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HomeMy WebLinkAbout07-3444f ~ IN THE COURT OF COMMON PLEAS OF CUMBERLAND COUNTY, PENNSYLVANIA DAVID P. DIEHL, Plaintiff, v. ELECTRONIC DATA SYSTEMS CORPORATION, and LIFE INSURANCE CORPORATION OF NORTH AMERICA, Defendants NOTICE JURY TRIAL DEMANDED CIVIL ACTION -LAW YOU HAVE BEEN SUED IN COURT. IF YOU WISH TO DEFEND AGAINST THE CLAIMS SET FORTH IN THE FOREGOING PAGES, YOU MUST TAKE ACTION WITHIN TWENTY (20) DAYS AFTER THIS COMPLAINT AND NOTICE ARE SERVED BY ENTERING A WRITTEN APPEARANCE, PERSONALLY OR BY AN ATTORNEY, AND FILING IN WRITING WITH THE COURT YOUR DEFENSES OR OBJECTIONS TO THE CLAIMS SET FORTH AGAINST YOU. YOU ARE WARNED THAT IF YOU FAIL TO DO SO, THE CASE MAY PROCEED WITHOUT YOU, AND A JUDGMENT MAY BE ENTERED AGAINST YOU BY THE COURT WITHOUT FURTHER NOTICE TO YOU OR RELIEF REQUESTED BY THE PLAINTIFF. YOU MAY LOSE MONEY OR PROPERTY OR OTHER RIGHTS IMPORTANT TO YOU. YOU SHOULD TAKE THIS PAPER TO YOUR LAWYER AT ONCE. IF YOU DO NOT HAVE A LAWYER OR CANNOT AFFORD ONE, GO TO OR TELEPHONE THE OFFICE SET FORTH BELOW TO FIND OUT WHERE YOU CAN GET LEGAL HELP. CUMBERLAND COUNTY BAR ASSOCIATION 32 SOUTH BEDFORD STREET CARLISLE, PA 17013 1-800-990-9108 717-249-3166 ' 1 ~ , i f ~ ~ IN THE COURT OF COMMON PLEAS OF CUMBERLAND COUNTY, PENNSYLVANIA DAVID P. DIEHL, Plaintiff, v. ELECTRONIC DATA SYSTEMS CORPORATION, and LIFE INSURANCE CORPORATION OF NORTH AMERICA, Defendants No, a 7- 3 ~ ~f y JURY TRIAL DEMANDED CIVIL ACTION -LAW COMPLAINT ANn Now, this 25th day of May, 2007, comes David P. Diehl by and through his attorney, JOSEPH C. KORSAK, EsQ., who files the following complaint: 1. Plaintiff David P. Diehl is an adult individual residing at 209 York Road, Jacobus, Pennsylvania, 17407. 2. Defendant Electronic Data Systems Corporation (hereafter, EDS) is believed to be a Texas corporation doing business in the Commonwealth of Pennsylvania. It has a facility located at 225 Grandview Avenue, E-90, Camp Hill, PA, 17011. 3. Defendant Life Insurance Corporation of North America(hereafter, LICNA) is believed to be a Texas corporation, with its principal place of business at 12225 Greenville Avenue, Suite 1000, Dallas, Texas. 4. Between the dates of March 13, 1993, and April 1, 2000, Plaintiff was hired as a ' ~ ~ . ~. contractor by EDS. 5. On or about April 1, 2000, Plaintiff was hired by EDS as an employee. 6. Plaintiff worked for EDS for approximately six (6) years. 7. Plaintiff was afull-time, active, salaried employee. 8. Plaintiff worked approximately 40 hours per week. 9. Plaintiff was employed at the EDS's Camp Hill facility until his disabling condition became such that EDS permitted him to telecommute from home. 10. As an employee of EDS, Plaintiff was entitled, among other things, to participate in the company short term disability plan and a long term disability plan. 11. EDS provides ashort-term disability (STD) benefit program for its employees who aze full-time, active employees, who work at least 30 hours per week, who have completed at least 60 days of service, and who are employed in the United States. Plaintiff meets all the criteria for participation. (See Exhibit A, attached) 12. The STD benefit is available to an employee considered to be disabled, defined as an employee unable to perform all the material duties of his or her occupation and unable to earn 80% or more of his covered earnings from working in his or her regulaz occupation. 13. Plaintiff was also entitled to participate in the company's Long Term Disability Plan. Plaintiff, for an additional chazge, purchased coverage over and above the base line amount of coverage available for purposes of Long Term Disability. 14. The STD benefit is not an insurance product. ~ ~ ` • ~ ~ [ ~ t . 15. The STD benefit is aself-funded salary continuance payroll practice of EDS which is administered under contract with the co-defendant Life Insurance Company of North America. 16. At the time Plaintiff applied for the STD benefit, he met all criteria for the receipt of benefits and continued to remain eligible so throughout. 17. The STD benefit provides for the Plaintiff provides up to 26 weeks of 100% of pay. 18. The STD benefit provided by EDS is a payroll practice, not governed by the Employee Retirement Income Security Act. 19. The administration of the EDS STD policy is underwritten by co-defendant LICNA, pursuant to a master agreement set forth as Exhibit B. 20. On or about May 11, 2006, Plaintiff stopped working due to lumbaz degenerative disc disease and lumbar radiculitis. (See attached Exhibit C) Plaintiff was deemed unable to work by his attending physicians. 21. On or about May 12, 2006, Plaintiff was granted Short-Term Disability Benefits. 22. Plaintiff engaged in physical therapy three times a week at Health South in York, Pennsylvania from June 12, 2006, through September 6, 2006. 23. On or about August 2, 2006, Plaintiff was informed by the plan administrator that his short-term disability benefits could not continue past July 7, 2006. (See attached Exhibit D) 24. On or about Monday, August 7, 2006, Plaintiff contacted the Disability Claim Manager for CIGNA to determine what was necessary to continue the receipt of STD. ~ I I a ~ ~ f 25. Co-Defendant CIGNA advised Plaintiff that a Functional Capacity Evaluation was all that would be required. 26. Plaintiff attempted the FCE but was unable to complete due to the condition of his health. (Exhibit E, attached) 27. Plaintiff was paid for approximately 17 weeks under the salary continuance program (STD benefit) provided by the Defendant. 28. On or about October 23, 2006, Plaintiff returned to work working four hours a day and taking four hours of vacation until vacation was fully consumed. The last day this occurred was November 17, 2006. 29. During this period, Plaintiff again received his STD for an additional four weeks more, bringing the total to 21 weeks. 29. Plaintiff timely appealed the decision by the Plan Administrator on September 22, 2006. 30. On or about October 10, 2006, Plaintiff s appeal was denied. (See attached Exhibit F). 31. Plaintiff provided substantial medical information establishing that he was disabled as that term is defined in the STD. 32. The denial of coverage was wrongful, azbitrazy, capricious, and constitutes a breach of the agreement by which the employer agreed to pay STD benefits to qualified employees. 33. Plaintiff is fully qualified and entitled to the full measure of coverage available under the EDS STD plan. • ~ ~ . ~ 1 I ~ ~ 1 ~ 34. In failing to honor its responsibilities, EDS owes to Plaintiff the balance of the wage continuation plan, which would include five weeks of wages, or a total of $8720.18, the Company's portion of the insurance premiums or $595.50, the Company contribution to his pension of $469.08, and the Company's match to his 401 K plan of $108.26. COUNT 1 As Against all Defendants 35. The averments of clauses 1 - 34 are incorporated by reference. 36. LICNA at all times acted as an agent on behalf of EDS. 37. The wage continuation plan is a fringe benefit or wage supplement as those terms are defined in the Pennsylvania Wage Payment and Collection Act. 38. EDS is an employer as defined within the Pennsylvania Wage Payment and Collection Act (PWPCA). 39. The additional 5 weeks of compensation are now overdue. 40. Plaintiff prays for the application of the statutory penalty under the PWPCA, counsel fees, and court costs. WHEREFORE, Plaintiff prays for entry of judgment in excess of $10,000.00 along with all penalties, counsel fees, and court costs. COUNT 2 As Against EDS 41. The averments of clauses 1 - 40 aze incorporated by reference herein. 42. While an employee of EDS, Plaintiff purchased additional long term disability coverage over and above that offered to employees. 43. Plaintiff was regularly charged for the coverage. 44. Plaintiff is further entitled to the coverage. 45. Plaintiff avers and believes that he was denied LTD solely as a consequence of being allegedly ineligible for STD. 46. Plaintiff avers an believes that the refusal to provide the full measure of STD was in violation of his contractual rights. 47. Plaintiff was eligible to receive $1,087.00 per week under the LTD plan. 48. To date, Plaintiff has received nothing. WHEREFORE, Plaintiff prays for entry of judgment against Defendant EDS in a sum in excess of $50,000.00, along with all penalties, counsel fees, and court costs. Y ~ Respectfully submitted, OF JOSH C. KORSAK Date: ~ ~ f ' 1j ~ ~ 1 By: Jose C. ~orsak, Esquire Sup m Court Id: 22233 33 o Queen Street Y , PA 17403 Telephone: (717)854-3175 Fax: (717)845-2643 Email: josephkorsak@comcast.net 2006 U.S. Benefits Handbook STD Benefits for Salaried Employees Eligible salaried employees, who have worked more than 60 days, will receive their regular salary during the seven consecutive calendar-day elimination period. After the elimination period has been exhausted, STD benefit eligibility is based upon the following schedule: • You are a full time, active employee, working at least 30 hours or more each workweek (temporary workers, contract laborers and seasonal employees are not eligible). • You have completed at least 60 days of active, continuous full-time employment, or re-employment in the case of rehired employees or if returning from personal or educational leave of absence. 0-2 Up to 8 weeks paid at 100% of pay; 6096 thereafter (max. 26 weeks total) 3-5 Up to 16 weeks paid 10096 of pay. 60% thereafter (max. 26 weeks) 6+ Up to 26 weeks paid 100% of pay (maximum Important note on overlap with FMLA: Although a seven consecutive calendar-day elimination period applies prior to payment of STD benefits, an eligible employee may qualify for FMIA leave of ler a three-day absence or otherwise as specified in the FMLA or other applicable state law. STD benefits for all employees end on the earliest of the following dates: • The end of the approved maximum benefit duration • The date the employee is no longer disabled • The date the employee fails to provide required medical information to support a disability claim • The date the employee fails to provide the signed reimbursement agreement • The date the employee is separated from EDS employment • The date of the employee's death • The date the employee is no longer an Eligible Employee Overpayments Any STD benefits or wages that are overpaid must be repaid as outlined in the reimbursement agreement. How the Policy Works Who is eligible to participate? You are an Eligible Employee and maybe eligible for coverage under the STD Policy if you meet all of the following conditions: • You are employed by EDS or one of its subsidiaries or other affiliates as designated by the appropriate committee of the EDS Board of Directors to participate in the EDS Short Term Disability Policy. • You are employed in the United States. Who is an active employee? You are an Active Employee if you: • Are an Eligible Employee working full-time for the employer doing all the material duties of your occupation at: (i) your usual place of business; or (ii) some other location that your employer's business requires you to be • Are a citizen or legal resident of the United States or Canada, receiving U.S. benefits and on U.S. payroll • Are not a temporary or seasonal employee ~'-- You will be deemed an Active Employee if: • You meet the above conditions; and • You are absent from