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Call Benefit Consultants, Inc. with any questions concerning your eligibility, coverage, claims or predetermination of benefits.  Benefit Consultants, Inc.'s office hours are 8:00 a.m. to 4:30 p.m. Monday through Friday.  (After office hours, the phone will be answered by an answering machine.  Leave your message on the recorder with your phone number.  Your call will be answered the next business day.)

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Call ESI with any questions about participating pharmacies, prescription drug coverage and prior authorization requests. 

IMPORTANT:  Prescription drugs must be obtained from a participating ESI pharmacy, unless coverage under the Plan is secondary (see pages 9 and 56-59 for details).

The Plan does not require that you or your health care provider obtain precertification prior to receiving health care services or supplies nor does it provide reduced benefits if you fail to obtain precertification.  The Plan offers a voluntary predetermination program that you or your health care provider may use to determine whether the Plan considers health care services or supplies that have not yet been provided to you to be medically necessary and appropriate.  If you participate in this voluntary predetermination program and a service or supply is determined to be medically necessary and appropriate, when your claim is submitted after the service or supply is provided, your claim will not be denied on the basis of medical necessity and appropriateness.  There is no penalty for failure to request a predetermination.  However, if you receive health care services or supplies without obtaining a predetermination, you risk learning after receiving the services or supplies, that they are not covered under the Plan because they are not considered medically necessary and appropriate.  Unless you obtain a predetermination, medical necessity will be decided when a claim is filed after the service or supply has been provided.  In such a case, you may be entirely responsible for the cost of any non-covered services or supplies.  To predetermine whether a hospitalization or a surgical procedure or other outpatient procedure is considered medically necessary and appropriate, contact Benefit Consultants, Inc. at (800) 434-4620.  BCI may refer your request to an independent medical consultant to determine the medical necessity and appropriateness of the service.  You and your physician will be informed of the decision

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NAME OF PLAN:  Paul Mueller Company Employee Benefit Plan. 

PLAN SPONSOR AND BENEFITS COMMITTEE:  The Plan is sponsored by Paul Mueller Company (the "Company").  The Plan's assets are held as part of the Company's general assets.  The members of the Benefits Committee (appointed by the Company's Board of Directors) are as follows:

The Benefits Committee shall be the named fiduciary of the Plan, pursuant to the Employee Retirement Income Security Act of 1974, as amended.  Any act which the Plan authorizes or requires the Benefits Committee to do may be done by a majority of the members then serving.  The action of such majority of the Committee may be expressed by vote at a meeting or in writing without a meeting.  The Committee may authorize one or more of its members to sign on its behalf any instructions, instruments, or other documents.  The Plan may be amended by resolution of the Committee. 

EFFECTIVE DATE:  This Plan is a Restatement of the Paul Mueller Company Employee Benefit Plan.  The Plan was originally effective as of June 1, 1988.  The Restatement is effective as of July 1, 2004. 

COMPANY:  The term "Company" is used in this Summary Plan Description to mean Paul Mueller Company and any Participating Employers. 

PARTICIPATING EMPLOYERS:  Any member of Paul Mueller Company's controlled group (as defined by the Internal Revenue Code) may, with the consent of the Benefits Committee, adopt the Plan for some or all of its Employees.  An employer that has done so becomes an additional Participating Employer.  At the time of printing of this Summary Plan Description, the only Participating Employer other than the Paul Mueller Company is Mueller Field Operations, Inc., which has adopted the Plan for certain of its nonbargaining unit Employees.  Upon written request, the Plan Administrator will provide you information as to whether a particular employer is a sponsor of the Plan and, if the employer is a Plan sponsor, the sponsor's address. 

PLAN ADMINISTRATOR:  The Plan Administrator is Paul Mueller Company, 1600 West Phelps Street, P.O. Box 828, Springfield, Missouri 65801-0828, (417) 831-3000. 

PLAN OFFICE AND ADMINISTRATIVE MANAGER:  The Benefits Committee maintains a Plan Office where the day-to-day business of the Plan is handled, pursuant to a contract with Benefit Consultants, Inc., to provide such services.  Benefit Consultants, Inc., is the Administrative Manager of the Plan.  All communications, notices and claims should be addressed to:

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Benefit Consultants, Inc.
13515 Barrett Parkway Drive, Suite 265
Ballwin, Missouri 63021-5870
Telephone:  (800) 434-4620 toll free or (314) 822-7890 in St. Louis

SERVICE PROVIDERS: The Plan contracts with service providers to provide certain services under the Plan.  As of the date of printing of this Summary Plan Description, the Plan's service providers are:

Refer to the Quick Reference Guide in the front of this Summary Plan Description for contact information for these service providers. 

IDENTIFICATION NUMBERS:  The IRS Employer Identification Number of Paul Mueller Company is 44-0520907; the Plan Number is 504.  The Plan number for the separate cafeteria plan set forth in Section VIII is 506. 

TYPE OF PLAN:  The Plan is an employee welfare benefit plan that provides hospital, medical, dental, disability income, death, and dismemberment benefits.  It includes a cafeteria plan, the provisions of which you can find in Section VIII. 

SERVICE OF LEGAL PROCESS:  Service of legal process may be made upon the Plan Administrator at the following address: 1600 West Phelps Street, P.O. Box 828, Springfield, Missouri 65801-0828. 

SOURCE OF CONTRIBUTIONS:  The Plan is maintained through Company contributions and contributions of Participants.  In addition, under certain circumstances, Participants and Dependents, whose coverage would otherwise terminate, are permitted to make contributions to keep their coverage in effect for limited periods. 

PAYMENT OF BENEFITS:  Life Insurance and Accidental Death and Dismemberment Benefits are insured pursuant to a Group Insurance Contract maintained by the Company.  Section III of this booklet describes the Benefits available to Eligible Participants, which are underwritten by a life insurance company, herein called the "Insurance Company." The Insurance Company is obligated to provide the Benefits which are described in detail in the Group Insurance Contract and which are described in summary form in this booklet, subject to payment of premiums by the Company.  Beyond payment of premiums due to the Insurance Company for Eligible Employees, the Company has no obligation with respect to these Benefits. 

Weekly Disability Income, Medical Care, Prescription Drug, and Dental Care Benefits are provided directly by the Company pursuant to the terms of the Paul Mueller Company Employee Benefit Plan Document. 

PLAN YEAR:  The Plan is operated on a calendar-year basis.  The records for the separate cafeteria plan set forth in Section VIII are also maintained on a calendar-year basis. 

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LANGUAGE IN THIS BOOKLET CONTROLLING:  This booklet is not just a summary of your Plan, but the actual Plan Document -- written so that it can be used by you, the Benefits Committee, and the Administrative Manager in administering the Plan.  However, the controlling document as to Life Insurance and Accidental Death and Dismemberment Insurance Benefits is the Group Insurance Contract issued by the Insurance Company. 

PLAN DOCUMENTS AVAILABLE TO PARTICIPANTS AND BENEFICIARIES:  Any Plan Document is available for inspection at the offices of Paul Mueller Company and at the Plan Office during regular business hours.  The Plan Documents include:

These documents are also available for your inspection at the offices of the Sheet Metal Workers' International Association, Local No. 208, 314-I East Pershing, Springfield, Missouri 65806-2112, within 10 days after receipt of a written request at the Plan Office. 

