Document RpRROk802zGRvgqa7Ee86EB1B

f'v-i-I/ L'OOtJ METK^OUTAN LJKE INSTRANCE fUPA.NY Croup Polity No..... ................................. bearing ds't of t''=7 ... ................................ loliowj: ................... XOSUSIVnMOWSU-*jyI*-*T*-u!r--iV>--->'V r;c. end meunng the Emplunej u ......................j, hereby entendc. Effective October 17, 1950 c.s to Ertloyee.e employed is i.'ev Jersey tao ere actively et worl- on tart dtte e-.d rued *r?loyee; e-.C;;yec r-:si ruent to tart <i:.te uid effective ao tne date of his return to eetlvc uork c> to lay ruse employee --to le not actively at work on October 17, 1950, by ruhrtitutinc for the Scheduletf lnrun.net end bployees' Muano Contributions, as ceended, la nbteetlon (1) of Section 6 of Croup Ineurtaee for Tascortrr CliebULlty benefits, Supplementary /freest fora C.K.65C attached to said Croup Policy as a pert thereof, tat folio-tay: *Cltc 111 Ibployeea SttUj $28.00 Xertnai Contribution of X=pl07M Subject to Provlaloas of ^_ )/i of IS of toe to- . p* y METROPOLITAN LIFE INSURANCE COMPANY Group Policy No.....P.577**..TM.............bearing date of.J.'ey..?.?1#.. 19^.. Employees of $ .......and insuring tht ------------- ----- ------------ JUX85SXP>;V-J!K..rr.i:l ;ix................ ............................. WMM (MU* irn IMMII i hereby emended i foflov*.- Elective.................................................. by adding ro..,,.5w.U.9P...L?j*#.J.^!^..onJ[ar*i 6 --------------- --..--------------- ------------- thereof, (he foiloving "It is tmdemaod end *greed that the Enencui experience under this Policy shaU be combined Mth the bnandal experience under Groim....P.OlA.QL Jlp*-if,l#6?rv_____ --- iaaucd to the Employer wh------- .of ItPue Jvfflwry 1*. 1953-------------- _ ___ -........................................................for the purpose of determining any AvtsiNe turpim here* under and under said Group.....iSA-TE.TM..." The forcfmng amendment ta to be ttrtehed to and made pan of said Group Policy, tad is subject to the afracmcnti end covenants cfcermn contained. Dmxmi Pltmle, Hev JffT .this.....Jfithday *f_____ AssSs*JASix (SPACE BELOW FOR USE OP METCQTOUTAN UFE INSURANCE COMPANY ONLY) -------- Btv lark. T-------- As,________ ftfaday M.jtaXX*JlSS______ METKOfOUTAN UTC MSUSANCS COMPANY. /a*U2T~ h* a u* Match IMI mmi uoo. ta*.* BO. tioa 6. AMDUHT Of OBURAHCE (Continued).-- u SCHEDULE 07 IKSURAKCI AHD EMPLOYEES' KAXMJM COtfTHIBUnDJB (Continued) Schedule ZZ. Additional Insurance dulc of Additional LIT* ZaJoraacc tad Insurance for Death or Dlsaeaberacnt by Accidental teaaa Cla laployees SDHcoimtiBirroHY bburascs Additional Life Insurance* He laauraace Additional Zaeuraaee for Death or Dlaiaeabenaent by Accidental Meaoa* So Znsuraaee Claaa CONTRIBUTOR? IHSURAHCE Additional Life Incurance* Additional Insurance for Death or PlsaeabcrBcnt by Accidental Meana* pt Salaried Xaployeea the anouat of Additional life Znauraaea, If any, shall be the aaallcr of (a) aa anount equal to the anouat of the Eaployee'a Beale life Insurance, and (b) the excess, If any, of $200,000 over the anouat of the Enployoe'a Basic Life Insurance. rthar laployees So Xasumaee She anouat of Additional Zaeuraaee for Death or Dlmeabement by Accidental Means, if say, shall be the snsllsr of (a) an anouat equal to the anouat of the Bsployee'a Basle Insurance for Death or Die* acabcment by Accidental Meaaa, and (b) the excoae, If any, of $200,000 over the anouat of the Employee'e Baele Insurance for Death or Dlanenbeneat by Accidental Means. So Znsuraaee dltloaal Accident sad Health Zaeuraaee is provided hereunder for say Employee. mtloa SoB-Costrlhutoxgr sad Contributory Zassrt (2*) 0.1.1.1931 %ecloa 5. AM3UJTC Of 2SURANCE (Continued) .wv