work solely due to vacation days, holidays, scheduled days off, or approved leaves of absence not due to Disability, an educational leave of absence, or a personal leave of absence. What determines if 1 am disabled under short-term disability? You are considered "Disabled° if, solely because of injury or sickness, you are: receiving Appropriate Care and Treatment from a Medical Provider on a continuing basis; and, • Are unable to earn more than 80 percent of your covered earnings from working in your Regular Occupation; and • Are unable to perform all the material duties of his or her Regular Occupation CIGNA AbilityRetums will require proof of continued disability. "Appropriate Care and Treatment" means the determination of an accurate and medically supported diagnosis of the employee's disability by a Medical Provider, or a plan established by a Medical Provider of ongoing medical treatment and care of the disability that conforms to generally accepted medical standards, including frequency of treatment and care. <136> J f 2006 U.S. Benefits Handbook "Regular Occupation" means the occupation the employee routinely performs at the time the Disability begins. In evaluating the Disability, CIGNA AbilityRetums will consider the duties of the occupation as it is normally performed in the general labor market in the national economy. It is not work tasks that are performed for a specific employer or at a specific location. "Medical Provider" means a person who: (i) is legally licensed to practice medicine; and (ii) is not related to you. A licensed medical practitioner will be considered a Medical Provider: • If applicable state law requires that such practitioners be recognized for the purposes of certification of disability; and, • The care and treatment provided by the practitioner is within the scope of his or her license Absences eligible for STD benefits are those that last more than seven consecutive calendar days. Your inability to work must be a direct result of your Disability. The STD Policy does not cover any condition that results from or is caused by or contributed to by: • War, insurrection, or rebellion • Active participation in a riot • Intentionally self-inflicted injuries or attempted suicide • Elective and/or cosmetic surgery that is not medically required to improve health (except where mandated by state or federal law) • Committing a felony Maternity Leave EDS allows employees to work until their expected due date. An additional two weeks off prior to the expelled due date is available and is considered part of the disability period. However, if any or all of this time is not used, the unused time may not be added to the end of the maternity leave. EDS recognizes employees have six weeks to recover after delivery, except in the case of a Cesarean section birth, in which case employees would receive eight weeks to recover. If additional time offis needed beyond the EDS guidelines due to medical reasons, a doctor's certification is required. Maternity leave is considered the same as Short Term Disability and, as such, receives the same consideration for salary continuation as other illnesses and injuries. Holiday days do not apply and will not be reimbursed retroactively if the employee has requested or is away from work due to a FMLA or Short Term Disability (STD) leave. Maternity leave is courned toward your eligible FMLA entitlement. Certain states may provide additional FMLA leave benefits. Employees eligible for FMLA may take time for bonding purposes beyond the disability period. Time taken away for bonding is not eligible for Short Term Disability benefits. Please also refer to the EDS "Parental Leave" section for information about additional time off allowed for new births. Please contact your HR representative for additional information. What is the EDS policy regarding maternity leave and taking off two weeks prior to your due date? My understanding is that I can take off two weeks prior to the expected due date as part of my Short Tenm Disability benefits. Is this correct? EDS considers the two weeks prior to the estimated due date part ofthe employee's Short Term Disability and Family & Medical Leave Act (FMLA) entitlement. Paid Time Off (PTO) is taken at the employee's discretion for hourly employees only. Salaried employees will have their salary continued as part of the salary continuation. If an employee chooses not to take this time off prior to the baby's birth, this time may not be added to the end of the maternity leave. Employees will receive six weeks paid Short Term Disability for recovery from a normal delivery or eight weeks Short Term Disability for a delivery via Cesarean section. Female employees with two or more years of service, will receive two weeks of paid Parental Leave. Here are two examples of time allowed for a new birth by a salaried, female employee with two or more years of service: 2 weeks prior to due date paid Short Term Disability leave, if taken 6 weeks paid Short Term Disability for a normal delivery 2 weeks paid Parental Leave 10 weeks total leave OR 2 weeks prior to due date paid Short Term Disability leave, if taken 8 weeks paid Short Term Disability for a delivery via Cesarean section 2 weeks paid Parental Leave 12 weeks total leave < 137 > 2006 U.S. Benefits Handbook Here is an example of time allowed for a new birth by an hourly, female employee with two or more years of service: 2 weeks prior to due date (this includes the 7 calendar-day waiting period during which the employee could use available PTO) 6 weeks paid Short Term Disability for a normal delivery 2 weeks paid Parental Leave 10 weeks total leave Who qualifies as a legitimate Medical Provider? For you to receive STD benefits, your Medical Provider must be a person who is legally licensed to practice medicine and is not related to you. A licensed medical practitioner will also be considered a Medical Provider if (1) the practitioner is recognized and authorized by applicable state law or regulations for the purposes of certification of disability; and (2) the care and treatment provided by the practitioner is within the scope of his/her license. Note: Depending upon the actual length of service and whether you are hourly or salaried, Short-Term Disability benefits may be paid at either 100 percent or 60 percent. Please refer to Benefit Payable section of the Short-Term Disability Wcb site. What does "Appropriate Care and Treatment" mean? Appropriate Care and Treatment° means the determination of an accurate and medically supported diagnosis of the employee's disability by a medical provider, or a plan established by a Employees with at least 12 months of service and 1,250 service medical provider of ongoing medical treatment and care of the hours may be eligible for a maximum of 12 weeks of unpaid leave within a rolling backward 12-month period under FMIA The time off associated with Short Term Disability benefits and the new Parental Leave runs concurrently with FMLA. For more information on FM1J1, please refer to the FMIA Web site. Questions & Answers What is the "elimination period?" The "elimination period" is the minimum length of time in which you must be disabled to qualify for STD benefits. It begins on the first day you become unable to work and lasts up to a maximum of seven consecutive calendar days. During this time, STD benefits are not payable. You must complete the elimination period and meet all other eligibility criteria before you are able to receive STD benefits. Can PTO hours be used to supplement my income while 1 am on STD? If you are an hourly employee eligible for PTO, PTO can be used to replace your income during the seven calendar day unpaid elimination period. Once an STD claim is approved, you may not use any remaining PTO hours until you have returned to work. PTO may not be used to replace the 40 percent differential between STD benefits and an hourly employee's regular hourly wages. disability that conforms to generally accepted medical standards, including frequency of treatment and care. What if I return to work and then have a relapse of the same condition? If you return to work and experience a relapse of the same medical condition for which you were already receiving STD benefits prior to working 30 continuous days, the seven calendar days elimination period will not apply and you again become eligible for STD benefits for up to the maximum 26- week period for that Disability. If your relapse occurs after working 30 continuous days you will be filing a new claim. What if CIGNA determines that I am able to return to full time work, but I do not return to work, and I have a relapse of the same condition? If you do not return to work upon CIGNAs determination that you are able to return to work full-time, then your STD benefits are denied, and your leave becomes unpaid. If you have a relapse ofthe same condition within 30 days, the claim will remain denied. Note: The 30 day timeframe begins on the day CIGNA determines you were able to return to work. Upon returning from an unpaid disability leave of absence, when am I eligible for STD benefits? You will be eligible for STD benefits after you have returned to work for 30 continuous days. <138> 2006 U.S. Benefits Handbook What if I am out of work receiving STD benefits, and develop a new and distinct condition? If a new qualifying condition occurs while you are currently receiving STD benefits, the condition will be treated as part of the same period of Disability for purposes of benefit coverage. STD benefits will continue for the duration of the approved STD absence or until the maximum benefit duration of 26 weeks occurs, whichever is earlier. However, once you have returned to work for one full day, any new and distinct condition that occurs after retuming to work will be treated as a separate event when determining STD eligibility, and you may qualify for benefits of up to a maximum of 26 weeks for the new Disability. In this event, a new seven calendar day elimination period will apply. Can my STD benefits be reduced? Subject to applicable laws, your STD benefits amount will be reduced by any recovery of disability income from athird-party payer, or benefits from Social Security or a state disability plan or workers' compensation Indemnity payments. If you recover lost wages from athird-party payer or receive benefits from Social Security or a state disability plan, and EDS STD benefits are/were paid, you must repay EDS the lesser of the disability income recovered or benefits received or the EDS STD benefit that was paid based on the schedule of benefits for your employment type, (hourly or salaried). Additionally, if you are in a state that provides a disability benefit, we will assume that you have applied for the state disability benefit. If your claim for EDS STD benefits is approved, we will assume you are receiving the state disability payment, and your EDS STD benefit will be reduced to the appropriate amount or stopped, In this case, you will be billed directly for your other EDS benefits. Will I be able to file a STD claim if my Medical Provider refuses to complete the required forms? It is the employee's responsibility to submit the necessary documentation to CIGNA AbilityRetums for claim eligibility. Therefore, a refusal by a medical provider to complete necessary documentation could result in a denial of benefit