20150709UWI to Staff 1,2,4,9,10,11,14,15.pdf

Lauyem
Boiser ldaho 83702
July 9,2015
?t]l5 Jl.iL -9 Pl4 2: 3l
420VestBannockSteet lL,r,,i.l-i i.,-.,:i,,
P.O. Bcm 256/183701 UTll-lTi[$ t]*]r'liriii;;dfrdb. F. McDevitt(208) 343-7s00
(208) 3366912 (Fa:r)DeanJ. floe) Miller
Celeste trL Miller
Yia llaad Dclivery & AS Meil
JeanJevre[ Secetary
I.laho Public Utilities Commission
472W. lTashington Sr
Boisq Idaho 8372A
Re: LNTI-\[-15-01
Dear Ms.JerrelL
Endosed fe1 filin& please find three (3) copies of United lVater Idaho's Second Response to
Commission Staffs Ffust Ptoduction Request No's 1,2,4,9,10,71,14 aold15.
Please note that the Response to Request No. 1 contains nigbly confidential infotmation and is filed
uoder seal
Response to Request No. 2 is provided it electoaic fotmat on afl enclosed disk"
Kiodly retum a file stamFed copy to me.
VeryTnrlyYouts,
McDevitt & Mller LLP
UAvll^
DeanJ. Millet
DJM/hh
Cq Uoited Water Idaho, Inc.
ORIGINAL
Dean J. Miller (lSB No. 1968)
McDEVITT & MILLER LLP
420 West Bannock Street
P.O. Box 2564-83701
Boise, lD 83702
Tel: [phone]
Far 208.336.6912
ioe@mcdevitt-m iller. com
Attomey for United Water ldaho lnc.
IN THE IIAITER OF THE APPLICATION
OF UNITED WATER IDAHO INC. FOR
AUTHORIW TO INCREASE ITS RATES
AND CHARGES FOR WATER SERVICE
IN THE STATE OF IDAHO
-':!
-! Pl,l ?: 3 |
Gase No. uW-W-15-01
UNITED WATER IDAHO'S
SECOND RESPONSE TO FIRST
PRODUCTION REQUEST OF THE
COMiiISSION STAFF
?"1 ! r; l{ 1lL! i - urL L
ll
r r.l' 'i iriil: ll'' -i
. r r- l i
BEFORE THE IDAHO PUBLIC UTILITIES COMMISSION
United Water ldaho lnc., ("United Watef') by and through its undersigned
attorneys, hereby submits its Responses to the Commission Staffs First Production
Request No's 1 ,2,4,9, 10, 11,14 and 15.
DATED ttris -[-day of July, 2015
UN WATER IDAHO INC.
UNITED WATER IDAHO'S SECOND RE$PONSE TO FIRST PRODUCTION REQUEST OF THE
commlssloN STAFF - I
J. Mlller (lSB No. ?968)
Attomey for United Water ldaha lnc.
CERTIFICATE OF SERVICE
I hereby certify that on ,n" Q[Oay of July, 2015, I caused to be served, via the
method(s) indicated below, true and correct copies of the foregoing document, upon:
Jean Jewell, Secretary Hand Delivered
ldaho Public Utilities Commission U.S. Mail
472 West Washington Street Fax
M
(J
P.O. Box 83720
Boise, lD 83720-0074
iiewell@puc. state. id. us
Donald L. Howell, ll
Daphne Huang
Deputy Attomey General
ldaho Public Utilities Commission
P.O. Box 83720
Boise, ldaho 83720-0074
don. howell@puc. idaho.oov
daphne. [e-mail]
Brad M. Purdy
Attorney at Law
2019 N. 17th Street
Boise, lD 83702
[e-mail]
Fed. Express ,-i
Email d
Hand Delivered
U.S. Mail
Fax
Fed. Express
Email
Hand Delivered
U.S. Mail
Fax
Fed. Express
Email
tJ
(J
aaK
l
IJ
+t
BY' \\{.ftHr-p r +o\ Lk,
McDEvnr & Mu*en LLP
UNITED WATER IDAHO'S SECOND RESPONSE TO FIRST PRODUCTION REQUEST OF THE
coMmtsstoN STAFF - 2
UNITED WATER IDAHO INC.
cAsE uw-w-{5-01
FIRST PRODUCTION REQUEST OF THE COMMISSION STAFF
Preparer/Sponsoring Witness: Greg Wyatt
RFAUEST NO. 1:
Please provide a copy of or access to all internal and external audit reports, work
papers, etc. for the years 2011 to present.
RESPONSE NO. 1:
lnformation responsive to this request is being filed as Confidential lnformation pursuant
to the Protective Agreement dated June 19,2015 and is available for inspection by
persons who have signed the Protective Agreement.
UNITED WATER IDAHO INC.
cAsE uwt-w-15-01
FIRST PRODUCTION REQUEST OF THE COMMISSION STAFF
Preparer/Sponsoring Witness:Roger Greaves/Kevin Doherty
REQUEST NO. 2:
Please provide a schedule showing all plant additions completed from Jan 1,2011
through Dec. 30, 2014 include the cost, retirement amounts associated with the project,
cost of removal, salvage, and Contributions !n Aid of Construction (CIAC) associated
with that project, similar to Mr. Greaves' Exhibit No. 3. ln addition please break out the
CIAC by additions.
RESPONSE NO.2:
Please refer to the attached Excel files for the requested data. Due to the voluminous
nature of the data requested, the Company believes that providing hard copy of these
attachments is impractical.
UNITED WATER IDAHO INC.
GASE UWI-W-15-01
FIRST PRODUCTION REQUEST OF THE COMMISSION STAFF
Preparer/Sponsoring Witness: Greg Wyatt
REQUEST NO.4:
Please provide details of all goal targets and criteria requirements comprising the
Company's Short Term lncentive Plan as mentioned in Cary's Direct Testimony on page
4, and show how much incentive bonus was applied to each criteria.
RESPONSE NO. 4:
Please see Response No. 4 Attachment 1 for the amount of incentive payments
charged to O&M in 2014. Please note that the majority of incentive payments are based
upon non-financial factors and are based upon personal goals. Based upon the
attached chart (Response No. 4 Attachment 2), the amount of STIP that is based upon
Non-Financial Objective is 60% and the portion related to the Financial Objective is
40o/o. However based upon the weighting of the various factors, the actual STIP
payments made in 2014 were lndividual (non-financial) objectives 52.2o/o and
Financial objectives 47 .8o/o.
Also, please see Response No. 4 Attachment 3 for a copy of the STIP program.
United Water ldaho
ldaho
STIP-paid personal goals
financialgoals
Total
Amount charged to O&M
Amount based upon personal goals - 52.2%
Amount based upon finadalgoals -47.8%
Response No. 4 Attachment 1
20t4
s126,816
!75,967
5242,783
77.83%
S91,092
g3,2gg
Sttqpgt
Attachment 2
Financial Objective %
Non-Financial obieclve %
50%
50%
30%
70%
50%
s0%
30%
70%
United Water ldaho
Case UW-W-15-01
Request No.4 Attachment 3
Page t of6
Short Term lncentive Plan
Pun DOCUMENT
JRnunRv 2008
United Water ldaho
Case UW-W-15-01
Request No.4 Attachment 3
Page 2 of 6
SHORT TERM INCENTIVE PLAN PLAN DOCUMENT
SHORT TERM INCENTIVE PLAN
PURPOSE
The Short Term lncentive Plan (STIP) is an annual compensation plan that supports United
Water's business objectives by:
o Providint an annual incentiye strategl that drives performance towards oblectives
critical to creating sharcholder value.o Offering competitive cash compensation opportunlties to all eligible employees.r Awarding outstanding achievement among employees who can directly impact
United Water's results.o Providing cash awards for both qualibtive and quantitatiye results.o Providing cash compensation opportunities for making sound business decislons
that impact the company's financial performance and the overall success of Suez.
ELIGIBILITY
All active exempt employees including expatriates are eligible to participate in STIP if not
covered by another annual incentive plan. Employees must be hired or promoted into STIP
eligible positions by the first pay period of the fourth quarter of the plan year, in order to be
eligible for a STIP award for that plan year..
AWARD OPPORTUNITIES
Employees are assigned a target award based on their iob/salary grade. Target awards for
expatriates will be based on thelr Suez compensation plan unless otherwise agreed to by Suez.
The target award is established at market competitive levels and ls expressed as a percentage of
base salary. Target awards will be prorated for part-time employees. Paid awards may range from
O"/o lo 2OOo/o of the target award based on achievement of financial objectives and personal
objectives. Should any events occur during the performance year that in the opinion of the
management of United Water materially affect the performance taryets set, then United Water
may recommend to the Compensation Advisory Commiftee and Suez that an adjustment be made
to any final payment.
PERFORMANCE MEASURES
The STIP plogam is based on two different measures of performance that are critical to United
Water's success, financia! and personal performance.
.3. United Water. s\./ez,
United Water ldaho
Case UW-W-15-01
Request No.4 Attachment 3
Page 3 of 6
SHORT TERM INCENTIVE PLAN PLAN DOCUMENT
FINANCIAL
Each year, Suez Environment and United Water's Compensation Advisory Committee determine
financial measures and target performance levels that will form the basis for measuring success
under STIP. Each objective is assigned a weight based on the employee's job/salary grade,
PERSONAL
As a part of the Performance and Development Review (PDR) process, employees have specific
annual objectives that support the attainment of departmental or organizational objectives. These
objectives form the basis for the personal objective portion of STIP. Managers have the flexibility
to set the weight of each personal objective in accordance with the plan's guidelines.
PAYOUT SCALES
Every level of company, business segmenUdepartment and individual performance earns a
different STIP payout. As United Water and its employees meet or exceed their objectives the
payout will grow as shown on the below payout scales.
Financia! Obiectives
% (}f ObiectiYe Achieved Plvmenr o/o
< 8O"/o O7o 0hreshold)
100"/o 100"/" (Target)
> l2Oo/"2OO"/o (Maximum)
No incentive will be paid for results at or below 80o/o (threshold) of an objective. An incentive
payment equal to two times the target can be earned for results equal to or greater than 120% of
objective. A cunilinearprogression applies for determining the payout o/o between threshold and
maximum. (See Appendix A)
Personal Obiectives
Scale Pertormance Definition Payment %
o Sienificantlv below obiective O o/"
I Close to obiective lo/"-9Ooh
2 Met obiective 9lo/o-ll0oh
3 Above obiective Tlto/o -l5Oo/o
4 SiEnificantlv above obiective LSLo/o - 2OOoh
"fr:United Water
-s\-/ez.
United Water ldaho
Case UW-W-I5-01
Request No.4 Attachment 3
Page 4 of 6
SHORT TERM INCENTIVE PLAN PLAN DOCUMENT
At the end of the perfomance year, managers will evaluate their employee's personal objectives
and assign a payment percentage based on the level of performance achieved. Personal
objectives that are financial indicators shoutd be measured using the scale for financial
objectives.
Sample Award Calculation
Key Assumptions: Base Salary = $82,000 lndividual Target = L5o/o or $12,300
Corporate Financials weight 30% and Personal Objectives weight 70%
Award Pavment Calculation
lndividual Target (15%)$12,300
Total Earned Award% X LO7.5o/o
STIP Award Payment $13,223
"fr:United Water
Perlormancc lrcrsur€
Target $M
Achlcvement
tlaymcnt%
(A)
wclgm
G)
EArneg Awato
GxB)
EBITDA $r26.8 99,2%9l.ZYo lo%9.7Yo
Free Cash Flow $-5r.2
101.306
LQ4.bYo 10%10.5%
Net Current lncome $3s.4
88,7%
52.1)lOo/o 5.204
lol.l rtmnc[l 300h 25.4%
Personal Objective #1 Met Obiective 100.o%2QTo 20.o%
Personal Objective *2 AboYC
Obiective
L20,Ovo to%12,o"h
Personal Oblective #3 Met ObicctiYe rlo.o%ro%t1.o%
Personal Objective #4 Clo6e to
Obiactive
70.o%l0o/"7.Oc/"
Budset Oblective s47.5 113.506 160.3%2Oo/"32.1o/"
Total Perconal
Tobl STIP ErrnCd
10006 82.L%
to75%
_svez
United Water ldaho
Case UWI-W-15-01
Request No.4 Attachment 3
Page 5 of 6
SHORT TERM INCENTIVE PLAN P|./'N DOCUMENT
PLAN PAYOUTS
Employees who are on the active payroll on December 31d of the performance year wi!! be
eligible to receive an award. Employees who are terminated for cause or gross misconduct or who
voluntarily resign prior to the end of a plan year will not receive a STIP award.
STIP awards will be prorated for eligible new hires based on the number of days on payroll the
year of hire. Employees whose target award may have changed during a plan year due to a job
change will receive a prcrated award based on number of days in each iob,
Employees who choose to retire prior to the end of any plan year and haye worked a minimum of
3 months in the plan year, will receive an award that is prorated to reflect the number of days
actually worked during the plan year. Thls also applies in the event of death, disabllity (defined
as any consecutive absence of 60 days or more), leave of absence, inter-company transfers or a
reduction in force. ln the event of disability the pro-ration will apply to financia! targets only and
not personal objectives. Payments will be made when normally paid in the ld quarter of the year
following the performance year.
STIP awards are based on year-end salary and are paid in lump sum during the first quader
followlng the end of the performance year. STIP award pyments can be defened, under the
terms of United Waterb Defened bmpensation Plan.
STIP awards are treated as ordinary income for tax purposes. Taxes will be withheld and are
owed in the year awards are paid.
ADMINISTRATION
United lltlater's Compensation Advisory Committee, Suez Environment and the CEO of United
Water administer the STIP program. The interpretation of the appllcation of the plan document is
at the sole discretion of the company and the CEO's decision will be binding. United Water's
Compensation group manages program administration.
lmMtant
Neithcr STIP, nor any action taken ln conjunction with this plan, shall be construed as giving to any cmployco
thc right to be rrtalned by Unlted Water, The statements ln this documant do not constitute a contract relativc
to comp€nsation treatment and are not intended to create any contnctual dghts, either expressed or implied,
betwecn United Water and its employees. Certaln situatlons may require compensatlon treatment diffcrcnt than
the practices expressed here, The policles, practice!, and procedures described in this document may be
changed, altered, modified, or deleted at any tlme, with or wlthotrt prior notice by United Water. The STIP may
be modified or termlnated at any tlme. These actions may affect present and future eliglble employees,
"?:United Water.SVEz,
United Water ldaho
Case UW-W-15-01
Request No.4 Attachment 3
Page 6 ol 6
PLAN DOCUMENTSHORT TERM INCENTIVE PLAN
Perf.
Score
Payment
oa
<80%o,ooh
Sloh 6.4V.
82c/o 13.4Yo
83%t9.70h
84%25.4o/o
85o/o 31.8%
860/o 37.5%
87%43.loa
aa%4A.4ofo
89%53.6%
9Oo/o 58.6%
9Lo/o 63.4o/o
92%68.0%
93%72.5o,h
APPENDIX A
Curvllinear Payment Table
Perf.
Score
Payment
o/o
94o/o 76.91o
950h 8t.106
9Ech 85.1o/o
97%89.0%
9804 92.8%
99Vo 96.5o/o
IOOYo 100.0%
lOlo/o 103.5%
lO2o/o LO7.20A
7O3o/"1I1.0c6
lo4%LtA.9%
10506 1r8.9%
106%123.1%
!O7o/o 127.5%
Perf.
Score
Payment
o/o
r08%l32.OVo
109%136.6%
llOo/o L4l.4o/o
lllo/o L46.40h
tt2%151.6%
ll3o/o 155.97o
lt4%L62.5'/o
tt5%L68.2%
tt5%174.1%
llTYo 180.306
118%186.57o
lLgo/o 193.2o/o
l20e/o 200.ooh
>L20%200,o./o
.,fr:United Watersve,z,
UNITED WATER IDAHO INL.
GASE UW!-W-15-01
FIRST PRODUCTION REQUEST OF THE COMMISSION STAFF
Preparer/Sponsoring Witness: Jarmila Cary
REQUEST NO. 9:
Please provide a copy of the Tower Watson Report mentioned in Cary's Testimony on
page 6.
RESPONSE NO.9:
Please see attached PDF file: Request No 9 Attachment.pdf
United Water ldaho
Case UW-W-15-01
Request No. 9 Attachment
Page 1 of 11
I CsmpG Ddw
Floor il
Parslppay, NJ 07011
T [phone]
twgBmtson.@m
TOWERS WATSON T.J
April 10,2015
Mr, David Altamura
United Water
200 Old Hook Road
Harrington Park, NJ 07640
Dear Dave:
2OI5 NET PERIODIC BENEFIT COST BUDGETS - GAAP
This letter provides initial 2015 net periodic benefit cost (NPBC) budgets for the following plans:
F United Water Resources lnc. Supplemental Executive Retirement Plan ("SERP")D United Water Resources lnc. Supplementhl Retirement lncome Plan for Key Executives ('SRIP')F United Water Resources and Subsidiaries Directors'Pension Anangement fDirectors')
ln this letter, the term "DB Plans' refers to all of the above, with the exception of OPEB and the term
"GMP' refers to ASC 715-30 and ASC 715-60.
Our calculations are based on the January 1,2014 actuarial valuations of these plans. However, we
have reflected the assumptions used for the December 31, 2014 GAAP disclosures for the plans.
The attached exhibits show the results.
Below is the comparison of the 2014 actual NPBC, the 2015 budgeted NPBC (as presented in our
September 30,2014 letter), and the updated budgeted 2015 NPBC.
UWR
UWES
SERP
SRIP
Directors
OPEB
Total
$12.7 million
$3.0 million'
$0.3 million
$0.2 million
$0.0 million
$5.0 million
$21.2 million
$12.4 millioir
$0.8 million
$0.4 million
$0.2 million
$0.0 million
$5.9 million
$19.7 million
$18.4 million
$1.4 million
$0.5 million
$0.2 million
$0.0 million
$6.8 million
$27.3 million
'indudes one-lime *ttlement drdtgB ot $2.2 millioo f@n lump sum window.
Our September 30h letter provided some details regarding the changes from the 20'14 actual NPBC to the
2015 Prelimlnary NPBC. The following table ouilines the key factors impacting the budget change since
that letter:
Pag. I ol 6
United Water ldaho
Case UW-W-15-01
Request No. 9 Attachment
Page 2 ot'l'l
ik Davld A{,.mutAflil 10,2015rowERS wArsoN Tu
- Pension
Mortality Table
Asset values
UWR
UWES
OPEB
4.260/o lncrease
,i,,rili;ji"-, .r,;. 4.?&. ..-u,._ j;riiffi
RP-2014 mortality table, lncrease
detrended to 2006 using
Scale MP-2014, then
RP-2000 mortaliiy table projecled using Scale
projected to 2025 using BB(2D);
Scale AA Benefits r reighted table used
for Pension, Headcount
weighted table used for
July 31d values,
projected to December
31 using a7.50%
annual rah
$31.4 million
$2.7 million
$6.0 million
$2'1.5 million
$2.6 million
$6.0 million
lncrease
lncrease
Neutral
Ass um ptionslMethods/Data
The assumptions, methods, and data used for these updated calculations are the same as included in our
February 26,2015 letters to the auditors providing year-end financial reporting information for the Pension
and OPEB plans.
Plan Changes
Consistent with our September 30rh letter, the plan provisions are generally the same as used in the
January 1. 2014 valuations.
The updated 2015 budget lnformation now reflects the aclual results of the lump sum windowthatwas
offered last fall, including a 2014 settlement charge for the UWES plan of $2.2 million. Note that the UWR
plan did not need settlement accounting under GAAP since the lump sums paid did not exceed the
service cost plus interest cost for the fiscal year.
