cost: estate - employees club of california...this is a summary only. please see plan booklet for a...

®

®

Legal Plan

for Employees C

lub

of California

EM

PLO

YE

ES

CLU

B O

F CA

LIFOR

NIA

ww

w.E

mp

loyeesC

lub

.com

DO

NE

SEAL WITH TAPE BEFORE MAILING - DO NOT STAPLE

CITY EMPLOYEES CLUB OF LOS ANGELES 311 S SPRING ST STE 1300 LOS ANGELES CA 90013-9844

NO POSTAGENECESSARY

IF MAILEDIN THE

UNITED STATES

BUSINESS REPLY MAILFIRST-CLASS MAIL LOS ANGELES CAPERMIT NO. 62722

POSTAGE WILL BE PAID BY ADDRESSEE

Artwork for Envelope, 3.75 x 8.5 (3.75" x 8.5")Layout: sample BRM Env with IMB.lytOctober 3, 2012

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NO POSTAGENECESSARY

IF MAILEDIN THE

UNITED STATES







NO POSTAGENECESSARY

IF MAILEDIN THE

UNITED STATES






EMPLOYEES CLUB OF CALIFORNIA311 S SPRING ST STE 1300LOS ANGELES CA 90013-9844


FIRST-CLASS MAIL PERMIT NO. 62722 LOS ANGELES CABUSINESS REPLY MAIL

Our legal plan covers m

any of the most frequently needed

personal legal matters:

Your ow

n attorney for only$21.00 a m

onth (individual)or $22.50 (fam

ily)!

Qu

estion

s?C

lub

Co

un

selors are read

y to

answ

er you

r qu

estion

s abo

ut o

ur

Legal Plan

. Call to

day...

(800) 464-0452

Mo

ney M

atters•

Deb

t Co

llection

Defen

se•

Iden

tity Th

eft Defen

se•

Iden

tity Man

agem

ent S

ervices2

•N

ego

tiation

s with

Cred

itors

•Perso

nal B

ankru

ptcy

•Pro

misso

ry No

tes

•Tax A

ud

it Rep

resentatio

n•

Tax Co

llection

Defen

se

Ho

me &

Real

Estate

•B

ou

nd

ary & T

itle Disp

utes

•D

eeds

•E

viction

Defen

se•

Foreclo

sure

•M

ortgag

es

•Pro

perty Tax A

ssessmen

ts•

Refin

ancin

g &

Ho

me E

qu

ity Loan

of

Primary, S

econ

dary o

r Vacation

Ho

me

•S

ale or Pu

rchase o

f Primary,

Seco

nd

ary or Vacatio

n H

om

e•

Secu

rity Dep

osit A

ssistance

•Ten

ant N

ego

tiation

s•

Zo

nin

g A

pp

lication

s

Estate P

lann

ing

•C

od

icils•

Co

mp

lex Wills

•H

ealthcare Proxies

•Livin

g W

ills•

Pow

ers of A

ttorn

ey (Health

care, Fin

ancial, C

hild

care, Imm

igratio

n)

•R

evocab

le & Irrevo

cable Tru

sts•

Sim

ple W

ills

Family &

Person

al•

Ad

op

tion

•A

ffidavits

•C

on

servatorsh

ip•

Dem

and

Letters•

Divo

rce - 20 ho

urs

•G

arnish

men

t Defen

se•

Gu

ardian

ship

•Im

mig

ration

Assistan

ce•

Juven

ile Co

urt D

efense, In

clud

ing

C

rimin

al Matters

•N

ame C

han

ge

•Paren

tal Resp

on

sibility M

atters•

Person

al Prop

erty Issues

•Pren

up

tial Ag

reemen

t•

Protectio

n fro

m D

om

estic Vio

lence

•R

eview o

f AN

Y Perso

nal Legal

Do

cum

ent

•S

cho

ol H

earing

s

Civil Law

suits

•A

dm

inistrative H

earing

s•

Civil Litigatio

n D

efense

•D

ispu

tes Over C

on

sum

er Go

od

s &

Services

•In

com

peten

cy Defen

se

•Pet Liab

ilities•

Sm

all Claim

s Assistan

ce

Eld

er-Care Issu

es•

Co

nsu

ltation

& D

ocu

men

t Review

fo

r Issues R

elated to

You

r Parents:

