Exec-U-Care provides health care reimbursement coverage to supplement base medical insurance that an employer makes available
to its employees. Benefits will not exceed:
the Per Occurrence Limit for Covered Health Care Expenses incurred as a result of any one condition, diagnosis,
illness, injury, period of confinement, or course of dental treatment during any calendar year; or
the Maximum Health Care Benefit for Covered Health Care Expenses incurred by the Insured Person and any
Dependents combined during any calendar year.
The Per Occurrence Limit and Maximum Health Care Benefit are shown in the Schedule of Benefits of the certificate.
PER OCCURRENCE LIMIT. Covered Health Care Expenses incurred by the same Insured Person or
Dependent during any one calendar year will be subject to the Per Occurrence Limit, if such expenses result from:
the same or related diagnosis, condition, illness or injury. Treatment of all injuries sustained by any one
Insured Person or Dependent, as a result of the same accident, will be considered one occurrence.
the same or related surgical procedures. Two or more surgical procedures will be considered one
occurrence if performed bilaterally, on two or more phalanges, or in the same orifice or operative field; unless
the procedures are performed during separate operative sessions and are due to unrelated conditions.
the same period of confinement in a hospital, skilled nursing care facility or other health care facility. Two or
more confinements will be considered part of the same period of confinement, whether they are in the same or
different health care facilities; unless they are separated by at least 30 consecutive days without confinement.
the same course of dental treatment. A course of dental treatment is a series of dental, periodontal or
orthodontic services prescribed by a dentist to correct a specific dental condition. Each series of such dental,
periodontal, or orthodontic services will be considered one occurrence; regardless of the number of teeth, quadrants,
procedures, prosthodontics, sessions or adjustments involved.
Exec-U-Care is underwritten by The Lincoln National Life Insurance Company, 8801 Indian Hills Drive, Omaha, NE 68114. 800-552-1213 http://www.LincolnFinancial.com/
