Common use of Co-Payments Clause in Contracts

Co-Payments. Effective January 1, 2020, the State Dental Plan will cover allowable charges for the following services subject to the co- payments and coverage limits stated. Higher out-of-pocket costs apply to services obtained from dental care providers not in the State Dental Plan network. Services provided through the State Dental Plan are subject to the State Dental Plan's managed care procedures and principles, including standards of dental necessity and appropriate practice. The plan shall cover general cleaning two (2) times per year and special cleanings (root or deep cleaning) as prescribed by the dentist.

Co-Payments. Effective January 1, 20202016, the State Dental Plan will cover allowable charges for the following services subject to the co- payments and coverage limits stated. Higher out-of-pocket costs apply to services obtained from dental care providers not in the State Dental Plan network. Services provided through the State Dental Plan are subject to the State Dental Plan's managed care procedures and principles, including standards of dental necessity and appropriate practice. The plan shall cover general cleaning two (2) times per year and special cleanings (root or deep cleaning) as prescribed by the dentist.

Co-Payments. Effective January 1, 20202014, the State Dental Plan will cover allowable charges for the following services subject to the co- co-payments and coverage limits stated. Higher out-of-pocket costs apply to services obtained from dental care providers not in the State Dental Plan network. Services provided through the State Dental Plan are subject to the State Dental Plan's managed care procedures and principles, including standards of dental necessity and appropriate practice. The plan shall cover general cleaning two (2) times per year and special cleanings (root or deep cleaning) as prescribed by the dentist.two

Co-Payments. Effective January 1, 202020122014, the State Dental Plan will cover allowable charges for the following services allowable charges for the following services subject to the co- payments and coverage limits stated. Higher out-of-pocket costs apply to services obtained from dental care providers not in the State Dental Plan network. Services provided through the State Dental Plan are subject to the State Dental Plan's managed care procedures and principles, including standards of dental necessity and appropriate practice. The plan shall cover general cleaning two (2) times per year and special cleanings (root or deep cleaning) as prescribed by the dentist.two

Co-Payments. Effective January 1, 202020102012, the State Dental Plan will cover allowable charges for the following services allowable charges for the following services subject to the co- payments and coverage limits stated. Higher out-of-pocket costs apply to services obtained from dental care providers not in the State Dental Plan network. Services provided through the State Dental Plan are subject to the State Dental Plan's managed care procedures and principles, including standards of dental necessity and appropriate practice. The plan shall cover general cleaning two (2) times per year and special cleanings (root or deep cleaning) as prescribed by the dentist.two