Accountlng Methodology
Our calculaUons are based on the United Water accounting policy that we understand has been used in
prior years. We have provided a summary of this accounting methodology in the appendix of this letter.
Discounl Rate
OPEB
,-;{ I .ri -, . .,r\CtUAlr{ . _ ,i, "'ii -{icJ i,'llYixlif:t.',i
December 31tt values lncrease
2015 Expected Contributions
PrgB 2 o( I
United Water ldaho
Case U\M-W-'|5-01
Request No. 9 Attachment
Page3of11
TOWERS WATSON T,)Mr David ArmuE
April 10,20'l5
Contribution Allocation
The contribution was allocated in accordance with the 'ABO'funded status as of December 31,2014.
We used this as a proxy to the January 1.2015 funded status under PPA. Once the January 1, 201 5
actuarial valuation is completed, we will adjust future contributions as appropriate. This may include
reallocating some of the conlributions made prior to that time by moving amounts from one account to
another. We will discuss this in more detail at the time.
Actuarial certification
United Water retained Towers Watson to perform a valuation of its plans for the purpose of estimating
future cost. This valuation has been conducted in accordance with generally accepted actuarial principles
and
The consulting actuaries are members of the Society of Actuaries and other professional actuarial
organizations and meet their 'General Qualification Standard for Prescribed Statements of Actuarial
Opinions'relating to pension and other postretirement beneflts plans.
ln preparing the results presented in this letter, we have relied upon information provided to us regarding
plan provisions, plan participants, and plan assets. We have reviewed this information for overall
reasonableness and consistency, but have neither audited nor independently verified this information.
The accuracy of the results presented in this letter is dependent upon the accuracy and completeness of
the underlying information.
As required by GAAP, the methods employed in the development of the NPBC and other disclosures
have been selected by the plan sponsor, with the concurence of Towers Watson. The actuarial
assumptions were selected by the plan sponsor, as required by GAAP, without using the work of Towers
Watson. Evaluation of the actuarial assumptions was outside the scope of Towers Watson's asslgnment
and would have required substantial additional work. GMP requires that the actuarial assumptions 'be
unbiased and mutually compatible.'
ln our opinion, all calculations are in accordance with GAAP, and the procedures followed and the results
presented conform with applicable actuarial standards of practice. ln preparing the results reflected in
this report, we followed the applicable Actuarial Standards of Practice (ASOPs) promulgated by the
Actuarial Standards Board.
Other actuarial assumptions could also be considered to be reasonable and within the best-estimate
range. Thus, reasonable results differing from those presented in this report could have been developed
by selecting different points within the best-estimate ranges for various assumptions.
The information contained in this letter was prepared for the internal use of United Water and its auditors
in connection with our actuarial valuation of the plans listed at the beginning of this letter. lt is neither
intended nor necessarily suitable for other purposes.
United Water may also distribute this letter to the appropriate authorities who have the legal right to
require United Water to provide them this report, in which case United Water will use best efforts to notify
Towers Watson in advance of this distribution. Further distribution to, or use by, other parties of all or part
of this report is expressly prohibited without Towers Watson's prior written consent.
Paoa 3 of 6
United Water ldaho
Case UW-W-15-0'l
Request No. 9 Attachment
Page 4 of 'l'l
rowERswArsoN W lJ;ffiilt*
Please let us knor if ,you have any questions or uould like to discuss.
Sincerely,
&.-tlli rn"iry
Lonalne Halpin, ASA, EA
Senlor Consultant - Retirement
Attachments
cq Michael Algranati - United Water
Kathy McGoldrick - Unfted Water
Gary Pallatta - United Water
Alina Rocha - Unlted Water
Marie Waugh - Unlted Water
Amiel Chong - Towers Wabon
Mark Srtotinsky, FSA, EA
Senior Consultant - Retlrement
United Water ldaho
Case UW-W-15-01
Request No. I Attachment
Page5of1l
lt DalirAla|rw
April 10.2015TOWERS WATSON W
Appendix - Accounting Methodology
Retirement Plan - UWR
The calculation of the NPBC is prepared for each business unit individually, and then added to develop a
plan total. The components are developed as follows:
Seryice cosl - developed directly based on business unit census data
,nteresl cosl - developed directly based on business unit census data
Pior seruice cost - developed directly based on business unit census data
Expected retum on assefs - the beginning of lhe year asset value for each business unit is increased by
contributions. Benefit payments are allocated based on expected payments for each business unit.
lnvestment income is calculated for each asset account. That rate of return is assumed to apply to each
business unit in that asset account.
The above is used to determine the beginning of the next year asset amount. That amount, along with
expected cash flow, generates the expected retum on assets for each business unit.
Gaintl.oss Amortization - Non-A/Y Eusrness Unfrs - The unrecognized gain/loss for the business unit is
compared to 10% of the lesser of the PBO or plan assets. The excess, if any, is then amortized over the
average future working lifetime of the plan pailicipants (or life expectancy where the populations is
signifi cantly inactive).
The following year, this comparison is done again for each business unit. lf there is no excess in that
year, there is no amortization payment (even if one had been established the prior year). lf there is an
excess, there is a "fresh start", in that the new excess is amortized over the appropriate period (average
future working lifetime or life expectancy), without regard to the prior yeafs amortization payment.
Gain/Loss Amortization - NY Buslness Unls - For New York locations, a new amortization base is
established each year to reflect the actual gain/loss for that year. This base is amortized on a straight line
over the next 1 0 years, and is reflected in the NPBC for each of those years.
Retirement Plan - UWES
The cost for the entire plan is determined, and then allocated back to business units, as follows:
Service cost, lnlerest cost, pior seruice cost, and expected retum on assefs - these are all determined
the same way as for the Retirement Plan - UWR
Gain/Loss Amodizatbn - the amortization payment for the entire plan is calculated in a mannlr similar to
the UWR Non-NY Business units. Then, the "excess'gainfloss is determined for each business unit. The
total amorlization payment is allocated to the business units in proportion to their excess gain/loss.
OPEB
The cosl for each business unit is determined, and then allocated back to business units, as follows:
Paqe 5 ot 6
United Water ldaho
Case UW-W-15-01
Request No. I Attachment
Page6of11
lf Devid Alhu€
Aoril 10.20'15TOWERS WATSON w
Seryice cosl interest cost, prior sevice cost, and expected retum o/, assets - these are all determined
the same way as for the Retirement Plan - UWR
Gain/Loss Amortization - Non-NY Busrness Unifs - the unrecognized gain/loss for the totial plan's
business units (excluding New York) is compared to 10% of the lesser of the PBO or plan assets for
these business units. The excess, if any, is then amortized over the average future r,torking lifetime of the
plan participants.
This amortization payment is then allocated to each non-NY business unit based on the unrecognized
gain/loss of that unit. Note that this is different from what is done for the Retirement Plan - UWES, where
the amortization payment is allocated to the excess gainfloss (over the 10% "conidof).
Gain/Loss Amodization -A/Y Suslness Unifs - the unrecognized galn/loss ls determined by taking the
unrecognized gain/loss and dividing by 10. This calculation is subject to a 'fresh start" each year,
different than what is done for the Retirement Plan - UWR NY amortizations,
PaOe 6 ol 6
Request No. I Attachment
Page 7 ol 11
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Case UW-W-15-01
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Case UW-W-15-01
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Case U\M-W-15-01
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Case UW-W-15-01
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United Water ldaho
Case UW-W-15-01
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UNITED WATER IDAHO INC.
CASE UWI-W-15-01
FIRST PRODUCTION REQUEST OF THE COMMISSION STAFF
Preparer/Sponsoring Witness: Jarmila Cary
REQUEST NO. 1O:
Please provide a copy of or access to the latest contract for medical, dental, and group
life insurance.
RESPONSE NO. 1O:
The Company's medical policies with Blue Cross and Aetna are self-insured. ln addition
to the claims payments that the Company makes, the Company also pays
administration fees. Please see Response No. 10 Attachment lfor the renewal pages
for Aetna and Blue Cross and Response No. 10 Attachment 2 for the Life insurance
policy with Liberty Mutual.
United Water ldaho
Case UWI-W-15-01
Response No. 1 0 Attachment 1
Page 1 ofs
United Water
Financial Renewal Overuiew : 01 /01 /201 5
through 12B1nU5
Group Number - 878274
a€tna'
!44l,lrE!lcAo
United Water ldaho
Case UW-W-'I5-01
Response No. '10 Attachment 1
Page 2 of 5
a€tna'Stephanie Moreno
MMA Senior Account Manager
Parsippany, NJ
Phone:[phone]
Moreno.S@aetna-com
August 14,20'14
United Water
Kethy Mccoldrick
200 Old Hook Road
Harrington Park, NJ 7620
Dear Ms. McGoldrick:
Thank you for allowing us to serve your health insurance and health benefit needs ov6r the past )€ar. We are hopeful
that this package will provide you wlth the lnformation )/ou need in order lo develop your companys future benefits
program. As w€ approach your January anniversary, we are pleased to present you with our renewal for the 201 5 policy
period.
We are pleased lo tell you about a new program Aelna is making available to you. For )pur upcoming plan year we have lncluded the A€tna
At Aetna*, we believe it is tundamental that you understand the full financial picture of )pur benefit plan. Therefore, the
enclosed package provides the following lmportanl informatlon about the cost of )eur cunent program
and the value that Aetna brings to )rou and your company.
r EAlg]S.UEgS.Oa - This section illustrates the cost projections to operate your cunent benefll program
for the period 1 /1 /201 5 through 1V31 fzfi 5.
This seclion contains lhe experience analysis and the dev€lopmenl of the projected costs.
- As shown in thls seclion, the cost to operate lour cunent plan will increase 2.0% for dental.
This increase reflects both th€ Aetna premium and the commission.
l@.ourrenewaloffeliscontin9entupontheparametersoUt|ined
hare. lt is imporiant to note thal deviations from these assumptions may result ln additional charges and/or
adjuslments on our Dental quotations. Please review this section thoroughly.
r DMOcoveraoeinNJisonlyavailablewhentheemplo)€esalsohavechoiceofanaltsmateplan. Ase
resull lhe DMO cen only be sold to NJ memberc as part of a Freedom of Choice, Oual Option or Dual
Choice sale. To ensure plan sponsors are in mmpliance, NJ r€quires tha attached state laws to be
delivered to all plan sponsors Blocting DMO cov€rage. Aelna is also required tc obtain and keep on file
notice of rec€ipt and compliance of the laws by the plan sponsor. Attached you will find the laws to b€
delivered to the plan sponsor and the compliance form which must be signed by lhe plan sponsor and
returned wilh the master applications.
lfthere are no changes affecting the conditions ofthis renewal a9 outlined in our Financial Assumptions section the
rates will remain in effect through 1213112015.
lfl/auwouldliketomakeanyplanchanges,pleasecontaclmebyl2l0ll20l4. lflDuhaveanyquestions,
please contact me a!.973-244-3522. lt has been a pleasure working with ),ou and llook fomard to working with )ou in lhe fulure.
Sincerely.
.- . r l 1.1r t * :,. ., ,
Stephanie Moreno
MMA Senlor Account Manager
Aetna ls the brand name used for producE and servlces provided by ons or mors of thc Aetna group of subaldlary
coflrpanles. Tho Aetna companhs that offer, underwrlte or admlnlstsr bonefit covrrage lncludo: Aotna Health lnc.,
Aetna Health of Californla lnc., Aetna Dental lnc., Aetna Dental of Calltomia lnc., Aetna Health lnrurance Company,
Health lnsurance Company of New York, Aetna Lffe lnsurance Cornpany (Aetna!. ln lrarrand, by A6tna Health lnc.,
l5l Famington Avenue, Hartford, CT 06156,
Each lnsurer has sols flnanclal respon3lblllty for lts own products.
Health benefits and health lrBurancc plans contaln llmltauons and excluslons.
Pollcyform numberc lnclude GR€rGR-9N, GR-23, GR-29/GR-29N, GR-700-W' and/or GR-8&435.
081L412074 www.aetna,com Renewal Letter Fl
United Water ldaho
Case UW-W-15-01
a€tna"
ArlgEt 14,2014
Unnsd Wai€r
Katiry Mccoldrick
2m Od Hook Road
Harington Park, NJ 7620
D6ar Ms. Mccolddck:
Thank you brallowirE us to w tour health iNBre and health benefit neds mr the past ysr. We sE hopeful lhat this package
will provlds you with the lnbma0m ,ou ffid in ordtr io devdop )6u mpany's lLture berefits prDgEm. As re appmch your
January anniwEary, re aE pleased to preffirt )/ou wllh ow renffil for lhe 2015 policy.
At Aetna', $,€ bollevG lt ls fundamenbl that )ou und€dand tho fr.{l financlal plclure of your bensfit plan. TherBbre, thg enclosed package
prcvldes tha follolylng imporbnt lnfomatim about tho cost of yr)u ct,rsnt program, polonlialchang$ yru may want t conEid€r and ths
valu6 that Aefia bringg lo you and your cmpsny.
r Rate Summary - THs stjon illEtates lhe cGt prcJectiG b opeEE your curent bemfrt progmm for the period
0'U01/2015 hrough 12J3112O15. Thls s6cton contalns the followlng: 6xporl6trco adlblts
arx, lllustratw admhistrativ€ s€rube hes.
- For lhe 0l/01f2015 thrugh 12R1l2015 cmtract petiod, the ho wi! irctBe 0p6 tror dental
Pmmm Serlrce lncluded - ThB sElion irchrd$ addilioBl $rui(s that Mw bes imluded in our priclng or Equire an
addltloml60.
B0a0clil-ASSutrpli0@- Our Bnml oftr ls mtingent upon 0E p€rameters oudin€d hers. lt ls lmpo(bnt to notB that
dwigtiom frqr these asumptims may leslt in additbnal €lErges and/d adiBfnenb m or Life, Mediel ard DenEl
quotatim tor cwenliml premlmg, Sfllce Fe6, and Sbp Loss rab(s) and 6cto(s). Pleaso ra/lew thls s€cton
thooughly.
ln the absca of any changes impacdng ths conditims of lhis rffil as qnftred in lirc FiEmial Assumption section, th6 ratss. fs,
ard factors pca€ntsd heE wlll emln in €fiect through 12Rll2015.
lf )au muld like to make any plan changs, please contacl m by 12n1m14. lf tEu haw any qu€Suons,
please contact mo 81973-244-3522.
W6 aE mmmttt€d to s/orklrE wlttr lEu b pwk e qulity prodsts and sMG that Ginforc€ your dsclslon io do buslns wlth Aetrra and
help manag6 yqr cun€nt ard futJE healh €re cls.
Sin@ly,
\rl t t /i, | -t.. 1, -lt:, ?/ '" 't/
Stsphanls MoBno
MMA Sonbr Account Mamger
Aolne b the bnnd namG r8ad ior Foducl3 lnd leryicB pdld.d by om or moB of th. A€lna grup of aubrldltry comprnlos. Th.
Astna companl6 that ofrr, unds$filto or r*nln&iLr b€nefit coyorag. lnchda: Altm H.allh lnc., A.tm H..llh ot C.lfornl. |rc,
Aatm Dantal lrE., Aetra Oenlal of Callfornla lrc., A:gs 11""1,n t*umc! Compeny, Ha.lth lnsur.me Comparry of Nm Yodq Altm
Llfr lcurenca Compsny(A.tna). ln Uaryl..d, by&lm Heshh lnc., 151 Fmlngtm Awme, Htrtiod, CT 06156.
Each l6uru hD rolg fimmlal roponalblll9 br lts m prodBt3,
Hulth bomitr and h.ellh lEurrca plans conltln llmltatloc and ercluclons.
Pollcy rom mbcrr lnclu& GR-UGR-9i|, GR-23, GR-29,GR-29N, GR-?lxlW, indrd GR-E&85 andror GR-96/476.
Stophania luor€no
MMA SalorAcunt Managor
Pardppsry, NJ
PtwE,97}.24+3522
[e-mail]
Response No. 10 Attachment 1
Page 3 of 5
08l1|noL4 w.tttnt.com Renewal Letter ASC
United Water ldaho
Case UW-W-15-0'l
Dental Renewal/Proposed Rates
United Water
Effective Date 01/01/201 5
. This exhibit outlines your Renewal/Proposed Rates effective January 01, 2015
Group Number:878274
. Please refer to the Financial Conditions and Plan Design Exhibits for an outline of the level of benefits
quoted, as well as the terms and conditions of lhis proposal.
. Refer to the Dental Renewal Assumptions - Financial & Administative page regarding
an explanation of the Health lnsurer Fee PEPM.
Monthly Totals
Response No. 10 Attachment 1
Page 4 of 5
DMO
Coveraoe Categories
CurrenUAssumed
Emolovees Current Rates
Proposed/ Renewal
Rat€s % Chanoe
lmp Only 38 $27.82 s28.38 2.O%
=mo + 5()0use 35 $s7.08 t58.22 2.Oo/o
im6 + Chil.llrenl 21 $59.4s $60.64 2.Oo/o
imo + Familv 62 $82.05 t83.69 2.O%
\ronthly Total 156 $9,390.51 $9,578.32 2.OTo
United Water ldaho
Case UW-W-I5-01
Response No. '10 Attachment 1
Page 5 of 5
SeMce Fee Detail
Unltld W.t.r
J.nu..y l, 2015 through Decomb.t 31, ml5
I The bdow Admlnktatlve SeMce Fees will become efftctlve VVz015
! The ho8 b€low €NcllJdc chaiges fur n€m3 swh a3 prinling, Epeclal run Gports and hL fscs
Those wlll bc blll.d separetsly: Tho below ASC fc€ a8sumos that Aetna will b€ Clelm Ftsuobry.
: Consulting Fe€, fepplheble, is subjoct to Pl.n Sponsor apploval
Prolec'ted t{umbor of EnrolLd Employe..
DPPCI:1,795
Curont Porlod
o1/l,.tml1-12t 112011
Adfiilnl't/.dua Se,vtcaFa,6
Sorvlca Fsos por Emplolcc per ilonth
y'dntinEtf;Etive
Aruru tl Sqvl ac Fca Ptulectto n
Actnr Llfr tnurancc Gompany
Group Numb.r - 878274
R€nawal Perlod
01101tfr13 -12frnm1t Ch.ng. %
3.87
83,350.80 E:1,350.E0
0.0c
0.0%
3.87
08/14i:D14 Pago 5
United Water ldaho
Case UW-W-15-01
Response No. '10 Attachment 1a
Page 1 of4
'Adminislralive Service Ag'eenrent Exltibit A
Group Name:
Term:
Group Number:
Crrrreut Dnrolltnent:
EXITIBIT AI SCHDDIJLE A - FINANCIAL TERMS
United Watcr
utn014 -t2l3u20ls
16026
2,166
$3 1.80 per contract per month
$22.23 per contract per rnonth
SECTIONA-l: FEES
A 1.l Admlnistrative Fees and Other tr'ees. The follorving charges shall be in effccl for the Terms specified
hereunder based on Contract Holder's Corent Enrollment:
Adrulnlslrallve Fees:
Yq I (effec.ive llLl20l4 - l2l3l?0l4)
uql1tu; +3.0%
(Actirrcs/Early Retirees):
(Retirees Over 65):
Year.2 (Sffecjive l/12015 - 121312015)
Health: +3.0%
(Acti ves/&rly Retirees):
(Retil€es Over 65):
'+HSA/HRA Banking Fee:
+ (For those enrolled).
