SECTION 3 - ELIGIBILITY AND EFFECTIVE DATES (Continued)
What Happens if There is a Transfer of Insurance Carriers? In order to prevent loss of coverage for you because of transfer of insurance carriers, this plan will provide coverage for you as follows: If You are not in Active Employment Due to Injury or Sickness Subject to premium payments, this plan will cover you if: 1. at the time of transfer you were covered under the prior carrier's plan; and 2. you are not in Active Employment due to Injury or Sickness on the effective date of this plan. Benefits will be determined based on the lesser of: 1. the amount of the Disability benefit that would have been payable under the prior plan and subject to any applicable plan limitations; or 2. the amount of Disability benefits payable under this plan. If benefits are payable under the prior plan for the Disability, no benefits are payable under this plan. If You are Disabled Due to a Pre-Existing Condition If you were insured under the prior carrier's plan at the time of transfer and were in Active Employment and insured under this plan on its effective date, benefits may be payable for a Disability due to a Pre-Existing Condition. If you can satisfy this plan's Pre-Existing Condition Exclusion, the benefit will be determined according to this plan. If you cannot satisfy this plan's Pre-Existing Condition Exclusion, then: 1. Lincoln will apply the Pre-Existing Condition Exclusion of the prior carrier's plan; and 2. if you would have satisfied the prior carrier's pre-existing condition exclusion, giving consideration towards continuous time coverage under this plan and the prior carrier's plan, the benefit will be determined according to this plan. However, the Maximum Monthly Benefit amount payable under this plan shall not exceed the maximum monthly benefit payable under the prior carrier's plan. No benefit will be paid if you cannot satisfy the Pre-Existing Condition Exclusions of either plan.
Transfer Provision
ADOC-ELG-9
Eligibility and Effective Dates
Made with FlippingBook - Online Brochure Maker