Article 61Long Term Care Insurance Plan
Section 1. Eligibility and Maintenance
The Long Term Care Insurance Plan (“LTC Plan”) in effect as of the date hereof, and all future amendments thereto, shall continue through March 1, 2021, under its current terms, except as amended below, and is incorporated by reference and made a part of this Agreement; provided, however, that the terms used in the LTC Plan and the definitions of such terms are applicable only to the LTC Plan and shall have no applicability to this Agreement unless the context of this Agreement specifically mandates the use of such terms. The LTC Plan will be continued and maintained in full force and effect during the term of this Agreement; provided, however, that if the Management Council determines that it would be more efficient and economical to administer the LTC Plan under the Former Player Life Improvement Plan, or through another benefit plan or arrangement, the LTC Plan may be terminated and the benefits provided hereunder be provided under the Former Player Life Improvement Plan or such other plan, subject to approval by the NFLPA. Only players who have permanently ceased playing professional football; who are vested under the Retirement Plan based on Credited Seasons; who have attained the age of 50 and not yet attained the age of 76; and who satisfy the underwriting requirements of the insurer are eligible for insurance under the LTC Plan.
Section 2. Benefits
All eligible players issued a Long Term Care insurance contract on or before March 1, 2021 provided by a national insurer as described in Section 1 of this Article 61 will be entitled to receive benefits under such contract in the event the player is certified by a licensed health care provider as (i) requiring critical supervision, or (ii) requiring the presence of another person within arm’s reach due to inability to perform a required number of defined activities of daily living. The Long Term Care insurance contract is renewable for life and entitles the player to receive a maximum daily benefit of $150 for a maximum of four years.
Section 3. Limitations
Benefits will continue to not be paid for confinement, treatment, services or care; (i) resulting from alcoholism, drug addiction, or chemical dependency, unless as a result of medication prescribed by a physician; (ii) arising out of suicide (while sane or insane), attempted suicide, or intentionally self-inflicted injury; (iii) provided in a government facility (unless otherwise required by law), services for which benefits are payable under Medicare, or would be payable except for application of a deductible or coinsurance amount, or other governmental programs (except Medicaid), and services for which no charge is normally made in the absence of insurance; (iv) received outside the United States; (v) for which benefits are payable under any state or federal workers’ compensation, employer’s liability of occupational disease law; (vi) that are not included in a participant’s plan of care; or (vii) that are prohibited by federal law.
Section 4. Plan Benefits Primary
Any player who is entitled to any payment or benefit under any other Article of this Agreement that would be eligible for payment or reimbursement under the LTC Plan will continue to have such payment or benefit offset by the amount eligible for payment or reimbursement under the LTC Plan.
Section 5. Administration
The NFL shall continue to administer the LTC Plan. The NFL shall not change any benefit provided under this Article 61 without the consent of the NFLPA.