Extension of Benefits

If you or a dependent are totally disabled when coverage under this plan terminates, you or your dependent can apply for an Extension of Benefits. An Extension of Benefits provides continued coverage but only for treatment of the condition that caused the disability. To qualify, the disabled person must meet the following conditions:

• The disabled person became totally disabled while covered under this plan (please see "Total Disability" on page 134).
• The disabled person must remain under the continuous care of the attending physician (MD or DO only). Periodic proof of the disability must be submitted during the Extension of Benefits period.

The disabled person must contact the Trust Office for an application. The completed application must then be received by the Trust Office within 60 days from loss of eligibility.

An Extension of Benefits continues for a maximum of 12 months or earlier if the disabled person is no longer considered totally disabled, plan maximums are exhausted or the disabled person is or becomes covered under any other group plan. There is no monthly contribution or other charge for this extension.

If you or a dependent elect an Extension of Benefits in lieu of COBRA coverage, you cannot elect COBRA when the Extension of Benefits terminates.