......................................................................................................... 204
Life and Accident Insurance ..................................................................................................232
Other Benefits.......................................................................................................................... 263
The Health & Wellness Centers Plan ............................................................................................... 264
The Group Legal Services Plan ........................................................................................................ 270
The Group Personal Excess Liability Insurance Plan ................................................................... 285
Back-Up Child Care ........................................................................................................................... 300
Expatriate Medical and Dental Plans ............................................................................................... 308
Plan Administration ................................................................................................................ 364
Contacts ................................................................................................................................... 392
Effective 1/1/19 Your JPMC Benefits Guide 3
About This Guide
Effective 1/1/19
This Guide serves as the summary plan description (SPD) for the following
plans of the JPMorgan Chase U.S. Benefits Program, effective as of January 1,
2019:
The JPMorgan Chase Medical Plan
The JPMorgan Chase Dental Plan
The JPMorgan Chase Vision Plan
The JPMorgan Chase Spending Accounts
The JPMorgan Chase Basic Life Insurance Plan
The JPMorgan Chase Supplemental Term Life Insurance Plan
The JPMorgan Chase Accidental Death and Dismemberment (AD&D)
Insurance Plan
The JPMorgan Chase Business Travel Accident Insurance Plan
The JPMorgan Chase Short-Term Disability Plan
The JPMorgan Chase Long-Term Disability Plan
The JPMorgan Chase Health and Wellness Centers Plan
The JPMorgan Chase Group Legal Services Plan
The JPMorgan Chase Group Personal Excess Liability Insurance Plan
The JPMorgan Chase Back-Up Child Care Plan
The JPMorgan Chase Expatriate Medical and Dental Plans
About This Summary
This section summarizes
certain information for
the health care and
insurance plans. Please
retain this section for
your records. Other
sections may be needed
in addition to this section
to provide a complete
summary plan
description (SPD) and/or
plan document for a
plan, including the
sections that describe
the benefits the plan
provides.
These
summaries/SPDs/plan
documents do not
include all of the details
contained in the
applicable insurance
contracts, if any. For
plans with applicable
insurance contracts, if
there is a discrepancy
between the insurance
contract and the
summary/SPD/plan
document, the insurance
contract will control.
The JPMorgan Chase Retirement Plan (this document does not include information related to the
JPMorgan Chase Retirement Plan; see the PDF available at www.jpmcbenefitsguide.com for the
entire SPD for the JPMorgan Chase Retirement Plan)
The JPMorgan Chase 401(k) Savings Plan (this document does not include information related to the
JPMorgan Chase 401(k) SavingsPlan; see the PDF available at www.jpmcbenefitsguide.com for the
entire SPD for the JPMorgan Chase 401(k) Savings Plan)
Effective 1/1/19 About This Guide 4
An SPD is a legally required document that provides a comprehensive description of benefit plans and
their provisions. The plans include:
Plan Administration
What Happens If…
Health Care Participation
Additional Plan Information
Your primary contact for matters relating to plan benefits is each plan’s claims administrator or service
provider. Contact the accessHR Contact Center for information about general administration issues such
as enrollment and eligibility for the plans.
Your benefits as a participant in the plans are provided under the terms of this document and insurance
contracts, if any, issued to JPMorgan Chase. If there is a discrepancy between the insurance contracts
and this document, the insurance contracts will control.
Please Note: No person or group (other than the plan administrator for the JPMorgan Chase U.S.
Benefits Program) has any authority to interpret the plans (or official plan documents) or to make any
promises to you about them. The plan administrator for the JPMorgan Chase U.S. Benefits Program has
complete authority in his or her absolute discretion to construe and interpret the terms of the plans and
any underlying insurance policies and/or contracts, including the eligibility to participate in the plans, and
to make factual determinations.
All decisions of the plan administrator for the JPMorgan Chase U.S. Benefits Program are final and
binding upon all affected parties. The plan administrators delegate their discretion to interpret the plans to
the claims administrators, and to decide claims and appeals, including making factual determinations, to:
The claims administrators; and
The Health and Income Protection Plans Appeals Committee.
No Assignment of Benefits
The plans are used exclusively to provide benefits to you and, in some cases, your survivors. Neither you
nor JPMorgan Chase can assign, transfer, or attach your benefits, or use them as collateral for a loan.
You may not assign your right to file actions under ERISA regarding the plans, or use power of attorney
or similar arrangements for that purpose.
Please Note: You may assign certain employee life insurance benefits and may assign to a health care
service provider the right to payment. Please contact the accessHR Contact Center for more information.
Right to Amend
JPMorgan Chase & Co. expressly reserves the right to amend, modify (including cost of coverage),
reduce or curtail benefits under, or terminate the benefit plans and programs at any time for any reason,
by act of the Benefits Executive, other authorized officers, or the Board of Directors. In addition, the plans
and benefits described in this Guide do not represent vested benefits.
JPMorgan Chase also reserves the right to amend any of the plans and policies, to change the method of
providing benefits, to curtail or reduce future benefits, or to terminate at any time for any reason, any or all
of the plans and policies described in this Guide.
If you have any questions about this plan, please contact the accessHR Contact Center.
Not a Contract of Employment
Neither this Guide nor the benefits described in this Guide create a contract or a guarantee of
employment between JPMorgan Chase and any employee. JPMorgan Chase or you may terminate the
employment relationship at any time.
Effective 1/1/19 About This Guide 5
The JPMorgan Chase U.S. Benefits Program is available to most employees on a U.S. payroll who are regularly
scheduled to work 20 hours or more a week and who are employed by JPMorgan Chase & Co. or one of its
subsidiaries to the extent that such subsidiary has adopted the JPMorgan Chase U.S. Benefits Program. This
information does not include all of the details contained in the applicable insurance contracts, plan documents, and
trust agreements. If there is any discrepancy between this information and the governing documents, the governing
documents will control. JPMorgan Chase & Co. expressly reserves the right to amend, modify, reduce, change, or
terminate its benefits and plans at any time. The JPMorgan Chase U.S. Benefits Program does not create a contract
or guarantee of employment between JPMorgan Chase and any individual. JPMorgan Chase or you may terminate
the employment relationship at any time.
Effective 1/1/19 About This Guide 6
What Happens If …
Effective 1/1/19
This section describes the impact of certain life changes and events on your JPMorgan Chase Health
Care and Insurance Plans for Active Employees benefits. Generally, you make elections once a year
during Annual Benefits Enrollment, unless you have a Qualified Status Change (QSC) or other event,
such as a change in work status. QSC’s are generally legally defined situations. See the following
information for types of changes and implications to your benefits. For more information, see the Benefits
Status Change Guide on My Health > My Resources.
New Dependents Must Be Verified
Please Note: If a QSC results in the ability to add a dependent to your coverage, that dependent is subject to the
dependent verification process from JPMorgan Chase or the plans' administrators, to confirm the dependent is
eligible.
The JPMorgan Chase U.S. Benefits Program is available to most employees on a U.S. payroll who are regularly
scheduled to work 20 hours or more a week and who are employed by JPMorgan Chase & Co. or one of its
subsidiaries to the extent that such subsidiary has adopted the JPMorgan Chase U.S. Benefits Program. This
information does not include all of the details contained in the applicable insurance contracts, plan documents, and
trust agreements. If there is any discrepancy between this information and the governing documents, the governing
documents will control. JPMorgan Chase & Co. expressly reserves the right to amend, modify, reduce, change, or
terminate its benefits and plans at any time. The JPMorgan Chase U.S. Benefits Program does not create a contract
or guarantee of employment between JPMorgan Chase and any individual. JPMorgan Chase or you may terminate
the employment relationship at any time.
Effective 1/1/19 What Happens If … 7
Table of Contents Page
Qualified Status Changes (QSCs)..............................................................................................9
You Get Married......................................................................................................................... 12
You Have or Adopt a Child or Become a Legal Guardian .....................................................13
A Covered Dependent Becomes Ineligible .............................................................................13
You and/or Your Dependents Lose Other Coverage .............................................................13
You and/or Your Dependents Gain Other Coverage ..............................................................14
You Move ................................................................................................................................... 14
You Divorce, Separate or Terminate a Domestic Partner Relationship ...............................14
You Pass Away.......................................................................................................................... 15
Other Events or Changes ......................................................................................................... 16
Change in Scheduled Work Hours ..................................................................................................... 16
You Go on Short-Term Disability Leave ............................................................................................ 17
You Go on Long-Term Disability........................................................................................................ 18
You Are on LTD and Become Eligible for Medicare ......................................................................... 19
You Become Eligible for Medicare ..................................................................................................... 19
You Go on a Military Leave................................................................................................................. 19
Paid Military Leave ........................................................................................................................... 19
Unpaid Military Leave ....................................................................................................................... 20
You Go on a Parental Leave ............................................................................................................... 20
You Go on Approved Family and Medical Leave ............................................................................. 20
You Go on Unpaid Leave .................................................................................................................... 21
You Return from a Leave of Absence................................................................................................ 21
You Leave JPMorgan Chase .............................................................................................................. 22
Your Expatriate Assignment Ends..................................................................................................... 25
You Retire from JPMorgan Chase ..................................................................................................... 25
You Work Past Age 65......................................................................................................................... 27
Effective 1/1/19 What Happens If … 8
Qualified Status Changes (QSCs)
There are many changes in your situation that meet the requirements to be
Qualified Status Changes (QSCs). While many of your benefits cannot be
changed during the year, if you have a QSC, some benefit changes are
allowed.
The following tables summarize the changes that you can make for each event.
They are separated into:
Health Benefits;
Spending Accounts;
Life Insurance Benefits; and
Accident Insurance Benefits.
If You Have an
Event …
If you have a QSC, or if
you are unclear whether
your situation is a QSC,
call the accessHR
Contact Center to get
answers on what you
can do in your situation.
31-Day Deadline
If you have a QSC, you have 31 days from the qualifying event to make benefits changes; 90 days from the qualifying
event if the event is the birth or adoption of a child. The benefits you elect will be effective the date of the event if you
make the elections timely. (Please Note: You will have 90 days from the QSC date to add any newly eligible
dependents to Medical Plan coverage should that dependent pass away within this 90-day period.). Any changes you
make during the year must be consistent with the status change. Be sure to take action promptly, so that you don't
miss the deadline to make any benefit changes!
QSCs for Health Benefits — Medical, Dental, Vision
QSC Employee
Spouse/Domestic
Partner
Dependent Child
or Domestic
Partner Child
Marriage Add Add Add
Domestic Partner
Commitment
Add Add Add
Divorce, Legal
Separation, or
Termination of DP
Commitment
N/A Drop Drop
Death of Spouse/DP N/A Drop Drop
Birth/Adoption/Legal
Guardianship
Add Add Add
Child Gains Eligibility Add Add Add
DP's Child Becomes
Eligible
Add Add Add
Child Gains Eligibility
due to QMCSO
Add N/A Add
Child/DP Child no
Longer Eligible
N/A N/A Drop
Death of Child/DP
Child
N/A N/A Drop
Effective 1/1/19 What Happens If … 9
QSC Employee
Spouse/Domestic
Partner
Dependent Child
or Domestic
Partner Child
You or Covered
Dependent Gains
Other Coverage
Drop/reduce # of
dependents
Drop/reduce # of
dependents
Drop/reduce # of
dependents
You or Covered
Dependent Loses
Other Coverage
Add Add Add
Change in Dependent
Care Provider or
Fees
N/A N/A N/A
Move out of Provider
Service Area
Change option change option change option
QSCs for Spending Accounts*
QSC
Health Care Spending
Account
Dependent Care
Spending Account
Marriage Begin, increase
Begin, increase, decrease, or
stop
Domestic Partner
Commitment
Begin, increase
Begin, increase, decrease, or
stop
Divorce, Legal Separation, or
Termination of DP
commitment
Decrease, stop
Begin, increase, decrease, or
stop
Death of Spouse/DP
Decrease, stop
Begin, increase, decrease, or
stop
Birth/Adoption/Legal
Guardianship
Begin, increase Begin, increase
Child Gains Eligibility
Begin, increase Begin, increase
DP's Child Becomes Eligible
Begin, increase Begin, increase
Child Gains Eligibility due to
QMCSO
Begin, increase N/A
Child/DP Child no Longer
Eligible
Decrease, stop Decrease, stop
Death of Child/DP Child Decrease, stop Decrease, stop
You or Covered Dependent
Gains Other Coverage
N/A Decrease, stop
You or Covered Dependent
Loses Other Coverage
Begin, increase Begin, increase
Change in Dependent Care
Provider or Fees
N/A
Begin, increase, decrease, or
stop
Move out of Provider Service
Area
N/A N/A
*You can change your Transportation Spending Accounts elections at any time.
Effective 1/1/19 What Happens If … 10
QSCs for Supplemental Term Life Insurance Benefits
QSC Employee Adult Dependent
Dependent
Child/Domestic
Partner Child
Marriage
Begin, increase,
decrease, or stop Begin, increase
Begin, increase,
decrease, or stop
Domestic Partner
Commitment
Begin, increase,
decrease, or stop Begin
Begin, increase,
decrease, or stop
Divorce, Legal
Separation, or
Termination of DP
Commitment
Begin, increase,
decrease, or stop Drop
Begin, increase,
decrease, or stop
Death of Spouse/DP
Begin, increase,
decrease, or stop Drop
Begin, increase,
decrease, or stop
Birth/Adoption/Legal
Guardianship
Begin, increase Begin, increase Begin, increase
Child Gains Eligibility
Begin, increase Begin, increase Begin, increase
DP's Child Becomes
Eligible
Begin, increase Begin, increase Begin, increase
Child Gains Eligibility
due to QMCSO
Begin, increase N/A Begin, increase
Child/DP Child no
Longer Eligible
Decrease, stop Decrease, stop Decrease, stop
Death of Child/DP
Child
Decrease, stop Decrease, stop Decrease, stop
You or Covered
Dependent Gains
Other Coverage
Decrease, stop Decrease, stop Decrease, stop
You or Covered
Dependent Loses
Other Coverage
Begin, increase Begin, increase Begin, increase
Change in Dependent
Care Provider or
Fees
N/A N/A N/A
Move out of Provider
Service Area
N/A N/A N/A
Effective 1/1/19 What Happens If … 11
QSCs for Accidental Death and Dismemberment (AD&D) Benefits
QSC Employee Adult Child
Marriage
Begin, increase,
decrease, or stop Begin, increase
Begin, increase,
decrease, or stop
Domestic Partner
Commitment
Begin, increase,
decrease, or stop Begin
Begin, increase,
decrease, or stop
Divorce, Legal
Separation, or
Termination of DP
Commitment
Begin, increase,
decrease, or stop Drop
Begin, increase,
decrease, or stop
Death of Spouse/DP
Begin, increase,
decrease, or stop Drop
Begin, increase,
decrease, or stop
Birth/Adoption/Legal
Guardianship
Begin, increase Begin, increase Begin, increase
Child Gains Eligibility
Begin, increase Begin, increase Begin, increase
DP's Child Becomes
Eligible
Begin, increase Begin, increase Begin, increase
Child Gains Eligibility
due to QMCSO
Begin, increase N/A Begin, increase
Child/DP Child no
Longer Eligible
Decrease, stop Decrease, stop Decrease, stop
Death of Child/DP
Child
Decrease, stop Decrease, stop Decrease, stop
You or Covered
Dependent Gains
Other Coverage
Decrease, stop Decrease, stop Decrease, stop
You or Covered
Dependent Loses
Other Coverage
Begin, increase Begin, increase Begin, increase
Change in Dependent
Care Provider or
Fees
N/A N/A N/A
Move out of Provider
Service Area
N/A N/A N/A
You Get Married
Getting married is a Qualified Status Change (QSC) that gives you the opportunity to adjust your
coverage in ways consistent with your change in status. For example, you could enroll yourself and/or
your new spouse for coverage.
Any changes based on a QSC must be submitted within 31 days of the change in status. For more
information, see the subsections titled "Changing Your Coverage Midyear" in the plan descriptions
If you are using the change to add a new dependent, you will be required to provide documentation of the
new dependent’s eligibility for coverage.
Effective 1/1/19 What Happens If … 12
You Have or Adopt a Child or Become a Legal
Guardian
Having or adopting a child or becoming a legal guardian of a child is a Qualified Status Change (QSC)
that gives you the opportunity to adjust your company coverage in ways consistent with your change in
status. For example, you could enroll your new child for coverage.
Any changes based on a QSC must be submitted within 31 days of the change in status, but the time
available is 90 days when the qualifying event is the birth or adoption of a child. For more information, see
the subsections in the plan descriptions titled "Changing Your Coverage Midyear." You will be required to
provide documentation of the new dependent’s eligibility for coverage.
