Common use of Dental Expense Insurance Clause in Contracts

Dental Expense Insurance. 10.01 Upon receipt by the insurer within ninety (90) days from the date of billing by the dentist and approval by the insurer of due proof that an eligible employee or dependent has incurred expenses for covered dental services, the insurer will, subject to Article 15, reimburse the employee for one hundred percent (100%) of the charges for covered dental services listed under Article 10.02, Part "A"; ninety percent (90%) of the charges for covered dental services listed under Article 10.02, Part "B", subject to $2,000.00 in a 24 month benefit period for services under Part "A" and/or Part "B" and, after satisfying a deductible of fifty dollars ($50.00) for each treatment plan, fifty percent (50%) of the charges for dental services listed under Article 10.02, Part "C", subject to a maximum lifetime benefit of $1,000.00. Benefits are provided under Parts "A" and/or "B" exclude that portion of any charge which is in excess of the prevailing Schedule of Fees of the Provincial Dental Association in the Province of residence. 10.02 Covered dental services shall be the following: - (a) oral examination and diagnosis; but not more than once in any nine (9) month period for employees and dependents age 18 or over; (b) complete series of periapical films but not more than once in any five (5) year period; (c) prophylaxis including scaling and polishing of teeth but not more than once in any nine (9) month period for employees and dependents age 18 or over; (d) bitewing x-rays but not more than once in any nine (9) month period for employees and dependents age 18 and over; (e) topical application of any anti-cariogenic agent (e.g., stannous fluoride); but not more than once in any nine (9) month period for employee and dependents age 18 or over; (f) plastic fillings (amalgam, silicate, acrylic or equivalent); (g) emergency treatment; (h) space maintainers not involving the movement of teeth; (i) periodontal treatment including surgery and post-surgical treatment, excluding prosthesis and appliances; (j) endodontic treatment (root canal therapy;) (k) oral surgical procedures, including the removal of teeth (erupted, un-erupted or impacted;) (l) general anesthesia in connection with oral surgery; (m) x-rays in connection with oral surgery; (n) injections of antibiotic drugs by the attending dentist; (o) one (1) oral hygiene instruction per insured individual per life- time. (a) inlays and crowns; (b) complete dentures; (c) partial dentures; (d) fixed bridgework; (e) repair or recementing of crowns, inlays, bridgework and dentures or relining of dentures; (f) periodontal prosthesis or appliances.

Dental Expense Insurance. 10.01 Upon receipt by the insurer within ninety (90) days from the date of billing by the dentist and approval by the insurer of due proof that an eligible employee or dependent has incurred expenses for covered dental services, the insurer will, subject to Article 15, reimburse the employee for one hundred percent (100%) of the charges for covered dental services listed under Article 10.02, Part "“A"”; ninety percent (90%) of the charges for covered dental services listed under Article 10.02, Part "“B"”, subject to a total annual maximum reimbursement of $2,000.00 in a 24 month benefit period 1,000.00 for services under Part "“A" ” and/or Part "“B" ” and, after satisfying a deductible of fifty dollars ($50.00) for each treatment plan, fifty percent (50%) of the charges for dental services listed under Article 10.02, Part "“C"”, subject to a maximum lifetime benefit of $1,000.00. Benefits are provided under Parts "“A" ” and/or "“B" exclude ” excludes that portion of any charge which is in excess of the prevailing Schedule of Fees of the Provincial Dental Association in the Province of residence. 10.02 Covered dental services shall be the following: -: (a) oral examination and diagnosis; but not more than once in any nine (9) month period for employees and dependents age 18 or over; (b) complete series of periapical films but not more than once in any five (5) year period; (c) prophylaxis including scaling and polishing of teeth but not more than once in any nine (9) month period for employees and dependents age 18 or overperiod; (d) bitewing x-rays but not more than once in any nine six (96) month period for employees and dependents age 18 and overperiod; (e) topical application of any anti-cariogenic agent (e.g., e.g. stannous fluoride); but not more than once in any nine (9) month period for employee and dependents age 18 or over; (f) plastic fillings (amalgam, silicate, acrylic or equivalent); (g) emergency treatment; (h) space maintainers not involving the movement of teeth; (i) periodontal treatment including surgery and post-surgical treatment, excluding prosthesis and appliances; (j) endodontic treatment (root canal therapy;)); (k) oral surgical procedures, including the removal of teeth (erupted, un-erupted or impacted;)); (l) general anesthesia in connection with oral surgery; ; (m) xm)x-rays in connection with oral surgery; (n) injections of antibiotic drugs by the attending dentist; (o) one (1) oral hygiene instruction per insured individual per life- time. (a) inlays and crowns; (b) complete dentures; (c) partial dentures; (d) fixed bridgework; (e) repair or recementing of crowns, inlays, bridgework and dentures or relining of dentures; (f) periodontal prosthesis or appliances.

