Common use of Major Medical Expense Limit Benefit Clause in Contracts

Major Medical Expense Limit Benefit. A provision will be to the major medical expense benefit section of the Plan to the effect that if in a calendar year a covered employee or dependent has incurred expenses not otherwise reimbursed under the Plan which aggregate $2,000 including the individual's cash deductible and (ii) the individual's 20% share of coÄ insurance under the hospital miscellaneous benefits and major medical expense benefit provisions, all further "covered expenses" of that individual in that calendar year which would otherwise come under the 80%/20% coinsurance proviÄ sions will instead be reimbursed under the major medical expense benefit provisions on a 100% basis. The four exclusions in the major medical expense benefit section will apply to this benefit. the The

Major Medical Expense Limit Benefit. A provision will be added to the major medical expense benefit section of the Plan to the effect that if in a calendar year a covered employee or dependent has incurred expenses not otherwise reimbursed under the Plan which aggregate $2,000 including the (i)the individual's cash deductible and (ii) the individual's 20% share of coÄ co-insurance under the hospital miscellaneous benefits and major medical expense benefit expensebenefit provisions, all further "covered expenses" of that individual in that calendar thatcalendar year which would otherwise come under the 80%/20% coinsurance proviÄ sions provisions will instead be reimbursed under the major medical expense benefit provisions on a 100% basis. The four exclusions in the major medical expense benefit section will apply to this benefit. the The.