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Receiving Your Benefits

If Your Claim Is Denied

Approval of an On-going Course of Treatment

If the Dental Plan has approved an ongoing course of treatment to be provided over a period of time or approved a number of treatments, the following will apply:

Unless the Dental Plan is amended or terminated, any reduction or termination in the course of treatment will be treated as an adverse determination on a claim (or a claim denial).

The Plan Administrator will notify you sufficiently in advance to allow you to appeal and obtain a decision on appeal before the reduction or termination.

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While this Summary Plan Description summarizes the major provisions of this plan, it does not provide you with every plan detail. The plan documents, which govern this plan, provide full details. If there are any discrepancies between this Summary Plan Description and the legal plan documents, the legal plan documents control.

 

 



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