An Employee’s child who meets the following requirements: 1. A child from live birth to 26 years old;
2. Any unmarried child or grandchild who is placed in the home of an Insured Person following execution of an act of voluntary surrender shall be considered the Insured Person’s Dependent Child from the date on which the act of voluntary surrender becomes irrevocable. 3. A child who is 26 or more years old residing with the Employee and incapable of self-sustaining employment by reason of intellectual or physical disability.
A child, for purposes of this provision, includes an Employee’s: 1. natural child;
2. adopted child, beginning with any waiting period pending finalization of the child’s adoption. It also means the legally adopted child of the Employee’s Spouse or Domestic partner/Partner to a Civil Union 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, grandchild for whom the Employee is the court-appointed legal guardian, as long as the child resides with the Employee 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; 5. a child of the Employee’s domestic partner/Partner to a Civil Union, provided the child is living with, and is financially dependent upon the Employee.
c) The first paragraph of the Hospital definition is replaced by the following:
An institution that meets all of the following: 1. It is licensed as a Hospital pursuant to applicable law; 2. It is primarily and continuously engaged in providing medical care and treatment to sick and injured persons; 3. It is managed under the supervision of a staff of medical doctors; 4. It provides 24-hour nursing services by or under the supervision of a graduate registered Nurse (R.N.); and 5. It has medical, diagnostic and treatment facilities, with major surgical facilities on its premises, or available to it on a prearranged basis.
d) The following Physical Therapy definition has been added:
Manipulation by physical and mechanical means including heat treatment or diathermy, ultrasonic, microtherm, manipulation, adjustment, massage therapy and acupuncture as performed by a licensed Physical Therapist, licensed chiropractor or licensed podiatrist.
Physical Therapy
5) Under the Administrative Provisions section, the first paragraph of the Changes in Premium Rates provision is updated as follows:
Changes in Premium Rates: The premium rates may be changed by Us from time to time with at least 31 days advance written notice, and 45 days advance written notice for rates increase of 20% or more. No change in rates will be made until 24 months after the Effective Date. An increase in rates will not be made more often than once in a 12 month period. However, We reserve the right to change the rates even during a period for which the rate is guaranteed, if any of the following events take place:
6) Under the General Provisions section, make the following changes:
a) Under the Incontestability provision, the time limit changed from two years to three years and removal of fraud as shown below:
This Policy or Participation Under This Policy After three years from the Policy Effective Date, no such statement will cause this Policy to be contested except for lack of eligibility for coverage.
A Covered Person's Insurance
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