Accidental Death and Dismemberment Insurance Handbook Summary

ACCI DENTAL DEATH AND
DI SMEMBERMENT (AD&D)
I NSURANCE
BENEFI TS HANDBOOK

Summary Plan Description (SPD)
Effective as of J anuary 1, 2013
A D &D I N S U R A N C E B E N E F I T S H A N D B O O K
Summary Pl an Descri pti on ef f ecti ve as of J anuary 1, 2013
TABLE OF CONTENTS
INTRODUCTION AND PLAN INFORMATION ..................................................................... 1
Plan Information and Notice ................................................................................... 1
Updates ............................................................................................................... 2
Notice of Company Rights ...................................................................................... 2
Effective Date ....................................................................................................... 2
Obtaining a Printed Copy of This Handbook .............................................................. 2
Other Information ................................................................................................. 2
SUMMARY OF KEY CHANGES ....................................................................................... 3
GROUP ACCIDENT AND FAMILY GROUP ACCIDENT INSURANCE ....................................... 4
Eligibility .............................................................................................................. 4
Enrolling for Group Accident or Family Group Accident Insurance ................................ 7
Default Coverage Elections ..................................................................................... 9
Changing Your Coverage During the Year ............................................................... 10
When Coverage Becomes Effective ........................................................................ 11
Naming a Beneficiary ........................................................................................... 11
Who Pays for Group Accident or Family Group Accident Insurance? ........................... 12
Your Group Accident or Family Group Accident Insurance Benefit .............................. 13
Additional Benefits .............................................................................................. 19
When Group Accident or Family Group Accident Insurance Coverage Ends ................. 24
Continuing Accident Insurance Coverage When Coverage Ends ................................. 24
Restrictions and Limitations .................................................................................. 26
PRIVATE PILOTS ACCIDENT INSURANCE ..................................................................... 28
Eligibility ............................................................................................................ 28
Enrolling for Private Pilots Accident Insurance ......................................................... 29
Default Coverage Elections ................................................................................... 29
Changing Your Coverage During the Year ............................................................... 30
Naming a Beneficiary for Private Pilots Insurance .................................................... 30
Who Pays for Private Pilots Accident Insurance? ...................................................... 30
Your Private Pilots Accident Insurance Benefit ......................................................... 31
Additional Benefits .............................................................................................. 35
When Private Pilots Accident Insurance Coverage Ends ............................................ 37
Continuing Private Pilots Accident Insurance Coverage When Coverage Ends .............. 38
Restrictions and Limitations .................................................................................. 38
OTHER BENEFITS ..................................................................................................... 40
Business Travel Accident Insurance ....................................................................... 40
Travel Assistance Benefits .................................................................................... 40
Summary Pl an Descri pti on ef f ecti ve as of J anuary 1, 2013
BENEFIT CLAIMS AND APPEAL PROCESS ..................................................................... 42
Reporting a Claim................................................................................................ 42
Payment of Claims .............................................................................................. 43
Initial Claims Decision .......................................................................................... 44
Right of Appeal ................................................................................................... 45
If a Claimants Appeal Request Is Denied ............................................................... 46
Other Important Information About Appeals ........................................................... 46
Grievances ......................................................................................................... 47
PLAN ADMINISTRATION AND LEGAL RIGHTS ............................................................... 48
Plan Name .......................................................................................................... 48
Type of Plan and Administration ............................................................................ 48
Plan Sponsor/Employer/EIN and Plan Identification Number ..................................... 48
Agent for Service of Legal Process ......................................................................... 48
Plan Year ........................................................................................................... 48
Plan Administrator ............................................................................................... 49
Claims Administrator ........................................................................................... 49
Discretionary Authority of the Plan Administrator and the Claims Administrator .......... 50
Plan Fiduciaries ................................................................................................... 50
Source of Contributions and Funding ..................................................................... 50
Electronic Media .................................................................................................. 50
Assignment of Benefits ........................................................................................ 50
Misstatement in Application for Benefits ................................................................. 50
Overpayments .................................................................................................... 51
Assistance in Reading the English Language ........................................................... 51
Statement of ERISA Rights ................................................................................... 51
TERMS TO KNOW ..................................................................................................... 53
WHERE TO GET MORE INFORMATION ......................................................................... 58

Summary Pl an Descri pti on ef f ecti ve as of J anuary 1, 2013 1
I NTRODUCTI ON AND PLAN I NFORMATI ON
Accidents happen more frequently than you might think. Statistics published by the Centers for
Disease Control and Prevention and the National Vital Statistics System show that accidental bodily
injuries are the fifth greatest cause of death in the United States and the number one killer of
Americans under the age of 45.
Serious injuries from an accident can limit or even end your ability to earn an income. However, by
planning ahead, you can protect your financial security and that of your family.
With this in mind, under the Delta Air Lines, Inc. Optional Insurances Plan (the Plan), you can
purchase group accident and dismemberment insurance (AD&D) coverage (Group Accident
Insurance) for you and your dependents, including your Spouse or Same Sex Domestic Partner and
your children (Family Group Accident Insurance). In addition, the Plan also offers additional
coverage for private pilots (Private Pilots Accident Insurance) to provide protection for those pilots
who are injured or killed while operating private or military aircraft or performing the duties of a pilot.
Group Accident Insurance, Family Group Accident Insurance and Private Pilots Accident Insurance
coverage are currently provided through group accident insurance contracts underwritten by The
Prudential Insurance Company of America (Prudential).
Plan I nformation and Notice
The Employee Retirement Income Security Act of 1974 as amended (ERISA) requires that certain
kinds of benefit plans be described to the participants of those plans in a Summary Plan Description
(SPD). This handbook (together with the sections describing Optional and Dependent Life Insurance
coverage in the Life Insurance and Survivor Benefits Handbook and the Pilots Life Insurance and
Survivor Benefits Handbook) constitutes the SPD for the Delta Air Lines, Inc. Optional Insurances Plan.
This handbook is only a summary of the accident insurance benefits provided by the Plan. Its purpose
is to give you an overview of the major features of the Plan and does not cover all the terms of the
Plan. The provisions of the Plan are defined in its official Plan documents, which govern the terms and
operation of the Plan. These documents include the certificates of coverage and group insurance
policies issued by Prudential describing the provisions of the Group Accident Insurance, Family Group
Accident Insurance and Private Pilots Accident Insurance coverages. The summary in this handbook
does not take the place of these documents. If there is a conflict between the information in this
handbook and the Plan documents, the Plan documents will govern.
While this handbook contains information relating to other programs that may be available to Delta
employees, such as Business Travel Accident Insurance and Travel Assistance benefits, these are not
benefits under the Plan.
Definitions of Capitalized Words
The capitalized terms in this handbook have special meaning. Please refer to the
Terms to Know section at the back of this handbook for definitions.
Updates
In addition to this handbook, you may, from time to time, be notified of the posting of updates or
Summaries of Material Modifications (SMMs) that describe changes to these benefits. You should
always timely refer to these updates, as well as the material in this handbook, to obtain the most
recent information available about these benefits.
Notice of Company Rights
As with all Delta benefits, Delta reserves the right to amend, modify, suspend or terminate all or any
part of the Plan in its sole discretion at any time and for any reason. Any such amendment, modification,
suspension or termination may apply to active employees, their dependents and beneficiaries, as well as
former employees, inactive employees, retirees, disabled employees, employees on a leave of absence
or furlough and COBRA participants, and each of their dependents. Any amendment or modification may
be applied prospectively or retroactively and may be applied only to one group of participants, such as
retirees, but not to other groups of participants.
The Plan is an insured plan and does not have plan assets; therefore, in the event of its termination
no assets are available for distribution.
The Plan may be amended or modified by resolution of the Board of Directors of Delta or through
approval or ratification by any person or persons authorized by the Board of Directors to take such
actions or by ratification by the company through its actions as a whole with respect to such matter.
Delta and its vendors have the right to recover overpayments, regardless of the cause, nature or
source of the overpayments.
Nothing in the Plan, including the receipt of benefits, is to be construed as a contract of employment,
and nothing in the Plan gives any employee the right to be retained in the employ of Delta or to
interfere with the rights of Delta to discharge any employee at any time.
Effective Date
This handbook summarizes the benefits available to eligible employees under the Plan as of
January 1, 2013, unless otherwise noted.
Obtaining a Printed Copy of This Handbook
If you would like to have a printed copy of this handbook, call the Delta Employee Service Center
(ESC) at 1-800 MY DELTA (1-800-693-3582) to learn how you can receive one.
Other I nformation
If you have questions after reviewing this handbook, refer to the Where to Get More Information
section at the back of this handbook.
SUMMARY OF KEY CHANGES
The list below highlights key changes made since the January 1, 2012 version of this handbook (which
included updates as of May 1, 2012), and directs you where to go within the document for additional
information:
New website address for Group Accident Insurance, used for designating or changing a
beneficiary (and other actions), given on pages 11 and 12.
Update to Business Travel Accident Insurance coverage for Military Airlift Command (MAC) flights,
as described on page 40.
This list includes only the key changes made to the Plans. Other changes may have also been made to
this handbook that are not reflected in the above list. This January 1, 2013 version replaces the
January 1, 2012 version of the AD&D Insurance Benefits Handbook (which included updates as of
May 1, 2012) in its entirety, not just for the sections listed above.
GROUP ACCI DENT AND FAMI LY GROUP
ACCI DENT I NSURANCE
Eligibility
Employees
You are eligible for Group Accident or Family Group Accident Insurance under the Plan if you are a
regular full-time or part-time pilot or non-pilot employee of Delta based in the United States, Canada,
Puerto Rico, the Bahamas or Bermuda. In addition, those employees designated by Delta as expatriate
employees working in other foreign countries are also eligible for Group Accident or Family Group
Insurance coverage. If you were enrolled in Group or Family Group Accident Insurance coverage on the
day immediately preceding your retirement and are classified by Delta as an eligible retired employee,
you will be eligible to continue your Group or Family Group Accident Insurance after retirement.
Your eligibility for Group Accident or Family Group Accident Insurance will continue when you are on
certain leaves of absence or during furloughs if you continue to pay required premiums. This is
explained more fully in the Coverage While on Leave of Absence/Furlough section.
Certain Pre-Merger Northwest Employees
Any formerly represented simulator technicians became eligible for Group Accident
Insurance as of January 1, 2011 (as long as they were Actively at Work on that
date)
Any formerly represented office/clerical employees became eligible for Group
Accident Insurance as of May 1, 2011 (as long as they were Actively at Work on
that date)
Any employees formerly represented by the AFA or IAM in IFS, ACS, CGO, RES or
TOP became eligible for Group Accident Insurance as of May 1, 2012 (as long as
they were Actively at Work on that date)

