Commencement and Duration of Benefits. Extended Disability Benefits to an eligible applicant shall be for the period commencing the day following the last day of disability included within the period for maximum number of weekly Accident and Sickness benefits, including weeks in which Accident and Sickness benefits were partially or wholly offset because or receipt of Workers’ Compensation Benefits. The maximum period during which Extended Disability Benefits may be payable shall be the number of months by which your full months of seniority at commencement of disability exceeds the maximum number of weeks for which you are entitled to receive Accident and Sickness benefits, but in no event beyond the date of death, the end of the month in which you attain age 65, or the time that you no longer satisfy the disability requirement. If your return to work with the Company does not qualify you for a new period of Accident and Sickness benefits or if you engage in some gainful occupation or employment other than one for which you are reasonably qualified by education, training, or experience, your satisfying of the disability requirement shall not be deemed to end, but your Extended Disability Benefit shall be suspended for the period of the return to work or the period you engage in such occupation or employment. For purposes of applying the maximum period for monthly Extended Disability Benefits, a month in which such benefits are partially or wholly offset by benefit payments from sources listed above, or are suspended, are counted as a full month. Fractions of the first and last month are counted as fractions of a month. The cumulative total number of months during any previous period of eligibility for Extended Disability Benefits, regardless of whether for the same or related disabling condition, reduces the maximum number of monthly benefit payments for which you are otherwise eligible when Extended Disability Benefits again commence. SUPPLEMENTARY HEALTH CARE FOR EMPLOYEES AND DEPENDENTS Covered Expenses Covered Expenses included under the plan are the charges which you are required to pay for the following services and supplies received while you are insured, for the treatment of non-occupational injuries and diseases, or for vision care. Nursing Home Expenses
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Commencement and Duration of Benefits. Extended Disability Benefits to an eligible applicant shall be for the period commencing the day following the last day of disability included within the period for maximum number of weekly Accident and Sickness benefits, including weeks in which Accident and Sickness benefits were partially or wholly offset because or receipt of Workers’ Compensation Benefits. The maximum period during which Extended Disability Benefits may be payable shall be the number of months by which your full months of seniority at commencement of disability exceeds the maximum number of weeks for which you are entitled to receive Accident and Sickness benefits, but in no event beyond the date of death, the end of the month in which you attain age 65, or the time that you no longer satisfy the disability requirement. If your return to work with the Company does not qualify you for a new period of Accident and Sickness benefits or if you engage in some gainful occupation or employment other than one for which you are reasonably qualified by education, training, or experience, your satisfying of the disability requirement shall not be deemed to end, but your Extended Disability Benefit shall be suspended for the period of the return to work or the period you engage in such occupation or employment. For purposes of applying the maximum period for monthly Extended Disability Benefits, a month in which such benefits are partially or wholly offset by benefit payments from sources listed above, or are suspended, are counted as a full month. Fractions of the first and last month are counted as fractions of a month. The cumulative total number of months during any previous period of eligibility for Extended Disability Benefits, regardless of whether for the same or related disabling condition, reduces the maximum number of monthly benefit payments for which you are otherwise eligible when Extended Disability Benefits again commence. SUPPLEMENTARY HEALTH CARE FOR EMPLOYEES AND DEPENDENTS Covered Expenses Covered Expenses included under the plan are the charges which you are required to pay for the following services and supplies received while you are insured, for the treatment of non-occupational occupa- tional injuries and diseases, or for vision care. Nursing Home ExpensesExpenses 1 Coverage for Nursing Home Care will provide benefits for the patient co-payment expense for each day an insured person, certified as eligible to receive Extended Care Benefits pursuant to the Health Insurance Act of Ontario, is residing in and receiv- ing daily care in an approved Nursing Home as defined in and licensed under the Nursing Homes Act of Ontario or effec- tive February in a Home for the Aged licensed by the Ministry of Community and Social Services under the Homes for the Aged and Rest Homes Act of Ontario. The benefit payment for the patient co-payment expense in any such Home or licensed Home for the Aged shall difference between the daily allowance paid to a Home the Ontario Ministry of Health for Extended Care Services in standard xxxx and the Nursing Home’s daily charge up to the semi-private rate if such accommodation is occupied, as approved by the Ministry of Health. If an insured person receives Extended Care in an approved facility and occupies a private accommodation, the benefit pay- ment of the patient co-payment shall be at the semi-private accommodation daily rate. Benefits shall be provided upon submission of proof satisfacto- ry to the Carrier that an eligible person received Extended Care Service and a payment of an allowance for such care was made to the Nursing Home or Home for the Aged on behalf of such person by the Ontario Ministry of Health for each such day for which benefits under the Program are claimed. No benefit payment shall be paid under this Program to any insured person:
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Samples: Agreement
Commencement and Duration of Benefits. Extended Disability Benefits to an eligible applicant shall be for the period commencing the day following the last day of disability included within the period for maximum number of weekly Accident and Sickness benefits, including weeks in which Accident and Sickness benefits were partially or wholly offset because or receipt of Workers’ Compensation Benefits. The maximum period during which Extended Disability Benefits may be payable shall be the number of months by which your full months of seniority at commencement of disability exceeds the maximum number of weeks for which you are entitled to receive Accident and Sickness benefits, but in no event beyond the date of death, the end of the month in which you attain age 65, or the time that you no longer satisfy the disability requirement. If your return to work with the Company does not qualify you for a new period of Accident and Sickness benefits or if you engage in some gainful occupation or employment other than one for which you are reasonably qualified by education, training, or experience, your satisfying of the disability requirement shall not be deemed to end, but your Extended Disability Benefit shall be suspended for the period of the return to work or the period you engage in such occupation or employment. For purposes of applying the maximum period for monthly Extended Disability Benefits, a month in which such benefits are partially or wholly offset by benefit payments from sources listed above, or are suspended, are counted as a full month. Fractions of the first and last month are counted as fractions of a month. The cumulative total number of months during any previous period of eligibility for Extended Disability Benefits, regardless of whether for the same or related disabling condition, reduces the maximum number of monthly benefit payments for which you are otherwise eligible when Extended Disability Benefits again commence. SUPPLEMENTARY HEALTH CARE FOR EMPLOYEES AND DEPENDENTS Covered Expenses Covered Expenses included under the plan are the charges which you are required to pay for the following services and supplies received while you are insured, for the treatment of non-occupational injuries and diseases, or for vision care. Nursing Home ExpensesExpenses Coverage for Nursing Home Care will provide benefits for the patient payment expense for each day an insured person, certified as eligible to receive Extended Care Benefits pursuant to the Health Insurance Act of Ontario, is residing in and receiving daily care in an approved Nursing Home as defined in and licensed under the Nursing Homes Act of Ontario or effective February in a Home for the Aged licensed by the Ministry of Community and Social Services under the Homes for the Aged and Rest Homes Act of Ontario. The benefit payment for the patient payment expense in any such approved Nursing Home or licensed Home for the Aged shall be the difference between the daily allowance paid to a Nursing Home by the Ontario Ministry of Health for Extended Care Services in a standard xxxx and the Nursing Home's daily charge up to the semi-private rate if such accommodation is occupied, as approved by the Ministry of Health. If an insured person receives Extended Care in an approved facility and occupies a private accommodation, the benefit payment of the patient payment shall be at the semi-private accommodation daily rate. Benefits shall be provided upon submission of proof satisfactory to the Carrier that an eligible person received Extended Care Service and a payment of an allowance for such care was made to the Nursing Home or Home for the Aged on behalf of such
Appears in 1 contract
Samples: Agreement
