Survivor Benefit Guide

Survivor Benefits Guide

for Active Employees

Information Provided

Medical

Supplemental Medical

Dental

AD & D

Life Insurance

Pension

Stock

401(k)

Travel

Credit Union

EAP

Updated July 2007 – This Guide is subject to change as benefit programs and privileges change.

This Survivor’s Benefits Guide is available to assist family members, surviving spouse

or domestic partner (DP), dependent children, or named beneficiary with information

regarding the employee’s benefits and privileges at the time of their death.

This guide should be used as a summary of the employee’s benefits and privileges and

does not override any policy or content provided in the Company’s governing

documents, (i.e. the Plan document, Employee Benefits Guide, TRIP Book,

Employee Policy Guide, etc.),

Should you have additional questions or need more specific information, please feel

free to contact HR Employee Services at 1-800-447-2000.

American Airlines, Inc.

HR Employee Services

MD 5141-HDQ

P.O. Box 619616

DFW Airport, TX 75261-9616

Please note: If you are in the Pilot workgroup, your Flight Administrator office will

conduct all business where Survivor Support Services is noted throughout this

document.

MANAGERS NOTIFICATION OF AN EMPLOYEE DEATH

Family members should contact the employee’s immediate supervisor or manager to

report the death. Pilot’s family members should contact their Flight Administration

Office.

When an employee dies, Employee Services offers support and assistance for

surviving family members. A representative from the employee's department should

contact Employee Services immediately when they learn about an employee’s death.

Mangers can also find additional information and a “Manager Checklist and Guidelines”

in the Employee Policy Guide on Jetnet – Leaving the Company – Death of Employee.

You will also find a “Death Notification Form” that must be completed and faxed to

Survivor Support.

At the time of the death a Survivor Support Administrator will contact the family via a

letter with important personalized information regarding survivor benefits and privileges.

They will continue to monitor the situation to ensure all benefits are processed and

issues resolved. For the Pilot group, your Flight Office will handle any unresolved

Updated July 2007 – This Guide is subject to change as benefit programs and privileges change.

issues.

GROUP TERM LIFE INSURANCE

** Make sure Beneficiaries are always kept up to date. Beneficiaries can be

changed at any time on Jetnet on the Benefits Page – Beneficiaries.

An important feature of the Company's overall benefit program is the availability of the

term life insurance benefit for its eligible employees. The amount of the life insurance

benefit is determined by the amount of coverage elected by the employee (less any

prior Accelerated Benefit Option). If over age 65 at the time of death, a reduction is

taken on the basic coverage.

At the time of an employee's death, the Group Term Life Insurance Plan will pay a

benefit to the designated beneficiary(s).

Life Insurance Claim

A Survivor Support Administrator will notify the life insurance beneficiary(s) in writing of

the benefit amount that is payable by the Plan, and will provide a MetLife Beneficiary

Life Insurance Claim Statement. This form must be completed by the named

beneficiary(s) and returned.

In addition to a completed MetLife Beneficiary Life Insurance Claim Statement, a

certified copy of the death certificate will be required for claim processing. In order to

expedite the process, the claim statement and certified death certificate should be

mailed together. NOTE: The death certificate will NOT be returned, but will be retained

by MetLife for their records.

Methods of Life Insurance Payment

Life Insurance Benefits in the Amount of $5,000 or Less

If the life insurance benefit is $5,000 or less, MetLife will issue a check directly to the

beneficiary. The issuance of benefits typically occurs within 4 to 6 weeks after MetLife

has received the beneficiary claim form and any required supporting documentation.

Life Insurance Benefits in the Amount of $5,000 and above

If the life insurance benefit is $5,000 and above, a no charge, interest generating

account (Total Control Account) will be established by MetLife. The Total Control

Account is a convenient and competitive option that affords the beneficiary the

opportunity to invest life insurance proceeds while deferring financial decisions until a

less stressful time. The beneficiary will be issued a “checkbook” and may write checks

against the account in amounts of 250.00 or more, at any time, up to the amount of the

available benefit. The beneficiary may withdraw the full account balance by simply

writing a check for the full life insurance benefit amount.