Clainrs Fiduciary Charge:
(Actives/Early Retirees) :
(Retirees Over 65):
$32,75 per contract per month
$22.90 per contiact per montlr
$4.00 per'contract per month
$1.00 per conttact pel month
$0.75 per'contract per montlt
Cluonic Care Managernent* Charge: $ L98 per contract per mouth
*Chronic Corc Managenrcnl (foruwly Disease Manogenrenl) semices inchtde: lsthna, Diabetes
BlueCard@ Progarn Access Fees: Included os part of Contact Holdet''s lncwt'ed Clains
A-l
United Water ldaho
Case UW-W-I5-01
Response No. 10 Attachment 1a
Page 2 ol 4
Afininistrative Semice Agreentenl Erhibit A
*1.2 Workils Cnnitnl Amornt. The follorving Wolking Capital Amount shall be in effect fol the stated period:
Worki ng Cap i t a I Anto u n I To Be Deternrined.
Contract Holder shall renrunerate to Horizon BCBSNJ the stated Workfurg Capital funount iu accordance
with the Ag'eement. Horizon BCBSNJ has the right to annually adjust the Working Capital Aulount in
accordance rvith the lerms of this Schedule A.
A-1.3 Erternal Anneals. To the extent that Corrtr"ct Holder's Plan is grandfatha'ed, as that teml is deflrned in the
Palient Protection and Affordable Care Act ("Affordable Care Act"), Horizon BCBSNJ urrdqstan& that the PIan
is not subject lo that Affordable Care Act's provisions with respect to tequired extanal appeals foras longas the
Plan's grandfathered status is tnaintained.
If Contract Holder's Plan is not grandfathered, Contlact Holdel may elect to have Horizon BCBSNJ, for the fee
of,, up to, $450 per external appeal, administer such external appeals in cooperation rvith Horizon BCBSNJ's
designated Independent Revierv Organizations (IROs). If Conlzct Holder clects not to do sq Contract Holder
shall be solely responsible for the adminislration ofsuch extemal appeals, in rvhich event thereshall benocharge
fol the Claims data and supporting docunrentntion Horizon BCBSNJ provides to Contract Holder's selected
lROs.
A-1.4 Claims Re-Pricine nnd Neqotiation Serviccs. If benefits are provided under Contract Holder's Plan for
Mrich services rvere delivered or othenvise provided by a Non-Nehvort Provider, Horizon BCBSNI nray
negotiate and/or re-price Claims for such Non-Netlork Provider services tluough the use ofinterlal or
exterual resources of its choice to nrake available savings in Out-of-Netrvork Claims (such savings realiz-ed to
be refered to as "Out-of-Netrvork Claims Savirtgs"),
Clahns Re-h'ichrg and Negolialion Fee(s): At reasonable Horizon BCBSNJ itrtemal and external
administrative cost not to exceed the Oul-of-Netrvork
Claiuts Savings.
A-1,5 Broker Pnvment Administrntiou.
Producet Conpensal ion :$0,00 per contract per rnonth
A-1,6 Tsxqr and Assessnreilts. Contract Holdet agrees lo renrain ruponsible for any Taxes and Assessments
imposed, anticipated, assessed, or levied by any federal, state, local or other governmental entity that is
applicable to the Plan or any frrnction undertaken by Horizon BCBSNJ under the Ag'eement. This shall
include interesl, fines, or perralties relatingto such charges, unless causocl by Horizon BCBSNJ's
unreasonable detelmination lo dispute the charges. Contract Holder shall rcirnbulse Horizon BCBSNJ, either
l'etrospectively, concurrently, or prospectively, in a manner Horizon BCBSNJ specifies, fol any Taxes and
Assessnrcnts, Horizon BCBSNJ shall annually, or at other practical periods, reconcile the anlount collected
for payrnent of such Taxes and Assessrnents. Horizon BCBSNJ shall use its best efforls to inform Contract
United Water ldaho
Case UWI-W-15-01
Response No. 10 Attachment 1a
Page 3 of 4
Adnlnlsh'alive Service Agreenrent Exhibil A
Holdel regalding applicable Taxes and Assessments billed by Holizon BCBSNJ.
SECTION A-2: BILLING TERMS
A-2J Billiue of Clairns. The follorving billing terms shall apply to rvith respect to the Plan's Clainrs:
OPTION 3 (Weekly)
Horizon BCBSNJ rvill provide Contract Holder rvith rveekly invoices of Paid Claims for the prior rveek's
Monday tltr'ouglr Sunday. Contracl Holder shall remit payrnent of the anrount due ("Clairns Due") rvithin one
banking day of the invoice date via bank rvire or ACH electronic funds transfer to a Horizon BCBSNJ
desigmted bank account.
A-2.2 Recorrclliatiou of Billetl Clnims. Horizon BCBSNJ ageas to condnct a nronthly reconciliation of Contract
Holder's Clairns payment for the preceding calendar rnonth, subject to the Agreelnent. Any additional
amounts due to Horizon BCBSNJ shall be included in Contract Holder's first next payment made in
accordance with Section A-2. /. Any amount due by Horizon BCBSNJ shalt be deducted fi'orn Conhacl
Holder''s fir'st next payrnent.
A-2.3 Bllllns of Admlnbtratlyc FeGs rnd Other Fces. Horizon BCBSNJ rvill invoice Contract Holder rnonthly
for the applicabh Administrrtive Fecs bsscd on the Plan's enrollnent as oflhe fifteenth (l 5'h) calendar day
oflhe colresponding nronth together with all other charges, including Netlo* Accass Fees and Other Fees as
applicable under this Agreement. Holizon BCBSNJ rvill use its best efforts to reconcile any such invoice on
a rnonthly basis, subject to the Agreemart.
Contract Holder shall remunerate to Horizon BCBSNJ the amorurt due no later thau thhty-one (3 I ) calendar
days folloving the first calendar day of the following month in Mich the services are plovided (the
"Adrnirristrative Fee Payrnent Due Date") by bank rvire to Horizon BCBSNJ's designated bank accounl. I;or
examplg fees originating from services provided by Horizon BCBSNJ in the month of June shall be due by
July 3 l.
A-2.4 BillintlDisnutes. If Conh'act Holder disputes a Clainr payrnent or any charges under this Schedule A, including
any changes in the Working Capital Arnount that is included on an invoice, Conlract Holder must still pay the
anlount invoiced and notifl Horizon BCBSNJ of tlre disputed arnounts. If Horizon BCBSNJ verifies that the
disputed arnount, or any part thereofi, is not Contract Holder's responsibility, Horizon BCBSNJ rvill credit
Contract Holder's subsequent lnvoices rvith the disputed amount, or, ifafter the tenninalion ofthe underlying
Aduinistrative Service Agreerneut, Florizon BCBSNJ rvill pay the arnouut in cash at a mutually agteed upon
schedute. All Clainrs payment disputes shall be brought rvithin tlenty-four (24) nrcnth of the original date of
invoice and all disputes pertaining to Charges shall be made rvithin ttrimy (30) days oflhe Adrninistrative Fee
Paynent Due Date. This provision shall not reduce the Claims paynent obligation of the PIan.
A-2,5 Limitatlon on Reconciliation. In no event shall Horizon BCBSNI be lesponsible to adjust or rcconcile the
invoiced Claims payment ot any Charyes beyond 24 months after the date of invoice. This provision shall survive
thetermination ofthis Agreernent and shall nol be construed to reduce thc Claims payrnent obligation ofthePlan.
A-2.6 Conflich. In the event of a conllicl betrveen the terrns of the Agreentent and the terms of this Schedule A, this
Schedule A shall govern ifit is a latet executed counterpart to the Agreernent,
("Pharmacy Benefits Manager") rvith respect to Clairns lncuned by Plan Participants for coverecl prescription drugs
duilng the term of this Agreernent, and the charges that Horizon BCBSNJ bill to Colrtlact Holder rvith respect
to tlrose Claims, Ivill rafleqt negotiated discounts off Average Wholesale Price
A-3
United Water ldaho
Case UW-W-15-01
Response No. 10 Attachment 1a
Page 4 of 4
Arlm i n i s h' a t ive Se rvice i g'ee nten t Ex lt i b i t A
SECTION A-[4[: REVISION OIr FEDS
A-[4].1 Adiustmelt to Fees: The charges set forth in Section A-l.l of this Schedule A may be adjusted by Horizon
BCBSNJ upon thirty (30) days plior rvritten notice to Contract Flolder at the expiration of the Term or tbe
grmrantee period. Applicable changes shall be issued by Horizon BCBSNJ via an anrcnded Schedule A.
Additionally, subject to thetenns and conditions of the Agreernent, thecharges on this ScheduleAmay besubject
to adjushuent(s) by Horizon BCBSNJ, rvith such adjustrnent(s) taking effect on the same date as the incident(s)
giving rise to the changes, upon the follorving conditions:
(a) A change in eruollntent by nrore thart l0% or more than 200 Plan Parlicipants;(lr) A change in the Plan's benet'its ol type of product administeled by }lorizon BCBSNJ;(c) A change in Contract Holder's Plau eligibility rules;(cl) A change in a federal or state larv or regulation that ntaterially impacts the benefits ot terms of Plan
adnrinistrotion; or(e) A change in Horizon BCBSNJ's vendor agrcements that result iu additional costs to Horizon
BCBSNJ;
A-[4].2 Artiusturent to Wotkins Canital Amount. The Working Capital Arnount set forth in Section A-1.2 of this
ScheduleA nray be adjusted annually by Horizon BCBSNJ upon thifty (30) days prior'\flritten noticetoContmct
Holder. Applicable changes shall be issued by Holizon BCBSNJ via an antended Schedule A. Additionally,
subject to tlle teflns and conditions of the Agleenrent, the Working Capital Arnount rnay be subject to
adjustrnent(s) by Horizon BCBSNJ, rvith such adjwtrneut(s) taking effect on the sarne date as the incident(s)
giving rise to the changes, upon tlrc folloling conditions:
(a) A change in the Plan's benefits or type of product administered by Horizon BCBSNJ;(b) A change in Coutract Holder's Plan eligibility rules;
G) A change in eruollment of more than l0olo or of more than 200 Plan Participants; or(d) In the event Projected Clairns do not accurately reflect actual Claims on a rcutine basis.
NOW, THEREFORD, Contract Holder represents to Horizon BCBSNJ that it accepts the above fees, terms, and
conditions for the stated Term and that the person signiug this Schedule is anauthorized reprcsentativeofC;ontract Holder'
rvith sufficient legal authority.
GROUP NAME Horizon Blue Cross Blue Shield of New Jersey
By:By:
Printed:Printedl Al Bolles
Title:
Date:
Title:
Date:
A-4
Response No. 1 0 Attachment 2
Page 1 of 1
Libertv
Mutudl.'-ir.rsuner.ice
Liberty Mrrtuirl hrur{rco
Group Dcnclits
175 Bcrkclsy Strcct
Iloston, lrlA 02116
(6r?) 367-9S00
United Vater Resotuces
200 Old Hook Rd"
Harrington Park, NJ 07640
The following tenerval rates are accepted and ate to be in fotce fot the pedod ofJanuary 1,2014 tbrouglr Decembet
31,2075t
RenewalRates:
Active
Retirce
optional life
Spouse
child
$0.135 per $1,000 of monthly volume
$2.03 per $1,000 o[mondrly volume
as is step mtes
$0.14 pet $1,000 of monthlyvolume
$0.08 per $1,000 of monthly volume
If, as of 9/l/ 15, the basic and optional life are nrnning at a combined Consmnt Loss Ratio of not mote tharr 95Vo,
this Rate Guamntee will be extendcd fot an additional trvo years. It is undcrstood that Liberty Mutual rehins dre
dght to revisit any premium rate, at any time, pet the tetms and conditions oudined in the Prerniums secdon of each
tespective contract
Accepted by:
s/z
b|n
///
United Water ldaho
Case UW-W-15-01
Request No. 10 Aftachment 2a
Page 'l of 64
Liber@"
INSURANCE
LiberB. Lifc Assurancc Compaal' of Boston
GROI.JP LIFE INSURANCE POLICY
Sponson United Water Resourceo, Inc.
Policy Number: 5A3{30-509893-01
Effective Date: ]une 1,2010
Goveming ]urisdiction is New |ersey and subject to the laws of that State.
Premiumg are due and payable monthly on the fust day of each month.
Policy Anniversaries shall occur each June 1st begirning in 2011.
Liberty Life Assurance Company of Boston (hereinafter referred to as Liberty) agrees to pay the benelits
provided by this policy in accordance with its provislons.
PLEASE READ THIS POLICY CAREFULLY FOR FULL DETAILS.
This policy is a legal contract and is issued in consideration of the Application of the Sponsor, a copy of
which is attached, and of the payment of premiums by the Sponsor.
For purposes of this potcy, tlre Sponsor acts on its own behaU or as the Covered Employee's agent.
Under no circumstances will the Sponsor be deemed the agent of Liberty.
This policy is delivered in and governed by the laws of the governing jurisdiction and to the extent
applicable by The Employee Retirement Income Security Act. o17974 (ERISA) and any subsequent
artendments.
The following pages including any amendments, riders or endorsements are a part of this policy.
Signed at Liberty's Home O6hce, 775 Berkeley Street, Boston, Massachusetts , 02177.
My--!\t .c2-{dr
Form GLP
United Water ldaho
Case UW-W-15-01
Request No. 10 Attachment 2a
Page 2 of 04
TABLE OF CONTENTS
SECTIONI. ... SCHEDULEOFBENEFTIS
SECTION 2...... .. ... DEFINITIONS
SECflON3.,.... ..... ELIGIBILITYANDETSECTIVEDATES
SECTION 4. . .. INSI,'RANCE BENETTIS
SECTION 5...... ..... EXCLUSIONS
SECTION 6. . . ... ..... TERMINATION PROVISIONS
SECTION 7...... .. . .. GENERAL PROVISIONS
SECTION 8...... ..... PREMIUMS
9ECfiON 9. .. . .. . . ... APPLICATION
Forn GLP-TOC Table of Contente
United Water ldaho
Case UW-W-15-01
Request No. 1 0 Attachment 2a
Page 3 of 64
SECTION 1- SCHEDULE OF BENEFITS
ELIGIBILITY REQUIREMENTS FOR INSURANCE BENEFITS
Minimum Houtly Requirement:
Applicable to Class 7, 2, 4, 5, 6, 7, 8, 9, 13, 2O, 27,22:
Employees working a minimum of 30 regularly scheduled hours per week
Applicable to Class 1O 71,12,23:
Employees working a minimum of 20 regularly scheduled hours per week
Applicable to Class 74, 15, 76, 17, 18, 19:
None
Classification of Covered Employees:
Class 1: All full time Active Employees of United Water and all United Water Services
Employees excluding non-union Employees of United Water AOS, United Water
NACO, United Water Utilities Service Group and those covered by a Collective
Bargaining Agreement except for WREP lndianapolis hired prior to 7/l/2070.
Class 2: All full time Active Employees of United Water and all United Water Services
Employees excluding non-union Employees of United Water AOS, United Water
NACO, United Water Utilities Service Group and excluding those covered by a
Collective Bargaining Agreement except for WREP Indianapolis hired 1/7/2070 or after.
Class 4: All full time Active union Employees of United Water Conhact Services and Regulated
Segment except United Water Camden, WREP Indianapolis, United Water New
Rochelle, US Water Springfield MA, United Water Pennsylvania, United Water
Killingly, CT and Bloomsburg.
Class 5: AII full time Active Employees of United Water Camden Union.
Class 6: AII full time Active union Employees of United Water New Rochelle.
Class 7: All full time Active non-union United Water AOS Employees hired prior to 7/ 7/ 20'10.
Class 8: All fuIl time Active non-rurion United Water AOS Employees hired 1/1/2010 or after.
Class 9: All full time Active union Employees of United Water AOS except for the Westerly, RI
location.
Class 10: All full time Active non-union Employees of United Water NACO.
Class 11: All full time Active union Employees of United Water NACO except for the Newport
RI and Pawtucket, RI locations.
Class 12: All full time Active union Employees of United Water NACO located in Newport, RI.
Class 13: All full time Active union Employees of Bloomsburg.
Form GLP-SCH-I
5A&830-50989101 R (3) Effective lanuary 1,2012
Schedule of Benefits
United Water ldaho
Case UW-W-15-0'l
Request No. 1 0 Attachment 2a
Page 4 of 64
Class 14: Retired Non-Union Employees of the United Resource Companies, United Water M&S,
United Water New Jersep United Water Rahway, United Water New York, United
Water Jersey City, United Properties Gtoup, United Water Mid-Atlantic & UW New
Rochelle.
Class 15: Retired Union & Non-Union Employees of the United Water Works Companies, United
Water Pennsylvania, United Water Arkansas, United Water Delaware, United Water
Toms River, United Water Owego, United Water Florida, United Water Connecticut,
United Water Idaho and United Water Rhode Island.
Class 16: Retired Union Employees at United Water New Jersey.
Class L7: Iletired Union Employees at United Water New York.
Class 18: Retired Union Employees at United Water New Rochelle.
Class 19: Retired Union Employees of United Water Bloomsburg.
Class 20: All full time Active union Employees of United Water AOS located in Westerly, RI.
Class 21: All full time Active union Employees of US Water Springfield, MA hired after'1./1./2005.
Class 22: All full time Active union Employees of United Water Pennsylvania and Kiltingly, CT.
Class 23: All full time Active union Employees of United Water NACO located in Pawtuckef RI
Note: Temporary and seasonal Employees and Employees who are not United States citizens or legal
residents working in the United States are not covered under this policy.
Eligibility Waiting Periodr
Applicable to Basic Insurance:
Applicable to Class 1.,2,4,5,6,7,8,9,10,71,13,74,75,16,77,78,19,20,27,22:
1. If the Covered Person is employed by the Sponsor on the policy effective date -
None
2. lf the Covered Person begins employment Ior the Sponsor after the policy cffective date -
None
Applicable to Class 12, 23:1. If the Covered Person is employed by the Sporuor on the policy eflective date -
None
2. If the Covered Person begins employment for the Sponsor after the policy elfective date -
First of the mon0r coincident with or next following 30 days of continuous, Active Employment
Apphcable to Optional Insurance:
1. If the Covered Person is employed by the Sponsor on the policy effective date -
None
2. If the Covered Person begins employment for the Sponsor after the policy effective date -
None
form GLP-SCH-1 (continued) Schedule of Benefits
SA383G509E93-fl R (3) Effective lamrary l,20l2
United Water ldaho
Case t W-W-lffi1 Request No. 10 Aftachment 2a
Page 5 ofe{
Employee Contributionc Required:
Active Employeee:
Employee Basic Life Insuance BenefiE: No
Employee OpdonalUfe Insurance Bmefits: Yes
Employee Basic A$idental Death and Dismembermmt Incurance Benefib: No
Dependmt Optional Lih kuurance Benefib: Yes
Retired Employeee:
Basic Life Insruance Benefits: No
Forrr GLP-SCH-I (continued) 9chedule of Benefito
SA98il-50lrE!B{n B (Q Etrec{iyc lenuery t 2m2
United Water ldaho
Case UWI-W-15-01
Request No. 10 Attachment 2a
Page 6 of 64
SECTION 1 . SCHEDULE OF BENEFITS
(Continued)
LITE INSURANCE
Amount of Insurance:
Employee Basic Life Insurance:
Applicable to Class 1:
An amount equal to 3 times Annual Earnings. If not a multiple of $1,000.00 this amount will be
rounded to the next higher multiple of $1,000.00. This amount may not exceed $900,000.00.
Applicable to Class 2, 8, 70, 11, 12, 23:
An amount equal to 1 times Arurual Earnings. If not a multiple of $1,000.0O this amount will be
rounded to the next higher multiple of $1,000.00. This amount may not exceed $300,000.00.
