List of Benefits. The following benefits are covered by the Health Plan. Benefits are listed alphabetically for your convenience. Some benefits are subject to benefit-specific limitations and/or exclusions, which are listed, when applicable, directly below each benefit. A broader list of exclusions that apply to all benefits, regardless of whether they are Medically Necessary, is provided under Exclusions in this section. Accidental Dental Injury Services We cover restorative Services necessary to promptly repair, but not replace, sound natural teeth that have been injured as the result of an external force. Coverage is provided when all of the following conditions have been met: 1. The accident has been reported to your primary care Plan Physician within seventy-two (72) hours of the accident. 2. A Plan Provider provides the restorative dental Services; 3. The injury occurred as the result of an external force that is defined as violent contact with an external object; not force incurred while chewing; 4. The injury was sustained to sound natural teeth; 5. The covered Services must be requested within sixty (60) days of the injury; and 6. The covered Services are provided during the twelve (12) consecutive month period commencing from the date that treatment for the injury occurred. Coverage under this benefit is provided for the most cost-effective procedure available that, in the opinion of the Plan Provider, would produce the most satisfactory result. For the purposes of this benefit, sound natural teeth are defined as a tooth or teeth that have not been: 1. Weakened by existing dental pathology such as decay or periodontal disease, or 2. Previously restored by a crown, inlay, onlay, porcelain restoration, or treatment by endodontics. See the benefit-specific exclusions immediately below for additional information. Benefit-Specific Exclusions: 1. Services provided by non-Plan Providers. 2. Services provided after twelve (12) months from the date the injury occurred. 3. Services for teeth that have been avulsed (knocked out) or that have been so severely damaged that, in the opinion of the Plan Provider, restoration is impossible. Allergy Services We cover the following allergy Services: 1. Evaluations and treatment; and 2. Injections and serum. Ambulance Services We cover licensed ambulance Services only if your medical condition requires: 1. The basic life support, advanced life support, or critical care life support capabilities of an ambulance for inter-facility or h...
List of Benefits. The District shall make available during the duration of this Agreement a benefits program consisting of the following:
List of Benefits. Note: This Article does not thoroughly describe your entire benefits package. Please refer to your insurance booklet for detailed coverage information. The District shall make available during the duration of this Agreement a benefits program consisting of the following:
List of Benefits. Section 3.23 of the Xxxxxx Disclosure Schedule contains a complete and accurate list of each plan, program, policy, practice, contract, agreement or other arrangement providing for employment, compensation, retirement, deferred compensation, loans, severance, separation, relocation, repatriation, expatriation, visas, work permits, termination pay, performance awards, bonus, incentive, stock option, stock purchase, stock bonus, phantom stock, stock appreciation right, supplemental retirement, fringe benefits, cafeteria benefits or other benefits, whether written or unwritten, including without limitation each “employee benefit plan” within the meaning of Section 3(3) of the Employee Retirement Income Security Act of 1974, as amended (“ERISA”), which is or has been sponsored, maintained, contributed to, or required to be contributed to by Xxxxxx and, with respect to any such plans which are subject to Code Section 401(a), any trade or business (whether or not incorporated) that is or at any relevant time was treated as a single employer with Xxxxxx within the meaning of Section 414(b), (c), (m) or (o) of the Code (an “ERISA Affiliate”) for the benefit of any person who performs or who has performed services for Xxxxxx or with respect to which Xxxxxx or any ERISA Affiliate has or may have any liability (including without limitation contingent liability) or obligation (collectively, the “Xxxxxx Employee Plans”). Xxxxxx has never, whether formally or informally, adopted or maintained any Xxxxxx Employee Plan for the benefit of employees outside the United States.
List of Benefits. The following benefits are covered by the Health Plan. Benefits are listed alphabetically for your convenience. Some benefits are subject to benefit-specific limitations and/or exclusions, which are listed, when applicable, directly below each benefit. A broader list of exclusions that apply to all benefits, regardless of whether they are Medically Necessary, is provided under Exclusions in this section.
List of Benefits
