Common use of Covered Dental Expenses Clause in Contracts

Covered Dental Expenses. Covered Dental Expenses are the usual charges of a dentist which an employee, retired employee or surviving spouse is required to pay for services and supplies which are necessary for treatment of a dental condition, but only to the extent that such services and supplies are customarily employed for treatment of that condition, and only if rendered in accordance with accepted standards of dental practice. Such expenses shall be only those incurred in connection with the following dental services which are performed, except as otherwise provided in Section VII (B), by a licensed dentist and which are received while insurance is in force. Payments for Covered Dental Expenses performed by a licensed dentist (or a licensed dental hygienist under conditions specified in Section VII (B) (1)) shall be based upon the applicable percentage of the lesser of the dentist's usual charge for the service or of the fee specified for the service in the Provincial Dental Association Schedule of Fees as defined in Section XIII, but only for the services set forth below, and not for any other services listed in such Schedule of Fees. Where fees for certain procedures are shown in such Schedule of Fees as "I.C." (Individual Consideration) payment will be made on the basis of the usual, reasonable and customary charges for such procedures. Provided, however, that in the event no Provincial Dental Association Schedule of Fees is in effect for 2008, payments under this Section III for Covered Dental Expenses, as described in the first sentence of this paragraph, shall be made on the basis of the usual, reasonable and customary charges for the service rendered or supply furnished in 2008. Payments for Covered Dental Expenses performed by a licensed denture therapist in accordance with Section VII (B) (2) shall be based upon the applicable percentage of the lesser of the denture therapist's usual charge for the service or of the fee specified for the service in the Ontario fee schedule for Licensed Denture Therapists as defined in Section XIII, but only for the services set forth below, and not for any other services listed in such fee schedule. Provided, however, that in the event no Ontario fee schedule for Licensed Denture Therapists is in effect for 2008, payments under this Section III for such Covered Dental Expenses shall be made on the basis of the usual, reasonable and customary charges for the service rendered or supply furnished in 2008.

Covered Dental Expenses. Covered Dental Expenses are the usual charges of a dentist which an employee, retired employee or surviving spouse is required to pay for services and supplies which are necessary for treatment of a dental condition, but only to the extent that such services and supplies are customarily employed for treatment of that condition, and only if rendered in accordance with accepted standards of dental practice. Such expenses shall be only those incurred in connection with the following dental services which are performed, except as otherwise provided in Section VII (B), by a licensed dentist and which are received while insurance is in force. Payments for Covered Dental Expenses performed by a licensed dentist (or a licensed dental hygienist under conditions specified in Section VII (B) (1)) shall be based upon the applicable percentage of the lesser of the dentist's usual charge for the service or of the fee specified for the service in the Provincial Dental Association Schedule of Fees as defined in Section XIII, but only for the services set forth below, and not for any other services listed in such Schedule of Fees. Where fees for certain procedures are shown in such Schedule of Fees as "I.C." (Individual Consideration) payment will be made on the basis of the usual, reasonable and customary charges for such procedures. Provided, however, that in the event no Provincial Dental Association Schedule of Fees is in effect for 2008, payments under this Section III for Covered Dental Expenses, as described in the first sentence of this paragraph, shall be made on the basis of the usual, reasonable and customary charges for the service rendered or supply furnished in 2008. Payments for Covered Dental Expenses performed by a licensed denture therapist in accordance with Section VII (B) (2) shall be based upon the applicable percentage of the lesser of the denture therapist's usual charge for the service or of the fee specified for the service in the Ontario fee schedule for Licensed Denture Therapists as defined in Section XIII, but only for the services set forth below, and not for any other services listed in such fee schedule. Provided, however, that in the event no Ontario fee schedule for Licensed Denture Therapists is in effect for 2008, payments under this Section III for such Covered Dental Expenses shall be made on the basis of the usual, reasonable and customary charges for the service rendered or supply furnished in 2008.

