Article XIV. If the joint report or, as the case may be, the decision of the arbitral tribunal under Article XIV finds that the defence is valid, the tribunal shall be bound by this finding. Tribunals for disputes on prudential issues and other financial matters shall have the necessary expertise relevant to the specific financial service in dispute.
Article XIV. 47 COUNTERPARTS ............................................................................. 47 ARTICLE XV .................................................................................... 47
Article XIV. 11-12 Hospitalization, Medical and Dental............................Article XVI.................. 15-17
Article XIV. ARTICLE XV. UNDERSTANDING THE BASICS OF YOUR COVERAGE 5 DEFINITIONS 6 SCHEDULE OF ELIGIBILITY 11 BENEFITS 17 EXCLUSIONS 22 PRE-DETERMINATIONS 24 ALTERNATE BENEFITS 24 COORDINATION OF THIS BENEFIT PLAN WITH OTHER DENTAL COVERAGE OF WHICH THIS BENEFIT PLAN FORMS A PART 24 BENEFIT EXTENSION PERIOD AFTER TERMINATION OF COVERAGE 24 CONTINUATION OF COVERAGE RIGHTS 25 GENERAL PROVISIONS – GROUP/POLICYHOLDER AND MEMBERS 31 COMPLAINT, GRIEVANCE AND APPEAL PROCEDURES 39 ERISA RIGHTS 42 MAKING PLAN CHANGES AND FILING CLAIMS 43 GENERAL PROVISIONS – GROUP/POLICYHOLDER ONLY 45 ARTICLE I. UNDERSTANDING THE BASICS OF YOUR COVERAGE The Schedule of Dental Benefits controls in regards to which specific dental Benefits are covered and the cost sharing (deductibles, coinsurance) applicable to each Benefit. The Benefits offered under this Benefit Plan are limited as stated in the Benefits section. UNITED CONCORDIA DENTAL United Concordia Companies, Inc. d/b/a United Concordia Dental (hereinafter “United Concordia Dental” or “Claims Administrator”) is the Blue Cross and Blue Shield of Louisiana’s network and claims administrator for the dental Benefits provided in this Contract, and is in charge of managing the dental networks, handling and paying claims, and providing customer services to the Members eligible to receive these benefits and their legal representatives. United Concordia Dental has more than one network. Only one specific network will be made available to Members under this Benefit Plan (hereinafter the “Network”). The specific Network will be disclosed on the Schedule of Dental Benefits. The Network consists of a select group of Providers who have contracted with United Concordia Dental to render services to Members for specified fees and under specific terms. All other Providers are considered Non-Participating. Non-Participating Providers may bill you more for their services than Participating Providers. In order to receive the full benefits under this Benefit Plan, the Member should verify that a Provider participates in the specific Network before any service is rendered. To locate a Participating Provider and verify their continued participation in the Network, or to ask any questions related to Benefits or claims, please visit the website at xxx.xxxxxx.xxx or contact a customer service representative at (000) 000-0000. We”, “Us” and “Our” in this Benefit Plan means the Company or United Concordia Dental when it acts on behalf of Blue Cross and Blue Shield...
Article XIV. A. Replace the existing Article 14.01 through 14.08 with the following:
Article XIV. 47 IMMUNITY OF INCORPORATORS, STOCKHOLDERS, OFFICERS AND DIRECTORS......................................... 47 SECTION 14.1.
Article XIV. Allocation of Income, Gains and Losses; Distributions........................................... 14
Article XIV. Rights in the Event of a Change in Control of a Member and Poor Financial Performance... 39 Section 14.1. PPG Purchase Rights Upon a Change in Control of Apogee............................. 39
Article XIV. 47 14.1 AMENDMENT..............................................................47 14.2
