Common use of Request for Non Listed Benefits Clause in Contracts

Request for Non Listed Benefits. Once You have met all of the conditions of the Eligibility For The Payment of Benefits provision, You may request a Request for Non Listed Benefits. The Request for Non Listed Benefits will include a Plan of Care mutually agreed upon by Your Physician (if appropriate and/or You desire), the Care Coordination Provider Agency, and Us. We will pay benefits in accordance with the Request for Non Listed Benefits. The following additional terms apply under this Benefit: (a) Except as We expressly agree in the Request for Non Listed Benefits, Your rights and Ours will be governed by all of the Policy terms; (b) All of the benefits We agree to pay under the Request for Non Listed Benefits must be for Qualified Long-Term Care Services as defined in Internal Revenue Code Section 7702B(c); and (c) We may agree with You only for a set period of time (for example, one year). At the end of that period of time, the Request for Non Listed Benefits will end unless We agree with You to renew it. You may terminate a Request for Non Listed Benefits at any time, by giving Us at least [15] days advance written notice of the termination. (d) After a Request for Non Listed Benefits terminates, We will resume paying benefits for expenses You incur in accordance with all of the terms of the Policy. (e) Requests for Non Listed Benefits are necessarily unique to each insured, and We reserve the right to decline to agree to any such request, or to any proposed term of a Request for Non Listed Benefits, but We will consider all Requests for Non Listed Benefits on a non- discriminatory basis. (f) The Elimination Period applies to this Benefit. Any amounts We pay under this Benefit will be counted against the Policy Lifetime Maximum Benefit.

Request for Non Listed Benefits. Once You have met all of the conditions of the Eligibility For The Payment of Benefits provision, You may request a Request for Non Listed Benefits. The Request for Non Listed Benefits will include a Plan of Care mutually agreed upon by Your Physician (if appropriate and/or You desire)If We agree, the Care Coordination Provider Agency, and Us. We will pay benefits in accordance with the Request for Non Listed BenefitsBenefits provision of the policy. The following additional terms apply under this Benefit: (a) Except as We expressly agree in the Request for Non Listed Benefits, Your rights and Ours will be governed by all of the Policy terms;. (b) All of the benefits We agree to pay under the Request for Non Listed Benefits must be for Qualified Long-Term Care Services as defined in Internal Revenue Code Section 7702B(c); and. (c) We may agree with You only for a set period of time (for example, one year). At the end of that period of time, the Request for Non Listed Benefits will end unless We agree with You to renew it. You may terminate a Request for Non Listed Benefits at any time, by giving Us at least [15] 15 days advance written notice of the termination. (d) After a Request for Non Listed Benefits terminates, We will resume paying benefits for expenses You incur in accordance with all of the terms of the Policy. (e) Requests for Non Listed Benefits are necessarily unique to each insured, and We reserve the right to decline to agree to any such request, or to any proposed term of a Request for Non Listed Benefits, but We will consider all Requests requests for a Request for Non Listed Benefits on a non- non-discriminatory basis. (f) The Elimination Period applies to this Benefit. Any amounts We pay under this Benefit will be counted against the Policy Lifetime Maximum Benefit.