Covered Dental Expenses. Covered Dental Expenses are the usual charges of a dentist which an employeea team member, retired employee team member or surviving spouse is required to pay for services and supplies which are necessary for treatment of a dental condition, but only to the extent that such services and supplies are customarily employed for treatment of that condition, and only if rendered in accordance with accepted standards of dental practice. Such expenses shall be only those incurred in connection with the following dental services which are performed, except as otherwise provided in Section VII subsection (B)h)(3) herein, by a licensed dentist and which are received while insurance is in force. Payments for Covered Dental Expenses performed by a licensed dentist (or a licensed dental hygienist under conditions specified in Section VII subsection (Bh)(3) (1)herein) shall be based upon the applicable percentage of the lesser of the dentist's usual charge for the service or of the fee specified for the service in the Provincial Dental Association Schedule of Fees as defined in Section XIIIsubsection (k) herein, but only for the services set forth belowherein, and not for any other services listed in such Schedule of Fees. Where fees for certain procedures are shown in such Schedule of Fees as "I.C." (Individual Consideration) payment will be made on the basis of the usual, reasonable and customary charges for such procedures. Provided, however, that in the event no Provincial Dental Association Schedule of Fees is in effect for 2008, payments under this Section III for at the time Covered Dental Expenses, as described in the first sentence of this previous paragraph, are incurred, payments under this subsection (d) shall be made on the basis of the usual, reasonable and customary charges for the service rendered or supply furnished furnished. Effective January 1, 2014, covered Dental Expenses will be reimbursed based on the Provincial Dental Association schedule of fees in 2008effect two (2) years prior to the date covered Dental Expenses are incurred. Effective October 1, 2017, covered Dental Expenses will be reimbursed based on the Provincial Dental Association schedule of fees in effect one (1) year prior to the date covered Dental Expenses are incurred. Payments for Covered Dental Expenses expenses performed by a licensed denture therapist in accordance with Section VII subsection (B) (2h)(3)(ii) shall be based upon the applicable percentage of the lesser of the denture therapist's usual charge for the service or of the fee specified for the service in the Ontario fee schedule for Licensed Denture Therapists as defined in Section XIIIsubsection (k), but only for the services set forth belowherein, and not for any other services listed in such fee schedule. Provided, however, that in the event no Ontario fee schedule for Licensed Denture Therapists is in effect for 2008at the time such Covered Dental Expenses are incurred, payments under this Section III for such Covered Dental Expenses subsection (d) shall be made on the basis of the usual, reasonable and customary charges for the service rendered or supply furnished furnished. Effective January 1, 2014, covered Dental Expenses will be reimbursed based on the Provincial Dental Association schedule of fees in 2008effect two (2) years prior to the date covered Dental Expenses are incurred. Effective October 1, 2017, covered Dental Expenses will be reimbursed based on the Provincial Dental Association schedule of fees in effect one (1) year prior to the date covered Dental Expenses are incurred.

Covered Dental Expenses. Covered Dental Expenses are the usual charges of a dentist which an employee, retired employee or surviving spouse is required to pay for services and supplies which are necessary for treatment of a dental condition, but only to the extent that such services and supplies are customarily employed for treatment of that condition, and only if rendered in accordance with accepted standards of dental practice. Such expenses shall be only those incurred in connection with the following dental services which are performed, except as otherwise provided in Section VII (B), by a licensed dentist and which are received while insurance is in force. Payments for Covered Dental Expenses performed by a licensed dentist (or a licensed dental hygienist under conditions specified in Section VII (B) (1)) shall be based upon the applicable percentage of the lesser of the dentist's usual charge for the service or of the fee specified for the service in the 2008 Provincial Dental Association Schedule of Fees as defined in Section XIII, but only for the services set forth below, and not for any other services listed in such Schedule of Fees. Where fees for certain procedures are shown in such Schedule of Fees as "I.C." (Individual Consideration) payment will be made on the basis of the usual, reasonable and customary charges for such procedures. Provided, however, that in the event no Provincial Dental Association Schedule of Fees is in effect for 2008, payments under this Section III for Covered Dental Expenses, as described in the first sentence of this paragraph, paragraph shall be made on the basis of the usual, reasonable and customary charges for the service rendered or supply furnished in 2008. Payments for Covered Dental Expenses performed by a licensed denture therapist in accordance with Section VII (B) (2) shall be based upon the applicable percentage of the lesser of the denture therapist's usual charge for the service or of the fee specified for the service in the current Ontario fee schedule for Licensed Denture Therapists as defined in Section XIII, but only for the services set forth below, and not for any other services listed in such fee schedule. Provided, however, that in the event no Ontario fee schedule for Licensed Denture Therapists is in effect for 2008, payments under this Section III for such Covered Dental Expenses shall be made on the basis of the usual, reasonable and customary charges for the service rendered or supply furnished in 2008.

