This coverage is available exclusively to ASME members* under age 70 who are at FULL-TIME WORK, provided their ANNUAL GROSS EARNED INCOME is at least $20,000 for the proceeding 12 month period. In order to become insured, satisfactory evidence of insurability must be provided and the required premium must be paid.
 

"FULL-TIME WORK" means the active performance of the regular duties of your normal occupation for pay or profit on the basis of at least 30 hours per week at the place such duties are normally performed.
 

You may request coverage for your lawful spouse who is under age 60 not insured as a member and actively performing the normal activities of a person in good health of like age with the same resident requirements as for members. Your spouse can be working for you, for someone else, or be a homemaker. Your, the member, must be insured for a minimum of $600 a month for your spouse to be eligible.
 

This coverage is only available for residents of the U.S. (except VT and territories) and Puerto Rico.
 

*Participation in the ASME Group Insurance Program requires active ASME membership status during the life of the coverage.

Choose From Three Coverage Options

All three policies pay monthly benefits while you are Totally Disabled. "Totally Disabled" means you are prevented by illness or injury from performing the material and substantial duties of your usual occupation, provided you are not otherwise working for pay or profit. Benefits begin at the end of the waiting period, provided you are Totally Disabled.
 

Note: Benefits for disabilities due to Mental Disorders is limited to a maximum of 24 monthly payments, regardless of choice.
 

Choose Your Coverage

Career Coverage

If you are Totally Disabled before age 63, benefits are payable up to age 65. There is a two year maximum benefit for Total Disabilities starting at ages 63 through 74.
 

Five-Year Coverage

Benefits are payable for up to five years for Total Disabilities commencing prior to age 60. For Total Disabilities starting at ages 60 through 62, benefits may continue up to age 65. For Total Disabilities starting at ages 63 through 74, benefits may continue for up to two years.
 

Inflation-Fighter Career Coverage

This Policy offers disability coverage that, once benefits begin, can help keep pace with inflation. Monthly benefits will be adjusted annually from the date of disability if you are Totally Disabled prior to age 63. Adjustments may be made to the Monthly Benefit paid in the second and each succeeding year. The adjusted amount will be based on the Consumer Price Index for Urban Consumers (CPI-U), up to a specified maximum each year (see your Certificate of Insurance) and an overall maximum increase of one times the original benefit. Once you are no longer disabled and the benefit payments stop, the Monthly Benefit returns to the original option amount.
 

Benefits are payable up to age 65 for Total Disabilities starting before age 63. For Total Disabilities starting at ages 63 through 74, the inflation-fighter feature is no longer applicable and benefits will be payable in accordance with the basic Career Coverage (i.e., up to two years maximum).

Choose Your Monthly Benefit

You have a choice of Monthly Benefit Options, from $150 to $7,500 (in $150 units). However, members age 65-69 may not request a monthly benefit option in excess of $3,750. The option you choose, together with any other disability income insurance you may have, cannot exceed 60% of your AVERAGE MONTHLY INCOME.

NOTE: On the premium due date on or immediately after reaching age 65, coverage in excess of $3,750 reduces to $3,750. On the premium due date on or immediately after reaching age 70, coverage in excess of $1,800 reduces to $1,800.

ANNUAL GROSS EARNED INCOME means your wages, salaries, commissions, fees and other amounts received for personal services — before deduction of income or social insurance taxes and after deduction of the normal business expenses which are deductible for income tax purposes — for any 12 month period. It does not include income from interest, dividends, rent, royalties, annuities, other insurance or other unearned income. AVERAGE MONTHLY INCOME means 1/12 of your ANNUAL GROSS EARNED INCOME.

Your Choice of Waiting Periods

You also have a choice of four waiting periods before benefit payments begin: 30, 90,180 or 365 days. A waiting period is the number of consecutive days you must be Totally Disabled before benefit payments begin. You should choose one that will provide benefits when your employer-provided salary continuation plan runs out. Coverage with a longer waiting period is less expensive.

Survivor Benefit

If you die— from any cause— while receiving benefits for Total Disability, a death benefit equal to three times the Monthly Benefit Option in force on the date of your death will be paid to your surviving relatives in the following order of survival: your spouse; or your children, equally; or your brothers and sisters, equally; otherwise, if there is no surviving relative, to the executor or administrator of your estate.
 

Organ Donation Benefit

If you have been insured under the policy for at least six months and undergo a surgical procedure to donate an organ for transplant, you will be considered Totally Disabled. No waiting period will apply, and benefits will be payable from the first day of Covered Total Disability. However, any portion of your Monthly Benefit Option which became effective in the six months immediately prior to such organ donation will not be payable for this Covered Total Disability. If you suffer a Covered Disability as a result of an organ donation, your Elimination Period will be 0 days.
 