Applicable to Aass 4,22:
An amount equal to 3 times Arurual Eamings. If not a multiple of $1,000.0O this amount will be
rounded to the next higher multiple of $1,000.00. This amount may not exceed $600,000.00.
Applicable to Class 5:
An amount equal to 1.5 times Arurual Earnings. If not a multiple of $1,000.00, this amount will be
rounded to the next higher multiple of $1,000.00. This amount may not exceed $200,000.00.
Applicable to Class 6:
Less than 5 years of Active Employment: $150,000.00
5 or more years of Active Employ'ment: $200,000,00
Applicable to Class 7:
An amount equal to 2 times Annual Earnings. If not a multiple of $1,000,0O this amount will be
rounded to the next higher multiple of $1,000.00. This amount may not exceed $500,000.00.
Applicable to Class 9:
An amount equal to 2 times Armual Eamings. If not a multiple of $1,000.0O this amount will be
ror:nded to the next higher multiple of $1,000.00. This amount may not exceed $200,000.00.
Applicable to Class 13:
Less than 10 years of qualified service - $20,000.00
10 or more years of qualified service - $32000.00-
Applicable to Class 14:
The lesser of 75.00o/" of the employer paid pre-retirement benefit or $50,000.00.
Applicable to Class 15:
If retired prior to age 65 - 50.00% of the pre-retirement non-contributory benefit. At age 65, the
benefit is $5,000.00.
Applicable to Class 16:
FoIrr GLP-SCH-Z8
SAlE30-50!r89+01 R (12) Effective September 1,2012
Schedule of Benefits
United Water ldaho
Case UW-W-15-01
Request No. 1 0 Attachment 2a
Page 7 of 64
If retired prior to March 1, 2006 - The lesser of the amount on file with Liberty and the Sponsor or
$30,000.00.
If retired on or after March 1, 2006, but before March 7, 2072 - $40,000.00.
If retired on or after March 1, 2012 - $50,000.00.
Applicable to Class 17:
If retired prior to August 31, 2003 with Iess than 20 years of service - The lesser of $15,500.00 or the
amount as on file with Liberty and the Sponsor.
If retired prior to August 31, 2009 with 20 or more years of service - The lesser of $16,500.00 or the
amount as on file with Liberty and the Sponsor.
lf retired between September 1, 2003 and November 30 2009 - The lesser of $20,000.00 or the
amount as on file with Liberty and the Sponsor,
If retired on December 1, 2009 or later - $25,000.00.
Applicable to Class 18:
$20,000.00
Applicable to Class 19:
$10,000.00
Applicable to Class 20:
An amount equal to 2 times Annual Earnings. If not a multiple of $1,ffi0.00, this amount will be
rounded to the next higher multiple of $1,000.00, This amount may not exceed $50,000.00.
Applicable to Class 21:
An amount equal to 1 times Annual Earnings. If not a multiple of $1,000.00, this amount will be
rounded to the next higher multiple of $1,000.00. This amount may not exceed $200000.00.
Employee Optional Life Insurance:
Applicable to Class 7, 2, 4, 7, 8, 9, 10, 17, 20, 27:
Option 1
An amount equal to 1. times Annual Earnings. If not a multiple of $1,000.00, this amount will be
rounded to the next higher multiple of $1,000.00. This amount may not exceed $100,000.00.
Option 2
An amotrnt equal to 2 times Arurual Earnings. If not a multiple of $L,000.00, this amount will be
rounded to the next higher multiple of $1,000.00. This amount may not exceed $200,000.00.
Option 3
An amount equal to 3 times Annual Earnings. If not a multiple of $1,000.0O this amount will be
rounded to the next higher multiple of $1,000.00. This amount may not exceed $300,000.00.
Option 4
An amount equal to 4 times Arurual Earnings. If not a multiple of $1,000.0O this amount will be
rounded to the next higher multiple of $1,000.00. This amount may not exceed $400,000.00.
Option 5
An amount equal to 5 times Annual Earnings. If not a multiple of $1,000.0O this amount will be
rounded to the next higher multiple of $1,000.00. This amount may not exceed $500,000.00.
Applicable to Class 6,22:
Form GLP-SCH-2.8 (continued)
SAlt-8:1G50989'01 R (12) Effective September ! 2012
Schedule of Benefits
United Water ldaho
Case UW-W-15-01
Request No. 10 Attachment 2a
Page 8 of 64
Option I
An amount equal to 1 times Annual Earnings. If not a multiple of $1,000.0O this amount will be
rounded to the next higher multiple of $1,000.00. This amount may not exceed $100,000.00.
Option 2
An amount equal to 2 times Annual Earnings. If not a multiple of $1,000.0O this amount will be
rounded to the next higher multiple of $1,000.00. This amount may not exceed $200,000.00.
Applicable to Class 1,4, 7:
The overall combined Employee LiIe maximum is $1,100,000.00
Applicable to Class 2,8,10,77,22:
The overall combined Employee Life maximum is $800,000.00
Applicable to Class 6:
The overall combined Employee Life maximum is $600,000.00
Applicable to Class 9:
The overall combined Employee Life maximum is $50O000.00
Applicable to Class 20:
The overall combined Employee Iife maximum is $55O000.00
Applicable to Class 21:
The overall combined Employee Life maximum is $70O000.00
Dependent Optional Life Insurance:
Applicable to Class 7, 2, 4, 6, 7, 8, 9, 70, 77, 20, 21, 22:.
There are three Dependmt Life options available: Spouse only, Spouse and Children, Children only.
SPOUSE
Spouse or Domestic Partner:
Applicable to Class 1,, 2, 4,7, 8,9, 70,17, 20,
An amount in increments of $10,000.00.
amount is $10000.00.
Applicable to Class 6, 22:
An amount in increments of $1O000.00.
amount is $10,000.00.
2't:
This amount may not exceed $100,000.00. The minimum
This amount may not exceed $50,000.00. The minimum
CHILD
Children (Age at Death):
L5 days, but under 26 years.
Applicable Class 1, 2, 4, 6, 7, 8, 9, 20, 2'l', 22:
15 days but under 6 months - $500.00
At Ieast 5 months, but less than the end of the calendar year in which the Dependent turns 26 years -
An amount in increments of $5,000.00. This amount may not exceed $25,000.00.
Applicable Class 1O 11:
Fornr GLP-SCH-2.8 (continued)
SA3-E30-$989901 R (12) Effective Septembq l, 2(JJ..2
Schedule of Benefits
United Water ldaho
Case UW-W-I5-01 Request No. 1 0 Attachment 2a
Page 9 of @l
At least 5 months, but less than the end of the calmdar year in which the Deperdmt tums 26 years:
An arnount in increments of $5,000,00. This amount may not exceed $25,000.00.
Note: The amount of Dependent l;ife Insurance may not exceed 100.00% of the amount of Employee
Life lnsurance inforce on the Covered Eurployee.
Fomr GLP-SCH-Z8 (continued)
SA3{30-501r893{n R fl2) Effective SeptemDct L 2m2
Schedule of Benditc
United Water ldaho
Case UW-W-I5-01
Request No. 1 0 Attachment 2a
Page 10 of64
SECTION 1 . SCHEDULE OF BENEFITS
(Continued)
ACCIDENTAL DEATH AND DISMEMBERJVIENT INSURANCE
Full Amount of Ineurance:
Employee Basic Accidental Death and Diememberment Ineurance:
Applicable to Class Z 8, 9:
An amount equal to 2 times Annual Earnings. If not a multiple of $1,000.00, this amount will be
rounded to the next higher multiple of $1,000.00. This amount may not exceed $500,000.00.
Applicable to Class 1O 11:
An amotmt equal to 1 times Arurual Earnings. If not a multiple of $1,000.00 this amount will be
rounded to the next higher multiple of $1,000.00. This amount may not exceed $300,000.00.
Fonn GLP-SCH-3.S
SAI,-E:10-5@E9:Xn R (1) Effective lutre 1,2010
Schedule of Benefite
United Water ldaho
Case UW-W-15-01
Request No. 1 0 Attachment 2a
Page 11 of64
SECTION 1- SCHEDULE OF BENEFTTS
(Continued)
ADDITIONAL ACCIDENTAL DEATH AND DISMEMBERMENT INSURANCE
Employee Seat Belt Benefih
Maximum Benefit Amotrnt: 10.00% of Full Amount up to $25,000.00
Employee Air Bag Benefit:
Maxirnum Benefit Amount: 10.00% of Full Amount up to $10,000.00
Employee Common Carrier Benefih
Maximum Benefit Amount: Full Amount up to $150000.00
Employee Child Education Benefit:
Maximum Armual Benefit (Per Dependent child): $2,500.00
Maximum Lifetime Family Benefit Amount $50,000.00
Dependent Children Maximum Age: 26 years
Employee Child Care Benefih
Maximum Annual Benefit (Per Dependent child): $2J00.00
Maximum Lifetime Family Benefit Amount: $50,000.00
Dependent spouse or Civil Union Partner or Domestic Partner Training Benefit:
Maximum Bmefit Amount $5,000.00
Employee Coma Benefit:
Maximum Benefit Amount 10.00% of Full Amount up to $25,000.00
Employee Critical Burn Benefit
Maximum Bmefit Amount: 10.00% of Full Amount up to $25,000,00
Employee Adaptive Home or Adaptive Vehicle Benefih
Maximum Benefit Amount: 10.00% of Full Amount up to $25,000.00
Reduction Formula:
Applicable to Basic Insurance:
Applicable to Class 7,4, 22:
Form GLP-SCH-4.21
SAlE30-509693-{If R (3) Effectiv e lantary l, 20iIJ2
Schedule of Benefits
United Water ldaho
Case UWI-W-15-01
Request No. 1 0 Attachment 2a
Page 12 ol 64
The amount of Life and Accidental Death and Dismemberment Insurance applicable to the Covered
Person's class of benefits will reduce at age 65 or older as follows:
Age iI hired prior to fanuary 1.,20{J7: Percentage:
age 65 & up: to 65.00%
Age ifhire on or afterJanuary 1, 200L: Percentage:age65-74: to 65.00%
age 75 & up: to 45.00%
Applicable to Class 2, 7, 8, 9, 70, 71, 72, 20, A, 23:
The amount of I;iIe and Accidental Death and Dismemberment Insurance applicable to the Covered
Personrs class of benefits will reduce at age 65 or older as follows:
age65 -74: to 65.00%
age 75 & up: to 45.00%
Applicable to Class 5, 13:
The amount of Life and Accidental Death and Dismemberment Insurance applicable to the Covered
Person's class of benefits will reduce at age 65 or older as follows:
Age if hired prior to fanuary 1, 2001: Percentage:
age 65 & up: to 65.00%
Age iI hired on or after January 1, 2001: Percentage:
age 65 -74: to 65.00%
age 75 & up: to 45.00%
Applicable to Class 6:
The amount of Life and Accidental Death and Dismembermmt lnswance applicable to the Covered
Person's class of benefits will reduce at age 65 or older as follows:
Age ifhired prior to January 1, 2001: Percentage:
age 65 & up: to 65.00%
Age if hired on or after |anuary 1, 2001.: Percentageage65-74: to 65.00%
age 75 & up: to 45.00%
Applicable to Class 15:
The amount of Life and Accidental Death and Dismemberment Insurance applicable to the Covered
Person's class of benefits will reduce at age 65 or older as follows:
age 65 & up: to $5,000.00
Applicable to Optional Insurance excluding Dependent Optional Life:
Applicable to Class 7,2, 6, 7, 8, 9, 70,77, 20,2'l-, 22:
The amount of LiIe Insurance applicable to the Covered Person's class ol benefits will reduce at age 65
or older as follows:
age65 to74: to 65.00%
age 75 & up: to 45.00%
Form GLP-SCH4.21 (continued) Schedule of Benefits
SA}E30-509E9:,-01 R (3) Effective fanuary 1,2012
United Water ldaho
Case UW-W-15-01
Request No. 1 0 Attachment 2a
Page 13 of64
AppUcable to Class 4:
The amount of Life Insurance applicable to the Covered Person's class of benefits will reduce at age 65
or older as follows:
age 65 -74:
age 75 & up:
Applicable to Dependent Optional Ufe Insurance:
Coverage terminates at age 70.
Form GLP-SCH{.Z (continued)
to 65.00%
to 45.00%
SA&8iX}-509E99l}l R (3) Effrtive lantary 7, 2tl2
Schedule of Benefits
United Water ldaho
Case UWI-W-15-01
Request No. 1 0 Attachment 2a
Page 14 of64
SECTION 1 . SCHEDULE OF BENEFITS
(Continued)
Evidence of Insurability Requirements
Non-Medical Maximum:
Employee Optional Life lnsurance Benefits: $200,000.00
Dependent Spouse or Domestic Parhrer Class 1.,2, 4, 6,
Optional Life Insurance Benefits: 27,22: $20,000.00
Class 7,8, 9, 20: $4O000.00
C1ass 1O 11: $50,000.00
Any amounts of insurance in excess of the amount shown above that are due solely to salary increases
are not subject to Evidence of InsurabiJity.
Annual Enrollment:
Employee Optional Any increases above the current
Life Iasurance Benefits: benefit level will be subject to
Evidence of Insurability.
Any increases elected during Annual Eruollment will be subject to Evidence of Insurability if an
Employee has previously been denied coverage. The Non-Medical Maximum will apply to any changes
made during the Annual Enrollment Period.
Dependent Spouse or Domestic Parhrer Any increases above the crurent
Optional Life Insurancei benefit level will be subject to
Evidence of Insurability.
Family Status Change:
Employee Optional Any increases above the current
Life Insurance Benefits: benefit level will be subject to
Evidence of Insurability.
Any increases elected due to a Family Status Change will be subject to Evidmce of Insurability if an
Employee has previously been denied coverage. The Non-Medical Maximum will apply to any changes
made due to a Family Status Change.
Dependent Spouse or Domestic Partner Any increases above the current
Optional Life Insurance: benefit level will be subject to
Evidence of Insurability.
Form GLP-SCH-S
SA383O-50989I}-(}1 R (2) Effective ]anuary 1,2012
Schedule of Benefits
United Water ldaho
Case UW-W-15-01 Request No. 1 0 Attachment 2a
Page 15 of 64
SECTION 2. DEFINITIONS
In this section Liberty defines some basic terms needed to understand this policy. The male pronoun
whenever used in this policy includes the female.
nActive Employment" means the Employee must be actively at work for the Sponsor:
1. on a full-time basis and paid regular eamings;
2. for at Ieast the minimum number of hours shown in the Schedule of Benefits; and either perform
such work:
a. at the Sponsor's usual place of business; orb. at a location to which the Sponsor's business requires the Employee to travel.
An Employee will be considered actively at work if he was actually at work on the day immediately
preceding:
1, a weekend (except where one or both of these days are scheduled work days);2. holidays (except when the holiday is a scheduled work day);3. paid vacations;4. any non-scheduled work day;5. an excused leave of absence (except medical Ieave for the Covered Person's own disabling
condition and lay-off); and6. an emergency leave of absence (except emergency medical leave for the Covered Person's own
disabling condition).
"Adminishative Office" means Liberty Life Assurance Company of Boston, 9 Riverside Road, Westorl
MA 02493.
Applicable to Class 1., 2, 4, 5, 6, 7, 8,9, 70, 1'1., 12,20, 27, 22:
"Annual Earninp" means the Covered Person's annual rate of eamings from the Sponsor. However,
such earnings will not include bonuses, commissions, overtime pay and extra compensation.
"Annual Enrollment Period" or "Enrollment Period" means the period before each policy aruriversary
so designated by the Sponsor and Liberty during which an Employee may enroll for coverage under this
policy.
Form GLP-DEF-I
SAIE30-SDE93-Or R (1) Effective lanuary 1,2012
Definitions
United Water ldaho
Case UWI-W-15-01
Request No. 1 0 Attachment 2a
Page 16 of64
SECTION 2. DEFINITIONS
(Continued)
"Application" is the document designated in Section 9; it is attached to and is made a part of this policy.
"Civil Union Partner" means an unmarried person of the legally recognized union of two eligible
individuals of the same sex established pursuant to the New Jersey Chapter 103 Act.
"Confined" means confinement in a hospital, skilled nursing facility or rehabilitation facility.
"Covered Dependent" means a Dependent whose coverage is in effect. It does not include a Dependent
whose coverage has ended.
"Covered Employee" means a person in Active Employment iruured under this policy or a Retired
Employee whose coverage is in effecl It does not include an employee whose coverage has ended.
"Covered Person" means an Employee in Active Employment, a Dependent, or a Retired Employee
iruured under this policy.
'Dependent" means:
1. a Covered Employee's lawful spouse, including a legally separated spouse or Civil Union
Partrer or Domestic Partrer; and
2. a Covered Employee's unmarried children, who meet the age requirements shown in the
Schedule of Benefits.
Children include the Covered Employee's own natural offspring lawfully adopted childre& and
full-time students as defined by the school being attended. A child will be considered adopted on the
date of placement in the Covered Employee's home.
They also include stepchildren who are dependent on the Covered Employee for support and
maintenance and living with the Covered Employee in a regular parent<hild relationship.
They also include children who, on and after the date on which insurance would otherwise end because
of the children's age, are Continuously Disabled.
With respect to thib provision, 'Continuouely Disabled" means a child who is incapable of
self-sustaining employment because of mental or physical disabilities and is chiefly dependent on the
Covered Employee for support and maintenance, or institutionalized because of mental or physical
disabilities.
Dependent does not include a person who is an eligible Employee or a member of the armed forces.
Form GLP-DEF-2.5 Definitions
United Water ldaho
Case UW-W-15-01
Request No. 10 Attachment 2a
Page 17 of64
SECTION 2. DEFINITIONS
(Continued)
"Domestic Partner" means an unmarried person of the same sex or opposite sex over the age of 52 with
whom the Covered Employee shares a committed relationship, is jointly responsible for the other's
welfare and financial obligations, at least 18 years of age and mentally competent to consent to a
conhact, not related by blood to a degree that could prohibit legal marriage in the state where legally
residing maintains the same residence(s) and is not married to or legally separated from anyone else. A
Domestic Partner certification must be completed and filed with the Sponsor before the partrer can be
designated as a Dependent.
A domestic parhrership can only be established when neittrer person has been a parhrer in a domestic
partnership that was terminated less than 180 days prior to the filing of the current certification of
domestic partnership. This prohibition does not apply if one of the partners died.
"Eligibility Date" means the date an Employee becomes eligible for insurance under this policy.
Eligibility Requirements are shown in the Schedule of Benefits.
"Eligibility lafaiting Period" means the continuous length of time an Employee must be in Active
Employment in an eligible class to reach his Eligibilify Date.
"Employee" means a person in Active Employment with the Sponsor.
"Enrollment Form" is the document completed by the Covered Employee, if required, when eruolling
for coverage. This form mustbe satisfactory to Liberty.
"Evidence of Insurability' means a statement of proof of the Covered Person's medical history upon
which acceptance for insurance will be determined by Liberty.
Iorm GLP-DEF-3.5 Definitions
United Water ldaho
Case UW-W-I5-01 Request No. 1 0 Attachment 2a
Page 18 of64
SECTION 2 - DEFINTTIONS
(Continued)
"Family and Medical Leave" means a leave of absence Ior the birth, adoption or foster care of a child, or
for the care of the Covered Employee's child, spouse or parent or for the Covered Employee's own
serious health condition as those terms are defined by the Federal Family and Medical Leave Act of 1993
(FMLA) and any ammdments, or by applicable state law.