Funeral Home Assignment

Often, the funeral home will request payment for services before a life insurance claim

can be processed. To assist in these situations, MetLife will accept funeral home

Updated July 2007 – This Guide is subject to change as benefit programs and privileges change.

assignments. This process allows the beneficiary the option of assigning the entire

benefit, or a portion thereof, directly to the funeral home to cover expenses.

In order to process a Funeral Home Assignment, American Airlines must receive the

following:

1. A Funeral Home Agreement signed by the life insurance beneficiary(s)

2. An itemized statement of funeral home expenses

3. A certified death certificate

After the Funeral Home Assignment claim has been processed, a check will be

forwarded directly to the funeral home in the amount of the assignment, and the

remaining benefit, if any, will be sent to the beneficiary(s).

ACCIDENTAL DEATH AND DISMEMBERMENT COVERAGE (AD&D)/

VOLUNTARY PERSONAL ACCIDENT INSURANCE (VPAI)

** Make sure Beneficiaries are always kept up to date. Beneficiaries can be

changed at any time on Jetnet on the Benefits Page – Beneficiaries.

If the employee’s death was accidental and he/she were enrolled in AD&D or VPAI

coverage, benefits may be payable. If benefits are determined to be payable by Cigna,

the named beneficiary(s) will receive written notification by a Survivor Support

Administrator of their eligibility. A claim application (CIGNA Group Accidental Death

Insurance) will be provided, along with an authorization form to release the information.

These forms must be completed by the named beneficiary(s).

Benefit Claim Processing

In addition to the completed CIGNA Group Accidental Death Insurance claim form, an

additional certified copy of the death certificate with the attending physician’s

record(s) is required. Any additional supporting documentation (e.g., emergency room

records/reports, police reports, newspaper articles, etc.) substantiating the nature of the

death should be provided if available. It is recommended that applicable forms and

supporting documentation be returned to Survivor Support Services together. Once all

the information is received, the claim will be filed with the Insurance Company of North

America.

GROUP MEDICAL / DENTAL COVERAGE

**Please refer to the Employee Benefit Guide for complete Details of Medical

Coverages.

90-Day Dependent Medical Coverage Provision

Updated July 2007 – This Guide is subject to change as benefit programs and privileges change.

Group medical coverage for dependents of an active employee will continue for 90 days

following the date of the employee’s death. For purposes of this provision, dependents

are defined as a spouse/DP or legally dependent children that were covered under the

employee’s medical plan prior to his/her death. This provision provides for the same

type of coverage, including Point-of-Service, Standard Medical, PPO and Health

Maintenance Organizations (HMO), which was in effect at the time of the employee’s

death.

If Eligible to Retire

If the employee met the requirements to retire (age 55, 50 for a Pilot, with 10 or more

years of company service) the surviving spouse/DP may continue with the Retiree

Medical Plan after the death of the employee.

If the employee was prefunding as an active employee, the spouse/DP will continue to

be covered under the American Airlines Retiree Group Medical Benefits Plan through

UnitedHealthcare to a maximum of $50,000 (or the unused balance of your remaining

medical maximum balance if less than $50,000) at the time of your spouse’s/DP’s

death. This will be determined based on your work group and retirement date.

Coverage for hospital/medical expenses will continue until you reach age 65, when you

become eligible for Medicare, or remarry/enter into a new Domestic Partner

relationship, whichever occurs first. At that time, your coverage will cease and may not

be reinstated.

If the employee was in a prefudning workgroup but decided not to prefund, the spouse

will not be eligible for Retiree Medical Benefit coverage.

If the employee was not in a prefunding workgroup during active employment, the

spouse will have the option to purchase the American Airlines Retiree Medical Benefits.

The information and cost will be included in the Survivor Support Package.

If the employee was not eligible to retire, the value of the prefunding account, less

any taxes or expenses, will be awarded to the beneficiary named on the employee’s

beneficiary form. The refund will be issued within 8 weeks following the end of the

calendar quarter in which the employee deceased.

