The words shown below have specific meanings when used in the Contract. Please read these definitions carefully. Throughout the Contract, these defined terms appear with their initial letters capitalized. They will help Members understand what services and supplies and benefits are provided.

ALCOHOL ABUSE: Abuse of or addiction to alcohol.

AMBULANCE: A certified transportation vehicle for transporting ill or Injured people that contains all life-saving equipment and staff as required by applicable state and local law.

AMBULATORY SURGICAL CENTER: A Facility mainly engaged in performing Outpatient Surgery. It must:

a) be staffed by Practitioners and Nurses, under the supervision of a Practitioner;

b) have operating and recovery rooms;

c) be staffed and equipped to give emergency care; and

d) have written back-up arrangements with a local Hospital for emergency care.

It must carry out its stated purpose under all relevant state and local laws and be either:

a) accredited for its stated purpose by either the Joint Commission or the Accreditation Association for ambulatory care; or

b) approved for its stated purpose by Medicare.

A Facility is not an Ambulatory Surgical Center, for the purpose of the Contract, if it is part of a Hospital.

ANNIVERSARY DATE: The date which is one year from the Effective Date of the Contract and each succeeding yearly date thereafter.

BIRTHING CENTER: A Facility which mainly provides care and treatment for women during uncomplicated pregnancy, routine full-term delivery, and the immediate post-partum period. It must:

a) provide full-time Skilled Nursing Care by or under the supervision of Nurses;

b) be staffed and equipped to give emergency care; and

c) have written back-up arrangements with a local Hospital for emergency care.

It must:

a) carry out its stated purpose under all relevant state and local laws; or

b) be approved for its stated purpose by the Accreditation Association for Ambulatory Care; or

c) be approved for its stated purpose by Medicare.

A Facility is not a Birthing Center, for the purpose of the Contract, if it is part of a Hospital.

CALENDAR YEAR: Each successive twelve-month period starting on January 1 and ending on December 31.

CASH DEDUCTIBLE or DEDUCTIBLE: The amount of Covered Charges that a Member must pay before the Contract pays any benefits for such charges. Cash Deductible does not include Coinsurance, Copayments, and Non-Covered Services and Supplies and Non-Covered Charges. See the Cash Deductible section of the Contract for details.

COINSURANCE: The percentage of Covered Services or Supplies or the percentage of Covered Charges, as applicable, that must be paid by a Member. Coinsurance does not include the Cash Deductible, Copayments, or Non-Covered Services and Supplies and Non-Covered Charges.

CONTRACT: The Contract, including the application and any riders, amendments or endorsements, between the Contract Holder and the insurance company.

CONTRACT HOLDER: Employer or organization which purchased the Contract.

COPAYMENT: A specified dollar amount which Member must pay for certain Covered Services or Supplies or Covered Charges. NOTE: The Emergency Room Copayment, if applicable, must be paid in addition to any other Copayments, Cash Deductible, and Coinsurance.

COSMETIC SURGERY or PROCEDURE: Any surgery or procedure which involves physical appearance, but which does not correct or materially improve a physiological function and is not Medically Necessary and Appropriate.

COVERED CHARGES: Reasonable and Customary charges for the types of services and supplies described in the Covered Charges and Covered Charges with Special Limitations sections of the Contract, as applicable to Out-of-Network benefits. The services and supplies must be:

a) furnished or ordered by a health care Provider; and

b) Medically Necessary and Appropriate to diagnose or treat an Illness or Injury.

A Covered Charge is incurred on the date the service or supply is furnished. Subject to all of the terms of the Contract, benefits are payable for Covered Charges incurred by a Member while he or she is covered by the Contract. Read the entire Contract to find out what is limited or excluded.

COVERED PARTICIPANT: A person who meets all applicable eligibility requirements, enrolls hereunder by making application, and for whom premium has been received.

COVERED SERVICES or SUPPLIES: The types of services and supplies described in the Covered Services and Supplies section of the Contract, as applicable to In-Network benefits. Read the entire Contract to find out what is limited or excluded.

CUSTODIAL CARE: Any service or supply, including room and board, which:

a) is furnished mainly to help a Member meet a Member's routine daily needs; or

b) can be furnished by someone who has no professional health care training or skills.

Even if a Member is in a Hospital or other Facility, the service is custodial and not medical if it meets the criteria above.

DEPENDENT: Your:

a) legal spouse;

b) unmarried Dependent child who is under age 19; and

c) unmarried Dependent child from age 19 until his or her 23rd birthday, who is enrolled as a full-time student at an accredited school. Periodic proof of a Dependent child's status as a full-time student may be required.

