My WebLink
|
Help
|
About
|
Sign Out
Home
Browse
Search
METLIFE DENTAL
Clerk
>
Contracts / Agreements
>
M
>
METLIFE DENTAL
Metadata
Thumbnails
Annotations
Entry Properties
Last modified
3/27/2018 10:31:58 AM
Creation date
3/27/2018 9:36:51 AM
Metadata
Fields
Template:
Contracts
Company Name
METLIFE DENTAL
Contract #
A-2018-020
Agency
PERSONNEL SERVICES
Council Approval Date
2/6/2018
Destruction Year
0
There are no annotations on this page.
Document management portal powered by Laserfiche WebLink 9 © 1998-2015
Laserfiche.
All rights reserved.
/
50
PDF
Print
Pages to print
Enter page numbers and/or page ranges separated by commas. For example, 1,3,5-12.
After downloading, print the document using a PDF reader (e.g. Adobe Reader).
View images
View plain text
DEFINITIONS <br />As used in this evidence of coverage, the terms listed below will have the meanings set forth below. When <br />defined terms are used in this evidence of coverage, they will appear with initial capitalization. The plural use <br />of a term defined in the singular will share the same meaning, <br />Amalgam means a silver filling material usually used an posterior teeth. <br />Anterior means teeth located in the front of the mouth — upper and lower six (B) teeth with three in each <br />Quadrant of the mouth; twelve (12) teeth In total. <br />Asymptomatic means without symptoms, the absence of any indication of disease, surrounding pathology or <br />impaired function. <br />Bicuspid means teeth located immediately In front of the molar teeth — upper and lower with two in each <br />Quadrant of the mouth; eight (8) teeth in total. <br />Bridge or Bridgework means a fixed replacement for one or more missing teeth that is permanently attached <br />to the teeth adjacent to the empty space(s). <br />Cast Restoration means an inlay, onlay, or crown. <br />Co -Payment or Co -Pay means a fixed dollar amount or a fixed percentage of the Maximum Allowed Charge <br />of the Covered Services performed by Your Selected General Dentist, for which We are not responsible, as <br />shown in the Schedule of Benefits. You must pay Your Co -Payment at the time of delivery of supplies or <br />services. <br />Cosmetic means services performed solely for appearance. Treatment of decay, disease or injury to the <br />teeth or supporting tissues of the teeth is not evident Cosmetic means any procedure which is directed at <br />improving the patient's appearance and does not meaningfully promote the proper function or prevent or treat <br />Illness or disease. <br />Covered Service means a dental service used to treat Your orYcur dependents dental condition which is: <br />• prescribed or performed by a Dentist while such person is covered for dental benefits; <br />• Dentally Necessary to treat the condition; and <br />• described in the Schedule of Benefits, or <br />• Dental Benefits sections of this evidence of coverage. <br />Crown means a restoration place over a tooth to strengthen andfor replace missing tooth structure. A crown <br />can be made of different materials, for example, noble, high noble, and base metals, or porcelain or porcelain <br />and metal. <br />Dental Hygienist means a person trained to: <br />• remove calcareous deposits and stains from the surfaces of teeth; and <br />• provide information on the prevention of oral disease, <br />The term does not include; <br />• You; <br />• Your Spouse; or <br />• any member of Your immediate family including Your and/or Your Spouse's parents; children <br />(natural, step or adopted); siblings; grandparents; or grandchildren. <br />Dentally Necessary means that a dental service or treatment is performed in accordance with generally <br />accepted dental standards and Is: <br />• necessary to treat decay, disease or injury of the teeth; or <br />• essential for the care of the teeth and supporting tissues of the teeth. <br />GCERT2011-DHMO-EOC 25C-33 19 <br />
The URL can be used to link to this page
Your browser does not support the video tag.