2. adopted child, beginning with any waiting period pending finalization of the child’s adoption. It also means the legally adopted child of the Employee’s Spouse or Domestic Partner/Partner to a Civil Union; 3. stepchild; 4. child for whom the Employee is the court-appointed legal guardian 5. a child of the Employee’s domestic partner Partner to a Civil Union.
c) The Emergency Room Treatment definition is replaced with the following:
Emergency medical services and care given in a Hospital as an out or inpatient, for a sudden, unexpected onset of a medical condition that manifests itself by symptoms of sufficient severity that in the absence of immediate medical attention could be expected to result in any of the following: 1. serious jeopardy to the covered Employee’s health; 2. serious impairment to bodily functions; or 3. serious dysfunction of any bodily organ or part.
d) The definition of Hospital is revised to exclude the requirement that a hospital be licensed.
e) The definition of Hospital Stay is revised to require 180 days in order to be considered a separate hospital stay for the same covered accident/loss.
f)
Totally Disabled is revised as follows:
Totally Disabled or Total Disability means either: 1. inability of the Covered Person who is currently employed to do any type of work for which he is or may become qualified by reason of education, training or experience; or 2. inability of the Covered Person who is not currently employed to perform the normal activities of a person of like age and sex and who is under the regular care of a Physician who certifies that such a person is Totally Disabled.
6) The Takeover Provision section is replaced is revised as follows:
a) The last sentence of Section A 2 has been revised to state Credit will be given for partial completion under the Prior Plan of Elimination Periods
b) Section A 2 has been revised to include the following:
Benefits will be determined based on the lesser of: (1) the amount of the gross benefit under the Prior Plan and any applicable maximums; and (2) those provided by this Policy. If benefits are payable under the Prior Plan for a Covered Loss, no benefits are payable under this Policy.
c) Section B and C do not apply
7) Under the Portability Provisions section, the following are removed from the Termination of Ported Insurance provision:
• for a Dependent Child, the date the Dependent Child reaches age 26 unless primarily supported by the Employee and incapable of self-sustaining employment by reason of mental or physical handicap or ceases to quality as a Dependent Child; • the date the Spouse or Dependent no longer meets the definition of Spouse or Dependent Child; • the date the Covered Person is considered to reside outside the United States. The Covered Person will be considered to reside outside the United States when the Covered Person has been outside the United States for a total period of 4 months during any 4 consecutive months.
8) Under the Common Exclusions section, the following changes are made:
a) The felony exclusion is revised as follows:
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