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.
The term Hospital* does not include a clinic, facility, or unit of a Hospital for rehabilitation, convalescent, custodial, educational, hospice, or skilled nursing care.
*As a result, a clinic, facility, or unit of a Hospital for the aged, drug addicts or alcoholics; and a facility primarily or solely providing psychiatric services to mentally ill patients will be treated as any other Hospital Admission or Hospital Stay.
c) The Injury definition is replaced with the following:
Accidental bodily injury sustained by the insured person and directly caused by an accident which is not the result of disease or bodily infirmity.
3) Under the Eligibility section, the following changes are made:
a) Add the following two paragraphs under Spouse and Dependent Children:
Newborn Child(ren) Coverage for a newly born child shall be provided without notice or additional premium for no less than 60 days after the date of birth. Adopted Child(ren) Coverage for a child under 18 due to adoption or placement of adoption for adoption of the child shall be provided as of the date of the adoption or placement for adoption. Placement for adoption means the assumption and retention by a person of a legal obligation for total or partial support of a child in anticipation of the adoption of the child. The child’s placement with a person terminates the ''placement of adoption'' legal obligations.
4) Under the Termination of Insurance section, the following is added to the Termination of Insurance provision:
For Continuation for Loss of Eligibility, the coverage on a Covered Person will end of the earliest date below due to a Qualifying Event:
The date the Covered Person is considered to reside outside of the United States. The Covered Person will be considered to reside outside the United States when the Covered Person has been outside the United States for a total period of 4 months or more during any 4 consecutive months.
5) Under the Continuation of Insurance Provisions section, the following is added to the Continuation of Insurance provision:
If an Employee is no longer in Active Service, coverage may be continued. The following provisions explain the continuation options available under this Policy. Please see the Schedule of Benefits , to determine the applicability of these benefits on a class level. Premiums are required for this coverage and are to be remitted in accordance with the Payment of Premium provision.
Continuation for Loss of Eligibility
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