2005-03-19 Minutes of the Special Called and Pre-Budget Meeting of the La Porte City Council

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SECTION 2-DEFINl110NS ADMINISTRATOR means an mganization which has been :retained by You and approved by Us to. provide claim and adminiStrative services for Yon. AGGREGATE MONTHLY FACTOR means the amount applicable to each Covered Person as shown in the Schedule. . ANNUAL AGGREGATE ATIACIIMENT POINT which is deff'l7)1;ned at the end of the Policy Year and is an amount equal to the product of the Aggregate Monthly Factor times the number of Covered Units for each applicable mo~ during the Policy Year. The Annual Aggregate Attacbment Point is ~ in the ScbedWe and is descnDed in Section 3. This amount is that portion of the Eligible Expenses not covered by this Policy and entirely retained by Yon for the total Number of Covered Units in each Policy Y car. APPLICATION means the application for excess. ~ insurance submitted by Yon to Us in connection with the isswmce oftbis Policy. BENEFIT PERCENTAGE .PAYABLE meaDS the fi1ctor that determines tbeamount of the Maximum Benefit payable to Yon as shown in the Schedule. . Separate benefit percentages may apply to either the Aggregate Excess Loss orto the Specific Excess Loss. . BENEFIT PERIOD means the period of 1ime, as shown in the Schedule, during which a covered expense must be ~ and/or Paid to be eligible for reimbursement under tbis Policy. COVERED MONTH is det~;ne.d :from the Effective Date. Each new Covered Month will begin on the date which corresponds with.the Effective Date. If there is no such date in any applicable month, then the last date of that month will be used. COVERED PERSON means an eligible employee or eligible dependent(s) . COVERED UNIT includes an elig1"b1e employee, c1igible employees and their depCDd~ or such other dP.tinM individuals as specifically agreed upon between Yon ~ US. DJSCLOSURE STATEMENf means the disclosure s1at~e:nt submitted by You to Us in connection with .. .1heissuanceof~PoJicy. ELlc:rRT ."R EXPENSES means the reasonable and cOstomarY charges cowred by the Plan and incmred by a Covered Person while insmcd under the Plan foJ; medically necessary treatmmt, services and/or supplies prescribed by an atteJWing phYsician. ..EF.FECTJVE DATE means tlie date the coverage begins as stated in the Schedule. EXPERIMENTAL or INVESTIGATIVE means care, procedures, ~ent~ or technology that BIC not widely recognized and accepte4 as ~ safe and appropriate fur the iDjury or illness by the medical profession in the U.S., that are jn research or Investigative stage, or coIJdocted for research or similar - putpQSCS; or for which the patient has been asked to give, or has signed, a release or other document, jndjNlfiTlg that the treatment is Experimental or Investigative or other similar term. .In detenn;mng any of the crlteri8 stated above We will rely on recognized medical ~ such as. butnot limited to the American Medical AssociatioP, the Council of Technology Assistance Piogram ~ the SL-2001. 5 (6101)