Dental Coverage

Dental coverage terminates as of the date of the employee’s death and is not part of the

90-day medical coverage provision. However, eligible dependents (dependents that

were covered under the employee’s dental coverage prior to his/her death) are eligible

to elect dental coverage as part of continuation (COBRA) coverage.

Continuation (COBRA) Coverage

After the 90-day coverage period ends, eligible dependents may purchase continuation

(COBRA) coverage for up to an additional 33 months. CONEXIS, our COBRA

administrator, will forward an informational package approximately 3 weeks after

notification of the employee’s death. The COBRA package will explain the continuation

of available coverages, cost quotes and the forms to be completed, should coverage be

desired. CONEXIS can be reached at:

Updated July 2007 – This Guide is subject to change as benefit programs and privileges change.

CONEXIS Member Services: 1-877-902-9207

P.O. Box 223886 E-mail Address: customerdelivery@conexis.com

Dallas, TX 75222

SUPPLEMENTAL MEDICAL PLAN COVERAGE

**If you did not elect this coverage at the time it was offered you cannot purchase

the coverage at a later date.

The Supplemental Medical Plan is an optional health coverage program that provides

an additional $500,000 in benefits after all AA medical coverage has been exhausted.

Plan participants pay the entire cost for this coverage. This plan is administered by

HealthFirst.

If the spouse of the employee was covered by the Supplemental Medical Plan at the

time of the employee’s death, he/she will be eligible to continue coverage. However,

Supplemental Medical coverage will cease, if the surviving spouse experiences any of

the following events:

• Failure to pay annual coverage premium

• Remarriage

• Exhausts coverage level

• Death

Eligible spouses may elect Supplemental Medical Plan even if they elect not to continue

coverage through COBRA. If the spouse elects the Supplemental Medical Plan

coverage and not COBRA, the Supplemental Medical Plan will be considered the

primary plan after the 90-day medical coverage provision ceases (only in the absence of

any other medical coverage plans).

If your Domestic Partner was covered by the Supplemental Medical Plan at the time of

your death, your Domestic Partner is eligible to continue the coverage for 90 days

immediately following your death, provided he or she pays the contribution rate to

continue coverage. Then the Supplemental Medical coverage ends and is not available

through COBRA.

Important Note to Continue Coverage

Survivor Support Services will notify HealthFirst of the death. However, if continued

coverage is desired, the surviving spouse must contact HealthFirst at 1-800-711-7083

to arrange for direct billing. If HealthFirst is not contacted within 30 days,

Supplemental Medical coverage for the surviving spouse will be terminated and

cannot be reinstated.

PENSION BENEFIT

Updated July 2007 – This Guide is subject to change as benefit programs and privileges change.

**The Plan provides an automatic 50% for a surviving spouse; you may place a

greater election on file. This form can be found on Jetnet – Benefits – Form Finder

– Retirement – Pre-Retirement Survivor Annuity Benefit Election Form.

Eligibility for a survivor benefit under the Retirement Benefit Plan (the “Pension Plan” or

the “Plan”) is determined by criteria set forth by Pension Plan provisions and specific

Federal laws that guide the administration of defined benefit plans. The deceased

participant’s survivor or beneficiary(s), if any, will receive written notification from a

Survivor Support Services Representative as to whether a benefit is payable, or not

payable, from the Retirement Benefit Plan (RBP) and/or the Variable Benefit Plan

(VBP), if applicable.

RBP Pension Benefit Eligibility – Survivor Benefit

Single Employee

Typically, no survivor benefits are payable from the Plan for an employee who was

single at the time of death. However, if the single employee was previously married,

and has a Qualified Domestic Relations Order (QDRO) against his/her pension, a

portion of the employee’s pension benefit may be payable to the former spouse in

accordance with the terms of QDRO.

Surviving Spouse Benefit

The surviving spouse of a deceased employee may be eligible for a survivor pension

benefit if the employee was eligible for a pension benefit at the time of death, or if all of

the following conditions apply:

• Employee was 100% vested in the Pension Plan at the time of death, and

• Employee and spouse were married at least one year prior to the employee’s death,

and Employee elected Qualified Pre-Retirement Spousal Annuity (QPSA) coverage

If the above conditions are met, the surviving spouse is eligible to commence a benefit

on the earliest date that the employee would have been eligible to commence a benefit.