coverage. If my Medical Provider charges a fee for completion of the Disability forms, am I responsible for the fee? Yes. Any fees associated with the completion of Disability claim forms are the employee's responsibility. If, in the opinion of my Medical Provider or an EDS- selected Medical Provider, I am able to return to work, what impact will this have on my STD benefits? If a Medical Provider finds you are capable of retuming to work in either a full or modified-duty capacity, and you refuse to return to work, your benefits and wages could be terminated or stopped, and you may be subject to disciplinary action up to and including separation from EDS. In addition, you may have to pay any wage overpayments that you received while you were out on unpaid or denied STD leave. If 1 return to work under restricted duty at the direction of a Medicat Provider, how is my pay affected? You will receive your regular compensation for all hours worked while on modified duty. Additionally, you could be entitled to STD benefits for the hours in which you are unable to work. If my position changes from an hourly position to salaried position, how are my STD benefits affected? If your position changes from an hourly position to a salaried position or vice versa, you will become eligible to receive the STD benefits based on your status the day your STD benefit began. If I have a pre-existing condition, can I file a STD claim? Yes. There are nopre-existing condition limitations applicable for short-term disability benefits. However, you must satisfy all STD benefit eligibility requirements. If i do not agree with my Medical Provider's prescribed treatment, will I be penalized for not following the treatment plan? If your inability to return to work is due to lack of compliance with your Medical Provider's treatment plan, your STD benefits could be denied or terminated. Therefore, if your STD claim is denied, you will be placed on an unpaid leave. How are payroll deductions for my other benefit elections handled if I am receiving STD benefits? Your payroll deductions will continue for your elected Flexible Benefits programs. However, if your Flexible Benefits premiums and/or deductions exceed your STD benefit amount, you will be billed for the difference. (Note: A "family-related" qualifying event is needed to change elections for EDS Flexible Benefit plan purposes.) Deductions will also continue for other programs in which you may participate, for example, the EDS Employee Stock Purchase Plan and the EDS 401(k) Plan. (Note: These plans may allow changes at any time). If your deductions for these plans exceed your pay, no deduction will be made. < 139 > 2006 U.S. Benefits Handbook What if I separate from EDS? If you separate from EDS, your eligibility to receive STD benefits will cease on your last day of employment. I am a salaried employee and was hired on September 1,1996. When will I receive 16 weeks of STD pay at 100 percent and when will I receive the full 26 weeks of STD pay at 100 percent? When do I appeal? If your STD claim has been denied and you disagree with CIGNA's decision, you will have 15 days from the date of the decision letter to submit your written -via letter or.e-mail - request for appeal. This request must contain your written request that CIGNA review your appeal and the medical documentation that supports your claim for disability benefits. You will be eligible to receive up to 16 weeks of STD benefits at What does CIGNA consider an appeal? 100 percent as of September 1,1999, and 100 percent of pay for up to 26 weeks of a Disability as of September 1, 2002. If I initially receive STD benefits and it is determined my claim is denied, am I required to reimburse this pay? You are required to reimburse any overpayment of STD benefits. This is detailed in the reimbursement agreement that requires your signature during claim filing. What does medically approved absences mean? CIGNA will review all medical documentation upon receipt. If the medical documentation supports disability as defined in the plan, your STD benefits will be approved and you will be considered on a "medically approved absence." What does CIGNA consider appropriate medical documentation/proof of a disability? In order to determine if you meet the definition of disability, it will be necessary to submit medical documentation to support your claim for benefits. This information may include but is not limited to: physician's office notes, hospital records, consultation reports, test result reports, therapy notes, physical and/or mental limitations (i.e., Functional Capacities Testing), treatment history including a list of prescribed drugs along with their dosages and frequency. If you are seeing more than one physican, it may be necessary to submit the above information from all physicans. A note from your physician is not sufficient and will not be considered as evidence of disability. What if my doctor indicates I cannot work, but CIGNA denies my claim? A note from your physician is not sufficient and will not be considered as evidence of disability. CIGNA will require appropriate medical documentation from your doctor to support their opinion that you need to be off work for a certain time period. EDS may require a written release from your If your claim is denied, you must send a written request to CIGNA for an appeal. With the written request, please submit medical documentation as described above. Please note the documentation must cover from your date of disability tothe / denial date forward. How many appeals am I allowed? Under the EDS Plan, CIGNA will consider one appeal. Therefore, it is important to submit all medical documentation for review with your written request for an appeal. How will I receive my disability payments? When your claim is submitted, EDS will continue to pay your salary until a disability decision is made by CIGNA. If your claim is approved, you will receive your benefits through your normal payroll cycle. Please note, in order to receive benefits, you must remain disabled as defined in the Plan. Although EDS continues your pay while CIGNA is conducting a medical investigation, this does not imply you are disabled or are an active employee. What happens to my pay if my Short-Term Disability is denied? If your short-term disability claim is denied, you will no longer receive a payroll check from EDS. Can I substitute vacation pay for my STD benefits if my claim is denied? With your manager's approval, you can substitute vacation pay for disability benefits and wages. However, it is important to note, this impacts your eligibility for benefits if you become disabled again. The definition of an active employee indicates if you are absent from work due to your own disability, you will not be considered an active employee. You must be an alive employee in order to be eligible for disability benefits. doctor before you can return to work. <140> 2006 U.S. Benefits Handbook Long-Term Disability You may be eligible for LTD that may provide income replacement protection to you after STD benefits due to Disability have been exhausted. Basic LTD coverage is provided to you at no cost and provides 60 percent income replacement (before taxes). You may also elect to purchase supplemental LTD coverage. Who is eligible to participate? You are eligible for tongTerm Disability benefit coverage if you meet all of the following conditions: • You are employed by EDS or one of its subsidiaries or other affiliates as designated by the appropriate committee of the EDS Board of Directors to participate in the EDS LongTerm Disability Policy. • You are afull-time, active employee and are regularly scheduled to work at least 30 hours or more each workweek (temporary workers, contract laborers and seasonal employ- ees are not eligible). • You have completed at least 60 days of alive continuous employment or reemployment in the case of rehired employees. • You are employed in the United States. When short-term disability benefits have ended, if you are unable to or do not return to work, you maybe separated. This may occur regardless of whether you are eligible or approved for tong Term Disability benefits. Who is an active employee? You are an Active Employee if you: • Are an Eligible Employee working for the employer doing all the material duties of your occupation at: (i) your usual place of business; or (ii) some other location that your employer's business requires you to be • Are a citizen or legal resident of the United States or Canada • Are not a temporary or seasonal employee You will be deemed an Active Employee if: You are considered "Disabled" under the tTD plan if, solely because of injury or sickness, you are: Receiving Appropriate Care and Treatment from a Medical Provider on a continuing basis; and -during your elimination period and the next 24month period you are unable to eam more than 80 percent of your covered eamings from working in your Regular Occupation; and - are unable to perform all the material duties of his or her Regular Occupation. After the first 24 months on LTD you are considered "Disabled" under the LTD plan if, solely because of injury or sickness, you are: • Receiving Appropriate Care and Treatment from a Medical Provider on a continuing basis; and - you are unable to eam more than 60 percent of your covered eamings from working in your Regular Occupation; and - are unable to perform all the material duties of his or her Regular Occupation. CIGNA AbilityRetums will require proof of continued disability. "Appropriate Care and Treatment" means the determination of an accurate and medically supported diagnosis ofthe employee's disability by a Medical Provider, or a plan established by a Medical Provider of ongoing medical treatment and care of the disability that conforms to generally accepted medical standards, including frequency of treatment and care. "Regular Occupation" means the occupation the employee routinely performs at the time the Disability begins. In evaluating the Disability, CIGNA AbilityReturns will consider the duties of the occupation as it is normally performed in the general labor market in the national economy. It is not work tasks that are performed for a specific employer or at a specific location. "Medical Provider" means a person who: (i) is legally licensed to practice medicine; and (ii) is not related to you. A licensed medical practitioner will be considered a Medical Provider: • You meet the above conditions; and • You are absent from work solely due to vacation days, holidays, scheduled days off or approved leaves of absence not due to Disability or a personal or educational leave of absence. If approved, LTD benefits begin the later of 180 days, or the end of the STD benefit period. If applicable state law requires that such practitioners be recognized for the purposes of certification of disability; and, The care and treatment provided by the practitioner is within the scope of his or her license. <141> 2006 U.S. Benefits Handbook Who is eligible for supplemental LTD coverage? You are eligible if you meet the eligibility requirements for the basic LTD benefit and you are actively at work on your effective date of coverage after 60 days of active continuous employment. If you enroll for supplemental tTD coverage but are not actively at work on the effective date of coverage, your coverage begins the