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<br />Rorlda Municipal Insurance Trust <br /> <br />Medical Master Plan of Benefits <br /> <br />licensed as a psychiatric hospital and properly accredited to provide <br />psychiatric, diagnostic and therapeutic services for the treatment of <br />patients who have mental illnesses. <br /> <br />Hospital Service means and includes receiving a participant into a hospital for <br />services set forth in this Plan and outlined on the hospital bill and subject to the <br />rules and regulations of the hospital, for and during such time only as the <br />participant is necessarily treated on an inpatient or outpatient basis in the <br />hospital, under the treatment and care of a physician for any conditions covered <br />hereunder. <br /> <br />Inpatient means a patient who has been admitted upon order of a physician as a bed <br />patient for treatment in a hospital for at least six (6) continuous hours. <br /> <br />Lifetime Maximum means the maximum liability of the Trust subject to the benefits <br />provided in this Plan, with respect to each participant covered under this Plan, <br />during the entire period such participant is covered hereunder. <br /> <br />Massage Therapist means a person properly licensed to administer massages, <br />pursuant to Chapter 480 of the Florida Statutes, or other states' applicable law. <br /> <br />Medically Necessary means treatment, care or services that are consistent with the <br />diagnosis, complies with acceptable medical standards, is not primarily for the <br />participant's convenience and is the most appropriate level of service which can <br />be safely provided. When applied to hospital inpatient care, it means that care <br />cannot be safely provided on an outpatient basis. Care that has not received <br />federal approval will not be considered medically necessary. <br /> <br />Midwife means any person, other than a licensed physician or Certified Nurse <br />Midwife, who is state licensed to practice midwifery. <br /> <br />Midwifery means the practice of supervising the conduct of a normal labor and <br />childbirth, with the informed consent of the parent; the practice of advising the <br />parents as to the progress of childbirth; and the practice of rendering prenatal <br />and postnatal care. <br /> <br />New Employee means an employee who has never been previously employed by the <br />employer prior to the effective date of this Plan and who is employed by the <br />employer on or after the effective date of this Plan, or an employee who was <br />employed by the employer prior to the effective date of this Plan and was ineligible <br />to participate in the employer's prior plan because the employee had not <br />completed the period of continuous employment with the employer as set forth in <br />such plan, if any, to qualify to participate in such plan. <br /> <br />Occupational Therapist means a person who is duly registered or licensed by the <br />state in which such person is engaged in the practice of occupational therapy and <br />who is a member of the American Occupational Therapy Association. <br /> <br />Outpatient means 'a patient who has not been admitted to a hospital as an inpatient <br />and who has not been charged for room and board. <br /> <br />Participant means and includes the employee and any of his or her legal dependents <br />covered under this Plan. Participant also means and includes those employees <br />and their dependents that qualify for continuation of coverage under COBRA. <br />