2. loss of a Spouse; whether by death, divorce, annulment or legal separation; 3. birth or adoption of a child, or acquiring a child through marriage; 4. a change in the group benefit plan available to the Spouse; 5. a change in the Spouse’s employment status that affects eligibility for group benefits for either the Employee or His Spouse; 6. termination of a Spouse’s employment; and 7. an event as specified in the Employer’s Plan which this Policy insures. Any coverage elected as a result of a Life Status Change, shall be effective in accordance with the Effective Date for Individuals Provision . Group Enrollment Effective Dates Annual Group Enrollment Period Coverage up to the Guaranteed Issue amount for which an Employee, Spouse and Dependent Child is eligible, will be effective on the effective date of this Policy’s anniversary following the enrollment period. Coverage in excess of the Guaranteed Issue amount will be effective on the later of: 1. the effective date of this Policy’s anniversary following the enrollment period, if the Employee’s and Spouse's Evidence of Insurability is approved by Us prior to the effective date of this Policy’s anniversary; 2. the date We approve the Employee’s and Spouse's completed Evidence of Insurability form; 3. the first of the month following the date We approve the Employee’s and Spouse's Evidence of Insurability form. For all Employee and Spouse coverage up to the Guaranteed Issue amount, Evidence of Insurability is not required. For all Employee and Spouse coverage in excess of the Guaranteed Issue amount, Evidence of Insurability is required. The Employee may apply for an increase in coverage on an insured Spouse or for coverage on a Spouse who is eligible to be insured but was not previously enrolled by the Employee. For all Dependent Child coverage Evidence of Insurability is not required. The Dependent Child who is eligible to apply, but was not previously enrolled by the Employee, the Employee may apply or is insured the Employee may apply for an increase for coverage. TAKEOVER PROVISION This provision applies only to Employees and the Employee's dependents who were covered for Critical Illness coverage under a Prior Plan provided by the Subscriber or by an entity that has been acquired by the Subscriber on the day prior to the date the Employee would have first become eligible to be insured under this Policy. 8. This section A applies to Employees who are not in Active Service on the day prior to the date the Employee would have first become eligible to be insured under this Policy due to a reason for which the Prior Plan and this Policy both provide for continuation of coverage on a premium paying basis. If the required premium is paid when due, We will insure an Employee and the Employee's dependents, to which this section applies during and for the balance of the period for which coverage would be continued under the Prior Plan that occurs after the effective date of this Policy. This coverage will be provided until the earlier of the date: (a) the Employee, returns to Active Service, or (b) continuation of coverage under the Prior Plan would end but for termination of that plan. The Policy will provide this coverage as follows: 1. If benefits are payable under the Prior Plan during the period that coverage is continued under this Policy, then no benefits are payable under this Plan. 2. If benefits are not payable under the Prior Plan during the period that coverage is continued under this Policy, solely because the Prior Plan terminated, benefits payable under this Policy will be the lesser of: (a) the benefits that would have been payable under the Prior Plan; or (b) those provided by this Policy. Credit will be given for partial completion under the Prior Plan of Elimination Periods.
22
Made with FlippingBook. PDF to flipbook with ease