TABLE OF CONTENTS
SECTION PAGE NUMBER SCHEDULE OF BENEFITS......................................................................................................................................................1 SCHEDULE OF BENEFITS FOR CLASS 1............................................................................................................................2 DESCRIPTION OF COVERAGES AND BENEFITS..............................................................................................................7 GENERAL DEFINITIONS........................................................................................................................................................9 ELIGIBILITY...........................................................................................................................................................................19 ENROLLMENT.......................................................................................................................................................................20 EFFECTIVE DATE PROVISIONS.........................................................................................................................................20 DEFERRED EFFECTIVE DATE PROVISIONS...................................................................................................................21 TAKEOVER PROVISION......................................................................................................................................................22 TERMINATION OF INSURANCE........................................................................................................................................23 CONTINUATION OF COVERAGE PROVISIONS..............................................................................................................23 PORTABILITY PROVISIONS...............................................................................................................................................24 EXCLUSIONS.........................................................................................................................................................................25 CLAIM PROVISIONS.............................................................................................................................................................26 ADMINISTRATIVE PROVISIONS.......................................................................................................................................28 GENERAL PROVISIONS.......................................................................................................................................................29 WELLNESS TREATMENT, HEALTH SCREENING TEST AND PREVENTIVE CARE BENEFIT RIDER...................31 HOSPITAL BENEFIT RIDER - PANDEMIC INFECTIOUS DISEASE ADMISSION ONLY BENEFIT ...............................33 MODIFYING PROVISIONS AMENDMENT........................................................................................................................35
GCI-02-CE1000.WY
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