Dental Maintenance Organization Clause Samples
A Dental Maintenance Organization (DMO) clause defines the structure and operation of a dental benefits plan in which members are required to use a specific network of dentists and dental care providers. Under this arrangement, participants typically select a primary care dentist from the network and must obtain all covered dental services through this provider, except in emergencies. The clause ensures cost control and coordinated care by limiting coverage to in-network services, thereby reducing out-of-pocket expenses for members and helping the plan sponsor manage overall dental care costs.
Dental Maintenance Organization. Effective January 1, 2000, the Employer shall offer an optional [Dental Maintenance Organization] DMO.
Dental Maintenance Organization. The Employer shall continue to offer bargaining unit employees the option of voluntarily enrolling in the dental maintenance organization (DMO). The parties understand that the state-approved service area for the DMO program encompasses only certain geographical areas. The DMO will grant a properly completed out-of-area waiver application from a unit employee. The parties also understand that all eligible dental services must be provided by a DMO network provider in order for coverage to be in effect (except for emergency treatment for the immediate relief of pain and suffering when the enrollee is more than fifty miles from a participating provider, which will be reimbursed at fifty percent (50%) of the usual, customary and reasonable rate of the non-participating provider).