Group Critical Illness Insurance Certificate

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 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; 2. confined at home under the care of a Physician for Sickness or Injury; b) The definition of Dependent Child is replaced with the following: An Employee’s child who meets the following requirements: 1. A child from live birth to 26 years old; 2. A child who is 26 or more years old, primarily supported by the Employee and incapable of self-sustaining employment by reason of mental or physical handicap. A child, for purposes of this provision, includes an Employee's: 1. natural child; 2. adopted child, beginning with the date of the filing of the petition for adoption, including where an Employee is a party to a suit in which an Employee seeks to adopt the child. It also means the legally adopted child of the Employee’s Spouse or domestic partner/Partner to a Civil Union; 3. stepchild; 4. child for whom the Employee is the court-appointed legal guardian or for whom the Employee must provide medical support under an order issued under Chapter 154, Family Code, or enforceable by a Texas Court. If an Employee, who is the legal guardian of a foster child, is not a step-parent, grandparent, aunt or uncle, then the child must have resided with the Employee for at least six consecutive months and intend to reside with the Employee for an indefinite period of time. 5. grandchild who is the dependent of the Employee for federal income tax purposes at the time application for coverage of the grandchild is made. Coverage for such grandchild may not be terminated solely because the grandchild is no longer a dependent of the Employee for federal income tax purposes. c) Under the definition of Physician, the following exclusions are removed: 1. living in the Covered Person’s household; or 2. a parent, sibling, spouse or child of the Covered Person. d) The definition of Sickness is replaced with the following: A physical or mental illness, including complications of pregnancy. 2) Under the Eligibility section, the following provision is added: Newborn Child(ren) Coverage for a newly born child shall be provided without notice for no less than 31 days after the date of birth. 3) Under the Termination of Insurance section, item six is replaced with the following: 6. the last day for which premium is paid, subject to the Grace Period; 4) Under the Extension of Benefits and Waiver of Premium Provision section, the Rehabilitation During a Period of Disability provision is removed.

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