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Glossary
ACTIVE EMPLOYMENT means you are working for your Employer for earnings that
are paid regularly and that you are performing the material and substantial duties of
your regular occupation. You must be working at least the minimum number of hours
as described under Eligible Group(s) in each plan.
Your work site must be:
your Employer's usual place of business;
an alternative work site at the direction of your Employer, including your home; or
a location to which your job requires you to travel.
Normal vacation is considered active employment.
Temporary and seasonal workers are excluded from coverage.
ELIMINATION PERIOD means a period of continuous disability which must be satisfied
before you are eligible to have your life premium waived by Unum.
EMPLOYEE means a person who is in active employment in the United States with the
Employer.
EMPLOYER means the Employer/Applicant named in the Application For Participation
in the Select Group Insurance Trust, on the first page of the Summary of Benefits and in
all amendments. It includes any division, subsidiary or affiliated company named in the
Summary of Benefits.
EVIDENCE OF INSURABILITY means a statement of your medical history which Unum
will use to determine if you are approved for coverage. Evidence of insurability will be
at Unum's expense.
GAINFUL OCCUPATION means an occupation that within 12 months of your return to
work is or can be expected to provide you with an income that is at least equal to 60%
of your annual earnings in effect just prior to the date your disability began.
GRACE PERIOD means the period of time following the premium due date during
which premium payment may be made.
HOSPITAL OR INSTITUTION means an accredited facility licensed to provide care and
treatment for the condition causing your disability.
INJURY means:
for purposes of Portability, a bodily injury that is the direct result of an accident and
not related to any other cause.
for all other purposes, a bodily injury that is the direct result of an accident and not
related to any other cause. Disability must begin while you are covered under the
plan.
INSURED means any person covered under a plan.
LAYOFF or LEAVE OF ABSENCE means you are temporarily absent from active
employment for a period of time that has been agreed to in advance in writing by your
Employer.
Your normal vacation time or any period of disability is not considered a temporary
layoff or leave of absence.
PAYABLE CLAIM means a claim for which Unum is liable under the terms of the
Summary of Benefits.
PHYSICIAN means:
a person performing tasks that are within the limits of his or her medical license; and
a person who is licensed to practice medicine and prescribe and administer drugs or
to perform surgery; or
a person with a doctoral degree in Psychology (Ph.D. or Psy.D.) whose primary
practice is treating patients; or
a person who is a legally qualified medical practitioner according to the laws and
regulations of the governing jurisdiction.
Unum will not recognize you, or your spouse, children, parents or siblings as a
physician for a claim that you send to us.
PLAN means a line of coverage under the Summary of Benefits.
REGULAR CARE means:
you personally visit a physician as frequently as is medically required, according to
generally accepted medical standards, to effectively manage and treat your disabling
condition(s); and
you are receiving the most appropriate treatment and care which conforms with
generally accepted medical standards, for your disabling condition(s) by a physician
whose specialty or experience is the most appropriate for your disabling condition(s),
according to generally accepted medical standards.
RETAINED ASSET ACCOUNT is an interest bearing account established through an
intermediary bank in the name of your beneficiary, as owner.
SICKNESS means:
for purposes of Portability, an illness, disease or symptoms for which a person, in
the exercise of ordinary prudence, would have consulted a health care provider.
for all other purposes, an illness or disease. Disability must begin while you are
covered under the plan.
TRUST means the policyholder trust named on the first page of the Summary of
Benefits and all amendments to the policy.
WAITING PERIOD means the continuous period of time (shown in each plan) that you
must be in active employment in an eligible group before you are eligible for coverage
under a plan.
WE, US and OUR means Unum Life Insurance Company of America.
YOU means an employee who is eligible for Unum coverage.
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