Upon written request to the Plan Office, you will be furnished with a copy of any Plan Document or part of any Plan Document that you specify.  There may be a charge to you for the cost of reproducing the requested material.  You may contact the Plan Office to learn what, if any, charge will be made. 

RESERVATION OF AUTHORITY:  The Benefits Committee retains the authority to change the Eligibility Rules and to change the Benefit program at any time.  At the Committee's discretion, such changes may include, but are not limited to: 

The Company specifically intends that the Benefits Committee have the greatest permissible discretionary authority to construe the terms of the Plan and to determine all questions concerning eligibility, participation, and benefits.  Any such decision made by the Committee shall be binding on the Company and on all employees, retirees, Participants, dependents and beneficiaries, and is intended to be subject to the most deferential standard of judicial review.  Such standard of review is not to be affected by any real or alleged conflict of interest on the part of the Committee. 

FURTHER INFORMATION AVAILABLE:  In addition to this document, there are other documents that govern the operation of the Plan.  As noted above under "Plan Documents Available to Participants and Beneficiaries," those other documents will be made available to you upon your request. 

No representative of the Company nor any individual member of the Benefits Committee has any authority to speak on behalf of the Committee.  If you have any questions pertaining to your eligibility or Benefits, the only party authorized to answer such questions for the Committee is the Administrative Manager.  Matters that are not clear or which require interpretation will be referred by the Administrative Manager to the full Committee.  Neither the Administrative Manager nor any other party has authority to act contrary to the written terms of the governing Plan Documents. 

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Any questions pertaining to the Life Insurance and Accidental Death and Dismemberment Insurance portion of the Benefit program must be answered by the Insurance Company; the Administrative Manager will help any Participant or Beneficiary in communicating with the Insurance Company, but the Administrative Manager is not authorized to make decisions for them.  With respect to any matter covered by a group contract with an insurance company, the terms of such contract are controlling. 

TERMINATION OF PLAN:  The Plan may be terminated at any time by action of the Board of Directors of Paul Mueller Company. 

CLAIMS PROCEDURES FOR LIFE INSURANCE AND ACCIDENTAL DEATH AND DISMEMBERMENT INSURANCE BENEFITS:  Claims for Life Insurance and Accidental Death and Dismemberment Insurance Benefits must be submitted to the Insurance Company through the Administrative Manager on forms available from the Administrative Manager.  Written notice of Accidental Death and Dismemberment claims must be given to the Insurance Company, through the Administrative Manager, within 20 days of occurrence of the loss on which claim is based.  Written proof of claim must be furnished within 90 days after the date of the loss in the case of death and dismemberment claims and within 12 months of termination of Life Insurance coverage in the case of Total Disability Death Benefit claims.  Except in the case of Total Disability Death Benefit claims, failure to furnish notice or proof of claim within the time required above will not invalidate or reduce any claim if it is shown not to have been reasonably possible to furnish such notice or proof within such time, provided such notice or proof is furnished as soon as possible thereafter. 

Life Insurance and Accidental Death and Dismemberment Insurance Benefits will be paid to your designated beneficiary or, if none, as provided by the insurance policy.  Life Insurance and Accidental Death and Dismemberment Insurance Benefits are assignable only to the extent permitted by the Insurance Company. 

If a claim for Life Insurance or Accidental Death and Dismemberment Insurance Benefits is wholly or partially denied by the Insurance Company, the claimant will be given written notice of the decision by the Insurance Company within 90 days after receipt of the claim, unless special circumstances require an extension of time for processing.  If such an extension of time is required, written notice of the extension will be sent to the claimant prior to termination of the 90-day period.  The extension notice will indicate the special circumstances requiring an extension of time and the date by which the insurance carrier expects to render a final decision.  In no event will this date be more than 90 days after the end of the initial 90-day period.  If no response is received within 90 days, allowing reasonable time for mailing, the claimant may assume the claim has been denied and proceed to the claim review stage outlined below.  The notice of denial will contain the following information:

The claimant or his duly authorized representative may: 

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A decision on review of the denied claim will be made by the Insurance Company not later than 60 days after the Insurance Company's receipt of a request for review, unless special circumstances require an extension of time for processing, in which case a decision will be rendered within a reasonable period of time, but in no event later than 120 days after receipt of a request for review.  If such an extension is required, the claimant will be so notified within 60 days after receipt of the request for review.  The decision on review will be in writing and will include the specific reason(s) for the decision and specific reference(s) to the pertinent Group Insurance Contract provisions on which the decision is based.  The decision of the Insurance Company will be final. 

CLAIMS PROCEDURES FOR WEEKLY DISABILITY INCOME BENEFITS:  Claims for Weekly Disability Income Benefits must be submitted to the Administrative Manager on forms prescribed by the Benefits Committee.  Forms may be obtained from the Administrative Manager or from the Human Resources office of Paul Mueller Company.  The Committee may, at its own expense, require an independent medical examination to be performed by a Physician selected by the Committee. 

Affirmative proof of claim must be furnished to the Administrative Manager within 90 days following commencement of Disability and as requested by the Administrative Manager thereafter during the continuation of Disability. 

Failure to furnish proof of claim within the time required above will not invalidate or reduce any claim if it is shown not to have been reasonably possible to furnish such proof within such time, provided such proof is furnished as soon as possible thereafter. 

Weekly Disability Income Benefits will be paid every two weeks during the period the claimant is eligible to receive Benefits, and any balance still unpaid at the end of such period will be paid immediately after receipt of due proof of claim. 

Weekly Disability Income Benefits are not assignable, except where benefits are payable following the death of a claimant, in which case benefits will be paid to the beneficiary or estate of the deceased Participant. 

Any unassigned Weekly Disability Income Benefits for services rendered that are unpaid at your death will be paid to the Beneficiary you designated under your Life Insurance under the Plan.  If you are incompetent, any unassigned Weekly Disability Income Benefits payable during your lifetime will be paid to your Life Insurance Beneficiary or, if you have not designated one, to the person or institution who is caring for you. 

If a claim for Weekly Disability Income Benefits is wholly or partially denied by the Administrative Manager, written notice of the decision will be furnished to the claimant by the Administrative Manager within 45 days after receipt of the claim, unless due to matters beyond the control of the Plan, an extension of time is necessary for processing.  If such an extension of time is required, the 45-day period may be extended for a period of up to 30 additional days and written notice of the extension will be sent to the claimant prior to termination of the 45-day period.  If, prior to the end of the first 30-day extension period, due to matters beyond the control of the Plan, a decision cannot be rendered within that extension period, the period for making the determination may be extended for up to an additional 30 days.  The claimant will be notified of this additional extension prior to the expiration of the first 30-day extension period.  In the case of any extension under this paragraph, the notice of extension will specifically explain the standards on which entitlement to a benefit is based, the unresolved issues that prevent a decision on the claim, and the additional information (if any) needed to resolve those issues; and the claimant shall be afforded at least 45 days within which to provide the specified information.  All extension notices will indicate the circumstances requiring an extension of time and the date by which the Plan expects to render a final decision.  The notice of any adverse benefit determination will contain the following information:

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The claimant or his duly authorized representative may:

The Benefits Committee's review of the appeal will take into account all comments, documents, records, and other information submitted by the claimant relating to the claim, without regard to whether such information was submitted or considered in the initial benefit determination.  The review will not afford deference to the initial adverse benefit determination and will be conducted by an appropriate named fiduciary of the Plan who is neither the individual who made the adverse benefit determination that is the subject of the appeal, nor the subordinate of such individual.  In deciding an appeal of any adverse benefit determination that is based in whole or in part on a medical judgment, including determinations with regard to whether a particular treatment, drug, or other item is experimental, investigational, or not medically necessary or appropriate, the appropriate named fiduciary shall consult with a health care professional who has appropriate training and experience in the field of medicine involved in the medical judgment and is neither an individual who was consulted in connection with the adverse benefit determination that is the subject of the appeal, nor the subordinate of any such individual.  Medical or vocational experts whose advice was obtained on behalf of the Plan in connection with a claimant's adverse benefit determination will be identified without regard to whether the advice was relied upon in making the benefit determination. 