Request for Non Listed Benefits. Once You have met all of the conditions of the Eligibility For The Payment of Benefits provision, You may request a Request for Non Listed Benefits. The Request for Non Listed Benefits will include a Plan of Care mutually agreed upon by Your Physician (if appropriate and/or You desire), the Care Coordination Provider Agency, and Us. We will pay benefits in accordance with the Request for Non Listed Benefits. The following additional terms apply under this Benefit: (a) Except as We expressly agree in the Request for Non Listed Benefits, Your rights and Ours will be governed by all of the Policy terms; (b) All of the benefits We agree to pay under the Request for Non Listed Benefits must be for Qualified Long-Term Care Services as defined in Internal Revenue Code Section 7702B(c); and (c) We may agree with You only for a set period of time (for example, one year). At the end of that period of time, the Request for Non Listed Benefits will end unless We agree with You to renew it. You may terminate a Request for Non Listed Benefits at any time, by giving Us at least [(15] ) days advance written notice of the termination. (d) After a Request for Non Listed Benefits terminates, We will resume paying benefits for expenses You incur in accordance with all of the terms of the Policy. (e) Requests for Non Listed Benefits are necessarily unique to each insured, and We reserve the right to decline to agree to any such request, or to any proposed term of a Request for Non Listed Benefits, but We will consider all Requests for Non Listed Benefits on a non- discriminatory basis. (f) The Elimination Period applies to this Benefit. Any amounts We pay under this Benefit will be counted against the Policy Lifetime Maximum Benefit.

Request for Non Listed Benefits. Once You have met all of the conditions of the Eligibility For The Payment of Benefits provision, You may request a Request for Non Listed Benefits. The Request for Non Listed Benefits will include a Plan of Care mutually agreed upon by Your Physician (if appropriate and/or You desire)If We agree, the Care Coordination Provider Agency, and Us. We will pay benefits in accordance with the Request for Non Listed BenefitsBenefits provision of the Policy. The following additional terms apply under this Benefit: (a) Except as We expressly agree in the Request for Non Listed Benefits, Your rights and Ours will be governed by all of the Policy terms;. (b) All of the benefits We agree to pay under the Request for Non Listed Benefits must be for Qualified Long-Term Care Services as defined in Internal Revenue Code Section 7702B(c); and. (c) We may agree with You only for a set period of time (for example, one year). At the end of that period of time, the Request for Non Listed Benefits will end unless We agree with You to renew it. You may terminate a Request for Non Listed Benefits at any time, by giving Us at least [15] days advance written notice of the termination. (d) After a Request for Non Listed Benefits terminates, We will resume paying benefits for expenses Eligible Charges You incur in accordance with all of the terms of the Policy. (e) Requests for Non Listed Benefits are necessarily unique to each insured, and We reserve the right to decline to agree to any such request, or to any proposed term of a Request for Non Listed Benefits, but We will consider all Requests requests for a Request for Non Listed Benefits on a non- non-discriminatory basis. (f) The Elimination Period applies to this Benefit. Any amounts We pay under this Benefit will be counted against the Policy Lifetime Maximum Benefit.

Request for Non Listed Benefits. Once You have met all of the conditions of the Eligibility For The Payment of Benefits provision, You may request a Request for Non Listed Benefits. The Request for Non Listed Benefits will include a Plan of Care mutually agreed upon by Your Physician (if appropriate and/or if You desire), the Care Coordination Provider Agency, Agency and Us. We will pay benefits in accordance with the Request for Non Listed Benefits. The following additional terms apply under this Benefit: (a) Except as We expressly agree in the Request for Non Listed Benefits, Your rights and Ours will be governed by all of the Policy terms; (b) All of the benefits We agree to pay under the Request for Non Listed Benefits must be for Qualified Long-Term Care Services as defined in Internal Revenue Code Section 7702B(c); and (c) We may agree with You only for a set period of time (for example, one year). At the end of that period of time, the Request for Non Listed Benefits will end unless We agree with You to renew it. You may terminate a Request for Non Listed Benefits at any time, by giving Us at least [(15] ) days advance written notice of the termination. (d) After a Request for Non Listed Benefits terminates, We will resume paying benefits for expenses You incur in accordance with all of the terms of the Policy. (e) Requests for Non Listed Benefits are necessarily unique to each insured, and We reserve the right to decline to agree to any such request, or to any proposed term of a Request for Non Listed Benefits, but We will consider all Requests for Non Listed Benefits on a non- discriminatory basis. (f) The Elimination Period applies to this Benefit. Any amounts We pay under this Benefit will be counted against the Policy Lifetime Maximum Benefit.