30 Payment Percentage The Payment Percentage and the covered medical charges to which such Payment Percentage applies are shown in the detailed Schedule of Benefits. The Payment Percentage applies after any applicable deductible amount has been met, and it is applied separately to each covered individual. Out-of-Pocket Limit The individual and family out-of-pocket limits are shown in the Schedule of Benefits. A separate out-of- pocket limit for the Prescription Drug Coverage applies for benefits under the Plan. The out-of-pocket limit is the maximum amount a covered individual will have to pay for covered charges during a calendar year. The out-of-pocket limit includes the deductible. When a covered individual’s cumulative out-of-pocket expenses in any calendar year reaches the applicable out-of-pocket limit shown in the Schedule of Benefits, all covered charges for the covered individual will be paid by the Plan at 100% for the remaining months of that calendar year. When your covered family members have accumulated individual out-of-pocket amounts in any calendar year that, when combined, equals or exceeds the amount of the family out-of-pocket limit shown in the Schedule of Benefits, all further covered charges for all covered family members will be paid by the Plan at 100% for the remaining months of that calendar year. For this purpose, the term family includes you, your Spouse, and your Eligible Dependent Children who are covered under the Plan. The above provisions do not apply to charges that exceed Usual, Customary and Reasonable (UCR) charges, charges that exceed Plan benefit limitations, or charges for services that are excluded under the terms of the Plan. Accumulation of Deductible and Out-of-Pocket Limits for In-Network and Out-of- Network Purposes Covered expenses incurred either in-network or out-of-network will cross accumulate to satisfy deductible amounts and maximum out-of-pocket limits. However, note that separate out-of-pocket limits apply to in-network and out-of-network covered medical charges and Prescription Drug Coverage. Lifetime Maximum The Plan does not impose an overall lifetime dollar maximum. However, there are limits that may apply for some types of visits, and/or a limit on the number of days permitted for the benefit under the terms of the Plan. In addition, there may be dollar limits applicable to certain benefits as described in this SPD.