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Last modified
3/27/2018 10:31:58 AM
Creation date
3/27/2018 9:36:51 AM
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Contracts
Company Name
METLIFE DENTAL
Contract #
A-2018-020
Agency
PERSONNEL SERVICES
Council Approval Date
2/6/2018
Destruction Year
0
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Continuation under a New Plan <br />Your Organization must notify each person who has continued benefits under this plan if this plan ends for <br />any reason and Is replaced by Your Organization with a new group plan. The notice must be given thirty (30) <br />days before this plan ends. The notice will be sent to the last known address of the person who has continued <br />coverage under this plan, If this plan ends, continued benefits under this plan will end. A person who has <br />continued benefits under this plan may then elect similar coverage under Your Organization's new group plan, <br />If any, for the balance of the period that the person would have remained covered under this plan. Continued <br />benefits will end for that person if the person does not, within thirty (30) days of receiving notice that this plan <br />has ended, enroll in the new plan and pay any required contribution to the cost of the new plan. Your <br />Organization will provide benefit and contribution information, enrollment forms and instructions for enrolling <br />In the new plan. This information will be sent to the last known address of the person who has a right to <br />continue benefits. If Your Organization or any successor Organization or purchaser of Your Organization <br />ceases to provide a similar group benefit plan to active employees, the right to continue benefits ends, <br />GENERAL PROVISIONS <br />Entire Contract <br />Your dental benefits are provided under a group contract with Your Organization, The entire contract with <br />Your Organization is made up of the following: <br />1. the group contract and Its Exhibits, which include the evidence of coverage and Schedules of <br />Benefits; <br />2. Your Organization's application; and <br />3. any amendments and/or endorsements to the group contract. <br />Incontestability: Statements Made by You <br />Any statement made by You will be considered a representation and not a warranty. We will not use such <br />statement to avoid or reduce benefits or defend a claim unless the following requirements are met: <br />1, the statement is in a Written application or enrollment form; <br />2. You have Signed the application or enrollment form; and <br />3, a copy of the application or enrollment form has been given to You or Your Beneficiary. <br />Misstatement of Age <br />If Your or Your dependent's age Is misstated, the correct age will be used to determine eligibility for dental <br />benefits and, as appropriate, We will adjust the benefits and/or premiums. <br />Conformity with Law <br />If the terms and provisions of this evidence of coverage do not conform to any applicable law, this evidence of <br />coverage shall be interpreted to so conform. <br />Public Policy Committee <br />The Public Policy Committee (°Committee") provides Our clients with the opportunity to participate in the <br />review of quality improvement activities. Representatives of group contractholders, Selected General <br />Dentists and Specialty Care Dentists, and Our employees, meet quarterly to discuss quality improvement <br />activities and policies. if You are Interested in being a representative to the Committee meeting, please <br />contact Us at (800) 880-1800 and ask for the Director of Quality Management. <br />GCERT2011-OHMO-EOC 26C-32 18 <br />
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