Extension of Eligibility
In certain situations, your eligibility for Group Accident or Family Group Accident Insurance coverage
is extended for a limited period of time. In the following instances, your eligibility for Group Accident
or Family Group Accident Insurance coverage is extended:
For 15 days following the date you are denied disability status under the terms of the Delta Family-
Care Disability and Survivorship Plan or the Delta Pilots Disability and Survivorship Plan, as
applicable, and you do not return to work or, if you are a flight attendant or pilot, do not return to
Active Payroll Status
For 15 days following the date you are placed on an approved unpaid medical leave of absence
For 60 days following the effective date of a suspension
If your eligibility is extended for one of the above-listed reasons, your coverage will automatically
continue with no payment of premiums required. Only one premium-free period per occurrence is
permitted.
In addition, if you pay the required premiums, your eligibility for Group Accident or Family Group
Accident Insurance coverage, is extended:
For 30 days following the date you are placed on a Sick Pending Approval status
For 12 weeks following the date that you are placed on an unpaid family medical leave of
absence (FMLA)
Coverage While on Leave of Absence/ Furlough
Disability Leaves of Absence
If you are disabled under the terms of the Delta Family-Care Disability and Survivorship Plan or the
Delta Pilots Disability and Survivorship Plan, as applicable, you may continue your Group Accident or
Family Group Accident Insurance coverage by paying the required premiums until age 65. (In some
cases, you may be eligible for a waiver of premium during your disability period. Refer to the Who
Pays for Group Accident or Family Group Accident Insurance section for more information.) You may
not increase the amount of coverage during your period of disability. If you remained disabled when
you reach age 65, your coverage amount will be reduced as if you were a retiree, as discussed in the
Group Accident Insurance for Retired Employees section.
Unpaid Leaves of Absence/Furloughs
If you are placed on one of the following approved unpaid leaves of absence or on furlough, you may
continue your Group Accident or Family Group Accident Insurance coverage by paying the required
premiums for up to a maximum period of 60 months (unless otherwise noted below):
Military leaves of absence, including military training and special conflict leaves
Personal leaves of absence, up to a maximum leave period of 24 months if you are a non-pilot
employee, and up to a maximum leave period of 10 years if you are a pilot
Company convenience leaves of absence (applicable to non-pilot employees only) as long as you
do not engage in any other commercial occupation during this leave period
Furloughs
You may not increase the amount of coverage during an unpaid leave of absence period.
If you do not continue coverage while on leave, or if you stop paying the required premiums for such
coverage, your Group Accident or Family Group Accident Insurance will not be reinstated until you
return to work for at least one full day.
If you retire from any of the leaves of absence or furloughs described above, and you either did not
continue your Group Accident or Family Group Accident Insurance or you had not been paying the
required premiums, you will not be eligible for Group Accident or Family Group Accident Insurance
under the Plan as a retiree.
Who Is Not Eligible for Group Accident Insurance?
You are not eligible for Group Accident Insurance under the Plan if you are a member of any of the
following groups:
Contract or leased employees
Employees stationed outside the United States (other than expatriate employees or those
stationed in Canada, Puerto Rico, Bermuda or the Bahamas)
Non-resident aliens with no U.S. source of income
Employees of:
Comair, Inc.
DAL Global Services, LLC
Delta Private Jets, Inc.
MLT, Inc.
Regional Elite Airlines Services, LLC
Segrave Aviation, Inc.
Other affiliates of Delta that have not adopted the Plan
Flight attendant students
Employees classified under Deltas payroll records as:
Ready Reserve employees
Seasonal employees
Student co-ops or interns
Part-time Representative Specialty Sales and Service Work at Home employees
Customer Service Agent Flex employees
Apprentice employees for the Delta Community Credit Union
Dependents
If you are eligible for Group Accident Insurance, you can also cover certain dependents under Family
Group Accident Insurance. Your eligible dependents include the following:
Your Spouse or Same Sex Domestic Partner;
Your naturally born or legally adopted children up to age 26
Your stepchildren or children of your Same Sex Domestic Partner up to age 26
Children up to age 26 for whom you have been appointed legal guardian by a court, who live with
you in a parent-child relationship and are primarily dependent on you for support
Foster children up to age 26 who live with you in a parent-child relationship, are primarily
dependent on you for support and for whom you receive no government reimbursement for
maintenance and support
Grandchildren, as long as their mother is covered by the Family Group Accident Insurance portion
of the Plan as your dependent child, the mother lives in your home with the grandchildren and
the grandchildren are primarily dependent on you for support
Extension of Child Eligibility for a Disabled Child
A physically or mentally disabled child may continue his or her eligibility for Family Group Accident
Insurance coverage beyond the age limit described above. The child must be incapable of self-
sustaining employment because of a mental or physical handicap. Proof of such handicap must be
provided to Prudential within 31 days after the date that the child reaches the applicable age limit, and
as otherwise requested by Prudential. Eligibility for Family Group Accident Insurance will continue
while such child remains incapable of self-sustaining employment because of a mental or physical
handicap and continues to meet the criteria described above except for the age limit.
Delta Couples
If you and your Spouse or Same Sex Domestic Partner are both employees eligible for the Plan, you
both have the same coverage options available. You may elect Family Group Accident Insurance for
your Spouse or Same Sex Domestic Partner; and your Spouse or Same Sex Domestic Partner may
also elect Family Group Accident Insurance for you.
However, for purposes of Family Group Accident Insurance, your children may not be considered
dependents more than once. The child of two Delta employees will be considered the qualified dependent
of the employee who is named in a written agreement on file with Delta. If there is no written
agreement, these rules determine which employee may cover the child as a qualified dependent:
If the child was previously the qualified dependent of only one of the employees while that
employee had Family Group Insurance coverage, the child will be that employees qualified
dependent
Otherwise, the child will be the qualified dependent of the employee who has the longest
continuous service with Delta, based on Deltas records
Enrolling for Group Accident or Family Group Accident I nsurance
You may enroll for Group Accident Insurance coverage for yourself, or Family Group Accident
Insurance coverage for yourself and your eligible dependents, during the following opportunities:
A designated enrollment period from your date of hire (or rehire), if you are a newly-hired or
rehired employee, including rehired retirees, or are returning to active status
The annual open enrollment period, if you are an active employee
In addition, if you experience a qualified life event or become eligible for coverage during the year,
you may be eligible to enroll for Group Accident or Family Group Accident Insurance coverage at such
time. See the Changing Your Coverage During the Year section.
Evidence of insurability (or proof of good health) is not required to enroll in Group Accident or Family
Group Accident Insurance.
Note: If you enroll in Family Group Accident Insurance, you will be covering any and all dependents you
may have no separate enrollment is required for each dependent. For example, if you are married and
have two children that meet the dependent criteria listed in the Eligibility section, when you enroll in
Family Group Accident Insurance, all three of your dependents will be eligible for coverage so long as
they continue to meet the definition of dependent. A dependents eligibility for coverage will be
determined as of the date of an accident for which benefits are being sought under the Plan.
If you acquire a dependent after you cease being Actively at Work and you have already enrolled for
Family Group Accident Insurance coverage, your newly-acquired dependent will not be eligible for
Family Group Accident Insurance coverage until you return to work for at least one full day.
If you have already enrolled for Family Group Accident Insurance coverage, any child conceived while
you are Actively at Work will be eligible for Family Group Accident Insurance coverage as soon as they
meet the definition of a dependent.
If You Are a Newly-Hired or Rehired Employee
If you are a newly-hired or rehired employee, you may enroll for Group Accident or Family Group
Accident Insurance, as well as other voluntary Delta benefits, during a designated enrollment period
from your date of hire (or rehire). You will be mailed a notification of your enrollment deadline, and you
can enroll online via the Delta Extranet or the DeltaNet home page: http://dlnet.delta.com. (See
How To Enroll on the next page.)
If You Are a Rehired Retiree
If you are a rehired retiree, you may enroll for Group Accident or Family Group Accident Insurance, as
well as other voluntary Delta benefits, during a designated enrollment period from your date of rehire
regardless of whether you continued such coverages during your retirement. You will be mailed a
notification of your enrollment deadline, and you can enroll online via the Delta Extranet or the
DeltaNet home page: http://dlnet.delta.com. (See How To Enroll on the next page.)
If You Are an Active Employee
Each year during the annual open enrollment period, you will have an opportunity to enroll for Group
Accident or Family Group Accident Insurance coverage. You can enroll online via the Delta Extranet or
the DeltaNet home page: http://dlnet.delta.com. (See How To Enroll on the next page.)
If You Are a Retiree
If you are eligible for Group Accident Insurance as a retiree, and were enrolled in Group Accident or
Family Group Accident Insurance on the day before your retirement date, you will be given an
opportunity to continue your coverage during your retirement in the amount described in the Group
Accident Insurance for Retired Employees section. You will be mailed a notification of your enrollment
deadline, and you can enroll online via the Delta Extranet or the DeltaNet home page:
http://dlnet.delta.com. (See How To Enroll on the next page.)
If You Are Returning to Active Status From Inactive Status
Returning during the same calendar year. You will not receive an additional enrollment
opportunity to change your Group Accident Insurance or Family Group Accident Insurance coverage
until the next annual open enrollment period. You will receive the default coverage listed in the
Default Coverage Elections section on the next page regardless of whether or not you continued
your coverage while inactive.
Returning during a different calendar year. You will be mailed an enrollment notification directing
you to enroll online by using Benefits Direct. Any changes you make to your Group Accident Insurance
or Family Group Accident Insurance coverage during the designated enrollment period become
effective on the first day of the pay period following the end of the designated enrollment period, if
you are on active status. If you do not make an election during the designated enrollment period, you
will receive the default coverage listed in the Default Coverage Elections section on the next page
regardless of whether or not you continued your coverage while inactive.
How To Enroll
Go online to http://dlnet.delta.com. You can use any computer with Internet
access. You will need a valid Delta Passport password. (If you can access TravelNet or
if you have home access to DeltaNet, you have a valid Passport password.) If you do
not know your Passport password, go to http://register.delta.com.
Go to http://dlnet.delta.com and enter your 9-digit employee number
(Username), along with your Delta Passport password
From the DeltaNet home page, place your mouse over Employee Info at the top
of the page
Select Self-Service from the drop-down menu
Read the notice and click Agree (Self-Service home page appears)
From the Self-Service home page, rollover My Benefits & Medical Events, on
the top tool bar, then click on Change Coverage to make eligible benefit elections
Benefits Direct allows you to review your current coverage and make your elections.
If you have questions about online enrollment, or if you experience difficulty enrolling,
contact the ESC at 1-800 MY DELTA (1-800-693-3582) Monday through Friday,
8 a.m. to 5 p.m. Eastern time. International callers should dial 404-677-8000.
Default Coverage Elections
If you remain an active employee and do not make an affirmative election regarding your Group
Accident or Family Group Accident Insurance, your current coverage will continue in effect for the
following plan year. You can view your current coverage amounts online at the Benefits Direct website.
If You Are a Newly-Hired or Rehired Employee
If you choose not to enroll in Group Accident or Family Group Accident Insurance coverage before
your first enrollment deadline, you will default to No Coverage. Your next opportunity to change your
election will be during the next annual open enrollment period, unless you experience a qualified life
event that would allow you to enroll during the year.
If you continued your Group Accident or Family Group Accident Insurance coverage during your
retirement and you do not make an affirmative election regarding such coverage before your first
enrollment deadline, your current coverage will remain in effect.
If you did not continue your Group Accident or Family Group Accident Insurance coverage during your
retirement and do not make an affirmative election regarding such coverage before your first enrollment
deadline, you will default to No Coverage. Your next opportunity to change your election will be during
the next annual open enrollment period, unless you experience a qualified life event that would allow
you to enroll during the year.
If you choose not to continue your Group Accident or Family Group Accident Insurance coverage as a
retiree before the applicable enrollment deadline, you will default to No Coverage. You will not have
another opportunity to enroll in this coverage through Delta.
You will be placed in the same Group Accident or Family Group Accident Insurance coverage you had
in place before your inactive status began.
Changing Your Coverage During the Year
If, during the year, you experience a qualified life event, you can either change your existing Group
Accident or Family Group Accident Insurance coverage or enroll for coverage for the first time. A
change in your election due to a qualified life event must be consistent with the event. The following
are each considered to be a qualified life event:
Marriage or entering into a same sex domestic partnership
Divorce or termination of a same sex domestic partnership
The birth, adoption or placement for adoption of a dependent child
Addition of a child (such as a stepchild, appointment of legal guardianship, or a foster child who
meets the eligibility requirements)
Death of a dependent
Your dependent ceasing to qualify as a dependent
Change in your or your dependents employment status, such as beginning or ending
employment, strike, lockout, taking or ending a leave of absence, changes in worksite or work
schedule, if it causes you or your dependent to gain or lose eligibility for group coverage
If you experience a qualified life event, you have 60 days from the date of that event to request a
benefit election or change consistent with the nature of your qualified life event.
Since Family Group Accident Insurance covers all of your eligible dependents, a newly added
dependent will automatically be covered if you have Family Group Accident Insurance coverage in
effect at the time the dependent is added. Dependent eligibility is determined at the time of a claim, in
accordance with the dependent criteria listed in the Eligibility section.
If only one person is covered as your dependent, and that person ceases to be eligible due to a
qualified life event, if you fail to submit his or her dependent status change to the ESC within 60 days,
any payroll deductions that continue from your pay for family group accident coverage after that
person ceases to be eligible will not be refunded to you.
When Coverage Becomes Effective
If you complete the enrollment process during your first enrollment opportunity, your Group Accident
or Family Group Accident Insurance will become effective as of the first day of the payroll period on or
following your completion of 30 days on Active Payroll Status.
If you enroll for Group Accident or Family Group Accident Insurance during the annual open
enrollment period, the coverage will become effective on the January 1 following the annual open
enrollment period.
IMPORTANT! Actively at Work Requirement
If, because of sickness or injury, you are not actively at work on the day before your
coverage would ordinarily become effective, your coverage will not become effective
until you have been actively at work for at least one full day.
If you are eligible to continue your Group Accident or Family Group Accident Insurance when you
retire from Delta, your retiree coverage will become effective as of your retirement date.
If You Have a Qualified Life Event
If you enroll or change your Group Accident or Family Group Accident Insurance as a result of a
qualified life event, your coverage will become effective as of the first day of the payroll period on or
following the date of your timely request, if you are on active status.
Naming a Beneficiary
Naming a Beneficiary for Group Accident Insurance
A Beneficiary is an individual designated by you to receive any Group Accident Insurance payable as a
result of your accidental death. It is important that you name a Beneficiary if you do not, your
benefit may not be paid to the person(s) you intended to receive it.
You may name one or more Beneficiaries. If you name more than one Beneficiary, you must indicate
the percentage amount you wish each to receive; otherwise multiple Beneficiaries will share equally.
To designate (or change) a Beneficiary, you must provide the required information online by accessing
the Beneficiary Designation website at www.prudential.com/mybenefits or by filling out a
beneficiary designation form that is available from the ESC or online at the Benefits Direct website.

How to Access the Beneficiary Designation Website the First Time
Go online to at www.prudential.com/mybenefits. You can use any computer
with Internet access
Select First Time User
In the Control Number field, enter 50002 and select Next
Complete the required information on the following screens and create a personal
user ID and personal password
Be sure to select Submit after you enter your beneficiary designations or make
any changes
If you have questions about accessing the site, please call 877-232-3561 Monday
through Friday, 8 a.m. to 8 p.m. Eastern time.

