ACCESSING BENEFITS Sample Clauses

ACCESSING BENEFITS. Participating Dentists Benefits Anthem Blue Cross & Blue Shield of Connecticut will pay the lesser of fifty percent of the dentist's usual charge or fifty percent of the Usual, Customary and Reasonable Charge, as determined by us, for the dental services described in the Rider. Dentists who participate in our dental programs agree to accept our allowance as full payment and may not ▇▇▇▇ the member for any additional charges except for the remaining coinsurance balance.

ACCESSING BENEFITS. Participating Dentists Benefits When a member receives care from one of over 1,800 Participating Dentists, he or she simply presents his or her identification card showing dental coverage. The dentist bills us directly for all covered services. For dental care provided by a Participating Dentist, we will pay the lesser of the dentist's usual charge or the Usual, Customary and Reasonable Charge as determined by us. The dentist accepts our reimbursement as full payment and may not ▇▇▇▇ the member for any additional charges. Non-Participating Dentists Benefits For covered dental services provided by a Non-Participating Dentist, in or out of Connecticut, we pay the • 1 lesser of the dentist's charge or the applicable allowance for the procedure, as determined by us. The member is responsible for any difference between the amount paid by us and the fee charged by the dentist. This does not constitute your health plan or insurance policy. It is only a general description for the purposes of this Request for Proposal, of the Anthem Blue Cross Blue Shield Full Dental Plan. Refer to your Master Group Policy or Description of Benefits, on file with your employer, for a complete listing of benefits, maximums, exclusions and limitations. 8133 Rev. IVO Cattinkt,Miture Su Cron ant awSNW h e tuts writ of rname NW* MIL Iv, al katepenlelt fame of do FINI Cras ird Din NW At tatiatbs (19 Rechteled mall dde Ellie fnet troilUSliddAlscciallea CZ99r In addition to the services provided under your dental program, the following additional basic benefits are provided: • Inlays (not part of bridge) • Onlays (not part of bridge) ♦ Crown (not part of bridge) • Space Maintainers • Oral Surgery consisting of fracture and dislocation treatment, diagnosis and treatment of cyst and abscess, surgical extractions and impaction ♦ Apicoectomy The dental services listed above are subject to the following qualifications: We will pay for individual crowns, inlays and onlays only when amalgam or synthetic fillings would not be satisfactory for the retention of the tooth, as determined by us. We will not pay for a replacement provided less than five (5) years following a placement or replacement which was covered under this Rider. We will not pay for individual crowns, inlays or onlays to alter vertical dimension, for the purpose of precision attachment of dentures, or when they are splinted together for any reason. If the member is not covered by Dental Amendatory Rider C (Prosthodontics) we will ...

ACCESSING BENEFITS. Members must call the Member Service Center to confirm eligibility and coverage prior to consulting with any attorney. The Member Service Center will assign a Participating Attorney to provide services relative to the matter.

ACCESSING BENEFITS. 1. Any retiree who is eligible will be allowed to purchase health care an amount determined by the Union less than the cost, provided there are funds available in the Retiree Health Care Account to cover the full amount of the offset. 2. In order to be eligible for the discount, a former employee must: a. Retire from employment with CMHA-CEI after October 1, 1991. b. Be in a Residential, RN or Large Bargaining Unit position for ten (10) years, including the five (5) prior to retirement. c. Buy health care through CMHA-CEI. d. Be at least sixty (60) years of age with six (6) years of service (if all other criteria are met, discount will begin at age 60). e. Be a retired CMHA-CEI employee, receiving health care coverage through the Employer, but the retired employee is not the policy holder and loses coverage (e.g., divorce from the policy holder death of the policy holder). 3. Retired employees qualifying for the discount shall have the full amount deducted from the next month's premium. If the discount exceeds the next month's premium, the balance shall be deducted from the following month's premium. 4. The Union may increase or reduce the amount of the discount, by notifying CMHA- CEI and the current participating retirees in writing at least thirty days (30) prior to the beginning of the effected month. 5. Retiring employees who participate in the discount shall be required to sign a form stating they are aware that there is no guarantee of on-going discounts in the future. 6. The Union shall direct CMHA-CEI where the current funds are to be invested. Such direction shall be in writing and funds shall not be moved more than twice (2) in any calendar year. 7. Changes in the administration of the Retiree Health Care Account shall be mutually agreed to by the Union and CMHA-CEI .

ACCESSING BENEFITS. Participating Dentists Benefits When a member receives care from one of over 1,800 Participating Dentists, he or she simply present his or her Identification card showing dental coverage. The dentist bills us directly for all covered services. For dental care provided by a Participating Dentist, we will pay the lesser of the dentist's usual charge or the Usual, Customary and Reasonable Charge as determined by us. The dentist accepts our reimbursement as full payment and may not ▇▇▇▇ the member for any additional charges.

ACCESSING BENEFITS. For dental care provided by a participating Dentist, we pay the lesser of the dentist’s usual charge or the Usual, Customary and Reasonable Charge as determined by us. The dentist accepts our reimbursement as full payment and may not bill the member for any additional charges. The dentist bills us directly for all covered services.

ACCESSING BENEFITS. Participating Dentists Benefits When a member receives care from one of over 1,800 Participating Dentists, he or she simply presents his or her identification card showing dental coverage. The dentist bills us directly for all covered services. For dental care provided by a Participating Dentist, we will pay the lesser of the dentist's usual charge or the Usual, Customary and Reasonable Charge as determined by us. The dentist accepts our reimbursement as full payment and may not ▇▇▇▇ the member for any additional charges. Non-Participating Dentists Benefits For covered dental services provided by a Non-Participating Dentist, in or out of Connecticut, we pay the lesser of the dentist's charge or the applicable allowance for the procedure, as determined by us. The member is responsible for any difference between the amount paid by us and the fee charged by the dentist. This does not constitute your health plan or insurance policy. It is only a general description for the purposes of this Request for Proposal, of the Anthem Blue Cross Blue Shield Full Dental Plan. Refer to your Master Group Policy or Description of Benefits, on file with your employer, for a complete listing of benefits, maximums, exclusions and limitations.

ACCESSING BENEFITS. Participating Dentists Benefits When a member receives care from one of over 1,800 Participating Dentists, he or she simply presents his or her identification card showing dental coverage. The dentist bills us directly for all covered services. For dental care provided by a Participating Dentist, we will pay the lesser of the dentist's usual charge or the Usual, Customary and Reasonable Charge as determined by us. The dentist accepts our reimbursement as full payment and may not ▇▇▇▇ the member for any additional charges. Non-Participating Dentists Benefits For covered dental services provided by a Non-Participating Dentist, in or out of Connecticut, we pay the lesser of the dentist's charge or the applicable allowance for the procedure, as determined by us. The member is responsible for any difference between the amount paid by us and the fee charged by the dentist. This does not constitute your health plan or insurance policy. It is only a general description for the purposes of this Request for Proposal, of the Anthem Blue Cross Blue Shield Full Dental Plan. Refer to your Master Group Policy or Description of Benefits, on file with your employer, for a complete listing of benefits, maximums, exclusions and limitations.