SUMMARY PLAN DESCRIPTION
SCOTT'S LIQUID GOLD - INC. & AFFILIATED COMPANIES
EMPLOYEE BENEFIT HEALTH AND WELFARE PLAN
GROUP NO. 398
The Employee Benefit Health and Welfare Plan as summarized in this booklet is provided through a combination
of insured and self-funded benefits. The final interpretation of any specific provision herein, regardless of whether
it is paid out of the self-funded or insured portion, is governed by the terms of a master Plan Document.
This booklet describes the Employee Benefit Health and Welfare Plan in an easily understood manner as in effect
on January 1, 1999, (and as subsequently amended), and is both the Summary Plan Description and the Plan
Document. It does not, however, create or confer any rights, as it merely summarizes some of the essential
provisions of the Plan and may not describe your particular circumstances.
The Plan is intended to be consistent with any contracts for policies of insurance under which the contributions
are made, and with any contracts for medical review services. To the extent the terms of the Plan are inconsistent
with such contracts, the terms of such contracts shall prevail.
The Plan will not be deemed to constitute a contract of employment or give any participant the right to be
retained in the service of the employer or to interfere with the right of the employer to discharge or otherwise
terminate the employment of any participant.
The claims are administered by:
TABLE OF CONTENTS
Mountain States Administration
13901 E. Exposition Avenue
Aurora, CO 80012
phone: (303) 360-9600 Local in Colorado
(800) 828-8847 Toll Free in Colorado
(800) 828-8012 Toll Free outside of Colorado
Hours: Monday - Friday 8:00 a.m. - 4:30 p.m. MST
This revised booklet describes the Plan of Benefits in effect as of January 1,
SCHEDULE OF MEDICAL BENEFITS 1