Eligibility for commencement of the benefit is based on the following criteria:

1) At least age 55 with 15 or more years of Credited Service in the RBP; or

2) At least age 60 with 10-14 years of Credited Service in the RBP; or

3) Age 65 with less than 10 years of Credited Service in the RBP.

Note: Credited Service is defined as the number of years an employee has been a

member of the RBP, not the number of years of service (Company seniority) with the

Company.

The surviving spouse will not be eligible for a survivor benefit if any of the following

conditions apply:

• Employee was not vested in the Pension Plan

• Employee and spouse were not married for at least one year prior to the death

• Employee waived the Qualified Pre-Retirement Spousal Annuity (QPSA) coverage

Updated July 2007 – This Guide is subject to change as benefit programs and privileges change.

Commencement of RBP Pension Benefit (Monthly Annuity)

A Survivor Support Services Representative will notify the surviving spouse of their

eligibility or non-eligibility for a survivor benefit. If the surviving spouse has been

determined to be eligible for a benefit, a Survivor Support Services Representative will

provide the date of earliest commencement, general information, forms and a list of

support documentation that is needed to commence the benefit.

VBP Benefit

If the employee was a member of the VBP, the named beneficiary may be entitled to a

benefit from the Plan. If a VBP benefit is payable, the beneficiary will be notified by a

Survivor Support Services Representative. Survivor Support Services will provide the

information and forms necessary to commence the benefit.

Pension Plan Trustee / Customer Service Assistance

State Street, the trustee for the American Airlines Pension Plan, issues the pension

benefit for all Plan participants. Once the survivor benefit has been commenced, all

inquires should be directed to the State Street Customer Service Center at 1-888-548-

4455.

If the State Street Customer Service Representative is unable to assist you with your

inquiry, he/she will direct you to the appropriate contact at American Airlines.

FINAL SALARY PAYMENTS

The Company will expedite any salary and/or other monies due the employee, such as

vacation pay, time card hours and sick premium pay. Non-management salaried

employees may be eligible for sick premium pay, if applicable, at the time of death. The

Payroll Department will determine whether the employee is eligible for this benefit. If

eligible, these hours will be included in the calculation of the final wage payment.

Married Employees

A Payroll Affidavit will be mailed to the spouse for completion. Once Survivor Support

Services receives the affidavit a check representing final wages will be mailed, if

applicable. If final wages are in excess of $1,500, an advance against final wages may

be issued to the legal spouse of the deceased employee.

Single Employees

The family should complete a Payroll Affidavit provided by a representative of Survivor

Support Services and return any information concerning heirs, wills, estates, etc., of the

employee in order to determine the legal recipient of the final wages. The final salary

payment will be withheld until this information has been received. When the required

documents are returned to Survivor Support Services, the Payroll Department will mail a

check to the designated person.

Updated July 2007 – This Guide is subject to change as benefit programs and privileges change.

Taxes

If final wages are paid in the same calendar year as the employee’s death, Social

Security and Medicare taxes are the only taxes that will be deducted from the final

payment. Accordingly, Social Security and Medicare wages will be reported on a W-2

Form in the same calendar year as the employee’s death. Wages, which normally are

subject to Federal taxes, are reported on a 1099 MISC Form, which will be issued to the

person/estate to which the final payment was issued. This will also include any state

taxes, if applicable.

If final wages are paid in the calendar year after the employee’s death, no Social

Security, Medicare, Federal or State taxes will be deducted from the final wages.

Wages which normally are subject to Federal and State taxes will be reported on a 1099

MISC Form which will be issued to the person/estate to which the final payment was

issued.

STOCK OPTIONS

If you have Stock Options available to transfer, the paperwork necessary to facilitate the

transfer of stock awards is listed in the below table. In order to list the beneficiaries

under your accounts information from both column A and column B will be required.

A Survivor Support Services Representative will notify the surviving spouse of their

eligibility or non-eligibility for a survivor benefit.

