DEFINITIONS (continued) radiation therapy; or dialysis. Physician means: a person licensed to practice medicine in the jurisdiction where such services are performed; or any other person whose services, according to applicable law, must be treated as Physician’s services for purposes of the Group Policy. Each such person must be licensed in the jurisdiction where they perform the service and must act within the scope of that license. They must also be certified and/or registered if required by such jurisdiction. The term does not include: You; Your Spouse or State-Registered Domestic Partner; or any member of Your immediate family including Your and/or Your Spouse or State-Registered Domestic Partner’s: parents; Child(ren); siblings; grandparents; or grandchildren. Policyholder means WA State Health Care Authority PEBB. Proof means Written evidence satisfactory to Us that a person has satisfied the conditions and requirements for any benefit described in this certificate. When a claim is made for any benefit described in this certificate, Proof must establish: the nature and extent of the loss or condition; Our obligation to pay the claim; and the claimant’s right to receive payment. Proof must be provided at the claimant's expense. Signed means any symbol or method executed or adopted by a person with the present intention to authenticate a record, which is on or transmitted by paper or electronic media which is acceptable to Us and consistent with applicable law. Spouse means Your legal spouse. State-Registered Domestic Partner as defined in state statue and substantially equivalent legal unions from jurisdictions as defined in Washington state statute. We, Us and Our mean MetLife. Written or Writing means a record which is on or transmitted by paper or electronic media which is acceptable to Us and consistent with applicable law. You and Your mean a Certificateholder who is insured under the Group Policy for the insurance described in this certificate. GCERT2024-WSHCA-WA-LIFE-EMPLOYEE1 43
