b. Have been Actively At Work for at least one full day after the end of that 12 months. D. Preexisting Condition For Employee-Paid Insurance This exclusion is waived for Members whose Evidence Of Insurability is approved by us. A separate Preexisting Condition exclusion applies to the Default and Buy Down plans of Employee- Paid Insurance. However, if you increase your Plan selection from the Employer-Paid to the Default Plan or the Buy Down Plan, or from the Buy Down Plan to the Default Plan, and LTD benefits are not payable under the new plan because of the Preexisting Condition exclusion, your claim will be administered as if you had not changed Plans. 1. Definition Preexisting Condition means a mental or physical condition whether or not diagnosed or misdiagnosed: a. For which you have done any of the following: i. Consulted a physician or other licensed medical professional; ii. Received medical treatment, services or advice; iii. Undergone diagnostic procedures, including self-administered procedures; iv. Taken prescribed drugs or medications; b. Which, as a result of any medical examination, including routine examination, was discovered or suspected; With respect to the Buy Down Plan, at any time during the 90-day period just before your insurance becomes effective under the Buy Down Plan; With respect to the Default Plan, at any time during the 90-day period just before your insurance under the Default Plan becomes effective. 2. Exclusion With respect to insurance under the Buy Down Plan: You are not covered for a Disability caused or contributed to by a Preexisting Condition or medical or surgical treatment of a Preexisting Condition unless, on the date you become Disabled, you: a. Have been continuously insured under the Buy Down Plan for 12 months; and b. Have been Actively At Work for at least one full day after the end of that 12 months. With respect to insurance under the Default Plan: You are not covered for a Disability caused or contributed to by a Preexisting Condition or medical or surgical treatment of a Preexisting Condition unless, on the date you become Disabled, you: a. Have been continuously insured under the Default Plan for 12 months; and b. Have been Actively At Work for at least one full day after the end of that 12 months. LT.EX.01X LIMITATIONS A. Care Of A Physician You must be under the ongoing care of a Physician during the Benefit Waiting Period. No LTD Benefits will be paid for any period of Disability when you are not under the ongoing care of a Physician. 377661-B - 16 6/29/2022
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