A decision on review of a denied claim will be made by the Benefits Committee not later than 45 days following the Administrative Manager's receipt of a request for review.  If special circumstances require a further extension of time for processing, a decision will be rendered within a reasonable period of time, but in no event later than 90 days following the Administrative Manager's receipt of the request for review.  If such an extension is required, the claimant shall be so notified within 45 days after the Administrative Manager's receipt of the request for review. 

The decision on review will be in writing and will include the specific reason(s) for the decision and specific reference(s) to the pertinent Plan provision(s) on which the decision is based.  The decision of the Benefits Committee will be final. 

As part of an initial benefit determination and upon review of an adverse benefit determination, if an internal rule, guideline, protocol, or other similar criterion was relied upon in making the adverse determination, a copy of such rule, guideline, protocol, or other criterion will be provided free of charge to the claimant upon request.  Likewise, if the adverse benefit determination or the decision on review is based on a medical necessity or experimental treatment or similar exclusion or limit, an explanation of the scientific or clinical basis for the determination, applying the terms of the Plan to the claimant's medical circumstances, will be provided free of charge upon request. 

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CLAIMS PROCEDURES FOR MEDICAL AND DENTAL BENEFITS:  Providers of medical and dental services and supplies may file claims in writing or electronically with the Administrative Manager (via the managed care organization in which the providers participate, if applicable).  Claims filed by Participants for reimbursement of medical and dental expenses must be filed in writing with the Administrative Manager.  Medicare Explanation of Benefit forms must accompany medical claims submitted on behalf of Medicare Retirees.  Claims must include a claim form prescribed by the Benefits Committee.  Claim forms may be obtained from the Administrative Manager or from the Human Resources office of Paul Mueller Company.  The Committee may, at its own expense, require an independent medical examination to be performed by a Physician selected by the Committee. 

A request for predetermination is not a claim.  To file a claim under this Plan, there must be a written request for payment of services or supplies that have already been provided to you.  If a request is made to extend a course of treatment beyond the period of time or number of treatments previously approved, the request must be made to the Administrative Manager in writing and the request will be treated as a request for predetermination. 

Affirmative proof of claim must be furnished to the Administrative Manager within 12 months following the date the Covered Expense on which the claim is based was incurred.  Failure to furnish proof of claim within the time required above will not invalidate or reduce any claim if it is shown not to have been reasonably possible to furnish such proof within such time, provided such proof is furnished as soon as possible thereafter. 

Medical and Dental Benefits provided under the Plan for Covered Expenses with respect to which a health care provider has allowed a discount to the Plan, in accordance with a discount agreement between the provider and the Benefits Committee, will be paid directly to the Hospital, Physician or Dentist.  All other Medical and Dental Benefits will be paid to you (or to a custodial parent pursuant to the terms of a Qualified Medical Child Support Order), except that you may assign payment of Benefits directly to the Hospital, Physician, or other person or institution rendering services or furnishing supplies for which Benefits are payable under the Plan.  The Committee is not required to inquire into the validity of any such assignment, and any payment made in good faith by the Committee discharges the obligation of the Committee to the extent of such payment.  The Plan will also honor any assignment of rights made by or on your behalf as required by Medicaid.  In addition, if Medicaid makes payments which this Plan has a legal liability to make, the Plan will reimburse Medicaid for those payments, but only to the extent it is required to do so by State statute. 

Any unassigned Medical and Dental Benefits for services rendered, that are unpaid at your death will be paid to the Beneficiary you designated under your Life Insurance under the Plan.  If you are incompetent, any unassigned Medical and Dental Benefits payable during your lifetime will be paid to your Life Insurance Beneficiary or, if you have not designated one, to the person or institution who is caring for you. 

The Administrative Manager will make a decision with respect to a claim for Medical and Dental Benefits within 30 days after receipt of the claim, unless matters beyond the control of the plan require an extension of time for processing.  If such an extension of time is required, written notice of the extension will be sent to the claimant prior to termination of the 30-day period.  The extension notice will indicate the circumstances requiring an extension of time and the date by which the Plan expects to render a final decision.  In no event will this date be more than 15 days after the end of the initial 30-day period.  If the extension of time is necessary due to the claimant's failure to submit all the information necessary to decide the claim, the claimant will be notified of the additional information needed and will be given 45 days to provide the information.  (The Plan's time limits are tolled while the Plan is waiting for you to provide the information.)

If a claim is denied, the notice of denial will contain the following information:

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The claimant, his duly authorized representative or any provider to whom benefits have been assigned may:

Information Available On Written Request.  With respect to an initial benefit determination and the review of an adverse benefit determination, if an internal rule, guideline, protocol, or other similar criterion was relied upon, a copy of such rule, guideline, protocol, or other criterion will be provided free of charge to the claimant upon written request.  If an adverse benefit determination or the decision on review is based on a medical necessity or experimental treatment or similar exclusion or limit, an explanation of the scientific or clinical basis for the determination, applying the terms of the plan to the claimant's medical circumstances, will be provided free of charge upon written request.  If advice was obtained from medical or vocational experts in connection with a claimant's adverse benefit determination, the identity of such experts will be provided free of charge upon written request regardless of whether their advice was relied upon in making the benefit determination. 

The Benefits Committee's review of the appeal will take into account all comments, documents, records, and other information submitted by the claimant relating to the claim, without regard to whether such information was submitted or considered in the initial benefit determination.  The review will not afford deference to the initial adverse benefit determination and will be conducted by an appropriate named fiduciary of the plan who is neither the individual who made the adverse benefit determination that is the subject of the appeal, nor the subordinate of such individual.  In deciding an appeal of any adverse benefit determination that is based in whole or in part on a medical judgment, including determinations with regard to whether a particular treatment, drug, or other item is experimental, investigational, or not medically necessary or appropriate, the appropriate named fiduciary shall consult with a health care professional who has appropriate training and experience in the field of medicine involved in the medical judgment and is neither an individual who was consulted in connection with the adverse benefit determination that is the subject of the appeal, nor the subordinate of any such individual. 

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A decision on review of a denied claim will be made by the Benefits Committee not later than 60 days following the Administrative Manager's receipt of a request for review. 

The claimant will be notified in writing of the decision on review not later than five days after the decision is made.  If the decision is adverse to the claimant, the notice will include:

The decision of the Benefits Committee will be final. 

If an appeal of denial of a claim for benefits or any other matter is denied, the Participant or claimant has the right to bring a civil suit under ERISA Section 502(a).  However, no legal action may be brought to recover on this plan prior to exhaustion of the plan's claims appeals process.  Nor may such action be brought after two years following the Benefits Committee's final appeal decision. 