Under certain circumstances, an incapacitated child is also a Dependent. See the Eligibility section of the Contract. Your "unmarried Dependent child" includes Your legally adopted child, Your step-child if such step-child depends on You for most of his or her support and maintenance, and children under a court appointed guardianship. A child is treated as as legally adopted from the time the child is placed in the home for purposes of adoption. Such a child will be treated this way whether or not a final adoption order is ever issued. A Dependent is not a person who is on active duty in any armed force. A Dependent is not a person who is covered by the Contract as a Participant. At is own discretion, the insurance company can require proof that a person meets the definition of a Dependent.

DEPENDENT'S ELIGIBILITY DATE: The later of:

a) Your Eligibility Date; or

b) the date the person first becomes a Dependent.

DIAGNOSTIC SERVICES: Procedures ordered by a Provider because of specific symptoms to diagnose a specific condition or disease. Some examples include, but are not limited to:

a) radiology, ultrasound, and nuclear medicine;

b) laboratory and pathology; and

c) EKGs, EEGs, and other electronic diagnostic tests.

With respect to Out-of-Network benefits, except as allowed under the Preventive Care Covered Charge, Diagnostic Services do not include procedures ordered as part of a routine or periodic physical examination or screening examination.

DISCRETION / DETERMINATION / DETERMINE: The insurance company's sole right to make a decision or determination. The decision will be applied in a reasonable and non-discriminatory manner.

DURABLE MEDICAL EQUIPMENT: Equipment judged by the insurance company to be:

a) designed and able to withstand repeated use;

b) used primarily and customarily for a medical purpose;

c) is generally not useful to a Member in the absence of an Illness or Injury; and

d) suitable for use in the home.

Durable Medical Equipment includes, but is not limited to: apnea monitors, breathing equipment, hospital-type beds, walkers, and wheelchairs.

Among other things, Durable Medical Equipment does not include:

adjustments made to vehicles, air conditioners, air purifiers, humidifiers, dehumidifiers, elevators, ramps, stair glides, Emergency Alert equipment, handrails, heat appliances, improvements made to a Member's home or place of business, waterbeds, whirlpool baths, exercise and massage equipment.

EFFECTIVE DATE: The date on which coverage begins under the Contract for a Member.

PARTICIPANT'S ELIGIBILITY DATE:

a) the date of Enrollment; or

b) the day after any applicable waiting period ends.

EXPERIMENTAL or INVESTIGATIONAL:

Services or supplies which the insurance company determines are:

a) not of proven benefit for the particular diagnosis or treatment of a Member's particular condition; or

b) not generally recognized by the medical community as effective or appropriate for the particular diagnosis or treatment of a Member's particular condition; or

c) provided or performed in special settings for research purposes or under a controlled environment or clinical protocol. Unless otherwise required by law with respect to drugs which have been prescribed for the treatment of a type of cancer for which the drug has not been approved by the United States Food and Drug Administration (FDA), We will not cover any services or supplies, including treatment, procedures, drugs, biological products or medical devices or any hospitalizations in connection with Experimental or Investigational services or supplies. We will also not cover any technology or any hospitalization in connection with such technology if such technology is obsolete or ineffective and is not used generally by the medical community for the particular diagnosis or treatment of a Member's particular condition.

Governmental approval of a technology is not necessarily sufficient to render it of proven benefit or appropriate or effective for a particular diagnosis or treatment of a Member's particular condition, as explained below. The following five criteria in Determining whether services or supplies are Experimental or Investigational:

1. any medical device, drug, or biological product must have received final approval to market by the United States Food and Drug Administration (FDA) for the particular diagnosis or condition. Any other approval granted as an interim step in the FDA regulatory process, e.g., an Investigational Device Exemption or an Investigational New Drug Exemption, is not sufficient. Once FDA approval has been granted for a particular diagnosis or condition, use of the medical device, drug or biological product for another diagnosis or condition will require that one or more of the following established reference compendia recognize the usage as appropriate medical treatment:

a) The American Medical Association Drug Evaluations;

b) The American Hospital Formulary Service Drug Information; or

c) The United States Pharmacopoeia Drug Information.