Your Beneficiary designation will become effective on the date that Prudential receives your properly
completed information.
If you die without having a properly designated Beneficiary, payment of your benefit will be made in
accordance with Plan guidelines, as outlined in the Benefit Claims and Appeal Process section under
Payment of Claims.
Please note that the Basic Life Benefit, Optional Life Insurance, Group Accident Insurance and Private
Pilots Accident Insurance each require separate Beneficiary designations.
Naming a Beneficiary for Family Group Accident Insurance
You are automatically the beneficiary for any Family Group Accident Insurance payable as a result of
your applicable dependents accidental death.
In the event that you predecease your covered dependent, payment of any Family Group Accident
Insurance benefit will be made to the dependent who suffered the Loss. If that dependent is not living,
the benefit will be paid to that dependents estate.
Who Pays for Group Accident or Family Group Accident
I nsurance?
You pay the cost of Group Accident or Family Group Accident Insurance through after-tax payroll
deductions. Your individual cost for coverage is listed online on the Benefits Direct website. Your
premium amounts are reviewed on an annual basis and are subject to change. You will be notified of
any changes in premium amounts and any adjustments to your payroll deductions will be effective
January 1 of the following Plan Year.
If you are an inactive or retired employee, premium payments are due in advance for any period in
which coverage is being extended, beginning with the first day of inactive or retired status. You will be
allowed a grace period of 31 days from the premium due date for payment of each premium due after
the initial premium.
If, while you are inactive or retired, you receive a payment from Delta, such as a disability payment or
a pension check, and your payment is sufficient to cover all of your Delta healthcare and insurance
benefits, then your Group Accident or Family Group Accident Insurance premiums will be deducted
from that payment. Otherwise, you will receive an invoice (Direct Bill) from the ESC and you should
mail your payment to the address provided on the invoice.
Waiver of Premiums While You Are Totally Disabled
If you become Totally Disabled, your Group Accident or Family Group Accident Insurance coverage will
be continued without requiring you to pay any premiums, if you meet all of the following conditions:
You are enrolled in Group Accident or Family Group Accident Insurance when you become Totally
Disabled
You are under age 60 when you become Totally Disabled
You remain Totally Disabled for 12 consecutive months
You give Prudential written proof, acceptable to them, of your Total Disability
Starting on the date Prudential receives this proof, your coverage under the waiver of premiums will
continue for successive one-year periods, as long as you continue to provide written proof annually
that you continue to be Totally Disabled.
Your coverage under the waiver of premiums will continue until the earliest of the following occurs:
You are no longer Totally Disabled
You reach age 65
You reach your normal retirement age under the Social Security Act
You fail to provide any required proof that your Total Disability continues
You fail to submit to a medical exam by doctors designated by Prudential, when and as often as
Prudential requires (Note: After the first two years of continued coverage under the waiver of
premiums, Prudential will not require an exam more often than once a year.)
You may not increase the amount of coverage during your period of disability. If you remain Totally
Disabled when you reach age 65, your coverage under the waiver of premiums will end. However, you
may choose to continue coverage until age 80 by paying the applicable premiums.
If your eligibility for waiver of premiums ends, but you continue to be classified as disabled under the
terms of the applicable Disability and Survivorship Plan, you may still continue Group Accident or
Family Group Accident Insurance coverage by paying the applicable premiums.
Your Group Accident or Family Group Accident I nsurance Benefit
Group Accident Insurance for Active Employees
You may elect coverage in increments of $25,000, up to a coverage amount of $250,000, then in
increments of $50,000, up to a maximum coverage amount of $1,500,000. Coverage amounts over
$750,000 cannot be greater than 10 times your annual Earnings, rounded to the next multiple of $50,000.
The coverage amount you elect is called your Insurance Amount.
Group Accident Insurance for Retired Employees
If you retire from Delta before you reach age 80, at your retirement you may elect to retain your Group
Accident Insurance in any amount, but not to exceed the amount nearest to 50% of the Insurance
Amount you had in effect on the day prior to your retirement date.
Once you reach age 80, your Group Accident Insurance coverage amount will be further reduced to 25%
of the Insurance Amount you had in effect on the day prior to your retirement date (rounded to the next
higher increment) or it may be continued in a lesser amount that you choose, but in no event will your
coverage amount be less than $25,000. This change will become effective on the first day of the
calendar month in which you reach age 80.
If you retire from Delta at age 80 or after, the reduction described above will become effective on your
retirement date.
You may elect to reduce your coverage amount at or during retirement. Once you make a reduction in
your coverage amount, you will not be permitted to increase your coverage amount in the future.
If you or your covered dependents suffer a Loss due to a Covered Accident within 30 days of
retirement, but before you elected to continue your coverage as a retiree, you or your dependents (as
applicable) will be paid the amount of coverage you were entitled to continue as a retiree, as if you
had elected to continue your coverage after retirement.
Family Group Accident Insurance
You do not elect a separate coverage amount for Family Group Accident Insurance. The amount of
coverage in effect for your eligible Spouse, Same Sex Domestic Partner or child(ren) is calculated as a
percentage of your own Insurance Amount. The exact percentage the Plan pays for a Loss the Benefit
Payment Amount is based on the type of Loss your dependent suffers (see the Benefits Payable for
Accidental Death and Injuries section).
For example, if you elect Family Group Accident Insurance coverage and your Insurance Amount is
$350,000, then, in the event that your dependent suffers a Loss of life due to a Covered Accident:
Your Spouse would have $227,500 in coverage, or 65% of your Insurance Amount
Each of your children would have $70,000 in coverage, or 20% of your Insurance Amount
When Benefits for Group Accident or Family Group Accident Insurance Are Payable
In order for benefits to be payable, you or your covered dependent must sustain a bodily Injury due to
a Covered Accident while enrolled for Group Accident or Family Group Accident coverage under the
Plan. The Loss must:
Directly result from that Injury and no other causes, and
Begin within 365 days of the Covered Accident
Additional conditions, restrictions and limitations may be specified in the following sections.
The person to whom payment is made depends on the type of benefit, as described in the Payment of
Claims section later in this handbook.
Benefits Payable for Accidental Death and Injuries
If you or one of your covered dependents suffers any of the following Losses within 365 days after a
Covered Accident, you (or your dependent) will be eligible for the following Benefit Payment Amounts.
For Loss* of, or Paralysis
Benefit Payment Amount for
You
(Percentage of Your
Insurance Amount)
Your Spouse
or Same Sex
Domestic Partner Your Child
Life (accidental death) 100%
65%
of the Benefit
Payment Amount
payable for
the same Loss
experienced by you
20%
of the Benefit
Payment Amount
payable for
the same Loss
experienced by you
Both hands or both feet 100%
Sight in both eyes 100%
Speech and hearing in both ears 100%
One hand and one foot 100%
Sight in one eye and one hand 100%
Sight in one eye and one foot 100%
Uniplegia 100%
One hand or one foot 50%
Sight in one eye 50%
Speech 50%
Hearing in both ears 50%
Thumb and index finger of same hand 25%
Four fingers of same hand 25%
Hearing in one ear 25%
All toes on one foot 25%
Big toe 5%
Hemiplegia 125%
Paraplegia 125%
Triplegia 150%
Quadriplegia 150%

* The definition of Loss is included in the Terms to Know section at the back of this handbook.
Brain Damage Benefit
The Plan also pays a monthly Benefit Payment Amount if you or a covered dependent suffers a Loss
due to Brain Damage within 365 days after a Covered Accident, and the Brain Damage:
Continues for 31 consecutive days, and
Is total, continuous and permanent at the end of that 31-day period
For each consecutive month that Brain Damage continues, the Benefit Payment Amount payable for you
or your covered dependent will be the percentage of your Insurance Amount indicated in the following
table. These benefits will begin with the 32nd day of Brain Damage, and continue up to 100 months.
Condition
Percentage of Your I nsurance Amount Payable Monthly for
You
Your Spouse or Same
Sex Domestic Partner Your Child
Brain Damage 1% 0.65% 0.20%

If you or your covered dependent dies while this Brain Damage benefit is payable, but before all of the
100 consecutive monthly payments have been paid, the unpaid benefits are payable in one lump sum
to you or your Beneficiary.
Coma Benefit
The Plan also pays a monthly Benefit Payment Amount if you or a covered dependent suffers a Loss
due to a Coma within 365 days after a Covered Accident, and the Coma:
For each consecutive month that the Coma continues, the Benefit Payment Amount payable will be the
percentage of your Insurance Amount indicated in the following table. These benefits will begin with
the 32nd day of the Coma, and continue up to 100 months.
Condition
Percentage of Your I nsurance Amount Payable Monthly for
You
Your Spouse or Same
Coma 1% 0.65% 0.20%

If you or your covered dependent dies while this Coma benefit is payable, but before all of the 100
consecutive monthly payments have been paid, the unpaid benefits are payable in one lump sum to
you or your Beneficiary.
Total and Permanent Disability Benefit
The Plan pays a Benefit Payment Amount if you become Totally and Permanently Disabled within 365
days after a Covered Accident and the Total and Permanent Disability:
Condition
Percentage of Your I nsurance Amount
You
Your Spouse or Same
Total and Permanent
Disability
100% 65% 20%

Examples
Suppose you have $100,000 as your Insurance Amount for Group Accident
Insurance coverage.
If you suffered the Loss of both feet as the result of a Covered Accident, your
Benefit Payment Amount would equal to 100% of your Insurance Amount, or
$100,000
If your covered Spouse suffered the Loss of both feet as the result of a Covered
Accident, your Spouses Benefit Payment Amount would equal 65% of the amount
payable for the same Loss suffered by you (65% of $100,000 = $65,000)
If your covered child suffered the Loss of both feet as the result of a Covered
Accident, your childs Benefit Payment Amount would equal 20% of the amount
payable for the same Loss suffered by you (20% of $100,000 = $20,000)
If you suffered the Loss of hearing in one ear as the result of a Covered Accident,
your Benefit Payment Amount would equal 25% of your Insurance Amount, or
$25,000
If your covered Spouse suffered the Loss of hearing in one ear as the result of a
Covered Accident, your Spouses Benefit Payment Amount would equal 65% of the
amount payable for the same Loss suffered by you (65% of $25,000 = $16,250)
If your covered child suffered the Loss of hearing in one ear as the result of a
Covered Accident, your childs Benefit Payment Amount would equal 20% of the
amount it would pay for the same Loss suffered by you (20% of $25,000 = $5,000)
Exposure and Disappearance
Any covered Loss due to exposure to the elements as a result of a Covered Accident is considered to
be the result of Injury.
If your body (or the body of your dependent) has not been found within one year after the conveyance
in which such person was riding disappeared or sank, it will be presumed that Injury caused Loss of
life within 180 days of the accident date.
Limits Per Covered Accident
If you or your covered dependent suffers more than one of the Losses listed under Benefits Payable
for Accidental Death and Injuries as a result of a Covered Accident, you (or your covered dependent)
will be eligible for a Benefit Payment Amount for each Loss, up to a maximum aggregate amount. This
maximum amount is the highest percentage of your Insurance Amount that the person is eligible to
receive as shown in the chart earlier. In other words:
For you, the maximum Benefit Payment Amount for all Losses you suffer in a single Covered
Accident will be limited to 100% of your Insurance Amount, unless you suffer Hemiplegia or
Paraplegia as a result of the Covered Accident, in which case it will be limited to 125% of your
Insurance Amount; or you suffer Triplegia or Quadriplegia, in which case it will be limited to
150% of your Insurance Amount
For your Spouse or Same Sex Domestic Partner, the maximum will be limited to 65% of the
maximum Benefit Payment Amount that would be payable if you had experienced the same
combination of Losses
For your child(ren), the maximum will be limited to 20% of the maximum Benefit Payment
Amount that would be payable if you had experienced the same combination of Losses
Example
If, as the result of a Covered Accident, your Spouse suffered the Loss of the entire
sight of one eye and Loss of hearing in one ear, the Benefit Payment Amount
payable would equal 65% of your Benefit Payment Amount that would be paid if
you suffered those same Losses (65% x 50% of your Insurance Amount = 32.5%
of your Insurance Amount, plus 65% x 25% of your Insurance Amount = 16.25%
of your Insurance Amount, totaling 48.75% of your Insurance Amount).
However, if your Spouse suffered a Loss of entire sight of one eye, Loss of hearing
in one ear, and Loss of one hand, the Benefit Payment Amount payable would be
limited to 65% of your Insurance Amount rather than the cumulative total of
81.25% ([65% x 50%] + [65% x 25%] + [65% x 50%] = 32.5% + 16.25% +
32.5% = 81.25%).