Applicable to Optional Insurance:
"Family Stafus Change" means any one of the following events that may occur:
1. the Employeers marriage or divorce;
2. the Employee's filing or rescinding of a Civil Union Partner or Domestic Parbrer certification;
3. the birth of a child to the Employee;
4. the adoption of a child by the Employee;
5. the death of the Employee's spouse or Civil Union Partner or Domestic Parbrer or child;
6. the commencement or termination of employment of the Employee's spouse or Civil Union
Partner or Domestic Partneg
7. the change from part-time employment to full-time employment by the Employee or the
Employee's spous€ or Domestic Parbrer;
8. the change from full-time employment to part-time employment by the Employee or the
Employee's spouse or Civil Union Parbrer or Domestic Parkrer;
9. the taking of unpaid leave of absence by the Employee or the Employee's spouse or Civil Union
Partner or Domestic Parh:er.
Form GLP-DEF-4.4 Definitions
United Water ldaho
Case UW-W-15-01 Request No. 10 Attachment 2a
Page 19 of64
SECTION 2 - DEFINITIONS
(Continued)
'Initial Eruollment Period' nreans one of the following periods during which an Employee may first
enroll for coverage under this policy:
L. if the Employee is eligible for insurance on the policy effective date, a period before the policy
elfective date set by the Sponsor and Liberty.
2. if tlre Employee becomes eligible for insurance after the policy effective date, the period which
ends 31 days after his Eligibility Date.
'Injuryn means bodily impairment resulting directly from an accidmt and indryendently of all other
causes.
nNo+Medical Maxlmumn means an amount of insurance on a Covered Person which is not su$ect to
Evidence of Insurability. The Non-Medical Maximum amounts are shown in the Schedule of Benefits.
Any amounts of insurance in excess of the Non-Medical Maximums are subiect to Evidence of
Insurability. Evidence of Insurability will be at the Covered Employee's expense.
"Phyeiciann means a person who:
f . is licensed to practice medicine and is practicing within the terms of his licerurc; or
2- is a licensed practitioner of the healing arb in a category specifically favored rmder the health
iruurance laws of the gtate where the treatment fu rec€ived and is practicing within the terms of
his license,
It does not include a Covered Person, any family member or domestic parkrer.
Forr GLP-DEF-S Deflnltions
United Water ldaho
Case UW-W-15-01
Request No. 10 Attachment2a
Page 20 of 64
SECTION 2. DEFINITIONS
(Continued)
"Proof" means the evidence in support of a claim for benefits and includes, but is not limited to, the
following:
1. a claim form completed and signed (or otherwise formally submitted) by the Covered Employee
or his beneficiary claiming benefits;
2. an attending Physician's statement completed and signed (or otherwise formally submitted) by
the Covered Personrs attending Physician; and
3. the provision by the attending Physician of standard diagnosis, chart notes, lab findings, test
results, x-rays and/or other forms of objective medical evidence in support of a claim for
benefits;
4. a certified copy of a death certificate.
Proof must be submitted in a form or format satisfactory to Liberty.
"Retired Employee" means a person is so classified by the Sponsor.
"Schedule of Benefits" means the section of this policy which shows, among other things, the Eligibility
Requirements, Eligibility Waiting Period, and Amount of Insurance Benefit.
"Sickness" means disease or illness including related conditions and recurrent symptoms of the
sickness. Sickness also includes pregnancy.
"Spon6or" means the entity to whom this policy is issued.
Fornr GLP-DEF{Definitions
United Water ldaho
Case UW-W-15-01
Request No. 10 Attachment 2a
Page 21 of64
SECTION 3 - ELIGIBILITY AND EFFECTIVE DATES
Eligibility Requirements for Employee and Dependent Ingurance Benefits
The eligibility requirements for insurance benefits are shown in the Schedule of Benefits.
Eligibility Date for Insurance Benefits
Employee Coverage:
If the Employee is in an eligible class he will qualify for insurance on the later of:
1. this policy's effective date; or
2. the day after he completes the Eligibility Waiting Period shown in the Schedule of Benefits.
Dependent Coverage:
If the Employee is eligible for Employee coverage he will be eligible for Dependent coverage on the later
of:
1. the date he h eligible for Employee coverage if on that date he has a Dependen! or
2. the date he acquires a Dependent if on that date he is eligible for Employee coverage.
If both parents are Employees, only one will be eligible for Dependent coverage with respect to their
Dependent childrm.
Applicable to Employee Optional Life Insurance Class 1, 2,4,6,7,8,9,70,11.,20,21,22,Dependent
Optional Life Insurance Class 1, 2, 4, 6, 7, 8, 9, 10, 17, 20, 27, Y2:
Annual Entollment Period
During each Annual Enrollment Period, an Employee may keep his coverage ai the same level or make
any one of the following changes in coverage for the next policy year, subject to any Evidence of
Insurability Requirements as shown in the Schedule of Benefits:
1. decrease his coverage;
2. increase his coverage including enrolling Ior the first time.
Eligibility and Effective Dates
SA3'83&50989$OI R (2) Effectivelantary 7,20IL2
Form GLP-ELG-I
United Water ldaho
Case UW-W-15-01
Request No. 1 0 Attachment 2a
Page 22 ol 64
SECTION 3 - ELIGIBILITY AND EFFECTIVE DATES
(Continued)
Applicable to Optional Employee Life Clasg 1,2,4,6,7,8,9,LO,\7,20,2L,22, Optional Dependent
Life Class 1, 2" 4, 6, 7, 8, 9, 10, lT, 20, 21, 2L,
Family Status Change
When a Covered Employee experiences a Family Status Change, a Covered Employee may keep his
coverage at the same level or make any one of the following changes in coverage, subject to any
Evidence of Insurability Requirements as shown in the Schedule of Benefits:
1. decrease his coverage;
2. increase his coverage including enrolling for the first time.
The Covered Employee must apply for the change in coverage wi0rin 31 days of the date of the Family
Stafus Change. Such changes in coverage must be due to or corristent with the reason that the change
in coverage was permitted. A change in coverage is consistent with a Family Status Change only if it is
necessary or appropriate as the result of the Family Status Change.
Effective Date for Insurance Benefits
lnsurance will be ef(ective at 12:01 A.M. Standard Time in the governing jurisdiction on the day
determined as follows, but only if the Employee's application or enrollment for insurance is made with
Liberty through the Sponsor in a form or format satisfactory to Liberty.
Employee Coverage:
1. For non-conhibutory coverage not subject to Evidmce of Irsurability, the Covered Employee
will be insured on his Eligibility Date.
2. For non-conuibutory coverage subject to Evidence of Insurability, the Covered Employee will be
insured on the later of the date Liberty gives approval or his Eligibfity.Date.
3. For conhibutory coverage not subject to Evidence of tnsurability, the Covered Employee will be
insured on the later of the date he makes application or his Eligibility Date, provided he makes
application no later than 31 days after his Efgibility Date.
4. For contributory coverage subject to Evidence of Insurability, the Covered Employee will be
insured on the later of the date Liberty gives approval or his Eligibility Date, provided he makes
application no later than 31 days after his Eligibility Date.
5. lf a Covered Employee makes application for conhibutory coverage more than 31 days after his
Etgibility Date, he must submit Evidence of Insurability. He will be insured on the date Liberty
gives approval.
Evidence of lnsurability will be at the Covered Employee's Expense.
Form GLP-ELG-2 Eligibility and Effective Dates
5A&830-50989&01 R (2) Effectiv e lantary 7, 20.x2
United Water ldaho
Case UW-W-15-01
Request No. 1 0 Attachment 2a
Page 23 of 64
SECTION 3 - ELIGIBILITY AND EFFECTIVE DATES
(Continued)
Effective Date for Ineurance Benefits (Continued)
Dependent Coverage:
1. For contributory coverage not subject to Evidmce of Insurability, the Covered Employee's
Dependent will be insured on the later of the date the Covered Employee makes application or
his Eligibility Date, provided he makes application no later than 31 days after his Eligibility
Date.
2. For contributory coverage subject to Evidence of Insurability, the Covered Employee's
Dependent will be insured on the later of the date Liberty gives approval or his Eligibility Date,
provided he makes application no later than 31 days after his Eligibility Date.
3. If a Covered Employee makes application for conkibutory coverage more than 31 days after his
Eligibility Date, he must submit Evidence of Insurability. The Covered Employee's Dependent
will be insured on the date Liberty gives approval.
Evidence of Insurability will be at the Covered Employee's Expense.
Increages or Decreases:
Any increase in or addition to coverage will take effect on the first of the month following the change.
Any decrease in or deletion of coverage will take effect on the first of the month following the change.
Any such change applies to loss of life or accidental Injury that occurs on or after the effective date of
the change.
Delayed Effective Date for Employee Insurance
The effective date of any initial, increased or additional insurance will be delayed for an individual if he
is not in Active Employment because of Injury or Sickness. The initial, increased or additional insurance
will begin on the date the individual returns to Active Employment.
Delayed Effective Date for Dependent and Retired Employee Insurance
If a Covered Dependent or Retired Employee is Confined on the date the increase or addition is to take
effect, it will take effect when the confinement ends.
Form GLP-ELG-3 Eligibility and Effective Dates
United Water ldaho
Case UW-W-15-01 Request No. 10 Attachment 2a
Page 24 of 64
SECTION 3 - ELIGIBILIfi AND EFFECTIVE DATES
(Continued)
Family and Medical Leave
A Covered Employee's coverage may be continued under this policy for an approved family or medical
leave of absence for up to 12 weeks following the date coverage would have terminated, subject to the
following:
1. the authorized leave is in writing
2. the required premium is paid;
3. the Covered Employee's benefit level, or the amount of earnings upon which the Covered
Employee's benefit may be based, will be that in effect on the date before said leave begins; and
4. continuation of coverage will cease immediately if any one of the following evenb should occur:
a. the Covered Employee returns to work;
b. this policy terminates;c. the Covered Employee is no longer in an eligible class;d. nonpayment of premium when due by the Sponsor or the Covered Employee;e, the Covered Employee's employment terminates.
Lay-off
Applicable to Class \,2, 4, 5, 6, 7,8, 9, 10,11, 12,13, 20, 27, 22, 23:
The Sponsor may continue the Covered Employee's coverage(s) by paying the required premiums, if the
Covered Employee's is temporarily laid off.
The Covered Employee's coverage(s) will not continue beyond the end of the month in which the lay-off
begins. In continuing such coverage(s) under this provision, the Sponsor agrees to keat all Covered
Employees equally.
Leave of Absence
Applicable to Class l,2, 4, 5, 6, 7, 8, 9, 7A, 77,12, 13, 20, 21, 22, 23:
The Sponsor may continue the Covered Employee's coverage(s) by paying the required premiums, if the
Covered Person is granted an approved leave of absence.
The Covered Employee's coverage(s) will not continue beyond the end of the month in which the leave
of absence begins. In continuing such coverage(s) under this provisioru the Sponsor agrees to treat all. Covered Employees equally.
Form GLP-ELG4 Eligibility and Effective Dates
SA$83G50969$OI R (3) Effective lanuary 1, Z)1ll
United Water ldaho
Case UW-W-15-01
Request No. 1 0 Aftachment 2a
Page 25 of&0
Leave of Absence f,)ue to Dieability
Applicable to Class L, 2, 4\ 5, 5, 7, 8, 9, 70, 71, 72, 13, 20, 21., 22" B:
The Sponsor may continue the Covered Employee's coverage(s) by paying the required premiums, if the
Covered Employee is granted an approved leave of absmce due to a disability.
The Covered Employee's covetage(s) will not continue beyond a period of twelve months. In continuing
such coverage(s) under this provisioq the Sponsor agrees to treat all Covered Employees equally.
Donsr GLP-ELG{ (continued)Etigtbiltty and Effective Datee
SA$83G509E9$(}1 R (3) Effective Jarntary t, 2tlil
United Water ldaho
Case UWI-W-15-01
Request No. '10 Attachment 2a
Page 26 of 64
SECTION 4 . INSURANCE BENEFITS
EMPLOYEE LIFE INSURANCE
Benefits
When Liberty receives satisfactory Proof of the Covered Employee's death, Liberty will pay the proceeds
of the Life Insurance in force on the Covered Employee's life under this policy. The benefit payable is
shown in the Schedule of Benefits.
Conversion Privilege
Conversion Privilege at Individual Termination or Reduction of Benefits:
If all or part of a Covered Employee's coverage ends, the Covered Employee may convert the amount
that ends to an individual Life Insurance policy. Conversion is subject to the following conditioru:
1. within 31 days after coverage mds or is reduced, the Covered Employee must make written
application to Liberty and pay the first premium payment.
2. the individual policy will be issued without Evidence of Insurability. It will contain Life
lnsurance benefits only. The policy wiII be one then being offered by Liberty. The premium due
will be based on the premium schedule of Liberty's conversion policy that applies to the
Covered Employee's class of risk and age at the birthday nearest to the effective date of the
individual policy.
The individual policy will be effective 31 days after the Covered Employee's group coverage ends.
Conversion Privilege at Class or Policy Termination:
If coverage ends for all employees or for a Covered Employee's class, the Covered Employee is entitled
to a limited conversion privilege. The Covered Employee must have been covered under this policy or
under a prior group life potcy with the Sponsor for at least 5 years. The Covered Employee must apply
for the individual policy in the same manner as described above. The amount the Covered Employee
may convert is limited to the lesser of:
1. the amount the Covered Employee was covered for on the date the group coverage terminated
Iess any group insurance he becomes eligible for within 31 days; or
2. $2,000.
The individual policy will be effective 31 days after the Covered Employee's group coverage ends.
Death Within the 31 Days Allowed for Conversion:
If a Covered Employee dies within the 31 days allowed for conversion, Liberty will pay to his
beneficiary the amount he was eligible to convert. Such insurance will be paid as a claim under this
policy. Any premiums paid for a converted policy will be refunded.
Form GLP-LIF-1.l1 Employee Life Insurance
United Water ldaho
Case UWI-W-15-01
Request No. 1 0 Attachment 2a
Page27 ol64
SECTION 4 - INSURANCE BENEFITS
(Continued)
Applicable to Basic Insurance Class 1, 2,4,5,6,7,8,9,10,\7,72,73,20,21,2r2,2'3, Optional Insurance:
EMPLOYEE LIFE INSURANCE COVERAGE (Continued)
Accelerated Death Benefit
Note: The receipt of an Accelerated Death Benefit may be taxable. A Covered Employee ehould
consult his tax consultant or legal advisor before applying for an Accelerated Death Benefit.
If, while insured under this policp a Covered Employee or Covered Dependent spouse or Civil Union
Partner or Donestic Parhrer gives Liberty satisfactory Proof of having a Terminal Condition, the
Covered Employee or Covered Dependent spouse or Civil Union Parkrer or Domestic Partner may
receive a portion of his Life lnsurance as an Accelerated Death Benefit. Such insurance will be paid one
time to the Covered Employee or Covered Dependent spouse or Civil Union Partner or Domestic
Partner in one Iump surn.
The arnount of Accelerated Death Benefit payable under this policy is limited to the lesser of the
following:
1. the Accelerated Death Benefit amount requested by the Covered Employee;
2. 80.00% of the Covered Employee's Life Insurance that is in force on the date the Covered
Employee applies for an Accelerated Death Benefit; or
3. $s00,000.00.
Applicable to Class 1,2, 4,7, E, 9, 10, 11, 20,2L:
The amount of Accelerated Death Benefit payable to the Covered Dependent spouse or Civil Union
Partner or Domestic Partner under this policy is limited to the lesser of the following:
1. the Accelerated Death Benefit amount requested by the Covered Dependent spouse or Civil
Union Partner or Domestic Parbrer;
2. 80.@% of the Covered Dependent spouse's or Civil Union Parh:er's or Domestic Partner's Life
Insurance that is in force on the date the Covered Dependent spouse or Civil Union Partner or
Domestic Partner applies for an Accelerated Death Benefi! or
3. $80,000.00.
Applicable to Class 6, 22:
Form GLP-LIF-2.L3
SAIEil-50989$01 R (3) Effective ]anuary 1,2012
Employee Life Insurance
United Water ldaho
Case UW-W-15-01
Request No. 1 0 Attachment 2a
Page 28 of 64
The amount of Accelerated Death Benefit payable to the Covered Dependmt spouse or Civil Union
Partner or Domestic Partrer under this policy is limited to the lesser of the following:
1. the Accelerated Death Benefit amount requested by the Covered Dependmt spouse or Civil
Union Partner or Domestic Partner;
2. 80.00% of the Covered Dependent spouse's or Civil Union Partner's or Domestic Parbrerrs Life
lnsurance that is in force on the date the Covered Dependent spouse or Civil Union Partner or
Domestic Parbrer applies for an Accelerated Death Benefib or
3, $40,000.00.
If the amount of a Covered Employee's or Covered Dependmt spouse's or Civil Union Parbrer's or
Domestic Partrer's Life tnsurance under tfiis policy is scheduled to reduce within 12 months following
the date the Covered Employee or Covered Dependmt spouse or Civil Union Partrer or Domestic
Parhrer applies for the Accelerated Death Benefit, the benefit payable under this policy will be based on
the reduced amomt.
Application for an Accelerated Death Benefit
A Covered Employee or Covered Dependent spouse or Civil Union Partner or Domestic Partner must
apply for an Accelerated Death Benefit. To apply, the Covered Employee or Covered Dependent spouse
or Civil Union Parhrer or Domestic Parhrer must give Liberty:
1, certificatio& from a Physician, that he has a Terminal Condidon, as defined by this policy;2. supporting evidence satisfactory to Liberty, documenting the Terminal Condition;3. a completd claims form.
fonn GLP-LIF-2l3 (continued) Employee Life Ineurance
SAlE3GS{!9E9}fl R (3) Effective lamraty 7,2O72
United Water ldaho
Case UW-W-I5-01 Request No. 1 0 Attachment 2a
Page 29 of 64
SECTION 4- INSURANCE BENEFITS
(Continued)
EMPLOYEE LIFE INSURANCE COVERAGE (Continued)
Accelerated Death Benefit (Continued)
Application for an Accelerated Death Benefit (Continued)
During the pendency of a claim, Liberty may, at its own expense, have a Physician examine the Covered
Employee or Covered Dependent spouse or Civil Union Partner or Domestic Partner.
If the Covered Employee or Covered Dependent spouse or Civil Union Partner or Domestic Parbrer has
assigned all or a portion of the Life Insurance under this policy or named an furevocable beneficiary, the
Covered Employee or Covered Dependent spouse or Civil Union Partner or Domestic Parturer must also
give Liberty a signed written consent form from the assignee or irrevocable beneficiary. If the Covered
Employee dies before all payments of the Accelerated Death Benefit are paid, the election will be
cancelled and the death benefit will be paid pursuant to this policy.
The Accelerated Death Benefit will be payable upon receipt of satisfactory Proof of a Terminal
Condition; and signed written consent from an assignee or irrevocable beneficiary, if required.
With respect to this provision nTerminal Condition' means a condition:l. which is expected to result in the Covered Employee's or Covered Dependent spouse's or Civil
Union Partner's or Domestic Partrer's death within 12 months; and2. from which there is no reasonable prospect of recovery.
Effect on Insurance
The amount of a Covered Employee's or Covered Dependent spouse's or Civil Union Partner's or
Domestic Parbrer's Life lnsurance wdl be reduced by the amotrnt paid as an Accelerated Death Benefit.
Premiums, il any, for the remaining portion of a Covered Employee's or Covered Deperrdent spousers or
Civil Union Parhrer's or Domestic Parbrer's Life Insurance will be based on the amount of the remaining
Life Insurance in effect after payment of the Accelerated Death Benefit. All other terms and provisions
of this policy wiII apply to the remaining portion. Receipt of an Accelerated Death Benefit does not
affect any Accidental Death or Dismemberment insurance benefit in force on a Covered Employee's or
Covered Dependent spouse's or Civil Union Partnet's or Domestic Parhrer's life.
