HIGHMARK BLUE SHIELDWhole Health Balance Subscription Agreement • October 31st, 2018
The Plan complies with applicable Federal civil rights laws and does not discriminate on the basis of race, color, national origin, age, disability, or sex, including sex stereotypes and gender identity. The Plan does not exclude people or treat them differently because of race, color, national origin, age, disability, or sex assigned at birth, gender identity or recorded gender.
WHOLE HEALTH BALANCE SUBSCRIPTION AGREEMENTWhole 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