SCSE3UI2 Or XffiURANCE AND EKPIOfES' MAXIMUM CONTHaUMO (Continued) M aaouat or Basle ud Additional Life Insurance hereunder me to (l) any Salaried Enployee at ybestos Division who m Insured oa December 31, 19S under the Employer's group life asureace plan la offset for hla oo December 31, 1968, and (n) aay other Salaried Xa^loyee ao as Insured hereunder on December 31, 1966 for a greater total amount of Life Insurance aaa the total amount applicable to bln la accordance with the foregoing Schedule I and chedule XZ shall be such greater total amount until euch time as ths aiwuat of Basic sad ddltlooal Life lasuraaee applicable to bln la accordance with said Schedule exceeds such reatsr total aaouat. Provisions Applicable to Life lasuraaee aad Insurance for Death or Dlaaaabemeat by Accidental aas la Aaouate Oreater Than $95,000 (Total Aaouat of Basic sad Additional lasuraaee) A) Aaouate of Life Insurance and Insurance for Death or Dlaaenbemeat by Accidental Means -rearer Than $95,000 But Not Greater Than $145,000. be following requirement* oust be satisfied by aa iMployee in order that be aay become insured ereunder for an aaouat of Life lasuraaee or Zdsursaee for Death or Dlsaeahemeat by Accidental 'cans greater than $95,000 but not greater thaa $145,000, or If he Is already Insured for an mount of Life lasuraaee or lasuraaee for Death or Dlsaeabemeat by Accidental Means greater baa $95,000 but not greater than $145,000, In order that aay Increase la such eoauat of asureace shall beeeae affective: a) as taployee oust be actively at verb and physically able to perforn all the duties of his occupation. b) as Employee oust be regularly working at least the auaber of hours la his employer's work week, but oot less than thirty hours per week, at his eaployer's business establish ment or at eoae other location to which hie eaployer's business requires hla to travel. c) ae Employee Bust not have been absent from work oo account of bis own sickness or Injury during tbs preeedlag three weeks. uch aaouat of lasuraaee, or the Increase in the amount of Insurance, shall become effective oa be first day as of which the dployee satisfies the requirements la (a), (b) sad (c) of the oregolag sentence, which is coincident with dir following the date as of which the Employee's arcings are such as to entitle him to aa amount of Insurance greater than $95,000 but net raster thaa $145,000, or aa Increase la the aaount of such lasuraaee. If the Jfeploye* does at satisfy suefa requlreaeats, the aaouat of bis Life Insurance and Insurance far Death or iaacoberaeat by Accidental Msaas each shall not exceed $95,000, nr the aaount for which he as Insured Immediately before the change la hla earnings, whichever aaouat Is greater. B) Amounts of Life Insurance aad Insurance for Death or Dismemberment by Accidental Mesas raster Than $145,000. n order that aa B^loyee aay beeosB Insured hereunder for aa aaouat of Life Insurance or nsurancs for Death or Dismeahermeot by Aeeldental Means greater thaa $145,000# or If the jspioyee is already insured hereunder for aa aaouat of Life lasuraaee or Insurance far Death >r Dlsaeabenest by Aeeldental Msaas grestsr than $145,000, la erdar that any Increase la such snat of insurance shall becom affective, the fiqployee Bust satisfy ths requlreasnts of a), (b) sad (o) of Paragraph (a) hereof aad also subalt evidence of his Insurability satis* 'aetozy to the Xnsuraaoa aa of a date vltbla tblrty*oos days of the date he satisfies :cablaBtloa *00-Coatrlbutory sad Coetrlhutory Zassrt (2f) 0.L.8.1931 rtioa 6. AMDUN? OF ECURA-VCS (Coatiaued).