ScheduleofBenefits保障福利表.PDFVIP

Schedule of Benefits 保障福利表 This Schedule of Benefits and Policy Face Page forms part of the health insurance Policy and is a summary outline of the benefits payable under the Policy. All benefits described are subject to the definitions, limitations, exclusions, and provisions of the Policy Face Page and the Schedule of Benefits. All amounts are shown in USD. 本保障福利表及本保险单构成本医疗险条款之组成内容，概述了本条款下的福利赔付额。所述全部福利均适用本保 险单和本保障福利表之定义、限制条件、责任除外和条款的限额。所有货币单位均为美元。 The following benefits are per person per Policy Period and subject to the Plan Participant’s Policy Period