Rehabilitation Benefit

This benefit is designed to help certain disabled members return to the work force. Under this provision, a professional rehabilitation staff reviews case histories and identifies individuals who appear to have the greatest likelihood of rehabilitation. Individuals selected by New York Life Insurance Company are offered the option of participating in a rehabilitation program at no cost to them. Participation is voluntary and benefits are not reduced due to participation in this program. Additionally, participation in a rehabilitation program for more than a total of 24 months will not be approved in connection with one period of Covered Total Disability.
 

Partial Disability Benefits

While you are recovering from a Covered Total Disability, you may be eligible to receive a partial disability benefit even though you return to work, if you are unable to perform one but not all of the material or substantial duties of your occupation. If you return to work within three months of a period of Covered Total Disability for which benefits were payable, you may continue to receive your monthly disability benefit until the earlier of the end of the maximum benefit period for Covered Total Disability, or 24 monthly payments. However, the amount of your Monthly Benefit Option together with all other disability benefits and income you earn that month, cannot exceed 80% of your MONTHLY GROSS EARNED INCOME for the 12 months before Covered Total Disability started.
 

Waiver of Premium

After you have been Totally Disabled for six consecutive months and you begin to receive benefits for Total Disability, all future premium contributions under the program will be waived for as long as you receive benefits for that disability.
 

Benefits for Recurring Disability

Successive periods of disability that are due to the same or related causes will be considered a single period of disability unless separated by a return to FULL-TIME WORK for three consecutive months or more.

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EXCLUSIONS AND LIMITATIONS

This policy does not provide benefits for: any disability that occurs during or is due or related to intentionally self-inflicted injury while sane or insane, any disability that does not require a doctor’s regular care (regular care of doctor does not include yourself, a close relative or a household member), declared or undeclared war or any act thereof, military service, pre-existing condition (see below) or your incarceration or participation (except as a victim) in an illegal occupation/activity or the commission of a crime; or any disability that is due or related to pregnancy or childbirth (except complications thereof), or any impairment or disease specifically excluded from your coverage.

This Policy limits benefits for disabilities due to Mental Disorders to a maximum of 24 monthly payments.
 

No benefits will be paid unless the disability occurs while you are insured under the Policy and you are under the care of a licensed physician or surgeon other than yourself (or member of your immediate family or household) during the period of disability.
 

Preexisting Condition Limitation

PREEXISTING CONDITION is an injury or sickness for which you consulted a doctor, received any medical services or supplies, or took any medication during the 12 months immediately before becoming insured under this policy. Benefits are not payable for a disability which is classified as a PREEXISTING CONDITION until the end of the earlier of 12 consecutive months during which you have not consulted a doctor, received medical services or supplies, or taken any medication for the condition; 24 consecutive months during which you have been insured under this policy.
 

Effective Date

You will become insured on the date specified by New York Life Insurance Company provided the first premium contribution has been paid, satisfactory evidence of insurability has been submitted, and you are actively performing the normal activities of a person in good health of like age [NC: a person of like age] on that date. If you are not performing your normal activities as required, coverage will not become effective until the day you are performing such normal activities provided such date is within three months of the date insurance would have been effective and you are still eligible for insurance. Payment of a premium contribution for insurance does not mean there is any coverage in force before the effective date as specified by New York Life Insurance Company.
 

Note: There are instances where New York Life Insurance Company may be able to offer insurance, at the same cost, by eliminating coverage for a specific impairment or disease.
 

When Coverage Ends

Your insurance may remain inforce until the premium due date on or immediately after you reach age 75, provided you: (a) do no cease FULL-TIME WORK other than for reasons of disability; (b) remain an ASME member; (c) continue to pay premium contributions when due; (d) do not enter full-time active duty in the armed forces (coverage may be restored upon termination of active duty status, subject to policy guidelines); or (e) you do not elect to terminate your coverage; (f) the group policy is not terminated or modified by the Policyholder; or (g) the day before the day the policy terminates, or New York Life Insurance Company to end insurance for the group of insureds to which you belong. Coverage for your spouse will terminate when: your coverage ends; the spouse turns age 65; premiums are not paid when due, or; upon divorce or legal separation.
 

Renewal Payments And Claims

Once you are approved into the insurance, you will have a 31-day grace period for your payment of renewal premium contributions. When you want to submit a claim, call or write the Administrator for claim forms.