Covered Dental Expenses. Covered Dental Expenses are the usual charges of a dentist which an employee, retired employee or surviving spouse is required to pay for services and supplies which are necessary for treatment of a dental condition, but only to the extent that such services and supplies are customarily employed for treatment of that condition, and only if rendered in accordance with accepted standards of dental practice. Such expenses shall be only those incurred in connection with the following dental services which are performed, except as otherwise provided in Section VII (B), by a licensed dentist and which are received while insurance is in force. Payments for Covered Dental Expenses performed by a licensed dentist (or a licensed dental hygienist under conditions specified in Section VII (B) (1)) shall be based upon the applicable percentage of the lesser of the dentist's usual charge for the service or of the fee specified for the service in the current Provincial Dental Association Schedule of Fees as defined in Section XIII, but only for the services set forth below, and not for any other services listed in such Schedule of Fees. Where fees for certain procedures are shown in such Schedule of Fees as "I.C." (Individual Consideration) payment will be made on the basis of the usual, reasonable and customary charges for such procedures. Provided, however, that in the event no Provincial Dental Association Schedule of Fees is in effect for 2008, payments under this Section III for one (1) year prior to the date Covered Dental Expenses, as described in the first sentence of this paragraph, are incurred, payments under this Section III shall be made on the basis of the usual, reasonable and customary charges for the service rendered or supply furnished in 2008one (1) year prior to the date the Covered Dental Expenses are incurred. Payments for Covered Dental Expenses performed by a licensed denture therapist in accordance with Section VII (B) (2) shall be based upon the applicable percentage of the lesser of the denture therapist's usual charge for the service or of the fee specified for the service in the current Ontario fee schedule for Licensed Denture Therapists as defined in Section XIII, but only for the services set forth below, and not for any other services listed in such fee schedule. Provided, however, that in the event no Ontario fee schedule for Licensed Denture Therapists is in effect for 2008one (1) year prior to the date such Covered Dental Expenses are incurred, payments under this Section III for such Covered Dental Expenses shall be made on the basis of the usual, reasonable and customary charges for the service rendered or supply furnished in 2008one (1) year prior to the date Covered Dental Expenses are incurred.

