e) The definition of Physician is replaced with the following:
A licensed health care provider practicing within the scope of His license and rendering care and treatment to a Covered Person that is appropriate for the condition and locality.
f) The definition of Rehabilitation Facility is removed.
g) The definition of Sickness is removed.
h) The definition of Totally Disabled or Total Disability is replaced with the following:
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. confined as an Inpatient in a Hospital.
4) Under the Eligibility section, following provision is added:
Newborn Child(ren) Coverage for a newly born child shall be provided without notice for no less than 31 days after the date of birth.
5) The Termination of Insurance section is replaced with the following:
The insurance on a Covered Person will end on the earliest date below: 1. the date this Policy or insurance for a Covered Class is terminated; 2. the date the Employee is no longer in Active Service; 3. the last day of the last period for which premium is paid, subject to the Grace Period;
4. with respect to a Spouse or Dependent Child, the date of the death of the covered Employee or the date of divorce from the covered Employee, unless the Spouse elects to continue insurance, including insurance on any Dependent Child. See the Continuation of Insurance Provisions section; 5. the date that the plan of benefits under which the Covered Person is covered is terminated; 6. for a Spouse, the date the Spouse reaches age 100; 7. for a Dependent Child, the date the Dependent Child reaches age 26, incapable or self-sustaining employment by reason of mental or physical handicap.
Termination will not affect a claim for a Covered Loss or Covered Injury that is the result, directly and independently of all other causes, of a Covered Accident that occurs while coverage was in effect.
Extension of Benefits If the Policy terminates while a Covered Person is Totally Disabled as the result of a Covered Accident, We will continue to pay benefits for that Covered Person until the earliest of: 1. 90 days after the Policy terminates; or 2. the date the Covered Person is no longer Totally Disabled.
6) Under the Continuation of Insurance Provisions , the following provision is added:
Continuation for Loss of Eligibility If an Employee’s coverage ends due to Loss of Eligibility from a qualifying event as defined in this section, coverage will continue up to the Maximum Benefit Period as shown in the Schedule of Benefits . The qualifying event means loss of employment (other than by reason of gross misconduct), including a reduction in hours that results in ineligibility for employer sponsored coverage. Insurance may be continued for the Employee and any dependents. If a Covered Spouse or Dependent Child’s coverage ends due to Loss of Eligibility from a qualifying event as defined in this section, coverage will continue up to the Maximum Benefit Period as shown in the Schedule of Benefits . The qualifying event means: 1. Divorce, dissolution, or legal separation of the Covered Employee from the Employee’s Spouse or civil union partner;
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