2. low back pain, metabolic syndrome, osteoarthritis, peripheral arterial disease, behavioral: anxiety, bipolar disorder, depression 3. diabetes mellitus: Type 1, Type 2 4. cardiac concerns: acute myocardial infarction, angina, congestive heart failure, coronary artery disease, heart disease.
Complications of Pregnancy Whether or not the pregnancy is terminated, any condition: 1. that requires hospital confinement; and 2.
whose diagnosis is distinct from pregnancy but is adversely affected or caused by pregnancy.
Examples include: acute nephritis; nephrosis; cardiac decompensation; missed abortion; and similar conditions of comparable severity, non-elective caesarean section; ectopic pregnancy which is terminated; and spontaneous termination of pregnancy which occurs during a period of gestation when a viable birth is not possible. Complications of pregnancy do not include: false labor; occasional spotting; physician prescribed rest during pregnancy; morning sickness; hyperemesis gravidarum; pre- eclampsia; and similar conditions associated with a difficult pregnancy but not considered a classifiable, distinct complication of pregnancy. A physical or mental disease or disorder including pregnancy and Complications of Pregnancy, that results in a Covered Loss. A Covered Illness includes medically-necessary quarantine in a Hospital in conjunction with medically-necessary preventive treatment due to an identifiable exposure to a life-threatening contagious and infectious disease.
Covered Illness
Any bodily harm that results directly from a Covered Loss.
Covered Injury
A loss that is: 1.
Covered Loss
specified in the Schedule of Benefits .
2. suffered by the Covered Person within the applicable time period specified in the Schedule of Benefits.
An eligible person, as defined in the Schedule of Benefits , who is enrolled and has been accepted by Us, required premium has been paid when due and coverage under this Policy remains in force.
Covered Person
An Employee’s child who meets the following requirements:
Dependent Child
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, from the earlier of the date the petition for adoption is filed or entry of the child in the adoptive home, or in the case of a child who is in the custody of the state, coverage shall begin at the date of entry of a final decree of adoption. It also means the legally adopted child of the Employee’s Spouse provided the child is living with, and is financially dependent upon the Employee; 3. stepchild who resides with the Employee and is financially dependent upon the Employee; 4. child for whom the Employee is the court-appointed legal guardian and primarily depends on the Employee for financial support. Financial support means that the Employee is eligible to claim the dependent for purposes of Federal and State income tax returns
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