CLAIMS PROCEDURES FOR PRESCRIPTION DRUG BENEFITS:  Providers of Prescription Drugs must file their requests for payment directly with the Pharmacy Benefit Manager.  Submission of a prescription to a pharmacy is not a claim.  If you receive a medication or supply from a pharmacy and believe that the copayment or other amount charged by the pharmacy is incorrect, you may then submit a written claim to the Administrative Manager requesting reimbursement of any amounts you believe were overcharged.  A request for reimbursement for a medication or supply obtained from a non-participating pharmacy will be considered a claim when filed with the Administrative Manager in writing. 

If this plan is your only or primary plan for prescription drugs, you must obtain prescriptions through a participating or mail order pharmacy and pay your portion of the cost directly to the pharmacy at the time you receive your prescription.  The plan will then reimburse the pharmacy through its pharmacy benefit manager.  If you have other prescription drug coverage that is primary, you must obtain prescriptions through that plan and may submit your receipts for any copayments to the Administrative Manager within 12 months of the date the prescription was filled for reimbursement.  Such reimbursement will be paid directly to you and may not be assigned. 

If your claim for prescription drug benefits has been denied, you may appeal through the Administrative Manager as shown above for Medical and Dental Benefits. 

CLAIMS FOR OTHER MATTERS:  Any claim by an Employee, Beneficiary, or other party involving a matter other than benefits (for example, if the Plan has denied that an Employee is eligible as a Participant) must be presented in writing to the Administrative Manager.  A written response will be furnished to the person presenting the claim.  If any Employee, Beneficiary, or other party believes that any action of the Plan is incorrect or improper, an appeal must be filed.  The appeal must be signed by the person affected by the action and submitted to the Administrative Manager within 180 days following the action which the appeal concerns.  The person appealing may review all papers pertinent to the subject matter of the appeal in the possession of the Benefits Committee and may present additional evidence and a statement of his position.  The Committee or a party appointed by the Committee will review the appeal and provide a prompt written decision to the person appealing. 

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Information Available On Written Request (this paragraph applies to Medical, Dental and Prescription Drug Benefits and to Weekly Disability Income Benefits as well).  With respect to an initial benefit determination and the review of an adverse benefit determination, if an internal rule, guideline, protocol, or other similar criterion was relied upon, a copy of such rule, guideline, protocol, or other criterion will be provided free of charge to the claimant upon written request.  If an adverse benefit determination or the decision on review is based on a medical necessity or experimental treatment or similar exclusion or limit, an explanation of the scientific or clinical basis for the determination, applying the terms of the plan to the claimant's medical circumstances, will be provided free of charge upon written request.  If advice was obtained from medical or vocational experts in connection with a claimant's adverse benefit determination, the identity of such experts will be provided free of charge upon written request regardless of whether their advice was relied upon in making the benefit determination. 

Legal Action:  If an appeal of denial of a claim for benefits or any other matter is denied, the Participant or claimant has the right to bring a civil suit under ERISA Section 502(a).  However, no legal action may be brought to recover on this plan prior to exhaustion of the plan's claims appeals process.  Nor may such action may be brought after two years following the Benefits Committee's final appeal decision. 

PRIVACY:  The Plan will disclose protected health information ("PHI") that is created or received in connection with the Medical, Prescription Drug, and Dental coverage under the Plan to the Company only to the extent permitted by the administrative simplification provisions of the Health Insurance Portability and Accountability Act (HIPAA) of 1996 and its regulations (the "Privacy Rule"). 

The Company agrees to:

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Access to and use and disclosure of PHI will be limited to only those employees designated by the Privacy Officer who have a need for the PHI in conjunction with their performance of plan administration functions for the Plan, including any employee who receives PHI relating to payment under, health care operations of, or other matters pertaining to the Plan in the ordinary course of business.  If the persons described above do not comply with the conditions set forth above, the Company will provide a mechanism for resolving issues of noncompliance, including appropriate disciplinary sanctions. 

Participants in the Plan have the right to notice of the uses and disclosures of PHI that may be made by the Plan, and of their rights and the Plan's legal duties with respect to PHI.  A complete copy of the Plan's Notice of Privacy Practices can be found in Appendix B. 

OTHER THINGS YOU NEED TO KNOW:  As a Participant covered under the Paul Mueller Company Employee Benefit Plan, you are entitled to certain rights and protections under the Employee Retirement Income Security Act of 1974 (ERISA).  ERISA specifies that all Participants shall be entitled to:

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The Plan is maintained pursuant to a Collective Bargaining Agreement. 

Words used in this Summary Plan Description in the masculine gender include the feminine and vice versa. 

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EMPLOYEE ELIGIBILITY AND EFFECTIVE DATE:  If you are a permanent Employee performing Active Work on a Full-Time Basis, your coverage will become effective on the day following the end of the first 90 days of employment during which you have worked 360 hours for the Company, provided that you properly enroll in the Plan and pay any required contributions, in accordance with the provisions of Section VIII.  You must still be performing Active Work on a Full-Time Basis on your eligibility date in order to become covered.  If you are otherwise eligible for coverage and are not performing Active Work on a Full-Time Basis on your eligibility date because of a health status-related reason, coverage will nevertheless become effective on your eligibility date. 

If, at 12:01 a.m. on the date your coverage (or an increase in the amount of coverage) would otherwise become effective or be reinstated, you are away from work due to Injury or Illness, the effective date of Weekly Disability Income coverage (or an increase in the amount of coverage) is postponed until you are available to return to Active Work on a Full-Time Basis.  If, on the date your coverage (or an increase in the amount of coverage) would otherwise become effective or be reinstated, you are not actively at work, your Life Insurance and Accidental Death and Dismemberment Insurance (or increase in the amount of coverage) will not become effective until you return to Active Work on a Full-Time Basis, provided you still meet the other requirements for eligibility at that time. 

A Participant may have a right to continue coverage for himself and his Eligible Dependent(s) during a period when the Participant is on a leave of absence authorized by the Company pursuant to the Family and Medical Leave Act of 1993 (FMLA Leave).  The Participant's right to continue coverage during a period of FMLA Leave and the manner in which that coverage is continued is described in the section entitled "Family and Medical Leave Act Coverage" on page 18. 

DEPENDENT ELIGIBILITY AND EFFECTIVE DATE:  "Eligible Dependents" are the following persons who have been properly enrolled in the Plan and for whom the required contributions for coverage have been received:

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No person may be simultaneously covered as an Employee and a Dependent or as a Dependent of more than one Employee. 

Your Eligible Dependent(s) will be covered on the same date your coverage is effective or the date they become an Eligible Dependent, whichever is later, provided that they are properly enrolled in the Plan within 30 days of their eligibility date.  If an Eligible Dependent is enrolled due to a Special Enrollment caused by loss of other group health coverage and within the 30-day enrollment period, coverage will be effective on the first day of the month following enrollment.  If an Eligible Dependent is enrolled due to Special Enrollment caused by marriage, birth or adoption within the 30-day enrollment period, coverage will become effective on the date of the marriage, birth or adoption.  In all events, coverage of your Dependents will be conditioned on your payment of the required contribution for Dependent coverage, in accordance with the provisions of Section VIII. 

If an Eligible Dependent, other than a newborn, is confined at home, in a hospital, or elsewhere because of a physical or mental condition on the date Dependent Life Insurance (or any increase or additional benefit provided under the insurance policy) would otherwise have become effective, the effective date of Dependent Life Insurance (or any increase or additional benefit provided under the insurance policy) will be deferred until the Eligible Dependent is discharged from the hospital or no longer confined and has engaged in substantially all the normal activities of a healthy person of the same age for a period of at least 15 consecutive days.  For purposes of this paragraph, the term "confined elsewhere" means the Eligible Dependent is unable to perform, unaided, the normal functions of daily living, or leave home or other place of residence without assistance. 

