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2012-038 Human Resources - Delta Dental Claims & Administrative fees
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2012-038 Human Resources - Delta Dental Claims & Administrative fees
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8/6/2012 10:25:32 AM
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3/12/2012 3:09:21 PM
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3/12/2012
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2012-038 Human Resources - Delta Dental $460,000
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D. Copayment <br />means the percentage of the charge, if any, that the Eligible Person must pay for Covered Services. <br />E. Covered Services <br />means the unique dental services selected for coverage as described in Exhibit A and subject to the terms <br />and conditions of this Contract. <br />F. Deductible <br />means the amount a person and/or a family must pay toward Covered Services before Delta Dental begins <br />paying for services under this Contract. If the Contractor has selected a Deductible, it will be indicated in <br />Exhibit A. <br />G. Delta Dental <br />means Delta Dental of North Carolina, a non-profit health service plan corporation. Delta Dental is not a <br />commercial insurance company. <br />H. Delta Dental Plan <br />means an individual dental benefit plan that is a member of the Delta Dental Plans Association, the <br />nation's lazgest, most experienced system of dental health plans. <br />I. Delta Dental PPO plus Premier <br />means Delta Dental's national preferred provider organization that can reduce out-of-pocket expenses for <br />Eligible Persons if they receive care from one of Delta Dental's PPO Dentists. This program has back-up <br />coverage through the Delta Dental Premier network when treatment is received from a Non-PPO Dentist. <br />J. Delta Dental PPO (Standard) <br />means Delta Dental's national preferred provider organization that can reduce out-of-pocket expenses for <br />Eligible Persons if they receive care from one of Delta Dental's PPO Dentists. <br />K. Delta Dental Premier <br />means Delta Dental's national fee-for-service dental benefits program. <br />L. Dentist <br />means a person licensed to practice dentistry in the state or country in which dental services are rendered. <br />1. Delta Dental PPO Dentist (PPO Dentist) means a Dentist who has signed an agreement with the <br />Delta Dental Plan in his or her state to participate in Delta Dental PPO. PPO Dentists agree to accept <br />Delta Dental's payment and the Eligible Person's Copayment, if any, as payment in full for Covered <br />Services. <br />2. Delta Dental Premier Dentist (Premier Dentist) means a Dentist who has signed an agreement <br />with the Delta Dental Plan in his or her state to participate in Delta Dental Premier. Premier Dentists <br />agree to accept Delta Dental's payment and the Eligible Person's Copayment, if any, as payment in <br />full for Covered Services. <br />3. Nonparticipating Dentist means a Dentist who has not signed an agreement with any Delta Dental <br />Plan to participate in Delta Dental PPO or Delta Dental Premier. <br />4. Out-of-Country Dentist means a Dentist whose office is located outside of the United States and its <br />territories. Out-of-Country Dentists are not eligible to sign participating agreements with Delta Dental, <br />but may participate in the Passport Dental program. <br />Revised 09/2011 2 <br />
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