3) Under the General Definitions section, the following changes are made:
a) The definition of Active Service is replaced with the following:
An Employee will be considered in Active Service with His Employer on any day that is either: 1. one of the Employer’s scheduled work days on which the Employee is performing His regular duties on a Full- time basis, either at one of the Employer’s usual places of business or at some other location to which the Employer’s business requires the Employee to travel; or 2. a scheduled holiday, vacation day or period of Employer-approved paid leave of absence, other than disability or sick leave after 7 days, only if the Employee was in Active Service on the preceding scheduled workday. A Covered Person is not considered in Active Service if He is: 1. Inpatient in a Hospital, or receiving Hospice Care during confinement in a rehabilitation or convalescence center and/or custodial care facility; 2. confined at home under the care of a Physician for Illness or Injury; 3. For the Employee’s Spouse: a. Totally Disabled; b. receiving disability benefits from any source due to His Illness or Injury; or c. unable to perform any of the activities of daily living (i.e. mobility, transferring, feeding, dressing, toileting,) without human supervision or assistance.
b) The definition of Dependent Child is replaced with the following:
An Employee’s child who meets the following requirements: 1. A child from live birth to 26 years old; 2. A child who is 26 or more years old, primarily supported by the Employee and incapable of self-sustaining employment by reason of mental or physical handicap.
A child, for purposes of this provision, includes an Employee’s: 1. natural child; 2.
adopted child, beginning with the date of the filing of the petition for adoption, including where an Employee is a party to a suit in which an Employee seeks to adopt the child. It also means the legally adopted child of the Employee’s Spouse or Domestic Partner/Partner to a Civil Union, including where the Spouse or Domestic Partner/Partner to a Civil Union is a party to a suit in which He seeks to adopt the child; 3. stepchild; 4. a child for whom the Employee is the court-appointed legal guardian or for whom the Employee must provide medical support under an order issued under Chapter 154, Family Code, or enforceable by a Texas court. If an Employee, who is the legal guardian of a foster child, is not a step-parent, grandparent, aunt or uncle, then the child must have resided with the Employee for at least six consecutive months and intend to reside with the Employee for an indefinite period of time. 5. grandchild who is the dependent of the Employee for federal income tax purposes at the time application for coverage of the grandchild is made. Coverage for such grandchild may not be terminated solely because the grandchild is no longer a dependent of the Employee for federal income tax purposes.
c) The definition of Emergency Room Treatment is replaced with the following:
Emergency medical services and care for a sudden, unexpected onset of a medical condition of such nature that failure to render immediate care could reasonably result in deterioration to the point of placing a Covered Person’s life in jeopardy, cause serious impairment to bodily functions, or cause serious dysfunction of any bodily organ or part.
d) The definition of Nurse is replaced with the following:
A licensed graduate registered Nurse (R.N.), a licensed practical Nurse (L.P.N.), or a licensed vocational Nurse (L.V.N.).
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