-%. SCHEDULE OF 2XSURASCZ A? EMPLOYEES' MAXIMUM COirrSJBUTIOKS (Continued) i requirements of (k), (b) and (c). If such evidence of inaurabllity le accepted by the juranee Company as satisfactory, such amount of insurance or increase shall become effective the earliest date the Enployee satisfies the requirements of Paragraph (A) hereof which is ) on or subsequent to the date he would otherwise be entitled to such amount of lasur&nee 1 (2) vlthin a period of thirty-one days of the date as of which such evidence is submitted, any Employee fails to submit any evidence of insurability required by the Insurance Company accordance with this paragraph, or if any such evidence of insurability is not accepted as tlsfaetory by the Insurance Company, the amount of the Employee's Life Insurance and Insurance r Death or Dlemcmberaent by Aeeldcatal aeons each shall not exceed the greater of (l) the sunt of such insurance for which the Employee was Insured immediately prior to the date on ieh any such increase would otherwise have becomo effective, nod (11) $1^5,000, subject to ; provisions of this Policy other than this Paragraph (B). ) Hie Insurance Company reserves the right to ehaage the foregoing provisions applicable to ousts of Life Insurance or Insurance for Death or Dismemberment by Accidental Means greater an $95,000 by-giving written notice of such change to the Enployer at least 60 dayc prior to e date such change is to become effective. She provisions so changed shall apply to each ployee whose earnings thereafter are such as to entitle him to an amount of Life Insurance Insurance for Death or Dismemberment by Accidental Means greater than $95,000 or, if he la ured for an amount of Life Insurance or Insurance for Death or Dismemberment by Accidental ana greater than $95,000 on the effective date of such change, to any increase in such oust of insurance. e Insurance Company reserves the right, by giving written notice to the Employer, to reduce maximum amount of Life Insurance for which so Employee may be insured hereunder on and ter the effective date stated la such written notice to (l) the amount specified in such lrten notice, or (11) the amount for which the Employee was insured hereunder on the day mediately preceding such effective date, whichever amount is greater, provided that the luced maximum amount of Life Insurance ohnil not be leos than $100,000 and that such factive date shall not be Icon than one year from the date of ouch written notice. Salaried Employees Age 65 or Older or Retired, Exeept Salaried Employeee Retired On or Prior to January 1. 1969 e amounts of Basle and Additional Life Insurance and Insurance for Soath or Dismemberment Accidental Means la accordance with the foregoing provisions of this Section 6 apply prior the earlier of an Enployee a 65th birthday and the date of bis retirement. an Enployee le age 65 or older or is retired, as determined by the Delayer, the amount bla Life Insurance shall be 50% of the amount of bis Basie Llfs Insurance hereunder on the y preceding the earlier of bis 65th birthday sad the date of his retirement. an Employee becomes insured hereunder on or subsequent to his 65th birthday, the percentage am the preceding parsgreph shall be applied to the amount of Basle Life Insurance applicable hla earnings or elasa la accordance with the foregoing provisions of this Seetloa 6 on the festive date of the Basle Life Insurance hereunder 00 account of tba Employee. Life Xssursnee or Basle sad Additional Insurance for Death or Dismemberment by eldestal Means is provldsd hereunder for the Saployee on and after his 65th birthday. ablnatlon Ron-Contributory and Contributory Insert (2g) G.L.H.1931 tctiaa 6. A>OUR7 07 IHSURA2TCE {Continued) SCHEDULE OF IHSURA5CE AKD FKPLOYSDS' MAXIMUM CGSTRIBtJTIDHS (Continued) All Other Hotlreil fcfrnnLnyooa amount