•D

eeds

•Leases

•M

edicare

•M

edicaid

•N

otes

•N

ursin

g H

om

e Ag

reemen

ts

•Po

wers o

f Atto

rney

•Prescrip

tion

Plan

s•

Wills

Veh

icle & D

riving

•D

efense o

f Traffic Tickets

3

•D

riving

Privileges R

estoratio

n•

License S

usp

ensio

n D

ue to

DU

I•

Rep

ossessio

n

With

ou

r legal p

lan, service is tailo

red to

you

r need

s. Yo

u

can ch

oo

se an atto

rney n

ear you

from

ou

r netw

ork o

f over

15,000 attorn

eys and

wo

rk with

them

by p

ho

ne, em

ail or in

p

erson

. An

d fo

r certain leg

al matters, yo

ur atto

rney m

ay be

able to

represen

t you

in co

urt w

itho

ut yo

u h

aving

to m

ake an

app

earance. Y

ou

can also

use an

ou

t-of-n

etwo

rk attorn

ey and

g

et reimb

ursed

for co

vered services acco

rdin

g to

a set fee sch

edu

le. 1

Qu

ality legal assistan

ce can b

e pricey. A

nd

it can

be h

ard to

kno

w w

here to

turn

to fi

nd

an atto

rney

you

can tru

st. Bu

t for $21.00 a m

on

th fo

r an

ind

ividu

al plan

or fo

r $22.50 a mo

nth

for a fam

ily p

lan, th

rou

gh

the C

lub

, you

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ave a team o

f exp

erienced

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rneys

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ned

and

un

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legal even

ts.

Th

rou

gh

ou

r legal p

lan, yo

u g

et experts to

assist yo

u o

n a b

road

rang

e of p

erson

al legal issu

es yo

u m

igh

t face thro

ug

ho

ut yo

ur life, like w

hen

yo

u’re g

etting

married

, bu

ying

or sellin

g a h

om

e, startin

g a fam

ily, or carin

g fo

r agin

g p

arents.

Best o

f all, you

have u

nlim

ited access to

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r atto

rneys fo

r all the leg

al matters co

vered u

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er yo

ur p

lan —

with

no

cop

ays, ded

uctib

les or claim

fo

rms —

givin

g yo

u p

eace of m

ind

kno

win

g yo

u’ll

have an

expert o

n yo

ur sid

e for as lo

ng

as you

n

eed th

em.

1 Yo

u w

ill be resp

on

sible to

pay th

e differen

ce, if any, b

etween

the p

lan’s p

aymen

t an

d th

e ou

t-of-n

etwo

rk attorn

ey’s charg

e for services.

Gettin

g h

elp is easy.

On

line. B

y Ph

on

e. In Perso

n.

Co

st: $21.00 a mo

nth

(ind

ividu

al) or $22.50 a m

on

th (fam

ily)

Th

is is a sum

mary o

nly. P

lease see plan

bo

oklet fo

r a com

plete d

escriptio

n o

f all ben

efits. Gro

up

legal p

lans are p

rovid

ed b

y Hyatt Leg

al Plan

s, Inc., a M

etLife co

mp

any, C

leveland

, OH

. In certain

states, gro

up

legal p

lans are p

rovid

ed th

rou

gh

insu

rance co

verage u

nd

erwritten

by M

etrop

olitan

Pro

perty an

d C

asualty

Insu

rance C

om

pan

y and

Affiliates, W

arwick, R

I. Payro

ll ded

uctio

n req

uired

for g

rou

p leg

al plan

s. For co

sts and

com

plete d

etails of th

e coverag

e, call or w

rite the

com

pan

y.

So

me services n

ot availab

le in all states. N

o service, in

clud

ing

con

sultatio

ns, w

ill be p

rovid

ed fo

r: 1) emp

loym

ent-related

matters, in

clud

ing

com

pan

y or

statuto

ry ben

efits; 2) matters in

volvin

g th

e emp

loyer, M

etLife and

affiliates and

plan

attorn

eys; 3) matters in

wh

ich th

ere is a con

flict of in

terest betw

een th

e em

plo

yee and

spo

use o

r dep

end

ents in

wh

ich case services are exclu

ded

for th

e spo

use an

d d

epen

den

ts; 4) app

eals and

class action

s; 5) farm an

d b

usin

ess m

atters, inclu

din

g ren

tal issues w

hen

the p

articipan

t is the lan

dlo

rd; 6) p

atent, trad

emark an

d co

pyrig

ht m

atters; 7) costs an

d fin

es; 8) frivolo

us o

r un

ethical

matters; 9) m

atters for w

hich

an atto

rney-clien

t relation

ship

exists prio

r to th

e particip

ant b

ecom

ing

eligib

le for p

lan b

enefits. Fo

r all oth

er perso

nal leg

al m

atters, an ad

vice and

con

sultatio

n b

enefit is p

rovid

ed. A

dd

ition

al represen

tation

is also in

clud

ed fo

r certain m

atters.