Additional Benefits
In some instances you or your dependents may be eligible to receive benefits in addition to the Benefit
Payment Amounts payable for Losses suffered due to a Covered Accident (as shown in the chart earlier
in this section).
These additional benefits are as follows:
Safe Driving Benefit (seat belt use and air bag use)
Common Accident Benefit
Common Carrier Benefit
Rehabilitation Expense Benefit
Home Alteration and Vehicle Modification Benefit
Bereavement and Trauma Counseling Benefit
Tuition Reimbursement Benefit for Your Spouse or Same Sex Domestic Partner
Tuition Reimbursement Benefit for Your Dependent Children
Child Care Expense Benefit
Critical Burn Benefit
Monthly Medical Premium Benefit
Monthly Mortgage Payment Benefit
Safe Driving Benefit
Seat Belt Use
An additional benefit will be payable if you or one of your covered dependents sustains an Injury
resulting in a Loss while riding in or operating an Automobile as long as:
The person who experiences the covered Injury was wearing a Seat Belt in the manner prescribed
by the vehicles manufacturer at the time of the Covered Accident, and
The actual use of the Seat Belt at the time of the Injury is verified in an official report of the
accident or certified in writing by the investigating officials
Air Bag
An additional benefit will be payable if you or one of your covered dependents sustains an Injury
resulting in a Loss while riding in or operating an Automobile as long as:
The person who experiences the covered Injury was wearing a Seat Belt in the manner prescribed
by the vehicles manufacturer at the time of the Covered Accident,
The actual use of the Seat Belt at the time of the Injury is verified in an official report of the
accident or certified in writing by the investigating officials,
The Automobile was equipped with a factory-installed Air Bag, and
A properly functioning Air Bag was deployed for the seat occupied by the person who experiences
the covered Injury
Benefit Payment Amount
If the situation meets the required conditions, the following additional benefits will be paid, as applicable:
For Covered Person Seat Belt Benefit Air Bag Benefit
You The lesser of 100% of your
Insurance Amount, or $50,000
The lesser of 100% of your
Insurance Amount, or $25,000
Your Spouse or Same Sex Domestic
Partner
The lesser of 65% of your Insurance
Amount, or $50,000
Amount, or $25,000
Your Child The lesser of 20% of your Insurance
Amount, or $50,000
Amount, or $25,000
Losses Not Covered by the Safe Driving Benefit
The Safe Driving Benefit does not cover a Loss that results from the driving or riding in any
Automobile being used in a race or a test of speed or endurance, for acrobatic or stunt driving, or for
any illegal purpose.
Common Accident Benefit
Your covered Spouses (or Same Sex Domestic Partners) Benefit Payment Amount for Loss of life will
increase to a total of 100% of your Insurance Amount if both you and your covered Spouse (or Same
Sex Domestic Partner) die as a result of either:
The same accident, or
Separate accidents that occur within the same 48 hour period
Common Carrier Benefit
An additional benefit will be payable if you or your covered dependents sustain an accidental bodily
Injury resulting in the Loss of life while boarding, leaving or riding as a passenger (but not as an
operator, pilot or crew member) in or as a result of being struck by a Common Carrier:
If the situation meets the required conditions, the Plan will pay an additional benefit equal to the
lesser of $250,000 or:
For you: 50% of your Insurance Amount
For your Spouse or Same Sex Domestic Partner: or 32.5% (65% of 50%) of your Insurance Amount
For each covered child: or 10% (20% of 50%) of your Insurance Amount
An additional benefit for rehabilitation expenses will be payable for you or your covered dependents if:
The covered person suffers an accidental bodily Injury that results in a Loss within two years of a
Covered Accident, and
A doctor determines that rehabilitative training is medically necessary to aid the Injured person to
return to work or school, or to become independent and mobile
If the situation meets the required conditions, the Plan will pay an additional benefit of up to 20% of
the covered persons Insurance Amount (subject to a $1,000 minimum and a $25,000 maximum). The
benefit will be paid until one of the following events occurs:
A doctor determines that you no longer need rehabilitation
You fail to furnish any required proof of your continuing need for rehabilitation
You fail to submit to a medical exam by doctors named by Prudential, at Prudentials expense,
when and as often as Prudential requires
An additional benefit for home alteration and vehicle modification expenses will be payable for you or
your covered dependents if:
The covered person suffers a Loss that requires home alteration or vehicle modification
The alterations to your residence are needed to make the residence accessible and habitable to
the person who has suffered the Loss
The modifications to a motor vehicle owned or leased by a person that are needed to make the
vehicle accessible or drivable by the person
The alterations or modifications that are made because of the Loss are completed by individuals
experienced in such alterations or modifications and are in compliance with any applicable laws
actual cost for the alteration or modification, up to a $10,000 maximum. This additional benefit
applies only once and it will not cover charges that exceed the reasonable and customary charges for
similar alterations or modifications in the area where the charges are incurred.
If you or a covered dependent requires bereavement or trauma counseling because you or the covered
dependent suffered a Loss, the Plan will pay the cost of the counseling sessions up to $150 per session,
up to a maximum of $1,500 per covered person.
This benefit is payable only for sessions for the Injured person that are essential to assist with coping
with the Loss. Counseling sessions must be provided within one year of the date of the accident
causing the Loss by a licensed psychologist, licensed psychiatrist or other medical professional acting
in the scope of their license.
Tuition Reimbursement Benefit for Your Spouse or Same Sex Domestic Partner
If you die as a result of a Covered Accident, the Plan will pay an additional benefit to reimburse tuition
costs for your Spouse or Same Sex Domestic Partner.
Your Spouse or Same Sex Domestic Partner does not need to be enrolled in Family Group Accident
Insurance to receive this additional benefit.
To be eligible for this additional benefit, the person who is your Spouse or Same Sex Domestic Partner
on the date of your death must, within 30 months after your death, enroll in a School or professional
or trades program to obtain or improve skills needed to earn a living and provide Prudential with proof
of such enrollment.
This tuition reimbursement benefit will be paid for one year and will equal the lesser of:
The actual annual tuition charged by the School or program,
5% of your Insurance Amount, or
$5,000
Tuition Reimbursement Benefit for Your Dependent Children
If either you, your covered Spouse or covered Same Sex Domestic Partner dies as a result of a
Covered Accident, the Plan will pay an additional benefit to reimburse tuition costs for each of your
dependent children who is under age 26.
To be eligible for this additional benefit, as of the date of the covered persons death, your child must
be wholly dependent on you for support and maintenance and either:
Be enrolled as a full-time student in a School, or
Be in the 12th grade, and become a full-time student in a post-secondary School within 365 days
In the event of your death, your child does not need to be enrolled in Family Group Accident Insurance
to receive this additional benefit.
This tuition reimbursement benefit will be paid annually for up to four consecutive years, but not
beyond the date your child reaches age 26. Proof of enrollment must be provided to Prudential. The
annual benefit will equal the lesser of:
The actual annual tuition charged by the School (not including room and board),
5% of the covered persons Benefit Payment Amount for Loss of life, or
$5,000
If there is no dependent child eligible for this additional benefit, a benefit of $1,000 will be paid to the
person indicated in the Payment of Claims section later in this handbook.
Child Care Expense Benefit
If either you, your covered Spouse or covered Same Sex Domestic Partner dies as a result of a
Covered Accident, the Plan will pay an additional benefit for child care expenses for each of your
dependent children who is under age 13.
To be eligible for this benefit, as of the date of the death of the covered person, your child must be
wholly dependent on you for support and maintenance and either:
Be enrolled at a Child Care Center, or
Become enrolled at a Child Care Center within 90 days
In the event of your death, your child does not need to be enrolled in Family Group Accident Insurance
to receive this additional benefit.
This child care expense benefit will be paid annually for up to four consecutive years, but not beyond
the date your child reaches age 13. Proof of enrollment must be provided to Prudential when the claim
is submitted. The annual benefit will equal the lesser of:
The actual annual cost charged by the Child Care Center,
5% of the covered persons Benefit Payment Amount for Loss of life, or
$5,000
If there is no dependent child eligible for this additional benefit, a benefit of $1,000 will be paid to the
person indicated in the Payment of Claims section later in this handbook.
Critical Burn Benefit
If you or a covered dependent suffers critical burns as a result of a Covered Accident (diagnosed as
worse than second degree) that result in permanent disfigurement, the Plan will pay an additional
benefit equal to the lesser of $25,000 or:
For you: 50% of your Insurance Amount
For your Spouse or Same Sex Domestic Partner: 32.5% (65% of 50%) of your Insurance Amount
For each covered child: 10% (20% of 50%) of your Insurance Amount
The critical burn benefit also will be payable for critical burns caused by an Injury that would normally
be excluded from coverage under the Plan (as described later in the Restrictions section) as if the
Injury was a covered Loss.
The Plan will pay you an additional benefit for your monthly Delta-sponsored medical plan premiums if
all the following apply:
You suffer an accidental bodily Injury that results in a Loss within 365 days of a Covered Accident,
The Injury results in your having to take a leave of absence or end your employment with Delta,
and
You choose to continue your coverage under the Delta medical plan beyond the time it would
otherwise end
The amount of the additional monthly benefit will be equal to the lesser of:
The amount of your medical premium,
$250
The benefit will be paid until one of the following events occurs:
Your coverage in the Delta medical plan ends,
You become covered under any other group medical plan, or
The benefit has been paid for 12 consecutive months
If you suffer an accidental bodily Injury that results in your death, the Plan will pay your surviving
Spouse or Same Sex Domestic Partner an additional benefit of up to $1,000 monthly toward the cost
of the mortgage payment (including any property tax and insurance that may be included in the
payment) for the home that you own and use as your primary residence if all of the following apply:
Your death occurred within 365 days of a Covered Accident,
You have a surviving Spouse or Same Sex Domestic Partner at the time of your death, and
You have an outstanding balance on your mortgage at the time of your death
Your surviving Spouse or Same Sex Domestic Partner dies,
Your mortgage is paid in full,
Your home is sold, or
When Group Accident or Family Group Accident I nsurance
Coverage Ends
Group Accident or Family Group Accident Insurance coverage will end when the earliest of the
following occurs:
You are no longer employed by Delta or you otherwise cease to be an eligible employee, including
the expiration of any extensions of eligibility
You fail to make any required contributions to continue your Group Accident or Family Group
Accident Insurance coverage
Note: If you have Family Group Accident Insurance coverage and continue to pay only the
required premiums for Group Accident Insurance coverage for yourself, then coverage for you
will continue but coverage for your family members will end
The Plan is terminated or no longer provides Group Accident and/or Family Group Accident
Insurance
In addition to the reasons above, Family Group Accident Insurance coverage will also end when:
You die
A Spouse, Same Sex Domestic Partner or child(ren) ceases to be a dependent and any available
extensions of eligibility are exhausted
Continuing Accident I nsurance Coverage When Coverage Ends
If your eligibility for Group Accident or Family Group Accident Insurance ends for the reasons listed in
this section, you can continue coverage under another group policy with Prudential. This is referred to
as portable insurance.
If you choose to continue portable insurance, you must apply within 31 days after your coverage ends.
Your continued coverage begins the day after this 31-day period ends, if you pay your first premium
within 31 days of the date your first bill is issued.
Prudential will issue new certificates of insurance that explain the new insurance benefits. The portable
insurance benefits under the new certificate may not be the same as those of your Delta Group
Accident or Family Group Accident Insurance.
Contact Prudential at 877-232-3561 for more information about insurance portability.
Group Accident Insurance
You have the option to continue your Group Accident Insurance coverage as portable insurance if all
the following apply:
Your Group Accident Insurance coverage ends for any reason other than:
Your failure to pay any contribution when due,
Your retirement, or
Coverage for all employees ends and is replaced by other group accidental death and
dismemberment insurance for which you are eligible or become eligible within the next 31 days
You are still eligible for coverage on the day your coverage ends,
You are younger than age 80, and
Your amount of Group Accident Insurance coverage is at least $25,000 on the day your coverage
ends
You have the option to continue your Family Group Accident Insurance coverage for your dependents
as portable insurance if all the following apply:
Your dependents Family Group Accident Insurance coverage ends because your own Group
Accident Insurance coverage ends for any reason other than:
Your retirement, or
dismemberment insurance for which you are eligible or become eligible in the next 31 days
You also continue your own Group Accident Insurance coverage as portable insurance,
Your Spouse or Same Sex Domestic Partner who is to be covered is younger than age 80,
Your dependent children who are to be covered are younger than age 26,
Your dependent is covered by Family Group Accident Insurance coverage on the day your Group
Accident Insurance coverage ends, and
Your dependent is not confined for medical care or treatment, at home or elsewhere, on the day
your Group Accident or Family Group Accident Insurance coverage ends
If You Die
If you die, your covered Spouse or Same Sex Domestic Partner may apply to continue his or her
coverage if he or she is:
Younger than age 80,
Covered by Family Group Accident Insurance coverage on the day your Group Accident Insurance
coverage ends, and
Not confined for medical care or treatment, at home or elsewhere, on the day your Group
Accident or Family Group Accident Insurance coverage ends
If your Spouse or Same Sex Domestic Partner continues his or her Family Group Accident Insurance
coverage as portable insurance, he or she may apply to continue coverage for your dependent children
if your dependent children are:
Younger than age 26,
Covered by Family Group Accident Insurance coverage on the day your Group Accident Insurance
coverage ends, and
If You Divorce or Your Spouse or Same Sex Domestic Partner Ceases to Be Your Qualified
Dependent
If coverage for your Spouse or Same Sex Domestic Partner ends because you divorce or your Spouse or
Same Sex Domestic Partner ceases to be a qualified dependent, your Spouse or Same Sex Domestic
Partner may apply to continue his or her coverage if he or she is:
Younger than age 80, and
Amount of Converted Coverage
The amount of your continued Group Accident Insurance coverage will be no more than the amount of
your coverage on the day your coverage ends (at least $25,000), up to a maximum that is the lesser of:
Five times your annual Earnings, or
$1,000,000
The amount of your dependents continued Family Group Accident Insurance coverage will be no more
than the amount of coverage the dependents have on the day their coverage ends.
Restrictions and Limitations
Restrictions
Neither Group Accident nor Family Group Accident Insurance covers any Loss that results from any of
the following:
Suicide or attempted suicide while sane or insane
Intentionally self-inflicted or attempted self-inflicted Injury
Sickness, or medical or surgical treatment of Sickness, whether the Loss results directly or
indirectly from the sickness (or treatment of the sickness).
Any bacterial or viral infection, except:
Pyogenic Infections resulting from an accidental cut or wound, or
Bacterial infections resulting from the accidental ingestion of a contaminated substance
Taking part in any insurrection
War or any act of war, except as provided by the War Risk Hazard provision described below.
War means declared or undeclared war and includes resistance to armed aggression. This
exclusion does not apply to Acts of Terrorism
An accident that occurs while the person is serving on full-time active duty for more than 60 days
in any armed forces, except for Reserve or National Guard active duty for training
Commission of or an attempt to commit a felony or assault
Being under the influence of any narcotic unless administered or consumed on the advice of a
doctor
Participation in the hazardous sports of hang gliding or sky diving
Travel or flight in any vehicle used for aerial navigation including getting in, out of, on or off
the vehicle if any of these apply:
The person is riding as a passenger in any aircraft not intended or licensed for the
transportation of passengers
The person is performing as a pilot or crew member of any aircraft other than one operated,
controlled or leased by or on behalf of Delta or any of its subsidiaries
Limitations
If premiums for Group Accident or Family Group Accident Insurance coverage are accepted for any
period beyond which coverage was to have been reduced or terminated, you will be eligible only for
the reduced coverage amount, when applicable. In this case, you may be eligible for a refund of any
premium overpayments.
War Risk Hazard
The Plan provides War Risk Hazard coverage if you are traveling in a Designated War Risk Area. These
areas include:
For travel while flying on an Authorized Business Trip: All areas except the United States, Canada
and your permanent country of residence; however, Acts of Terrorism are covered worldwide
For all other travel: All areas except the United States, Canada, another country that is your
country of permanent residence, Afghanistan and Iraq; however, Acts of Terrorism are covered
worldwide
PRI VATE PI LOTS ACCI DENT I NSURANCE
Eligibility
Employees
You are eligible for Private Pilots Accident Insurance coverage if you are eligible for Group Accident
Insurance coverage (including pursuant to any extension of eligibility). Refer to the Eligibility section
in the Group Accident Insurance portion of this handbook for a complete list of eligible employees.
Also, you may enroll in Private Pilots Accident Insurance coverage only if you are also enrolled in
Group Accident Insurance coverage.
Coverage While on Leave of Absence/ Furlough
Disability Leaves of Absence
If you are disabled under the terms of the Delta Family-Care Disability and Survivorship Plan or the
Delta Pilots Disability and Survivorship Plan, as applicable, you may continue your Private Pilots
Accident Insurance coverage by paying the required premiums until age 65. (In some cases, you may
be eligible for a waiver of premium during your disability period. Refer to the Who Pays for Private
Pilots Accident Insurance section for more information.) You may not increase the amount of
coverage during your period of disability. If you remained disabled when you reach age 65, your
coverage amount will be reduced as if you were a retiree, as discussed in the Private Pilots Accident
Insurance for Retired Employees section.
Unpaid Leaves of Absence/Furloughs
If you are placed on one of the following approved unpaid leaves of absence or on furlough, you may
continue your Private Pilots Accident Insurance coverage by paying the required premiums for up to a
maximum period of 60 months (unless otherwise noted below):
Military leaves of absence, including military training and special conflict leaves
Personal leaves of absence, up to a maximum leave period of 24 months if you are a non-pilot
employee, and up to a maximum leave period of 10 years if you are a pilot
Company convenience leaves of absence (applicable to non-pilot employees only) as long as you
do not engage in any other commercial occupation during this leave period
Furloughs
You may not increase the amount of coverage during an unpaid leave of absence period.
If you do not continue coverage while on leave, or if you stop paying the required premiums for such
coverage, your Private Pilots Accident Insurance will not be reinstated until you return to work for at
least one full day.
If you retire from any of the leaves of absence or furloughs described above, and you either did not
continue your Private Pilots Accident Insurance or you had not been paying the required premiums,
you will not be eligible for Private Pilots Accident Insurance under the Plan as a retiree.
Who Is Not Eligible for Private Pilots Accident Insurance?
If you are not eligible for Group Accident Insurance, you also are not eligible for Private Pilots Accident
Insurance. Refer to the Who is Not Eligible for Group Accident Insurance section in the Group
Accident Insurance portion of this handbook for a complete list of ineligible employees. Further, if you
are not enrolled in Group Accident Insurance coverage, you are not eligible for Private Pilots Accident
Insurance coverage.
Dependents
Dependents, including Spouses, Same Sex Domestic Partners and children, are not eligible for Private
Pilots Accident Insurance.
Enrolling for Private Pilots Accident I nsurance
You enroll for Private Pilots Accident Insurance in the same way as you do for Group Accident
Insurance. Refer to the Enrolling for Group Accident or Family Group Accident Insurance section for
information on how to enroll for this benefit.
Default Coverage Elections
If you remain an active employee and do not make an affirmative election regarding your Private
Pilots Accident Insurance, your current coverage will continue in effect for the following plan year. You
can view your current coverage amounts online at the Benefits Direct website.
If You Are a Newly Hired or Rehired Employee
If you choose not to enroll in Private Pilots Accident Insurance coverage before your first enrollment
deadline, you will default to No Coverage. Your next opportunity to change your election will be
during the next annual open enrollment period, unless you experience a qualified life event that would
allow you to enroll during the year.
If you continued your Private Pilots Accident Insurance coverage during your retirement and you do not
make an affirmative election regarding such coverage before your first enrollment deadline, your current
coverage will remain in effect.
If you did not continue your Private Pilots Accident Insurance coverage during your retirement and do
not make an affirmative election regarding such coverage before your first enrollment deadline, you
will default to No Coverage. Your next opportunity to change your election will be during the next
annual open enrollment period, unless you experience a qualified life event that would allow you to
enroll during the year.
If you choose not to continue your Private Pilots Accident Insurance coverage as a retiree before the
applicable enrollment deadline, you will default to No Coverage. You will not have another
opportunity to enroll in this coverage through Delta.
You will be placed in the same Private Pilots Accident Insurance coverage you had in place before your
inactive status began.
Changing Your Coverage During the Year
If, during the year, you experience a qualified life event, you can either change your existing Private
Pilots Accident Insurance coverage or enroll for coverage for the first time. A change in your election
due to a qualified life event must be consistent with the event. Refer to the Changing Your Coverage
During the Year section in the Group Accident Insurance portion of this handbook for a list of the
events that are considered to be a qualified life event.
If You Have a Qualified Life Event
If you experience a qualified life event, you have 60 days from the date of that event to request a
benefit election or change consistent with the nature of your qualified life event.
If you enroll or change your Private Pilots Accident Insurance as a result of qualified life event, your
coverage will become effective as of the first day of the payroll period on or following the date of your
timely request, if you are on active status.
Naming a Beneficiary for Private Pilots I nsurance
You name your Beneficiary for Private Pilots Accident Insurance in the same way as you do for Group
Accident Insurance. Refer to the Naming a Beneficiary for Group Accident Insurance section for
information on how to name a Beneficiary.
It is important to keep your Beneficiary information current. If you die without having a properly
designated Beneficiary, payment of your benefit will be made in accordance with Plan guidelines, as
outlined in the Benefit Claims and Appeal Process section under Payment of Claims.
Who Pays for Private Pilots Accident I nsurance?
You pay the cost of Private Pilots Accident Insurance through after-tax payroll deductions. Your individual
cost for coverage is listed online on the Benefits Direct website. Your premium amounts are reviewed on
an annual basis and are subject to change. You will be notified of any changes in premium amounts and
any adjustments to your payroll deductions will be effective January 1 of the following Plan Year.
If you are an inactive or retired employee, premium payments are due in advance for any period in
which coverage is being extended, beginning with the first day of inactive or retired status. You will be
allowed a grace period of 31 days from the premium due date for payment of each premium due after
the initial premium.
If, while you are an inactive or retired employee, you receive a payment from Delta, such as a
disability payment or a pension check and your payment is sufficient to cover all of your Delta
healthcare and insurance benefits, then your Private Pilots Accident Insurance premiums will be
deducted from that payment. Otherwise, you will receive an invoice (Direct Bill) from the Employee
Service Center (ESC), and you should mail your payment to the address provided on the invoice.
Waiver of Premiums While You Are Totally Disabled
If you become Totally Disabled, your Private Pilots Accident Insurance coverage will be continued
without requiring you to pay any premiums, if you meet all of the following conditions:
You are enrolled in Private Pilots Accident Insurance when you become Totally Disabled
You are under age 60 when you become Totally Disabled
You remain Totally Disabled for 12 consecutive months
You give Prudential written proof, acceptable to them, of your Total Disability
Starting on the date Prudential receives this proof, your coverage under the waiver of premiums will
continue for successive one-year periods, as long as you continue to provide written proof annually
that you continue to be Totally Disabled.
Your coverage under the waiver of premiums will continue until the earliest of the following occurs:
You are no longer Totally Disabled
You reach age 65
You reach your normal retirement age under the Social Security Act
You fail to provide any required proof that your Total Disability continues
You fail to submit to a medical exam by doctors designated by Prudential, when and as often as
Prudential requires (Note: After the first two years of continued coverage under the waiver of
premiums, Prudential will not require an exam more often than once a year.)
You may not increase the amount of coverage during your period of disability. If you remain Totally
Disabled when you reach age 65, your coverage under the waiver of premiums will end. However, you
may choose to continue coverage until age 80 by paying the applicable premiums.
If your eligibility for waiver of premiums ends, but you continue to be classified as disabled under the
terms of the applicable Disability and Survivorship Plan, you may still continue Private Pilots Accident
Insurance coverage by paying the applicable premiums.
Your Private Pilots Accident I nsurance Benefit
Private Pilots Accident Insurance for Active Employees
You may elect coverage in increments of $15,000, up to a maximum coverage amount of $300,000,
but in no amount greater than either:
50 times the number of logbook pilot hours, rounded to the next $15,000 increment, or
The Insurance Amount you have enrolled in under Group Accident Insurance coverage
The coverage amount you elect is called your Insurance Amount.
Private Pilots Accident Insurance for Retired Employees
If you retire from Delta before you reach age 80, at your retirement you may elect to retain your
Private Pilots Accident Insurance in any amount, but not to exceed 50% of the coverage amount (to
the nearest $15,000 increment) you had in effect on the day prior to your retirement date.
Once you reach age 80, your Group Accident Insurance coverage amount will be further reduced by
50% (to the nearest $15,000 increment) to a minimum of $15,000, or it may be continued in a lesser
amount that you choose, but in no event will your coverage amount be less than $15,000. This change
will become effective on the first day of the calendar month in which you reach age 80.
If you retire from Delta at age 80 or after, the reduction described above will become effective on your
retirement date.
You may elect to reduce your coverage amount at or during retirement. Once you make a reduction in
your coverage amount, at no time later will you be permitted to increase your amount of coverage.
Private Pilots Accident Insurance for Disabled Employees
If you are disabled under the terms of the Delta Family-Care Disability and Survivorship or the Delta
Pilots Disability and Survivorship Plan, as applicable, and you are not eligible for a premium waiver (as
described in the Who Pays for Private Pilots Accident Insurance? section), you may continue the
amount of coverage you had in effect immediately prior to your disability effective date until the
earlier of (i) the date you retire or (ii) when you reach age 65 (provided you continue to pay the
required premiums). You may not increase your coverage amount while you remain disabled. If you
reach age 65 while still disabled, your coverage amount will be reduced as if you were a retired
employee (as described in the section above).
When Benefits for Private Pilots Accident Insurance Are Payable
In order for benefits to be payable, you must sustain a bodily Injury due to a Covered Accident while
enrolled for Private Pilots Accident Insurance coverage under the Plan. The Loss must:
Directly result from that Injury and no other causes, and
Begin within 365 days of the Covered Accident
Additional conditions, restrictions and limitations may be specified in the following sections.
The person to whom payment is made depends on the type of benefit, as described in the Payment of
Claims section later in this handbook.
Benefits Payable for Accidental Death and Injuries
If, because of an accidental Injury that occurs while you are operating or performing the duties of a
pilot or crew member in any properly licensed private aircraft or military aircraft, provided you are
properly licensed and currently qualified to pilot that aircraft, you experience one of the following
Losses, you will be paid the percentage of your Insurance Amount indicated in the following table.
Loss* of, or Paralysis Percentage of Insurance Amount Payable
Life (accidental death) 100%
Both hands or both feet 100%
Sight in both eyes 100%
Speech and hearing in both ears 100%
One hand and one foot 100%
Sight in one eye and one hand 100%
Sight in one eye and one foot 100%
Uniplegia 100%
One hand or one foot 50%
Sight in one eye 50%
Speech 50%
Hearing in both ears 50%
Thumb and index finger of same hand 25%
Four fingers of same hand 25%
Hearing in one ear 25%
All toes on one foot 25%
Big toe 5%
Hemiplegia 125%
Paraplegia 125%
Triplegia 150%
Quadriplegia 150%