day after you complete one full day of alive work. How do I apply for LTD benefits? If you are out on disability through the integrated disability program, your claim will be automatically evaluated fortTD eligibility if you are disabled for more than three months. Failure to return the application materials may affect your ability to receive tTD benefits. In addition to completing the forms, you must also obtain a physician's statement that provides your medical condition, including documentation such as test results, office notes and treatment plans. All completed forms and supporting documentation must be sent to Cigna AbilityRetums, as outlined in your packet. Basic LTD Benefits If you qualify for basic LTD coverage, you may receive 60 percent of your total pay to a maximum monthly benefit of $3,000 before applicable taxes. For example, if your total pay is $48,000, you would receive $2,400 per month of income replacement: $48,000 total annual pay =12 months = $4,000 monthly pay $4,000 x 60% _ $2,400 monthly benefit The LongTerm Disability (LTD) benefit is calculated during each annual enrollment period and is effective the following plan year from January 1 through December 31. This benefit is based on your "total pay." The total pay calculation is composed of a salary as of a point in time, (July 1 of the year prior to the effective plan year) and bonuses and commissions received over aone-year period (July 1 of the year prior to the effective plan year back to the preceding July 2). For example, an employee who has a date of Disability that occurs on any date during the year 2003, the LTD benefit will be calculated as follows: Your salary as of July 1, 2002, plus Any bonuses and commissions received from July 2, 2001, to July 1, 2002. If approved for benefits, you will receive a disability check once a month for as long as you are eligible for benefits. This benefit is reduced by applicable federal, state, local taxes and other entitlements (e.g., Social Security, Workers' Compensation, etc.). The same reductions, exclusions, limitations, definitions and requirements that apply to basic LTD coverage also apply to supplemental LTD. Any LTD benefits that are overpaid must be repaid as described in the LTD plan, Limitations & Exclusions Monthly benefits are limited to 24 months during your lifetime if you are Disabled due to a mental or nervous disorder or disease, unless your disease results from schizophrenia, bipolar disorder, dementia or organic brain disease. If you are Disabled due to alcohol, drug or substance abuse or dependency, monthly benefits are limited to one period of Disability during your lifetime. Income benefits are paid for up to 24 months while you participate in a rehabilitative program recommended and approved by a Medical Provider. tTD benefits are not paid if your Disability results from: • Intentionally self-inflicted injuries or attempted suicide • War, insurrection or rebellion • Active participation in a riot • Committing a felony Certificates of Insurance A Certificate of Insurance for tongTerm Disability Insurance for the employees of Electronic Data Systems Corporation is available upon request. This information is intended to be a summary of the Certificate that provides a detailed description of your benefits under the LTD Plan in effect as of January 1,1998. The Certificate will be furnished within 30 days after receiving a written request for the Certificate of Insurance for Long Term Disability Insurance. Send requests to EDS Disability Services, 5400 Legacy Drive, H3-1C-53, Plano, TX 75024. Questions & Answers What about pre-existing conditions? LTD benefits will not be available for any Disability due to a pre-existing condition until you have been an active employee under this plan for 12 consecutive months. Apre-existing condition is a Disability for which you, in the three months before your date of coverage, received medical treatments, consultation, care or services, took prescription medications or had medications prescribed. Pre-existing condition rules also apply to any supplemental increase in coverage. < 142 > 2006 U.S. Benefits Handbook What happens to my medical, dental and life benefits? While receiving LTD benefits, you and your dependents may continue health and dental benefits on an after-tax basis for 30 months from the first day of your disability. Life insurance may be continued for the duration of the disability. You will be billed each month for these premiums. Premiums are due to be paid by the first of each month. If the premium is not received by the first of the following month, coverage will be canceled. If you wish to lower your health, dental or life insurance coverage, you may do so within 31 days of being approved for tTD benefits. You may not increase your employee life insurance once you receive approval for LTD benefits. Your medical and dental coverage will continue if you remain "totally disabled" under the terms of the LTD plan and if you have applied for and been denied Medicare coverage. Coverage is subject to the contribution requirements of the EDS Health Benefit Plan. Employee coverage ends when you become eligible for Medicare. Dependents who want to continue coverage must: • Have been enrolled in the plan when you became totally Disabled • Be continually enrolled in the plan for at least 30 consecutive months since your disability occurred • Have no other group insurance available Once you are approved for Social Security disability benefits, you may be Medicare-eligible 24 months from that date. Contact the Social Security Administration department at least two months prior to the date your health benefits will end and enroll. This should ensure a smooth transition for your health insurance benefit. If you or your dependents have other coverage, continuation of EDS coverage after 30 months is available only for existing conditions that are limited to or excluded by your other coverage. Your monthly benefit, including your rehabilitation incentive (below) when applicable • The amount of your eamings for working while Disabled The combined sum will never exceed 100 percent of your pre- disabilityeamings. After the first 24 months of LTD benefits, your monthly benefit will be reduced by 50 percent of your eamings from working while Disabled. Upon request, you must provide CIGNA AbilityRetums any evidence needed to verify eamings. What is the rehabilitation incentive? While Disabled, your monthly benefit is increased by 10 percent when you participate in a rehabilitation program approved by CIGNA AbilityRetums. This rehabilitation incentive will begin if you: • Retum to active employment on either apart-time orfull-time basis to enable you to resume gainful employment or service in an occupation for which you are reasonably qualified taking into account your training, education, experience and past eamings; or • Participate in vocational training or physical therapy deemed appropriate by a rehabilitation coordinator from the CIGNA AbilityRetums team. During the first 24 months of LTD benefits, when you work or participate in a rehabilitation program approved by CIGNA AbilityRetums, you may also be reimbursed for eligible family care expenses that you incur when participating in a rehabilitation program (up to $250 for each family member living with you as part of your household and chiefly dependent on you for support). Family expenses include child cam by licensed facilities or qualified providers for eligible family members under age 13 and care for an eligible family member who, as a result of a mental or physical impairment, is incapable of caring for himself or herself. Employees on tTD who have opted out of EDS medical, dental or life insurance will not receive the benefit dollar associated with those plans. Can I still make 4O1(k) contributions? No, you are ineligible to contribute to the EDS 401(k) Plan or Employee Stock Purchase Plan while on LTD. What happens to my LTD benefits if I work at EDS or at another company while Disabled? If you work while Disabled, you will receive the sum of the following amounts: Eligible family care expenses do not include services provided by a member of your immediate family, services provided by anyone living in your residence or expenses for which you are eligible for reimbursement under any other group plan or from any other source. Will my LTD benefits (basic and supplemental) be reduced by other income benefits? Your monthly LTD benefit will be reduced by: • The amount of Social Security disability income you and your dependents are awarded. Under the tTD plan, federal cost-of-living adjustments to your Social Security disability award will not further reduce your tTD benefit payments. <143> 2006 U.S. Benefits Handbook • The amount of any disability income provided or available from any employer's pension plan • The amount of any disability income provided by any group disability income or health insurance plan, if EDS makes contributions or payroll deductions to the plan • The amount of any disability and/or retirement income you receive, attributable to EDS' contributions to the EDS Retirement Plan • The basic reparations portion for loss of income of a law providing for payments without determining fault in connection with automobile accidents; supplemental disability benefits you buy under a no-fault auto law will not be counted • The amount of disability income provided by any compulsory benefit act or law and/or any sick pay/salary continuation, other than vacation pay, paid to you by EDS • The amount of any disability income provided by any Workers' Compensation, Occupational Disease, Maritime Maintenance & Cure, Unemployment Insurance and similar law/program • The amount of recovery you receive for loss of income as a result of claims against a third party by judgment, settlement or otherwise You are guaranteed a $100 minimum monthly payment from the LTD Plan, regardless of other income benefits. Wili my LTD benefits be taxed? LTD benefit payments are not subject to Social Security or Medicare taxes. However, the LTD basic benefit payments are subject to federal income tax and any applicable state income and city taxes. The supplemental LTD benefit payment is not subject to federal income tax or any applicable state or city taxes for claims with a date of disability of January 1, 2003, or later. This is because the premiums were paid with post-tax dollars beginning January 1, 2003. What is the LTD survivor benefit payment? If you die while you are receiving income benefit payments under this plan, an eligible survivor may be entitled to receive a lump-sum survivor's benefit. This payment is equal to three times your monthly LTD income benefit, before reductions for other income benefits. The amount of survivor's benefits payable is reduced by any overpayments that may have occurred. An eligible survivor is one of the following: • Our surviving spouse If there is no surviving spouse, your unmarried children or your spouse's unmarried children under age 25. The term children also includes adopted children and children placed for adoption until legal adoption. Payment will be divided into equal shares among eligible children. Survivor's benefits will be paid to your eligible survivor on the date one month after the last monthly benefit payment was made before your death. However, if there is no eligible