(You will have 90 days from the QSC to add any newly eligible dependents to the JPMC Medical Plan
should that dependent pass away within this 90-day period; please contact the accessHR Contact Center
if this situation applies to you.)
If you are using the change to add a new dependent, you will be required to provide documentation of the
new dependent’s eligibility for coverage.
A Covered Dependent Becomes Ineligible
If your dependent becomes ineligible (such as when a dependent child reaches age 26, for health care
coverage), the dependent’s coverage will end on the last day of the month in which he or she no longer
meets the eligibility requirements. For Supplemental Term Life and AD&D, once your dependent is no
longer eligible, it is your responsibility to remove the dependent from your coverage.
When coverage ends, the dependent may have a right to elect COBRA for up to 36 months. (Please see
"Continuing Coverage Under COBRA" in the Health Care Participation section for more information on
COBRA.)
A covered dependent becoming ineligible is a Qualified Status Change (QSC) that gives you the
opportunity to adjust your coverage in ways consistent with your change in status. This means you could
cancel company coverage or stop contributions to spending accounts.
Any changes based on a QSC must be submitted within 31 days of the change in status. For more
information, see the subsections in the plan descriptions titled "Changing Your Coverage Midyear."
You and/or Your Dependents Lose Other
Coverage
If you declined company coverage because you had coverage from another source and you lose that
coverage, you may be eligible to enroll for company coverage because of your HIPAA Special Enrollment
rights. Similarly, if you declined company coverage for an eligible dependent because he or she had
coverage from another source and he or she loses that coverage, you may be eligible to enroll your
eligible dependent for company coverage because of your HIPAA Special Enrollment rights. See "HIPAA
Special Enrollment Rights" in the Health Care Participation section for more details.
Both of these situations are Qualified Status Changes (QSCs) that give you the opportunity to adjust your
company coverage in ways consistent with your change in status.
Any changes based on a QSC must be submitted within 31 days of the change in status. For more
information, see the subsections in the plan descriptions titled "Changing Your Coverage Midyear." You
will be required to provide documentation of the new dependent’s eligibility for coverage.
If you are using the change to add a new dependent, you will be required to provide documentation of the
new dependent’s eligibility for coverage.
Effective 1/1/19 What Happens If … 13
You and/or Your Dependents Gain Other
Coverage
Gaining access to other coverage is a Qualified Status Change (QSC) that gives you the opportunity to
adjust your coverage in ways consistent with your change in status. This means you could decline
company coverage and enroll for the newly available coverage, instead.
Any changes based on a QSC must be submitted within 31 days of the change in status. For more
information, see the subsections in the plan descriptions titled "Changing Your Coverage Midyear."
You Move
If you move out of your Medical or Dental Plan option service area and your current option is no longer
available, you can change Medical and/or Dental Plan option for yourself and your covered dependents.
(Please Note: In this situation, you will be assigned new coverage by JPMorgan Chase based on your
new service area. However, you will have the ability to change this assigned coverage within 31 days of
the qualifying event.)
You Divorce, Separate or Terminate a
Domestic Partner Relationship
Getting divorced, separated, or terminating a domestic partner relationship is a Qualified Status Change
(QSC) that gives you the opportunity to adjust your coverage in ways consistent with your change in
status. This means you could decline company coverage or enroll yourself and/or your dependents for
coverage if you declined it in the past.
Any changes based on a QSC must be submitted within 31 days of the change in status. For more
information, see the subsections in the plan descriptions titled "Changing Your Coverage Midyear."
If you are using the change to add a new dependent, you will be required to provide documentation of the
new dependent’s eligibility for coverage.
For medical, dental, and vision coverage: If your spouse and/or child(ren) lose medical, dental, or
vision coverage because of divorce/separation, they may have a right to elect COBRA for up to
36 months. (Please see "Continuing Coverage Under COBRA" in the Health Care Participation section for
more information on COBRA.)
If you divorce or become legally separated, certain court orders could require you to provide health care
benefits to covered child(ren). JPMorgan Chase is legally required to recognize qualified medical child
support orders within the limits of the JPMorgan Chase plans. If you’re a party in a divorce settlement that
involves the JPMorgan Chase plans, you should have your attorney contact the accessHR Contact
Center to make sure the appropriate documents are filed and that the court order in question is actually a
qualified medical child support order that complies with governing legislation. Please see “Qualified
Medical Child Support Orders” in the Health Care Participation section for more information.
For the spending accounts: In case of divorce or separation, you can decrease or stop contributions to
the Health Care Spending Account and can start, change, or stop contributions to the Dependent Care
Spending Account.
For the Life and Accident Insurance Plans: If you divorce or become legally separated, your covered
spouse/domestic partner would be ineligible to continue coverage under the JPMorgan Chase Life and
Accident Insurance Plans, and coverage would end as of the date of the status change. Your formerly
covered spouse/domestic partner can port or convert their dependent Supplemental Term Life Insurance.
Accidental Death & Dismemberment insurance may be ported. For more details, see the information in
each plan description about continuing coverage in the Life and Accident Insurance section.
Effective 1/1/19 What Happens If … 14
For the Group Legal Services Plan: If you divorce or become legally separated, coverage for your
spouse will end on the date of your divorce or legal separation.
For the Group Personal Excess Liability Plan: If you divorce or become legally separated, coverage
for your spouse will end on the date of your divorce or legal separation.
You Pass Away
For medical, dental, and vision coverage, including expatriate coverage: If you pass away while
actively employed at JPMorgan Chase, any dependents who were covered under your JPMorgan Chase
health care coverage before your death will continue to be covered until the last day of the month in which
you pass away. Covered dependents can then elect to continue coverage under COBRA and pay the
active employee rate for coverage for up to 36 months of the COBRA period. Dependents must be
covered under the Medical Plan at the time of your death to be eligible for COBRA coverage at
JPMorgan Chase-subsidized rates. (Please see "Continuing Coverage Under COBRA" in the Health Care
Participation section for more information on COBRA.)
In addition, your dependents may be eligible to continue coverage under the Retiree Medical, Dental
and/or Vision Plans if, at the time of death:
You have already met the general eligibility requirements for retirement. (For more information, please
see the As You Retire Guide, available on me@jpmc); or
You have already met the alternative eligibility requirements for retirement in the event of position
elimination. (For more information, please see the As You Retire Guide as noted above.); or
You have 25 years of total service with JPMorgan Chase.
Dependents may continue coverage under the Retiree Medical, Dental and/or Vision Plans as long as
they meet the plans’ requirements.
For the spending accounts: If you pass away, claims for spending accounts for expenses incurred on or
before the date of death can be filed to the appropriate program administrator, please see the Spending
Accounts section for more details and the appropriate deadlines.
For the Life and Accident Insurance Plans: If you pass away, benefits from the Life and Accident
Insurance Plans are paid to the beneficiary named. If a beneficiary has not been named, then the benefits
are paid according to the order listed under “Beneficiaries” in the Life and Accident Insurance section.
If your dependents are enrolled for supplemental term life and accidental death and dismemberment
(AD&D) insurance when you pass away, they may port their coverage by contacting MetLife, the
claims administrator. Your dependents will be directly billed for this coverage. Dependents can also
convert their supplemental term life insurance; however, they may not convert AD&D coverage.
1
For the Group Legal Services Plan: In the event of your death while actively employed by
JPMorgan Chase, your dependents have the option to continue their group legal coverage by contacting
Hyatt Legal Plans within 31 days of the date of your death to extend coverage for an additional 24 months
with direct payment to Hyatt Legal Plans. Any services in progress at the time of your death will be
provided, even if your dependents don’t elect to continue coverage.
For the Group Personal Excess Liability Plan: In the event of your death, covered surviving members
of the household should contact Arthur J. Gallagher Risk Management Services for instructions on paying
the balance due. If payment is not received within 31 days of the date of the letter sent by Arthur J.
Gallagher Risk Management Services to the participant’s survivor, the policy will be canceled as of the
date of your death. The Plan will also cover any legal representative or person having proper temporary
custody of the participant’s property. Also, coverage will be provided until the end of the policy period or
policy anniversary date, whichever occurs first, for any surviving member of your household who is a
covered person at the time of death. Premium payments for this coverage apply.
1
Certain states have additional, specific requirements. Please refer to MetLife for state-specific rules.
Effective 1/1/19 What Happens If … 15
Other Events or Changes
Change in Scheduled Work Hours
This section describes how your benefits are affected if your work status changes but you are still
employed by the company. The focus is on changes to your scheduled work hours. A change in work
status that changes your eligibility gives you the opportunity to adjust your coverage in ways consistent
with your change in status. This means you could decline company coverage or enroll for coverage if you
declined it in the past, and can enroll your eligible spouse for coverage. If your spouse has children and
they become your eligible dependents, you can also enroll them for coverage.
Any changes must be submitted within 31 days of the change in status. For more information, see the
subsections in the plan descriptions titled "Changing Your Coverage Midyear."
Here’s how coverage is affected if your schedule changes and you are regularly scheduled to work fewer
than 20 hours per week:
Your JPMorgan Chase medical, dental, and vision coverage will end on the last day of the month
in which your work status changes and you are then scheduled to work fewer than 20 hours per week.
Even if your coverage ends, you may be able to continue medical, dental, and/or vision coverage for a
certain period under the Consolidated Omnibus Budget Reconciliation Act of 1985 (COBRA). (Please
see "Continuing Coverage Under COBRA" in the Health Care Participation section for more
information on COBRA.)
For expatriate coverage, COBRA continuation applies if you are a U.S. home-based expatriate or
an expatriate assigned to the United States. Non-U.S. home-based expatriate employees assigned
outside the United States and their dependents are not eligible for COBRA continuation coverage.
Your contributions to the Health Care Spending Account will end on the last day of the month in
which your work status changes and you are then scheduled to work fewer than 20 hours per week. In
this case, you may continue to make contributions to the Health Care Spending Account on an after-
tax basis under the Consolidated Omnibus Budget Reconciliation Act of 1985 (COBRA), if elected.
(Please see "Continuing Coverage Under COBRA" in the Health Care Participation section for more
information on COBRA.)
Your contributions to the Dependent Care and Transportation Spending Accounts end on the
date your work status changes and you are then scheduled to work fewer than 20 hours per week.
For the Basic Life Insurance Plan, Supplemental Term Life Insurance Plan, and the AD&D
Insurance Plan: Your coverage and eligibility will end on the date of your status change and you are
then scheduled to work less than 20 hours per week. For more information on when you increase work
hours to more than 20 hours, please see the Life and Accident Insurance section.
You can convert your basic life insurance to an individual policy within 31 days of your status
change date by contacting MetLife, the claims administrator, for a conversion application.
You can port or convert your employee supplemental term life insurance and/or port your AD&D —
up to the lesser of five times your eligible compensation or $1 million — through a direct billing
arrangement with MetLife. Contact MetLife, the claims administrator, within 31 days of your change
in status. If you port your coverage, you may also port dependent coverage. For more details, see
the information in each plan description about continuing coverage in the Life and Accident
Insurance section.
For the Business Travel Accident Insurance Plan, you remain eligible for coverage regardless of
your scheduled work hours, if you are otherwise eligible for coverage.
Your Health & Wellness Centers Plan coverage will end on the last day of the month in which your
work status changes and you are then scheduled to work fewer than 20 hours per week. Even if your
coverage ends, you may be able to continue coverage for a certain period under the Consolidated
Omnibus Budget Reconciliation Act of 1985 (COBRA). (Please see "Continuing Coverage Under
COBRA" in the Health Care Participation section for more information on COBRA.)
Effective 1/1/19 What Happens If … 16
Your Group Legal Services Plan coverage will end on the date your work status changes and you
are then scheduled to work fewer than 20 hours per week. However, you can continue coverage for
additional 30 months by contacting Hyatt Legal Group.
Your Group Personal Excess Liability Insurance Plan coverage will end on the date your work
status changes and you are then scheduled to work fewer than 20 hours per week. However, you may
continue coverage through the end of year by contacting Arthur J. Gallagher Risk Management.
For information on becoming eligible for benefits due to a work status change, see each specific plan
section (e.g., Medical).
You Go on Short-Term Disability Leave
Under the Short-Term Disability Plan, you may have the financial protection of full or partial pay for up to
25 weeks. While you are on a short-term disability leave you may continue many of your elected benefits
provided you make the necessary contributions. Benefits that do not continue while you are on short-term
disability leave include Business Travel Accident Insurance, the Dependent Care Spending Account, and
the Transportation Spending Account.
For the Medical Plan, the Dental Plan, the Vision Plan, the Health & Wellness Centers Plan, the
Group Legal Services Plan, and the Group Personal Excess Liability Insurance Plan: For the
approved period of your disability leave, you’ll remain eligible to be covered under the Medical Plan,
the Dental Plan, the Vision Plan, the Health & Wellness Centers Plan, the Group Legal Services Plan,
and the Group Personal Excess Liability Insurance Plan, and you will remain eligible to participate in
the Health Care Spending Account. JPMorgan Chase will deduct any required contributions for
medical coverage from the pay you receive during this period on a before-tax basis for the health care
plans and the Health Care Spending Account and on an after-tax basis for the Group Legal Services
Plan and the Group Personal Excess Liability Insurance Plan.
This medical and dental coverage continuation includes expatriate medical and dental coverage. If
you are not receiving pay via Expat Payroll during your leave, JPMorgan Chase will bill you directly
for any required contributions.
For the Dependent Care Spending Account, your participation is suspended during a period of paid
or unpaid leave.
For the Transportation Spending Account, your participation is terminated during a period of paid
or unpaid leave and any unused credits in your account(s) will be forfeited if you do not return to work
and reenroll in the Transportation Spending Account. If you know you will be going on a leave, you
should change your contribution amount to zero approximately one month before your leave begins in
order to avoid forfeiting any contributions. Expenses incurred after your leave begins will not be
eligible for reimbursement or payment from your account(s). If you wish to continue participation after
you return to active service, you must re-enroll. However if you participated in the “Pay Me Back”
option, you have 180 days following the end of any particular benefit month you participated in the
program to file claims for reimbursement from your “Pay Me Back” account.
For the Basic Life Insurance Plan, Supplemental Term Life Insurance Plan, and the AD&D
Insurance Plan: For the approved period of your disability leave, you’ll remain eligible to be covered
under the Basic Life Insurance Plan (including Identity Theft (ID) Assistance Program, Travel
Assistance and Emergency Evacuation services, funeral concierge services, and SurvivorSupport
®
financial counseling services), Supplemental Term Life Insurance Plan, and the AD&D Insurance Plan.
In the case of the Basic Life Insurance Plan, your eligible compensation is updated as changes
occur throughout the year.
For the Business Travel Accident Insurance Plan: While you are on disability leave, your business
travel accident insurance will be suspended.
Effective 1/1/19 What Happens If … 17
You Go on Long-Term Disability
If you receive long-term disability (LTD) benefits from the JPMorgan Chase Long-Term Disability Plan
(LTD Plan), you will continue to be eligible to participate in the following benefits* as long as you continue
to make timely premium payments:
Medical
Dental
Vision
Group Legal
Group Personal Excess Liability Plan
Basic Life Insurance (fully paid by JPMC)
Supplemental Term Life Insurance
Accidental Death and Dismemberment Insurance
* You can also continue participation in the Health & Wellness Centers Plan.
You’ll be eligible to continue these benefit plans at active employee rates for the first 24 months after
going on approved LTD (that is, 30 months from the date of disability). The premiums will be converted to
a monthly rate, and you will be required to pay for this coverage monthly on an after-tax basis. You will
pay for this coverage on a direct-bill basis with JPMorgan Chase’s administrator.
If you are an expatriate and you qualify for long-term disability (LTD) benefits from a JPMorgan Chase
long-term disability plan, your expatriate assignment will end and, coincidentally, so will your eligibility for
the Expatriate Medical and Dental Plan options. You must then elect coverage under your home country
Medical and/or Dental Plan options, if available. If you are a U.S. home-based expatriate employee,
medical coverage under one of the U.S. domestic options may continue while you are receiving LTD
benefits under the U.S. LTD Plan. Be sure to consider this carefully before you decline coverage under
the LTD Plan.
In certain cases, you may be temporarily approved for additional leave under another JPMorgan Chase
Policy, such as the Disability and Reasonable Accommodation Policy. (For details on medical plan
coverage should you become eligible for Medicare during this timeframe, please see “You Are on LTD
and Become Eligible for Medicare” on page 19.)
Absent any temporary leave accommodation, your employment with JPMorgan Chase will end
immediately after you have received 24 months of payments under the LTD Plan. However, you will
continue to be eligible for LTD benefits provided you meet all eligibility provisions of the LTD Plan. Even if
your LTD benefits end, you may be able to continue medical, dental, vision, and Health & Wellness
Centers coverage for a certain period under the Consolidated Omnibus Budget Reconciliation Act of 1985
(COBRA). (Please see "Continuing Coverage Under COBRA" in the Health Care Participation section for
more information on COBRA.)
