GENERAL DEFINITIONS Please note that certain words used in this Policy have specific meanings. The words defined below and capitalized within the text of this Policy have the meanings set forth below. Active Service 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 or holiday period, 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 other than an Employee is not considered in Active Service if He is: 1. Inpatient in a Hospital, receiving hospice or confined in a rehabilitation or convalescence center or custodial care facility or receiving Outpatient care for chemotherapy or radiation therapy; 2. confined at home under the care of a Physician for Sickness or Injury; Meets the criteria described for the diagnosis of Alzheimer’s Disease, in addition to the cognitive deficits interfering with independence in completion of Instrumental Activities of Daily Living as needed for Mild Stage Alzheimer’s Disease, assistance is also required for completion of at least 2 Physical Activities of Daily Living. The Date of Diagnosis of the Covered Person’s Advanced Stage Alzheimer’s disease is the date of the Covered Person's inability to perform at least 2 Physical Activities of Daily Living from this disorder, as confirmed by a Physician. For purposes of Initial Premium calculations upon initial eligibility unless otherwise stated, a Covered Person’s age is His Age attained on the date coverage becomes effective for Him under this Policy. 1. For purposes of increases to coverage, including Enrollment Events and Life Status Changes, a Covered Person’s Age, will be His Age as of the effective date of such increase. 2. For purposes of premium calculation for Portability prior to group policy termination, a Covered Person’s Age is His Age as of His last birthday. 3. For the purposes of Portability, except as to premium calculations, Extension of Benefits, Waiver of Premium, or Continuation due to Disability, a Covered Person’s Age is His Age as of His last birthday. 4. For all other purposes, changes in rates due to age including, age-based terminations, a Covered Person’s Age will be His Age on the Policy Anniversary Date coinciding with or following the Covered Person’s birthday. A progressive neurodegenerative disorder that is manifested by a significant cognitive decline from previous general functional level in one or more cognitive domains (attention, learning and memory, executive function, language, perceptual-motor, or social cognition). 1. The cognitive deficit is documented by standardized neuropsychological testing (including but not limited to Wechsler Adult Intelligence Scale (WAIS), the Wechsler Memory Scale (WMS), the Halstead/Reitan Neuropsychological Test Battery, Boston Naming Test, the Dellis-Kaplan Executive Function Scale) or, if not available, another quantified clinical assessment (including but not limited to the Mini-Mental state Examination(MMSE) or the Montreal Cognitive Assessment (MoCA); and
Advanced Stage Alzheimer's Disease
Age
Alzheimer's Disease
9
Made with FlippingBook. PDF to flipbook with ease