What events does Standard Insurance Company's filed dental insurance policy say it pays for?

AI-drafted from filed documents · reviewed: pendingwhether a specific event is coveredStandard Insurance Company

Standard Insurance Company's filed dental insurance policy in Kentucky (KY) states that it pays for dental expenses incurred by an Insured, determined by the terms of the group policy [1]. Covered Expenses include usual and customary charges made by a provider for necessary dental treatment rendered while the person is insured [1]. The policy also pays for orthodontic expenses incurred by an Insured, defined as usual and customary charges for necessary orthodontic treatment rendered while insured [2]. Benefits for both dental and orthodontic expenses are subject to the Deductible, Coinsurance Percentage, and Maximum Amount shown in the Schedule of Benefits [1][2]. The Maximum Amount is the maximum benefit payable during the Insured’s lifetime for covered expenses [2]. This does not appear in these excerpts — check the full policy for a complete list of covered events or procedures.

Information only — not legal advice. The insurer decides.

These answers quote forms insurers filed with state regulators. Your own policy, its endorsements and your state’s rules control. A filed form may not be the version sold to you.

Where this comes from (2)

[1] Standard Insurance Company · KY · SERFF AMFA-132876431 · form 9219 KY Rev. 06-21 · p. 1 · 1 · DENTAL EXPENSE BENEFITS
DENTAL EXPENSE BENEFITS We will determine dental expense benefits according to the terms of the group policy for dental expenses incurred by an Insured. An Insured person has the freedom of choice to receive treatment from any Provider. DETERMINING BENEFITS. The benefits payable will be determined by totaling all of the Covered Expenses submitted into each benefit type as shown in the Table of Dental Procedures. This amount is reduced by the Deductible, if any. The result is then multiplied by the Coinsurance Percentage(s) shown in the Schedule of Benefits. … (excerpt — the filed text continues)
[2] Standard Insurance Company · KY · SERFF AMFA-133762011 · form 9260 KY Rev. 07-23 · p. 1 · 1 · ORTHODONTIC EXPENSE BENEFITS
ORTHODONTIC EXPENSE BENEFITS Orthodontic expense benefits will be determined according to the terms of the policy for orthodontic expenses incurred by an Insured. DETERMINING BENEFITS. The benefits payable will be determined by totaling all of the Covered Expenses submitted. This amount is reduced by the Deductible, if any. The result is then multiplied by the Coinsurance Percentage shown in the Schedule of Benefits. Benefits are subject to the Maximum Amount shown in the Schedule of Benefits. DEDUCTIBLE. The Deductible is shown on the Schedule of Benefits and is a specified amount of Covered Expenses that must be incurred and paid by each Insured person prior to any benefits being paid. MAXIMUM AMOUNT. The Maximum Benefit During Lifetime shown in the Schedule of Benefits is the maximum amount that may be paid for the Covered Expenses incurred by an Insured during his or her lifetime. COVERED EXPENSES. Covered Expenses refer to the usual and customary charges made by a provider for necessary orthodontic treatment rendered while the person is insured under this section. Expenses are limited to the Maximum Amount shown in the Schedule of Benefits and Limitations. … (excerpt — the filed text continues)

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Drafted by a local AI model from the excerpts above, then checked by rules (citations, no rankings, no “not covered” claims from a partial excerpt). Question id Q37a33778. Spotted an error? Tell us.