Amyotrophic Lateral Sclerosis (ALS)
25%
Not Available
Parkinson's Disease
25%
Not Available
Multiple Sclerosis
25%
Not Available
Childhood Conditions
% of Initial Benefit Amount
Recurrence % of Initial Benefit Amount
Muscular Dystrophy
100%
Not Available
Cystic Fibrosis
100%
Not Available
Cerebral Palsy
100%
Not Available
Poliomyelitis
100%
Not Available
Other Specified Conditions
% of Initial Benefit Amount
Recurrence % of Initial Benefit Amount
Benign Brain Tumor
100%
100%
Blindness
100%
Not Available
Coma
25%
25 %
End-Stage Renal (Kidney) Disease
100%
100%
Major Organ Failure
100%
100%
Paralysis
100%
100%
OPTIONAL BENEFITS WELLNESS TREATMENT, HEALTH SCREENING TEST AND PREVENTIVE CARE BENEFIT RIDER All Employee benefits under this Rider are payable at 100% of the Benefit Amount shown for the Eligible Employee. All Spouse benefits are payable at 100% of the Benefit Amount shown for the Employee. All Dependent Child(ren) benefits are payable at 100% of the Benefit Amount shown for the Employee. Voluntary Benefit Benefit Waiting Period 0 days LEVEL 1 EMPLOYEE BENEFITS Benefit Type Benefit Amount
Wellness Treatment Benefit Health Screening Test Benefit Preventive Care Benefit Benefit Amount
$50 per day 1 per year
Maximum Benefit
5
Made with FlippingBook. PDF to flipbook with ease