Please Note: If you became disabled before January 1, 2011, your coverage will continue at active
employee rates while you receive benefits under the Long-Term Disability Plan. If you do not make the
required contributions to continue your coverage, your coverage will be canceled.
For the Health Care Spending Account, while you are receiving benefits under the JPMorgan Chase
LTD Plan, you may continue to make monthly contributions to the Health Care Spending Account on an
after-tax basis via direct bill. Participation in the Health Care Spending Account will cease at the end of
the benefit plan year in which you start to receive LTD benefits.
For the Dependent Care Spending Account: For the Dependent Care Spending Account, you may use
your account balance only for eligible expenses incurred prior to your LTD effective date and must file
those claims by March 31 of the next calendar year.
Effective 1/1/19 What Happens If … 18
For the Transportation Spending Account, your participation is suspended and any unused credits in
your account(s) will be forfeited if you do not return from LTD. If you know you will be going on a leave,
you should change your contribution amount to zero approximately one month before your leave begins
in order to avoid forfeiting any contributions. Expenses incurred after your leave begins will not be eligible
for reimbursement or payment from your account(s). If you wish to continue participation after you return
to active service, you must re-enroll. However if you participated in the “Pay Me Back” option, you have
180 days following the end of any particular benefit month you participated in the program to file claims
for reimbursement from your “Pay Me Back” account.
Your Business Travel Accident Insurance Plan coverage does not continue while you are receiving
LTD benefits.
You Are on LTD and Become Eligible for Medicare
If you are receiving full long-term disability (LTD) benefits from the JPMorgan Chase Long-Term Disability
Plan (LTD Plan), are not actively at work and become eligible for Medicare, Medicare becomes the
primary source of your medical coverage. You will no longer be eligible for the active JPMorgan Chase
medical coverage. Instead, Medicare-eligible participants have access to individual supplemental
Medicare coverage available through Via Benefits, a private Medicare exchange, which is not coverage
sponsored by JPMorgan Chase. For those Medicare-eligible individuals who enroll in coverage through
Via Benefits and are eligible for a medical subsidy, JPMorgan Chase sponsors the Health
Reimbursement Arrangement Plan associated with that coverage. For further details, call the accessHR
Contact Center.
You Become Eligible for Medicare
If you are a JPMorgan Chase employee enrolled in an active JPMorgan Chase health care plan, such as
the Medical Plan, Dental Plan, or Vision Plan, are actively working and you become entitled to Medicare
because of your age or a qualifying disability, the JPMorgan Chase plans continue to be the primary
source of your coverage. For further details on Medicare, see www.medicare.gov.
You Go on a Military Leave
Your benefits coverage may be affected if you take a military leave (paid or unpaid), as described below.
For detailed information about the JPMorgan Chase Military Leave and Reserve Training Policy, please
visit me@jpmc. In all cases, JPMorgan Chase will comply with legal requirements, including the
Uniformed Services Employment and Reemployment Rights Act (USERRA).
Paid Military Leave
If you qualify for a paid military leave, you will be provided with continuation of most benefits. Please
Note: Certain benefits plans have exclusions for injury or illness that results from an act of war.
Benefits that do not continue while you are on a paid military leave include:
Business Travel Accident Insurance Plan;
Transportation Spending Account;
Long-Term Disability Plan (after 16 weeks of paid military leave); and
Short-Term Disability Plan.
You may resume your benefits coverage when you return to work. Some of your benefits are reinstated,
but for others like the Transportation Spending Account, you must re-enroll. Please Note: Evidence of
insurability may also be required for some plans.
Effective 1/1/19 What Happens If … 19
Unpaid Military Leave
If you qualify for an unpaid military leave, you may continue many of your
elected benefits, provided you make the necessary contributions in a timely
manner. Please Note: Certain benefits plans have exclusions for injury or
illness that results from an act of war.
Benefits that do not continue while you are on an unpaid military leave include:
Business Travel Accident Insurance Plan;
Dependent Care Spending Account;
Transportation Spending Accounts;
Long-Term Disability Plan (after 12 weeks of unpaid military leave); and
Making
Contributions While
on Unpaid Leave
If you wish to continue
certain benefits while on
any unpaid leave, you
must make the
necessary contributions
on a timely basis, even if
you do not receive a bill.
Short-Term Disability Plan.
You may resume your benefits coverage when you return to work. Some of your benefits are reinstated,
but for others like the Transportation Spending Account, you must re-enroll. Please Note: Evidence of
insurability may also be required for some plans.
You Go on a Parental Leave
While you are on an approved parental leave, you may continue many of your elected benefits, provided
you make the necessary contributions in a timely manner. Benefits that do not continue while you are on
a parental leave include Business Travel Accident Insurance, the Dependent Care Spending Account,
and the Transportation Spending Accounts.
Generally, if your benefits coverage ended during your leave, you may resume coverage when you return
to work.
You Go on Approved Family and Medical Leave
You may continue many of your elected benefits while you are on an approved family and medical leave,
provided you make the necessary contributions in a timely manner. Benefits that do not continue while
you are on family leave include Business Travel Accident Insurance, the Dependent Care Spending
Account, and the Transportation Spending Accounts.
Generally, if your benefits coverage ended during your leave, you may resume your benefits coverage
when you return to work.
Special Rules for Health Care Spending Account
Special rules apply to your Health Care Spending Account. When you take a leave covered under the
Family and Medical Leave Policy, the entire amount you elected under your Health Care Spending
Account will be available to you during your leave period, less any prior reimbursements that you have
received for that plan year, as long as you continue to make your contributions during your leave of
absence. If you stop making contributions, your participation in the Health Care Spending Account will
terminate while you are on a leave and you may not receive reimbursement for any health care expenses
you incur after your coverage terminated.
If your Health Care Spending Account participation terminates during your leave, your Health Care
Spending Account contributions will begin again if you return to work during the same year in which your
leave began. You will not be able to submit claims for reimbursement for expenses incurred during your
leave, and your contributions will increase to “make up” for the contributions you missed during your
leave. The amount available for reimbursement will be the same annual amount you elected before the
leave.
You may not use your Health Care Spending Account for expenses incurred during the period you did not
participate.
Effective 1/1/19 What Happens If … 20
You Go on Unpaid Leave
For medical, dental, and vision coverage: For an approved unpaid leave of absence, the Medical,
Dental, and Vision Plans will still cover you, as long as you make any required contributions. You will be
directly billed for any required contributions on an after-tax basis. You will also still be covered by the
Health & Wellness Centers Plan.
If you do not make the required contributions to continue your coverage in a timely manner, your
coverage will be canceled. However, your coverage may be reinstated when you return to work.
For the Health Care Spending and Dependent Care Spending Accounts: During an approved unpaid
leave of absence, you may continue to make monthly contributions to the Health Care Spending Account
on an after-tax basis, via your benefits invoice. If you stop making contributions, your participation in the
Health Care Spending Account will terminate while you are on a leave and you may not receive
reimbursement for any health care expenses you incur after your coverage terminated. You may not
make contributions to a Dependent Care Spending Account during an unpaid leave. For the Dependent
Care Spending Account, you may use your account balance only for eligible expenses incurred prior to
the date of your approval to go on unpaid leave, and must files those claims by March 31 of the next
calendar year.
For the Transportation Spending Account, you must disenroll and any unused credits in your
account(s) will be forfeited. If you know you will be going on a leave, you should change your contribution
amount to zero approximately one month before your leave begins in order to avoid forfeiting any
contributions. Expenses incurred after your leave begins will not be eligible for reimbursement or payment
from your account(s). If you wish to continue participation after you return to active service, you must re-
enroll. However if you participated in the “Pay Me Back” option, you have 180 days following the end of
any particular benefit month you participated in the program to file claims for reimbursement from your
“Pay Me Back” account.
For life and accident coverage: While you are on an unpaid leave, you will continue to pay your
premiums for supplemental term life and AD&D insurance to JPMorgan Chase. Your basic life insurance
continues at no cost to you. Your business travel accident insurance will end.
For Group Legal Services Plan coverage, you will be billed monthly to continue coverage.
For Group Personal Excess Liability Insurance Plan coverage, you will be billed monthly to continue
coverage.
You Return from a Leave of Absence
If you go on a leave of absence (such as a disability, long-term disability, or paid or unpaid leave) and you
return to work in a work status that makes you eligible for benefits, then:
For medical, dental, and vision coverage: The coverage that you had before your leave of absence will
be reinstated.
For the Health Care Spending Account:
If you return to work in the same plan year in which your leave began, deductions of required before-
tax contributions from your pay will automatically continue. Your total remaining amount will be
prorated over the remaining pay cycles.
If you return to work from a paid disability leave in a different plan year than the one in which your
leave began, deductions of required before-tax contributions from your pay will automatically continue,
if you elected coverage at Annual Enrollment.
If you return from an unpaid disability leave or unpaid leave of absence in a different plan year
than the one in which your leave began, or if you return to work from a leave in which you were
receiving benefits under the JPMorgan Chase Long-Term Disability Plan, you may enroll in the
Health Care Spending Account when you return from leave.
Effective 1/1/19 What Happens If … 21
For the Dependent Care Spending Account:
If you return to work from a disability leave in the same plan year in which your disability leave
began, deductions of required before-tax contributions from your pay will automatically continue.
If you return to work from a paid or unpaid disability leave or other leave of absence in a different
plan year than the one in which your leave began, or if you return to work from a leave in which
you were receiving benefits under the JPMorgan Chase Long-Term Disability Plan, you may
enroll in the Dependent Care Spending Account when you return from your leave.
For the Transportation Spending Account: If you return to work from a leave and wish to participate in
TSA, you must enroll in this account when you return to work. The effective date of your participation
depends on the date of your enrollment. Please wait approximately ten days for your return to work
information to reach WageWorks. Changes to your TSA elections become effective as of the first of the
month for the following month’s expenses (i.e., April deductions for May expenses).
For LTD Benefits:
If your Total Annual Cash Compensation (TACC) is less than $60,000, you will be reinstated in LTD
coverage immediately.
If your TACC is equal to or greater than $60,000, generally, you have to re-enroll for LTD coverage
within 31 days of your return from your leave, and you may be required to provide evidence of
insurability (EOI). Your coverage will resume on the first pay cycle after EOI is approved. If you don’t
re-enroll within 31-days, your next opportunity to enroll will be Annual Benefits Enrollment. Call
accessHR for specific questions.
If you are on an approved medical leave, your LTD coverage remains in effect throughout your
leave
If you are on a paid parental leave, your LTD coverage ends after 16 weeks
If you are on an unpaid leave, your LTD coverage ends after 16 weeks
If you are on any other type of nonmedical, paid or unpaid leave, coverage ends after 16 weeks
Total Annual Cash Compensation (TACC)
Total Annual Cash Compensation (TACC) is your annual rate of base salary/regular pay plus any applicable job
differential pay (e.g., shift pay) as of each August 1, plus any cash earnings from any incentive plans (e.g., annual
incentive, commissions, draws, overrides and special recognition payments or incentives) that are paid to or deferred
by you for the previous 12-month period ending each July 31. Overtime is not included. It is recalculated as of each
August 1 to take effect the following January 1 and will remain unchanged throughout the year. For most employees
hired on or after August 1, it will be equal to your annual rate of base salary/regular pay plus applicable job
differentials.
You Leave JPMorgan Chase
For health care coverage: If your employment with JPMorgan Chase terminates, participation in the
Medical, Dental, Vision, and Health & Wellness Centers Plans for you and your covered dependents ends
on the last day of the month in which you end active employment. However, you generally will be eligible
to continue participation for a certain period under the Consolidated Omnibus Budget Reconciliation Act
of 1985 (COBRA). (Please see "Continuing Coverage Under COBRA" in the Health Care Participation
section for more information on COBRA.) The health care plans cannot reimburse expenses incurred
after the end of the month in which you leave JPMorgan Chase unless you choose to continue your
participation under COBRA or under JPMorgan Chase retiree coverage. For more information, please
see the As You Leave Guide on me@jpmc.
The provisions noted above for the health care plans also apply to the expatriate medical and dental
options. If you are a U.S. home-based expatriate or an expatriate assignment to the U.S., under
certain circumstances, you may be eligible to continue participation for a certain period of time under
COBRA. Non-U.S. home-based expatriate employees assigned outside the United States and their
dependents are not eligible for COBRA continuation coverage.
Effective 1/1/19 What Happens If … 22
For the Health Care Spending Account, if you are participating in the Health Care Spending Account
when your employment with JPMorgan Chase ends, you will be covered for eligible expenses incurred in
the plan year up to the end of the month in which you terminate. You then have until March 31 of the year
following your termination from JPMorgan Chase to submit claims for any eligible expenses incurred
during the previous year, up to the end of the month in which you terminate. Expenses incurred after the
end of the month in which you leave JPMorgan Chase cannot be reimbursed by the JPMorgan Chase
Health Care Spending Account unless you choose to continue your Health Care Spending Account
participation under COBRA. By electing continuation coverage under COBRA, you may continue your
Health Care Spending Account participation through any month up until the end of the year in which your
employment ends, if you make after-tax contributions to the account. (Please see "Continuing Coverage
Under COBRA" in the Health Care Participation section for more information on COBRA.)
For the Dependent Care Spending Account, if you have a balance remaining in the Dependent Care
Spending Account when your employment with JPMorgan Chase ends, you may continue to submit
claims against the balance in the account for eligible expenses incurred in the plan year up to your
termination date. You then have until March 31 of the year following your termination from
JPMorgan Chase to submit claims for any eligible expenses incurred during the previous year, up to your
termination date. Expenses incurred after your termination date cannot be reimbursed by the
JPMorgan Chase Dependent Care Spending Account. You may not continue to make contributions to the
Dependent Care Spending Account after your termination.
For the Transportation Spending Accounts, if you have a balance remaining in the “Pay Me Back”
option of the Parking Account when you leave, you may continue to submit claims against the balance in
your account for up to 180 days following the end of the benefit month (for example, expenses incurred in
January must be claimed by July); otherwise, your Parking Account balance will be forfeited. You may not
continue to make contributions to the Transportation Spending Accounts after your termination. If you are
planning to leave the company, you should change your contribution amount to zero approximately one
month before your departure in order to avoid forfeiting any contributions. The Transportation Spending
Accounts, under Section 132 of the Internal Revenue regulations, allow qualified transportation expenses
to be excluded from an employee’s gross income. Under these regulations, before-tax contributions are
non-refundable to the employee under any circumstances including termination of employment.
For the Life and Accident Insurance Plans, if your employment with JPMorgan Chase terminates,
active participation in the Business Travel Accident, Basic Life, Supplemental Term Life and AD&D
Insurance Plans generally end on the date your employment ends. For more information, please see the
Life and Accident Insurance section.
For Basic Life, upon receipt of the MetLife conversion package at your
home mailing address, and within 31 days of your termination date, you may
convert any portion of your Basic Life Insurance to an individual policy by
contacting Metropolitan Life Insurance Company (MetLife), the plan
administrator. Financial advisors at Mass Mutual (acting on behalf of
MetLife) will be able to address any questions on how much to convert to an
individual policy. MetLife will bill you directly.
If You Port or
Convert
For any policies you port
or convert, you must
designate beneficiaries
directly with MetLife.
For Supplemental Term Life, within 31 days of your termination date, you
have the option to convert your employee and/or dependent life insurance coverage to an individual
life policy or port that coverage following your termination of employment as follows:
Employee Supplemental Life Insurance:
- You may convert the coverage to an individual policy; OR
- You may port the lesser of your total life insurance in effect at date of termination or up to $2
million (in increments of $25,000)
- You must provide MetLife evidence of insurability for the additional coverage amount
- If you are already at the $2 million maximum you may not increase your coverage.
Effective 1/1/19 What Happens If … 23
Dependent Spouse Supplemental Life Insurance:
- You may convert the coverage to an individual policy; OR
- You may port the minimum of $2,500 ($10,000 when porting Dependent Spouse life insurance
alone) to a maximum of the lesser of your total dependent spouse life insurance in effect at date
of termination, or $300,000.
Dependent Child Supplemental Life Insurance:
- You may convert the coverage to an individual policy; OR
- You may port your dependent child supplemental life insurance coverage at a minimum of
$1,000 to a maximum of the lesser of the total amount in effect at the date of termination or
$20,000.
For Accidental Death and Dismemberment (AD&D) Insurance:
You may port up to $2 million of your employee AD&D coverage with Metropolitan Life Insurance
Company (MetLife) within 31 days of your termination date.