survivor on the date payment is due to be paid, no payment will be made. Payment to a minor child may be made to an adult who submits proof satisfactory to us that he or she has assumed custody and support of the child. What if I separate from EDS? When you separate from EDS, you maybe eligible to buy a conversion policy for your LTD coverage if you have been an alive employee under this plan for 12 consecutive months prior to the date your employment ends, for reasons other than retirement. Contact EDS Disability Services at 1 972 605 7335. You will then need to complete the conversion application and pay the first premium for the Long Term Disability conversion plan within 31 days after your coverage under this plan ends. Evidence of insurability is not required. Supplemental LTD Benefits You may buy additional income replacement coverage through supplemental LTD benefits. The cost of this supplemental coverage is based on the option you choose and your total pay. Monthly premiums are paid on apost-tax basis. You may enroll for supplemental LTD coverage within 31 days of your start date or during the annual EDS Flexible Benefits open enrollment. If you make less than $60,000 in total pay, you may purchase supplemental LTD coverage that will bring your total income protection level up to 70 percent. If you make more than $60,000 in total pay, you have the option of purchasing supplemental tTD coverage that will bring you up to the 60 percent income protection level. The 60 percent option is made available because the maximum monthly benefit for the Basic LTD Plan is $3,000. if you make more than $60,000, your monthly benefit would exceed that maximum. Therefore, this option allows you to receive 60 percent income replacement beyond the company-paid limit. <144> Case 1:06-cv-02222-CCC Document 16-2 Filed 05/02/2007 Page 14 of 23 CLAIM CONSULTING AGREEMENT Advice to Pay -Certification of Disability and Benefet Calculation No. SHD-985005 Between: ELECTRONIC DATA SYSTEMS CORPORATION Plano, Texas ("Employer"} And: LIFE INSURANCE COMPANY OF NORTH AMERICA Philadelphia, Pennsylvania {"Consultant") Effective: January 1, 2004 WHEREAS, Employer sponsors aself-funded salary continuance payroll practice (the "Plan") for its employees; and WHEREAS, Consultant is qualified and experienced as an administrator of benefits under plans similar to the Plan; and WHEREAS, Employer desires to retain Consultant to provide the services specified herein for the proper administration ofthe Plan; IN CONSIDERATION OF the mutual promises herein contained, the parties agree as follows Section 1. The Plan. As used in this Agreement, "Plan" refers to the salary continuance payroll practice provided by Employer to its employees, together with any modifications to the Plan made in accordance with this Section. A copy of the Plan as existing on the effective date of this Agreement is included as Schedule C. Employer warrants that it has provided eligible employees with a complete and accurate description of the benefits provided by the Plan. Employer reserves the right to modify, amend, or terminate the Plan. Employer agrees to notify Consultant in writing of any such modification, amendment or termination, or of any acquisition, divestiture, merger or other corporate reorganization which may affect employee eligibility. Implementation of any of the foregoing shall be mutually agreed upon by the Employer and Consultant, subject to data processing systems changes, retroactive effective dates, adjustments in Consultant's compensation, and other adjustments and procedure changes made necessary thereby. • . Case 1:06-cv-02222-CCC Document 16-~ Filed 05/02/2007 Page 15 of 23 Consultant is entitled to rely on the teens of the Plan as set forth in Schedule C and shalt not be responsible for administering any changes in the Plan until 34 days after receipt of written notice of such changes, and after any adjushnents described in the preceding paragraph have been agreed upon. Section 2. Performance of Services. Consultant agrees to furnish the services specified in Schedule A in connection with the PIan. These services may be modified upon agreement of the parties. Any such modification (and the revised administration charge, if any, applicable thereto) shall be evidenced by letter agreement between the parties which, upon execution, shall become a part ofthis Agreement. Employer shall remain responsible for performance of all services in connection with the Plan other than those provided for in this Agreement. Without limiting the generality of the foregoing, this shall include all activities relating to the enrollment of eligible employees, maintenance of eligibility and enrollment records and salary information, furnishing such information to Consultant when necessary for the determination of any claim for benefits under the Pian, calculating benefits payab}e, issuing benefit payment checks, notifying employees of approval. or denial of the claim and handling routine inquiries from employees; as well as any other duties and responsibilities reserved to the Employer in Schedule A. Section 3. Consultant's Compensation. In return for the performance of the specified services, Employer agrees to pay Consultant the fees set forth in Schedule B on a monthly basis. In addition, Employer shall reimbwse Consultant for any expenses or liabilities provided for in Section 6 of this agreement which are incurred by Consultant. Consultant shall bill Employer monthly at a single location or at multiple locations as requested by Employer and invoices shall specify fees charged for covered employees at each location as requested by Employer and as agreed to by Consultant. Employer shall provide 30 days notice of any change that would affect the billing of multiple locations. Payment of fees shall be due on the I Sa' of the month following the month to which the fees relate. Fees not paid within 30 days of the due date will be assessed a late charge at the rate of 13% per annum. Employer shall remain liable for all fees billed to separate locations. The fees set forth in Schedule B shall be subject to change as provided for in Sections 1 and 2 of this Agreement. In addition, Consultant shall have the right to revise the schedule of fees at the end of the initial term of this Agreement, or at any time thereafter, by giving Employer not less than 90 days prior written notice. Further, Consultant shall have the right to review and revise the schedule of fees if the covered employee population change +/- 10% due to expansion or reduction, acquisitions, divestitures, new business ventures, etc. Section 4. Term of the Agreement. This Agreement shall be effective for an initial term of 12 months commencing with the effective date shown above. This Agreement shall thereafter automatically continue, until terminated as provided for herein. -2- Case 1:06-cv-02222-CCC Document ,16-2 • Filed 05/02/2007 Page 16 of 23 Either party may terminate this Agreement as of the end ofthe initial term, or at any time thereafter, by giving the other party at least 90 days advance written notice. This Agreement shall automatically terminate upon the termination ofthe Plan or upon the effective date of any statute, regulation, or court decision which would prohibit the activities of the parties under this Agreement. Consultant may terminate this Agreement immediately, upon written notice to Employer, in the event Employer fails to pay the fees and, if applicable, charges as provided in Section 3 within the time specified, or otherwise breaches any provision of this Agreemen#. Any such notice shall state with particularity the reasons therefor, and shall not be effective unless Employer shall fail within 30 days to pay the fees due or initiate and pursue the cure of any other breach, and to resolve the breach to Consultant's reasonable satisfaction within 90 days of such notice. Employer may terminate this Agreement at any time, following written notice to Consultant, in the event Consultant fails to perform the services required under this Agreement in a manner reasonably satisfactory to Employer, or otherwise breaches any provision of this Agreement. Any such notice shalt state with particularity the reasons therefor, and shall not be effective unless Consultant shall fait within 30 days to initiate and pursue the removal of such grounds to the reasonable satisfaction of Employer. This Agreement may be terminated as of any other date that is mutually agreed upon by the parties. Upon termination of this Agreement for any reason, Consultant shall cease the processing of all Plan claims then in its possession, and shall make all records relating to claims in process reasonably available to the Employer. Section 5. Service Staadards• Liability Consultant shall use ordinary and reasonable care in the performance of its duties, but shall not be liable to the Employer for mistakes of judgment or other actions taken in good faith. Consultant agrees to indemnify and hold harmless Employer, and its parents, affiliates, directors, officers and employees (excluding employees who bring litigation described herein) ("Indemnitees") from and against all claims, liabilities, losses, damages and expenses, including court costs and reasonable attorneys' fees, but excluding costs described in Section 6 of this Agreement, incurred by Indemnitee solely as the result of litigation undertaken by an employee of Employer against Indemnitee seeking redress for alleged improper determination, denial or termination of benefit payments hereunder, where Employer, acting solety on direction provided by Consultant, denies or terminates such benefit payments. This obligation to indemnify and hold harmless shall not arise with regard to claims, liabilities, losses, damages and expenses which do not arise directly and solely as a result of the negligent act or omission, criminal actor willful misconduct of Consultant. This obligation shall apply only with respect to claims denied or terminated an or before December 3 t, 2006. -3- , . . Case 1:06-cv-02222-CCC Document 18-~ Filed 05/02/2007 Page 17 of 23 Section 6. Liability for Benefits. Expenses and Taxes This is not a contract of insurance and Consultant shall not underwrite any risk of the Plan. All liability for payment of claims made under the Plan shall rest with Employer. Consultant acts only as the provider of the services described in this Agreement and, with respect to Plan participants, acts only as the agent of the Employer. Except as otherwise expressly provided in this Agreement, all expenses and liabilities incident to the operation of the Plan shall be the Employer's responsibility. Without limiting the generality of the foregoing, Employer shall be responsible for: • Any state or federal tax, however denominated, including but not limited to premium taxes, taxes based on sales or gross receipts, and employment taxes, together with any penalties and interest, assessed on the basis of and/or measured by (i} the amount of Plan benefits; or (ii) the amount of Consultant's fees hereunder. • Any costs or expenses incurred by Consultant in obtaining medical records, attending physician statements, reports of insurance support organizations, medical or rehabilitation consultant reports, or any other item of expense incurred with respect to any particular claims for benefits under the Plan. • The