Common Contracts

2 similar Whole Health Balance Subscription Agreement contracts

WHOLE HEALTH BALANCE SUBSCRIPTION AGREEMENT
Whole Health Balance Subscription Agreement • November 15th, 2018

DESCRIPTION OF COVERAGE: This Agreement sets forth a program of limited dental, fitness and wellness education, hearing and vision care benefits. Cost-sharing in the form of Copayments applies to certain benefits. Maximums also apply to certain benefits. Maximums may apply in the form of maximum program Plan Allowances and/or benefit frequencies. When provider charges exceed an applicable maximum Plan Allowance, the Member will be responsible for additional amounts not covered by the Plan. Benefits provided for certain covered services or products are only available when performed by or received from a Network or Participating Provider, as designated by the Plan. Benefits for dental services are only available when covered services are received from a United Concordia Advantage Plus Provider Network provider. Hearing services and aids are only available from a TruHearing Provider. Benefits for vision care services and products are only available from a Davis Vision Network provider. A

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WHOLE HEALTH BALANCE SUBSCRIPTION AGREEMENT
Whole Health Balance Subscription Agreement • November 15th, 2018

DESCRIPTION OF COVERAGE: This Agreement sets forth a program of limited dental, fitness and wellness education, hearing and vision care benefits. Cost-sharing in the form of Copayments applies to certain benefits. Maximums also apply to certain benefits. Maximums may apply in the form of maximum program Plan Allowances and/or benefit frequencies. When provider charges exceed an applicable maximum Plan Allowance, the Member will be responsible for additional amounts not covered by the Plan. Benefits provided for certain covered services or products are only available when performed by or received from a Network or Participating Provider, as designated by the Plan. Benefits for dental services are only available when covered services are received from a Network, United Concordia Advantage Plus Provider Network provider. Hearing services and aids are only available from a TruHearing Provider. Benefits for vision care services and products are only available from a Davis Vision Network pro

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