Exceptions
No Accelerated Death Benefit will be paid if:1. the Covered Employee or Covered Dependent spouse or Civil Union
Partner is required by a court of Iaw to exercise this option to satisfy
whether in bankruptcy or otherwisei
Partner or Domestic
a claim of creditors,
2. the Covered Employee or Covered Dependent spouse or Civil Union Parbrer or Domestic
Partner is required by a governmental agency to exercise this option in order to apply for,
receive, or continue a government benefit or entitlemenf
3. all or a part of a Covered Employee's insurance must be paid to the Covered Employee's
children or spouse or former spouse as part of a divorce decree, separate maintenance
agreemeart or property settlement agreemenl4, ttre Covered Employee is married and lives in a community property state, urless the Covered
Employee's spouse has given Liberty signed written consenq or5. the Covered Employee or Covered Depmdent spouse or Civil Union Partner or Domestic
Partner has previously received an Accelerated Death Bmefit under this policy.
Form GLP-LIF-3.11 Employee Life Insurance
United Water ldaho
Case UW-W-15-01 Request No. 1 0 Attachment 2a
Page 30 of 64
SECTION 4 . INSURANCE BENEFITS
(Continued)
DEPENDENT LIFE INSURANCE
Benefits
When Uberty receives satisfactory Proof of the Covered Dependent's death, Liberty will pay to the
Covered Employee the amount in force on such Covered Dependent's life under this policy. The
Dependent Life hsurance benefit will be paid in one sum. It is shown in the Schedule of Bmefits.
Conversion Privilege
Conversion Privilege at Individual Termination or Reduction of Benefits:
U a Covered Dependent's coverage ends becawe:
1. of the Covered Employee's death; or2. the Covered Employee's employment in an eligible class for Dependent Life Insurance ends,
the Covered Employee's Covered Depmdent spouse or Civil Union Partner or Domestic Parbrer may
convert Dependent Life Insurance to an individual policy. Within 31 days after coverage ends, the
Covered Dependent spouse or Civil Union Partner or Domestic Parkrer must make written application
to Liberty and pay the first premium payment. The individual policy will contain Life Insurance
benefits only. The policy will be one then being off'ered by Uberty. Evidence of Insurability will not be
required.
Conversion Privilege at Class or Policy Termination:
If a Covered Dependent's coverage ends because:
1. coverage ends for all employees; or2, coverage ends for all employees in the Covered Employee's eligible class,
the Covered Dependent spouse or Civil Union Partrer or Domestic Partner is entitled to a limited
conversion privilege. The Covered Employee must be entitled to convert to an individual policy in
order for his Covered Dependent spouse or Civil Union Partner or Donrestic Parher to lrave this limited
privilege, Conversion must be applied for in the same way as stated above. The anrount the Covered
Dependent spouse or Civil Union Parbrer or Domestic Partrrer may convert is limited to the lesser of
7. the amount the Covered Dependent spouse or Civil Union Partner or Domestic Partner was
covered for on the date coverage ended less any group insurance he becomes eligible for within
31 days; or2. $10,000.
The individual policy will become effective 31 days after the Covered Dependent spouse's or Civil
Union Partner's or Domestic Parhrer coverage ends.
Death Within the 31 Days Allowed for Conversion:
Dependent Life Insurance is payable if a Covered Dependent spouse or Civil Union Parhrer or Domestic
ParErer dies during this period. The amount payable is the amount the Covered Dependent spouse or
Civil Union Partner or Domestic Partner was entitled to convert, Such insurance will be paid under this
policy. Any premium paid for an individual policy will be reftrnded.
Forn GLP-DEP-I.2I Dependent Life Insurance
United Water ldaho
Case UW-W-15-01 Request No. '10 Attachment 2a
Page 31 of64
SECTION 4 - INSURANCE BENEFITS
(Continued)
EMPLOYEE ACCIDENTAL DEATH AND DISMEMBERMENT INSURANCE
Benefits
Accidental Death and Dismenrberment benefits are payable when a Covered Employee suflers a loss
solely as the result of acridental lnjury that oc'curs while covered. The loss must occur within 365 days
after the date of the accidmt The benelit payable is called the FulI Amotrnt. It is shown in the Schedule
of Bene6ts.
Loss Schedule: BenefitPayable:
Life FuIl Amount
Both Hands or Both Feet FuIl Amount
Sight of Both Eyes Full Amount
One Hand and One Foot Full Amouat
One Hand and Sight of One Eye Full Amount
One Foot and Sight of One Eye Full Amount
Speech and Hearing in Both Ears Full Amount
One Hand or One Foot One-half Full Amount
Sight of One Eye One-half Full Amount
Speech or Hearing in Both Ears One-half Full Amount
Thumb and Index Finger of the Same Hand One-quarter FuIl Amount
Payment is made for loss due to each accident without regard to loss resulting from any prior accident.
In no event may the total amount payable lor all losses due to any one accident exceed the Full Amount.
Loss of hands or feet means complete severance through or above the wrist or ankle joint.
Loss of sight, speech or hearing must be total and irrecoverable.
Loss of thumb and index finger means that all of the thumb and index finger are cut off at or above the
joint closest to the wrist. This benefit is not payable iI a benefit is payable for the loss of the sane entire
hand.
Form GLP-ADD-1 Accidental Death and Dismemberment Insurance
United Water ldaho
Case UW-W-15-01
Request No. 1 0 Attachment 2a
Page 32 of 64
SECTION 4, INSURANCE BENEFITS
(Continued)
ADDITIONAL ACCIDENTAL DEATH AND DISMEMBERMENT INSURANCE
Benefits
Seat Belt Benefit
Liberty will pay an additional benefit if accidental death was caused by an Automobile accident while
the Covered Person was driving or riding in an Automobile and the Covered Person was covered by
this policy. The benefit is payable if the Covered Person was wearing a Seat Belt at the time of the
accident. The benefit payable is shown in the Schedule of Benefits.
Libefty must be given satisfactory written Proof that the Covered Person's death resulted from an
Automobile accident while wearing a Seat Belt. A copy of the police accident report should be
submitted with the claim. If a copy of the police accident report is not available, or if it is unclear that
the Covered Person was wearing a Seat Belt, Libe*y will pay 10.00% of the maximum benefit as shown
in the Schedule of Benefits.
No benefit will be paid if the Covered Person was the driver of the Automobile and did not hold a
current valid driver's license.
Air Bag Benefit
Liberty will pay an additional benefit if accidental death was caused by an Automobile accident while
the Covered Person was driving or riding in an Automobile and the Covered Person was covered by
this policy. The benefit is payable if the Covered Person was wearing a Seat BeIt at the time of the
accident and was seated behind a properly installed Air Bag, The benefit payable is shown in the
Schedule of Benefits.
Liberty must be given satisfactory written Proof that the Covered Person's death resulted from an
Automobile accident while wearing a Seat Belt and the Automobile was equipped with an Air Bag
direcdy in front of the Covered Person. A copy of the police accident report should be submitted with
the claim.
No benefit will be paid if the Covered Person was the driver of the Automobile and did not hold a
current valid driver's license.
With respect to this provision, 'Air Bag" means the passive restraint device in an Automobile which
inllates automatically upon collision to provide protection in Automobile accidents. The Air Bag must
meet the Federal Vehicle Safety Standards of the National Highway Traffic Safety Adminishation and be
installed by the manufacturer or an authoriz-ed dealership of the manufacfurer.
With respect to this provision, "Automobile" means a private passenger motor vehicle licensed Ior use
on public highways.
With respect to this provisior\ "Seat Belt'r means a combination lap and shoulder restraint system that
must meet the Federal Vehicle Safety Standards of the National Highway Traffic Safety Administration
and be installed by the manuJacfurer or an authorized dealership of the manufacturer. A Seat Belt will
include a lap belt alone, but only if the Automobile did not have a combination lap and shoulder
restraint system when manufactured. Seat Belt does not include a shoulder reshaint alone.
Form GLP-ADD-2.2 Additional Accidental Death and Dismemberment Insurance
United Water ldaho
Case UWI-W-15-01
Request No. 1 0 Attachment 2a
Page 33 of 64
SECTION 4 - INSTJRANCE BENEFITS
(Continued)
ADDITIONAL ACCIDENTAL DEATH AND DISMEMBERMENT INSURANCE (Continued)
Benefits (Continued)
Common Carrier Benefit
Liberty will pay an additional benefit to the bmeficiary if the Covered Person suffers loss of life as a
result of an accidmt occurring while riding as a fare-paying Passenger on a public conveyance. The
benefit payable is equal to the Full Amount payable under Accidental Death and Dismemberment up to
the maximum benefit shown in the Schedule of Benefits.
With respect to this provision, "Common Cariey'' means a public conveyance operated by a licensed
Common Carrier for the transportation of the general public for a fare and operating on regu.lar
passenger routes, within the contigu.ous United States, Alaska and Hawaii, with a definite schedule of
deparfures and arrivals.
With respect to this provisiorl "Passenger" is defined as an individual other than a pilot, operator or
crew member who is riding in or on, boarding, or dismounting from a public conveyance.
Form GLP-ADD-3.2 Additional Accidental Death and Dismemberment Insurance
United Water ldaho
Case UW-W-15-01
Request No. 1 0 Attachment 2a
Page 34 of 64
SECTION 4. INSURANCE BENEFITS
(Continued)
ADDITIONAL ACCIDENTAL DEATH AND DISMEMBERMENT INSURANCE (Continued)
Benefits (Continued)
Child Education Benefit
Liberty will pay a one-time benefit to the Covered Person or beneficiary on behalf of the Covered
Person's Dependent children if the Covered Employee suffers loss of life as a result of an accident
provided:
L. the Dependent child meets the definition of Dependent under this policy; and
2. satisfactory proof is fumished to Liberty that the child is a Dependent drild; and
3. on the date of the accident the Dependent child was at the 12th grade level and enrolls as a
fuIl-time studmt in an accredited post-secondary irstitution of higher learning within 365 days
of the Covered Person's death; or
4. the Dependmt child continues to be enrolled as a firll-time student in an accredited
post-secondary institution of higher learning.
The one-time benefit payable is shown in the Schedule of Benefits. A benefit will not be payable beyond
the earlier of:
a. 4years;b. the attainmmt of a bachelor's degree; orc. the attainment of the Dependent maxirnum age shown in the Schedule of Benefits.
The maximtrm bmefit payable under this provision is shown in the Schedule of Benefits.
Fornr GLP-ADD4.I Additional Accidental Death and Diememberzrent Insurance
United Water ldaho
Case UW-W-15-01
Request No. 1 0 Attachment 2a
Page 35 of 64
SECTION 4 - INSURANCE BENEFITS
(Continued)
ADDITIONAL ACCIDENTAL DEATH AND DISMEMBERMENT INSURANCE (Continued)
Benefits (Continued)
Child Care Benefit
Liberty will pay a one-time benefit to the Covered Person or beneficiary on behalf of the Covered
Person's Dependent children if the Covered Employee sulfers loss of life as a result of an accident
provided:
L. the Dependent child meets the definition of Dependent under this policy; and
2. proof is fumished to Liberty that the child is a Dependent child and is ageT or under; and
3. the Dependent child is enrolled within 365 days of the Covered Person's death or continues to
be enrolled in a legally licensed Child Care Program.
Proof of a Dependent child's enrollment in a Chjld Care ftogram may be in the form of, but not limited
to, the following:
1. a copy of the Dependent child's approved enrollment application in a Child Care Program; or
2. a canceled check which proves payment for a Child Care Program; or
3. a letter from the Child Care Ptogram stating the Dependent child is attending a Child Care
Program or has been mrolled in a Child Care Program and will be attending within 365 days of
ttre date of the Covered Person's death.
The benefit payable is shown in the Schedule of Benefits. The maximum benefit payable under this
provision is shown in the Schedule of Benefits.
With reepect to this provision, "Child Care Program' means a cmter of child care which:
1. holds a Ucense as a day care center, or is operated by a licensed day care provider, if required;
ot2. il licensing is not required, operates primarily for the care of children on a daily basis for 12
months a year; and
3. is operated in a private home, school or other facility; and
4. customarily charges for (he care provided.
A Child Care Program does not include a hospita! the Dependent child's home or care provided during
normal school hours while a Dependent child is attending grades one through three.
Forrn GLP-ADD-S.4 Additional Accidental Death and Digmemberment Insurance
United Water ldaho
Case UW-W-I5-01
Request No. 1 0 Attachment 2a
Page 36 of 64
SECTION 4. INSURANCE BENEFNS
(Continued)
ADDHONAL ACCIDENTAL DEATH AND DISMEMBERMENT INSURANCE (Continued)
Benefits (Continued)
Spouse Training Benef it
Liberty will pay a one-time benefit to a surviving Dependent spouse or Civil Union Partner or Domestic
Partrer if the Covered Employee suffers loss of life as a result of an accident provided:
1. satisfactory proof is furnished to Uberty that the Dependmt spouse or Civil Union Partner or
Domestic Partner meets the definition of Dependent under this policy; and
2. within 365 days after the Covered Employee's death, the surviving Dependent spouse or Civil
Union Partner or Domestic Partner is enrolled and attending an accredited institution or trades
program for the purpose of obtaining employment or increasing eamings.
The benefit payable is shown in the Schedule of Benefits.
Fonn GLP-ADD-5.4 Additional Accidental Death and Dismemberrrent Insurance
United Water ldaho
Case UW-W-15-01
Request No. 10 Attachment 2a
Page 37 of64
SECTION 4 - INSI,JRANCE BENEEITS
(Continued)
ADDITIONAL ACCIDENTAL DEATH AND DISMEMBERMENT INSURANCE (Continued)
Benefite (Continued)
Coma Benefit
Subject to all terms, coirditioru, and limitatioru of the Policp Liberty will pay a Coma Benefit if, as a
result of an accident, the Covered Employee becomes Comatose.
For the Coma benefit to be payable:
1. the Covered Employee must become comatose within a 3l day period from {he date of the
accident; and
2. remain Comatose for at least 30 days.
The Coma Benefit payable is:
1. 10.00% of the full Accidental Death and Dismemberment benefit amormt up to a maximum of
$25,000.00; and
2. in addition to the Accidmtal Death and Dismemberment benefit payable under the policy,
The Coma Benefit will be paid to the Covered Person or the designated beneficiary.
For the purposes of this provisioo "Coma' or'Comatose" means complete and continuous:
1. unconsciousness; and
2. inabi[ty to respond to extemal or internal stimuli.
Libety must be given satisfactory written proof of the Covered Employee's medical condition.
Form GLP-ADD-7.4 Additional Accidental Death and Digmernbennent Insurance
United Water ldaho
Case UW-W-15-01 Request No. 10 Attachment 2a
Page 38 of 64
SECTION 4 - INSURANCE BENEFITS
(Continued)
ADDffiONAL ACCIDENTAL DEATH AND DISMEMBERMENT INSURANCE (Continued)
Benefits (Continued)
Critical Burn Benefit
Subject to all terms, conditions, and limitations of the Policy, Liberty will pay a Critical Burn Benefit if,
as a result of an acciden! the Covered Employee suffers a Critical Burn.
For the Critical Burn Benefit to be payable:
1. the Covered Employee must, as a result of an accident that occurred while covered under the
Policy Accidental Death and Dismemberment provision;
2. be Critically Burned and sulfer scarring over at least 25% of their body; and
3. requirereconstructivesurgery.
The Critical Bum Benefit payable is:
1. 10.00% of the fuIl Accidental Death and Dismemberment benefit amount up to a maximum of
$25,000.00; and
2. in addition to the Accidental Death and Dismemberment benefit payable under the terms of the
PolicY.
With respect to this provision "Critical Burn" or "CriHcally Burned" me.rns a third degree bum
certified by a Physician that occurs while the Covered Employee is covered for this Benefit.
Form GLP-ADD-8.2 Additional Accidental Death and Dismemberinent Insurance
United Water ldaho
Case UW-W-'|5-0'l Request No. 10 Attachment 2a
Page 39 of 64
SECTION 4 - INSURANCE BENEFITS
(Continued)
ADDffIONAL ACCIDENTAL DEATH AND DISMEMBERMENT INSURANCE (Continued)
Benefits (Continued)
Adaptive Home or Adaptive Vehicle Benefit
Subject to all terms, conditions, and limitations of the Policy, Liberty will pay, in addition to the
Accidental Death And Dismemberment benefit on tlre Loss Schedule, a one time benefit for
reimbursement of Expense Inctured for either Adaptive Home or Vehicle Modifications if, as the result
of an acciden! the Covered Employee suffers a loss listed on the Loss Schedule, other than a loss of life.
For the Home Modification Reimbursement Benefit to be payable, the Home Modifications must be:
1. necessary, due to the accident, to make the Covered Employee's home accessible; and
2. performed by a licensed conbactor, if such a Iicense is required in the state, who is not the
Covered Person, any family member, or domestic partner.
For the Vehicle Modification Reimbursement Benefit to be payable, the Vehicle Modifications must be:
1. necessary, due to the accident, to make the Covered Employee's private automobile accessible
for driving or riding by the Covered Employee.
2. performed by a licensed contractor, if such a license is required in the state, who is not the
Covered PersorL any family member, or domestic partler.
The Adaptive Home or Vehicle Modification Benefit payable is the lesser of:
L. Expmse Incurred; or
2. 10.00% of the full Accidental Death and Dismemberment benefit amount up to a maximum of
$25,000.00.
With respect to this provision, "Expense Incurred" means the acfual cost of the Home or Vehicle
Modifications.
The Home or Vehicle Modifications must be made within the two year period that begins on the date of
the Covered Employee's accident.
Form GLP-ADD-l3.2 Additional Accidental Death and Dismemberment Insurance
United Water ldaho
Case U\M-W-15-01
Request No. 1 0 Attachment 2a
Page 40 ot 6,4
SECTION 5. EXCLUSIONS
LITE INSURANCE HCLUSIONS
Applicable to Optional Insurance:
No benefits are payable for any loss for death that results from, is contributed to or caused by:
1. suicide committed while sane or insang occurring within 24 montlrs after the Covered Person's
initial effective date of insurance with the Sponsor; and
2. suicidg committed while sane or iruane, occuring within 24 months after the date any
additional insurance elected by the Covered Person becomes effective rurder this Policy.
The suicide exclusion will apply to any amounts of ingurance for which the Covered Person pays all or
part of the premium.
The suicide exclusion will also apply to any amount that is subject to Evidence of Insurability Liberty
approved.
Form GLP-LEX-l.4 Life Insurance Excluelong
United Water ldaho
Case UW-W-15-01
Request No. 1 0 Attachment 2a
Page 41 of64
SECTION 5 . EXCLUSIONS
(Continued)
ACCIDENTAL DEATH AND DISMEMBERMENT EXCLUSIONS
No benefits are payable for any loss that is conhibuted to or caused by:
1. war, declared or undeclared, or any act of war;
2. intentionally self-inllicted injuries, while sane or insane;
3. suicide, or suicide attemPt, while sane or insane;
4. active Participation in a Rio!
5. committing or attempting to commit a felony or the engagement in an illegal occupation;
6. disease, bodily or mental illness (or medical or surgical treatnrent thereo$;
7. infections, except septic infections of and through a visible wound;
8. being under the influence of any narcotic that is voluntarily taken, ingested or injected, unless
administered or consumed on the advice of a Physician
9. serving full-time active duty in the Armed Forces of any country or international authority;
10. boarding, Ieaving or being in or on any kind of aircraft. However, this exclusion will not
apply if the Covered Person is a fare paying passenger on a commercial aircraft or kaveling as
a passenger in any aircraft that is owned or leased by or on behalf of the Sponsou or
11. the presence of alcohol in the Covered Person's blood which raises a presumption that the
Covered Person was under the inlluence of alcohol and contributed to the cause of the
accidmt, The blood alcohol level is governed by the jurisdiction of the state in which the
accident occurred.
