Jefferson Pilot Life Ins.#1 - Laserfiche WebLink

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TABLE OF CONTENTS • Schedule of Benefits ................................................................................................... ............................... 3 Definitions.................................................................................................................. ............................... 4 GeneralProvisions ...................................................................................................... ............................... 8 Eligibility and Effective Dates for Employee Dental Coverage ................................. ............................... 10 Termination of Employee Dental Coverage ............................................................... ............................... 11 Eligibility for Dependent Dental Coverage ................................................................ ............................... 13 Termination of Dependent Dental Coverage .............................................................. ............................... 15 Premiums and Premium Rates .................................................................................... ............................... 16 PolicyTermination ..................................................................................................... ............................... 17 DentalExpense Benefits ............................................................................................. ............................... 18 AlternativeProcedures ............................................................................................... ............................... 19 Limitations and Exclusions ........................................................................................ ............................... 20 Coordination of Dental Expense Benefits .................................................................. ............................... 23 • Claims Procedures for Dental Coverage ..................................................................... ............................... 25 Predeterminationof Benefits ...................................................................................... ............................... 27 DentalCoverage Continuation ................................................................................... ............................... 28 TypeI Procedures ....................................................................................................... ............................... 31 TypeII Procedures ..................................................................................................... ............................... 32 TypeIII Procedures .................................................................................................... ............................... 35 PriorCarrier Credit Provision ..................................................................................... ............................... 37 • G L 11 -2 -TC 2 09/01/01