Predetermination of Benefits If charges for a planned course of treatment by a licensed dentist would exceed $300.00, proposed details and x-rays should be submitted to the Plan Administrator for approval. Failure to do so may result in a payment of a lesser benefit amount because of the difficulty in determining the need for such treatment after it has been provided. Dental x-rays will be promptly returned to the dentist.
Adjustment of Grievance The School District and the teacher shall attempt to adjust all grievances which may arise during the course of employment of any teacher within the School District in the following manner:
Accrual of Benefits An employee may accrue benefits for thirty (30) days during a leave of absence.
COMPUTATION OF BENEFITS All hours paid to an employee shall be considered as hours worked for the purpose of computing any of the benefits under this Agreement.
Adjustment Plan (A) If the Employer introduces or intends to introduce a measure, policy, practice or change that affects the terms, conditions or security of employment of a significant number of employees by classification to whom the Collective Agreement applies;
Summary of Benefits Plan Feature Employee Co-pay - Network Only Preventive and Diagnostic Services • Examination • Cleaning • x-rays $0 $0 $0 Minor Restorative • Fillings and extractions • Oral surgery • Endodontic services1 • Periodontal services1 $0 $40-$196 based on specific service $45-$310 based on specific service $25-$145 based on specific service 1 Additional employee co-pay if approved specialist performs services. Major Restorative • Crowns • Bridges • Complete Dentures $92-$190 based on specific service $115-$291 based on specific service $249-$264 based on specific service Complete Orthodontics $1,850 co-pay D PPO “Buy Up” Option (Voluntary) Summary of Benefits Plan Feature In Network/Out of Network Class I (Preventative) 100%/100% Class II (Basic/Restorative) 80%/80% Class III (Major) 60%/60% Class IV (Orthodontia - adult ortho is included) 50%/50% Annual Deductible per Member (does not apply to Class I services) $50/$50 Orthodontia Lifetime Max $1,500/$1,500
ADJUSTMENT/APPROPRIATION OF PAYMENTS The Allottee authorizes the Promoter to adjust/appropriate all payments made by him/her under any head(s) of dues against lawful outstanding, if any, in his/her name as the Promoter may in its sole discretion deem fit and the Allottee undertakes not to object/demand/direct the Promoter to adjust his payments in any manner.
Payment of Benefits Any amounts due under this Agreement shall be paid in one (1) lump sum payment as soon as administratively practicable following the later of: (i) Xx. Xxxxxx'x Termination Date, or (ii) upon Xx. Xxxxxx'x tender of an effective Waiver and Release to the Company in the form of Exhibit A attached hereto and the expiration of any applicable revocation period for such waiver. In the event of a dispute with respect to liability or amount of any benefit due hereunder, an effective Waiver and Release shall be tendered at the time of final resolution of any such dispute when payment is tendered by the Company.
Supplementation of Compensation Award If an employee is prevented from performing the employee's regular work with the City on account of an occupational accident that is recognized by the Workers' Compensation Board as compensable within the meaning of the Workers' Compensation Act, the City will supplement the award made by the Workers' Compensation Board for loss of wages to the employee by such an amount that the award of the Workers' Compensation Board for loss of wages (excluding non- economic loss payment), together with the supplementation by the City, will equal 100% of the employee's regular net wage (gross pay less statutory deductions, union dues and required benefit plan contributions). The said supplementation shall not be payable to any employee entitled to compensation after pension age if such an employee is entitled to an unreduced pension as provided under the Local Authorities Pension Plan or after the full age of 65 years if such an employee is not entitled to a pension. Subject to the foregoing limitation, the procedure to be followed in operating this policy shall be as follows:
ADJUSTMENT OF GRIEVANCES 26.01 Any complaint, disagreement or difference of opinion between the Employer and the Union, or the employees covered by this Agreement, which concerns the interpretation, application, operation or alleged violation of the terms and provisions of this Agreement, shall be considered as a grievance.