ENROLLMENT:  Employees and Eligible Dependents may be enrolled in the Plan in the following circumstances:

Open Enrollment will be held during the month of December.  You may elect coverage under the Plan for yourself and your Eligible Dependents during this period by completing an enrollment form, which the Plan must receive by December 31.  Coverage will become effective on the following January 1.  Please note that each employee is only entitled to one Open Enrollment during his or her lifetime even if he or she gains additional dependents following such open enrollment.  Once you have used Open Enrollment to add coverage, additional enrollment changes will only be permitted due to eligibility changes or Special Enrollment events. 

SPECIAL ENROLLMENT:  You and your Eligible Dependents may be enrolled in the Plan in the following circumstances:

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TERMINATION OF EMPLOYEE COVERAGE:  Your coverage will terminate as follows:

However,

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In no event, however, will your coverage be continued beyond the earliest of the following dates:

If your coverage is terminated because you retire, a reduced amount of Life Insurance will be continued after your retirement in accordance with the provisions in the "Schedule of Benefits" (on page 26) in Section III of this booklet.  In addition, you may be eligible to continue your Medical and Prescription Drug coverage on a self-payment basis.  See "COBRA Continuation Coverage" and ''Limited Self-Payment Privilege for Retired Employees and Surviving Dependent(s)" on pages 19 and 22, respectively, in this booklet. 

The length of coverage you are entitled to under this section after you cease Active Work on a Full-Time Basis shall be reduced to the extent necessary to avoid duplicating any coverage available under the section entitled "Family and Medical Leave Act Coverage." If your coverage is extended under this section on account of your retirement, termination of employment, involuntary layoff, Total Disability, or period of military service or training and FMLA leave, any contributions for your coverage or that of your Eligible Dependents will be waived during the period of extended coverage.  If your coverage is extended under this section because you took unpaid leave, were "out of work" or were voluntarily laid off, and you choose not to drop coverage for yourself or your Eligible Dependents in accordance with Section VIII, your contributions for coverage must be made on a pre-tax basis under that section once you return to pay status.  Contributions will be recouped over a six-month period on a pro-rata basis, or sooner if you elect. 

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The Administrative Manager will furnish to persons whose coverage under the Plan terminates a Certificate of Creditable Coverage as required by the Health Insurance Portability and Accountability Act (HIPAA). 

TERMINATION OF DEPENDENT COVERAGE:  The coverage of your Dependent(s) will terminate on the earliest of the following dates:

If a covered unmarried Child, who is dependent upon you for support, is incapable of self-sustaining employment because of mental retardation or physical handicap on the date his coverage would otherwise terminate, his coverage will not terminate solely because of attained age.  Proof of such current and continuing incapacity is required within 31 days after the date the Child would otherwise cease to be eligible and from time to time thereafter as requested by the Benefits Committee. 

Upon notice of termination, the Administrative Manager will furnish to persons whose coverage under the Plan terminates a Certificate of Creditable Coverage as required by the Health Insurance Portability and Accountability Act (HIPAA). 

REINSTATEMENT OF COVERAGE:  Except as described in the "Family and Medical Leave Act Coverage" section below, if, after your coverage is terminated (or would have been terminated were it not for your election of Continuation Coverage), you resume Active Work on a Full-Time Basis, your coverage will be reinstated as follows:

If the termination of coverage is due to the cessation of work by reason of military leave, the "160 hours of work" requirement will not apply and your coverage will be made effective on the date you resume Active Work on a Full-Time Basis, provided that you apply for reemployment within the time periods specified by the Uniformed Services Employment and Reemployment Rights Act of 1994 (USERRA). 

If termination is due to Total Disability and you remain continuously Totally Disabled until you resume employment with the Company, the "160 hours of work" requirement will not apply and your coverage will be made effective on the date you resume Active Work on a Full-Time Basis. 

Upon reinstatement of your coverage, you may also cover any Eligible Dependents who were covered at the time your coverage was terminated and any Eligible Dependents who you acquired subsequent to termination of your coverage.  You may not add coverage for any Eligible Dependents for whom you previously declined coverage.  Such Eligible Dependents may be enrolled only if a Special Enrollment Event occurs or during a once per lifetime Open Enrollment period.  (See "Enrollment" on page 14). 

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EXTENDED BENEFITS:  If your Medical and Prescription Drug coverage is terminated while you are Totally Disabled, Extended Benefits will be payable with respect to Covered Expenses incurred after such termination solely as a result of the Injury or Illness causing such Total Disability.  Extended Benefits will also be payable, in the case of a Dependent whose coverage is terminated while the Dependent is Totally Disabled, solely for Covered Expenses resulting from the Injury or Illness causing such Total Disability. 

Extended Benefits will be payable for six months, but in no event beyond the earliest of the date:

[NOTE:  Pregnancy is treated as any other Illness in determining eligibility for Extended Benefits (i.e., you must be Totally Disabled in order to qualify).]

COBRA CONTINUATION COVERAGE:  You and your Eligible Dependents have the opportunity to continue coverage in certain instances where coverage would otherwise end.  Such continuation coverage is described in the Consolidated Omnibus Budget Reconciliation Act of 1985 ("COBRA").  You may elect COBRA Continuation Coverage at your own expense if your Medical, Prescription Drug, and Dental coverage under the Plan terminates because of a reduction in hours of employment or termination of employment (for reasons other than gross misconduct). 

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Your Spouse may elect COBRA Continuation Coverage if his or her Medical, Prescription Drug, and Dental coverage under the Plan terminates for any of the following reasons:

Your Dependent Child may elect COBRA Continuation Coverage if his Medical, Prescription Drug, and Dental coverage under the Plan terminates for any of the following reasons:

The events described above which may result in eligibility for COBRA Continuation Coverage are referred to as "Qualifying Events." In the event you fail to return to work at the conclusion of your FMLA Leave, the Qualifying Event occurs on the last day of your FMLA Leave. 

Under COBRA, "Qualified Beneficiaries" are entitled to elect COBRA Continuation Coverage.  A "Qualified Beneficiary" is an individual who was covered by this Plan on the day before experiencing a Qualifying Event and who lost coverage under the Plan as a result of that event within the applicable maximum COBRA coverage period.  The following persons are also Qualified Beneficiaries:

If multiple individuals are eligible to elect COBRA Continuation Coverage due to the same Qualifying Event, each individual has a separate and independent right to elect COBRA Continuation Coverage.  You are not eligible to elect COBRA coverage if, on the day before the Qualifying Event, you are covered under the Plan by reason of another individual's electing of COBRA Continuation Coverage and you are not already eligible for COBRA Continuation Coverage. 

For COBRA Continuation Coverage to be available, the Qualified Beneficiary or Participant must inform Paul Mueller Company, by written notice to the following address, of a divorce or legal separation or of a Child ceasing to be an Eligible Dependent under the Plan within 60 days of the Qualifying Event:

Paul Mueller Company
Human Resources
1600 West Phelps Street, P.O. Box 828
Springfield, Missouri 65801-0828

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The Administrative Manager will, within 14 days after receipt of notification from Paul Mueller Company that a Qualifying Event has occurred, notify the Qualified Beneficiary that he has the right to elect COBRA Continuation Coverage.  The Qualified Beneficiary must then make a written election of COBRA Continuation Coverage.  That election must be submitted to the Administrative Manager within 60 days after the later of:

If the Qualified Beneficiary does not elect COBRA Continuation Coverage within the time limits described above, his Medical, Prescription Drug, and Dental coverage will not be continued. 