defense of any legal action or proceeding to recover benefits under the Plan, and any legal liability arising in connection with any such action or proceeding (other than liability assumed by Consultant under Section 5 of this Agreement). This obligation shall survive the termination of this Agreement. To avoid misunderstanding by third parties concerning the respective duties and liabilities hereunder, the Employer agrees not to use Consultant's name or logotype in any release or printed forms without the prior written approval of Consultant. Section 7. Record Retention and Review. All documents relating to the determination of benefit claims shall be the property of the Employer subject to Consultant's right io possession and use during the continuation of this Agreement. Upon 30 days' advance written request and execution of any audit agreement, such documentation shall be made available to the Employer, at Employer's expense, for its auditor inspection during regular business hours at the places of business where it is maintained by Consultant. Upon termination of this Agreement, such documentation shall be returned to Employer. Any liability resulting from Employer's use or disclosure of such information or documentation shall be the sole responsibility of the Employer. Employer's property interest and right of access shall not extend to any claim data recorded for or otherwise integrated into Consultant's data processing systems during the ordinary course of business. Consultant shalt maintain such data records for the periods of time required by law and subject to the privacy and confidentiality requirements ofa11 applicable laws. -4- . ~ I Case 1:06-cv-02222-CCC Document 16-2 ,Filed 05/02/2007 Page 18 of 23 Section 8. General Provisions. a. This Agreement constitutes the entire contract between the parties and, subject to the provisions of Sections 1, 2 and 3, no modification or amendment hereto shall be valid unless in writing and signed by an officer of each of the parties. b. This Agreement shall be governed by, and shall be construed in accordance with the laws of the Commonwealth of Pennsylvania, without regard to its principles of conflict of laws. c. The failure of either party to insist upon strict adherence to any term of this Agreement shall not be considered a waiver or deprive that party of the right thereafter to insist upon strict adherence to that term of the Agreement. d. Consultant may, at any time, without prior notice to or approval from Employer, assign any or all of its rights or obligations under this Agreement to an affiliate of its choice. e. Neither Consultant nor any of its ofiicers, directors or employees shall be deemed to be an employee of Employer. Neither Emp}ayer nor any of its officers, directors or employees shall be deemed to be an employee of Consultant. The sale relationship of the parties is that of independent contractors. f. This is an agreement solely between Employer and Consultant. It shall not create any right or legal relation whatever between Consultant and any person other than the Employer, including, without limitation, any employee of Employer or any participant in the Plan. IN WITNESS WHEREOF, and intending to be legally bound, the parties have signed this Agreement. LIFE INSURANCE COMPANY OF NORTH AMERICA Date February 28, 2005 ' ; :..... tuegory Fi. iS-ollr:Pre~denc ELECTRONIC DATA SYSTEMS CORPORATION Date By: Title: -5- . , Case 1:06-cv-02222-CCC Document 16-2 Filed 05/02/2007 Page 19 of 23 SCHEDULE A DESCRIPTION OF ADMINISTRATIVE BENEFITS I. CLAIlVI ADMINISTRATION Basic Review of Claims Consultant will provide Employer with a supply of Consultant's standard disability claims forms, or Consultant will provide Employer with an electronic or telephonic means for collection of claim form information. Employer shall furnish Consultant's telephone number or claim forms to all employees who provide notice of claim. For paper claim form, Employer will complete the employer portion of the claim form and will forward completed claim forms to Consultant. fior electronic or telephonic claim form, Employer will provide employer information as requested by Consultant. Consultant will provide the initial and ongoing screening of claims to determine whether benefits are payable in accordance with the terms of the Plan. Where required, and at Employer's expense, Consultant will seek and obtain information from medical providers and others necessary to determine qualification for benefits and amount thereof. Consultant will review the expected claim duration against duration guidelines used by the claim office at the dme of the claim and deternnine the reasonable duration based on feedback from the claimant's attending physician, as appropriate. Consultant will advise Employer, with respect to each claim, as to whether, in Consultant's judgment, the claim is payable under the Plan. If payable, Consultant will advise Employer of the approved payment period and amount payable under the terms of the Plan. Employer shall be responsible for making the final decision with respect to all claims, for communicating such decisions and the amount payable to the claimants and Consultant, and for funding and issuing all benefit payments. In determining any person's right to benefits under the Plan, Consultant shall rely upon eligibility information furnished by the Employer. It is mutually understood that the effective performance of this Agreement by Consultant will require that it be advised on a timely basis by the Employer during the continuance of this Agreement of the identity of individuals eligible for benefits under the Plan. Such information shall identify the effective date of eligibility and the termination date of eligibility and shall be provided promptly to Consultant in a form and with such other information as may reasonably be required by Consultant for the proper administration of the Plan. Employer acknowledges that its prompt and complete furnishing of the required eligibility and income information is essential to the timely and efficient review by Consultant of claims for Plan benefits. Screening and Implementation for Rehabilitation and Social Security Benefits Consultant shall at appropriate times and intervals screen ail claims for rehabilitation potential and for potential entitlement for Social Security benefits. -b- Case 1:06-cv-02222-CCC Document 16-~ Rehabilitation Assistance Filed 05/02/2007 Page 20 of 23 Where Consultant determines that a claimant has the potential for successful rehabilitation and re- employment, Consultant shall develop and implement a rehabilitation program for the claimant. Social Security Appeal Assistance Where Consultant determines that a claimant potentially qualifies for Social Security disability benefits, Consultant will notify claimant, providing general information concerning filing far benefits and providing assistance with appeals if benefits are denied. Standards for Qnaiity Assurance Where required in Consultant's judgment, Consultant will consult with its in-house medical director and with other qualified professionals to determine whether a claimant is disabled and whether the claimant's disability is covered in accordance with the terms of the Plan and applicable laws. Consultant sha[l regularly audit a random sample of claims from Consultant's claim offices that are not dedicated to a specific account to assure that determination of disability has been proper, payment periods and benefit payments have been property calculated, and that Consultant's general standards for the proper and timely handling of claims have been followed. In the event Consultant finds that i# has advised that a benefit payment to any person be less than the amount to which he is entitled under the Plan, Consultant will promptly report the underpayment to Employer. In the event Consultant finds that it has advised an overpayment to any person entitled to benefits under the Plan, or advised payment of benefits to any person who is not entitled to them, Consultant shall promptly report the overpayment to Employer. Employer shall be responsible for recovering the overpayment Consultant shall not be required to initiate court proceedings to recover an overpayment. Handling of Inquiries. Complaints and Appeals Subject to Section 5. of the Agreement, Consultant shall have no duty or obligation to defend against any legal action or proceeding brought to recover a claim for Plan benefits. Consultant shall, however, make available to the Employer and its counsel, such evidence relevant to such action or proceeding as Consultant may have as a result of its administration of the contested benefit determination. -7- ', ~~ ~~/ ~aaar a tP g ln: Pah~ Mans . F_Iscbodra . M ta! Dfsaders. / Mwiiai~. Genera/RehsbiGtetlan Bruce E. Sia'1i8, M. D. BoaRO cERnF/ED: An-ericrn Bamd ~Physla~t Msat~i~ne a R.n~r~~°n '~IariaP. delosAnge%s, M.D. '~of°~0a`M~~ Arnricsri cord aPair, Are~a6otne Initial Evaluation Re: David P. Diehl June 7, 2006 DOB: 5/24149 York Neurosurgical Associates 2319 South George Street York, PA 17403 Dear Dr. Krzeminski, HPI: Thank you fot your referral. Mr. Diehl is a 58 year old gentleman with chronic low back Pain. ~ fen flow back sya~toms for > 6 months. Symptoms occurred somewhat spontaneously when he was standing, Pops in his low back_ Sinx that limo he's had excruciating low back pain limiting his ability to work. He works at hoar, but his job requires prolonged sitting and he's been unable to do that so far because of pain and if be takes pain medication he's too groggy to concentrate on the cmnputer. 'This work~up including CT scan of the pelvis, MRI of the lumbar spine, hmobar discogtam reveals huubar ~ disc disease. Facet i~edions wen not beneficial. He has not had physical therapy- I saw him in 2003, for diacogenic tow back pain, that resolved to a manageable level with an epidural steroid injection. He feels the pain has been getting worse gradually. The pain in the low back is constant bet intc~cntly severe with radiation into ~ 1~ and hoes. Pain is worse with standing, twisting, sitting and wal>ong. Pain levels are rated at 6. Activity level is cxtr+emely limited and he reports having to ~j pn ~ lie down on the sofa to get relief from his back pain. Mood is obviously very depressed. Sleep Pattern is Poor. Bahr ~~, sly revealed increased uptake at Ifl 5. Flexion extension x rays of the himbar spine are unremarkable for instabtlity, there is degenerative changes. Medication: Paxil 20 mg darly, allopurino1300 mg daily, colchicine 0.6 mg daily, loratadine 10 mg daily, Azmacort inhaler, propoxyphene 2 or 3 tablets a day, soma 2 or 3 tablets a day. Allergies: Penicillin Past Medical History: Gastroesophageal refhnc disease, Gout, obstructive sleep apnea, ncphmlithiasis ,occipital skull fracture 1966, left wrist fracture as a child, asthma. amnety and depression. Past Surgical History: IDET lumbaz spine 2003, left cataract extraction. 9/~~ ~D6 Faintly History: colon cancer, heart disease. Social History: Employed as a computer analyst, no tobacco use and no alcohol use, presently disabled in the process of applying for short term disability. ROS: Negative fever, skin rash, weight change, headache, bhmed vision, seiwres, chest pain, SOB, nausea, vomiting. diarrhea, constipation, stomach pain. liver disease, bowel income, bhuickr inccx, , positive lower limb and mmobness, positive low back stiffness, joie aching, negative swelling, Positive fatigue, spasm, cramping, Physical Ezam Height 5 foot 10 inches Weight 230 pounds 1'uLse 72 regular The patient is alert, oriented, and well nourished. Speech is clear and the face is symmetric. There is no skin rash. Pedal pulses are palpable. He is in a moderate amount of distress. 