FRA Certification Helpline: (216) 694-0240

CLEVELAND, November 18 — A number of changes to the BLET Short-Term Disability Insurance Plan will become effective January 1, 2009. These changes will impact you if you are an eligible employee working on a railroad that participated in the Wage Rules portion of the National Agreement dated December 16, 2003. Two parts to the Plan are being offered as outlined below:

Part A – Non-Occupational Disabilities

Effective January 1, 2009, the current plan covering both occupational and non-occupational disabilities will be modified:

• Part A will pay $402 per week for non-occupational disabilities only. This is an increase from $362 per week.
• Occupational disabilities will not be covered.
• Each eligible member will also be insured for $50,000 of Accidental Death and Dismemberment (AD&D) coverage.

NOTE:
• This plan change will not impact members with current claims. Those members who have a date of disability prior to January 1, 2009 will continue to qualify for the $362 per week benefit for occupational or non-occupational as determined by the Plan.
• Claims for occupational disabilities prior to January 1, 2009 will continue to be administered as they are today, making them subject to repayment upon receipt of a FELA settlement (repayment after a personal injury settlement).

Part B – Occupational Disabilities

Effective January 1, 2009:
• Part B will be voluntary.
• The cost will be $23 per month and will be payroll deducted with your monthly union dues.
• The weekly benefit for occupational disabilities will be $402 per week.
• Each eligible member will also be insured for $50,000 of AD&D coverage.
• The benefit will not be subject to repayment upon receipt of a FELA settlement (no repayment after a personal injury settlement).
• The benefit will not be considered taxable income.

NOTE:
• Eligibility for Part B will be driven by your eligibility for Part A. You will have two options if you become ineligible for Part A: Pay $40 directly to the BLET Trust Fund by the 10th of the month for Part A and continue your payroll deduction of $23 for Part B or drop out of Part B. If you choose to drop out of Part B, you may discontinue the $23 payroll deduction. However, you may not resume coverage for Part B until a subsequent annual enrollment period.
• Participation in this additional occupational coverage is not required. If you wish NOT to participate, you must notify us in writing by completing and returning the attached form prior to December 1, 2008. Your completed form should be sent to the Secretary-Treasurer of your Local Division. If you are a BLET member and do nothing, you will be automatically enrolled in Part B effective January 1, 2009.
• Members opting out of Part B coverage effective January 1, 2009, will not be eligible to enroll for the coverage until the next annual enrollment period.
• UTU members may purchase Part B coverage by making an annual payment of $276 to the BLET Trust Fund.

If you have any questions, please contact the undersigned.

Fraternally yours,

Jim Bradford
BLET Short-term Disability Administrator

(216) 241-2630, ext. 205 or email Bradford@ble-t.org

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OPT OUT FORM
PART B – BLET SHORT TERM DISABILITY INSURANCE PLAN

(You need only complete this form if you wish to DECLINE Part B coverage)

If you desire to OPT OUT or DECLINE Part B coverage under the BLET Short Term Disability Insurance Plan, complete the remainder of this form. Be sure to include your signature and the date and deliver to your Division Secretary-Treasurer by December 1, 2008.

“I, _____________________________(Print your name here and sign below), hereby choose to DECLINE coverage, or OPT OUT, of the BLET Short Term Disability Insurance Plan, Part B. I understand that I may only seek enrollment in Part B during a future open enrollment period.”

Signature: ___________________________

Date: __________________________

Phone Number: ______________________

DEADLINE TO OPT OUT IS DECEMBER 1, 2008

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A copy of this letter and the opt out form are available as a PDF here:
https://www.ble-t.org/pr/pdf/STDletter.pdf

For UTU members, an “opt in” form is available for download:
https://www.ble-t.org/pr/pdf/BLETSTD-UTUform.pdf