Covered Dental Expenses. Covered Dental Expenses are the usual charges of a dentist which an employee, retired employee or surviving spouse is required to pay for services and supplies which are necessary for treatment of a dental condition, but only to the extent that such services and supplies are customarily employed for treatment of that condition, and only if rendered in accordance with accepted standards of dental practice. Such expenses shall be only those incurred in connection with the following dental services which are performed, except as otherwise provided in Section VII subsection (B)h)(3) herein, by a licensed dentist and which are received while insurance is in force. Payments for Covered Dental Expenses performed by a licensed dentist (or a licensed dental hygienist under conditions specified in Section VII subsection (Bh)(3) (1)herein) shall be based upon the applicable percentage of the lesser of the dentist's usual charge for the service or of the fee specified for the service in the Provincial Dental Association Schedule of Fees as defined in Section XIIIsubsection (k) herein, but only for the services set forth belowherein, and not for any other services listed in such Schedule of Fees. Where fees for certain procedures are shown in such Schedule of Fees as "I.C." (Individual Consideration) payment will be made on the basis of the usual, reasonable and customary charges for such procedures. Provided, however, that in the event no Provincial Dental Association Schedule of Fees is in effect for 2008, payments under this Section III for at the time Covered Dental Expenses, as described in the first sentence of this previous paragraph, are incurred, payments under this subsection (d) shall be made on the basis of the usual, reasonable and customary charges for the service rendered or supply furnished furnished. Effective January 1, 2013, covered Dental Expenses will be reimbursed based on the Provincial Dental Association schedule of fees in 2008effect two years prior to the date covered Dental Expenses are incurred. Effective January 1, 2017, covered Dental Expenses will be reimbursed based on the Provincial Dental Association schedule of fees in effect one (1) year prior to the date covered Dental Expenses are incurred. Payments for Covered Dental Expenses performed by a licensed denture therapist in accordance with Section VII subsection (B) (2h)(3)(ii) shall be based upon the applicable percentage of the lesser of the denture therapist's usual charge for the service or of the fee specified for the service in the Ontario fee schedule for Licensed Denture Therapists as defined in Section XIIIsubsection (k), but only for the services set forth belowherein, and not for any other services listed in such fee schedule. Provided, however, that in the event no Ontario fee schedule for Licensed Denture Therapists is in effect for 2008at the time such Covered Dental Expenses are incurred, payments under this Section III for such Covered Dental Expenses subsection (d) shall be made on the basis of the usual, reasonable and customary charges for the service rendered or supply furnished furnished. Effective January 1, 2013, covered Dental Expenses will be reimbursed based on the Provincial Dental Association schedule of fees in 2008effect two years prior to the date covered Dental Expenses are incurred. Effective January 1, 2017, covered Dental Expenses will be reimbursed based on the Provincial Dental Association schedule of fees in effect one (1) year prior to the date covered Dental Expenses are incurred.

Covered Dental Expenses. Covered Dental Expenses dental expenses are the usual charges of a dentist which an employee, retired employee or surviving spouse is required to pay for services and supplies which are necessary for treatment of a dental condition, but only to the extent that such services and supplies are customarily employed for treatment of that condition, and only if rendered in accordance with accepted standards of dental practice. Such expenses shall be only those incurred in connection with the following dental services which are performed, except as otherwise provided in Section section VII (B), by a licensed dentist and which are received while insurance is in force. Payments for Covered Dental Expenses covered dental expenses performed by a licensed dentist (or a licensed dental hygienist under conditions specified in Section section VII (B) (1)) shall be based upon the applicable percentage of the lesser of the dentist's usual charge for the service or of the fee specified for the service in the Provincial Dental Association Schedule of Fees as defined in Section section XIII, but only for the services set forth below, and not for any other services listed in such Schedule of Fees. Where fees for certain procedures are as shown in such Schedule of Fees as "I.C." (Individual Consideration) payment will be made on the basis of the usual, reasonable and customary charges for such procedures. Provided, however, that in the event no Provincial Dental Association Schedule of Fees is in effect for 2008, payments under this Section III for Covered Dental Expensesone (1) year prior to the date covered dental expenses, as described in the first sentence of this paragraph, are incurred, payments under this section III shall be made on the basis of the usual, reasonable and customary charges for the service rendered or supply furnished in 2008one (1) year prior to the date the covered dental expenses are incurred. Payments for Covered Dental Expenses performed by a licensed denture therapist in accordance with Section section VII (B) (2) shall be based upon the applicable percentage of the lesser of the denture therapist's usual charge for the service or of the fee specified for the service in the Ontario fee schedule for Licensed Denture Therapists as defined in Section section XIII, but only for the services set forth below, and not for any other services listed in such fee schedule. Provided, however, that in the event no Ontario fee schedule for Licensed Denture Therapists is in effect for 2008one (1) year prior to the date such covered dental expenses are incurred, payments under this Section section III for such Covered Dental Expenses shall be made on the basis of the usual, reasonable and customary charges for the service rendered or supply furnished in 2008one (1) year prior to the date covered dental expenses are incurred.