* The definition of Loss is included in the Terms to Know section at the back of this handbook.
Brain Damage Benefit
The Plan also pays a monthly Benefit Payment Amount if you suffer a Loss due to Brain Damage within
365 days after a Covered Accident, and the Brain Damage:
For each consecutive month that Brain Damage continues, the Benefit Payment Amount payable will
be 1% of your Insurance Amount. This benefit will begin with the 32nd day of Brain Damage, and
continue up to 100 months.
If you die while this Brain Damage benefit is payable, but before all of the 100 consecutive monthly
payments have been paid, the unpaid benefits are payable in one lump sum to your Beneficiary.
Coma Benefit
The Plan also pays a monthly Benefit Payment Amount if you suffer a Loss due to a Coma within 365
days after a Covered Accident, and the Coma:
For each consecutive month that the Coma continues, the Benefit Payment Amount payable will be
1% of your Insurance Amount. This benefit will begin with the 32nd day of the Coma, and continue up
to 100 months.
If you die while this Coma benefit is payable, but before all of the 100 consecutive monthly payments
have been paid, the unpaid benefits are payable in one lump sum to your Beneficiary.
Total and Permanent Disability Benefit
The Plan pays a Benefit Payment Amount equal to 100% of your Insurance Amount if you become
Totally and Permanently Disabled within 365 days after a Covered Accident and the Total and
Permanent Disability:
Exposure and Disappearance
Any covered Loss due to exposure to the elements as a result of a Covered Accident is considered to
be the result of Injury.
If your body (or the body of your dependent) has not been found within one year after the conveyance
in which such person was riding disappeared or sank, it will be presumed that Injury caused Loss of
life within 180 days of the accident date.
Limits Per Covered Accident
If you suffer more than one of the Losses listed under Benefits Payable for Accidental Death and
Injuries as a result of a Covered Accident, you will be eligible for a Benefit Payment Amount for each
Loss, up to a maximum aggregate amount. This maximum amount is the highest percentage of your
Insurance Amount that you are eligible to receive as shown in the chart earlier in this section.
In other words, the maximum Benefit Payment Amount for all Losses you suffer in a single Covered
Accident will be limited to 100% of your Insurance Amount, unless you suffer Hemiplegia or Paraplegia as
a result of the Covered Accident, in which case it will be limited to 125% of your Insurance Amount; or
you suffer Triplegia or Quadriplegia, in which case it will be limited to 150% of your Insurance Amount.
Example
If you were accidentally injured in a Covered Accident and suffered the Loss of both
hands and the entire sight of one eye, the amount payable will be limited to 100% of
your Insurance Amount rather than the cumulative total of 150% (100% + 50%).
Additional Benefits
In some instances, you may be eligible to receive the following benefits in addition to the Benefit Payment
Amounts payable for Losses due to a Covered Accident (as described in the Benefits Payable for
Accidental Death and Injuries section). To receive the additional benefits, the Loss must occur while you
are operating or performing the duties of a pilot or crew member in any properly licensed private aircraft
or military aircraft, provided you are properly licensed and currently qualified to pilot that aircraft.
These additional benefits are as follows:
Return of Remains Benefit
An additional benefit for rehabilitation expenses will be payable if:
You suffer an accidental bodily Injury that results in a Loss within two years of a Covered
Accident, and
A doctor determines that rehabilitative training is medically necessary to aid you to return to
work or school, or to become independent and mobile
If the situation meets the required conditions, the Plan will pay an additional benefit of up to 20% of
your Insurance Amount (subject to a $1,000 minimum and a $25,000 maximum).
A doctor determines that you no longer need rehabilitation
You fail to furnish any required proof of your continuing need for rehabilitation
You fail to submit to a medical exam by doctors named by Prudential, at Prudentials expense,
when and as often as Prudential requires
An additional benefit for home alteration and vehicle modification expenses will be payable if:
You suffer a Loss that requires home alteration or vehicle modification
The alterations to your residence are needed to make the residence accessible and habitable to
you
The modifications to a motor vehicle owned or leased by you are needed to make the vehicle
accessible or drivable by you
The alterations or modifications that are made because of the Loss are completed by individuals
experienced in such alterations or modifications and are in compliance with any applicable laws
actual cost for the alteration or modification, up to a $10,000 maximum. This additional benefit
applies only once and it will not cover charges that exceed the reasonable and customary charges for
similar alterations or modifications in the area where the charges are incurred.
If you require bereavement or trauma counseling because you suffered a Loss, the Plan will pay the cost
of the counseling sessions up to $150 per session, up to a maximum of $1,500.
This benefit is payable only for sessions for you that are essential to assist with coping with the Loss.
Counseling sessions must be provided within one year of the date of the accident causing the Loss by
a licensed psychologist, licensed psychiatrist or other medical professional acting in the scope of their
license.
Return of Remains Benefit
If you die while traveling outside of a 150-mile radius from your home, the Plan will pay Reasonable
Expenses (up to a maximum of $3,000) to return your remains home to the United States or Canada.
The Plan will pay you an additional benefit for your monthly Delta-sponsored medical plan premiums if
all the following apply:
You suffer an accidental bodily Injury that results in a Loss within 365 days of a Covered
Accident,
The Injury results in your having to take a leave of absence or end your employment with Delta,
and
You choose to continue your coverage under the Delta medical plan beyond the time it would
otherwise end
The amount of the additional monthly benefit will be equal to the lesser of:
The amount of your medical premium,
$250
Your coverage in the Delta medical plan ends,
You become covered under any other group medical plan, or
If you suffer an accidental bodily Injury that results in your death, the Plan will pay your surviving
Spouse or Same Sex Domestic Partner an additional benefit of up to $1,000 monthly toward the cost
of the mortgage payment (including any property tax and insurance that may be included in the
payment) for the home that you own and use as your primary residence if all of the following apply:
Your death occurred within 365 days of a Covered Accident,
You have a surviving Spouse or Same Sex Domestic Partner at the time of your death, and
You have an outstanding balance on your mortgage at the time of your death
Your surviving Spouse or Same Sex Domestic Partner dies,
Your mortgage is paid in full,
Your home is sold, or
When Private Pilots Accident I nsurance Coverage Ends
Your Private Pilots Accident Insurance coverage will end when the earliest of the following occurs:
You are no longer employed by Delta or you otherwise cease to be an eligible employee, including
the expiration of any extensions of eligibility
You fail to make any required contributions to continue your Private Pilots Accident Insurance
coverage
Your Group Accident Insurance coverage ceases
The Plan is terminated or no longer provides Private Pilots Accident Insurance
Continuing Private Pilots Accident I nsurance Coverage When
Coverage Ends
If your eligibility for Private Pilots Accident Insurance ends for the reasons listed in this section, you can
continue coverage under another group policy with Prudential. This is referred to as portable insurance.
If you choose to continue portable insurance, you must apply within 31 days after your coverage ends.
Your continued coverage begins the day after this 31-day period ends, if you pay your first premium
within 31 days of the date your first bill is issued.
Prudential will issue new certificates of insurance that explain the new insurance benefits. The portable
insurance benefits under the new certificate may not be the same as those of your Delta Private Pilots
Accident Insurance.
Contact Prudential at 877-232-3561 for more information about insurance portability.
Provided you also elect to continue your Group Accident Insurance as portable coverage, you have the
option to continue your Private Pilots Accident Insurance coverage as portable insurance if all the
following apply:
Your Private Pilots Accident Insurance coverage ends for any reason other than:
Your retirement, or
dismemberment insurance for which you are eligible or become eligible within the next 31 days
You are still eligible for coverage on the day your coverage ends,
You are younger than age 80, and
Your amount of Private Pilots Accident Insurance coverage is at least $15,000 on the day your
coverage ends
The amount of your continued Private Pilots Accident Insurance coverage will be no more than the
amount of your coverage on the day your coverage ends (at least $15,000), up to a maximum that is
the lesser of:
Five times your annual Earnings, or
$1,000,000
Restrictions and Limitations
Private Pilots Accident Insurance does not cover any Loss (fatal or not-fatal) that results from any of
the following:
Suicide or attempted suicide while sane or insane
Intentionally self-inflicted or attempted self-inflicted Injury
Sickness, or medical or surgical treatment of Sickness, whether the Loss results directly or
indirectly from the sickness (or treatment of the sickness)
Any bacterial or viral infection, except:
Pyogenic Infections resulting from an accidental cut or wound, or
Bacterial infections resulting from the accidental ingestion of a contaminated substance
Taking part in any insurrection
War or any act of war, except as provided by the War Risk Hazard provision described below.
War means declared or undeclared war and includes resistance to armed aggression. This
exclusion does not apply to Acts of Terrorism
An accident that occurs while you are serving on full-time active duty for more than 60 days in
any armed forces, except for Reserve or National Guard active duty for training
Commission of or an attempt to commit a felony or assault
Being under the influence of any narcotic unless administered or consumed on the advice of a
doctor
Participation in the hazardous sports of hang gliding or sky diving
Limitations
The Private Pilots Accident Insurance coverage will apply only while you are operating or performing
the duties of a pilot or crew member in any properly licensed private aircraft or military aircraft,
provided you are properly licensed and currently qualified to pilot such aircraft.
Properly licensed private aircraft or military aircraft do not include:
An aircraft certified by the FAA as experimental, restricted or limited, or as a prototype aircraft;
An aircraft being used for waivered flying, crop dusting, test flying, flight instruction or
participation in speed or endurance contests;
An aircraft being used for stunt flying (other than performing legal aerobatic flying specifically
approved by the FAA for such purposes and in an area and at an altitude approved by the FAA);
while flying for hire, except for Delta or any of its subsidiaries; or while flying in violation of any
FAA regulations; or
An aircraft that is not equipped, inspected, certified or maintained in accordance with FAA
regulations
If premiums for Private Pilots Accident Insurance coverage are accepted for any period beyond which
coverage was to have been reduced or terminated, you will be eligible only for the reduced coverage
amount, when applicable. In this case, you may request a refund of any premium overpayments.
War Risk Hazard
The Plan provides War Risk Hazard coverage if you are traveling in a Designated War Risk Area. These
include all areas except the United States, Canada, another country that is your country of permanent
residence, Afghanistan and Iraq; however, Acts of Terrorism are covered worldwide.
OTHER BENEFI TS
Business Travel Accident I nsurance
In addition to offering you Group, Family Group and Private Pilots Accident Insurance, Delta also
provides Business Travel Accident Insurance to all employees, including pilots, crew members and
other designated personnel.
This coverage is provided to you automatically; you do not have to enroll in Business Travel Accident
Insurance. Additionally, the benefit is provided at no cost to you.
Business Travel Accident may pay you or your beneficiary a benefit of $500,000 if you die or suffer
certain serious injuries as a result of a felonious assault while traveling for Delta on business. The
coverage pays up to $1,000,000 if you die or suffer certain serious injuries as a result of loss, directly or
indirectly, from any declared or undeclared war outside the United States, Canada or your jurisdiction of
permanent residence, or while traveling on assignment on a training flight, check flight, test flight or a
Military Airlift Command (MAC) flight that is not between or within the United States, its territories
(including Guantanamo Bay Naval Base) and its possessions and Canada. Certain exclusions apply.
Business Travel Accident Insurance is a separate coverage that is not part of the Delta Air Lines, Inc.
Optional Insurances Plan and is not covered by ERISA. If you suffer a loss that is covered under
Business Travel Accident Insurance, Delta will file a claim for you.
Travel Assistance Benefits
Prudential gives you access to the AXA Travel Assistance Program, which provides you and your
dependents with emergency assistance services while traveling internationally or domestically more
than 100 miles from home for up to 120 consecutive days. Worldwide, 24 hours a day, 365 days a
year, a phone call to trained multilingual staff will give you quick access to these services:
Medical referrals and appointments when you need health care while traveling
Hospital admission assistance, by validating your health coverage and/or advancing funds
Emergency evacuation
Critical care monitoring
Medically supervised repatriation after you are discharged from a hospital
Dispatch of prescription medicine
Transmission of emergency messages
Transportation to join a patient traveling alone who must be hospitalized for more than seven days
Care for minor children left unattended as a result of accident or illness
Return of mortal remains if a participant dies while traveling
Legal referrals
General travel information to help you prepare for a trip
Lost document or luggage assistance
Emergency cash or bail assistance
Evacuation for political reasons
Pet housing and return
In order to be eligible under this program, AXA personnel must authorize and arrange all treatment
and authorize and provide all services. The maximum benefit per person for costs associated with
medical evacuations, repatriations or the return of mortal remains is $150,000 per occurrence.
For more information about these services or to obtain assistance, call the program hotline at
800-565-9320 in the United States, or 312-935-3654 outside the United States (call collect).
BENEFI T CLAI MS AND APPEAL PROCESS
For purposes of this Benefit Claims and Appeal Process section, the person making a claim under the
Plan will be referred to as a claimant. In addition to you or a Beneficiary, you or the Beneficiary may
authorize an individual to act on your or the Beneficiarys behalf in pursuing a claim or appeal. This
individual is known as an authorized representative. For information about how to designate an
authorized representative, contact Prudential.
Reporting a Claim
To report a claim under Group Accident, Family Group Accident or Private Pilots Accident Insurance,
contact Prudential at 877-232-3561 or at the following address:
The Prudential Insurance Company of America (Prudential)
Prudential Group Life Claim Division
P.O. Box 8517
Philadelphia, PA 19176
You should indicate under which coverage you are making a claim, and provide the contract/policy
number, which is 50002 for all these coverages.
You must provide written notice of a claim within 20 days after experiencing a covered Loss, or as
soon afterward as is reasonably possible.
When Prudential receives your notice of claim, it sends claim forms to you within 10 days. If you do
not receive these forms within 10 days, you can submit your proof of Loss by sending Prudential a
letter that describes the claim.
You must provide written proof of Loss to Prudential within 90 days of the date of the Loss. If you fail
to do so because it was not reasonably possible for you to meet the 90-day deadline, your claim will
not be invalidated or reduced as long as you furnish proof as soon as reasonably possible.
Prudential has the right (at its own expense) to examine any individual whose Loss is the basis of a
claim, as often as is reasonably necessary to verify a claim. Similarly, in the case of death, Prudential
has the right (at its own expense) to perform an autopsy where it is not forbidden by law.
Payment of Claims
Under Group Accident or Family Group Accident Insurance
Claims for any Loss under Group Accident or Family Group Accident Insurance coverage are paid as
soon as Prudential receives and approves written proof of the Loss.
Payment of claims will be made to you even for claims payable with respect to your covered
dependents with the following exceptions:
For benefits for any of your Losses that are unpaid at your death or become payable because of
your death, benefits are paid according to your Beneficiary designation. If no Beneficiary
designation is on file with Prudential, these benefits are paid to:
The beneficiary that is on file for your Basic Life Benefit under the applicable Delta Disability
and Survivorship Plan; or, if no such beneficiary is on file, to:
>Your surviving Spouse or Same Sex Domestic Partner, if alive,
>Your surviving child(ren) in equal shares, if there is no surviving Spouse or Same Sex
Domestic Partner
>Your surviving parent(s) in equal shares, if there are no surviving children
>Your surviving sibling(s) in equal shares, if there are no surviving parents
>Your estate, if there are no surviving siblings
For the Tuition Reimbursement Benefit for your Spouse or Same Sex Domestic Partner payable if
you die in a Covered Accident, benefits are paid to:
Your Spouse or Same Sex Domestic Partner, if living, or
Your Spouses or Same Sex Domestic Partners estate
For the Tuition Reimbursement Benefit or Child Care Expense Benefit for your dependent
child(ren), benefits are paid to the person or institution appearing to Prudential to have assumed
the main support of the child(ren), when benefits are payable due to:
Your death in a Covered Accident, or
The death of your Spouse or Same Sex Domestic Partner in a Covered Accident that are
unpaid at your death
For the Monthly Mortgage Payment Benefit, benefits payable if you die in a Covered Accident,
benefits are paid to your Spouse or Same Sex Domestic Partner
For the Common Accident Benefit, benefits are paid to the person or institution appearing to
Prudential to have assumed the main support of your dependent children
Under Private Pilots Accident Insurance
Claims for any Loss under Private Pilots Accident Insurance are paid as soon as Prudential receives
and approves written proof of the Loss. Payment of claims will be made to you, with the following
exceptions:
For benefits for any of your Losses that are unpaid at your death or become payable because of
your death, benefits are paid according to your Beneficiary designation. If no Beneficiary
designation is on file with Prudential, these benefits are paid to:
The beneficiary that is on file for your Group Accident Insurance; or, if no such beneficiary is
on file, to:
>The beneficiary that is on file for your Basic Life Benefit under the applicable Delta Disability
and Survivorship Plan; or, if no such beneficiary is on file, to:
>Your surviving Spouse or Same Sex Domestic Partner, if alive
