Group Critical Illness Insurance Certificate

provided to a Spouse. Domestic Partner means any of the following:

1. A person with whom the Employee has a registered domestic partnership under state law which imposes legal obligations on the parties substantially similar to marriage. Such person will continue to be recognized as a Domestic Partner unless and until: (1) the domestic partnership is dissolved under applicable law; or (2) either the Employee or the Domestic Partner marries another person. All references in the policy to ''Spouse'' shall be changed to read ''Spouse and Domestic Partner'' except as follows: 1. A Domestic Partner shall be deemed eligible to be enrolled for insurance or eligible for Additional Benefits on the latest of: a. the date of registration under Item 1 of the definition of Domestic Partner; b. the date that the Employee is eligible for insurance under the Policy; or; c. the effective date of this Rider to the Policy. 2. A child of a Domestic Partner may only be eligible to be insured or eligible for Additional Benefits if: a. the child is primarily dependent on the Employee for financial support; b. the Employee has a legal obligation of support of the child; or c. the Employee is the child’s legal guardian. 3) Under the Schedule of Benefits section the following revisions are made: a) If Heart Attack is not already listed as a Covered Condition a minimum benefit of $1,000 for Heart Attacks will be available. For purposes of this benefit, the definition of Heart Attack is as follows: An identifiable clinical event that results in ischemic death of a portion of the heart muscle confirmed by diagnostic testing through: 1. electrocardiographic (EKG) changes indicative of myocardial infarction. In the case of myocardial infarction ST wave changes, Q wave changes and/or T wave inversion must be documented and included as one of the criteria on establishing a diagnosis; and, or 2. elevation of cardiac enzyme markers of myocardial injury. In the event of death, an autopsy confirmation and/or death certificate identifying myocardial infarction as the cause of death will be accepted. The Date of Diagnosis is the date that the ischemic death of a portion of the heart muscle occurred. In the event of death, the Date of Diagnosis will be the date of death listed on the death certificate. b) the Schedule of Benefits section will be updated to include in the Continuation Option(s) continuation up to 6 months for Labor Disputes. The following will then be added to the Continuation section: If an Employee’s Active Service ends due to a strike, lockout, or other labor dispute, coverage will continue up to the Maximum Benefit Period as shown in the Schedule of Benefits . Premiums are required for this coverage and are to be remitted directly to the Policyholder 4) Under the General Definitions section the following changes are made: a) Active Service is revised as follows: 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, vacation day or period of Employer-approved paid leave of absence, other than disability

64

Made with FlippingBook. PDF to flipbook with ease