CONDITIONS ON ELIGIBILITY FOR BENEFITS Eligibility for benefits under this rider is satisfied when all of the following conditions are met: 1. the insured is chronically ill; 2. the certificate and rider are in force; 3. the insured has satisfied the elimination period; 4. the insured has used qualified long term care services and been chronically ill during the last 180 consecutive days; 5. the insured is receiving qualified long term care services while this rider is in force; 6. the insured is in a period of care that begins while this rider is in force; 7. the insured incurred charges for qualified long term care services which are included in the insured’s plan of care; and 8. all irrevocable beneficiaries and assignees have signed the written request for this benefit. We may periodically require certification that the insured is chronically ill, but not more than once every 90 days. The benefits payable under this rider are voluntary and are not intended to cause an involuntary reduction of the death benefit ultimately payable to the beneficiary. Therefore, the benefits are not available if the insured is: 1. required by law to use this option to meet the claims of creditors, whether in bankruptcy or otherwise; or 2. required by a government agency to use this option in order to apply for, obtain, or keep a government benefit or entitlement. PRE-EXISTING CONDITION LIMITATION We do not pay benefits under this rider for a period of care that begins in the first 6 months after the rider effective date if a pre-existing condition causes the insured to be chronically ill. This limitation does not apply to a period of care that begins more than 6 months after the rider effective date that is caused by a pre-existing condition. MONTHLY ACCELERATED DEATH BENEFIT We will accelerate a portion of the death benefit for each monthly benefit period or fraction thereof during which the insured is eligible for benefits. The maximum monthly accelerated death benefit amount is equal to the lesser of: 1. (A – B) x C, where: “A” is the death benefit amount on the day the elimination period is first satisfied; “B” is the total death benefit accelerated under any other rider(s) since the day the elimination period for this rider is first satisfied; “C” is the acceleration percentage shown in the certificate for this rider; and 2. A – S, where: “A” is as defined above; “S” is the sum of all accelerated death benefit amounts for all prior monthly benefit periods under this rider (excluding benefits paid under the Monthly Extension of Accelerated Death Benefits provision) and any accelerated death benefit amounts from other riders attached to the certificate. If a full month of qualified long term care services was received, we will accelerate the maximum monthly accelerated death benefit amount. If the insured is confined for only a fraction of a monthly benefit period, we will accelerate a pro rata amount for each day of confinement within that monthly benefit period. If the insured receives qualified non-confined care services less than 2 times during a monthly benefit period, we will accelerate a pro rata amount for each day of the monthly benefit period that qualified non-confined care services were received. In no instance will we accelerate more than the maximum monthly accelerated death benefit amount, as calculated above. The death benefit available for acceleration does not include the amount of any Accidental Death Benefit or Term Rider(s). If the insured satisfies the conditions stated in the Conditions on Eligibility for Benefits provision, we will pay a monthly benefit to the certificate holder upon our receipt of: 1. the certificate holder’s written request for the accelerated death benefit; 2. written certification from a licensed health care practitioner that the insured is chronically ill; and 3. signed consent from any irrevocable beneficiary or assignee. The monthly benefit payable to the certificate holder as a result of the monthly acceleration of death benefit is equal to: 1. the monthly accelerated death benefit amount; less 2. a pro rata portion (based on the monthly accelerated death benefit amount) of the certificate debt, if any; less 3. any due and unpaid premium. GWPLTCE1IN Page 5
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