No benefit will be payable for any loss suffered as a result of Accidental Injury during any period of
imprisonment as a result of the Covered Employee's conviction of a crime,
With respect to this provision, "Participation" shall include promoting, inciting conspiring to promote
or incite, aidin& abetting, and all forms of taking part in, but shall not include actions taken in defense
of public or private property, or actions taken in deferue of the Covered Persory if such actions of
defense are not taken against persons seeking to maintain or restole law and order including, but not
limited to police officers and fire fighters.
With respect to this provisiorl nRiot" shall include all forms of public violence, disorder or disturbance
of the public peace, by tfuee or more persons assembled together, whether or not acting wittr a common
intent and whether or not damage to persons or property or unlawful act or acts is the intent or the
consequence of such disorder.
Form GLP-AEX-1.8 Accidental Death and Dismemberment Insurance Exclusions
United Water ldaho
Case UW-W-15-01
Request No. 10 Attachment 2a
Page 42 otil
SECTION 6 . TERMINATION PROVISIONS
Terrnination of a Covered Pereon'g Ineurance
A Covered Petson will cease to be insured on the earliest of the following dates:
1. the date this policy hrurinates, but without preiudice to any claim originating prior to the time
of termination;
2. ihe date the Covered Employee is no longer in an eligible class;
3. the date the Covered Employee's class is no longer included for insurance;
4. the last day for whidr any required Employee conkibution has been made;
5. the date mrployment (status as an active Eurployee) or eligibility errds for any reason; or
6. ihe date the Covered Employee ceases to be in Active Employment due to a labor dispute,
induding any stsike, work slowdow& or lockout
Liberty reserves the right to review and terminate all dasses insured under this policy if any class(es)
cease(s) to be covered.
Fonn GLP-TER-I Termrination Proviglong
United Water ldaho
Case UW-W-15-0'l
Request No. 1 0 Attachment 2a
Page 43 of 64
SECTION 6 - TERMINATTON PROVISIONS
(Continued)
Policy Termination
1, Termination of this policy under any conditions will not prejudice any claim which occurs while this
policy is in force.
2. If the Sponsor fails to pay arry premium within the grace period, this policy will terminate at 12:00
midnight Standard Time on the last day of the grace period. The Sponsor may terminate this policy
by advance written notice delivered to Liberty at least 31 days prior to the termination date. This
policy will not terminate during any period for which premium has been paid. The Sponsor will be
Iiable to Liberty for all premiums due and unpaid for the full period for which this policy is in force.
3. Liberty may terminate this policy on any premium due date by grving written notice to the Sponsor
at least 31 days in advance if:
a. the number of Employees iruured is fewer ttran 10; or
b. less ttran 100% of the Employees eligible for any non-contributory insurance are insured for it; or
c. less than 25.00% of the Employees eligible for any contributory basic insurance are insured for i!
ord. the Sporuor fails:i. to fumish promptly any information which Liberty may reasonably require; or
ii. to perform any other obligations pertaining to this policy.
4. Liberty may terminate this policy or .rny coverage(s) afforded hereunder and for any class of
covered Employees on any premium due date after it has been in force for 12 months. Liberty will
provide written notice of such termination to the Sponsor at least 31 days before the tetmination is
effective.
5. Termination may take effect on an earlier date if agreed to by the Sponsor and Liberty,
Form GLP-TER-2 Termination Provieions
United Water ldaho
Case UWI-W-15-01
Request No. 1 0 Attachment 2a
Page 44 of 64
SECTION 7. GENERAL PROVISIONS
Appeal Process
Liberty will notify in writing any Covered Person or beneficiary whose claim is denied in whole or part.
That written notice will explain the reasons for denial. If the claimant does not agree with the reasons
grven, he may request an appeal of the claim. To do so, the claimant should write to Ubertl within 60
days after the notice of denial was received. The claimant should state why he believes the claim was
improperly denied. Any data, questions or comments that the claimant thinks are appropriate should
be included. Unless Liberty requests additional material in a timely fashion, the claimant will be
advised of Liberty's decision within 60 days after his or her letter is received.
Assignment
The coverage under this policy is not assignable by the Sponsor without Liberty's written consent. A
Covered Employee may assign all of his present and future right, title, interest, and incidents of
ownership of:
1. any Life Lrsurance;2. any disability provision of LiIe Insurance; and
3. any Accidental Death and Dismemberment Insurance under this policy.
Such assignment will include, but is not limited to, the rights:
1. to make any conhibution requied to keep the coverage in force;2. to exercise any conversion privilege; and3. to change the beneficiary.
Beneficiary
Each Covered Employee must name a beneficiary to whom the insurance benefits under this policy are
payable. lf more than one beneficiary is named and if their interesb are not specified, any surviving
Beneficiaries will share equally. For any Dependent Life Insurance, the Covered Employee is
automatically designated as the beneficiary.
If, at the death of a Covered Employee, there is no named or surviving beneficiary, Liberty will pay the
benefits to the executor or administrator of the Covered Employee's estate. Liberty may, at its option,
pay the benefits to a surviving relative in the following order: spouse, child, parent, sibling. Such
payment will release Liberty of all further liability to the extent of payment.
A Covered Ernployee may change his beneficiary at any time by written request. Liberty or the Sponsor
will provide a form for that purpose. Any change of beneficiary will take effect when the Sponsor
receives the written request whether or not the Covered Employee is alive at that time. Such change
will relate back to the date of the request. Any change of bene(iciary will not apply to any payment
made before the request was received by the Sponsor.
Conformity with State Statutes
Any provision of this policy which, on its effective date, is in conflict with the statutes of the governing
furisdiction of this policy is hereby amended to conform to the minimum requirements of such stafute.
Form GLP-GNP-l.14 General Provisions
United Water ldaho
Case UW-W-15-01
Request No. 1 0 Attachment 2a
Page 45 of 64
SECTION 7- GENERAL PROVISIONS
(Continued)
Employee's Certificate
Liberty will provide a Certificate to the Sponsor for delivery to Covered Employees. It will state:
1. the name of the insurance company and the policy number;
2. a description of the insurance provided;3. the method used to determine the amount of benefits;
4. to whom benefits are payable;5. limitations or reductions that may apply;
6. the circumstances under which insurance terminates; and7. the righb of the Covered Person upon termination of this policy.
If the terms of a Certificate and this policy differ, this policy will govern.
Entire Contract - Policy Changes
1. This policy is the entire conEact. It consists of:
all of the pages;
the attached signed Application of the Sponsor; and
iI contributory each Employee's signed application for insurance.
2. This policy may be changed in whole or in part. Only an officer of Liberty can approve a change to
the policy. The approval must be in writing and endorsed on or attached to this policy.
3. No other person, including an agent, may change this policy or waive any part of it.
ExaminaHon
Liberty, at its own expense, has the right and opportunity to have a Covered Person, whose Iniury or
Sickness is the basis of a claim, examined or evaluated at reasonable intervals deemed necessary by
Liberty. This right may be used as often as reasonably required.
Facility of Payment
Liberty has the right, at its optiorl to pay up to $500 to any person whom Liberty considers equitably
mtitled thereto by reason of having incurred funeral or other experues incident to the last ilbness or
death of the Covered Person. Such payment will release Liberty of all further liability to the extent of
payment.
a.
b.
c.
Form GLP-GNP-2.9 General Provisions
United Water ldaho
Case UW-W-I5-01 Request No. 10 Attachment 2a
Page 46 of 64
SECTION 7. GENERAL PROVISIONS
(Continued)
Fumishing of Information - Access to Records
1. The Sporuor will furnish at regular intervals to Liberty:
a, information relative to Employees:
i. who qualily to become insured;ii. whose amounts of insurance change; and/oriii, whose insurance terminates.
b. any other information about this policy that may be reasonably required.
The Sponsor's records whid, in the opinion of Liberty, have a bearing on the insurance will be
opened for inspection at any time that is reasonable.
2. Clerical error or omission will not deprive an Employee of insurance.
Incontestability
This policy will not be contested, except for the nonpayment of premium, after it has been in force for
two years from the date of issue. The coverage of any Covered Person shall not be contested, except for
the nonpayment of premium, on the basis of a statement that is made relating to insurability of the
Covered Person after such coverage has been in force for two years during the Covered Person's
lifetime,
Any statements in any application will be deemed to be representations and not to be warranties. No
representation made by:
1. the Sponsor in applying for this policy will make it void unless the representation is contained in
the Sponsor's signed Application; or
2. any Covered Person in enrolling for insurance under this policy will be used to reduce or deny a
claim unless the representation is contained in an application signed by him and such
application is given to him or his beneficiary.
Interpretation of the Policy
Liberty shall possess the authority, in its sole disoetioru to construe the terms of this policy and to
determine benefit eligibility heretrnder. Liberty's decisions regarding the construction of the terms of
this policy and benefit eligibility shall be conclusive and binding. However, these decisions may be
modified or reversed by a court or by a regulatory agency with appropriate jurisdiction.
Legal Proceedings (Applicable to Accidental Death & Dismemberment)
A claimant or the claimant's authorized representative carmot start any legal action:
1. until 60 days after Proof of claimhas been given; or
2. more than tfuee years after the time Proof of claim is required.
Fonn GLP-GNP-3.2l General Provisions
United Water ldaho
Case UW-W-15-01
Request No. 1 0 Attachment 2a
Page47 ol64
SECTION 7- GENERAL PROVISIONS
(Continued)
Misatatement of Age
If a Covered Person's age has bem misstated, an equitable adjusbnent will be made in the premium. If
the amount of the benefit is dependent upon the Covered Person's age, the amount of the bmefit will be
the amount the Covered Person would have been entitled to if his correct age were known.
A refund of premium will not be made for a period more than L2 months before the date Liberty is
advised of the error.
Notice and Proof of Claim (Applicable to Accidental Death & Dismemberment)
7. Notice
a. Notice of claim must be given to Liberty within 20 days of the date of the loss on which the
claim is based. If that is not possible, Liberty must be notified as soon as it is reasonably
possible to do so. Such notice of claim must be received in a form or format satisfactory to
Liberty.b. When written notice of claim is applicable and has been received by Liberty, the Covered Person
will be sent claim forms. If the forms are not received within 15 days after written notice of
claim is sent, the Covered Person can send to Liberty written Proof of claim without waiting for
the forms.
2. Proof
a. Satisfactory Proof of loss must be given to Liberty no later than 30 days after the date of loss.
b. Failure to furnish such Proof within such time shall not invalidate or reduce any claim if it was
not reasonably possible to furnish such Proof within such time. Such Proof must be furnished as
soon as reasonably possible.
Liberty reserves the right to determine if the Covered Person's Proof of loss is satisfactory.
Optional Methods of Settlement
Bmefits are usually payable in one sum. However, the Covered Person may elect in writing to have the
proceeds paid tfuough an installment program offered by Liberty. If the Covered Person makes no such
election, his beneficiary may do so at the Covered Ptrson's death.
Any installments remaining after the death of the payee will be paid as directed in the election of this
option. Such direction is subject to the approval of Liberty.
Liberty Security Account
If the benefits to be paid total more than $LO00O a beneficiary may elect to have the proceeds deposited
into a Liberty Security Account. The Liberty Secwity Account is an interest-bearing checking account,
that is fully guaranteed by Liberty, and the beneficiary may draw on the entire sum of the proceeds at
any time. If the Liberty Security Account is not elected, benefits may be paid in one sum.
Payment of Benefits
All benefits are payable when Liberty receives written satisfactory Proof of loss. Benefits for loss of life
of the Covered Employee are paid to the beneficiary. Benefits for loss of life of the Covered Dependent
are paid to the Covered Employee. Benefis for other losses are paid to the Covered Employee.
Form GLP-GNP4.24 General Provisions
United Water ldaho
Case UW-W-15-01 Request No. 10 Attachment 2a
Page 48 of 64
SECTION 7. GENERAL PROVISIONS
(Continued)
Right of Recovery
Liberty has the right to recover any overpa)rrrent of benefits caused by, but not limited to, the following:
L. fraud;2. any error made by Liberty in processing a clalm; or3. any error made in the eligibility or adminiskation of this policy by the Sponsor.
Uberty may recover an overpayment by, but not limited to, the following:
1. requesting a lump sum payment of the overpaid amoun!2. reducing any benefits payable rmder this policy; or3. taking any appropriate collection activity available including any legal action needed.
It is required that full reimbursenent be made to Liberty.
Time Payment of Claim
When Liberty receives satisfactory proof of claim, the benefit payable under this policy will be paid
within 60 days of receipt of such proof. The benefit payable will be paid at least montNp depending on
the coverage for which claim is made, during any period for which Uberty is liable.
Workerst CompentaHon
This Policy and the coverages provided are not in lieu of, nor will they affect any requirements for
coverage under any Workers'Compensation Law or other similar law.
Form GLP-GNP-5.6 General Itovisions
United Water ldaho
Case UW-W-15-01 Request No. 1 0 Attachment 2a
Page 49 of 64
SECTION 8. PREMIUMS
Premium Rates
Liberty has set the premiums that apply to the coverage(s) provided under this policy. Those premiums
are shown in a notice given to the Sponsor with or prior to delivery of this policy.
A change in the initial premium rate(s) will not take effect within the fust 35 months except that Liberty
may change premium rates at any time for reasons which affect the risk assumed, including those
reasons shown below:
1. a change occurs in the policy desigD
2. a division, subsidiary or Associated Company is added to or deleted from this policy;
3. when the number of Covered Persons changes by 15.00% or more from the number insured on
this policy's effective date; or
4. a change in existing law which affects this policy.
Liberty may, upon notice to the Sponsor, set new premium rates to become effective on or at any time
after the first anrriversary date of this policy. However, no premium may be changed unless Liberty
notifies the Sponsor at least 31 days in advance. Premium changes may take effect on an earlier date
when both Liberty and the Sponsor agree.
Payment of Premiums
1. All premiums due under this policy, including adjustments, if any, are payable by the Sponsor on or
before their due dates at Libertyrs Administrative Officg or to Liberty's agent. The due dates are
specified on the first page of this policy.
2. All payments made to or by Liberty shall be in United States dollars.
3. If premiums are payable on a monthly basis, premiums for additional or increased inswance
becoming effective during a policy month will be charged from the next premium due date.
4. The prernium charge for insurance terminated during a policy month will cease at the end of the
policy month in which such insurance terminates. This manner of charging premium is for
accounting purposes only. It will not extend insurance coverage beyond a date it would have
otherwise terminated as shown in the "Termination of a Covered Person's Insu:ance" provision of
this policy.
5. If premiums are payable on other than a monttrly basis, premiums for additional, increased, reduced
or terminated insurance will cause a prorated adjustment on the next premium due date.
6. Except for fraud and premium adjustments, refirnds of premiums or charges will be made only for:
a. the current policy year; andb. the immediately preceding policy year.
Form GLP-PRE-I Premiumg
United Water ldaho
Case l,rwl-W-15-01 Request No. 10 Attachment 2a
Page 50 of64
SECUON 8 - PREMruMS
(Continued)
Grace Period
A graceperiod of 31 days udl berkulcdlorErpaynentof preofum rffrrpranftrmdtrdeEottcr
than the first. No interest wI[ be du3od. DntrttG Erit pcdod &i! @y wilt contntr er for,cc. DrS, tr
theSponsorgivesI$ertywritErnodcebEmtnrt0rpdlcyanmeuffcrdrts drnErbpo[cywil
end on such eadier date. Thc Spurcor muit Fy Ifie pro rata premirmr for the time the policy was in
force druing the grace per:iod.
EomrGLP-PRE2 Premluns
United Water ldaho
Case UW-W-I5-01
Request No. 1 0 Attachment 2a
Page 51 of 64
AMENDMENT NO. 1
It is agreed the Iollowing changes are hereby made to this policy: S43-830-509893-01
The effective date of this dtange is luly 1.2010.
This policy's terms and provisions will apply other than as stated in this amendment.
Dated this 8th day of fuly, 2010.
Issued to and Accepted by:
United Water Resources, Inc.
Sponsor
Signature and Title of Officer
Liberty Life Assurance Company of Boston
Changee Additions Deletions
aunge Leave of Absence due to
)isability for Class L, 2,4,6,73 ar.d
2 from 30 months to 12 months.
;orm GLP-ELG4 R (1):orm GLP-ELG-4
Form GLP-AMENDMENT DeletdAdd Policy Pages
United Water ldaho
Case UWI-W-15-01 Request No. 10 Attachment 2a
Page 52 of64
AMENDMENT NO. 2
It is agreed the following changes are hereby made to this policy: 543-83&50989101
The effective date of this change is September 4, 2010.
This policy's terms and provisions will apply other than as stated in this amendment.
Dated this 1st day of October, 2010.
Issued to and Accepted by:
United Water Resources. Inc.
Sponsor
Signature and Title of Officer
Liberty Life Aosurance Company of Boston
By
AdditionsGmmtr-rTIiI
GLP-SCH-2.8 R (1)
GLP-SCH-4.8 R (1)
GLP-ELG-4 R (2)
GLP.SCH-2.8
GLP-SCH-4.8
GLP-ELG4 R (1)
Form GLP-AMENDMENT Delete/Add Policy Pages
United Water ldaho
Case UW-W-15-01
Request No. 10 Attachment 2a
Page 53 of 64
AMENDMENT NO. 3
It is agreed the following changes are hereby made to this policy: SA3-83G50989&01
The effective date of this change is Iune 1. 2010.
This policy's terms and provisions will apply other than as stated in this amendment.
Dated this 10th day of December, 20L0.
Issued to and Accepted by:
United Water Resources, Inc.
Sponsor
Signature and Title of Officer
Liberty Life Assurance Company of Boston
By
Deletions
;pd-A;l coverag-from --po-rm cInscH-zs nBl ---Torm CtmeFt-zsn1lf -
13, lncrease AD&D form GLP-SCH-3.5 R (1) fiorm GLP-SCH-3.S
for Class 7,8 and9 to form GLP-ELG-I R (1) fiorm GLP-ELG-I
Remove AD&D from porm GLP-ELG-2 R (1) fiorm GLP-ELG-2
20 and revise Dependmt ['orm GLP-LIF-2.13 R (2) fiorm GLP-LIF-2.I3 R CI)for Class 7,89 & 20 to mirrorl i
2.
Form GLP-AMENDMENT Delete/Add Policy Pages
United Water ldaho
Case UW-W-15-01
Request No. 10 Attachment 2a
Page 54 of 64
AMENDMENT NO. 4
It is agreed the following changes are hereby made to this policy: SA3-83G509893-01
The effective date of this change is I@arL!.!0lt
This policy's terms and provisions will apply other than as stated in this amendment.
Dated this lTth day of December, 2010.
Issued to and Accepted by:
United Water Resources, Inc.
Sponsor
Signature and Title of Officer
Liberty Life Asgurance Company of Boston
Yf-fu^**
Changes Additions Deletions
\dd Dependent Optional to qass :torm GLP-SCH-2.8 R (3)
:orm GLP-SCH-S R (1)
lorm GLP-SCH-z.E R (Z)
iorm GLP-SCH-S
Form GLP-AMENDMENT Delet{Add Policy Pages
United Water ldaho
Case UW-W-15-0'l
Request No. 10 Attachment 2a
Page 55 of 64
AMENDMENT NO. 5
It is agreed the following changes are hereby made to this policy: SA3-83G509893-01
The elfective date of this change is Iune 1. 2010.