©2019 M

etLife Services an

d S

olu

tion

s, LLC, H

yatt Legal P

lans, In

c., a MetLife C

om

pan

y, 1111 S

up

erior A

venu

e, Su

ite 800, Clevelan

d, O

H 4

4114 –– All R

igh

ts Reserved

. L1219000038[exp0321][A

ll States][D

C,P

R]

Imm

igratio

n S

ervices:W

e provide guidance and support to help you navigate the imm

igration process. By phone and in person, w

e help you with a

wide variety of m

atters including imm

igration education, hearing and affidavit preparation, document review

, and more.

The best part is, your attorney fees are covered and paid in full, with no deductible, no co-pays and no claim

forms w

hen using a N

etwork A

ttorney for a covered service.* If you’re thinking about imm

igrating to the United S

tates, think about signing up for the legal plan.

At M

ovies, Th

eme Parks, A

ttraction

s, S

po

rting

Even

ts, Th

eaters and

S

ho

ws, S

pecial E

vents, an

d M

ore!

Exp

lore 1,000’s o

f disco

un

ts and

exclu

sive 2-for-1 an

d 50%

OFF d

eals at lo

cal eateries, sho

ps, travel sites, an

d

mo

re. Disco

un

ts available th

rou

gh

ou

t th

e U.S

. and

Can

ada.

SAV

E BIG!!

Up to 55%

OFF

•D

ININ

G•

SHO

PPING

•TRA

VEL

•M

OV

IE THEA

TERS•

SPORTIN

G EV

ENTS

•A

TTRAC

TION

S•

THEM

E PARKS

•BU

SINESS SERV

ICES

•SPEC

IAL EV

ENTS

•C

AR REN

TALS

•TH

EATRIC

ALS

•M

ERCH

AN

DISE

•W

ATER PA

RKS•

SKI LIFT TIC

KETS

•SEA

SON

AL EV

ENTS

OV

ER 75,00

0 D

ISCO

UN

TS!

®

Clu

b M

emb

ership

is a mo

nth

ly ben

efit that can

be can

celled

at anytime. C

lub

Mem

bers are b

illed b

i-weekly o

r mo

nth

ly th

rou

gh

yo

ur

mu

nicip

al em

plo

yer’s o

ffice

to

ded

uct

from

you

r salary or p

ensio

n th

e amo

un

t for yo

ur C

lub

M

emb

ership

.

Th

e E

mp

loyees

Clu

b

of

Califo

rnia

is an

en

han

ced

sup

plem

ental vo

lun

tary ben

efits provid

er for state, lo

cal, an

d m

un

icipal g

overnm

ent em

plo

yees of C

aliforn

ia.

Th

e Clu

b p

rovides d

iscou

nt en

tertainm

ent an

d in

suran

ce b

enefits ab

ove and

beyo

nd

wh

at is offered

thro

ug

h th

e em

plo

yee’s wo

rk.

Sin

ce 1928, the C

lub

has b

een celeb

rating

the w

ork an

d

lives of m

un

icipal g

overnm

ent em

plo

yees by p

rovidin

g

sign

ifican

t d

iscou

nts

on

en

tertainm

ent,

afford

able

insu

rance, an

d in

sane cu

stom

er service.

You

r Clu

b M

emb

ership

is on

e of th

e m

ost im

po

rtant so

urces o

f saving

s availab

le to m

un

icipal govern

men

t em

ployees in

Califo

rnia.

Join the Club Today! Monthly

ACTIVE/RETIRED EMPLOYEES

$600

CLUB MEM

BERSHIP

The Employees C

lub of California is a m

embership program

of LAC

EA Insurance S

ervices, Inc. (C

A D

OI Lic. #0B

98000). LAC

EA Insurance S

ervices, Inc. is a licensed insurance agency offering insurance benefits to qualified C

lub mem

bers. LAC

EA Insurance S

ervices, Inc. is not directly affiliated w

ith Metropolitan Life Insurance C

ompany.

Zip

I am paid hourly

City

Job Title

StateWork Address

Yes, I am an active California State Employee. Yes, I am an active Los Angeles City Employee.