When you leave JPMorgan Chase, you may increase the amount of your portable AD&D coverage
in increments of $25,000, up to a maximum of $2 million. Evidence of Insurability (EOI) may be
required.
You may also port any dependent AD&D coverage, but only if you elect to port your employee
AD&D coverage.
Financial advisors at Mass Mutual (acting on behalf of MetLife) will also be able to address any
questions on how much AD&D coverage to port for you and/or your dependents.
When you port your coverage(s), MetLife will bill you directly.
For Business Travel Accident Insurance, you may not convert or port this coverage to an individual
policy.
For more details, see the information in each plan description about continuing coverage in the Life
and Accident Insurance section.
Porting Versus Converting Insurance Policies
When leaving the company, you may be able to either “port” or “convert” the group insurance policy to an individual
policy. Both typically result in higher rates than a group policy, but there are differences.
When you convert an insurance policy, you are not required to provide proof of insurability to receive coverage.
The premium you pay is based on your age at the time of policy conversion.
When you port a policy, you must provide proof of insurability to receive preferred, or less expensive, premiums.
Also, the premiums generally change as you age.
For the Group Legal Services Plan, if your employment with JPMorgan Chase terminates, participation
for you and your covered dependents usually ends on your termination date. You have the option to
continue coverage by contacting Hyatt Legal Plans, the claims administrator, within 31 days of the date
your coverage ends and electing to continue the Plan. Currently you can continue the Plan for an
additional 30 months with direct payment to Hyatt Legal Plans. Any services in progress before your
termination date will be provided, even if you don’t continue coverage.
For the Group Personal Excess Liability Plan, if your employment with JPMorgan Chase terminates,
participation for you and your covered dependents usually ends on your termination date. While you
cannot convert or port your coverage, you may continue your current coverage through the end of the
calendar year by paying the balance of the remaining premium in full directly to Arthur J. Gallagher Risk
Management Services.
Effective 1/1/19 What Happens If … 24
Your Expatriate Assignment Ends
If your expatriate assignment ends, your Expatriate Medical and/or Dental Plan coverage will end on the
last day of the month in which your work status changes. If you remain an active JPMorgan Chase
employee, you will need to elect coverage under your local/domestic, home-country medical plan and/or
dental plan.
You Retire from JPMorgan Chase
For medical, dental, and vision coverage: You need to meet minimum age and service requirements at
the time of retirement to be eligible for retiree medical and dental coverage. For vision coverage, you may
enroll for retiree vision coverage even if you were not covered under the Vision Plan at the time of your
retirement.
For expatriate medical and dental coverage, you must be a U.S. home-based expatriate employee
and meet minimum age and service requirements and have active medical coverage at the time of
retirement to be eligible for U.S. retiree medical coverage.
For more information, please see the As You Retire Guide on me@jpmc.
For the Health Care Spending Account, if you are participating in the Health Care Spending Account
when your employment with JPMorgan Chase ends, you will be covered for eligible expenses incurred in
the plan year up to the end of the month in which you terminate. You then have until March 31 of the year
following your termination from JPMorgan Chase to submit claims for any eligible expenses incurred
during the previous year, up to the end of the month in which you terminate. Expenses incurred after the
end of the month in which you leave JPMorgan Chase cannot be reimbursed by the JPMorgan Chase
Health Care Spending Account unless you choose to continue your Health Care Spending Account
participation under COBRA. By electing continuation coverage under COBRA, you may continue your
Health Care Spending Account participation through any month up until the end of the year in which your
employment ends, if you make after-tax contributions to the account. (Please see "Continuing Coverage
Under COBRA" in the Health Care Participation section for more information on COBRA.)
For the Dependent Care Spending Account, if you have a balance remaining in the Dependent Care
Spending Account when your employment with JPMorgan Chase ends, you may continue to submit
claims against the balance in the account for eligible expenses incurred in the plan year up to your
termination date. You then have until March 31 of the year following your termination from
JPMorgan Chase to submit claims for any eligible expenses incurred during the previous year, up to your
termination date. Expenses incurred after your termination date cannot be reimbursed by the
JPMorgan Chase Dependent Care Spending Account. You may not continue to make contributions to the
Dependent Care Spending Account after your termination.
For the Transportation Spending Accounts, if you have a balance remaining in the “Pay Me Back”
option of the Parking Account when you leave, you may continue to submit claims against the balance in
your account for up to 180 days following the end of the benefit month (for example, expenses incurred in
January must be claimed by July); otherwise, your Parking Account balance will be forfeited. You may not
continue to make contributions to the Transportation Spending Accounts after your termination. If you are
planning to leave the company, you should change your contribution amount to zero approximately one
month before your departure in order to avoid forfeiting any contributions. The Transportation Spending
Accounts, under Section 132 of the Internal Revenue regulations, allow qualified transportation expenses
to be excluded from an employee’s gross income. Under these regulations, before-tax contributions are
non-refundable to the employee under any circumstances including termination of employment.
For the Life and Accident Insurance Plans, if your employment with JPMorgan Chase terminates,
active participation in the Business Travel Accident, Basic Life, Supplemental Term Life and AD&D
Insurance Plans generally end on the date your employment ends. For more information, please see the
Life and Accident Insurance section.
Retiree Life Insurance Coverage may be available. You need to meet minimum age and service
requirements at the time of retirement to be eligible for retiree medical and dental coverage. For
details on the eligibility requirements, please see the As You Retire Guide on me@jpmc.
Effective 1/1/19 What Happens If … 25
For Basic Life, upon receipt of the MetLife conversion package at your
home mailing address, and within 31 days of your retirement date, you may
convert any portion of your Basic Life Insurance (over the first $10,000) to
an individual policy by contacting Metropolitan Life Insurance Company
(MetLife), the plan administrator. Financial advisors at Mass Mutual (acting
on behalf of MetLife) will be able to address any questions on how much to
convert to an individual policy. MetLife will bill you directly after you retire.
If You Port or
Convert
For any policies you port
or convert, you must
designate beneficiaries
directly with MetLife.
For Supplemental Term Life, within 31 days of your retirement date, you
have the option to convert your employee and/or dependent life insurance coverage to an individual
life policy or port that coverage following your retirement as follows:
Employee Supplemental Life Insurance: You may port up to $2 million of your employee
Supplemental Term Life Insurance with MetLife within 31 days of your retirement date.
When you retire from JPMorgan Chase, you may increase the amount of your portable employee
supplemental life insurance coverage in increments of $25,000, up to a maximum of $2 million. You
must provide evidence of insurability for the additional coverage amount. If you are already carrying
the maximum amount of coverage, you may not increase your coverage.
You have two options for Dependent Supplemental Life Insurance:
1. If you elect to port your employee supplemental life insurance, you also have the opportunity to
port your dependent supplemental life insurance
2. If you do not elect to port your employee supplemental life coverage but want to continue
coverage for your dependents, you must convert your dependent supplemental life insurance to
an individual whole life policy
For Accidental Death and Dismemberment (AD&D) Insurance:
When you retire from JPMorgan Chase, you may port up to $2 million of your employee AD&D
coverage with Metropolitan Life Insurance Company (MetLife) within 31 days of your retirement
date.
When you leave JPMorgan Chase, you may increase the amount of your portable AD&D coverage
in increments of $25,000, up to a maximum of $2 million. You must provide evidence of insurability
for the additional coverage amount.
- If you’re age 80 or older, your benefit will be limited to $100,000.
You may also port any dependent AD&D coverage, but only if you elect to port your employee
AD&D coverage.
Financial advisors at Mass Mutual (acting on behalf of MetLife) will also be able to address any
questions on how much AD&D coverage to port for you and/or your dependents.
When you port your coverage(s), MetLife will bill you directly.
For Business Travel Accident Insurance, you may not convert or port this coverage to an individual
policy.
For more details, see the information in each plan description about continuing coverage in the Life
and Accident Insurance section.
For the Health & Wellness Centers Plan, if you retire from JPMorgan Chase, your Health & Wellness
Centers Plan coverage will end on the last day of the month in which you retire. However, you generally
will be eligible to continue participation for a certain period of time under COBRA, if elected. (Please see
"Continuing Coverage Under COBRA" in the Health Care Participation section for more information on
COBRA.) For more information, please see the As You Retire Guide on me@jpmc.
Effective 1/1/19 What Happens If … 26
For the Group Legal Services Plan, if you retire from JPMorgan Chase, coverage for you and your
covered dependents ends on your retirement date. Any services in progress before your termination date
will be provided, even if you don’t continue coverage. You may be eligible to elect to continue coverage
under the Retiree Group Legal Services Plan. For more information, please see the As You Retire Guide
on me@jpmc.
For the Group Personal Excess Liability Insurance Plan, if you retire from JPMorgan Chase, coverage
for you and your covered dependents ends on your retirement date. You are eligible to continue your
participation through the end of the policy year in which you retire, provided you pay the balance of the
policy in full. After your employment ends, Arthur J. Gallagher & Co., the plan administrator, will contact
you with instructions for continuing your coverage and paying the balance. If your payment is not received
within 31 days, your policy will be cancelled effective as of your retirement date. For more information,
please see the As You Retire Guide on me@jpmc.
You Work Past Age 65
For medical, dental, and vision coverage: If you continue to work for JPMorgan Chase after you reach
age 65 (and/or if your spouse/domestic partner reaches age 65 while you’re still working at
JPMorgan Chase), you and your spouse/domestic partner can continue to be covered under the
JPMorgan Chase health care plans (the Medical Plan, the Dental Plan, and the Vision Plan). If you or
your spouse/domestic partner chooses to enroll in Medicare at age 65, Medicare coverage will provide
secondary benefits to the JPMorgan Chase coverage while you remain actively employed.
If you’re covered under both the JPMorgan Chase plan and Medicare, your claims need to be
submitted to the JPMorgan Chase plan first. If any bills remain unpaid after the JPMorgan Chase plan
has paid up to the limits of its coverage, you should file a claim with Medicare. (Please Note: Medicare
has rules regarding eligible services and providers; please contact Medicare directly with questions.)
Please Note: Medical coverage under Medicare is not automatic. You must file for coverage when you
first become eligible. If you continue to work past age 65 and you have coverage under the
JPMorgan Chase plan, you may wait and apply for Medicare immediately after you leave
JPMorgan Chase. For more information about Medicare, contact your local Social Security office or
visit www.medicare.gov.
For the spending accounts: If you continue to work for JPMorgan Chase after you reach age 65, you
can continue participating in the spending accounts, as long as you meet all the other eligibility
requirements to participate.
For Life and Accident Insurance Plans: If you continue to work for JPMorgan Chase after you reach
age 65, you may continue to participate in the Life and Accident Insurance Plans, as long as you are
actively employed and meet all eligibility requirements.
If you continue working after age 75, AD&D coverage is limited to no more than $200,000 beginning
the January 1 after the year in which you reach age 75, and is reduced to a maximum of $100,000
beginning the January 1 after the year in which you reach age 80. This limitation also applies to your
spouse/domestic partner.
For the Health & Wellness Centers Plan: If you continue to work for JPMorgan Chase after you reach
age 65, you may continue to participate in the Health & Wellness Centers Plan, as long as you are
actively employed and meet all eligibility requirements.
For the Group Legal Services Plan: If you continue to work for JPMorgan Chase after you reach
age 65, you and your covered dependents can continue to be covered under the Group Legal Services
Plan.
For the Group Personal Excess Liability Plan: If you continue to work for JPMorgan Chase after you
reach age 65, you may continue to participate in the Plan, as long as you are actively employed and meet
all eligibility requirements.
Effective 1/1/19 What Happens If … 27
Plan Administration
Effective 1/1/19
This section of the Guide provides you with important information as required
by the Employee Retirement Income Security Act of 1974 (ERISA) about the
JPMorgan Chase Health Care and Insurance Plans for Active Employees.
While ERISA doesn’t require JPMorgan Chase to provide you with benefits, by
choosing to do so, ERISA mandates that JPMorgan Chase clearly
communicate to you how the plans subject to the provisions of ERISA operate
and what rights you have under the law regarding plan benefits. This section is
part of the summary plan description of each of your JPMorgan Chase Health
Care and Insurance Plans for Active Employees governed by ERISA. This
section of the Guide also provides important information about certain benefits
plans that are not governed by ERISA, such as the Personnel Excess Liability
Plan.
For most plans, the summary plan description and the plan document are the
same document. For plans where this is not the case, copies of the plan
documents are filed with the plan administrator and are available upon request.
For plans that are funded through insurance, if there is a discrepancy between
the insurance policy and the SPD, the insurance policy will govern.
About This Section
This section summarizes
administrative and rights
information for the
Health Care and
Insurance Plans for
Active Employees.
Please retain this section
for your records. Other
sections may be needed
in addition to this section
to provide a complete
summary plan
description (SPD) and/or
plan document for a
plan, including the
sections that describe
the benefits the plan
provides.
These SPDs/plan
documents do not
include all of the details
contained in the
applicable insurance
contracts, if any. For
plans with applicable
insurance contracts, if
there is a discrepancy
between the insurance
contract and the
SPD/plan document, the
insurance contract will
control.
Effective 1/1/19 Plan Administration 364
Questions?
Please see the Contacts section as well as the “Questions?” box at the start of each section of this Guide for details
on where to call and how to access the appropriate web center for each benefit plan. Each section of the Guide also
includes a subsection titled “Claims Administrators’ Contact Information.”
For questions about eligibility and plan operations, contact the accessHR Contact Center: at 877-JPMChase (877-
576-2427) (or 212-552-5100, if calling from outside the United States). Service Representatives are available Monday
through Friday, from 8 a.m. to 7 p.m. Eastern time, except certain U.S. holidays.
The JPMorgan Chase U.S. Benefits Program is available to most employees on a U.S. payroll who are regularly
scheduled to work 20 hours or more a week and who are employed by JPMorgan Chase & Co. or one of its
subsidiaries to the extent that such subsidiary has adopted the JPMorgan Chase U.S. Benefits Program. This
information does not include all of the details contained in the applicable insurance contracts, plan documents, and
trust agreements. If there is any discrepancy between this information and the governing documents, the governing
documents will control. JPMorgan Chase & Co. expressly reserves the right to amend, modify, reduce, change, or
terminate its benefits and plans at any time. The JPMorgan Chase U.S. Benefits Program does not create a contract
or guarantee of employment between JPMorgan Chase and any individual. JPMorgan Chase or you may terminate
the employment relationship at any time.
Effective 1/1/19 Plan Administration 365
Table of Contents Page
General Information ................................................................................................................ 367
Plan Administrative Information ............................................................................................368
Participating Companies ........................................................................................................ 371
Your Rights Under ERISA.......................................................................................................371
Privacy Information ................................................................................................................. 373
HIPAA Privacy Rights and Protected Health Information ............................................................. 374
Claims Related to Eligibility to Participate in the Plans and Plan Operations ..................375
How to File This Type of Claim and What You Can Expect........................................................... 376
If Your Claim Is Denied...................................................................................................................... 376
Claiming Benefits: Plans Subject to ERISA..........................................................................377
Steps in the Benefits Claims and Appeals Process ....................................................................... 377
Step 1: Filing Your Initial Claim for Benefits ................................................................................... 377
Step 2: Receiving Notification from the Claims Administrator/Plan Administrator if an Initial
Claim for Benefits Is Denied ........................................................................................................... 379
Step 3: Filing an Appeal to the Claims Administrator/Plan Administrator if an Initial Claim for
Benefits Is Denied .......................................................................................................................... 380
Step 4: Receiving Notification from the Claims Administrator/Plan Administrator if Your Appeal
Is Denied ........................................................................................................................................ 382
Step 5: Receiving a Final Appeal by an Independent Review Panel ............................................. 383
Filing a Court Action ......................................................................................................................... 384
Contacting the Claims Administrators: Plans Subject to ERISA........................................384
Contacting the Claims Administrators: Plans Not Subject to ERISA.................................387
If You Are Covered by More Than One Health Care Plan ....................................................388
Non-Duplication of Benefits ............................................................................................................. 388
Determining Primary Coverage ........................................................................................................ 388
Coordination with Medicare ............................................................................................................ 389
Right of Recovery.............................................................................................................................. 389
Subrogation of Benefits .................................................................................................................. 389
Right of Reimbursement ................................................................................................................. 390
Special Notice for Employees Who Have Been Rehired by JPMorgan Chase ..................391
Effective 1/1/19 Plan Administration 366
General Information
The following summarizes important administrative information about the
JPMorgan Chase Health Care and Insurance Plans for Active Employees
governed by ERISA. Please Note: Each plan can be identified by a specific
plan number, which is on file with the U.S. Department of Labor. Please see
“Plan Administrative Information” on page 368 for a listing of official plan names
and numbers.
