| |
| Who is eligible for coverage? | All members of the American Enterprise Association who: - are under age 65;
- are in active service; and
- have not been hospital confined more than once in the 12 months preceding enrollment and are not scheduled for a hospital confinement at the time of enrollment
are eligible to enroll in the AEA limited accident & sickness plans. Insured members may also enroll their spouse and dependent children (under age 19 or under age 26 if a full-time student); dependents must satisfy the above requirements as well.
“Active service” means that the person is actively at work for his or her employer or, if not employed, able to engage in substantially all of the usual activities of a person in good health of like age and sex and not confined in a hospital or other institution or at home under a doctor’s care. |
| |
| How do I enroll? | Once you’ve met the eligibility requirements above, click the Enroll link on the menu bar and follow the instructions. |
| |
| When is coverage effective? | Coverage will be effective the 1st of the month following receipt of your enrollment form provided that the full premium is also received. |
| |
Are There Any
Limitations On
Pre-Existing
Conditions? | A “pre-existing condition” is defined as any injury or sickness for which diagnosis has been made, treatment has been recommended, treatment has been rendered, or expenses have been incurred within 6 months prior to becoming covered under the plan. It includes any condition manifesting itself in symptoms which would cause an ordinarily prudent person to seek medical advice, diagnosis, care or treatment. Benefits under the Hospitalization or Surgery provisions of the plan are not payable for a “pre-existing condition” for the first 6 months following an insured’s effective date. |
| |
| Termination Provisions | Coverage will remain in effect as long as premium is paid when due; the member and dependents remain eligible; and the policy remains in effect. Note that members and spouses who reach age 65 may continue coverage under the plan up to age 70; dependent children are no longer eligible upon reaching age 19 (or age 26 if a full-time student). Coverage will terminate upon reaching these ages. |
| |