1881 Loucks Road 423 S. Wa~gton 57met Gsltysbag, PA 17325 Yak, PA 17408 (717) 339-099~D (717J 7s4-o843/o8ao FAx(7~7~ 7s4-1sn1 FAxn17~ ~s4-~sn1 E'iwerra vnagr ,_,_,~ CIGhA Group Insurance ~~225+'(Ire~hvill~Avenue Suite 1000 Dallas,lX 75243-9337 Phone: 800-352-0611 ex~ 5604 Fax: 860-731-3511 s ~e ii~^ ~. .~, ~e ~~ s~- l~~ ~= MR DAVID D1EHL 209 YORK ROAD YORI{, PA 17407 August 2, ZU06 Name: Employee ID: Plan/Policy Number: Plan/Policy Holder: Administered By: DEAR MR D1EHL, ,, ~ ~ .7 ~ DAVID DIEHL 01083961 SHD0985005 ELECTRONIC DATA SYSTEMS Life Insurance Company of North America CIGNA Group Insuran Life • Accident • Disability This letter is regarding your Short Term Disability (STD) claim. After completing our review of your claim, we are unable to continue paying benefits beyond July 7, 2006. your contract contains the following provision: "The employee is considered Disabled if, solely because of Injury or Sickrsess, he or she is: 1. Unable to perforyrt all Ilse mater~ia! duties of his or her Regular Occupation: and " Z. Unctbte to earn 80'/ or more of his or her Covered Earnings from working in his or her Regular Occupation. "Appropriate Care means the determination of an accurate and medically ~PPo~ diagnosis of the Employee's Disability by a PhJ~ician, or a plan established by a Physician of ongoing medical treatment and cxtre of the Disabilig- that conforms tv generally accepted medical standards, includingfrequency of treatment and care." "The occupation the Employee routinely performs at the time the Disability begins. In evaluating the Disability, we will consider the duties of the occupation as it is normally performed in the general labor market in the national economy. l is not r+~ork tasks that are performed for a specif c employer or at a spec f c location." We recently completed a review of the informmation on file. Specifically, this included: • Office visit notes from Dr. Maria delosAngeles dated June 16, 2006 • Office visit notes from Dr. Bruce Sicilia dated June 29, 2006 • Office visit notes from Dr. Diane Zimardo dated July 12, 2006 • Office visit notes from Dr. Ica Garonzik dated July 3, 2006 • Medical Request Form completed by Dr. Ira Garonzik dated July 24, 2006 Medical information reviewed provides no clinical basis to support any measured changes in your condition after your previously approved through date of July 7, 2006, or to provide measured functional deficits to a severity to preclude yt from performing the material duties of your occupation beginning July 8, 2006. Medical information was reviewed by the Claim Manager, Nursc Case Manager, and the Associate Medical Director and it was determined that information •CIGNK and'CIGNA Getup ka:uw~w•• ~ roy~laiad:arviu made and rdara,rarioue uaeuTxw auhs"af~iaa °~ gGNA Corpordioa Produeb and aani~ees "ie povidea by Mesa suhekfiarisa and net by CIGNA CeTnraUa2 These au6sidiadas inducts LYe k~sutanea Company of Nath Amedea• CIGNA LHa Ineuranea Company of Nair Yak. and Camseticut General ~ ~ ` n • ` . august 2, 2006 '` Page 2 received after the last approval date was inadequate in establishing clinical measurable deficits that support the limitations and restrictions of your off work status. The Associate Medical Director observed that there is no new s treatment plan outlined in any of the clinical documentation presented. Dr. Sicilia stated his scepticism regarding the a h sicians did ~~ option of surgery and recommended the contim~ation of conservative therapy. In addition, your treating p y not outline any return to work plan. .~.e ~~ At this time your claim has been closed and no further benefits are payable. ass: ~: You may request a review of this denial by writing to the attention of the representative signing this letter at: Life Insurance Company of Nortb America 12225 Greenville Ave. Saite 1000 Dallas, TX 75243 The written request for review must be sent within 15 days of the date of this letter and state the reasons why you feel your claim should not have been denied. Please inch~de anY medical evidence, which supports your contimrting disability. Medical evidence includes, but is not Limited to physician's office notes, hospital records, consultation report test result reports, therapy notes, Physical and/or mental limitations (ie. Functional Capacities Testing), treatment histo: including a list of prescnbed drugs along with their dosages, frequency and response, etc• These records should cover from duly 8, 2006 through the present. A note from your physician is not sufficient and will not be considered as evidence of disability. tCIGNA will not reach out to any of yoar physiciiana for additional information. If due tQ eztenmting circumstanes, yon are unable bu provide the medical docnmenhtion within 15 days, we mast be notified immediately. Please be advised that you are entitled to access of relevant documents, records, and other information that was used to make this determination. This information w~71 be supplied upon your request. Under normal circumstances, you will be notified of a decision on your appeal within 45 days of the daft your request for review is received. If there are special circumstances requiring delay, yon will be notified of the reason for delay within 30 days of receipt of your request, and every 30 days thereafter. A final decision will be made no later than 90 ~- Nothing contained in this letter should be tom'trued as a waiver of any rights or defenses under the policy. This determination has been made in good faith and without prejudice under the teams and conditions of the contract, whetht or not spocific~lly mentioned herein. Should yon have any information which would prove contrary to our findings, please submit it to us. We will be pleased to review any information yon may wish to submit. Please review your insurance booklet, certifiarte or coverage information available from your employer to determine if -~ you-are eligible feF-additional benefits: - -- - - --~- - - - - - - Your leader will discuss with you any reimbursement to I:DS for disability benefits that were over paid to you as a resu of the denial or closure of your claim. Your Short-Term Disability (STD) may also qualify as a FMLA leave under your company's Family Medical Leave Ac (FML.A) policy. You wdl receive additional information ender s~arate cover from our CIGNA Leave Solutions servic ceirter regarding your FMLA status. Please contact our office at 800-352-0611 ext. 5604 should you have any futher questions. sincerely, ~~~ or~~ Emeka Ohagi Disability Claim Manager ~ a r a t ~ ~ • • ~ r w ` • Karen L HIchols ~ 'r. ~ « « • Appeals Claim Manage. CIGNA Disability Management Solutions O~ \ ~ .~ a ~ VVV ~ i \\ CIGNA Group Insurance tibe . A«ident • Disebnity October 10, 2006 12225 Greeaville Ave DAVID DIEHL Ste. 1000 LB 179 209 YORK ROAD Dallas, TX 75243-9384 YORK PA 17407 Telephone 800-352-0611X1249 Faaimile 860-731-3211 Re: LOB Short Term Disability Policy #: SHD 985005 Policyholder. Electzonic Data Systems Administered by: Life Insurance Company of North America Dear Mr. Diehl: We have completed our review of your appeal for Short Term Disability benefits under the above captioned Plan. We must advise you that we aze affirming our previous denial of benefits dated August 2, 2006, (copy enclosed). Please refer to our letter for specific Plan provisions and details regazding your denial. The definition of disability under the above Plan is defined as follows: Under the EDS Short Term Disability Plan, the employee is considered Disabled if, solely because of Injury or Sickness, he or she is: 1. unable to perform all the material duties of his or her Regular Occupation; or 2. unable to eam 8096 or more of his or her Indexed Covered Earnings from working in his or her Regular Occupation. Regulaz Occupation: The occupation the Employee routinely performs at the time the Disability begins. In evaluating the Disability, the Insurance Company will rnnsider the duties of the occupation as it is normally performed in the general labor market in the national economy. It is not work tasks that are performed for a specific employer or at a specific location. For the purposes of this review we will determine whether or not you aze unable to function in your occupation after July 7, 2006, the last date you were paid benefits under the above group plan. The information on file indicates that your occupation is that of an Information Specialist. This occupation as it is performed in the national economy is sedentary in nature. The definition of sedentary work is as follows: Exerting up to 10 pounds of force occasionally (occasionally: activity or condition exists up to 1/3 of the time) and/or a negligible amount of force frequently (frequently: activity or condition exists from 1/3 to 2/3 of the time) to lift carry, push, pull, or otherwise move objects, including the human body. Sedentary work involves sitting most of the time, but may involve walking or 'CIGNA• and "CIGNA Group losrrtano:' arc registcrcd servim marks and refe* to vuious opwgng su6sfdiades of CIGNA ~w.44./ w...wrn. w.w.tALir .~A ww w.. I9rN • r ~n.w ...w.i.4..ar t...d...i. ~ as. 1...........~. r`........w....r wlw. ~ J+ -. October 10, 2006 Page 2 standing for brief periods of time. Jobs are sedentazy if walking and standing are required only occasionally and all other sedentary aiteria aze met. We based our decision to deny your claim for benefits on Plan language and all of the documents contained in your claim file, viewed as a whole. The additional medical information we received when you appealed, was records from Steven Triantafyllou, MD, Bruce Sicilia, MD, Ira Gazonzik, MD, and Physical Therapy records from Healthsouth. This additional information and the information already on rernrd were reviewed as part of the whole of your appeal. The information in your file indicates you stopped working May 11, 2006, because of your back condition and your disability claim was approved through July 7, 2006. Your disability claim was denied additional benefits as medical information did not support functional deficits to prevent you from performing your occupational duties. The new and existing medical information on file was reviewed by our Associate Medical Director. The results of that review indicated that the medical information does not support a functional impairment precluding your capacity to work. The records reviewed were l3MG/NCS dated June 16, 2006, noted as positive for mild lift lateral plantaz sensory neuropathy, but no radiculopathy, a May 25, 2006 note by Dr. Triantafyllou noted that you might be a candidate for dernmpression, however there is no current documentation of any significant physical, rngnitive or gsychological limitations andlor clinical infnrrnation to support a change in our prior assessment. Your exam showed that you were overweight, your have 4+/5 leg strength, significant loss of range of motion, not otherwise quantified, however, the Physical Therapy note of July 12, 2006 indicates that was your start date, but it does not