Initial Required

Facility NameDept Name

Email Address (No work email address)*

I am a salaried employee

Pay Status (Select One)

/ /

/ /

( )( )( )

Employees Club of CaliforniaSocial Security Number

Name of Association

First Name Middle Initial Last Name

City State ZipHome Address

Home Phone Work Phone Mobile Phone

Gender

Male MarriedFemale Single

Marital Status

Date of Birth (MM/ DD/ YYYY)

Date of Hire (MM/ DD/ YYYY)

* The e-mail address you provide will help us communicate with you regarding updates and benefits that may become available to you. Your e-mail address will be used solely by the Employees Club of California and will not be distributed to others.

Family Plan ($22.50 / month)Individual Plan ($21.00 / month)

FOR LOS ANGELES CITY AND DWP EMPLOYEES

PAYROLL DEDUCTION AUTHORIZATION

City Employee #City Dept # (5 - 6 Digits)

To:

DWP Employee #

City Active

City Retired

Fire/ Police Pension (Officers Only)

DWP Active

DWP Retired

Los Angeles City / DWP Employee Date

Social Security Number

Controller–City of Los Angeles, or Fire and Police Pension, or City Employees Retirement System, or Paymaster–Department of Water and Power

Please select one:

FOR OFFICE USE ONLY

Code Deduction/ /SIGN

HERE X

I hereby authorize the deduction from my and pension of amounts sufficient to cover premiums/ membership fees on any of my group benefits provided by the Employees Club of California. In the event any premiums should change due to age, increase in salary or benefits, or a general rate increase for the entire Association, I authorize you to make such change upon notification from the Employees Club of California and such deduction to remain in force until canceled by me in writing.

Employees Club of California311 S. Spring St. STE 1300Los Angeles, CA 90013(800) [email protected]

In addition to payroll/ pension deductions for group benefits, if any, you will receive all Club benefits for a payroll/pension deduction of only $6.00 per month (active employees) or $4.00 per month (retired). You authorize these monthly deductions by signing the Payroll Deduction Authorization form.

FOR EMPLOYEES OF THE STATE OF CALIFORNIA

Last Name

Organization Name

California State Employee Date

Middle InitialFirst Name Social Security Number

Los Angeles City Employees Association, Inc. (LACEA)

California State Controller

/ /SIGNHERE X

I hereby authorize the State Controller to deduct from my salaries and wages the amount specified now or in the future for membership dues and any benefit program for which I have applied, which is sponsored by the above named organization. This authorization will remain in effect until cancelled by me or by the above named organization. I certify that I am a member of the above named organization, and understand that termination of membership will cancel all deductions made under this authorization.

To:

FOR OFFICE USE ONLY

Code Deduction


PAYROLL DEDUCTION AUTHORIZATION In addition to payroll deductions for group benefits, if any, you will receive all Club benefits for a payroll deduction of only $6.00 per month. You authorize these monthly deductions by signing the Payroll Deduction Authorization form.

089-067Ded./ Org. Code:

Last Name Middle InitialFirst Name

At M

ovies, Th

eme Parks, A

ttraction

s, S

po

rting

Even

ts, Th

eaters and

S

ho

ws, S

pecial E

vents, an

d M

ore!

Exp

lore 1,000’s o

f disco

un

ts and

exclu

sive 2-for-1 an

d 50%

OFF d

eals at lo

cal eateries, sho

ps, travel sites, an

d

mo

re. Disco

un

ts available th

rou

gh

ou

t th

e U.S

. and

Can

ada.

SAV

E BIG!!

Up to 55%

OFF

•D

ININ

G•

SHO

PPING

•TRA

VEL

•M

OV

IE THEA

TERS•

SPORTIN

G EV

ENTS

•A

TTRAC

TION

S•

THEM

E PARKS

•BU

SINESS SERV

ICES

•SPEC

IAL EV

ENTS

•C

AR REN

TALS

•TH

EATRIC

ALS

•M

ERCH

AN

DISE

•W

ATER PA

RKS•

SKI LIFT TIC

KETS

•SEA

SON

AL EV

ENTS

OV

ER 75,00

0 D

ISCO

UN

TS!

®

Clu

b M

emb

ership

is a mo

nth

ly ben

efit that can

be can

celled

at anytime. C

lub

Mem

bers are b

illed b

i-weekly o

r mo

nth

ly th

rou

gh

yo

ur

mu

nicip

al em

plo

yer’s o

ffice

to

ded

uct

from

you

r salary or p

ensio

n th

e amo

un

t for yo

ur C

lub

M

emb

ership

.

Th

e E

mp

loyees

Clu

b

of

Califo

rnia

is an

en

han

ced

sup

plem

ental vo

lun

tary ben

efits provid

er for state, lo

cal, an

d m

un

icipal g

overnm

ent em

plo

yees of C

aliforn

ia.