Plan Sponsor
JPMorgan Chase Bank, NA
545 Washington Boulevard
12th Floor
Mail Code: NY1-G120
Keep Your
Information Current
Update your contact
information (home
address and phone
numbers) on My
Personal Profile. To
access My Personal
Profile while actively
employed, go to
https://mpp.jpmchase.net
Jersey City, NJ 07310
(Certain participating companies have adopted some or all of the plans for their eligible employees. See
“Participating Companies” on page 371 for a list of participating companies.)
Plan Year
January 1 – December 31
Plan Administrator
For all plans described in this Guide except for the Business Travel Accident Insurance and the Short-
Term Disability Plan:
JPMorgan Chase U.S. Benefits Executive
c/o JPMorgan Chase Benefits Administration
545 Washington Boulevard
12th Floor
Mail Code: NY1-G120
Jersey City, NJ 07310
For the Business Travel Accident Insurance Plan:
JPMorgan Chase Corporate Insurance Services
JPMorgan Chase & Co.
480 Washington Blvd.
Mail code: NY1-F014
10th floor
Jersey City, NJ 07310-1616
For Short-Term Disability Plan (Not applicable to the JPMorgan Chase Long-Term Disability Plan):
JPMorgan Chase Employee Relations Executive
JPMorgan Chase & Co.
28 Liberty Street
22nd Floor
Mail Code: NY1-A302
New York, NY 10005-1401
Effective 1/1/19 Plan Administration 367
Claims Administrator
The contact information for claims administrators for the various benefits plans can be found under
“Contacting the Claims Administrators: Plans Subject to ERISA” on page 384 and “Contacting the Claims
Administrators: Plans Not Subject to ERISA” on page 387.
COBRA Administrator
COBRA questions should be directed to JPMorgan Chase accessHR Contact Center.
COBRA payments should be directed to:
COBRA Payments JPMorgan Chase
P.O. Box 27524
New York, NY 10087-7524
(877) 576-2427
Benefits Fiduciaries
Please see “About Plan Fiduciaries” on page 372 for information on benefits fiduciaries.
Agent for Service of Legal Process
Legal Papers Served:
JPMorgan Chase & Co.
4 Chase Metrotech Center
FL 18, NY1-C312
Brooklyn, NY 11245
Service of legal process may also be made upon a plan trustee or the Plan Administrator.
Employer Identification Number
13-4994650
Plan Administrative Information
The following chart shows the information that varies by plan. All of the following plans are governed by
ERISA. (The Dependent Care Spending Account, Transportation Spending Accounts, and the Group
Personal Excess Liability Insurance Plan are not governed by ERISA and are not listed here. For more
information, see "Contacting the Claims Administrators: Plans Not Subject to ERISA" on page 387.)
Plan Name/
Number
Insurer Payment of Benefits Type of
Administration
The
JPMorgan Chase
Medical Plan/502
See “Contacting the Claims
Administrators: Plans
Subject to ERISA” on
page 384 for names,
addresses, and telephone
numbers for the Medical
Plan and the Prescription
Drug Plan.
See “Contacting the Claims
Administrators: Plans
Subject to ERISA” on
page 384 for names,
addresses and telephone
numbers for the Medical
Plan and the Prescription
Drug Plan.
Self-Insured/Trustee
Effective 1/1/19 Plan Administration 368
Plan Name/
Number
Insurer Payment of Benefits Type of
Administration
The
JPMorgan Chase
Dental Plan/502
See “Contacting the Claims
Administrators: Plans
Subject to ERISA” on
page 384 for names and
addresses for the Preferred
Dentist Program (PDP)
Option, the Dental
Maintenance Organization
(DMO) Option, the Dental
Health Maintenance
Organization (DHMO)
Option, and the Expatriate
Dental Option.
See “Contacting the Claims
Administrators: Plans
Subject to ERISA” on
page 384 for names,
addresses, and telephone
numbers for the PDP Option,
the DMO Option, the DHMO
Option, and the Expatriate
Dental Option.
Self-Insured/Trustee:
PDP Option and
Expatriate Dental
Option
Fully Insured:
DMO Option and
DHMO Option
The
JPMorgan Chase
Vision Plan/502
(Group 1018009)
FAA/EyeMed Vision Care
P.O. Box 8504
Mason, OH 45040-7111
FAA/EyeMed Vision Care
P.O. Box 8504
Mason, OH 45040-7111
Fully Insured
The
JPMorgan Chase
Basic Life
Insurance
Plan/502*
Metropolitan Life Insurance
Company (MetLife)
200 Park Avenue
New York, NY 10017
Metropolitan Life Insurance
Company (MetLife)
200 Park Avenue
New York, NY 10017
Fully Insured
The
JPMorgan Chase
Supplemental
Term Life
Insurance
Plan/502*
Metropolitan Life Insurance
Company (MetLife)
200 Park Avenue
New York, NY 10017
Metropolitan Life Insurance
Company (MetLife)
200 Park Avenue
New York, NY 10017
Fully Insured
The
JPMorgan Chase
Accidental Death
and
Dismemberment
(AD&D)
Insurance
Plan/502
Metropolitan Life Insurance
Company (MetLife)
200 Park Avenue
New York, NY 10017
Metropolitan Life Insurance
Company (MetLife)
200 Park Avenue
New York, NY 10017
Fully Insured
The
JPMorgan Chase
Business Travel
Accident (BTA)
Insurance
Plan/506
AIG — National Union Fire
Insurance Company of
Pittsburgh, PA
175 Water Street
New York, NY 10038
AIG — National Union Fire
Insurance Company of
Pittsburgh, PA
175 Water Street
New York, NY 10038
Fully Insured
The
JPMorgan Chase
Long-Term
Disability Plan’s
Group (LTD)/502
The Prudential Insurance
Company of America
P.O. Box 13480
Philadelphia, PA 19176
The Prudential Insurance
Company of America
P.O. Box 13480
Philadelphia, PA 19176
Fully Insured
Effective 1/1/19 Plan Administration 369
Plan Name/
Number
Insurer Payment of Benefits Type of
Administration
The
JPMorgan Chase
Long-Term
Disability Plan’s
Individual
Disability
Insurance
(IDI)/502
Unum
1 Fountain Square
Chattanooga, TN 37402
Unum
The Benefits Center
P.O. Box 100262
Columbia, SC 29202-3262
Fully-Insured
The
JPMorgan Chase
Short-Term
Disability
Plan/548
N/A Sedgwick Claims
Management Services
JPMorgan Chase Leave of
Absence Service Center
P.O. Box 14648
Lexington, KY 40512-4648
Self Insured
The
JPMorgan Chase
Group Legal
Services
Plan/502
Hyatt Legal Plans, Inc.
1111 Superior Avenue
Cleveland, OH 44114
Hyatt Legal Plans, Inc.
1111 Superior Avenue
Cleveland, OH 44114
Fully Insured
The
JPMorgan Chase
Employee
Assistance
Program
(EAP)/502
Administrator: Cigna
Behavioral Health, Inc.
Attn: Karen Cierzan,
President
11095 Viking Drive, Suite
350
Eden Prairie, MN 55344
Insurer: Cigna Health and
Life Insurance Company
900 Cottage Grove Rd.
Hartford, CT 06152
Administrator: Cigna
Behavioral Health, Inc.
Attn: Karen Cierzan,
President
11095 Viking Drive, Suite
350
Eden Prairie, MN 55344
Insurer: Cigna Health and
Life Insurance Company
900 Cottage Grove Rd.
Hartford, CT 06152
Fully-Insured (CA &
NV—clinical
component only)
Pre-Paid Service (all
other)
The
JPMorgan Chase
Health Care
Spending
Account
Plan/510
N/A See “Contacting the Claims
Administrators: Plans
Subject to ERISA” on
page 384 for names,
addresses, and telephone
numbers for the Health Care
Spending Account Plan
Salary Reduction/
Paid from the general
assets of the
employer
The
JPMorgan Chase
Health &
Wellness
Centers Plan/559
N/A JPMorgan Chase Medical
Director
JPMorgan Chase & Co.
270 Park Avenue 11th Floor
Mail Code: NY1-K318
New York, NY 10017-2014
Self-Insured
The
JPMorgan Chase
Back-up Child
Care Plan/502
N/A Bright Horizons Family
Solutions
200 Talcott Avenue, South
Watertown, MA 02472
Self-Insured
* The JPMorgan Chase Basic Life Insurance Plan and the JPMorgan Chase Supplemental Term Life Insurance Plan are
collectively referred to as the “Life Insurance Plan” in this SPD.
Effective 1/1/19 Plan Administration 370
Participating Companies
In some cases, affiliates or subsidiaries of JPMorgan Chase have decided to participate in the
JPMorgan Chase benefits plans and offer the benefits described in this Guide. These affiliates or
subsidiaries are referred to here as “participating companies.” The list may change from time to time, and
any company may end its participation in a plan at any time.
Bear Stearns Asset Management, Inc.
Chase Bank USA, National Association
Chase BankCard Services, Inc.
eCast Settlement Corp
FNBC Leasing Corporation
Highbridge Capital Mgmt, LLC
J.P. Morgan Alternative Asset Management,
Inc.
J.P. Morgan Chase Custody Services, Inc.
J.P. Morgan Electronic Financial Services,
Inc.
J.P. Morgan Institutional Investments, Inc.
J.P. Morgan Investment Holdings LLC
J.P. Morgan Investment Management Inc.
J.P. Morgan Securities, LLC
J.P. Morgan Treasury Technologies
Corporation
J.P. Morgan Trust Company of Delaware
JPMorgan Bank and Trust Company,
National Association
JPMorgan Chase Bank, National Association
JPMorgan Chase Holding LLC
JPMorgan Distribution Services, Inc.
Neovest, Inc.
Paymentech, LLC
Security Capital Research & Management,
Incorporated
WePay Inc
Your Rights Under ERISA
The Employee Retirement Income Security Act of 1974 (ERISA) gives you
certain rights and protections while you are a participant in the
JPMorgan Chase employee benefits plans described in this Guide. It is unlikely
you will need to exercise these rights, but it is important that you be aware of
what they are.
ERISA provides that all plan participants are entitled to:
An Important Note
The Dependent Care
Spending Account,
Transportation Spending
Accounts, and Group
Personal Excess Liability
Insurance Plan are not
Examine, without charge, at the office of the Plan Administrator, all plan
documents including insurance contracts and copies of all documents filed
by the plans with the U.S. Department of Labor, such as detailed annual
reports (Form 5500 Series).
Obtain, upon written request to the Plan Administrator, copies of all plan documents and other plan
information (for example, insurance contracts, Form 5500 Series, and updated summary plan
descriptions). The plan administrator may require reasonable charges for the copies.
Receive a summary of the plans’ annual financial reports. (The plan administrator is required by law to
furnish each participant with a copy of such reports.)
Continue health care coverage for yourself, your spouse, or your eligible dependents if there is a loss
of coverage under the plan because of a qualifying event. You or your dependents may have to pay
for such coverage. Review this summary plan description and the documents governing the plan on
the rules governing your COBRA continuation coverage rights.
subject to the provisions
of ERISA.
Effective 1/1/19 Plan Administration 371
Enforce Your Rights
If your claim for a welfare benefit is denied or ignored, in whole or in part, you
have the right to know why this was done, to obtain copies of documents
relating to the decision free of charge, and to appeal any denial, all within
certain time schedules.
Under ERISA, there are steps you can take to enforce the above rights. For
instance:
If you request a copy of the plans’ documents or the latest annual report
from the plan administrator and do not receive it within 30 days, you may file
suit in a U.S. federal court. In such a case, the court may require the plan
administrator to provide the information and pay up to $110 a day until you
receive the materials, unless they were not sent because of reasons beyond
the control of the Plan Administrator.
If you have a claim for benefits that is denied or ignored, in whole or in part,
you may file suit in a U.S. state or federal court. In addition, if you disagree
with the plan’s decision, or lack thereof, concerning the qualified status of a
domestic relations order or a medical child support order, you may file suit in
federal court.
Keep Your Contact
Information Current
Active participants are
required to update their
personal contact
information, including
mailing address, to
receive benefits-related
information and
correspondence. You
can make changes
online via My Personal
Profile at
mpp.jpmorganchase.co
m. You can also call the
accessHR Contact
Center. See the
Contacts section.
If it should happen that the plans’ fiduciaries misuse the plans’ money, or if you are discriminated
against for asserting your rights, you may seek assistance from the U.S. Department of Labor, or you
may file suit in a U.S. federal court. The court will decide who should pay court costs and legal fees. If
you are successful, the court may order the person you have sued to pay these costs and fees. If you
lose, the court may order you to pay these costs and fees, for example, if it finds your claim to be
frivolous.
About Plan Fiduciaries
The plan “fiduciary” is the individual or organization responsible for plan administration, claims
administration, and managing plan assets. The plan fiduciary has a duty to administer the plan prudently
and in the best interest of all plan members and beneficiaries.
Prudent Actions by Plan Fiduciaries
In addition to establishing the rights of plan participants, ERISA imposes duties upon the people who are
responsible for the operation of the benefits plans. Certain individuals who are responsible for the plans
are called “fiduciaries,” and they have a duty to administer the plans prudently and in the interest of you,
other plan members, and beneficiaries. While participation in these plans does not guarantee your right to
continued employment, no one — including your employer or any other person — may terminate you or
otherwise discriminate against you in any way to prevent you from obtaining your benefits or exercising
your rights under ERISA.
Health Care and Insurance Plans for Active Employees
For each of the following plans that are governed by ERISA, the Plan Administrators delegate fiduciary
responsibility for claims and appeals to the claims administrators, and to the Health Care and Insurance
Plans Appeals Committee, where that committee is authorized to decide appeals as described in this
Guide:
Medical Plan;
Prescription Drug Plan;
Dental Plan;
Health Care Spending Account Plan;
Vision Plan;
Effective 1/1/19 Plan Administration 372
Health & Wellness Centers Plan;
Life and AD&D Insurance Plans;
Business Travel Accident Insurance Plan;
Long-Term Disability Plan, including Group LTD and Individual Disability Insurance;
Short-Term Disability Plan;
Employee Assistance Program;
Group Legal Services Plan; and
Back-Up Child Care Plan.
Assistance with Your Questions
If you have any questions about the JPMorgan Chase Health Care and Insurance Plans for Active
Employees, you should contact the accessHR Contact Center. (See the Contacts section.) If you have
any questions about this statement or about your rights under ERISA, you should contact the nearest
Regional Office of the Employee Benefits Security Administration, U.S. Department of Labor, listed in
your telephone directory, or:
Division of Technical Assistance and Inquiries
Employee Benefits Security Administration
U.S. Department of Labor
200 Constitution Avenue, N.W.
Washington, DC 20210
You may also obtain certain publications about your rights and responsibilities under ERISA by calling the
publications hotline of the Employee Benefits Security Administration or by visiting www.dol.gov/ebsa via
the Internet.
You should also contact the Department of Labor if you need further assistance or information about your
rights under the Health Insurance Portability and Accountability Act of 1996 (HIPAA), with respect to
health benefits that are offered through a group health plan, as well as the remedies available if a claim is
denied in whole or in part.
Privacy Information
The privacy of your health information is important to you and to JPMorgan Chase. We are committed to
ensuring your personal health information is protected and secure, and that our practices comply with
privacy laws, including the Health Insurance Portability and Accountability Act (HIPAA). (For detailed
information about HIPAA Privacy Rights, please see “HIPAA Privacy Rights and Protected Health
Information” on page 374.) This means that when you complete a Wellness Screening or a Wellness
Assessment, participate in any health coaching activities, or receive health care treatment of any kind,
your personal health information is not disclosed to anyone, including JPMorgan Chase, without your
authorization and except as permitted by HIPAA.
If you are enrolled in the Medical Plan, your health care company will have access to your individual
health care and prescription claims data, in addition to the results of your Wellness Screening and
Wellness Assessment. A medical professional at your health care company will review the results and
may contact you to discuss ways to improve your health. Your health care company maintains the
confidentiality of your information in accordance with privacy regulations such as HIPAA.
Similarly, if you have waived coverage under the JPMorgan Chase Medical Plan and you participate in
the Wellness Screening and Wellness Assessment, a medical professional at Cigna will review the results
and may contact you to discuss ways to improve your health. Cigna will maintain the confidentiality of
your information in accordance with privacy regulations such as HIPAA.