Dental Expense Insurance. 10.01 Upon receipt by the insurer within ninety (90) days from the date of billing by the dentist and approval by the insurer of due proof that an eligible employee or dependent has incurred expenses for covered dental services, the insurer will, subject to Article 15, reimburse the employee for one hundred percent (100%) of the charges for covered dental services listed under Article 10.02, Part "“A"”; ninety percent (90%) of the charges for covered dental services listed under Article 10.02, Part "“B"”, subject to a total annual maximum reimbursement of $2,000.00 in a 24 month benefit period 1,000.00 for services under Part "“A" ” and/or Part "“B" ” and, after satisfying a deductible of fifty dollars ($50.00) for each treatment plan, fifty percent (50%) of the charges for dental services listed under Article 10.02, Part "“C"”, subject to a maximum lifetime benefit of $1,000.00. Benefits are provided under Parts "“A" ” and/or "“B" exclude ” excludes that portion of any charge which is in excess of the prevailing Schedule of Fees of the Provincial Dental Association in the Province of residence. 10.02 Covered dental services shall be the following: -: (a) oral examination and diagnosis; but not more than once in any nine (9) month period for employees and dependents age 18 or over; (b) complete series of periapical films but not more than once in any five (5) year period; (c) prophylaxis including scaling and polishing of teeth but not more than once in any nine (9) month period for employees and dependents age 18 or overperiod; (d) bitewing x-rays but not more than once in any nine six (96) month period for employees and dependents age 18 and overperiod; (e) topical application of any anti-cariogenic agent (e.g., e.g. stannous fluoride); but not more than once in any nine (9) month period for employee and dependents age 18 or over; (f) plastic fillings (amalgam, silicate, acrylic or equivalent); ; (g) emergency g)emergency treatment; (h) space maintainers not involving the movement of teeth; (i) periodontal treatment including surgery and post-surgical treatment, excluding prosthesis and appliances; (j) endodontic treatment (root canal therapy;) (k) oral surgical procedures, including the removal of teeth (erupted, un-erupted or impacted;) (l) general anesthesia in connection with oral surgery; (m) x-rays in connection with oral surgery; (n) injections of antibiotic drugs by the attending dentist; (o) one (1) oral hygiene instruction per insured individual per life- time. (a) inlays and crowns; (b) complete dentures; (c) partial dentures; (d) fixed bridgework; (e) repair or recementing of crowns, inlays, bridgework and dentures or relining of dentures; (f) periodontal prosthesis or appliances.

Dental Expense Insurance. 10.01 Upon receipt by the insurer within ninety (90) days from the date of billing by the dentist and approval by the insurer of due proof that an eligible employee or dependent has incurred expenses for covered dental services, the insurer will, subject to Article 15, reimburse re-imburse the employee for one hundred percent (100%) of the charges for covered dental services listed under Article 10.02, Part "A",; ninety percent (90%) of the charges for covered dental services listed under Article 10.02, Part "B", subject to $2,000.00 in a 24 month benefit period for services under Part "A" and/or Part "B" and, after satisfying a deductible of fifty dollars ($50.00) for each treatment plan, fifty percent (50%) of the charges for dental services listed under Article 10.02, Part "C", subject to a maximum lifetime benefit of $1,000.00. Benefits are provided under Parts "A" and/or "B" exclude that portion of any charge which is in excess of the prevailing Schedule of Fees of the Provincial Dental Association in the Province of residence. 10.02 Covered dental services shall be the following: - (a) oral examination and diagnosis; but not more than once in any nine (9) month period for employees and dependents age 18 or over; (b) complete series of periapical films but not more than once in any five (5) year period; (c) prophylaxis including scaling and polishing of teeth but not more than once in any nine (9) month period for employees and dependents age 18 or over; (d) bitewing x-rays but not more than once in any nine (9) month period for employees and dependents age 18 and over; (e) topical application of any anti-cariogenic agent (e.g., stannous fluoride); but not more than once in any nine (9) month period for employee and dependents age 18 or over; (f) plastic fillings (amalgam, silicate, acrylic or equivalent); (g) emergency treatment; (h) space maintainers not involving the movement of teeth; (i) periodontal treatment including surgery and post-surgical treatment, excluding prosthesis and appliances; (j) endodontic treatment (root canal therapy;) (k) oral surgical procedures, including the removal of teeth (erupted, un-un- erupted or impacted;) (l) general anesthesia in connection with oral surgery; (m) x-rays in connection with oral surgery; (n) injections of antibiotic drugs by the attending dentist; (o) one (1) oral hygiene instruction per insured individual per life- time. (a) inlays and crowns; (b) complete dentures; (c) partial dentures; (d) fixed bridgework; (e) repair or recementing of crowns, inlays, bridgework and dentures or relining of dentures; (f) periodontal prosthesis or appliances.