EXHIBIT 10.87
UNUM PROVIDENT
PNM Resources, Inc.
Your Group Long Term Care Plan
Policy No. 574573
Underwritten by Unum Life Insurance Company of America
01-2003
Policy Excerpt:
Unum Life Insurance Company of America
2211 Congress Street
Portland, Maine 04122
This Certificate of Insurance is a part of the entire contract. This certificate
is subject to the terms and conditions stated on the attached pages, all of
which are part of the Policy. The Policy is intended to be a qualified Long Term
Care insurance contract under Section 7702B(b) of the Internal Revenue Code of
1986.
Policy Number 574573
Caution: If you completed an Application for Long Term Care Insurance which
included evidence of insurability, the issuance of this long term care insurance
certificate was based upon your responses to the questions on your application.
A copy of your Application for Long Term Care Insurance was retained by you when
you applied. If your answers are incorrect or untrue, Unum may have the right to
deny benefits or rescind your coverage. The best time to clear up any questions
is now, before a claim arises! If, for any reason, any of your answers are
incorrect, contact Unum at this address: Unum Life Insurance Company of America,
2211 Congress Street, Portland, Maine 04122.
o You are entitled to examine a copy of the Policy during regular office hours
at the Policyholder's place of business.
o You have a 30 day right to examine this certificate.
If, after examining this certificate, you are not satisfied for any reason,
you may withdraw your enrollment in this plan by returning this certificate
within 30 days of its delivery to you. The certificate, to be there with a
written request for such withdrawal, must be sent to the Policyholder's
plan Administrator.
Upon receipt, your insurance will be deemed void from its effective date
and any premium contribution(s) paid will be returned.
THIS CERTIFICATE IS NOT A MEDICARE SUPPLEMENT CERTIFICATE. If you are eligible
for Medicare, review the guide to health Insurance for people with Medicare
available from Unum.
Unum is not representing Medicare, the federal government or any state
government.
NOTICE TO BUYER: This certificate may not cover all of the costs associated with
long term care incurred by you during the period of coverage. You are advised to
review carefully all coverage limitations.
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Throughout this certificate:
"You" or "your" means an "insured" or "covered" Active Employee and
"insured" or "covered" Family Member.
"Unum" or "we" means Unum Life Insurance Company of America, and
"Policyholder" means PNM Resources, Inc. and its and its covered
divisions, covered divisions, subsidiaries, and affiliated companies.
/s/ J. Harold Chandler
---------------------------
President
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SUMMARY OF BENEFITS
Available Available
January 1, 2003 March 1, 2003
Active Employees- Family members
At the Employer's expense At your expense
------------------------- ---------------
Monthly Benefit Maximum
Long Term Care (LTC) Facility $4,000 $4,000 to $6,000 in
- ----------------------------- $1,000 increments
Assisted Living Facility 100% of the LTC 100% of the LTC
- ------------------------ Facility amount Facility amount
Professional Home Care Services 100% of the LTC 100% of the LTC
- ------------------------------- Facility amount Facility amount
OR
Total Home Care 100% of the LTC
- ---------------
Facility amount
Uncapped Compound Inflation Protection 5% compounded annually 5% compounded
- -------------------------------------- annually
Nonforefeiture Benefit YES
- ----------------------
Lifetime Maximum 36X the LTC 36X the LTC
- ----------------
Amount Facility amount Facility amount
- ------
OR
72X the LTC
Facility amount
OR
Unlimited
Elimination Period 90 consecutive days 90 consecutive days
- ------------------
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Available
March 1, 2003
Active Employees-
At your expense
---------------
Monthly Benefit Maximum
Long Term Care (LTC) Facility $1,000 to $2,000
- ----------------------------- additional coverage
in $1,000 increments
Total Home Care 100% of the LTC
- --------------- Facility amount
Other Coverage Options
Nonforefeiture Benefit YES
- ----------------------
Lifetime Maximum 72 the LTC
- ---------------- Facility amount
Amount
OR
Unlimited
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