Effective 1/1/19 Plan Administration 373
If you use a JPMorgan Chase Health & Wellness Center, your personal health information is likewise kept
confidential. While the JPMorgan Chase Health & Wellness Centers are staffed with nurses and some
doctors who are employed by JPMorgan Chase, they are medical professionals and do not disclose your
personal health information to anyone outside the Center without your permission. If you choose to visit
one of our onsite Health & Wellness Centers, and/or share your Wellness Screening results or any other
health information with staff in the Centers, that information will be kept private and will not be shared with
management, Human Resources, or any other individual or group within JPMorgan Chase. For more
information, go to My Health > Privacy Statement.
HIPAA Privacy Rights and Protected Health Information
JPMorgan Chase is committed to maintaining the highest level of privacy and discretion about your
personal compensation and benefits information.
However, federal legislation under the Health Insurance Portability and Accountability Act (HIPAA) legally
requires employers—like JPMorgan Chase—to specifically communicate how certain “protected health
information” under employee and retiree health care plans may be used and disclosed, as well as how
plan participants can get access to their protected health information.
What Is Protected Health Information?
Protected health information is considered to be individually identifiable health information as it relates to the:
Past, present, or future health of an individual; or
Health care services or products provided to an individual; or
Past, present, or future payment for health care services or products.
The information included in this section is a summary of HIPAA privacy regulations. To comply with the
law, JPMorgan Chase will distribute to you once every three years, a “Privacy Notice of Protected Health
Information Under the JPMorgan Chase Health Care Plans” that describes in detail how your personal
health information may be used and your rights with regard to this information.
A copy of the privacy notice is also available at My Health or by contacting the accessHR Contact Center
at any time to request a paper copy. Under HIPAA, protected health information is confidential, personal,
identifiable health information about you that is created or received by a claims administrator (like those
under the JPMorgan Chase Medical Plan), and is transmitted or maintained in any form. (“Identifiable”
means that a person reading the information could reasonably use it to identify an individual.)
Under HIPAA, the Medical Plan may only use and disclose participants’ protected health information in
connection with payment, treatment, and health care operations. In addition, the Medical Plan must
restrict access to and use of protected health information by all employees/groups except for those
specifically involved in administering the Medical Plan, including payment and health care operations. In
compliance with HIPAA, the Medical Plan agrees to:
Not use or further disclose protected health information other than as permitted or required by law;
Not use or disclose protected health information that is genetic information for underwriting purposes;
Ensure that any agents (such as an outside claims administrator) to whom the Medical Plan gives
protected health information agree to the same restrictions and conditions that apply to the Medical
Plan with respect to this information;
Not use or disclose the information for employment-related actions and decisions or in connection with
any other benefit or employee benefit plan of JPMorgan Chase;
Notify you if a breach of your protected health information is discovered;
Report to the JPMorgan Chase HIPAA Privacy Officer any use or disclosure of the information that is
inconsistent with the designated protected health information uses or disclosures;
Effective 1/1/19 Plan Administration 374
Obtain your authorization for any use or disclosure of protected health information for marketing, or
that is a sale of the protected health information as defined under applicable law;
Make available protected health information in accordance with individuals’ rights to review such
personal information;
Make available protected health information for amendment and incorporate any amendments to
protected health information consistent with the HIPAA rules;
Make available the information required to provide an accounting of disclosures in accordance with the
HIPAA rules;
Make the Medical Plan’s internal practices, books, and records relating to the use and disclosure of
protected health information received from the claims administrators available to the Secretary of
Health and Human Services for purposes of determining the Medical Plan’s compliance with HIPAA;
Return or destroy all protected health information received in any form from the claims administrators.
The Medical Plan will not retain copies of protected health information once it is no longer needed for
the purpose of a disclosure. An exception may apply if the return or destruction of protected health
information is not feasible. However, the Medical Plan must limit further uses and disclosures of this
information to those purposes that make the return or destruction of the information infeasible; and
Request your authorization to use or disclose psychotherapy notes except as permitted by law, which
would include for the purposes of carrying out the following treatment, payment or health care
operations:
Use by the originator of psychotherapy notes for treatment;
Use or disclosure by the Medical Plan for its own training program; or
Use or disclosure by the Medical Plan to defend itself in a legal action or other proceeding brought
by you.
If you believe that your rights under HIPAA have been violated, you can file a complaint with the
JPMorgan Chase HIPAA Privacy Officer or with the Secretary of the U.S. Department of Health and
Human Services. If you wish to file a HIPAA complaint with the JPMorgan Chase HIPAA Privacy Officer,
please contact the Privacy Officer for the JPMorgan Chase Health Care Plans in writing at this address:
HIPAA Privacy Officer for the JPMorgan Chase Health Care Plans
JPMorgan Chase Corporate Benefits
4041 Ogletown Road, Floor 02
Newark, DE, 19713-3159
Mail Code: DE6-1470
Claims Related to Eligibility to Participate in the
Plans and Plan Operations
This section provides information about the claims and appeals process for questions relating to eligibility
to participate in the plans, such as whether you meet the requirements of
employees/dependents/beneficiaries who are allowed to obtain benefits under the plans, and whether you
are eligible for Medical Reimbursement Account (MRA) funds. In addition, if, with respect to the plans
subject to ERISA, you have a type of claim that is not otherwise described in this Guide, including claims
related to general plan operations or Section 510 of ERISA, you must file your claim in accordance with
this section. For information on filing claims for benefits, please see “Claiming Benefits: Plans Subject to
ERISA” beginning on page 377.
In addition, for appeals relating to eligibility to participate in the Short-Term Disability Plan, the plan
administrator delegates responsibility to decide the appeals to the Short-Term Disability Plan Appeals
Committee.
Effective 1/1/19 Plan Administration 375
Help Pursuing Claims for Eligibility
You may authorize someone else to pursue claim information on your behalf. If you would like to designate an
authorized representative for claims related to eligibility to participate in a plan, please contact the accessHR Contact
Center.
How to File This Type of Claim and What You Can Expect
For questions about eligibility to participate in the Health Care and Insurance Plans for Active Employees
and to receive benefits or about general plan operations, please contact the accessHR Contact Center.
(See the Contacts section.)
For the plans that are subject to ERISA, if you are not satisfied with the response, you may file a written
claim with the appropriate plan administrator at the address provided in “General Information” on
page 367. The plan administrator will assign your claim for a determination. You must file your claim
within 90 days of the event giving rise to your claim. You will receive a written decision within 90 days of
receipt of your claim. Under certain circumstances, this 90-day period may be extended for an additional
90 days if special circumstances require extra time to process your request. In this situation, you will
receive written notice of the extension and the reasons for it, as well as the date by which a decision is
expected to be made, before the end of the initial 90-day period. If the extension is required because of
your failure to submit information necessary to decide the claim, the period for making the determination
will begin as of the date you submit the additional information, assuming it is provided in a timely fashion.
If Your Claim Is Denied
If you receive a notice that your claim has been denied, either in full or in part, the notice will explain the
reason for the denial, including references to specific plan provisions on which the denial was based. If
your claim was denied because you did not furnish complete information or documentation, the notice will
state the additional materials needed to support your claim. The notice will also tell you how to request a
review of the denied claim and the time limits applicable to those procedures.
To appeal a denial of the type of claims described in this section for any of the Health Care and Insurance
Plans for Active Employees, you must submit a written request for appeal of your claim to the appropriate
plan administrator within 60 days after receiving the notice of denial. In connection with your appeal, you
may submit written comments, documents, records, or other information relevant to your claim. In
addition, you will be provided, upon written request and free of charge, with reasonable access to (and
copies of) all documents, records, and other information relevant to your claim. The plan administrator for
the Business Travel Accident Insurance Plan will decide your appeal under that plan. The plan
administrator for the Short Term Disability Plan will decide appeals under that plan. The Health Care and
Insurance Plans Appeals Committee is delegated responsibility for deciding appeals under all other
Health Care and Insurance Plans for Active Employees.
In most cases, a decision will be made within 60 days after you file your appeal. But if special
circumstances require an extension of time for processing, and you are notified that there will be a delay
and the reasons for needing more time, there will be an extension of up to 60 days for deciding your
appeal. If an extension is necessary because you did not submit enough information to decide your
appeal, the timing for making a decision about your appeal is stopped from the date the plan
administrator sends you an extension notification until the date that you respond to the request for
additional information, assuming your response comes within a reasonable time frame.
Once a decision is reached, you will be notified in writing of the outcome. If an adverse benefit
determination is made on review, the notice will include the specific reasons for the decision, with
references to specific plan provisions on which it is based.
If you would like to file a court action after your appeal, please see “Filing a Court Action” on page 384,
which sets forth the rules that will apply.
Effective 1/1/19 Plan Administration 376
Claiming Benefits: Plans Subject to
ERISA
This section explains the benefits claims and appeals process for the benefits
of the JPMorgan Chase Health Care and Insurance Plans for Active
Employees that are subject to the Employee Retirement Income Security Act of
1974 (ERISA). It includes detailed information about what happens at each
step in the process and includes important timing requirements. This section
also includes information about each plan’s “fiduciary” and contact information.
See “About Plan Fiduciaries” on page 372
_ and “Contacting the Claims
Administrators: Plans Subject to ERISA” on page 384. For claims relating to
eligibility questions or claims, please see “Claims Related to Eligibility to
Participate in the Plans and Plan Operations” on page 375.
Please Note: Any claims or appeals that are related to a disability will be
handled in accordance with the Department of Labor regulations found in
Code 29 section 2560. This section of the Code provides certain procedural
protections and safeguards for disability benefit claims. For example, the
regulations require that disability claimants receive a clear explanation of why
their claim was denied and of their rights to appeal a claim denial. It also allows
claimants to review and respond during the course of an appeal to any new or additional evidence that
the Plan relied on in connections with the claim.
An Important
Reminder
The Dependent Care
Spending Account,
Transportation Spending
Accounts, and Group
Personal Excess Liability
Insurance Plan are not
subject to the provisions
of ERISA described in
this section. For
information about those
plans, please see
“Contacting the Claims
Administrators: Plans
Not Subject to ERISA”
beginning on page 387.
Help Pursuing Claims
You may authorize someone else to pursue claim information on your behalf. If you do so, you must notify the claims
administrator in writing of your choice of an authorized representative.
For the Medical, Dental, and Vision Plans, your claims administrator will provide you with a HIPAA (Health Insurance
Portability and Accountability Act of 1996) consent form that you must use to specify the extent to which your
personal representative is authorized to act on your behalf. This form must be on file with your claims administrator
prior to any action by your personal representative.
Steps in the Benefits Claims and Appeals Process
Step 1: Filing Your Initial Claim for Benefits
In general, when you file a claim for benefits, it is paid according to the provisions of the specific benefits
plan. There are different timing requirements for different plans, as outlined in the following table. For all
initial benefits claims, please contact the appropriate claims administrator for the plan. See “Contacting
the Claims Administrators: Plans Subject to ERISA” on page 384.
Plan/Option Appropriate Claims
Administrator
Timing for Filing Your Initial
Claim
Medical Plan*,
including the Medical
Reimbursement
Account
Claims administrator for your
Medical Plan option
No later than December 31 of the year
after the year in which services were
provided. Please contact your claims
administrator for more information.
Prescription Drug
Plan
CVS Caremark
Dental Plan*
Claims administrator for your Dental
Plan option
Effective 1/1/19 Plan Administration 377
Plan/Option Appropriate Claims
Administrator
Timing for Filing Your Initial
Claim
Vision Plan*
FAA/EyeMed Vision Care
Health Care Spending
Account
Claims administrator for your Health
Care Spending Account
March 31 of the year following the
year for which the expense is incurred.
Life Insurance Plan
Metropolitan Life Insurance
Company (MetLife)**
There is no time limit to file a claim
after a covered individual passes
away.
AD&D Insurance Plan
Metropolitan Life Insurance
Company (MetLife)
Within 90 days following the date of
an employee’s loss.
Business Travel
Accident Insurance
Plan
AIG-National Union Fire Insurance
Company of Pittsburgh, PA
Within 20 days after an employee’s
loss, or as soon as reasonably
possible thereafter.
Group Long-Term
Disability
The Prudential Insurance Company
of America
Within 272 days (nine months)
following the start of the disability***.
Individual Disability
Insurance
Unum Within 30 days following the start of
the disability.
Short-Term Disability
Plan
Sedgwick Within 30 days of first day of absence
from work.
Group Legal Services
Plan****
Hyatt Legal Plans, Inc. No later than December 31 of the year
following the year in which services
were provided.
Employee Assistance
Program
Cigna Behavioral Health, Inc.
Insured (CA & NV residents): Cigna
Health and Life Insurance Company
Within 90 days from date of service.
Health & Wellness
Centers Plan
JPMorgan Chase Medical Director
JPMorgan Chase & Co.
270 Park Avenue, 11th Floor
Mail Code: NY1-K318
New York, NY 10017-2014?
No later than December 31 of the year
following the year in which services
were provided.
Back-up Child Care
Plan
Bright Horizons Family Solutions
200 Talcott Avenue, South
Watertown, MA 02472
Within 60 days from the date of
service.
* Generally, in-network claims filing is performed by the physician or care provider.
** Please note that MetLife has sole responsibility and discretion to resolve any issues regarding beneficiary designations.
*** In certain circumstances, the time limit to file a claim may be up to 637 days (one year and nine months) following the start of
the disability. The time limit may be even longer if the employee lacks legal capacity to file a claim earlier.
**** Generally, in-network services are filed by the Group Legal plan attorney.
Life Insurance Claims & Appeals
Life insurance claims and appeals are divided between two parties.
The plan administrator handles all eligibility and other administrative decisions concerning your life insurance
benefits.
MetLife is primarily responsible for determining your beneficiaries. If you submit a claim/appeal regarding a
beneficiary designation to the Plan Administrator, it will be re-rerouted to MetLife.
Effective 1/1/19 Plan Administration 378
Step 2: Receiving Notification from the Claims Administrator/Plan
Administrator if an Initial Claim for Benefits Is Denied
If an initial claim for benefits is denied, the claims administrator or plan
administrator will notify you within a “reasonable” period, not to exceed the time
frames outlined in the following table.
Under certain circumstances, the claims administrator or Plan Administrator, as
applicable, is allowed an extension of time to notify you of a denied benefit.
Please Note: If an extension is necessary because you did not submit
necessary information needed to process your health care claim or life and
AD&D insurance claim, the timing for making a decision about your claim is
stopped from the date the claims administrator or plan administrator sends you
an extension notification until the date that you respond to the request for
additional information. You generally have 45 days from the date you receive
the extension notice to send the requested information to the claims
administrator or Plan Administrator.
What Qualifies as a
“Denied Benefit”?
A “denied benefit” is any
denial, reduction, or
termination of a benefit,
or a failure to provide or
make a payment, in
whole or in part, for a
benefit. In addition, a
benefit may be denied if
you didn’t include
enough information with
your initial claim.
Plan/Option Timing for Notification of a Denial of Benefits
Claim
Medical Plan, Prescription Drug
Plan, Dental Plan, Vision Plan,
Health Care Spending Account,
Employee Assistance Program, and
Health & Wellness Centers
As soon as reasonably possible but no more than 72
hours for claims involving urgent care, where the life of a
claimant could be jeopardized (may be oral, with written
confirmation within three days). Please Note: You must
be notified if your claim is approved or denied.
15 days for pre-service claims, where approval is required
before receiving benefits, plus one 15-day extension
because of matters beyond the plan’s control.
30 days for post-service claims, where the claim is made
after care is received, plus one 15-day extension because
of matters beyond the plan’s control.
Life Insurance Plan
60 days to make a determination once all claim information
has been submitted, plus one extension
AD&D Insurance Plan
45 days, plus one 45-day extension for matters beyond the
plan’s control.
Business Travel Accident Insurance
Plan
90 days, plus one 90-day extension for matters beyond the
plan’s control
Group Long-Term Disability
45 days, plus two 30-day extensions for matters beyond the
plan’s control.
Individual Disability Insurance
45 days
Short-Term Disability Plan
45 days, with 2-day extensions
Group Legal Services Plan
30 days, with no extensions
Back-up Child Care Plan
90 days, plus one 90-day extension for matters beyond the
plan’s control
Please Note: Concurrent care claims are claims for which the plan has previously approved a course of
treatment over a period of time or for a specific number of treatments, and the plan later reduces or
terminates coverage for those treatments. Concurrent care claims may fall under any of the other steps in
the claims appeal process, depending on when the appeal is made. However, the plan must give you
sufficient advance notice to appeal the claim before a concurrent care decision takes effect.
Effective 1/1/19 Plan Administration 379
The Explanation You’ll Receive from the Claims Administrator/Plan Administrator in the Case of a
Denied Benefit
If your initial claim is denied, the claims administrator or plan administrator is legally required to provide an
explanation for the denial, which will include the following:
The specific reason(s) for the denial;
References to the specific plan provisions on which the denial is based;
A description of any additional material or information needed to process your claim and an explanation of why
that material or information is necessary; and
A description of the plan’s appeal procedures and time limits, including a statement of your right to bring a civil
action under Section 502(a) of ERISA after, and if, your appeal is denied.
