2. DEFINITIONS · your step-child; · a foster child placed with you by a licensed agency; · a child for whom you have or your Spouse has legal guardianship of the child’s person; · your adopted child, including any child placed with you for adoption from the earlier of the date of placement for the purpose of adoption or the date of the entry of an order granting the adoptive parent custody of the child for the purpose of adoption; or · a child of your Spouse. If a unmarried or married child is age 26 or older and is incapable of self-sustaining employment because of an intellectual disability, developmental disability or physical handicap that child will continue to be considered a Dependent Child under the Policy for as long as these conditions exist. No person may be considered to be a Dependent Child of more than one Employee. Dependent Child does not include any person who is insured as an Employee. Diagnosed, Diagnosis or Diagnoses means an evaluation of an Insured’s medical condition that is performed by a Physician whose specialty is appropriate for the condition being evaluated, and who is board certified in that specialty in accordance with the American Board of Medical Specialties criteria. The evaluation must be consistent with the most current medically accepted diagnostic standards according to Nationally Recognized Authorities. A Diagnosis must be based on conditions, clinical signs on examination, or test results that have changed substantially since becoming insured under the Policy. In addition, if cognitive function is being evaluated, the conclusions must be confirmed with neuropsychological testing conducted by a clinical psychologist at the doctorate level certified through the American Board of Professional Psychology in the area of clinical neuropsychology. Eligibility Waiting Period means the length of time you must be a member in an Eligible Class before you can apply for insurance. The Eligibility Waiting Period is shown in the Benefit Highlights. Employee means a person who is: · employed by the Employer within the United States; · a U.S. citizen or a U.S. resident; · scheduled to work at least the minimum hours shown in the Benefit Highlights; · paid regular earnings in accordance with applicable state and federal wage and hour laws; and · has a legitimate federal tax identification number. Employee does not include a seasonal or temporary employee whose annual work schedule is less than 12 months during a calendar year. If you are an Employee and you are working on a temporary assignment outside of the United States for 12 months or less, you will be deemed to be working within the United States. If you are an Employee and you are working on a temporary assignment outside of the United States for more than 12 months, you will not be considered an Employee under the Policy unless we agree in Writing. Employer means the Employer named on the cover page of this Certificate and includes any subsidiary or affiliated company named in the application. Enrollment Period means the period of time each year not to exceed 30 days during which eligible Employees may elect, or change, or cancel insurance under the Policy. The Enrollment Period cannot exceed 30 days or occur more than once in any 12-month period, unless we agree in Writing. Family Member means: (a) your Spouse, civil union partner or domestic partner and (b) the following relatives of you or your Spouse, civil union partner or domestic partner: (1) parent; (2) grandparent; (3) child; (4) grandchild; (5) brother, (6) sister; (7) aunt; (8) uncle; (9) first cousin; (10) nephew or niece. This includes adopted, in-law and step-relatives. 16-SD-C-01 Page9
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