This policy's terms and provisions will apply other than as stated in this amendment.
Dated this 2?nd day of February, 2011.
Issued to and Accepted by:
United Water Resources. Inc.
Sponsor
Signahre and Title of Officer
Liberty Life Agsurance Company of Boston
?r-*<b*--
Chanses Addiuons LreleEons
lhange Class 3 Eligibility Waiting
'eriod from none to 90 days
ollowine date of hire.
torm GLP-SCH-I R (2)torm GLP-SCH-I R (1)
Form GLP-AMENDMENT Delete/Add Policy Pages
United Water ldaho
Case UW-W-I5-01 Request No. 1 0 Attachment 2a
Page 56 of 64
AMENDMENT NO. 6
It is agreed the following changes are hereby made to this policy: 5A3-830-509893-01
The effective date of this change is August 1, 2011..
This policy's terms and provisions will apply other than as stated in this amendment.
Dated this 2nd day of August, 2011.
Issued to and Accepted by:
United Water Resources. lnc.
Sponeor
Signature and Title of Officer
Liberty Life Assurance Company of Boston
?r-vw*
By
Class 1 from $600,000.00 to
Form GLP-AMENDMENT Delete/Add Policy Pages
United Water ldaho
Case UW-W-1s-o't
Request No. '10 Attacfiment 2a
Page 57 of64
AMENDMENT NO. 7
It is agreed ihe following changes are hereby made to this policyl SA3-83G,509893-01
The effective date of this change is leEugry-l/qle
This policy's terms and provisions will apply other than as stated in this anendment.
Dated this 14th day of December, 2011.
Issued to and Accepted by:
United Wabr Reoources. Inc.
SPoneor
Signature and Title of Officer
Liberty Life Aeeurance Company of Boeton
?r-kw
ChanBes Additions Deletions
(emove Class 3, Utilties t ervice
iroup, from the Policy.
brmGLP-SCH-IR (3)
rorm GLP-SCH-2.8 R (5)
tonn GLP-SCH-4.8 R (2)
tormGLP-SCH-S R (2)
tonnGLP-DEF-IR (1)
torm GLP-ELG-1 R (2)
bmGLP-ELC-2R (2)
tormGLP-ELG4R (3)
torrr GLP-LIF-2.l3 R (3)
tormGLP€CH-IR (2)
iorm GLP-SCH-2.8 R (4)
:orm GLP-SCH4.8 R (1)
:ormGLP-SCH-S R (1)
rorm GLP-DEF-I
torm GLP-ELG1 R (1)
tormGLP-ELC-2 R (1)
tomr GLP-ELG4 R (2)
torm GLP-LIF-2.13 R (2)
FoIr. GLP-AMENDMENT Delete/Add Policy Pagee
United Water ldaho
Case UW-W-15-01
Request No. 10 Attachment 2a
Page 58 of 64
AMENDMENT NO. 8
It is agreed the following changes are hereby made to this policy: 5A3'830-50989$01
The effective date of this change is December 2, 2011.
This policyrs terms and provisioru will apply other than as stated in this amendment.
Dated this 21st day of March, 2012.
Issued to and Accepted by:
United Water Resources, Inc.
Sponsor
Signahrre and Title of Officer
Liberty Life Agsurance Company of Boston
?r-vw-
By
Changea Additione Deletions
Jpdates were made to the Class 13
lasic Life Insurance benefit
morrnt
rorTr cLP-!iCtI-2.6 R (6)torm GLP-SCH-2.E R (5)
Forrr GLP-AMENDMENT Delete/Add Policy Pagea
United Water ldaho
Case UW-W-15-01
Request No. 10 Attachment 2a
Page 59 of 64
AMENDMENT NO. 9
It is agreed the following changes are hereby made to this policy: 5A3-830-50989101
The effective date of this change is March 1, 2012.
This policy's terms and provisions will apply other than as stated in this amendment.
Dated this 29th day of March,2072.
Issued to and Accepted by:
United Water Resources, Inc.
Sponsor
Signatute and Title of Officer
Liberty Life Assurance Company of Boston
Changes Additions Deletione
[dded O&d benefit tier to Class 16
or Retired Employeec who retiren o rftan Mrah 1 ?D12
iorm GLP-SCH-2.8 R (7)lorm GLP-SCH-2.8 R (6)
Form GLP-AMENDMENT Delet{Add Policy Pages
United Water ldaho
Case UW-W-15-01
Request No. 10 Attachment 2a
Page 60 of64
AMENDMENT NO. 10
It is agreed the following changes are hereby made to this policy: 5A3-830-509893-01
The effective date of this dtange is February 29,2A12.
This policy's terms and provisions will apply other than as stated in this amendment.
Dated this 23rd, d,ay ol April,2072.
Issued to and Accepted by:
United Water Resources, Inc.
Sponsor
Signature and Title of Officet
Liberty Life Ageurance Company of Boston
Yf-S*w-
By
Chaneee Additions Deletione
e benefitstructure for Chss 6
rk Liftchanged from e multiple
Annuat E mftE to a fht
lountbased on vears ofrervhe.
tormGLP-SCH-2.8 R (4 torm GLP€CH-2.8 R (6)
Forrr GLP-AMENDMENT DeletdAdd Policy Pages
United Water ldaho
Case UW-W-15{1 Request No. 10 Attachment 2a
Page 61 of04
AMENDMENT NO. 11
It is agreed the following dunges are hereby made to this policy: 5A$830-50989!01
The effective date of this change is bnuetll2012.
This policy's hrrrs and provisioru will apply other than ae sht€d in ftis amendmmt.
Dated this 25th day of fune,2012.
Issued to and Accepted by:
United Water Resources, Inc.
Sponsor
Stgnature and Title of Offlcer
Ltbedy Life Agsurance Corrpany of Boston
Changea AddiHons Deletlons
Jrangeo ure uePenoent Lfiro
naximum ase to 26 vears.
,orm uLr-bLrl-z.d K (v,
tormGLP-SCH-4.8R 6)
ormuLr-br-n-z.u r( (u,rorm GLP-SCH.[.8 R (2)
Fomr GLP-AMENDMENT DeletdAdd Policy Pages
United Water ldaho
Case UW-W-15-01 Request No. 1 0 Attachment 2a
Page 62 of 64
AMENDMENT NO. 12
It is agreed the following changes are hereby made to this policy: SA3S3G5@8%-01
The effective date of this change is luly 1, 2011.
This policy's terms and provisioru will apply other than as stated in this amendment.
Dated this 25th day of September, 2012.
Issued to and Accepted by:
United Water Resotrrces, Inc.
Sponsor
Signatue and Title of Officer
Liberty Life Aesurance Company of Boston
?f-*'{@----
By
Changes Additions Deletions
llass 23 benefit amount changed
rom flat $3Q000.00 to L times
\nnual Earnings to a maximum of
i300.o00 rxt
;orm GLI'-SCH-2.E R (10)lorm GLP-SCH-2.8 R (9)
Form GLP-AMENDMENT Delete/Add Policy Pages
United Water ldaho
Case UW-W-15-01
Request No. 10 Attachment 2a
Page 63 of 64
AMENDMENT NO. 13
It is agreed the following changes are hereby made to this policy: 5A3-830-509893-01
The effective date of this change is Ianuary 1. 2012.
This policy's terms and provisions will apply ottrer than as stated in this amendment.
Dated this 12th day olOctober, 2012.
Issued to and Accepted by:
United Water Resources, lnc,
Sponsor
Signature and Title of Officer
Liberty Ltfe Aseurance Company of Boston
?r*M
Changee Additiona Deletions
-kurry tne maxrmum a8e tor
)eoendmt Children
brmGLP-SCH-2.8 R (11 tormGLP-9CH-2.8 R (10)
Forn GLP-AMENDMENT Delet{Add Policy Pagec
United Water ldaho
Case UVVI-W-15-01
Request No. 1 0 Attachment 2a
Page 64 of 64
AMENDMENT NO. 14
It is agreed the following dunges are hereby made to this policy: SA3$G5D893-01
The effective date of this change is September 1. 2012.
This policy's terms and provisions will apply other than as stated in this amendment.
Dated this 11th day of April, 2013.
lssued to and Accepted by:
United Water Resources, Inc.
Sponeor
Signature and Title of Officer
Liberty Life Aesurance Company of Boston
Yr"*M
By
Chanqes Additiong Deletions
)Iarify the Class 15 Basic Life
tenefit
iorm GLP-SCH-Z.U R (12)rormGLP-SCH-2.E R (11)
Fornr GLP-AMEMMENT DeletdAdd Policy Pagea
UNITED WATER IDAHO INL.
CASE UWI.W.15.O1
FIRST PRODUCTION REQUEST OF THE COMMISSION STAFF
Preparer/Sponsoring Witness: Jarmilla Cary
REQUEST NO.11:
For all expenses allocated from the parent and affiliated companies, please provide a
schedule showing the total revenue, the atlocated amount to each entity, the allocation
percentage, and methodology used to determine the allocation amount.
RESPONSE NO. 1 1:
Please see Response No. 11 Attachment for the amount of total M&S fees for 2014 and
the amount charged to each affiliate. The allocations are based upon the affiliate
agreement between United Water ldaho and United Water Management and Services.
United Water ldaho
Period Ending 12 Months ,,2l3llL4
Request No. 11 Attachment
YTD
00002 United Water Pennsylvania
00004 United Water Arkansas
OOO27 United Water Delaware
00029 United Water Bethel
00044 United Water Toms River
00045 United Water Owego
00049 United Water SouthCounty Sewer
00053 United Water New Rochelle
00055 United Water Westchester
00050 United Water ldaho
00051 United Water Rhode lsland
00100 United Water New Jersey
00101 Corwick Realty Corporation
00200 United Water New York
United Water Env. Services lnc
United Water Env. Services lnc
United Water Operations, lnc.
UW Operations Inc.
United Water Env. Services lnc
United Water Operations, lnc.
United Water Operations, lnc.
United Water Env. Services lnc
United Water Env. Services lnc
United Water Long lsland lnc
United Water Env. Services lnc
United Water Services lndiana
White River Env Partnership
United Properties Group
United Water Env. Services lnc
United Water Env. Services lnc
United Water Env. Services lnc
United Water Env. Services lnc
United Water Resources
US BD-General
United WERCs
United Water Env. Services Inc
UW Services Mississippi LLC
United Water Env. Services lnc
United Water Service Milwaukee
United Water Env. Services lnc
UW Laredo LLC
UW Arlington Hills - Sewer
United Water Matchaponix
United Water West Milford -Sew
United Water Princeton Meadows
00800 UnitedWaterworks
00976 United Water lnc.
Total
00303
00304
00307
00311
00312
00313
00315
00370
00401
00420
o0447
00485
00487
00500
00s21
00s45
00551
00575
00600
00514
0063s
00575
00676
00682
0068s
00687
00688
00720
0076s
oo770
00780
2,433,928.42
0.00
7,621,908.70
78,067.23
1,990,9t7.12
120,652.39
46,495.44
2,588,204.79
514,663.46
3,246,498.93
331,715.58
\2,787,418.75
0.00
4,570,380.t7
1,502,923.5t
615,688.94
0.00
0.00
1,306,693.11
0.00
50,otg.42
0.00
576,780.77
739,294.55
77,77g.tg
2,99L,771.54
0.00
0.00
5L2,799.20
1,059,428.95
287,875.35
780,747.9L
12,43L.41
4,827,02t.01
74,950.73
2,717,39L.57
24,618,39
1,834,373.67
181.36
1,930,349.15
0.00
18,051.97
110,075.01
79,843.17
132,t52.46
134.15
3,153.21
52,569,453.59
UNITED WATER IDAHO INC.
CASE UWI-W-I5-01
FIRST PRODUCTION REQUEST OF THE COMMISSION STAFF
Preparer/Sponsoring Witness: Jarmilla Cary
REQUEST NO. 14:
Please provide the most recent insurance agreements for general corporate insurance.
RESPONSE NO. 14:
General Corporate insurance
General corporate insurance is primarily secured on a corporate-wide basis and covers
the other insurance types not identified elsewhere and also includes broker fees.
Examples of coverage within this category are General Liability, Umbrella and Excess
Liability, Crime and Employment Practices Liability. Coverage secured solely for
individual entities or groups of entities are charged accordingly. The premiums are
pooled across the corporation and then allocated to the individual business units. The
premium allocation is based on the value of "Assets, less Cash, lnter-Company
Receivables and lnvestment in Subsidiaries" in the particular entity as a ratio to the total
asset value under the corporate-wide policy. The same method is used to allocate
deductible losses across all of the regulated utility companies. The non-regulated
entities are charged directly for their losses and the regulated entities do not bear any
portion of the non-regulated operations deductible losses.
Propertv lnsurance
Property insurance is secured on a corporate-wide basis and the premiums are pooled
across the corporation and then allocated to the individual business entities. The
allocation is based on the value of "Net Property, Plant and Equipment" in the particular
entity as a ratio to the total value of Net Property, Plant and Equipment of the
corporation. Losses within the property deductible are borne by the operating company.
Property premiums are expected to increase the next two years.
Please refer to Response No. 14 Attachment for the allocation factors for the year 2015.
UNTTED WATER MANAOEMENT & SERVICES ALLOCATION
UNITED WATER RESOURCES POLICIES
PREMITJM BILLINGS
For Procuroment proce3sed thru June 2015
June 2015 BILLING
United Water Resources - CASUALTY INSURANCE
R6poe No. 14 Attahnml
PAGE I OF2
Ca6.l, Exc6 & Orb{ AIloc Auto Allocdion Prcpdy A[oc.
PHirm D.ductiblc Prsnlum Dedwtibh De 14
2,576,957 97 79% 2,5't6,9s2 100 00%18.!29 069% 0 000%40,166 152% 0 000%@ffi
Nunbq Nuobcr
of of
vchicle Vctlicld
-t6 w.h ffi
42 18% 5r9lr 41./. ,44
44 520/o 561
De l4 Assts La
Cash, Iot co Re,
Iry in Sube
De l4 Asls L6s
Csh, Int 6 Rcc ,
Irv ia Suhc
Net
Propfiy, Plet
EsaiE.ted CorB:
M&S
Ulility opsatioN
Nm-r4larcd sulrs
AfEliat6
lbtal
Totals to alloclte
Sp*ific chuge
Total
Utllity Op3rtiotrs
fr0l00 UtriEd Watq NJ
00200 United Wat6 I.IY
Tdsl
United Watm'orls
00004 Arksd
00060 ldrho
Iebdville
00044 T06 Rirc.
00051 tlcw Roetrclle
00M6 Owcgo
0004? Nichols
00048 Sourh Cowty Wds
00049 South Couoty Swq
00027 Delaw{c
00029 Bethel
00054 Comoticul
00002 Pmylvmia
00061 RlDde lslud
000Ji Wdch6tq
Orida (Idaho)
Total llnircd WW
00700 Md Atlanric Util (C)
fod Utility Opo
M&S
539
1U
561
--t3!9--
D3e/.
029%
0 4tr/.
42't8% 2,416,787
tt 43v" 1,25t44.52% t0,257
39 35%
t6 48%80
l0l
6350/. 80 63s%21890/. 301 2389%
t1 54% 221 t7 540/o
2,494,296 100.00%
1,084,260 43 47%369.612 1482%ffi
r,013.916
424,580
1,438,516
-?!,3]!-2,516,952
1848% 1,011,936
t6 lr/. 424,580
54.59%r,43E,5t6 5s.82%
0 000% 0 000% 0268,222 r0.l870 268,222 t04t./t s2000% 0 000% 0163.954 622% 163,954 616% 32221,801 I 49% 221,803 8.68% 428,493 0!2% r,493 03370 40 000% 0 00070 00 000% 0 000ryo 01,92? 0t5./" !,92? 0 t5% 088,565 526o/o 138,566 5 38% 34?,828 030% ?,828 03V/. 00 000% 0 000% 0220,564 E 37% 220,564 I 56% 6124,627 093% 24,627 096./0 150,241 I 9t% 50,24t I 95% 00 000% 0 000% 0
I,l 10,220 42.t10/. ,,110,220 41.08% 238
0_00% 0 000%l8t9% 238 t8 89%
0
0
\2)33% 42
0 320/.
0 007.
o $tr/.
0 00e/r
4
0
0
0210% 34000% 0000% 0
5 32o/o 61056% 7000% 0
0 00%
4 tt%
0 00%
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0 00%
4 1!o/.
0 00%
254%
1 331.4
0 320/r
0 00%
0 00vo
0 00%
2 10%
0 00%
0 00%
5 32%
0 561/o
o0o%
0
25t,8 t0
138,185
t88.449
6,696
0
0
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123,111
'1,641
0
202,580
22,00r
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0 00%
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26,075 \M%
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-'lrffi
UNITED WATER MANAGEMENT & SERVICES ALI.OCATION
UNITED WATER RESOURCES POLICIES
PREMIUM BILLINGS
For Procurement proc$sed thru June 2015
June 2015 BILLING
United Water Resources - CASUALTY INSURANCE
EslollcXa-!-4ssLEa!
PAGE 2 OF 2
Z0l5 Opcntlns Plrn
(i6dol, Ercss & othq AIoc.
Premium Dedo.tiblc
Auto Allo.ation
Vehicl* Vehicles
0 000%o 000%o 000%
Dcductible
Numbs
of
0
0
0
41
7
20
0
A
0
0
70
0
Paemium
Nwtcr
of
Propcrty Alloc
Dec l4
Nd
kopeily, PImi
Notr-regtrlated Subsidieris
Utritcd Propdi6
t,PC Credil (A)
HobokerS04
J6sy City -303
Ralway-3 I 2
Bayow-3t2n111
UW Operatiom Contracts BU3 l2 custl000
Maalapm-315
00301 Ops Inc-Kmy
Florida OPS
EM2
Total Dorreg
UWR AfR[ris rot rtrolly-otr,ncd
Dun&e
Utrys Alflirts - Auocrled PrcDiums
0097 I SUEZ Eav No Ancrica
UWS Milwauk*
UWS Arlmta
WREP
486 WREPJndy Custl0l8
4tt7 WRLP-Cary Cust 1020
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UW Contract Sery LLC-52I
UW Cmden U.C-545/,042
UW Hydro Mgt LLC-55 l/1000
UW Spriogficld l.l-C-s75i 1080
trw Aos.687
uw NACO-675
UW M$sippj LLC-676
UW Sm Anronio-44?,/l0l 7
IJWS l* -681
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Total amliats - sllocaled
UWS Afflirtcs - DiNt Charged Premlums
Mctffing Swics
WREP - lndy
UWS Milwaukec
UWS Atlilta
tlWS Inc
UWS Lr - U\\R/LDE rtumhi!
Total afriiare - direct
Total t,WS Affiliat6
Dcc 14 Asss Lss
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0 00%
0 250/.
0 13o/o
0 00%
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0
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0
0
0
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807
1,891
68
4.356
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UNITED WATER IDAHO INC.
CASE UWI-W-I5-01
FIRST PRODUCTION REQUEST OF THE COMMISSION STAFF
Preparer/Sponsoring Witness: Jarmilla Cary
REQUEST NO. 15:
Please provide invoices making up the $347,390 in test year general corporate
insurance expense.
RESPONSE NO.15:
Please see response to Request No. 14 for a discussion of how corporate insurance is
allocated to the various companies.
Please refer to Response No. 15 Attachment for the monthly journa! entry details that
make up the $347,390. Each of the journal entry amounts are made up of several
allocations depending upon the type of insurance and time period covered.
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