Common use of In-Network Annual Maximum Clause in Contracts

In-Network Annual Maximum. This Policy has an in-network annual maximum for in-network non-orthodontic benefits described in the Adult Dental Care section of this Policy. There is no annual maximum for the in-network pediatric dental essential health benefit. When Members receiving adult dental care or additional pediatric dental care have met the in-network annual maximum for non-orthodontic in-network Covered Services in the Schedule of Benefits section of this Policy, no more benefits will be payable for that Member for the remainder of that Plan Year. If you have other than individual coverage, the individual in-network annual maximum for adult dental care benefits applies to each person covered under this Policy. Once a person within a family meets the individual in-network annual maximum for adult dental care, no more benefits for services will be payable for that person. If other than individual coverage applies, when persons in the same family covered under this Policy have collectively met the family in-network annual maximum for benefits described in the Adult Dental Care section of this Policy, no more benefits will be payable for the family for the rest of that Plan Year.