If your claim is for the Medical Plan, the explanation must also include:
If the benefit was denied based on a medical necessity, an experimental or unproven treatment, or similar
exclusion or limit, either an explanation of the scientific or clinical judgment for the denial applying the terms of the
plan to your medical circumstances, or a statement that such explanation will be provided free of charge upon
request.
Any internal rule, guideline, protocol, or other similar criterion relied upon in making the benefit denial, or a
statement that a copy of this information will be provided free of charge upon request. This requirement also
applies to denials under the Short-Term Disability Plan and the Long-Term Disability Plan, including the Individual
Disability Insurance.
Step 3: Filing an Appeal to the Claims Administrator/Plan Administrator if
an Initial Claim for Benefits Is Denied
If you have filed a claim for benefits and your claim is denied, you have the right to appeal the decision.
JPMorgan Chase is not involved in deciding appeals for any denied benefit claim under the:
Medical Plan, including Prescription Drug Plan
Preferred Dentist Program (PDP); Dental Plan Dental Maintenance Organization (DMO) Option; and
Dental Health Maintenance Organization (DHMO) Option;
Vision Plan;
Health Care Spending Account;
Long-Term Disability Plan, including Group LTD and Individual Disability Insurance;
Short-Term Disability Plan;
Life and AD&D Insurance Plans;
Business Travel Accident Insurance Plan;
Back-Up Child Care Plan
Group Legal Services Plan; and
Employee Assistance Program.
The plan administrators delegate all fiduciary responsibility and decisions about a claim for a denied
benefit under these plans to the applicable claims administrator.
Under certain plans, final appeals for denied claims will be heard by a review panel that is independent of
both the company and the Medical Plan claims administrators. The independent review panel will hear
appeals for the following plans:
Medical Plan;
Prescription Drug Plan; and
Health & Wellness Centers Plan.
Effective 1/1/19 Plan Administration 380
Please Note: Appeals related to denied claims under the Short-Term Disability Plan are determined by
Sedgwick. Employees who work in New Jersey have the right to appeal to the Division of Temporary
Disability Insurance for the State Temporary Disability Insurance portion of the JPMorgan Chase Short
Term Disability Plan. You have one year from the date your disability began to file this appeal.
Send your written appeal to:
Division of Temporary Disability Insurance Private Plan Operations
Claims Review Unit
P.O. Box 957
Trenton, NJ 08625-0957
Telephone: (609) 292-6135
If your initial claim for benefits is denied, you — or your authorized representative — may file an appeal of
the decision with the applicable claims administrator or plan administrator within the time frames indicated
below, after receipt of the claim denial.
Plan Timing for Filing an Appeal of a
Denial of Benefits Claim
Medical Plan and Prescription Drug Plan
180 days
Dental Plan
Vision Plan
Health Care Spending Account
Long-Term Disability, including Individual
Disability Insurance
Short-Term Disability Plan
Business Travel Accident Insurance Plan
Employee Assistance Program
Health & Wellness Centers Plan
Life and AD&D Insurance Plans
60 days
Group Legal Services Plan
Back-up Child Care Plan
180 days
In your appeal, you have the right to:
Submit written comments, documents, records, and other information relating to your claim.
Request, free of charge, reasonable access to, and copies of, all documents, records, and other
information that:
Was relied upon in denying the benefit.
Was submitted, considered, or generated in the course of denying the benefit, regardless of
whether it was relied on in making this decision.
Demonstrates compliance with the administrative processes and safeguards required in denying
the benefit.
For health care: constitutes a policy statement or plan guideline concerning the denied benefit
regardless of whether the policy or guideline was relied on in denying the benefit.
Effective 1/1/19 Plan Administration 381
If your appeal is for health care, you also have the right to receive:
A review that does not defer to the initial benefit denial and that is conducted by someone other than
the person who made the denial or that person’s subordinate.
For a denied benefit based on medical judgment (including whether a particular treatment, drug, or
other item is experimental or unproven), a review in which the plan fiduciary/claims administrator
consults with a health care professional who has appropriate training and experience in the field of
medicine involved in the medical judgment, and who was not consulted in connection with the initial
benefits denial, nor the subordinate of this person.
The identification of medical or vocational experts whose advice was obtained in connection with
denying the benefit, regardless of whether the advice was relied on in making this decision.
In the case of an urgent care claim where the life of a claimant could be jeopardized, an expedited
review process in which:
You may submit a request (orally or in writing) for an expedited appeal of a denied benefit.
All necessary information, including the decision on your appeal, will be transmitted between the
plan fiduciary/claims administrator and you by telephone, facsimile, or other available similarly
prompt method.
Step 4: Receiving Notification from the Claims Administrator/Plan
Administrator if Your Appeal Is Denied
If your appeal is subsequently denied, the claims administrator, plan administrator, or Short-Term
Disability Plan Appeals Committee is legally required to notify you in writing of this decision within a
“reasonable” period of time according to the time frames outlined in the following table.
Plan/Option Timing for Notification of a Denial of Benefits
Claim
Medical Plan, Prescription
Drug Plan, Dental Plan, Vision
Plan, Health Care Spending
Account, Employee
Assistance Program, and
Health & Wellness Centers
As soon as reasonably possible but no more than 72 hours for
claims where the life of a claimant could be jeopardized (urgent
care)
15 days where approval is required before receiving benefits (pre-
service claims)
30 days where the claim is made after care is received (post-
service claims)
Group Long-Term Disability
45 days, plus one 45-day extension for matters beyond the
plan’s control.
Individual Disability
Insurance
45 days, plus one 45-day extension for matters beyond the
plan’s control.
Short-Term Disability Plan
45 days, plus one 45-day extension for matters beyond the
plan’s control.
Life Insurance Plan
60 days to review and make a determination once all the
information has been submitted plus one extension
AD&D Insurance Plan
45 days, plus one 45-day extension for matters beyond the plan’s
control
Business Travel Accident
Insurance Plan
The decision on appeal will be made on the date of the next meeting
of the claims administrator’s appeal committee, subject to extensions
permitted by law
Group Legal Services Plan
60 days
Effective 1/1/19 Plan Administration 382
Plan/Option Timing for Notification of a Denial of Benefits
Claim
Back-up Child Care Plan
45 days, plus one 60-day extension for matters beyond the plan’s
control
The claims administrator or the plan administrator is allowed to take an extension to notify you of a denied
appeal under certain circumstances. If an extension is necessary, the claims administrator or plan
administrator will notify you before the end of the original notification period. This notification will include
the reason(s) for the extension and the date the claims administrator or the plan administrator expects to
provide a decision on your appeal for the denied benefit. Please Note: If an extension is necessary
because you did not submit enough information to decide your appeal, the time frame for decisions is
stopped from the date the claims administrator or the plan administrator sends you an extension
notification until the date that you respond to the request for additional information.
The Explanation You’ll Receive from the Claims Administrator/Plan Administrator in the Case of a
Denied Benefit
If an appeal is denied, the claims administrator or plan administrator is legally required to provide an explanation for
the denial, which will include the following:
The specific reason(s) for the denial;
References to the specific plan provisions on which the denial is based;
A statement that you’re entitled to receive, upon request and free of charge, reasonable access to, and copies of,
all documents, records, and other information relevant to your claim for benefits; and
A statement describing any appeal procedures offered by the plan and your right to obtain the information about
such procedures, and a statement of your right to bring a civil action under ERISA.
If your appeal is for Medical Plan, the explanation must also include:
If the benefit was denied based on a medical necessity, experimental, or unproven treatment, or similar exclusion
or limit, either an explanation of the scientific or clinical judgment for the denial applying the terms of the plan to
your medical circumstances, or a statement that such explanation will be provided free of charge upon request.
A description of the expedited review process for urgent care claims in the Medical Plan, where the life of the
claimant could be jeopardized.
Any internal rule, guideline, protocol, or other similar criterion relied upon in making the benefit denial, or a
statement that a copy of this information will be provided free of charge upon request in the Medical Plan.
The health care plans generally require two levels of appeal, which you must complete if you would like to
pursue your claim further.
The Group Long Term Disability coverage under the LTD Plan permits a voluntary second appeal. You
must file the voluntary second appeal within 180 days after the denial of the first appeal. The insurer of
the coverage, Prudential Insurance Company, can provide additional information about the voluntary
second appeal.
Step 5: Receiving a Final Appeal by an Independent Review Panel
If your appeal of a benefits claim is denied, your final appeal for coverage will be heard by a review panel
that is independent of both the company and the Medical Plan claims administrators. The independent
review panel will hear appeals for the following plans:
Medical Plan;
Prescription Drug Plan; and
Health & Wellness Centers Plan.
Effective 1/1/19 Plan Administration 383
The independent review panel hears only appeals that involve medical judgment or a rescission of
coverage; the panel does not hear appeals about eligibility to participate in a plan or legal interpretation of
a plan that does not involve medical judgment.
Filing a Court Action
If an appeal under a plan subject to ERISA is denied (in whole or in part), you may file suit in a U.S.
federal court. If you are successful, the court may order the defending person or organization to pay your
related legal fees. If you lose, the court may order you to pay these fees (for example, if the court finds
your claim frivolous). You may contact the U.S. Department of Labor or your state insurance regulatory
agency for information about other available options.
If you bring a civil action under ERISA, you must start the action by the earlier of: (i) one year after the
date of the denial of your final appeal; or (ii) three years after the date when your initial claim should have
been filed, regardless of any state of federal statutes relating to limitations of actions. For the health
plans, you cannot file a suit unless you have completed two appeals, if required by the claims
administrators.
Contacting the Claims Administrators: Plans
Subject to ERISA
This section provides specific contact information for each benefit plan covered by ERISA.
For contact information for the plans that are not subject to ERISA (which include the Dependent Care
Spending Account, Transportation Spending Accounts, and Group Personal Excess Liability Insurance
Plan), please see “Contacting the Claims Administrators: Plans Not Subject to ERISA” on page 387.
Generally for all health care and insurance plans, questions related to general plan administration and
eligibility to participate in the plans can be addressed by the accessHR Contact Center. (See the
Contacts section.)
For questions related to plan interpretation, filing initial claim, benefit provision under the plan, payment of
benefits, or denial of benefits, please refer to the appropriate claims administrator for each benefit plan,
as listed below.
Medical Plan Claims Administrators
Medical Plan
Cigna
Cigna
P.O. Box 182223
Chattanooga, TN 37422-7223
800-790-3086
UnitedHealthcare
UnitedHealthcare
P.O. Box 740809
Atlanta, GA 30374
800-272-8970
Prescription Drug Plan*
CVS Caremark
Attention: Claims Department
P.O. Box 52196
Phoenix, AZ 85072-2196
866-209-6093
Effective 1/1/19 Plan Administration 384
Medical Plan Claims Administrators
Expatriate Medical Option*
Cigna Global Health Benefits
P.O. Box 15050
Wilmington, DE 19850-5050
800-390-7183
302-797-3644 (if calling from outside the U.S.)
* Options marked with an asterisk are self-insured. All other options are fully insured.
Dental Plan Claims Administrators
Preferred Dentist Program (PDP)*
MetLife Dental
P.O. Box 981282
El Paso, TX 79998-1282
888-673-9582
Dental Maintenance Organization
(DMO) Option
Aetna, Inc.
P.O. Box 14094
Lexington, KY 40512
(800) 741-4781
Dental Health Maintenance
Organization (DHMO) Option
Cigna Dental Health
P.O. Box 188045
Chattanooga, TN 37422-8045
(800) 790-3086
Expatriate Dental Option*
Cigna International
JPMorgan Chase Dedicated Service Center
P.O. Box 15050
Wilmington, DE 19850-5050
(800) 390-7183
(302) 797-3644 (if calling from outside the U.S.)
* Options marked with an asterisk are self-insured. All other options are fully insured.
Other Health Care and Insurance Plans Subject to ERISA
Plan Contact
Vision Plan
FAA/EyeMed Vision Care
P.O. Box 8504
Mason, OH 45040-7111
(833) 279-4363
Health Care Spending Accounts
Refer to the same provider that you selected for your Medical
Plan coverage. If you waived Medical Plan coverage, contact
Cigna.
Cigna
P.O. Box 182223
Chattanooga, TN 37422-7223
(800) 790-3086
UHC Health Care Account Service Center
P.O. Box 981506
El Paso, TX 79998-1506
(800) 331-0480
Back-Up Child Care Plan
Bright Horizons Family Solutions
200 Talcott Avenue, South
Watertown, MA 02472
Effective 1/1/19 Plan Administration 385
Other Health Care and Insurance Plans Subject to ERISA
Plan Contact
Health & Wellness Centers Plan
JPMorgan Chase Medical Director
JPMorgan Chase & Co.
270 Park Avenue, 11th Floor
Mail Code: NY1-K318
New York, NY 10017-2014
Group Long-Term Disability
The Prudential Insurance Company of America
P.O. Box 13480
Philadelphia, PA 19176
(877) 361-4778
Individual Disability Insurance
Unum
The Benefits Center
P.O. Box 100262
Columbia, SC 29202-3262
(888) 226-7959
Short-Term Disability Plan*
Sedgwick Claims Management Services
JPMorgan Chase Leave of Absence Service Center
P.O. Box 14648
Lexington, KY 40512-4648
(888) 931-3100
Life and AD&D Insurance Plans
Metropolitan Life Insurance Company (MetLife)
200 Park Avenue
New York, NY 10017
(800) MET-LIFE ((800) 638-5433)
Business Travel Accident Insurance
Plan
AIG – National Union Fire Insurance Company of Pittsburgh,
PA
Accident & Health Claims Department
P.O. Box 25987
Shawnee Mission, KS 66225-5987
(800) 551-0824
Group Legal Services Plan
Hyatt Legal Plans, Inc.
1111 Superior Avenue
Cleveland, OH 44114
(800) 821-6400
Employee Assistance Program
Cigna Behavioral Health, Inc.
Attn: Karen Cierzan, President
11095 Viking Drive, Suite 350
Eden Prairie, MN 55344
Insurer: Cigna Health and Life Insurance Company
900 Cottage Grove Rd.
Hartford, CT 06152
* Options marked with an asterisk are self-insured. All other options are fully insured.
Effective 1/1/19 Plan Administration 386
Contacting the Claims Administrators: Plans
Not Subject to ERISA
Plans that are not subject to ERISA include the Dependent Care Spending Account, Transportation
Spending Accounts, and Group Personal Excess Liability Insurance Plan.
Although these plans are not subject to the claims process described under “Claiming Benefits: Plans
Subject to ERISA” on page 377, you can always contact the claims administrator listed for each plan with
questions about the eligibility of an expense for reimbursement, payment of benefits, or denial of plan
benefits. For claims relating to questions of eligibility for benefits under the plans and how the plans
operate, please see “Claims Related to Eligibility to Participate in the Plans and Plan Operations” on
page 375.
For questions related to plan interpretation, filing initial claim, benefit provisions under the plan, payment
of benefits, or denial of benefits, please refer to the appropriate claims administrator for the benefit plan,
as listed below.
Plan Contact
Dependent Care Spending Accounts
Refer to the same provider that you selected for your Medical
Plan coverage. If you waived Medical Plan coverage, contact
Cigna.
Cigna
P.O. Box 188061
Chattanooga, TN 37422-8061
(800) 790-3086
UHC Dependent Care Service Center
P.O. Box 981506
El Paso, TX 79998-1506
Transportation Spending Accounts
WageWorks
P.O. Box 14053
Lexington, KY 40511
(877) 924-3967
Group Personal Excess Liability
Arthur J. Gallagher & Co.
Insurance Plan
2 Westchester Park Drive, 3rd Floor
White Plains, NY 10604-3408
(866) 631-4630
Effective 1/1/19 Plan Administration 387
If You Are Covered by More Than One Health
Care Plan
The JPMorgan Chase medical and dental plans (including the plans for expatriates) all have provisions to
ensure that payments from all of your group health care plans don’t exceed the amount the
JPMorgan Chase plans would pay if they were your only coverage.
The rules described here apply to the JPMorgan Chase plans. The following rules do not apply to any
private, personal insurance you may have.
Non-Duplication of Benefits
The JPMorgan Chase health care plans do not allow for duplication of benefits. If you and your eligible
dependents are covered under more than one group plan, the primary plan (the one responsible for
paying benefits first) needs to be determined. The non-duplication provisions of the JPMorgan Chase
health care plans will ensure that, in total, you receive benefits up to what you would have received with
the JPMorgan Chase plans as your only source of coverage (but not in excess of that amount), based on
the primary carrier’s allowable amount.