The documentation under column A will serve to name the person responsible for

handling the affairs of the deceased employee. That person is generally known as the

personal representative or executive/executrix of the estate.

The form under column B will allow the personal representative or executive/executrix

give official instructions on who should receive the benefit of the stock (beneficiaries). If

there is more than one beneficiary, this form will need to include the percentages in

whole numbers that should be allocated to each of them, the designation of the primary

beneficiary and the corresponding information as listed in the following table.

(A)

Many states will allow you to bypass probate

if the estate is not significant. Please check

with the probate officer at your county clerk’s

office or with your attorney to determine

the applicable document or form.

and (B)

One of the following:

(see glossary below for explanations)

Notarized Letter of Instructions from

the person named in the document in

Column (A).

• Letter of Testamentary

• Letter of Administration

• Waiver of Probate

• Letter of Heirship

• Small Estate Affidavit

Updated July 2007 – This Guide is subject to change as benefit programs and privileges change.

• Letter of Attestation from an Attorney on

Attorney’s Letterhead

After our legal department certifies these documents, Survivor Support will provide

Mellon Investor Services with authorization to add the beneficiaries to the employee’s

account. Transferees will be notified via mail upon completion of the transfer.

Once the beneficiary receives the official Beneficiary Notification, they will be able to

contact JP Morgan Retirement Plan Services at 1-800-345-2345, and ask to be

transferred to a Customer Service Representative at Mellon Investor Services. The

Mellon Investor Service Representative will confirm the employee’s social security

number as well as the beneficiary’s social security number before any information is

released.

Stock – Glossary of Terms:

Letter of Testamentary / Letters of Administration: A document issued by the probate court

appointing an individual or corporation, and authorizing that person or corporation to settle the estate of

the deceased.

Communications from a probate court officially recognizing that a person has been designated as the

executor or administrator of an estate.

Probate: Court proceeding by which a will is proved valid or invalid. Term is used to mean all

proceedings pertaining to the administration of estates such as the process by which assets are gathered;

applied to pay debts, taxes, and expenses of administration; and distributed to those designated as

beneficiaries in the will. Probate is conducted in state courts.

In some states, families with very small estates may be able to use abbreviated probate procedures or

avoid probate entirely.

Heir: A person entitled under state laws of intestacy to property of a decedent who did not have a will. At

common law, this term was restricted to lawfully born children who could inherit land from an ancestor;

under statues, it includes all those who have the right to inherit from a deceased person if there is no will

specifying how it’s divided.

Small Estate Affidavit: An official form, executed by the legal heir(s), stating that the person whose

estate is sought to be administered is deceased, and that such a person did not leave an interest in real

property and that the value of the personal property within the state does not exceed the state’s limits.

Attestation: Attestation refers to the act of witnessing a document or a signature in writing. Most

contracts and wills contain an attestation clause that simply states that the witnesses have followed the

required formalities and that the instrument can take effect.

TRAVEL PRIVILEGES

The continuation of travel privileges is based on the number of years of service the

employee had with the Company at the time of death.

Updated July 2007 – This Guide is subject to change as benefit programs and privileges change.

American Airlines is focused on leading the industry – for its customers as well as for

our people. One way we do that is by providing Jetnet, the Web site that provides

convenient access to personalized travel privileges – anytime, anywhere. At the time of

an employee’s death the surviving spouse/DP will receive information on how to access.

An active employee with 15 years of company service, the surviving spouse/DP will

have the following travel privileges:

�� The surviving spouse/DP and dependent children will receive unlimited D-2 travel

privileges on American Airlines/American Eagle only. This travel privilege is on a

standby, space-available boarding priority.

�� The surviving spouse may also authorize twenty-four (24) one-way guest travel

passes per calendar year.

�� Family members and guests must be registered through Jetnet in order to be eligible

to travel.

�� The Spouse is not eligible for D-2 companion, 5-year or 25-year service charge

waived travel.

�� If at any time the spouse remarries/DP enters into another relationship travel

benefits will cease immediately. Please notify HR Employee Services at 1-800-447-

2000 with this information. Any abuse of this travel privilege may result in

repayment at full fare value.