>Your surviving child(ren) in equal shares, if there is no surviving Spouse or Same Sex
Domestic Partner
>Your surviving parent(s) in equal shares, if there are no surviving children
>Your surviving sibling(s) in equal shares, if there are no surviving parents
>Your estate, if there are no surviving siblings
For the Monthly Mortgage Payment Benefit, benefits payable if you die in a Covered Accident,
benefits are paid to your Spouse or Same Sex Domestic Partner
I nitial Claims Decision
If a claim for Group Accident, Family Group Accident or Private Pilots Accident Insurance benefits
under the Plan is denied, the claimant will receive a written notification of the denial from Prudential
within 45 days of the date the claim was properly and completely filed. However, in special
circumstances, Prudential may require additional time to review the claim and the 45-day period may
be extended by a two additional periods of no more than 30 days each. If such additional time is
needed, the claimant will be notified of the reasons for the delay and the date the claimant can expect
to receive a decision about his or her claim.
The written notification of the claimants denial will contain the following information:
Specific reasons for the denial and reference to the specific Plan provisions on which the claim
determination was based
Description and explanation of any additional information needed to process the claim, and an
explanation of why such information is necessary
Description of the Plans appeal procedures and the applicable time limits, as well as the claimants
right to bring legal action under Section 502(a) of ERISA after he or she has exhausted the appeals
process
Right of Appeal
If a claimant disagrees with the decision made by Prudential about his or her claim, the claimant may
appeal this decision in accordance with the appeal procedures described below. It is important that these
procedures are strictly followed. Failure to do so may cause the claimant to lose certain legal rights.
What to Include in Your Appeal and Access to Information
All appeal requests must be made in writing. Claimants are encouraged to submit additional facts,
documents or other material relevant to their claim. In addition, upon request and free of charge,
claimants may have reasonable access to and copies of all documents, records and information
relevant to their claim. Claimants should direct any appeal requests to Prudential at the addresses
provided in the chart at the end of this Benefit Claims and Appeal Process section.
About the Appeal Process
All levels of appeal will be reviewed by a new decision-maker referred to in this section as the
claims reviewer. This means that the first level of appeal will not be conducted by the individual who
denied the initial claim or by that persons subordinate.
The appeal process will take into account all information regarding the denied claim (whether or not
presented or available when the original decision was made). The claims reviewer will not give
deference to the original decision made about the claim. That is, the reviewer will give the claim a
fresh look and make an independent decision about the claim.
Appeals
Prudential is the claims reviewer for Group Accident, Family Group Accident or Private Pilots Accident
Insurance under Plan. If a claim for benefits was denied by Prudential, the claimant has the right to
file an appeal with the claims reviewer in accordance with the process described below.
There are two levels of appeal available for Group Accident, Family Group Accident or Private Pilots
Accident Insurance; the first level is mandatory and the second level is voluntary.
First-Level Appeal Process
If a claimant wishes to appeal a claim denial involving Group Accident, Family Group Accident or
Private Pilots Accident Insurance, the claimant must request an appeal within 180 days of the date of
the claim denial from Prudential.
The claimant will receive written notification of the claim reviewers decision within 45 days of the date
the appeal was received. However, if special circumstances require, Prudential may extend its review
time by up to an additional 45-day period. If such additional time is needed, the claimant will be
notified of the reasons for the delay and the date when he or she can expect to receive a decision
about the appeal.
If, in the notice of delay, additional information is requested from the claimant to complete the review,
the period for making a benefit determination will be suspended from the date on which the notice for
additional time is sent to the claimant until the date the claimants response is received.
Second-Level Appeal Process
If a claimant remains dissatisfied with the outcome of his or her first-level appeal request, the claimant
has a right to request a second-level appeal from Prudential. The claimants second-level appeal request
must be submitted in writing within 180 days of the date the claimant received notification from
Prudential of the outcome of his or her first-level appeal.
The claimant will receive written notification of the claim reviewers decision within 45 days of the date
the appeal was received. However, if special circumstances require, Prudential may extend its review
time by up to an additional 45-day period. If such additional time is needed, the claimant will be
notified of the reasons for the delay and the date when he or she can expect to receive a decision
about the appeal.
If, in the notice of delay, additional information is requested from the claimant to complete the review,
the period for making a benefit determination will be suspended from the date on which the notice for
additional time is sent to the claimant until the date the claimants response is received.
I f a Claimants Appeal Request I s Denied
If a claimants appeal request is denied, in whole or in part, the applicable claims reviewer will provide
the claimant with a written or electronic notice of its decision, including:
The specific reason or reasons for the denial of the appeal
Reference to the specific Plan provision(s) on which the denial is based
A statement that the claimant is entitled to receive, upon request and free of charge, reasonable
access to, and copies of, all documents, records and other information relevant to the claimants
claim for benefits
A description of any voluntary appeal procedures available to the claimant under the Plan and the
claimants right to obtain information about such procedures and the time limits under those
procedures, and a statement regarding the claimants right to bring an action under Section 502(a)
of ERISA
Other I mportant I nformation About Appeals
The Plan uses the claims and appeal procedures outlined in this section, which are the exclusive
administrative claim procedures provided under the Plan, to ensure that the Plans provisions are
correctly and consistently applied. The decisions of the final claims reviewers are conclusive and
binding. Once a claimant exhausts the mandatory levels of appeal, no further review of the claim is
available under the terms of the Plan.
Exhaustion of Remedies
A claimant must timely exhaust all mandatory levels of review described in this section before any
legal action to recover benefits, or to enforce or clarify rights, under the Plan may be filed. In no event
may a claimant bring any legal action or proceeding for benefits against the Plan with respect to the
benefits described in this handbook after three years from date that written proof of Loss is required
to be furnished.
Grievances
For Employees Represented by ALPA Only
After following the preceding claims and appeal procedures, a claim for benefits under the Plan that
exceeds $1,500 may be grieved in accordance with the Benefit Review Board Letter of Agreement
between Delta and ALPA.
For Employees Represented by PAFCA Only
After following the preceding claims and appeal procedures, if your claim is still denied in whole or in
part, you may be able to file a grievance under the terms of your collective bargaining agreement.
PLAN ADMI NI STRATI ON AND LEGAL RI GHTS
This section contains a description of general administrative and legal information applicable to the
Delta Airlines, Inc. Optional Insurances Plan, of which Group Accident Insurance, Family Group
Accident Insurance and Private Pilots Accident Insurance are a part. This information does not apply to
Business Travel Accident Insurance, which is not a part of the Plan.
Plan Name
Delta Air Lines, Inc. Optional Insurances Plan.
Type of Plan and Administration
The Plan is a welfare benefit plan providing life and accident insurance benefits. The Plan is
administrated by insurance providers, which, with respect to Group Accident Insurance, Family Group
Accident Insurance and Private Pilots Accident Insurance benefits under the Plan is The Prudential
Insurance Company of America (Prudential).
Plan Sponsor/Employer/EI N and Plan I dentification Number
The plan sponsor and employer is Delta Air Lines, Inc. You may contact the plan sponsor at the
following address:
Delta Air Lines, Inc.
P.O. Box 20706
Atlanta, GA 30320-6001
The Employer Identification Number (EIN) assigned by the IRS is 58-0218548. The Plan Number
assigned to the Delta Air Lines, Inc. Optional Insurances Plan is 543.
Agent for Service of Legal Process
The agent for service of legal process on the Plan, and the address where process can be served, is:
Secretary, Administrative Committee
Department 981
1030 Delta Boulevard
Atlanta, GA 30354
Plan Year
The Plan Year begins January 1 of each year and ends on December 31.
Plan Administrator
The Administrative Committee of Delta Air Lines, Inc. (the Administrative Committee) is the Plan
Administrator of the Plan. It is the named fiduciary for administration of the Plan and is responsible for:
Operating and administering of the Plan
Exclusive power to construe and interpret the Plan and determine questions of eligibility for
participation and receipt of benefits
Determining the amount, the manner and the time of payment of benefits
Authorizing the payment of benefits and reasonable expenses for administering the Plan
Carrying out the provisions of the Plan pertinent to the responsibility of the Administrative
Committee
Delegating any of its fiduciary authority to determine and review claims
In exercising its functions, the Administrative Committee or its delegate has the broadest discretionary
authority permitted under law. Members of the Administrative Committee are appointed by the
Executive Vice President Human Resources of Delta. The Administrative Committee members may
be substituted or removed from their positions at the sole discretion of the Executive Vice President
Human Resources. They receive no compensation in their capacities as members, but receive
compensation as employees of Delta.
The address and telephone number of Administrative Committee is:
The Administrative Committee of Delta Air Lines, Inc.
Department 844
P.O. Box 20706
404-715-2600
Claims Administrator
Prudential is the Claims Administrator for the Plan and processes claim payments. In addition,
Prudential insures the Group Accident Insurance, Family Group Accident Insurance and Private Pilots
Accident Insurance benefits under the Plan, and, therefore, is financially responsible for the benefits
under the Plan.
You can contact the Claims Administrator at:
The Prudential Insurance Company of America (Prudential)
P.O. Box 8517
877-232-3561
Discretionary Authority of the Plan Administrator and the Claims
Administrator
The Plan Administrator has delegated to Prudential or its affiliates the authority to determine claims
eligibility and benefit amounts in accordance with the Plans terms. As such, the Claims Administrator
has the broadest discretionary authority permitted under law to interpret the provisions of the Plan
and determine eligibility for benefits.
The Claims Administrator serves as the final reviewer under the Plan and has sole and complete
discretionary authority to determine conclusively any and all questions concerning the administration
and interpretation of the Plan, including questions about eligibility to participate in the Plan; eligibility
for benefits; the relevant facts; the amount and type of benefits payable to any participant, Spouse or
Beneficiary; and the construction of all terms of the Plan.
Decisions by the Claims Administrator will be final, conclusive and binding on all parties claiming to
have an interest in the Plan and are not subject to further review by Delta. Benefits are paid under the
Plan only if the Claims Administrator or the Plan Administrator decides, in its sole authority, that the
participant or other claimant is entitled to them.
Plan Fiduciaries
The members of the Administrative Committee are the named fiduciaries of the Plan. However, the
Administrative Committee has delegated the complete and broadest discretion to decide and review
benefit claims under the Plan to the Claims Administrator, as previously described.
Source of Contributions and Funding
The benefits under the Plan are fully insured by Prudential. Insurance premiums for Group Accident
Insurance, Family Group Accident Insurance and Private Pilots Accident Insurance are paid by employees
after-tax contributions. No fund or trust of any kind is used for the accumulation of Plan assets.
Electronic Media
The Plan Administrator may use electronic media in accordance with the provisions of ERISA to satisfy
all disclosure and recordkeeping obligations imposed on the Plan under Title I of ERISA.
Assignment of Benefits
Assignment of Group Accident Insurance, Family Group Accident Insurance and Private Pilots Accident
Insurance benefits is not permitted.
Misstatement in Application for Benefits
If you or a Beneficiary in any application or response to the Plan Administrator or Claims Administrator
makes any statement that is erroneous, omits any material facts, or fails to correct any information
that you previously incorrectly provided to the Plan for its records, the amount of benefits will be
adjusted on the basis of the facts, and the amount of any overpayment will be adjusted or recovered
by the means described in the section relating to overpayments on the next page.
Overpayments
On occasion, you or your Beneficiary may receive more benefits than he or she is entitled to receive
under the Plan. If an overpayment occurs, you or your Beneficiary must reimburse the Plan the entire
overpayment amount.
Assistance in Reading the English Language
If, due to language translation difficulties, you need assistance in interpreting this handbook, you may
contact the Delta Employee Service Center (ESC) at 1-800 MY DELTA (1-800-693-3582) for
assistance. A customer service representative will be pleased to work with you to provide the
necessary explanations of rights and obligations under the Plan, as well as the procedures to be
followed in obtaining needed assistance.
Statement of ERI SA Rights
As a participant in the Plan, you are entitled to certain rights and protections under the Employee
Retirement Income Security Act of 1974 (ERISA). (This information does not apply to Business Travel
Accident Insurance, which is not a part of the Plan.) ERISA provides that you are entitled to:
Receive Information About Your Plan and Benefits
Examine, without charge, at the Plan Administrators office and at other specified locations such
as worksites and union halls, all documents governing the Plan, including insurance contracts and
collective bargaining agreements, and a copy of the latest annual report (Form 5500 series) filed
by the Plan with the U.S. Department of Labor and available at the Public Disclosure Room of the
Employee Benefits Security Administration (EBSA)
Obtain, upon written request to the Plan Administrator, copies of documents governing the
operation of the Plan, including insurance contacts and collective bargaining agreements, and
copies of the latest annual report (Form 5500 series) and updated summary plan descriptions.
The Plan Administrator may request a reasonable charge for the copies
Receive a summary of the Plans annual financial report. The Plan Administrator is required by
law to furnish each participant with a copy of this summary annual report
Prudent Actions by Plan Fiduciaries
In addition to creating rights for Plan participants, ERISA imposes duties upon the people who are
responsible for the operation of employee benefit plans. The people who operate your Plan, called
fiduciaries of the Plan, have a duty to do so prudently and in the interest of you and other Plan
participants and beneficiaries. No one, including your employer, your union or any other person, may
fire you or otherwise discriminate against you in any way to prevent you from obtaining a welfare
benefit or exercising your rights under ERISA.
Enforce Your Rights
If your claim for a welfare benefit is denied or ignored, in whole or in part, you have a right to know
why this was done, to obtain copies of documents relating to the decision without charge, and to
appeal any denial, all within certain time schedules.
Under ERISA, there are steps you can take to enforce the above rights. For instance:
If you request a copy of Plan documents or the latest annual report from the Plan and do not
receive them within 30 days, you may file suit in a federal court. In such a case, the court may
require the Plan Administrator to provide the materials and pay you up to $110 a day until you
receive the materials, unless the materials were not sent for reasons beyond the control of the
administrator
If you have a claim for benefits that is denied or ignored, in whole or in part, you can file suit in a
state or federal court
If it should happen that Plan fiduciaries misuse the Plans money, or if you are discriminated
against for asserting your rights, you may seek assistance from the U.S. Department of Labor, or
you can file suit in a federal court
The court will decide who should pay court costs and legal fees. If you are successful, the court may
order the person you sued to pay these costs and fees. If you lose, the court may order you to pay
these costs and fees if, for example, it finds your claim is frivolous.
Assistance With Your Questions
If you have any questions about your Plan, you should contact the Plan Administrator. If you have any
questions about this statement or about your rights under ERISA, or if you need assistance in
obtaining documents from the Plan Administrator, you should contact the nearest EBSA office listed in
your telephone directory.
Or you can contact the Department of Labors Division of Technical Assistance and Inquires by writing to:
Employee Benefits Security Administration
U.S. Department of Labor
200 Constitution Avenue N.W.
Washington, D.C. 20210
You also may obtain certain publications about your rights and responsibilities under ERISA by calling
the publications hotline of the Employee Benefits Security Administration at 866-275-7922. You also
may visit the EBSAs website at www.dol.gov/ebsa.
TERMS TO KNOW
Actively at Work
A full-time or part-time employee on active status with Delta is considered to be Actively at Work.
Acts of Terrorism
Acts of Terrorism are any sustained, clandestine use of violence by a terrorist unit, either individual or
group, to coerce or intimidate the civilian population to achieve a political, military or social purpose.
Such acts include, but are not limited to, murder, kidnapping, hijacking, sabotage or bombing. Acts of
Terrorism do not include conventional warfare designed to result in wholesale loss of life through the
use of missiles, aerial bombardment, nuclear, chemical or biological warfare, or outright invasion.
Air Bag
An inflatable safety device that meets published federal safety standards, is installed by the
Automobiles manufacturer and is not altered after that installation.
Authorized Business Trip
A trip that Delta authorizes you to take for the purpose of furthering its business. An Authorized
Business Trip starts when you leave your residence or Regular Place of Employment, whichever is
later. It ends when you return to your residence or Regular Place of Employment, whichever is earlier.
Automobile
A validly registered:
Vehicle that may be legally driven with the standard issue class of motor vehicle drivers license
and no additional class of license is necessary to operate this vehicle, or
Four wheel, two axle private passenger motor vehicle or truck

