Services or supplies provided by one of the following [members] of the Employee's family: spouse, child, parent, in-law, brother, sister or grandparent. Services or supplies furnished in connection with any procedures to enhance fertility which involve harvesting, storage and / or manipulation of eggs and sperm. This includes, but is not limited to the following: a) procedures: in vitro fertilization; embryo transfer; embryo freezing; and Gamete intra-fallopian Transfer (GIFT) and Zygote Intrafallopian Transfer (ZIFT); donor sperm, surrogate motherhood and b) Prescription Drugs not eligible under the Prescription Drugs section of the Policy and c) ovulation predictor kits. See also the separate Exclusion addressing sterilization reversal. Except as otherwise stated in the Hearing Aids and Newborn Hearing Screening provisions, services or supplies related to hearing aids and hearing examinations to determine the need for hearing aids or the need to adjust them. Services or supplies related to herbal medicine. Services or supplies related to hypnotism. Services or supplies necessary because the [Member] engaged, or tried to engage, in an illegal occupation or committed or tried to commit an indictable offense in the jurisdiction in which it is committed, or a felony. As required by 29 CFR Exception: 2590.702(b)(2)(iii) this exclusion does not apply to injuries that result from an act of domestic violence or to injuries that result from a medical condition. Except as stated below, Illness or Injury, including a condition which is the result of disease or bodily infirmity, which occurred on the job and which is covered or could have been covered for benefits provided under workers' compensation, employer's liability, occupational disease or similar law. Exception: This exclusion does not apply to the following persons for whom coverage under workers’ compensation is optional unless such persons are actually covered for workers’ compensation: a self-employed person or a partner of a limited liability partnership, members of a limited liability company or partners of a partnership who actively perform services on behalf of the self-employed business, the limited liability partnership, limited liability company or the partnership. Local anesthesia charges billed separately if such charges are included in the fee for the Surgery. Membership costs for health clubs, weight loss clinics and similar programs. Services and supplies related to marriage, career or financial counseling, sex therapy or family therapy, and related services.
Services or supplies provided by one of the following [members] of the Employee's family: spouse, child, parent, in-law, brother, sister or grandparent. Services or supplies furnished in connection with any procedures to enhance fertility which involve harvesting, storage and / or manipulation of eggs and sperm. This includes, but is not limited to the following: a) procedures: in vitro fertilization; embryo transfer; embryo freezing; and Gamete intra-fallopian Transfer (GIFT) and Zygote Intrafallopian Transfer (ZIFT); donor sperm, surrogate motherhood and b) Prescription Drugs not eligible under the Prescription Drugs section of the Policy and c) ovulation predictor kits. See also the separate Exclusion addressing sterilization reversal. Except as otherwise stated in the Hearing Aids and Newborn Hearing Screening provisions, services or supplies related to hearing aids and hearing examinations to determine the need for hearing aids or the need to adjust them. Services or supplies related to herbal medicine. Services or supplies related to hypnotism. Services or supplies necessary because the [Member] engaged, or tried to engage, in an illegal occupation or committed or tried to commit an indictable offense in the jurisdiction in which it is committed, or a felony. Exception: As required by 29 CFR 2590.702(b)(2)(iii) this exclusion does not apply to injuries that result from an act of domestic violence or to injuries that result from a medical condition. Except as stated below, Illness or Injury, including a condition which is the result of disease or bodily infirmity, which occurred on the job and which is covered or could have been covered for benefits provided under workers' compensation, employer's liability, occupational disease or similar law. Exception: This exclusion does not apply to the following persons for whom coverage under workers’ compensation is optional unless such persons are actually covered for workers’ compensation: a self-employed person or a partner of a limited liability partnership, members of a limited liability company or partners of a partnership who actively perform services on behalf of the self-employed business, the limited liability partnership, limited liability company or the partnership. Local anesthesia charges billed separately if such charges are included in the fee for the Surgery. Membership costs for health clubs, weight loss clinics and similar programs. Services and supplies related to marriage, career or financial counseling, sex therapy or family therapy, and related services.
hmopos_contract.docx