An employee with less than 15 years of Company service (including those on Leave of

Absence) the surviving spouse/DP will have the following travel privileges:

�� The surviving spouse/DP and dependent children will receive unlimited D-2 travel

privileges on American Airlines/American Eagle only. This travel privilege is on a

standby, space-available boarding priority.

�� Travel privileges are only valid for two (2) years from the employee’s date of death.

�� The surviving spouse/DP may also authorize twenty-four (24) one-way guest travel

passes per calendar year.

�� Family members and guests must be registered through Jetnet in order to be eligible

to travel.

�� The spouse/DP is not eligible for D-2 companion, 5-year or 25-year service charge

waived travel.

�� If at any time the spouse remarries/DP enters into another relationship the travel

benefits will cease immediately. Please notify HR Employee Services at 1-800-447-

2000 with this information. Any abuse of this travel privilege may result in

repayment at full fare value.

RETURN OF COMPANY PROPERTY

The family should return all Company-issued property to the employee's supervisor.

Company property would include the employee’s identification card, airport identification

card, and airport parking sticker, uniforms, Company keys or any other Company

material they may have. If applicable, tool boxes, locks, etc.

Updated July 2007 – This Guide is subject to change as benefit programs and privileges change.

JP MORGAN – 401k

If the employee was a participant of the 401k Plan, the beneficiary on the account will

be contacted directly by JP Morgan within 2-3 weeks of receiving notification of the

death. The telephone number for JP Morgan is (800) 345-2345.

CREDIT UNION

If the employee was a member of the Credit Union, the beneficiary on the account will

be contacted directly by the Credit Union within 2-3 weeks of receiving notification of the

death. The telephone number for the American Airlines Credit Union is (800)533-0035.

EMPLOYEE ASSISTANCE PROGRAM

The Employee Assistance Program (EAP) is a benefit available to all employees, their

spouses/Domestic Partners, and their family members. EAP is a valuable source of

information available to you during this difficult time in your life. The EAP provides a

confidential referral to professionals in the community for counseling, psychotherapy,

and treatment of emotional distress. Any charges associated with professional services

provided are your responsibility. These charges may be covered under the provisions

of your Group Health Plan. You may contact a representative at (800)555-8810.

Survivor Support Services Quick Reference Guide

Employee Services American Airlines (800)-447-2000, option 5

Payroll American Airlines (918)-254-3433 or

800-447-2000 option 1

Medical Claims United Healthcare

Standard Plan

Point of Service Plan

(800) 638-9599

(800) 545-9075

Web site: www.myuhc.com

Prescription Drug Program Medco

If over age 65, United

Health Care

(800) 988-4125

Web site: www.medco.com

(800) 638-9599

Supplemental Medical Plan HealthFirst TPA, Inc. (800) 711-7083

Dental MetLife (800) 638-9599

Web site: www.metlife.com

Updated July 2007 – This Guide is subject to change as benefit programs and privileges change.

Vision Spectera (800) 638-3120

Web site: www.spectera.com

Life Insurance Claims MetLife (800) 638-6420

Web site: www.metlife.com

AD&D / VPAI Cigna (800) 238-2125

Long Term Care MetLife (800) 438-6388

Health Care and

Dependent Day Care FSA’s

United Healthcare (877) 311-7849

Grief Support/Counseling Employee Assistance

Program (EAP)

(800) 555-8810

Golden Wings Additional Medical (800) 521-2510

TWU Optional Life Future Planning Assoc. (800) 626-0291

COBRA CONEXIS (877) 722-2667

E-mail:

customerdelivery@conexis.com

Ceridian Retiree Medical billing (800) 995-9935

Web site:

www.ceridian-benefits.com

Credit Union Member Services (817) 963-6000

Pension Check Inquiries State Street (888) 548-4455

$uper$aver 401(k) J.P. Morgan (800) 345-2345

Social Security Benefits Social Security Admin. (800) 772-1213

Veteran Benefits Veterans Administration (800) 827-1000