Automobile does not include a motor vehicle intended for off-road use or a motor vehicle being used
without the owners permission.
Beneficiary
The individual you last designated in writing to receive a Plan benefit payable as a result of your
accidental death.
Benefit Payment Amount
The specific amount the Plan pays for a particular type of covered Loss.
Benefit Payment Amounts for you are usually shown as a percentage of your Insurance Amount. For
example, for your Loss of life, your Benefit Payment Amount is 100% of your Insurance Amount. If
you experience the Loss of speech, your Benefit Payment Amount is 50% of your Insurance Amount.
Benefit Payment Amounts for your dependents are usually shown as a percentage of what the Plan
would pay if you experienced the same type of Loss:
Benefit Payment Amounts for your Spouse or Same Sex Domestic Partner are 65% of your
Benefit Payment Amount for the same type of Loss
Benefit Payment Amounts for your covered child(ren) are 20% of your Benefit Payment Amount
for the same type of Loss
Brain Damage
Brain Damage is physical damage to the brain that causes the complete inability to perform all
substantial and material functions and activities normal to everyday life.
Child Care Center
A facility or individual that:
Operates according to any applicable local laws,
Is not a member of your family, and
Primarily provides care and supervision for children in a group setting on a regular, daily basis
Coma
A profound state of unconsciousness from which the person cannot be aroused, even by powerful
stimulation, as determined by the persons doctor.
Common Carrier
A Common Carrier is any:
Any air, land or water vehicle operated under a license to transport passengers for hire, or
Any aircraft operated by the Military Air Transport Service (MATS) of the United States or by the
similar air transport service of any recognized country
This includes a shuttle bus, tram or other vehicle used to transport people within an airport and
chartered aircraft, but does not include being a passenger in any aircraft owned, operated, controlled
or leased by on or behalf of Delta or any of its subsidiaries or affiliates or its customers.
Covered Accident
An accident that happens to you (or a covered dependent) while coverage under the Plan is in force
and results in a Loss or Injury for which benefits are payable.
Claims Administrator
The Claims Administrator is Prudential and its affiliates.
Earnings
The gross amount of money paid to you by Delta in cash for performing the duties required of your
job. Bonuses, overtime pay, Earnings for more than 40 hours per week, and all other benefits are not
included.
Hemiplegia
Total and permanent paralysis of the upper and lower limbs on one side of the body.
Injury or Injured
Injury to the body of you or your covered dependents.
Insurance Amount
The dollar amount of coverage you elect for yourself for Group Accident Insurance or Private Pilots
Accident Insurance. It is equal to the Benefit Payment Amount the Plan pays for your Loss of life.
The Insurance Amounts for your dependents covered under Family Group Accident Insurance are a
percentage of your Insurance Amount for Group Accident Insurance:
For your Spouse or Same Sex Domestic Partner, it is 65% of your Insurance Amount
For your covered child(ren), it is 20% of your Insurance Amount
Loss
Any of the following is considered a Loss:
Loss of life
Total and permanent loss of sight
Total and permanent loss of speech
Total and permanent loss of hearing
Loss of a hand by severance at or above the wrist joint
Loss of a foot by severance at or above the ankle joint
Loss of the thumb and index finger of the same hand by severance at or above the point at which
they are attached to the hand
Loss due to Quadriplegia, Triplegia, Hemiplegia, Paraplegia or Uniplegia
Loss of all toes on the same foot by severance at or above the point at which they are attached to
the foot
Loss of use (a total and permanent loss of function) of a hand or foot
Loss due to coma
Loss due to Brain Damage
Total and Permanent Disability
Loss of big toe
Loss of four fingers of the same hand
Paraplegia
Total and permanent paralysis of both lower limbs.
Plan Administrator
The Administrative Committee of Delta Air Lines, Inc.
Plan Year
January 1 to December 31.
Pyogenic Infection
An infection generally caused by one of the pyogenic bacteria and is marked by severe inflammation.
Quadriplegia
Total and permanent paralysis of both upper and lower limbs.
Regular Place of Employment
The Delta place of business at which you spend at least 50% of your working hours and which is
located within 100 miles of your primary residence. This includes satellite offices located within 100
miles of your primary residence, and employees working on Delta-operated aircraft.
Same Sex Domestic Partner
Your Same Sex Domestic Partner must meet all of the following eligibility criteria:
You and this individual are the same gender
This individual is at least 18 years old
You and this individual are not legally married to any other person
You and this individual are not engaged in another domestic partnership
You and this individual are not related by blood or law
You and this individual reside in the same permanent residence and have lived in a spousal-type
relationship for at least six continuous months
You and this individual are financially interdependent
School
An institution of higher learning. This includes but is not limited to a university, college or trade
school.
Seat Belt
Any passive restraint device for an adult that meets published safety standards, is installed by the
Automobiles manufacturer and is not altered after that installation. This also includes a federally
approved, properly installed infant and child safety seat.
Sick Pending Approval
Sick Pending Approval is a Delta leave of absence payroll status for employees who are not actively at
work due to illness or injury, but who have not provided proof of their disability status under Deltas
disability plans.
Sickness or Sick
Any disorder of the body or mind of you or a covered dependent, but not an Injury; also includes
pregnancy of you or a covered dependent, including abortion, miscarriage or childbirth.
Spouse
Your lawful spouse, according to the laws of your state of residence. This includes your same-sex
spouse in states where same-sex marriage is legal. It also includes partnerships in which the members
are registered with a government agency as domestic partners or members of a civil union, where
such registration is available.
Total and Permanent Disability
A person is Totally and Permanently Disabled when, due to a Covered Accident, the person is not able
to perform, for wage or profit, the material and substantial duties of his or her occupation, or those of
a person of like age and gender, for the rest of the persons lifetime.
Total Disability
You are Totally Disabled when:
You are not working at any job for wage or profit; and,
Due to Sickness, Injury or both, you are not able to perform, for wage or profit, the material and
substantial duties of any job for which you are reasonably fitted by your education, training or
experience
Triplegia
Total and permanent paralysis of any three limbs.
Uniplegia
Total and permanent paralysis of a single limb.
WHERE TO GET MORE I NFORMATI ON
If you have any questions concerning the information in this handbook, please refer to the appropriate
contact listed below. Additional frequently called phone numbers can be accessed on DeltaNet.
Benefit Type Contact
Medical
Delta Account-Based Healthcare Plan (DABHP)
- Gold HRA Medical Option, Silver HRA Medical
Option, Gold OOA HRA Medical Option
- Diamond HSA Medical Option, Ruby HSA Medical
Option
- Puerto Rico OOA Medical Option
- Flight Dispatchers Medical Option (FDMO): Network
Option, OOA Option
Delta Pilots Medical Plan (DPMP)
- Network Option
- Out-of-Area Option
Delta Family-Care Medical Plan (DFCMP)
- Standard Medical Option
- Out-of-Area Medical Option
- High Value Medical Option

