DEFINITIONS HC13GPIN 7 B-21113 (11/25) DOCTOR means a person performing tasks that are within the limits of his or her medical license, and also meets one of the following requirements: • Is licensed to practice medicine and prescribe and administer drugs or to perform surgery. • Has a doctoral degree in Psychology (Ph.D. or Psy.D.) whose primary practice is treating patients. • Is a legally qualified medical practitioner according to the laws and regulations of the jurisdiction where treatment occurred. We will not recognize you or your family members, including but not limited to: spouse, domestic partner, children, parents, including in-laws, or siblings, including in-laws, a business or professional partner, or any person who has a financial affiliation or business interest with you as a doctor for a claim that you send to us. ELIGIBLE SURVIVOR means your spouse, if living; otherwise, your children under age 26. EMPLOYEE means a person who is a citizen or legal resident of the United States in active employment with the Employer in the United States. EMPLOYER means the Policyholder and includes any division, subsidiary or affiliated company named in the policy. GAINFUL OCCUPATION means an occupation that is or can be expected to provide you with an income within 12 months of your return to work, that exceeds: • 80% of your indexed monthly earnings, if you are working. • 80% of your indexed monthly earnings, if you are not working. GRACE PERIOD means the 60 day period following the premium due date during which premium payment for the policy may be made by the Policyholder. GROSS MONTHLY PAYMENT means your benefit before any reduction for deductible sources of income and disability earnings. HOSPITAL CONFINED means you are confined as an in-patient in a hospital, health facility or institution. In-patient means you are physically confined for an overnight stay, as a registered bed patient. HOSPITAL, HEALTH FACILITY or INSTITUTION means an accredited facility licensed to provide care and treatment for the condition causing your disability. INDEXED MONTHLY EARNINGS means your monthly earnings adjusted on each anniversary of benefit payment by the lesser of 10% or the current annual percentage increase in the Consumer Price Index. Your indexed monthly earnings may increase or remain the same, but will never decrease. The Consumer Price Index CPI-U is published by the U.S. Department of Labor. We reserve the right to use some other similar measurement if the Department of Labor changes or stops publishing the CPI-U. Indexing is only used as a factor in the determination of the percentage of lost earnings while you are disabled and working, and in the determination of gainful occupation. INJURY means a bodily injury that is the direct result of an accident and not related to any other cause. The injury must occur, and disability resulting from the injury must begin, while you are covered under the policy. Injury that occurs before you are covered under the policy will be treated as a sickness. INSURED PERSON means a person who is eligible for the coverage under the policy, becomes covered according to the terms of the policy, and whose coverage remains in effect according to the terms of the policy. LAW, PLAN or ACT means the original enactments of the law, plan or act and all amendments. LEAVE OF ABSENCE means you are absent from active employment for a period of time that has been agreed to in advance in writing by your Employer. Your normal vacation time or any period of disability is not considered a leave of absence.
Monthly Disability Income Insurance Plan for Noblesville Schools Page 7 Page 9