of Basic Life Znournnee In accordance with the foregoing provlalona of thla Section 6 piles prior to the date of an Baployee's retlreaent. an Employee la retired, aa determined by the Baployer, the aaount of hie Life Inauranee n3i aa follows: Aa to any Employee of Manhattan Rubber Division retired on or subsequent to October 1$, 1951 but prior to the date specified In the following item 4. - - $1,000.00 As to any Saployee of Vabash Division retired on or subsequent to September 22, 1952* - - $1,000.00 As to any toployee of General Asbestos and Rubber Division retired on or subsequent to January 2, 1953. - - $1,000.00 Aa to any Bnployee of Manhattan Rubber Divirion who Is (l) a Salaried BnpLoyce, other than a Salaried finployec on the Male Office payroll, retired on or subsequent to October 28, 1955 but prior to January 2, 1969, (11) subject to tbe Bargaining Agreement between Manhattan Rubber Works Independent Union, Inc. retired on or subsequent to October 26, 1955, (ill) a member of Manhattan Ledge 1879, International Association of Machinists retired on or aubaequent to November 25, 1955, or (lv) a Main Office Payroll Employee retired on or subsequent to January 1, 1956 (but prior to January 2, 1969 in tbe ease of a Salaried ttaployee on tbs Main Office Payroll). - - 30% of the aaount of bis Basle Life Insurance hereunder on the day preceding the date of bis retlreaent. As to say dnployee of United States Asbestos Division retired on or subsequent to April 1, 1964. - - $3,000.00 As to any ether Bsployee, except a Salaried Employee retired on or after January 2, 1969 - - the amount of hie Basic Life Insurance hereunder on the day preceding the date of his retirement. * retired Deploys* nay contribute to the cost of hie lnsuranot and 00 Dnployee may contribute the cost of the Son-Contributory Insurance, the amount which an Employee nay ccotributa the cost of the Contributory Inauranee shall not exceed $0.60 per aootb ($0.14 por week tbe ease of any Baployee who contributes weekly) per $1,000 of Life Insurance and the alum charged for tbe amount of his other insurance, subject to such further limitation rviee provided for Bnployees alloyed In tbe State of Sev York. th Benefit: She aaount of Death Benefit pursuant to Section 8 hereof shall be as fallows: With respeet to a Salaried Employee - (1) an amount equal to the total amount of the b&loyee'e Basle Lift insurance hereunder and Additional Life Insurance hereunder, if any, at the date of termination of bis employment, IT the ft^loyee's death occurs prior to bln 65th birthday, and (2) an amount equal to 30% of the amount of the Employes 'e Basle Lift Insurance hereunder at the date of termination of his employ ment, if the S^loyss's death occurs on or after his 65th birthday.., ilnatlon Ben-Ceatrlbutory and Contributory Insert (2b) G.L.B.1931 ictlou 6. *>CUHT 0? DCURARCS (Continued). -- 8CSEDUL* 07 2EUMNCE AHD MPL0Y22S ' MAXIMJK CONTKIByTIOKS (Continued) With respect to any other Ctployte - an amount equal to the amount af the liployee1t Ufa loauraaee hereunder at the data of bemination of hla employment. eh Bi^loyee ttooee Life Insurance hereunder io,reduced on or after the data of bis retirement all bare the ease privilege of obtaining an individual policy of life Insurance on the te or such reduction, vlth respect to the excess of ) the amount of life Insurance far ublcb such teployee was insured hereunder on the day imediataly prior to such reduction, over ) the aaount of life Ineurancc for \d>ieb such fisployee may be insured hereunder lanadlately after aueh reduction Is applicable upon termination of employment, as set forth in Section 9 hereof. >laatioo Xoa-Coctrihutory and Contributory Insert (21) C.L.H.1931