Each Qualified Beneficiary has a separate and independent right to elect COBRA Continuation Coverage.  If any Qualified Beneficiary elects COBRA Continuation Coverage, the Plan will provide him with Medical, Prescription Drug, and Dental coverage which, as of the time coverage is being provided, is identical to the Medical, Prescription Drug, and Dental coverage provided under the Plan to similarly situated active Covered Individuals. 

If a Qualified Beneficiary acquires a new Dependent while on COBRA Continuation Coverage, that new dependent can be covered for the balance of the maximum coverage period, provided that the Qualified Beneficiary notifies the Administrative Manager of the new Dependent within 30 days after the date the new Dependent was acquired and provided the Qualified Beneficiary pays any additional COBRA premium that may be required. 

[NOTE:  If an employee on COBRA has a new Child or adopts or has one placed for adoption, the new Child has an independent right to continue coverage for the balance of the maximum coverage period, even if the employee's coverage does not continue for the entire maximum coverage period.  No other after-acquired Dependent has this right.]

DURATION OF COBRA CONTINUATION COVERAGE:  COBRA Continuation Coverage may be maintained for a maximum of 36 months from the date of the Qualifying Event unless coverage was lost because of termination of employment or reduction in hours.  In that case, the maximum COBRA Continuation Coverage period is 18 months from the date of the Qualifying Event. 

If the Qualified Beneficiary is determined by the Social Security Administration to be Totally Disabled as of the date of the Qualifying Event or within the first 60 days of COBRA Continuation Coverage and so notifies the Administrative Manager within 60 days after the Social Security Administration's determination and prior to the end of the 18-month coverage period, the maximum COBRA Continuation Coverage period for the disabled Qualified Beneficiary as well as for every other Qualified Beneficiary who lost coverage due to the same Qualifying Event will be extended for an additional 11 months -- for a total of 29 months -- but not beyond the first day of the month that is more than 30 days after the date of a final determination by the Social Security Administration that the disabled Qualified Beneficiary is no longer Totally Disabled.  The Qualified Beneficiary must notify the Administrative Manager within 30 days following a determination by the Social Security Administration that the Qualified Beneficiary is no longer Totally Disabled. 

If, during that 18 or 29 months, a Qualified Beneficiary experiences another Qualifying Event (employee's death, divorce or legal separation, or loss of Dependent status), coverage may be extended, but in no case may the total amount of COBRA Continuation Coverage be more than 36 months from the date of the original Qualifying Event.  Please note that termination of employment following a reduction in work hours is not considered a second Qualifying Event and will not entitle Qualified Beneficiaries to coverage beyond the initial 18 months of COBRA Continuation Coverage. 

A special rule applies if you become entitled to Medicare benefits within 18 months prior to terminating employment.  Even if that Medicare entitlement does not cause your Eligible Dependents to lose coverage under the Plan, your subsequent termination of employment will entitle your Eligible Dependents to COBRA Continuation Coverage that extends until the later of 18 months after your termination of employment or 36 months after your Medicare entitlement. 

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The 18-, 29-, and 36-month periods referred to in this section include (i.e., are reduced by) the 14-, 90-, and 180-day and the 30-month extensions provided in paragraphs 1, 2, and 3 of the section entitled "Termination of Employee Coverage" on pages 15 and 16. 

In no event will COBRA Continuation Coverage be continued beyond the earliest of the following dates:

The Benefits Committee will determine the monthly premium rates applicable to Qualified Beneficiaries who elect COBRA Continuation Coverage annually.  Premium rates may be higher for the additional 11 months of COBRA Continuation Coverage available to Totally Disabled Qualified Beneficiaries than during the first 18 months of COBRA Continuation Coverage. 

A grace period of 45 days from the election date will be allowed for payment of the initial premium for COBRA Continuation Coverage and 30 days for payment of each subsequent COBRA Continuation Coverage premium.  If the first premium is not received by the end of the grace period, COBRA Continuation Coverage will not take effect and the right to COBRA Continuation Coverage is forfeited.  If any subsequent premium is not received by the end of the grace period, COBRA Continuation Coverage will be terminated as of the end of the period for which the last timely premium was received and may not be reinstated.  Premiums must be made in full; however if a timely payment is made in an amount that is "not significantly less" than the full amount due, the Qualified Beneficiary will be notified and will have 30 days from the date of such notice to pay the delinquent amount.  For purposes of this provision, a payment will be considered "not significantly less" than the amount due if it is within the lesser of 10% or $50 of the required premium. 

MILITARY LEAVE OF ABSENCE:  If you take a leave of absence for the purpose of military service or training (as described in the Uniformed Services Employment and Reemployment Rights Act), you may continue your coverage under the Plan (and that of your enrolled Dependents, as well).  The rules applicable to such continued coverage are similar to the COBRA Continuation Coverage rules described above.  Unlike COBRA Continuation Coverage, however, no contribution is required for your or your Eligible Dependents' coverage during the first 30 days of such a leave or, if longer, the duration of your extended coverage under the section entitled "Termination of Employee Coverage" on page 15.  Contact the Administrative Manager for additional information concerning this coverage continuation option. 

LIMITED SELF-PAYMENT PRIVILEGE FOR RETIRED EMPLOYEES AND SURVIVING DEPENDENT(S):  If you become a Retired Employee, you may elect, following the COBRA Continuation Coverage described in the section entitled "COBRA Continuation Coverage" above, to continue your Medical and Prescription Drug coverage (provided you are not eligible for Federal Medicare coverage, Part A or Part B) and/or that of your Eligible Dependent(s) (provided they are not eligible for Federal Medicare coverage, Part A or Part B), but not your Life Insurance and Accidental Death and Dismemberment Insurance or your Weekly Disability Income or Dental coverage, on a self-payment basis at rates determined by the Benefits Committee. 

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Self-payment coverage must commence immediately upon termination of your (and/or your Eligible Dependent's) COBRA Continuation Coverage under the Plan and must be continuous.  Self-payment must be made monthly as determined by the Benefits Committee and must be received by the Administrative Manager within 30 days following the beginning of the period for which due. 

Your coverage may not be continued beyond the earliest of the date you: 

Coverage of your Eligible Dependent(s) may not be continued beyond the earliest of the date:

If you die while an active Participant and while eligible for early or normal retirement, continued Medical and Prescription Drug coverage on a self-payment basis is also available to your surviving Eligible Dependent(s) to the same extent and subject to the same requirements and limitations as if you had been a Retired Participant at the time of your death. 

OBTAINING INDIVIDUAL HEALTH INSURANCE ONCE YOUR COVERAGE ENDS:  If you exhaust COBRA Continuation Coverage and you are ineligible for Medicare or any other group health coverage or insurance, you may be able to obtain an individual health insurance policy from an insurance company.  Federal law requires issuers of individual health insurance to accept such enrollees without imposing a preexisting condition limitation as long as any break in creditable coverage is fewer than 63 days.  This Plan does not provide such individual health insurance.  To see if you can take advantage of this Federal law, you should contact an insurance agent or the State Insurance Commissioner. 