Th

e Clu

b p

rovides d

iscou

nt en

tertainm

ent an

d in

suran

ce b

enefits ab

ove and

beyo

nd

wh

at is offered

thro

ug

h th

e em

plo

yee’s wo

rk.

Sin

ce 1928, the C

lub

has b

een celeb

rating

the w

ork an

d

lives of m

un

icipal g

overnm

ent em

plo

yees by p

rovidin

g

sign

ifican

t d

iscou

nts

on

en

tertainm

ent,

afford

able

insu

rance, an

d in

sane cu

stom

er service.

You

r Clu

b M

emb

ership

is on

e of th

e m

ost im

po

rtant so

urces o

f saving

s availab

le to m

un

icipal govern

men

t em

ployees in

Califo

rnia.

Join the Club Today! Monthly

ACTIVE/RETIRED EMPLOYEES

$600

CLUB MEM

BERSHIP

The Employees C

lub of California is a m

embership program

of LAC

EA Insurance S

ervices, Inc. (C

A D

OI Lic. #0B

98000). LAC

EA Insurance S

ervices, Inc. is a licensed insurance agency offering insurance benefits to qualified C

lub mem

bers. LAC

EA Insurance S

ervices, Inc. is not directly affiliated w

ith Metropolitan Life Insurance C

ompany.

Zip

I am paid hourly

City

Job Title

StateWork Address

Yes, I am an active California State Employee. Yes, I am an active Los Angeles City Employee.

Initial Required

Facility NameDept Name

Email Address (no CA State work email address)*

I am a salaried employee

Pay Status (Select One)

/ /

/ /

( )( )( )

Employees Club of CaliforniaSocial Security Number

Name of Association

First Name Middle Initial Last Name

City State ZipHome Address

Home Phone Work Phone Mobile Phone

Gender

Male MarriedFemale Single

Marital Status

Date of Birth (MM/ DD/ YYYY)

Date of Hire (MM/ DD/ YYYY)

* The e-mail address you provide will help us communicate with you regarding updates and benefits that may become available to you. Your e-mail address will be used solely by the Employees Club of California and will not be distributed to others.

Family Plan ($22.50 / month)Individual Plan ($21.00 / month)

FOR LOS ANGELES CITY AND DWP EMPLOYEES

PAYROLL DEDUCTION AUTHORIZATIONName

City Employee #City Dept # (5 - 6 Digits)

To:

DWP Employee #

City Active

City Retired

Fire/ Police Pension (Officers Only)

DWP Active

DWP Retired

Los Angeles City / DWP Employee Date

Social Security Number

Controller–City of Los Angeles, or Fire and Police Pension, or City Employees Retirement System, or Paymaster–Department of Water and Power

Please select one:

FOR OFFICE USE ONLY

Code Deduction/ /SIGN

HERE X

I hereby authorize the deduction from my and pension of amounts sufficient to cover premiums/ membership fees on any of my group benefits provided by the Employees Club of California. In the event any premiums should change due to age, increase in salary or benefits, or a general rate increase for the entire Association, I authorize you to make such change upon notification from the Employees Club of California and such deduction to remain in force until canceled by me in writing.


In addition to payroll/ pension deductions for group benefits, if any, you will receive all Club benefits for a payroll/pension deduction of only $6.00 per month (active employees) or $4.00 per month (retired). You authorize these monthly deductions by signing the Payroll Deduction Authorization form.

FOR EMPLOYEES OF THE STATE OF CALIFORNIA

Last Name

Organization Name

California State Employee Date

Middle InitialLast Name Social Security Number

Los Angeles City Employees Association, Inc. (LACEA)

California State Controller

/ /SIGNHERE X

I hereby authorize the State Controller to deduct from my salaries and wages the amount specified now or in the future for membership dues and any benefit program for which I have applied, which is sponsored by the above named organization. This authorization will remain in effect until cancelled by me or by the above named organization. I certify that I am a member of the above named organization, and understand that termination of membership will cancel all deductions made under this authorization.

To:

FOR OFFICE USE ONLY

Code Deduction


PAYROLL DEDUCTION AUTHORIZATION In addition to payroll deductions for group benefits, if any, you will receive all Club benefits for a payroll deduction of only $6.00 per month. You authorize these monthly deductions by signing the Payroll Deduction Authorization form.

089-067Ded./ Org. Code:

cost: estate - employees club of california...this is a summary only. please see plan booklet for a...

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