DEDUCTIBLE: The Deductible is an amount of Eligible Charges that a Covered Person must incur before Major Medical Benefits will be payable. The Deductible will be met when Eligible Charges equal the Individual Deductible shown on your Schedule of Benefits. The Covered Person must meet a new Deductible each calendar year. A calendar year begins on January 1^st and ends on December 31^st of that same year.

The Deductible will be applied separately to each Covered Person's Eligible Charges except when the Family Deductible (shown on your Schedule of Benefits) has been met by the Family Unit with Eligible Charges used toward any Individual Deductibles. In the event that the Family Deductible is met, all members of the Family Unit will be in a Benefit Period; and no further Deductible will be required during that calendar year, except for Inpatient Hospital Deductibles or Emergency Room Deductibles, if applicable. (See your Schedule of Benefits to determine if your Plan has a Family Aggregate Deductible.)

Common Accident Deductible: When two (2) or more family members are injured in the same accident, only one (1) Deductible will be applied to the Eligible Charges incurred as a result of that accident. If your Plan has an Accident Benefit, this applies once that benefit has been exhausted. (See your Schedule of Benefits to determine if your Plan has an Accident Benefit.)

BENEFIT PERIOD: A Covered Person's Benefit Period begins when the Covered Person has incurred, during the calendar year, Eligible Charges equal to the Deductible. A Covered Person's Benefit Period ends on the earliest of the following dates:

1. the last day of the calendar year;
2. the day such Covered Person's Coverage provided by the Plan ends; or
3. the day the Lifetime Maximum Benefit is paid.

BENEFIT: The Plan will pay Major Medical Benefits if, during a Benefit Period, a Covered Person incurs charges which:

1. are not excluded by the terms of the Plan and are covered by the Plan; and
2. are not paid under any other terms of the Plan; or
3. are not paid by any other Plan or Third Party obligation (unless Subrogation is in force).

The amount of Benefit to be paid after the Deductible will be equal to:

1. the Benefit Percentage (shown on your Schedule of Benefits) multiplied by the Usual and Customary allowance for that diagnosis and procedure; or
2. the total Eligible Charges which are:
(a) in excess of the Deductible and the Out-of-Pocket Maximum (see your Schedule of Benefits); and
(b) incurred during the Benefit Period.

MAXIMUM BENEFITS: The Benefits paid for a Covered Person's Illness and Injuries will not exceed the Maximums per Covered Person shown on your Schedule of Benefits.

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