contain measured lumbaz range of motion documentation. Dr. Garonzik the Neuro surgeon recommends no sitting for more than an hour at a time, however the July 3, 2,006 note he refer to documents full bilateral lower a mules strength and again does not document lumbar range of motion deficits. Finally the August 2, 2006, physiatrist note by Dr. Sicilia, indicates gait pattern is normal, moderately limited lumbaz range of motion, and normal muscle strength. There is no medical documentation on file to support significant findings that would preclude return to work after July 7, 2006. In conclusion our Associate Medical Director indicated that the review of the available information does not document any significant physical limitation and/or clinically measured functional deficits in the lumbaz area, such as measured range of motion deficits to support the recommended sitting restrictions that would preclude working at a sedentary level of function. Disability is determined by medically supported functional limitations/restrictions which preclude an inability to perform your occupation. We do not dispute you may have been somewhat limited or restricted due to your diagnosis as your claim was initially approved through June 9, 2006; however, we have not received sufficient clinical medical documentation to substantiate any limitations and restrictions to support an inability in ~. •. • . H ~ t~ h 1 ~ ~ • VERIFICATION ~ • w r t. h The undersigned verifies that the statements made in the foregoing instrument which aze within the personal knowledge of the undersigned, aze true and correct, and as to the facts based on the information of others, the undersigned, after diligent inquiry, believe them to be true. And further, this Verification is signed on the recommendation of my attorney, who advises me that the allegations and language in this document aze required legally to raise issues for resolution at trial, by the Court, or by continuing investigation and prepazation for trial. I understood that some of these allegations may prove inappropriate after investigation and trial prepazation are complete and I leave the determination of these matters to my attorney on his advice. I understand that all statements herein are made subject to the penalties of 18 Pa.C.S.A. §4904 relating to unsworn falsifications to authorities. Date: ~ ~`f ~ 7' ~~~ ~ ~ .,o r w ~'' „n hp ~'~i '~ ^J ~ ~~ ~~ T, ,- .~ ~-_ - ~: V 1 ..,,~ .. _ L.J ~T .. .:.~ c._~ 0 ~_~-~ i"` -.)~w ',.~ ~) r_:' '..~ 7-~ m :_.. a .`~~', .c Alan R. Boynton, Jr. PA 39850 Kimberly M. Colonna PA 80362 McNees Wallace & Nurick LLC 100 Pine Street, P.O. Box 1166 Harrisburg, PA 17108-1166 (717) 232-8000 (telephone) (717) 237-5300 (facsimile) Counsel for Defendant Electronic Data Systems Corporation IN THE COURT OF COMMON PLEAS OF CUMBERLAND COUNTY, PENNSYLVANIA David P. Diehl, Plaintiff, v. Electronic Data Systems Corporation and Life Insurance Company of North America, Defendants. CASE NO. 07-3444 NOTICE OF FILING OF NOTICE OF REMOVAL OF CIVIL ACTION TO FEDERAL COURT TO THE CLERK OF THE ABOVE-ENTITLED COURT AND TO PLAINTIFF DAVID P. DIEHL AND HIS ATTORNEY OF RECORD: PLEASE TAKE NOTICE that on July 3, 2007, Defendant Electronic Data Systems Corporation filed with the United States District Court for the Middle District of Pennsylvania the original of a Notice of Removal of Civil Action (the "Notice"), together with copies of all process, pleadings and orders served upon it in the above-captioned action. A copy of the Notice is attached hereto as Exhibit A and is served upon you. The filing of the Notice effects the removal of this action and this Court of Common Pleas may proceed no further unless the case is remanded. McNEES WALLCE & NURICK LLC By - ~ - ~r~-- Alan R. ynton, Jr. PA 39850 Kimberly M. Colonna PA 80362 McNees Wallace & Nurick LLC 100 Pine Street, P.O. Box 1166 Harrisburg, PA 17108-1166 (717) 232-8000 (telephone) (717) 237-5300 (facsimile) Counsel for Defendant Electronic Data Systems Corporation Of Counsel: Michelle B. Anselmo manselmo@bakerlaw.com Martin T. Wymer mwymer@bakerlaw.com Baker & Hostetler LLP 3200 National City Center 1900 East Ninth Street Cleveland, OH 44114-3485 (216) 621-0200 (telephone) (216) 696-0740 (facsimile) Dated: July 3, 2007 2 E~"~bk ~ 1. On or about November 13, 2006, David P. Diehl ("Plaintiff') initiated a civil action against Defendant Life Insurance Company of North America ("LINA") by filing a complaint with this Court, captioned David P. Diehl v. Life Insurance Company of North America, Case No. 1:06-CV-2222, (the "First Federal Action"), a copy of which has been attached as Exhibit A. 2. That action was premised solely on alleged violations by LINA of the Employee Retirement Income Security Act ("ERISA"), 29 U.S.C. § 1001-1461, arising from denial of short term disability benefits under the Short Term Disability Policy (the "STD Policy") maintained by EDS, Plaintiffls former employer. 3. LINA moved to dismiss the complaint on the grounds that the single claim made by Diehl did not arise under federal law, because the EDS STD Policy is not a "benefit plan" within the meaning of the federal ERISA. Specifically, LINA demonstrated the EDS STD Policy was a payroll practice, funded solely by EDS with benefits paid out of EDS' general assets, and therefore excluded from the coverage of ERISA. 4. All issues relevant to LINA's motion to dismiss were fully briefed by the parties. 2 4. On May 3, 2007, this Court granted LINA's motion and dismissed Plaintiff's claim on the grounds that the Court lacked subject matter jurisdiction because the STD Policy could not be characterized as an ERISA plan. A copy of the Court's Memorandum and Order is attached hereto as Exhibit B. 5. On or about May 25, 2007, Plaintiff filed a complaint with the Court of Common Pleas of Cumberland County Pennsylvania, captioned David P. Diehl v. Electronic Data Systems Corporation and Life Insurance Company of North America, Case No. 07-3444 (the "State Court Action"), a copy of which has been attached as Exhibit C. 6. In the State Court Action, Plaintiff reasserted his claim for benefits under the STD Policy against both EDS and LINA. He brought these claims under the Pennsylvania Wage Payment and Collection Act and not ERISA. 7. Unlike the First Federal Court Action, Plaintiff also included for the first time a claim in which he alleged he was entitled to long term disability benefits under EDS' Long Term Disability Plan (the "LTD Plan"). See Exhibit C at ¶¶ 41-48. 8. The first date upon which any Defendant was served with a copy of the complaint was June 13, 2007. 3 9. This Notice of Removal is timely filed within 30 days after the first Defendant was served and all Defendants consent to and join in the removal of this action. (Exhibit D -Consent of Defendant LINA). 10. This Court has federal question jurisdiction as provided in 28 U.S.C. § 1331 and 28 U.S.C. § 1441(b). Count II of Plaintiff s State Court Action arises out of Plaintiff s alleged entitlement to benefits under EDS' LTD Plan which, unlike the STD Policy, clearly is an employment benefit plan governed by ERISA. 11. Insofar as Plaintiff's claim in Count II is for long term disability benefits, it arises under the Employee Retirement Income Security Act ("ERISA"), 29 U.S.C. § 1001 et seq. and, therefore, raises a federal question. As such, it is properly removed to this Court. 12. Removal is not made for purposes of delay and EDS is not attempting to engage in a game of jurisdictional ping-gong. However, the claim over which this Court has jurisdiction -the ERISA claim for LTD benefits -was not asserted initially in the First Federal Action and for some reason was asserted for the first time in the State Court Action. Thus, neither LINA nor EDS had any reason to believe a federal question was being asserted, or would be asserted, by Plaintiff at the time LINA filed its motion to dismiss in the First Federal Action. 4 13. EDS files with this Notice of Removal a copy of all process, pleadings, and other papers served upon it or filed by all parties in the State Court Action prior to the filing of this Notice of Removal (see Exhibit C). 14. EDS has provided a copy of this Notice of Removal to Joseph E. Korsak, counsel of record for Plaintiff, as well as to counsel for LIMA. In addition, EDS has filed a copy of this Notice of Removal with the Clerk of the Court of Common Pleas of Cumberland County Pennsylvania. WHEREFORE, EDS requests that the Court take jurisdiction in this Notice of Removal and issue all necessary orders and process in order to remove the above-captioned case from the Court of Common Pleas of Cumberland County, Pennsylvania to the United States District Court for the Middle District of Pennsylvania. McNEES WALLCE & NURICK LLC By s/Kimberly M. Colonna Alan R. Boynton, Jr. PA 39850 Kimberly M. Colonna PA 80362 McNees Wallace & Nurick LLC 100 Pine Street, P.O. Box 1166 Harrisburg, PA 17108-1166 (717) 232-8000 (telephone) (717) 237-5300 (facsimile) Counsel for Defendant Electronic Data Systems Corporation Of Counsel: Michelle B. Anselmo manselmo@bakerlaw. com Martin T. Wymer mwymer@bakerlaw.com Baker & Hostetler LLP 3200 National City Center 1900 East Ninth Street Cleveland, OH 44114-3485 (216) 621-0200 (telephone) (216) 696-0740 (facsimile) Dated: July 3, 2007 6 CERTIFICATE OF SERVICE I hereby certify that on July 3, 2007, a copy of the foregoing Notice of Removal was served upon the following through the means indicated: By First Class Mail, postage pre-paid: Joseph C. Korsak Law Office of Joseph C. Korsak 33 North Queen Street York, PA 17403 Counsel for Plaintiff, David P. Diehl Christina McNally CIGNA Group Insurance Law Department Two Liberty Place - TL 16J 1061 Chestnut Street Philadelphia, PA 19121 Counsel for Defendant, Life Insurance Company of North America s/Kimberly M. Colonna Kimberly M. Colonna PA 80362 CERTIFICATE OF SERVICE I hereby certify that on July 3, 2007, a copy of the foregoing Notice of Removal was served upon the following through the means indicated: B_y First Class Mail, postage pre-paid: Joseph C. Korsak Law Office of Joseph C. Korsak 33 North Queen Street York, PA 17403 Counsel for Plaintiff David P. Diehl Christina McNally CIGNA Group Insurance Law Department Two Liberty Place - TL16J 1061 Chestnut Street Philadelphia, PA 19121 Counsel for Defendant, Life Insurance Company of North America Kimbei+ly . Colonna C'? `~-" p _ C_.._ %. "~ ~ ~Tl _ ~_,.. ~ .lam} i,_} ~ - _.-4-~ -_~ ..:~~5,. ~ ~ i o~ 1 ~', -5 < ~y ~..+ SHERIFF'S RETURN - REGULAR CASE NO: 2007-03444 P COMMONWEALTH OF PENNSYLVANIA: COUNTY OF CUMBERLAND DIEHL DAVID P VS ELECTRONIC DATA SYSTEMS ET AL MEGAN GILBRIDE Sheriff or Deputy Sheriff of Cumberland County,Pennsylvania, who being duly sworn according to law, says, the within COMPLAINT & NOTICE was served upon ELECTRONIC DATA SYSTEMS CORPORATION the DEFENDANT at 1704:00 HOURS, on the 13th day of June 2007 at 225 GRANDVIEW AVENUE E-90 CAMP HILL, PA 17011 by handing to RANDY IRELAND, ADULT IN CHARGE a true and attested copy of COMPLAINT & NOTICE together with and at the same time directing His attention to the contents thereof. Sheriff's Costs: Docketing 18.00 Service 14.40 Postage .41 Surcharge 10.00 /~ .00 ~ ~ 191 7 `'7"~' 4 2.81 Sworn and Subscibed to before me this day of , So Answers: R. Thomas Kline 06/14/2007 By: JOSEPH KORSAK ' -Deputy Sheriff A . D . / fd~L ~~~~ ~iLi5~i0~