ELIGIBILITY DEFINITIONS:  For purposes of the eligibility provisions of the Plan:

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WHEN BENEFIT IS PAYABLE:  If you die at any time or place while you are insured, your Life Insurance Benefit of $50,000 will be paid in a lump sum (or, if elected, in installments as provided in the group insurance policy) to your Beneficiary. 

TOTAL DISABILITY DEATH BENEFIT:  If you become Totally Disabled while insured and before you attain age 65, and if your Life Insurance is terminated, a death Benefit will nevertheless be payable when you die provided that all the following requirements are fulfilled:

The amount of the Total Disability Death Benefit is $50,000 if you die before attaining age 65.  If you qualify as a Retired Employee at age 65, the Total Disability Death Benefit payable, if you die thereafter, is $1,000.  If you do not qualify as a Retired Employee at age 65, no Total Disability Death Benefit is payable if you die thereafter. 

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"Totally Disabled" for the purposes of this Total Disability Death Benefit means that you have a condition that prevents you from performing the material and substantial duties of any occupation for which you are suited by education, training, or experience, and it is expected that this condition will last for at least 180 days from your last day of work as an active, full-time employee; or you have been diagnosed with a life expectancy of six months or less. 

BENEFICIARY:  Payment will be made to the Beneficiary designated by you.  You may change your beneficiary designation whenever you wish.  To do so, simply ask the Administrative Manager for a "Change of Beneficiary" form, fill it out, sign it, and return it, so that the change may be properly recorded. 

If you have no designated Beneficiary, your Life Insurance may be paid --

If a minor beneficiary does not have a legal guardian, the Insurance Company may, until such a guardian is appointed, pay the person it deems to be caring for and supporting him.  Such payment will be in monthly installments of not more than $200. 

If you apply for an individual policy under the Conversion Privilege described below and name a different Beneficiary than the one you named under the group policy, you will be considered to have changed your Beneficiary under the group policy to the Beneficiary designated in the application for the individual policy. 

ACCELERATED BENEFIT:  If you are under 65 years of age, insured for at least $10,000 and submit satisfactory proof to the Insurance Company that you have been diagnosed as having a terminal Illness with a life expectancy of six months or less as certified by your Physician, you may request that a portion of your Life Insurance Benefit be paid to you prior to your death.  This "Accelerated Benefit" must be at least $3,000 and cannot exceed 80% of the maximum Life Insurance Benefit to which you are entitled.  The Accelerated Benefit is a prepayment of a portion of your Life Insurance Benefit and will be deducted from the Life Insurance Benefit payable to your Beneficiary upon your death. 

You are entitled to only one Accelerated Benefit. 

CONVERSION PRIVILEGE:  If your Life Insurance or any portion of it terminates, you will have a period of 31 days following such termination during which you may obtain an individual Life Insurance policy, without medical examination, by making application to the Insurance Company and paying the applicable premium.  The amount of the individual policy may not exceed the amount of your Life Insurance that ceases because of such termination.  Any type of individual policy (except term insurance), without Disability or other supplementary Benefits, customarily issued by the Insurance Company at the time, will be available. 

If you should die during this 31-day period, the amount of insurance convertible will be payable whether or not you applied for an individual policy. 

If your Life Insurance terminates because of termination of the group insurance policy, a more limited Conversion Privilege is available. 

The Administrative Manager will assist you in contacting the Insurance Company, but it is your responsibility to initiate the request for conversion. 

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WHEN BENEFIT IS PAYABLE:  If any of your Eligible Dependents dies while covered, the Dependent Life Insurance amount shown in the "Schedule of Benefits" will be paid --

TOTAL DISABILITY DEATH BENEFIT:  If you qualify for the Total Disability Death Benefit, above, your Dependent Life Insurance will continue until the earliest of the date:

CONVERSION PRIVILEGE:  If your Dependent Life Insurance is terminated because of your death or your cessation of eligibility under the Plan, the group coverage may be changed to an individual Life Insurance policy.  Written application must be made for the individual policy on the life of each Dependent whose coverage is terminated within the same period and under the same terms and conditions as those described under "Conversion Privilege" for your insurance. 

WHEN BENEFIT IS PAYABLE:  If you sustain accidental bodily injuries while your Accidental Death and Dismemberment Insurance is in force, and as a direct result of the accident and independently of all other causes you suffer the loss of life or limb or sight, the Benefit indicated below will be payable, provided the loss occurs within 90 days of the accident and is not excluded by the Limitations and Exclusions provision. 

DEATH BENEFIT:  For loss of life, the Maximum Amount of $50,000 will be payable to your Beneficiary. 

Your Beneficiary will be the same as under the Life Insurance coverage unless you make a separate written designation for the Accidental Death Benefit.  Any such separate designation shall be subject to all terms of the beneficiary provision of the Life Insurance coverage, including the effect of designating a Beneficiary in an application for conversion to an individual policy of Life Insurance. 

DISMEMBERMENT BENEFIT:  One-half of the Maximum Amount (i.e., $25,000) will be payable to you for loss of:

The Maximum Amount of $50,000 will be payable to you for loss of more than one of the above, resulting from one accident. 

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Loss of hand or foot means loss by severance through or above the wrist or ankle joint, respectively, and loss of sight means the loss of an eye or the complete and irrevocable loss of sight of an eye. 

LIMITATIONS AND EXCLUSIONS:  No more than the Maximum Amount of $50,000 will be paid for all losses sustained as a result of any one accident whether or not such losses occur simultaneously or in succession during the 90-day period after the accident. 

No payment will be made for losses connected in any way with any of the following:

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WHEN BENEFITS ARE PAYABLE:  Weekly Disability Income Benefits are payable when you become Disabled, while covered under the Plan, by an Injury or by an Illness so as to be unable to perform your regular work.  Confinement to your home is not necessary; however, treatment by a legally qualified Physician or Surgeon (Doctor of Medicine, Doctor of Osteopathy or Doctor of Podiatric Medicine) is required. 

The day on which Weekly Disability Income Benefits begin is shown in the "Schedule of Benefits" above. 

If you apply for Weekly Disability Income Benefits for a period of Disability expected to last more than five months, you must also apply for Social Security Disability Income Benefits.  This includes making timely claim for and fully pursuing all avenues of appeal provided for under the Social Security Act with respect to denial of such benefits.  As a condition of the payment of Weekly Disability Income Benefits, you must, in writing --

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AMOUNT OF BENEFITS:  The Weekly Benefit Amount and the maximum Payment Period are shown in the "Schedule of Benefits" above.  If Benefits are due for less than a full week, one-fifth of the Weekly Benefit Amount will be paid for each Covered Day of Disability.  In no event will Benefits be payable for more than the Maximum Payment Period during any one Disability Period. 

WEEKLY DISABILITY INCOME DEFINITIONS:  For purposes of the Weekly Disability Income Benefit provision of the Plan:

LIMITATIONS AND EXCLUSIONS:  Weekly Disability Income Benefits are not payable for any day of Disability:

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[NOTE:  The medical Deductible is separate from and is not related in any way to the dental and prescription drug Deductibles explained in other sections of this Plan Document.]

Individual.  The Deductible is applicable each calendar year to the Covered Expenses incurred by each Covered Individual.  The Deductible is satisfied as soon as Covered Expenses are incurred by the Covered Individual in an amount equal to:

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Charges applied to any of the Deductibles above count toward the other Deductibles required above. 

