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Jefferson Pilot Life Ins.#1
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RFP No. 01-10-01 Employee Dental, Life, Insurance
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Jefferson Pilot Life Ins.#1
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Last modified
6/18/2012 10:02:26 PM
Creation date
12/28/2010 3:46:06 PM
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CityClerk-Bids_RFP_RFQ
Project Name
Employee Insurance
Bid No. (xx-xx-xx)
01-10-01
Project Type (Bid, RFP, RFQ)
RFP
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ALTERNATIVE PROCEDURES <br />W eere may be two or more methods of treating a dental condition. The amount of Covered Expense will be limited to the charge for <br />least costly procedure or treatment which: <br />(1) the dental profession recognizes to be Professionally Adequate, in accord with widely accepted standards of <br />dental practice; and <br />(2) the Company determines to be both Adequate and Appropriate, in view of the Covered Person's total current oral <br />condition. <br />To determine its liability for a dental procedure submitted for consideration, the Company may request the pre- operative dental x -rays <br />and any other pertinent information. Based on its review of this information, the Company will decide which procedure would <br />provide Professionally Adequate restoration, replacement or treatment. <br />The Covered Person may receive the more expensive procedure or treatment. However, the Company's liability for Covered Expense <br />will be limited to the least expensive procedure which it determines to be Professionally Adequate care. <br />To find out in advance what charges or alternative procedures will be considered Covered Expenses, a Covered Employee may use <br />the Dental Claim Procedure for Predetermination of Benefits, described in this Policy. <br />• <br />• <br />GL11 -13 -AP <br />19 09/01/01 <br />
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