As an alternative to such recognition in one or more of the compendia, the usage of the drug will be recognized as appropriate if it is recommended by a clinical study and recommended by a review article in a major peer-reviewed professional journal. A medical device, drug, or biological product that meets the above tests will not be considered Experimental or Investigational. In any event, any drug which the Food and Drug Administration has determined to be contraindicated for the specific treatment for which the drug has been prescribed will be considered Experimental or Investigational;

2. conclusive evidence from the published peer-reviewed medical literature must exist that the technology has a definite positive effect on health outcomes; such evidence must include well-designed investigations that have been reproduced by non-affiliated authoritative sources, with measurable results, backed up by the positive endorsements of national medical bodies or panels regarding scientific efficacy and rationale;

3. demonstrated evidence as reflected in the published peer-reviewed medical literature must exist that over time the technology leads to improvement in health outcomes, i.e., the beneficial effects outweigh any harmful effects;

4. proof as reflected in the published peer-reviewed medical literature must exist that the technology is at least as effective in improving health outcomes as established technology, or is usable in appropriate clinical contexts in which established technology is not employable; and

5. proof as reflected in the published peer-reviewed medical literature must exist that improvements in health outcomes, as defined in paragraph 3, is possible in standard conditions of medical practice, outside clinical investigatory settings.

EXTENDED CARE CENTER: See Skilled Nursing Center.

FACILITY: A place which:

a) is properly licensed, certified, or accredited to provide health care under the laws of the state in which it operates; and

b) provides health care services which are within the scope of its license, certificate or accreditation and are covered by the Contract.

FULL-TIME: A normal work week of 25 or more hours. Work must be at the your regular place of business or at another place to which an individual must travel to perform his or her regular duties for his or her full and normal work hours.

GOVERNMENT HOSPITAL: A Hospital operated by a government or any of its subdivisions or agencies, including, but not limited to: a Federal, military, state, county or city Hospital.

HEALTH BENEFITS PLAN: Any hospital and medical expense insurance policy or certificate; health, hospital, or medical service corporation contract or certificate; or health maintenance organization subscriber contract or certificate delivered or issued for delivery in New Jersey by any carrier to an Employer group pursuant to section 3 of P.L. 1992, c. 162 (C. 17B: 27A-19). Health Benefits Plan excludes the following plans, policies or contracts: accident only, credit, disability, long term care, coverage for Medicare services pursuant to a contract with the United States government, Medicare supplement, dental only, prescription only, or vision only, insurance issued as a supplement to liability insurance, coverage arising out of a workers' compensation or similar law, hospital confinement or other Supplemental Limited Benefit Insurance coverage, automobile medical payment insurance, or personal injury protection coverage issued pursuant to P.L. 1972, c. 70 (C. 39:6A-1 et seq.).

HOME HEALTH AGENCY: A Provider which provides Skilled Nursing Care for Ill or Injured people in their home under a home health care program designed to eliminate Hospital stays. It must be licensed by the state in which it operates, or it must be certified to participate in Medicare as a Home Health Agency.

HOSPICE: A Provider which provides palliative and supportive care for terminally Ill or terminally Injured people under a hospice care program. It must carry out its stated purpose under all relevant state and local laws, and it must either:

a) be approved for its stated purpose by Medicare; or

b) be accredited for its stated purpose by either the Joint Commission or the National Hospice Organization.

HOSPITAL: A Facility which mainly provides Inpatient care for Ill or Injured people. It must carry out its stated purpose under all relevant state and local laws, and it must either:

a) be accredited as a hospital by the Joint Commission; or

b) be approved as a Hospital by Medicare.

Among other things, a Hospital is not a convalescent, rest or nursing home or Facility, or a Facility, or part of it, which mainly provides Custodial Care, educational care or rehabilitative care. A Facility for the aged or substance abusers is not a Hospital.

ILLNESS: A sickness or disease suffered by a Member. A Mental or Nervous Condition is not an Illness.

INITIAL DEPENDENT: Those eligible Dependents You have at the time You first become eligible for Participant coverage. If at the time You do not have any eligible Dependents, but later acquire them, the first eligible Dependents You acquire are Your Initial Dependents.

INJURY: Damage to a Member's body due to accident, and all complications arising from that damage.

INPATIENT: Member, if physically confined as a registered bed patient in a Hospital or other health care Facility; or services and supplies provided in such a setting.

JOINT COMMISSION: The Joint Commission on the Accreditation of Health Care Organizations.

LATE ENROLLEE: An eligible Participant or Dependent who requests enrollment under the Contract more than 30 days after first becoming eligible. However, an eligible Participant or Dependent will not be considered a Late Enrollee under certain circumstances. See the Participant Coverage and Dependent Coverage subsections of the Eligibility section of the Contract.

