Common use of Continuation of Coverage - Extended Benefits Clause in Contracts

Continuation of Coverage - Extended Benefits. In the event that we cancel this agreement, benefits shall be extended for a pregnancy that began while the agreement was in force and for which benefits would have been payable had the agreement remained in force. If you are disabled on the termination date of this agreement, your benefits will be temporarily extended for any continuous loss, which commenced while the agreement was in force. The services provided under this benefit are subject to all terms, conditions, limitations and exclusions listed in this agreement, and the care you receive must relate to or arise out of the disability you had on the day this agreement ended. The extension of benefits will cease upon the earliest of the following events: • the continuous disability ends; or • twelve (12) months from the termination date; or • payment of the maximum benefits under this agreement has been met. Extended benefits apply ONLY to the subscriber who is disabled. If you want to receive coverage for continued care when this agreement ends, you must provide us with proof that you are disabled. We will make a determination whether your condition constitutes a disability and you will have the right to appeal our determination or to take legal action. Please see Section 7.0 – Adverse Benefit Determinations and Appeals.

Appears in 8 contracts

Samples: Subscriber          Agreement, Subscriber          Agreement, Subscriber          Agreement

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Continuation of Coverage - Extended Benefits. In the event that we cancel or refuse to renew this agreement, benefits shall be extended for a pregnancy that began while the agreement was in force and for which benefits would have been payable had the agreement remained in force. If you are disabled on the termination date of this agreement, your benefits will be temporarily extended for any continuous loss, loss which commenced while the agreement was in force. The services provided under this benefit are subject to all terms, conditions, limitations and exclusions listed in this agreement, and the care you receive must relate to or arise out of the disability you had on the day this agreement ended. The extension of benefits will cease upon the earliest of the following events: • the continuous disability ends; or • twelve (12) months from the termination date; or • payment of the maximum benefits under this agreement has been met. Extended benefits apply ONLY to the subscriber who is disabled. If you want to receive coverage for continued care when this agreement ends, you must provide us with proof that you are disabled. We will make a determination whether your condition constitutes a disability and you will have the right to appeal our determination or to take legal action. Please see action as described in Section 7.0 – Adverse Benefit Determinations and Appeals7.0.

Appears in 5 contracts

Samples: Subscriber          Agreement, Subscriber Agreement, Subscriber          Agreement

Continuation of Coverage - Extended Benefits. In the event that we cancel this agreement, benefits shall be extended for a pregnancy that began while the agreement was in force and for which benefits would have been payable had the agreement remained in force. If you are disabled on the termination date of this agreement, your benefits will be temporarily extended for any continuous loss, which commenced while the agreement was in force. The services provided under this benefit are subject to all terms, conditions, limitations and exclusions listed in this agreement, and the care you receive must relate to or arise out of the disability you had on the day this agreement ended. The extension of benefits will cease upon the earliest of the following events: the continuous disability ends; or twelve (12) months from the termination date; or payment of the maximum benefits under this agreement has been met. Extended benefits apply ONLY to the subscriber who is disabled. If you want to receive coverage for continued care when this agreement ends, you must provide us with proof that you are disabled. We will make a determination whether your condition constitutes a disability and you will have the right to appeal our determination or to take legal action. Please see Section 7.0 – Adverse Benefit Determinations and Appeals.

Appears in 5 contracts

Samples: Subscriber Agreement, Subscriber Agreement, Subscriber Agreement

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Continuation of Coverage - Extended Benefits. In the event that we cancel this agreement, benefits shall be extended for a pregnancy that began while the agreement was in force and for which benefits would have been payable had the agreement remained in force. If you are disabled on the termination date of this agreement, your benefits will be temporarily extended for any continuous loss, which commenced while the agreement was in force. The services provided under this benefit are subject to all terms, conditions, limitations and exclusions listed in this agreement, and the care you receive must relate to or arise out of the disability you had on the day this agreement ended. The extension of benefits will cease upon the earliest of the following events: • the continuous disability ends; or • twelve (12) months from the termination date; or • payment of the maximum benefits under this agreement has been met. Extended benefits apply ONLY to the subscriber who is disabled. If you want to receive coverage for continued care when this agreement ends, you must provide us with proof that you are disabled. We will make a determination whether your condition constitutes a disability and you will have the right to appeal our determination or to take legal action. Please see Section 7.0 – Adverse Benefit Determinations and Appeals.

Appears in 3 contracts

Samples: Subscriber          Agreement, Subscriber          Agreement, Subscriber          Agreement

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