Common use of BENEFITS AFTER TERMINATION OF COVERAGE Clause in Contracts

BENEFITS AFTER TERMINATION OF COVERAGE. 1. If a Member is continuously disabled on the day this Agreement is terminated by the Plan, benefits will be provided under the terms of this Agreement while the Member is so continuously disabled. For purposes of this Subsection, continuously disabled means that the Member is an Inpatient in a Facility Provider. Continuation of benefits under this Paragraph will not be provided if this Agreement is terminated by the Plan for fraud or intentional misrepresentation of a material fact. Benefits will be provided, for charges Incurred for the inpatient confinement, until the earlier of: a. the Maximum level of benefits has been reached; or b. the end of the Benefit Period. Any such continuation of benefits after the date this Agreement is terminated is conditioned upon the continuous inpatient confinement of the Member and the providing of documentation as required by the Plan which evidences such continued inpatient confinement. 2. If a Member is pregnant on the date coverage terminates, except for non-payment of premium, fraud or intentional misrepresentation of a material fact, benefits will be provided for Covered Services related to that pregnancy until the Maximum amount of benefits has been paid. 3. If a newborn child is not otherwise eligible for continuing benefits beyond the first thirty- one (31) days as a Dependent under this or any other current agreement, benefits may be continued for such child if, within said thirty-one (31) day period, the Member applies for and is issued an Agreement for said newborn either individually or as a Dependent, subject to Paragraph 1 of this Subsection. If this Agreement terminates as the result of non-payment of premiums, fraud or intentional misrepresentation of a material fact, the liability of the Plan shall cease as of the date of such termination, and no benefits will be provided for newborn care Incurred after that date, subject to Paragraph 1 of this Subsection.

BENEFITS AFTER TERMINATION OF COVERAGE. 1. If a Member is continuously disabled on the day this Agreement is terminated by the Plan, benefits will be provided under the terms of this Agreement while the Member is so continuously disabled. For purposes of this Subsection, continuously disabled means that the Member is an Inpatient in a Facility Provider. Continuation of benefits under this Paragraph will not be provided if this Agreement is terminated by the Plan for fraud or intentional misrepresentation of a material fact. Benefits will be provided, for charges Incurred for the inpatient confinement, until the earlier of: a. the Maximum level of benefits has been reached; or b. the end of the Benefit Period. Any such continuation of benefits after the date this Agreement is terminated is conditioned upon the continuous inpatient confinement of the Member and the providing of documentation as required by the Plan which evidences such continued inpatient confinement. 2. If a Member is pregnant on the date coverage terminates, except for non-payment of premium, fraud or intentional misrepresentation of a material fact, benefits will be provided for Covered Services related to that pregnancy until the Maximum amount of benefits has been paid. 3. If a newborn child is not otherwise eligible for continuing benefits beyond the first thirty- one (31) days as a Dependent under this or any other current agreement, benefits may be continued for such child if, within said thirty-one (31) day period, the Member applies for and is issued an Agreement for said newborn either individually or as a Dependent, subject to Paragraph 1 1. of this Subsection. 4. If this Agreement terminates as the result of non-payment of premiums, fraud or intentional misrepresentation of a material fact, the liability of the Plan shall cease as of the date of such termination, and no benefits will be provided for newborn care Incurred after that date, subject to Paragraph 1 1. of this Subsection.

BENEFITS AFTER TERMINATION OF COVERAGE. 1. If If a Member is continuously disabled on the day this Agreement is terminated by the Plan, benefits will be provided under the terms of this Agreement while the Member is so continuously disabled. For purposes of this Subsection, continuously disabled means that the Member is an Inpatient in a Facility Provider. Continuation of benefits under this Paragraph will not be provided if this Agreement is terminated by the Plan for fraud or intentional misrepresentation of a material fact. Benefits will be provided, for charges Incurred for the inpatient confinement, until the earlier of: a. the Maximum level of benefits has been reached; or b. the end of the Benefit Period. Any such continuation of benefits after the date this Agreement is terminated is conditioned upon the continuous inpatient confinement of the Member and the providing of documentation as required by the Plan which evidences such continued inpatient confinement. 2. If a Member is pregnant on the date coverage terminates, except for non-payment of premium, fraud or intentional misrepresentation of a material fact, benefits will be provided for Covered Services related to that pregnancy until the Maximum amount of benefits has been paid. 3. If a newborn child is not otherwise eligible for continuing benefits beyond the first thirty- one (31) days as a Dependent under this or any other current agreement, benefits may be continued for such child if, within said thirty-one (31) day period, the Member applies for and is issued an Agreement for said newborn either individually or as a Dependent, subject to Paragraph 1 B.1. of this Subsection. If this Agreement terminates as the result of non-payment of premiums, fraud or intentional misrepresentation of a material fact, the liability of the Plan shall cease as of the date of such termination, and no benefits will be provided for newborn care Incurred after that date, subject to Paragraph 1 B.1 of this Subsection.