Apply for more than $10,000 of insurance if the Policy is terminated or amended to terminate the insurance for any class of Insureds, or the Employer cancels participation under the Policy.
Conversion in these cases is only permitted if you have been covered by the Policy or, any group life insurance policy issued to the Employer which the Policy replaced, for at least 3 years.
Idaho residents:
1) Under the Schedule of Benefits section, the following changes are made:
a) Tier 1 benefits are not available. Tier 2 benefits will always be paid.
b) The Benefit Waiting Period does not apply.
c) The Maximum Benefit Period for the Hospital Stay will not be less than 31 days and will not exceed 180 days
d) The Maximum Benefit Period for the ICU Stay will not be less than 31 days and will not exceed 180 days
e) The Maximum Benefit Period for the Newborn Nursery Care Stay Benefits will not be less than 31 days and will not exceed 180 days
f) The Maximum Benefit for Skilled Nursing Stay Benefits will not be less than 31 days.
g) The Maximum Benefit for Mental Illness and Nervous Disorder Facility Care will not be less than 31 days.
h) The Maximum Benefit for Substance Abuse Facility Care will not be less than 31 days.
i) Elimination Periods will not apply. Under the Hospital Observation Stay Benefit, the Elimination Period is referred to as the Observation Period.
2) Under the Definitions section the following changes are made:
a) The definition of Congenital Anomaly has be added:
Congenital Anomaly A condition existing at or from birth that is a significant deviation from the common form or function of the body, whether caused by a hereditary or developmental defect or disease. The term “significant deviation” is defined to be a deviation which impairs the function of the body and includes but is not limited to the conditions of cleft lip, cleft palate, webbed fingers or toes, sixth toes or fingers, or defects of metabolism and other conditions that are medically diagnosed to be congenital anomalies.
The Date of Diagnosis is the date a Physician makes a diagnosis of Congenital Anomaly that is based on generally accepted principles of medicine in the United States at the time the diagnosis is made.
b) The definition of Dependent Child has been 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, who is chiefly dependent upon the Employee for support and maintenance and incapable of self-sustaining employment by reason of intellectual disability or physical disability.
A child, for purposes of this provision, includes an Employee’s: 1. natural child;
2. adopted child, , on the date of the child’s birth if Placement occurs within 60 days after the child’s birth, or otherwise on the date of Placement for purpose of adoption. As used in this paragraph, “Placement” means
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