MEDICAID: The health care program for the needy provided by Title XIX of the United States Social Security Act, as amended from time to time.

MEDICAL EMERGENCY: The sudden, unexpected onset, due to Illness or Injury, of a medical condition that is expected to result in either a threat to life or to an organ, or a body part not returning to full function. Examples of Medical Emergencies include but are not limited to heart attacks, strokes, convulsions, serious burns, obvious bone fractures, wounds requiring sutures, poisoning, and loss of consciousness. A near-term delivery is not a Medical Emergency.

MEDICALLY NECESSARY AND APPROPRIATE: Services or supplies provided by a health care Provider that the insurance company determine to be:

a) necessary for the symptoms and diagnosis or treatment of the condition, Illness or Injury;

b) provided for the diagnosis or the direct care and treatment of the condition, Illness or Injury;

c) in accordance with generally accepted medical practice;

d) not for a Member's convenience;

e) the most appropriate level of medical care that a Member needs; and

f) furnished within the framework of generally accepted methods of medical management currently used in the United States.

MEDICARE: Parts A and B of the health care program for the aged and disabled provided by Title XVIII of the United States Social Security Act, as amended from time to time.

MEMBER: An eligible person who is covered under the Contract (includes Covered Participant's and covered Dependents, if any).

MENTAL HEALTH CENTER: A Facility that mainly provides treatment for people with mental health problems. It will be considered such a place if it carries out its stated purpose under all relevant state and local laws, and it is either:

a) accredited for its stated purpose by the Joint Commission;

b) approved for its stated purpose by Medicare; or

c) accredited or licensed by the State of New Jersey to provide mental health services.

MENTAL or NERVOUS CONDITION: A condition which manifests symptoms which are primarily mental or nervous, for which the primary treatment is psychotherapy or psychotherapeutic methods or psychotropic medication regardless of any underlying physical cause. A Mental or Nervous Condition includes, but is not limited to: psychoses, neurotic and anxiety disorders, schizophrenic disorders, affective disorders, personality disorders, and psychological or behavioral abnormalities associated with transient or permanent dysfunction of the brain or related neurohormonal systems. In determining whether or not a particular condition is a Mental or Nervous Condition, the insurance company may refer to the current edition of the Diagnostic and Statistical manual of Mental Conditions of the American Psychiatric Association.

IN-NETWORK PROVIDER: A Provider who has an agreement, directly or indirectly with the insurance company to provide Covered Services or Supplies.

NEWLY ACQUIRED DEPENDENT: An eligible Dependent You acquire after You already have coverage in force for Initial Dependents.

NICOTINE DEPENDENCE TREATMENT: "Behavioral Therapy," as defined below, and Prescription Drugs which have been approved by the U.S. Food and Drug Administration for the management of nicotine dependence. For the purpose of this definition, covered "Behavioral Therapy" means motivation and behavior change techniques which have been demonstrated to be effective in promoting nicotine abstinence and long term recovery from nicotine addiction.

NON-COVERED CHARGES: Charges which do not meet the Contract's definition of Covered Charges or which exceed any of the benefit limits shown in the Contract, or which are specifically identified as Non-Covered Services and Supplies and Non-Covered Charges or are otherwise not covered by the Contract.

NON-COVERED SERVICES: Services or supplies which are not included within the insurance company's definition of Covered Services or Supplies, are included in the list of Non-Covered Services and Supplies and Non-Covered Charges, or which exceed any of the limitations shown in the Contract.

OUT-OF-NETWORK PROVIDER: A Provider which is not an In-Network Provider.

NURSE: A registered nurse or licensed practical nurse, including a nursing specialist such as a nurse mid-wife or nurse anesthetist, who:

a) is properly licensed or certified to provide medical care under the laws of the state where the nurse practices; and

b) provides medical services which are within the scope of the nurse's license or certificate and are covered by the Contract.

OUTPATIENT: Member, if not confined as a registered bed patient in a Hospital or recognized health care Facility and not an Inpatient; or services and supplies provided in such a setting.

PARTICIPANT: A Student of the University.

PERIOD OF CONFINEMENT: Consecutive days of Inpatient services provided to an Inpatient, or successive Inpatient confinements due to the same or related causes, when discharge and re-admission to a Facility occurs within 90 days or less. The insurance company determines if the cause(s) of the confinements are the same or related.

PER LIFETIME: During the lifetime of an individual:

a) as a Participant or Dependent; and

b) with or without interruption of coverage.