A summary of coordination rules (that is, how JPMorgan Chase coordinates coverage with another group
plan to ensure non-duplication of benefits) follows. If you have questions, please contact your health care
company for help. (Please see contact information in the Contacts section.)
Here’s an example of how the JPMorgan Chase health care plans coordinate benefits with other group
health care plans:
Assume your spouse/domestic partner has a necessary covered procedure with a reasonable and
customary (R&C) charge of $100 after meeting any deductible.
If your spouse/domestic partner’s plan (which we’ll assume is primary) pays 70% for that procedure,
your spouse/domestic partner will receive a $70 benefit (70% of $100).
Also assume that your JPMorgan Chase health care plan (which we’ll assume is your
spouse/domestic partner’s secondary coverage and that the deductible has already been satisfied)—
would pay 80% for this necessary procedure. In this case, your spouse/domestic partner normally
would receive an $80 benefit (80% of $100) from the JPMorgan Chase plan.
Since your spouse/domestic partner already received $70 from his or her primary plan, he or she
would receive the balance ($10) from the JPMorgan Chase plan.
If, however, your JPMorgan Chase plan considered the R&C charge to be $80, no additional benefit
would be payable, as the JPMorgan Chase plan would pay 80% of $80, or $64. As that amount would
have already been paid by your spouse/domestic partner’s plan, no additional benefit would be
payable from the JPMorgan Chase plan.
Determining Primary Coverage
To determine which health care plan pays first as the primary plan, here are some general guidelines:
If you are enrolled in the JPMorgan Chase plan and another plan and your other health care plan
doesn’t have a coordination of benefits provision, that plan will be considered primary, and it will pay
first for you and your covered dependents.
If your covered dependent has a claim, the plan covering your dependent as an employee or retiree
will be considered primary to this plan.
If your claim is for a covered child who is enrolled in coverage under both parents’ plans, the plan
covering the parent who has the earlier birthday in a calendar year (based on the month and date of
birthday only, not the year) will be considered primary. In the event of divorce or legal separation, and
in the absence of a qualified medical child support order, the plan covering the parent with court-
Effective 1/1/19 Plan Administration 388
decreed financial responsibility will be considered primary for the covered child. If there is no court
decree, the plan of the parent who has custody of the covered child will be considered primary for the
covered child. (Please see “Qualified Medical Child Support Orders” in the Health Care Participation
section.)
If payment responsibilities are still unresolved, the plan that has covered the claimant the longest pays
first.
After it is determined which plan is primary, you’ll need to submit your initial claim to that plan.
After the primary plan pays benefits (up to the limits of its coverage), you can then submit the claim to the
other plan (the secondary plan) to consider your claim for any unpaid amounts. You’ll need to include a
copy of the written Explanation of Benefits from your primary plan.
Coordination with Medicare
Medicare is a national health insurance program administered by the Centers for Medicare and Medicaid
Services (CMS). It generally provides coverage for Americans ages 65 and older. It also provides
coverage to younger people with a qualifying disability. As long as you remain an active employee with
JPMorgan Chase, your JPMorgan Chase coverage will be primary, and any Medicare coverage for you
will be secondary. Additionally, any covered dependents who become eligible for Medicare, while you
remain an active employee, will also have JPMorgan Chase coverage as primary.
While you remain an active JPMorgan Chase employee, the JPMorgan Chase health care plans will
be primary for you and your covered dependents unless those dependents have primary coverage
elsewhere. If your covered dependents have primary coverage elsewhere, those claims will be
considered by that primary coverage first, JPMC coverage will be secondary and Medicare will
consider claims for those health care expenses tertiary (third) Even if you work past age 65 and you
and/or a covered spouse/domestic partner enroll in Medicare, the JPMorgan Chase plans will consider
claims for your health care expenses before Medicare while you are an active employee.
When you are no longer an active JPMC employee or are receiving LTD benefits, Medicare coverage
will be primary for the Medicare enrolled individual. JPMC coverage will be terminated upon Medicare
eligibility and coverage in Medicare plans is available from Via Benefits. Please see “You Work Past
Age 65” in the What Happens If .... section.
Right of Recovery
If the JPMorgan Chase plan provides benefits to you or a covered dependent that are later determined to
be the legal responsibility of another person or company, the JPMorgan Chase plans have the right to
recover these payments from you or from the person or company who is determined to be legally
responsible. Assignment of your claim to a third party does not exempt you from your responsibility for
repaying the plan. You must notify the JPMorgan Chase plan promptly of any circumstance in which a
third party may be responsible for compensating you with respect to an illness or injury that results in the
JPMorgan Chase plan making payments on your behalf.
Subrogation of Benefits
The purpose of the JPMorgan Chase health care plans is to provide benefits for eligible health care
expenses that are not the responsibility of any third party. The JPMorgan Chase plans have the right to
recover from any third party responsible for compensating you with respect to an illness or injury that
results in the JPMorgan Chase plans making payments on your behalf or on behalf of a covered
dependent. This is known as subrogation of benefits. The following rules apply to the plan’s subrogation
of benefits rights:
The JPMorgan Chase plans have first priority from any amounts recovered from a third party for the
full amount of benefits the plans have paid on your behalf, regardless of whether you are fully
compensated by the third party for your losses.
You agree to help the JPMorgan Chase plans use this right when requested.
Effective 1/1/19 Plan Administration 389
If you fail to help the JPMorgan Chase plans use this right when requested, the plans may deduct the
amount the plans paid from any future benefits payable under the plans.
The JPMorgan Chase plans have the right to take whatever legal action they deem appropriate
against any third party to recover the benefits paid under the plans.
If the amount you receive as a recovery from a third party is insufficient to satisfy the JPMorgan Chase
plans’ subrogation claim in full, the plans’ subrogation claim shall be first satisfied before any part of a
recovery is applied to your claim against the third party.
The JPMorgan Chase plans are not responsible for any attorney fees, attorney liens, or other
expenses you may incur without the plans’ prior written consent. The “common fund” doctrine does not
apply to any amount recovered by any attorney you retain regardless of whether the funds recovered
are used to repay benefits paid by the plans.
If you receive a subrogation request and have questions, please contact your health care company (see
contact information in the Contacts section).
Right of Reimbursement
In addition to their subrogation rights, the JPMorgan Chase health care plans are entitled to
reimbursements from a covered person who receives compensation from any third parties (other than
family members) for health care expenses that have been paid by the plans. The following rules apply to
the plans’ right of reimbursement:
You must reimburse the JPMorgan Chase plans in first priority from any recovery from a third party for
the full amount of the benefits the plan paid on your behalf, regardless of whether you are fully
compensated by the third party for your losses.
Regardless of any allocation or designation of your recovery made in a settlement agreement or court
order, the JPMorgan Chase plans shall have a right of full reimbursement, in first priority, from the
recovery.
You must hold in trust for the benefit of the JPMorgan Chase plans the gross proceeds of a recovery,
to be paid to the plans immediately upon your receipt of the recovery. You must reimburse the plans,
in first priority and without any set-off or reduction for attorney fees or other expenses. The “common
fund” doctrine does not apply to any funds recovered by any attorney you retain, regardless of whether
the funds recovered are used to repay benefits paid by the plans.
If you fail to reimburse the JPMorgan Chase plans, the plans may deduct any unsatisfied portion of the
amount of benefits the plans have paid or the amount of your recovery from a third party, whichever is
less, from future benefits payable under the plans.
If you fail to disclose the amount of your recovery from a third party to the JPMorgan Chase plans, the
plans shall be entitled to deduct the full amount of the benefits the plans paid on your behalf from any
future benefits payable under the plans.
Effective 1/1/19 Plan Administration 390
Special Notice for Employees Who Have Been
Rehired by JPMorgan Chase
If your employment has been reinstated with JPMorgan Chase (that is, you have been rehired within 31
days of your employment termination date or your coverage termination date), your coverage for certain
benefits under the JPMorgan Chase U.S. Benefits Program may be affected, as highlighted in the
following chart:
Medical (including Medical
Reimbursement Account), Dental,
and Vision Plans
You and your dependents will be assigned the same
coverage you had before your coverage termination date.
Please Note: If you are a retired employee when rehired, you
must take active employee coverage and discontinue any
retiree coverage you may have elected.
Health Care Spending Account
Your previously elected annual contribution amount will be
reinstated and prorated accordingly for the balance of the
plan year. Please Note: Expenses incurred during your
break in service are not eligible for reimbursement, unless
you elected to make after-tax contributions under COBRA.
Dependent Care Spending Account
Your previously elected annual contribution amount will be
reinstated and prorated accordingly for the balance of the
plan year. Please Note: Expenses incurred during your
break in service are not eligible for reimbursement.
Transportation Spending Accounts
(Transit/Parking)
There are no reinstatement provisions for these accounts.
You will need to make a new enrollment election upon your
date of hire.
Life Insurance Plan
You and your dependents will be assigned the same
coverage amount in effect before your termination date.
Accidental Death and
Dismemberment (AD&D) Insurance
Plan
You and your dependents will be assigned the same
coverage amount in effect before your termination date.
Group Personal Excess Liability
Insurance Plan
You will be assigned the same coverage in effect before your
termination date.
Group Legal Services Plan
You will be assigned the same coverage in effect before your
termination date.
Please Note: If you are rehired after 31 days of your termination date, you will need to make new benefits
elections for all plans for which you would like to participate.
Effective 1/1/19 Plan Administration 391
Contacts
Effective 1/1/19
My Health, My Rewards and the accessHR
Contact Center for More Information
My Health
In addition to the provider resources noted below, My Health provides one-stop access to all
your Medical Plan, prescription drug, Medical Reimbursement Account, Spending Accounts,
JPMorgan Chase Health & Wellness Centers, wellness programs, and access to the Benefits
Web Center where you can access information about the Dental and Vision Plans as well as
Life and AD&D Insurance, Group Legal and Personnel Excess Liability Insurance. Simply use
your Single Sign-On password to access other sites from My Health.
From work: My Health from the intranet.
From home: https://myhealth.jpmorganchase.com.
Please Note: Your covered spouse/domestic partner can access My Health without a
password, but their health care company’s site will require a username and password.
My Rewards
The accessHR
Contact Center
In addition to the provider resources noted below, My Rewards provides one-stop access to
retirement and savings information. Simply use your Single Sign-On password to access
other sites from My Rewards.
From work: My Rewards from the intranet.
From home: https://myrewards.jpmorganchase.com/.
Like My Health and My Rewards, the accessHR Contact Center provides access to benefits
information.
877-JPMChase ((877) 576-2427)
Quick Path: Enter your Standard ID or Social Security number; press 1; enter your PIN;
press 1.
If calling from outside the United States:
(212) 552-5100 (GDP# 352-5100)
Service Representatives are available Monday – Friday, from 8 a.m. to 7 p.m., Eastern Time,
except certain U.S. holidays. For assistance with the Retirement Plan, representatives are
available until 8:30 p.m.
Effective 1/1/19 Contacts 392
Issue/Benefit Contact Information
Medical (Not Including
Cigna
Prescription Drugs)
(800) 790-3086
24/7
My Health or www.mycigna.com
UnitedHealthcare
(800) 272-8970
8 a.m. to 8 p.m., all time zones, Monday – Friday
My Health or www.myuhc.com
Prescription Drugs
CVS Caremark
(866) 209-6093
24/7
www.caremark.com
Employee Assistance
Program (EAP)
Cigna (EAP) and LifeCare (Work-Life)
(877) 576-2007
www.eapandworklife.com
Tobacco Cessation Program
(866) QUIT-4-LIFE ((866) 784-8454)
myquitforlife.com/jpmorganchase.com
Expert Medical Advice
Grand Rounds
(888) 868-4693
8 a.m. to 9 p.m., Eastern Time, Monday – Friday
www.grandrounds.com/jpmc
Health Care Spending
Your Medical Plan carrier — Cigna or UnitedHealthcare — is the
Account
administrator of your Health Care and Dependent Care Spending
Dependent Care Spending
Account
Accounts. If you are not enrolled in the Medical Plan, Cigna is your
administrator of these accounts.
Cigna
(800) 790-3086
24/7
www.mycigna.com
UnitedHealthcare
(800) 272-8970
8 a.m. to 8 p.m., all time zones, Monday – Friday
www.myuhc.com
You can check your spending account balances through My Health.
Effective 1/1/19 Contacts 393
Issue/Benefit Contact Information
Dental
MetLife Preferred Dentist Program (PDP) Option:
MetLife Dental
(888) 673-9582
8 a.m. to 11 p.m., Eastern Time, Monday – Friday
https://mybenefits.metlife.com
Aetna, Inc. Dental Maintenance Organization (DMO) Option:
Aetna
(800) 741-4781
8 a.m. to 6 p.m., Eastern Time, Monday – Friday
www.aetna.com
Cigna Dental Health Maintenance Organization (DHMO) Option:
Cigna Dental Health
(800) 790-3086
24/7
http://mycigna.com
Vision
EyeMed Vision Care
(833) 279-4363
7:30 a.m. to 11 p.m., Eastern Time, Monday – Saturday
11 a.m. to 8 p.m., Eastern Time, Sunday
My Health > Benefits Web Center
Transportation Spending
Accounts (including for
questions about eligibility
and enrollment)
WageWorks
(877) 924-3967
8 a.m. to 8 p.m., all time zones, Monday – Friday
www.wageworks.com
You can check your Transportation Spending Accounts balances on
from the Transportation Spending Accounts Web Center via
My Rewards. (myrewards.jpmorganchase.com)
Group Long –Term Disability
The Prudential Insurance Company of America
(877) 361-4778
Monday through Friday from 8 a.m. to 11 p.m. Eastern time
Individual Disability
Insurance
Covala Group
(800) 235-3551
Monday through Friday from 8:30 a.m. to 5:30 p.m. Eastern time
Short-Term Disability Plan
Sedgwick Claims Management Services, Inc.
(888) 931-3100
Service Representatives are available 24/7, Sunday through
Saturday.
You can also obtain answers to your questions 24 hours a day,
seven days a week online at claimlookup.com/jpmc.
Life and Accidental Death &
Metropolitan Life Insurance Company (MetLife)
Dismemberment Insurance
(800) MET-LIFE ((800) 638-5433)
8 a.m. to 8 p.m., Eastern Time, Monday – Friday
My Health > Benefits Web Center
Bereavement Services
The Ayco Company
(800) 235-3417
8 a.m. to 5 p.m., Eastern Time, Monday – Friday
Effective 1/1/19 Contacts 394
Issue/Benefit Contact Information
ID Theft Assistance Program,
Travel Assistance, and
Emergency Evacuation
Services
AXA Assistance
(800) 454-3679 (outside the U.S., call collect at (312) 935-3783)
24/7
Funeral Concierge Services
Dignity Memorial
(866) 853-0954
Business Travel Accident
Insurance
AIG-National Union Fire Insurance Company of Pittsburgh, PA
(800) 551-0824 or (302) 661-4176
8 a.m. to 5 p.m., Central Time, Monday – Friday
401(k) Savings Plan
My Rewards > My Web Centers > 401(k) Savings Plan
401(k) Savings Plan Call Center
(866) JPMC401k ((866) 576-2401)
TTY number (800) 345-1833
Outside the U.S.: (303) 737-7249
Speak to a Representative 8 a.m. to 10 p.m. Eastern Time,
Monday – Friday (except NYSE holidays)
Retirement (Pension) Plan
My Rewards > My Web Centers > Pension Plan
accessHR Contact Center
(877) JPMChase ((877) 576-2427)
Outside the U.S.: (212) 552-5100
Speak to a Representative 8 a.m. to 8:30 p.m. Eastern Time,
Monday – Friday (except certain U.S. holidays)
Health & Wellness Centers
The Health & Wellness Centers Directory on My Health has a list of
JPMorgan Chase Health & Wellness Centers locations, phone
numbers, and hours. Go to My Health > JPMC Health & Wellness
Centers.
Group Legal Plan
Hyatt Legal Plans, Inc.
(800) 821-6400
8 a.m. to 8 p.m., Eastern Time, Monday – Friday
Personal Excess Liability
Insurance
Arthur J. Gallagher
Risk Management Services
(866) 631-4630
9 a.m. to 5 p.m., Eastern Time, Monday – Friday
Back-up Child Care Plan
Bright Horizons
(877) BH-CARES ((877) 242-2737)
https://backup.brighthorizons.com/jpmc (for reservations)
me@jpmc > Health, Life & Parenting > parents@jpmc (for
information about the Plan)
Expatriate Medical and Dental
Plans
Cigna Global Health Benefits
(800) 390-7183 (outside the U.S., call collect at (302) 797-3644
24/7
www.CignaEnvoy.com
Effective 1/1/19 Contacts 395