The Deductible does not apply to the Benefits listed under "Covered Expenses not Subject to the Deductible" (page 33). 

Covered Expenses incurred during the last three months of one calendar year for which Benefits were not payable solely because of being included in that year's Deductible may be used toward satisfying the Deductible for the next calendar year. 

Family.  The Deductible will be considered satisfied by all members of that family unit for the remainder of a calendar year if, during that calendar year, covered Deductible expenses are incurred by a family unit in an amount equal to:

Charges applied to any of the Deductibles above count toward the other Deductibles required above. 

Amount of Benefits.  After satisfaction of the applicable Medical Deductible requirement and subject to the Maximum Amounts, Benefits are payable in an amount equal to:

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Charges payable under any of the items above count toward the $10,000 required to be paid at 50% under any of the other items above. 

If a Preferred Provider's negotiated charges exceed the provider's usual charges and the Covered Individual is responsible for payment of that excess, the Plan will pay the Benefits described in the preceding sentence, plus 100% of the amount by which the negotiated charge exceeds the provider's usual charge. 

Maximum Benefit.  The total amount of Benefits payable for a Covered Individual for all Covered Expenses will not exceed a Lifetime Maximum of $1,000,000, effective with respect to Benefits paid on or after March 22, 1995. 

Benefits payable for treatment of alcoholism, chemical dependency, and drug addiction are further limited to a maximum of $12,000 per calendar year and $50,000 lifetime. 

Coverage for inpatient treatment of nervous or mental conditions is limited to 30 days per calendar year and 75 days lifetime (all days, including those prior to January 1, 1998, are counted toward the lifetime maximum). 

Refer to paragraph 22 (on page 43) of the section entitled "Covered Expenses" for the $1,500 cardiac and pulmonary rehabilitation services maximum. 

Refer to paragraph 23 (on page 43) of the section entitled "Covered Expenses" for the $200 smoking cessation maximum. 

VOLUNTARY PREDETERMINATION PROGRAM:  The Plan does not require that you or your health care provider obtain precertification prior to receiving health care services or supplies nor does it provide reduced benefits if you fail to obtain precertification.  The Plan offers a voluntary predetermination program that you or your health care provider may use to determine whether the Plan considers health care services or supplies that have not yet been provided to you to be medically necessary and appropriate.  If you participate in this voluntary predetermination program and a service or supply is determined to be medically necessary and appropriate, when your claim is submitted after the service or supply is provided, your claim will not be denied on the basis of medical necessity and appropriateness. 

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There is no penalty for failure to request a predetermination.  However, if you receive health care services or supplies without obtaining a predetermination, you risk learning after receiving the services or supplies, that they are not covered under the Plan because they are not considered medically necessary and appropriate.  Unless you obtain a predetermination, medical necessity will be decided when a claim is filed after the service or supply has been provided.  In such a case, you may be entirely responsible for the cost of any non-covered services or supplies. 

If you do not request a predetermination or if the predetermination is that the service is not medically necessary, then a claim submitted after services are provided will be reviewed without regard to whether you participated in the voluntary predetermination program or to any negative determination made as part of that program. 

HOW TO OBTAIN PREDETERMINATION:  To predetermine whether a hospitalization or a surgical procedure or other outpatient procedure is considered medically necessary and appropriate, contact the Administrative Manager at the telephone number listed in the Quick Reference Guide in the front of this Summary Plan Description.  The Administrative Manager may refer your request to an independent medical consultant to determine the medical necessity and appropriateness of the service.  You and your physician will be informed of the decision

CONCURRENT REVIEW:  If you obtained a predetermination of hospital admission, the Administrative Manager will perform periodic reviews of your medical progress and will check with your physician and/or hospital.  If the Administrative Manager determines the continued stay to be medically necessary and appropriate, your claim will not be denied on that basis. 

EMERGENCY HOSPITAL ADMISSIONS:  In the event of an emergency hospital admission, you or your physician may contact the Administrative Manager following the admission to participate in the concurrent review program. 

REVIEW OF PREDETERMINATION DECISIONS:  If you or your physician disagree with a predetermination that hospitalization, length of stay, surgery or outpatient procedure is not medically necessary or appropriate, you or your physician may contact the Administrative Manager to review the situation.  Because the Plan does not recognize a request as a claim until after the services have been rendered, the Plan's formal appeal procedure does not apply to adverse predetermination decisions.  If you disagree with the predetermination decision, you may obtain the services and, when the claim is submitted after the services have been performed, the claim will be reviewed by the Plan without deference to the negative predetermination decision. 

ELIGIBILITY AND COVERAGE:  If you wish to know whether the patient is eligible and whether the proposed service or supply is covered or excluded under the terms of the plan, you or your health care provider should contact the Administrative Manager.  Even if a service or supply is predetermined to be medically necessary and appropriate, the Administrative Manager will review the claim for eligibility and coverage when it is submitted.  Thus, a claim for medically necessary and appropriate services may be denied on other grounds. 

Neither the Administrative Manager, the Plan nor any medical consultants used by the Plan will make any decisions regarding your medical treatment or the receipt of health care services.  You should make all final decisions about your medical care after consultation with your Physician. 

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SECOND SURGICAL OPINION BENEFIT:  Covered Expenses for a second surgical opinion are not subject to the Deductible, and Benefits will be payable for 100% of the first $100 of Covered Expenses (regular Plan Benefits apply to any such expenses in excess of $100) for a second surgical opinion which meets the following conditions:

If the first two opinions differ, the Plan will also pay the Benefits described above for a third opinion. 

HIGH RISK PREGNANCY BENEFIT:  If a pregnant Participant or Spouse complies with all of the following requirements and delivers a well baby, the Plan will pay the first $200 of the baby's Hospital charges at the rate of 100%:

AUDIT BY PARTICIPANTS:  Subject to the following conditions and limitations, the Plan will pay directly to the Participant 50% of any reduction in Plan Benefits directly resulting from billing error(s) detected by the Participant and corrected through his efforts: 

If the Covered Individual's Deductible has not been satisfied, 50% of any such reduction in Covered Expenses will be credited toward his Deductible. 

EMPLOYEE ASSISTANCE PROGRAM:  The Plan has contracted with a vendor to provide Employee Assistance Program (EAP) services to Participants and Dependents.  The EAP Vendor is an organization separate and independent from the Plan.  The Plan pays a fee to the EAP Vendor to make its EAP services available to Participants and Dependents. 

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The EAP provides short-term counseling to assist Employees and Dependents with personal problems, including:

The EAP provides an assessment interview and up to six counseling sessions at no cost to you.  In addition, the EAP may refer you to outside Psychiatrists, Clinical Psychologists, Licensed Clinical Social Workers, and Licensed Professional Counselors.  A portion of the fees charged by these professionals may be covered under other provisions of the Plan.  The EAP may also refer you to other community resources which charge no fees or reduced fees based on your ability to pay. 

Your use of the EAP is confidential.  Information will not be released to Paul Mueller Company without your permission. 

You may access the EAP by calling the EAP Vendor whose telephone number is listed in the Quick Reference Guide in the front of this Summary Plan Description. 

COVERED EXPENSES:  Subject to the Deductible and Maximum Benefit, Medical Benefits are payable with respect to Covered Expenses incurred by a Covered Individual while covered under the Plan for any of the following:

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MEDICAL DEFINITIONS:  For purposes of the Medical Benefit provisions of the Plan:

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