Pre-Existing Conditions Limitation

A Pre-Existing Condition is an injury or illness for which you or your dependent receives medical care, medical treatment, including the prescribing of prescription drugs, or for which a diagnosis was made in the six (6) month period prior to the effective date of your coverage or the effective date of your dependent's coverage.

The Plan will make no payment towards an expense incurred related to a Pre-Existing Condition until the earlier of (1) the end of a continuous six (6) month period during which you or your covered dependent do not receive care or treatment for the Pre-Existing Condition or (2) the end of a continuous twelve (12) month period measured from the effective date of coverage.

This Pre-Existing Conditions limitation will apply to all plan participants and their dependents upon their initial eligibility for plan benefits and will reapply to all Plan participants and dependents upon reinstatement of their plan eligibility following a break in coverage for a period of six (6) consecutive months or more.

This limitation will be waived in whole or in part upon presentation of a Certificate of Creditable Coverage, providing a break of less than sixty-three (63) days existed between the cessation of coverage under a prior plan and the commencement of eligibility under this plan.  (Contact the Fund Office for more information.)

The Pre-Existing Conditions limitation does not apply to the Life Insurance, Accidental Death and Dismemberment or Weekly Disability benefits.  Further, this provision will not apply to covered maternity expenses incurred by a participant or spouse or to covered expenses of a newborn or a newly adopted child under age eighteen (18), if enrolled within thirty (30) days of adoption.