Covered Dental Expenses. The Dental Expense Plan will pay for incurred claims for employee and/or enrolled dependents at the applicable percentage of either the actual fee or the usual, customary and reasonable fee, whichever is lower, for the dental benefits covered under the Dental Expense Plan. Coverage for the following services under each plan is listed in Appendix G-3:
Covered Dental Expenses. Covered Dental Expenses are the usual charges of a dentist which an employee, retired employee or surviving spouse is required to pay for services and supplies which are necessary for treatment of a dental condition, but only to the extent that such services and supplies are customarily employed for treatment of that condition, and only if rendered in accordance with accepted standards of dental practice. Such expenses shall be only those incurred in connection with the following dental services which are performed, except as otherwise provided in Section VII (B), by a licensed dentist and which are received while insurance is in force. Payments for Covered Dental Expenses performed by a licensed dentist (or a licensed dental hygienist under conditions specified in Section VII (B) (1)) shall be based upon the applicable percentage of the lesser of the dentist's usual charge for the service or of the fee specified for the service in the Provincial Dental Association Schedule of Fees as defined in Section XIII, but only for the services set forth below, and not for any other services listed in such Schedule of Fees. Where fees for certain procedures are shown in such Schedule of Fees as "I.C." (Individual Consideration) payment will be made on the basis of the usual, reasonable and customary charges for such procedures. Provided, however, that in the event no Provincial Dental Association Schedule of Fees is in effect for 2008, payments under this Section III for Covered Dental Expenses, as described in the first sentence of this paragraph, shall be made on the basis of the usual, reasonable and customary charges for the service rendered or supply furnished in 2008. Payments for Covered Dental Expenses performed by a licensed denture therapist in accordance with Section VII (B) (2) shall be based upon the applicable percentage of the lesser of the denture therapist's usual charge for the service or of the fee specified for the service in the Ontario fee schedule for Licensed Denture Therapists as defined in Section XIII, but only for the services set forth below, and not for any other services listed in such fee schedule. Provided, however, that in the event no Ontario fee schedule for Licensed Denture Therapists is in effect for 2008, payments under this Section III for such Covered Dental Expenses shall be made on the basis of the usual, reasonable and customary charges for the service rendered or supply furnished in 2008.
Covered Dental Expenses. The Dental Expense Plan will pay for incurred claims for employee and/or enrolled dependents at the applicable percentage of either the actual fee or the usual, customary and reasonable fee, whichever is lower, for the dental benefits covered under the Dental Expense Plan up to a maximum of $1,500 for each covered person in each twelve (12) month period beginning October 1, exclusive of orthodontics for which there is a separate $1,500 lifetime maximum benefit.
Covered Dental Expenses. The Dental Expense Benefit includes Basic and Supplemental services. The Basic Program pays 100% of the usual, customary, and reasonable fees charged by your dentist. The supplemental Program pays 80% of the usual, customary and reasonable fees charged by your dentist. These benefits are described in a summary plan description.
Covered Dental Expenses. The State Dental Plan will pay for incurred claims for 36 employee and/or enrolled dependents at the applicable percentage of either the 37 actual fee or the usual, customary and reasonable fee, whichever is lower, for the 38 dental benefits covered under the State Dental Plan for each covered person in each 39 twelve (12) month period (fiscal year) exclusive of orthodontics for which there is a 40 separate lifetime maximum benefit. 41 42 (1) The following services will be paid at the 100% benefit level:
Covered Dental Expenses. 2.1 listed below which, for the condition being treated, are: i) necessary;
