Orthodontia Care Sample Clauses

Orthodontia Care. The City will contribute up to Ten Thousand Dollars for each fiscal year into a fund to provide reimbursement for employees' receipted costs for orthodontia expenses over the dental payment limit of One Thousand Five Hundred Dollars. Eligible employees can be reimbursed up to One Thousand Dollars per individual per lifetime for orthodontia upon proof of expense and limit reached on primary and secondary insurance. Reimbursements will be at the same percentage rate as the dental coverage (currently sixty percent). The orthodontia reserve account will be on a first come first serve basis. If funds are unavailable in one fiscal year, expenses may be submitted in the next fiscal year.

Orthodontia Care. The HEALTH PLAN shall provide, for MA, GAMC, or MinnesotaCare/MA Enrollees, orthodontia care if (i) an Out of Plan provider or the STATE has prior authorized such care, (ii) the care falls under an established plan of care, and (iii) the care plan has a definitive end date. Payment to the prior provider must be at least equivalent to the STATE MA fee-for-service rate for orthodontia care. In the alternative, the HEALTH PLAN may transfer the Enrollee to a HEALTH PLAN provider, if such a transfer would not create undue hardship on the Enrollee, and is clinically appropriate.