PRACTITIONER: A medical practitioner who:

a) is properly licensed or certified to provide medical care under the laws of the state where the practitioner practices; and

b) provides medical services which are within the scope of the practitioner's license or certificate and which are covered by the Contract.

PRE-APPROVAL or PRE-APPROVED: The insurance company's approval for specified services and supplies prior to the date the charges are incurred. Services or supplies for which the charges have not been pre-approved are not covered.

PRE-EXISTING CONDITION: An Illness or Injury which manifests itself in the six months before a Member's coverage under the Contract starts, and for which:

a) A Member sees a Practitioner , takes prescribed drugs, receives other medical care or treatment or had medical care or treatment recommended by a Practitioner in the six months before the Member's coverage starts; or

b) An ordinarily prudent person would have sought medical advice, care or treatment in the six months before the person's coverage starts. A pregnancy which exists on the date a Member's coverage starts is also a Pre-Existing Condition. See the Non-Covered Services and Supplies and Non-Covered Charges section of the Contract for details on how the Contract limits the services and benefits for Pre-Existing Conditions.

PRESCRIPTION DRUGS: Drugs, biologicals and compound prescriptions which are sold only by prescription and which are required to show on the manufacturer's label the words: "Caution - Federal Law Prohibits Dispensing Without a Prescription" or other drugs and devices as determined by the insurance company, such as insulin. But the insurance company only cover drugs which are:

a) approved for treatment of the Member's Illness or Injury by the Food and Drug Administration;

b) approved by the Food and Drug Administration for the treatment of a particular diagnosis or condition other than the Member's and recognized as appropriate medical treatment for the Member's diagnosis or condition in one or more of the following established reference compendia:

· The American Medical Association Drug Evaluations;

· The American Hospital Formulary Service Drug Information;

· The United States Pharmacopoeia Drug Information; or

c) recommended by a clinical study and recommended by a review article in a major peer-reviewed professional journal. Coverage for the above drugs also includes Medically Necessary and Appropriate services associated with the administration of the drugs.

The insurance company will not pay for:

a) drugs labeled: "Caution - Limited by Federal Law to Investigational Use"; or

b) any drug which the Food and Drug Administration has determined to be contraindicated for the specific treatment for which the drug has been prescribed.

PREVENTIVE CARE: Services and supplies in connection with routine physical examinations, including laboratory tests and x-rays, immunizations and vaccines, well baby care, pap smears, mammography, screening tests and Nicotine Dependence Treatment.

PRIMARY CARE PHYSICIAN (PCP): An In-Network Practitioner who is a doctor specializing in family practice, general practice, internal medicine, or pediatrics who supervises, coordinates, arranges and provides initial care and basic medical services to a Member; initiates a Member's Referral for Specialist Services; and is responsible for maintaining continuity of patient care.

PROVIDER: A recognized Facility or Practitioner of health care.

REASONABLE and CUSTOMARY: With respect to In-Network services and supplies, the negotiated arrangement. With respect to Out-of-Network benefits, an amount that is not more than the usual or customary charge for the service or supply as determined by the insurance company, based on an amount which is most often charged for a given service by a Provider within the same geographic area.

REFERRAL: With respect to In-Network services or supplies, specific direction or instruction from a Member's Primary Care Physician or UHP in conformance with the insurance company's policies and procedures that directs a Member to a Facility or Provider for health care.

REHABILITATION CENTER: A Facility which mainly provides therapeutic and restorative services to Ill or Injured people. It must carry out its stated purpose under all relevant state and local laws, and it must either:

a) be accredited for its stated purpose by either the Joint Commission or the Commission on Accreditation for Rehabilitation Facilities; or

b) be approved for its stated purpose by Medicare.

In some places a Rehabilitation Center is called a "rehabilitation hospital."

ROUTINE FOOT CARE: The cutting, debridement, trimming, reduction, removal or other care of corns, calluses, flat feet, fallen arches, weak feet, chronic foot strain, dystrophic nails, excrescences, helomas, hyperkeratosis, hypertrophic nails, non-infected ingrown nails, deratomas, keratosis, onychauxis, onychocryptosis, tylomas or symptomatic complaints of the feet. Routine Foot Care also includes orthopedic shoes, foot orthotics and supportive devices for the foot.

ROUTINE NURSING CARE: The appropriate nursing care customarily furnished by a recognized Facility for the benefit of its Inpatients.

