• Racing – riding in or driving any motor-driven vehicle in a race, stunt show or speed Doctor is a person who is duly quali昀椀ed as a practitioner of the healing arts acting within test in a professional or semi-professional capacity. the scope of his license, and: is licensed to practice medicine; prescribe and administer • Illegal Occupation – voluntarily participating in, committing, or attempting to commit drugs; or to perform surgery, or is a duly quali昀椀ed medical practitioner according to the a felony or illegal act or activity, or voluntarily working at, or being engaged in, an laws and regulations in the state in which treatment is made. illegal occupation or job. In Montana: For purposes of treatment, the insured has full freedom of choice in the − In Connecticut: voluntarily participating in, committing, or attempting to commit selection of any licensed physician, physician assistant, dentist, osteopath, chiropractor, a felony. optometrist, podiatrist, licensed social worker, psychologist, licensed professional − In Illinois: committing or attempting to commit a felony or being engaged in an counselor, acupuncturist, naturopathic physician, physical therapist, or advanced illegal occupation. practice registered nurse. − In Nebraska and Tennessee: voluntarily participating in, committing, or A Doctor does not include you or any of your Family Members. For the purposes of attempting to commit a felony or voluntarily working at, or being engaged in, an this de昀椀nition, Family Member includes your spouse as well as the following members illegal occupation or job. of your immediate family: son, daughter, mother, father, sister, or brother. In Arizona, − In Pennsylvania: committing or attempting to commit a felony, or being engaged however, a doctor who is your family member may treat you. In South Dakota, however, in an illegal occupation. a doctor who is your family member may treat you if that doctor is the only doctor in the − In South Dakota: voluntarily committing a felony. area and acts within the scope of his or her practice. • Sports – participating in any organized sport in a professional or semi-professional A Hospital is not a nursing home; an extended care facility; a skilled nursing facility; capacity. a rest home or home for the aged; a rehabilitation facility; a facility for the treatment of alcoholism or drug addiction (except in Vermont); an assisted living facility; or any • Custodial Care – this is non-medical care that helps individuals with the basic tasks facility not meeting the de昀椀nition of a Hospital as de昀椀ned in the certi昀椀cate. of everyday life, the preparation of special diets, and the self-administration of A Hospital Intensive Care Unit is not any of the following step-down units: a progressive medication which does not require the constant attention of medical personnel. care unit; a sub-acute intensive care unit; an intermediate care unit; a private monitored • Treatment for being overweight, gastric bypass or stapling, intestinal bypass, and any room; a surgical recovery room; an observation unit; or any facility not meeting the related procedures, including any resulting complications. de昀椀nition of a Hospital Intensive Care Unit as de昀椀ned in the certi昀椀cate • Services performed by a family member. Sickness means an illness, infection, disease, or any other abnormal physical condition − In Arizona: this exclusion does not apply. or pregnancy that is not caused solely by, or the result of, any injury (In Maine, illness or − In South Dakota: this exclusion does not apply. disease of an insured). A Covered Sickness is one that is not excluded by name, speci昀椀c • Services related to sex or gender change, sterilization, in vitro fertilization, vasectomy description, or any other provision in this plan. For a bene昀椀t to be payable, loss arising or reversal of a vasectomy, or tubal ligation. from the covered sickness must occur while the applicable insured’s coverage is in − In Washington D.C. and Washington: Services related to sterilization, in vitro force (except in Montana). fertilization, vasectomy or reversal of a vasectomy, or tubal ligation. Treatment is the consultation, care, or services provided by a doctor. This includes • Elective Abortion – an abortion for any reason other than to preserve the life of the receiving any diagnostic measures and taking prescribed drugs and medicines. person upon whom the abortion is performed. Treatment does not include telemedicine services (except in Kansas). − In Tennessee, or if the pregnancy was the result of rape or incest, or if You May Continue Your Coverage the fetus is non-viable. Your coverage may be continued with certain stipulations. See certi昀椀cate for details. • Dental Services or Treatment. Termination of Coverage • Cosmetic Surgery, except when due to: Your insurance may terminate when the plan is terminated; the 31st day after the − Reconstructive surgery, when the service is related to or follows surgery premium due date if the premium has not been paid; or the date you no longer belong resulting from a Covered Accidental Injury or a Covered Sickness, or is related to to an eligible class. If your coverage terminates, we will provide bene昀椀ts for valid claims or results from a congenital disease or anomaly of a covered dependent child. that arose while your coverage was in force. See certi昀椀cate for details. − Congenital defects in newborns. NOTICES If this coverage will replace any existing individual policy, please be aware that TERMS YOU NEED TO KNOW it may be in your best interest to maintain your individual guaranteed-renewable A Covered Accident is an accident that occurs on or after an insured’s effective date policy. while coverage is in force, and that is not speci昀椀cally excluded by the plan. Notice to Consumer: The coverages provided by Continental American Dependent means your spouse or dependent children, as de昀椀ned in the applicable rider, Insurance Company (CAIC) represent supplemental bene昀椀ts only. They do not who have been accepted for coverage. Spouse is your legal wife, husband, or partner in constitute comprehensive health insurance coverage and do not satisfy the a legally recognized union. Refer to your certi昀椀cate for details. requirement of minimum essential coverage under the Affordable Care Act. Dependent Children are your or your spouse’s natural children, step-children, CAIC coverage is not intended to replace or be issued in lieu of major medical grandchildren who are in your legal custody and residing with you, foster children, coverage. It is designed to supplement a major medical program. children subject to legal guardianship, legally adopted children (in Texas, adopted For more information, ask your insurance agent/producer, call 1.800.433.3036, children), or children placed for adoption. (In Florida, coverage may be provided for the or visit a昀氀acgroupinsurance.com. children of custodial and non-custodial parents.) Newborn children are automatically covered from the moment of birth for 60 days. Newly adopted children (and foster children in North Carolina) are automatically covered for 60 days also. See certi昀椀cate for details. Dependent children must be younger than age 26 (In Arizona, on the ef昀椀ctive date of coverage and in Louisiana and Illinois, unmarried). See certi昀椀cate for details. Continental American Insurance Company (CAIC ), a proud member of the Aflac family of insurers, is a wholly-owned subsidiary of Aflac Incorporated and underwrites group coverage. CAIC is not licensed to solicit business in New York, Guam, Puerto Rico, or the Virgin Islands. Continental American Insurance Company • Columbia, South Carolina The certificate to which this sales material pertains may be written only in English; the certificate prevails if interpretation of this material varies. Read your certificate carefully for exact terms and conditions. You’re welcome to request a full copy of the plan certificate through your employer or by reaching out to our Customer Service Center. Benefits, terms, and conditions may vary by state. This brochure is subject to the terms, conditions, and limitations of Policy Series C80000. In Arkansas, C80100AR. In Oklahoma, C80100OK. In Oregon, C80100OR. In Pennsylvania, C80100PA. In Texas, C80100TX. In Virginia, C80100VA.