Certificate Of Insurance

This information is only a brief description of the principal provisions and features of the policy. The complete terms and conditions are set forth in the group policy issued by New York Life to the Trustee under Trust Agreement with the American Society of Mechanical Engineers.
 

When you become insured, you will be sent a Certificate of Insurance summarizing your benefits under the policy.
 

"30-Day Free Look"

If you are not completely satisfied with the terms of your Certificate of Insurance, you may return it, without claim, within 30 days. Your coverage will be invalidated and you will receive a full refund—no questions asked

How New York Life Obtains Information and Underwrites Your Request For ASME Group Disability Income Insurance

In this notice, references to “you” and “your” include any person proposed for insurance. Information regarding insurability will be treated as confidential. In considering whether the person(s) in your request for insurance qualify for insurance , we will rely on the medical information you provide, and on the information you AUTHORIZE us to obtain from your physician, other medical practitioners and facilities, other insurance companies to which you have applied for insurance and MIB, LLC (“MIB”). MIB is a not-for-profit organization of insurance companies, which operates an information exchange on behalf of its members. If you apply for life or health insurance coverage, a claim for benefits is submitted to an MIB member company, medical or non-medical information may be given to MIB, and such information may then be furnished by MIB, upon request, to a member company.
 

Your AUTHORIZATION may be used for a period of 24 months from the date you signed the application for insurance, unless sooner revoked. The AUTHORIZATION may be revoked at any time by notifying New York Life in writing at the address provided. Your revocation will not be effective to the extent New York Life or any other person already has disclosed or collected information or taken other action in reliance on it, or to the extent that New York Life has a legal right to contest a claim under an insurance certificate or the certificate itself. The information New York Life obtains through your AUTHORIZATION may become subject to further disclosure. For example, New York Life may be required to provide it to insurance, regulatory or other government agencies. In this case, the information may no longer be protected by the rules governing your AUTHORIZATION.
 

MIB and other insurance companies may also furnish New York Life, its subsidiaries or the Plan Administrator with non-medical information (such as driving records, past convictions, hazardous sport or aviation activity, use of alcohol or drugs, and other applications for insurance). The information provided may include information that may predate the time frame stated on the medical questions section, if any, on this application. This information may be used during the underwriting and claims processes, where permitted by law.
 

New York Life may release this information to the Plan Administrator, other insurance companies to which you may apply for life and health insurance, or to which a claim for benefits may be submitted and to others whom you authorize in writing, however, this will not be done in connection with test results concerning Acquired Immune Deficiency Syndrome (AIDS) or Human Immunodeficiency Virus (HIV). We may also make a brief report of your protected health information to MIB, but we will not disclose our underwriting decision.
 

New York Life will not disclose such information to anyone except those you authorize or where required or permitted by law. Information in our files may be seen by New York Life and Plan Administrator employees, but only on a "need to know" basis in considering your request. Upon receipt of all requested information, we will make a determination as to whether your request for insurance can be approved.
 

If we cannot provide the coverage you requested, we will tell you why. If you feel our information is inaccurate, you will be given a chance to correct or complete the information in our files. Upon written request to New York Life or MIB, you will be provided with non-medical information. Generally, medical information will be given either directly to the proposed insured or to a medical professional designated by the proposed insured. Your request is handled in accordance with the Federal Fair Credit Reporting Act procedures. If you question the accuracy of the information provided by MIB, you may contact MIB and seek a correction. MIB's information office is: MIB, LLC, 50 Braintree Hill Park, Suite 400, Braintree, MA 02184-8734, telephone 866-692-6901(TTY 866 346-3642). Information for consumers about MIB may be obtained on its website at www.mib.com

For NM Residents: PROTECTED PERSONS¹ have a right of access to certain CONFIDENTIAL ABUSE INFORMATION² we maintain in our files and they may choose to receive such information directly. You have the right to register as a PROTECTED PERSON by sending a signed request to the Administrator at the address listed on the application. Please include your full name, date of birth and address.
 

¹PROTECTED PERSON means a victim of domestic abuse; who has notified us that he/she is or has been a victim of domestic abuse; and who is an insured or prospective insured person.
 

²CONFIDENTIAL ABUSE INFORMATION means information about: acts of domestic abuse or abuse status; the work or home address or telephone number of a victim of domestic abuse; or the status of an applicant or insured family member, employer or associate of a victim of domestic abuse or a person with whom the applicant or insured is known to have a direct, close, personal, family or abuse-related relationship.
 

New York Life Insurance Company

7/15 ed.
 

ASME is compensated in connection with this group policy to provide and maintain this valuable membership benefit.