Special Notes

Your employer determines prerequisites for eligibility, which include minimum hours worked per week, waiting periods before coverage becomes effective, and the amount and method for sharing costs between employee and employer. You may contact your own School District’s Business or Personnel Office for more information.

Health Expense Coverage is expense-incurred coverage only and not coverage for the disease or injury itself. This means that this Plan will pay benefits only for expenses incurred while this coverage is in force. Except as described in any extended benefits provision, no benefits are payable for health expenses incurred before coverage has commenced or after coverage has terminated; even if the expenses were incurred as a result of an accident, injury, or disease which occurred, commenced, or existed while coverage was in force. An expense for a service or supply is incurred on the date the
service or supply is furnished.

When a single charge is made for a series of services, each service will bear a pro rata share of the expense. The pro rata share will be determined by the Plan. Only that pro rata share of the expense will be considered to have been an expense incurred on the date of such service. The Plan may delegate this responsibility to a third party.

The Plan assumes no responsibility for the outcome of any covered services or supplies. The Plan makes no express or implied warranties concerning the outcome of any covered services or supplies.