Plan Benefit Highlights Maximum Benefit Period Pre-Existing Condition Limitation Benefits are payable up to 90 (Plan I) or 150 (Plan II) days for a No disability benefit will be payable if Disability is caused by or covered Injury or Sickness. resulting from a Pre-Existing Condition and begins before you have been continuously covered under the policy for 12 months. This provision will not apply if you have: received no treatment When Coverage Begins and received no diagnosis or advice from a physician, for 12 Certificates will become effective on the requested effective date consecutive months for such condition(s). following the date we approve the application, provided you are on This limitation will not apply to a Disability resulting from a Pre- active employment and premium has been paid. Existing Condition that begins after you have been continuously Physician Expense Benefit covered under the policy for 12 months. Injury - $150.00 per Injury Any increase in benefits will be subject to this Pre-Existing If you need personal treatment by a physician due to an Injury, we Condition limitation. A new Pre-Existing Condition period must will pay the amount shown above provided no other claim has been be met with respect to any increase applied for and approved paid under the policy. You are not required to miss one full day by us. of work in order to receive the Injury benefit. This benefit will be Pre-Existing Condition means a disease, Injury, Sickness, physical limited to 8 payments per calendar year. condition or mental illness for which you: recieved treatment; or Accidental Death Benefit received a diagnosis or advice from a physician, during the 12 month period immediately before your effective date of coverage. A lump sum of $50,000 will be paid to your designated beneficiary if The term Pre-Existing Condition will also include conditions which you die as the direct result of an Injury within 90 days after are related to such disease, Injury, Sickness, physical condition, or the Injury. mental illness. Survivor Benefit A lump sum benefit equal to 3 times the Disability payment will be paid if on the date of your death your Disability had continued for 90 or more consecutive days and you were receiving or entitled to receive Disability payments. The Survivor Benefit may be paid earlier if you have a terminal illness. Donor Benefit If you are Disabled as a result of being an organ or tissue donor, we will pay your benefit as any other Sickness under the terms of the plan. If You Are Disabled Due to a Covered Disability and Not Working We will pay the disability Benefit described in the benefit schedule. No Disability payment will be provided for any period in which you are not under the regular and appropriate care of a physician.