UnitedHealthcare
P.O. Box 740800
877-683-8555
www.myHealthcareView.com
Health Plan Hawaii Hawaii Medical Service Association
818 Keeaumoku Street
Honolulu, HI 96814
Current Members: 808-948-6372
Prospective Members: 808-948-6111
www.hmsa.com
Humana Health Plans of Puerto Rico Humana Health Plan of Puerto Rico
Edificio El Mundo 3er. Piso
383 Ave F D Roosevelt
San J uan, PR 00918-2131
787-282-7900 ext. 5500
www.humana.com
Dental
DABHP or DFCMP Comprehensive Dental Option or
Preventive Dental Option
FDMO Dental Option
DPMP Dental Option

Delta Dental of Minnesota
P.O. Box 330
Minneapolis, MN 55440-0330
877-810-4023
www.deltadentalmn.org/ dal
DeCare Dental Option (an additional option under the
DABHP or DFCMP)
DeCare Dental
Administrative Offices
P.O. Box 29
Minneapolis, MN 55440
877-606-3402
www.decare.com/ dal
Vision Davis Vision
Vision Care Processing Unit
P.O. Box 1525
Latham, NY 12110
800-947-9955
www.davisvision.com
Flexible Spending Accounts UnitedHealthcare Member Services
P.O. Box 981506
El Paso, TX 79998-1506
877-683-8555
Fax: 915-231-1709
Toll-free fax: 866-262-6354
www.myHealthcareView.com
Eligibility and Enrollment Issues
Qualified Life Events
Employee Service Center
P.O. Box 52045
Phoenix, AZ 85072
1-800 MY DELTA (1-800-693-3582)
COBRA SHPS COBRA Continuation Services
P.O. Box 105413
866-334-2942
Life Insurance
Basic
Optional Life
Dependent Life
Metropolitan Life Insurance Company (MetLife)
MetLife Recordkeeping Center
P.O. Box 14401
Lexington, KY 40512-4401
866-939-7409
www.metlife.com
Group Accident Insurance and
The Prudential Insurance Company of America
(Prudential)
P.O. Box 8517
877-232-3561
www.prudential.com/ mybenefits

If you are not currently enrolled, enter the following to
log on to the site: Control Number 50002
Private Pilots Accident Insurance

The Prudential Insurance Company of America
(Prudential)
P.O. Box 8517
877-232-3561
www.prudential.com/ mybenefits

If you are not currently enrolled, enter the following to
log on to the site: Control Number 50002
Direct Bill/ Premium Payments

For questions about Direct Bill/premium payments, call
the ESC: 1-800 MY DELTA (1-800-693-3582)

Send all Direct Bill/premium payments to:
ACS HR Solutions for Delta Air Lines
P.O. Box 382119
Pittsburgh, PA 15251-8119
Absence Management (Non-Pilot Employees)
Certified Time, Western/Northeast Sick Time
Short-Term Disability Benefits
Long-Term Disability Benefits
Sedgwick Claim Management Services, Inc.
P.O. Box 14455
Lexington, KY 40512-4553
877-67-DELTA (877-673-3582)
Fax: 800-922-8914
Absence Management (Pilot Employees)
Temporary Disability Benefits
Long-Term Disability Benefits
Harvey Watt & Company
P.O. Box 20787
Atlanta, GA 30320
404-767-7501 or 800-241-6103
Fax: 404-761-8326
State Disability Insurance Plan Websites

- State of California
- State of Hawaii
- State of New J ersey
- State of New York
- State of Rhode Island
For help filing your state disability claim:
Non-pilot employees contact Sedgwick CMS at
877-67 DELTA (877-673-3582)
Pilot employees contact Harvey Watt at 800-241-6103

http:/ / www.edd.ca.gov/ Disability
http:/ / hawaii.gov/ labor/ dcd/ abouttdi.shtml
http:/ / lwd.state.nj.us/ labor/ tdi/ tdiindex.html
http:/ / ww3.nysif.com/ DisabilityBenefits.aspx
http:/ / www.dlt.ri.gov/ tdi/
Delta Family-Care Savings Plan [401(k)] (Non-
Pilot Employees)
Delta Pilots Savings Plan
Delta Pilots Defined Contribution Plan
Delta Service Center at Fidelity
800-554-0262
TDD# 800-610-4015

Fidelity NetBenefits
SM

www.netbenefits.com
Employee Assistance Program (EAP)

OptumHealth Behavioral Solutions
800-533-6939
www.liveandworkwell.com (Access Code: DAL)
Delta Perks Auto & Home Insurance, Voluntary
Benefits and Discount Programs
YouDecide: 800-884-4217
www.youdecide.com/ DAL
Miscellaneous Charges
Passes
Uniforms
Accessories
Employee Accounts Receivable
P.O. Box 101924
Paid Personal Time (PPT) (Non-Pilot Employees)
Accident and Sick Leave (Pilot Employees)
Vacation
Non-Pilot Employees: Local Department Supervisor or
Manager

Pilot Employees: Chief Pilot Support Center at
877-DAL-2FLY (877-325-2359)
Pass Travel Privileges Delta Air Lines, Inc.
Employee Service Center
P.O. Box 52176
Phoenix, AZ 85072
1-800 MY DELTA (1-800-693-3582)
Corporate Security
ID Badge
CHRC (Fingerprinting)
Delta Air Lines
Department 969/ATG
1020 Delta Blvd.
ID Office: 404-715-2400
CHRC (Fingerprinting): 404-773-1217
Delta Community Credit Union (DCCU) Loan Delta Community Credit Union
Hartsfield-J ackson International Airport
P.O. Box 20541
Atlanta, GA 30320
Credit Union Loans 930/ATL
404-715-4725 or 800-544-3328
Payroll Overpayment Delta Payroll Department
1-800 MY DELTA (1-800-693-3582)
Payroll Department
P.O. Box 52179
Phoenix, AZ 85072

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