UNDERSTANDING THE BASICS. 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. Benefits available under this Benefit Plan are described in the Dental Care and Treatment Benefits Article below. Not every Group provides coverage for every service. The services that are available to the Plan Participant under this Benefit Plan are listed in the Schedule of Benefits. A Plan Participant must meet the Employer’s Eligibility Waiting Period before coverage is effective on this dental plan. Once effective, each service may be subject to a different Dental Waiting Period, Deductible, Coinsurance, Benefit Period Maximum and/or Lifetime Maximum as shown in the Schedule of Benefits. The Group may apply to the Plan Administrator to change the covered services on the Group's anniversary date. Any special Benefits or limitations are shown in the Schedule of Benefits. Benefits offered may be limited to the least costly treatment. As of the later of the Original Effective Date or the Amended Effective Date of the Benefit Plan shown in the Group’s Schedule of Benefits, We agree to provide the dental Benefits specified herein for Employees of the Group and their enrolled Dependents. This Benefit Plan replaces any others previously issued to the Group/Policyholder. A word used in the masculine gender applies also in the feminine gender, except where otherwise stated. Reference to health care may be applied to dental services provided under this Benefit Plan.
UNDERSTANDING THE BASICS. OF YOUR COVERAGE THIS IS A LIMITED BENEFIT POLICY PROVIDING COVERAGE FOR NEEDLE STICKS ONLY. PLEASE READ CAREFULLY. Blue Cross and Blue Shield of Louisiana issues this Student Group Health Insurance Limited Benefit Plan to the University shown on the Schedule of Benefits. A copy of this Benefit Plan provided to a Subscriber serves as the Subscriber’s certificate of coverage. As of the Benefit Plan Date shown in the University’s Schedule of Benefits, We agree to provide the Benefits specified herein for Subscribers of the University. This Benefit Plan replaces any others previously issued to the University as of the Benefit Plan Date or amended Benefit Plan Date. This Plan describes Your Benefits, as well as Your rights and responsibilities under the Plan. We encourage You to read this Benefit Plan carefully. You should call Us if You have questions about Your coverage or any limits to the coverage available to You. Many of the sections of this Benefit Plan are related to other sections of this Plan. You may not have all of the information You need by reading just one section. Please be aware that Your Physician does not have a copy of Your Benefit Plan, and is not responsible for knowing or communicating Your Benefits. Except for necessary technical terms, We use common words to describe the benefits provided under this Benefit Plan. “We,” “Us” and “Our” means BLUE CROSS AND BLUE SHIELD OF LOUISIANA. Capitalized words are defined terms in Article II - “Definitions.” A word used in the masculine gender applies also in the feminine gender, except where otherwise stated.