SCHEDULE: The Schedule of Covered Services and Supplies and Covered Charges.

SERVICE AREA: As applicable to In-Network services and supplies, the geographic area is defined by county.

SKILLED NURSING CARE: Services which are more intensive than Custodial Care, are provided by a Registered Nurse (R.N.) or Licensed Practical Nurse (L.P.N.), and require the technical skills and professional training of an R.N. or L.P.N.

SKILLED NURSING CENTER: A Facility which mainly provides full-time Skilled Nursing Care for Ill or Injured people who do not need to be in a Hospital. It must carry out its stated purpose under all relevant state and local laws, and it must either:

a) be accredited for its stated purpose by the Joint Commission; or

b) be approved for its stated purpose by Medicare.

In some places, a "Skilled Nursing Center" may be called an Extended Care Center.

SPECIAL CARE UNIT: A part of a Hospital set up for very ill patients who must be observed constantly. The unit must have a specially trained staff and it must have special equipment and supplies on hand at all times.

Some types of Special Care Units are:

a) intensive care units;

b) cardiac care units;

c) neonatal care units; and

d) burn units.

SPECIALIST: A Practitioner who provides medical care in any generally accepted medical or surgical specialty or sub-specialty.

SPECIALIST SERVICES: Medical care in specialties other than family practice, general practice, internal medicine or pediatrics.

SUBSTANCE ABUSE: Abuse of or addiction to drugs.

SUBSTANCE ABUSE CENTER: A Facility that mainly provides treatment for people with Substance Abuse problems. It must carry out its stated purpose under all relevant state and local laws, and it must either:

a) be accredited for its stated purpose by the Joint Commission; or

b) be approved for its stated purpose by Medicare.

SUPPLEMENTAL LIMITED BENEFIT INSURANCE: Insurance that is provided in addition to a Health Benefits Plan on an indemnity non-expense incurred basis.

SURGERY:

a) The performance of generally accepted operative and cutting procedures, including surgical diagnostic procedures, specialized instrumentations, endoscopic examinations, and other invasive procedures;

b) The correction of fractures and dislocations;

c) Pre-operative and post-operative care; or

d) Any of the procedures designated by Current Procedural Terminology codes as surgery.

THERAPEUTIC MANIPULATION: Treatment of the articulations of the spine and musculoskeletal structures for the purpose of relieving certain abnormal clinical conditions resulting from the impingement upon associated nerves causing discomfort. Some examples are manipulation or adjustment of the spine, hot or cold packs, electrical muscle stimulation, diathermy, skeletal adjustments, massage, adjunctive, ultra-sound, doppler, whirlpool or hydrotherapy or other treatment of similar nature.

THERAPY SERVICES: The following services or supplies ordered by a Provider and used to treat or promote recovery from an injury or illness:

Chelation Therapy - the administration of drugs or chemicals to remove toxic concentrations of metals from the body.

Chemotherapy - the treatment of malignant disease by chemical or biological antineoplastic agents.

Cognitive Rehabilitation Therapy - retraining the brain to perform intellectual skills which it was able to perform prior to disease, trauma, surgery, congenital anomaly or previous therapeutic process.

Dialysis Treatment - the treatment of an acute renal failure or chronic irreversible renal insufficiency by removing waste products from the body. This includes hemodialysis and peritoneal dialysis.

Infusion Therapy - the administration of antibiotic, nutrients, or other therapeutic agents by direct infusion.

Occupational Therapy - treatment to restore a physically disabled person's ability to perform the ordinary tasks of daily living.

Physical Therapy - the treatment by physical means to relieve pain, restore maximum function, and prevent disability following disease, injury, or loss of a limb.

Radiation Therapy - the treatment of disease by X-ray, radium, cobalt, or high energy particle sources. Radiation Therapy includes rental or cost of radioactive materials. Diagnostic services requiring the use of radioactive materials are not Radiation Therapy.

Respiration Therapy - the introduction of dry or moist gases into the lungs.

Speech Therapy - treatment for the correction of a speech impairment resulting from Illness, Surgery, Injury, congenital anomaly, or previous therapeutic processes.

TOTAL DISABILITY or TOTALLY DISABLED: Except as otherwise specified in the Contract, a Participant who, due to Illness or Injury, cannot perform any duty of his or her occupation or any occupation for which he or she is, or may be, suited by education, training and experience, and is not in fact, engaged in any occupation for wage or profit. The Participant must be under the regular care of a Practitioner.

YOU, YOUR, and YOURS: The Participant.