Receiving Your Benefits

If Your Claim Is Denied

Urgent Care Claims

If your appeal is in connection with an urgent care claim, the Plan Administrator will notify you of its decision on appeal as soon as possible taking into account medical circumstances, but not later than 72 hours after the Dental Plan received the appeal.

Claim Requiring Advance Approval or Pre-Authorization

If your appeal is in connection with a claim for benefits requiring advance approval by the Plan Administrator, you will be notified of its decision on appeal, adverse or not, within a reasonable period of time appropriate to the medical circumstances, but not later than 30 days after the Dental Plan received your appeal.

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.