b) The Incontestability provision titled This Policy or Participation Under this Policy is modified as follows: All statements made by the Subscriber to obtain this Policy or to participate under this Policy are considered representations and not warranties. No statement will be used to deny or reduce benefits or be used as a defense to a claim, or to deny the validity of this Policy or of participation under this Policy unless a copy of the instrument containing the statement is, or has been, furnished to the Subscriber. Misrepresentations, omissions, concealment of facts, and incorrect statements may not prevent a recovery under the Policy or Contract unless either (1) fraudulent; (2) material either to the acceptance of the risk, or to the hazard assumed by the Insurer; or (3) the Insurer in good faith would either not have issued the Policy or Contract, or would not have issued a Policy or Contract in as large an amount, or at the same premium or rate, or would not have provided coverage with respect to the hazard resulting in the loss, if the true facts had been made known to the insurer as required either by the Application for the Policy or Contract or otherwise. After two years from the Policy Effective Date, no such statement will cause this Policy to be contested except for fraud. c) The Policy Termination provision is modified as follows: We may terminate insurance on or after the first anniversary of the Policy Effective Date. The Subscriber may terminate insurance on any Premium Due Date. Written or authorized electronic notice by certified mail must be given at least 45 days prior to such Premium Due Date. Failure by Subscriber to pay premiums when due or within the Grace Period shall be deemed notice to Us to terminate insurance at the end of the period for which premium was paid. Termination will not affect a claim for a Covered Loss that is the result, directly and independently of all other causes, of a loss that occurs while insurance was in effect. 7) The third paragraph of the Face Page of the Certificate is modified as follows: This Certificate describes the benefits and basic provisions of Your coverage. It is part of the entire contract of insurance and does not waive or alter any terms of the Policy. If questions arise, the Policy language will govern. You may examine the Policy at the office of the Policyholder or the Administrator. 8) Under the Hospital Benefit Rider the following changes are made: Not all covered conditions are available in the state. Additional chronic conditions or other mental disorders must be filed prior to use. Arkansas residents: 1) Under the General Definitions section, items 2 and 3 of the second paragraph of the definition of Dependent Child are replaced with the following: 2. In the case of minor children under an Employee’s charge, care and control for whom the Employee has filed a petition to adopt, coverage will be effective: a. From the date of birth if the petition for adoption is filed and a request for coverage is made within 60 days of the date of birth; or b. On the date of the filing of the petition for adoption if a request for coverage is made within 60 days of the date of filing. Coverage shall terminate upon the dismissal of a petition for adoption. 2) Under the Effective Date Provisions section, the following paragraph is added to the Effective Date for Individuals Behavioral Health Admission Only Benefit is not available. Musculoskeletal Admission Only Benefit is not available.
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