Questions & answers · Dental insurance
What events does United Concordia Insurance Company's filed dental insurance policy say it pays for?
AI-drafted from filed documents · reviewed: pendingwhether a specific event is coveredUnited Concordia Insurance Company
United Concordia Insurance Company's filed dental insurance policy in California (CA) states that benefits are paid for Covered Services shown on the attached Schedule of Benefits, provided the services are Dentally Necessary unless otherwise specified in a Rider [2]. These services are subject to coinsurance, deductibles, annual maximums, lifetime maximums, out-of-pocket maximums, and waiting periods as detailed in the Schedule of Benefits [2]. No benefits are paid for services, supplies, or charges listed in the Schedule of Exclusions and Limitations [2]. Services with a coinsurance of zero (0) also do not receive benefits [2]. The specific covered services are defined in the Schedule of Benefits, which is part of the policy documents [2]. This does not appear in these excerpts — check the full policy for the exact list of covered services.
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] United Concordia Insurance Company · CA · SERFF UCIN-133561073 · form CA 9802S/L (01/23) · p. 1 · 1 · GROUP INSURANCE POLICY
GROUP INSURANCE POLICY for Dental Benefits United Concordia Insurance Company {1800 Center Street, Suite 2B 220} {Camp Hill, PA 17011} Policyholder: {insert group name} Group Number(s): {insert group number(s)} Effective Date: {insert date} {Minimum Participation Required: {1-100% enrolled} {1-100,000 enrolled} {initial enrollment levels}} Term: {{one, two, three} years} {XX months} Advance Renewal or Non-Renewal Notice: {60-240} days Advance Amendment Notice: {60-180} days {This is a Family Policy; This Policy covers only Certificate Holders} The Policyholder and United Concordia Insurance Company (“Company”) will make the dental benefit plan available to eligible Certificate Holder(s) of the Policyholder and/or their Dependents (“Members”) at 12:01 AM on the Effective Date and upon the terms and conditions contained in this Group Insurance Policy (Group Policy). The Company will pay the benefits described in the Certificate of Insurance (hereinafter referred to as “Certificate”) and any schedules, amendments, endorsements or riders attached thereto, subject to the Group Policy terms. The parties shall fulfill the obligations stated herein. Certain terms in this Group Policy have specific meanings as set forth in the Definitions section of the Certificate which is attached and incorporated herein by this reference. … (excerpt — the filed text continues)
[2] United Concordia Insurance Company · CA · SERFF UCIN-133561073 · form CA 9804-B (06/23) SOV · p. 11 · 19 · Covered Services
Covered Services Benefits and any applicable Coinsurance, Deductibles, Annual Maximums, Lifetime Maximums, Out-of-Pocket Maximums and Waiting Periods are shown on the attached Schedule of Benefits. Covered Services shown on the Schedule of Benefits must be Dentally Necessary unless otherwise specified in a Rider to this Group Policy and are subject to frequency or age Limitations detailed on the attached Schedule of Exclusions and Limitations. No benefits will be paid for services, supplies or charges detailed under the Exclusions on the Schedule of Exclusions and Limitations, and no benefits will be paid for services on the Schedule of Benefits with a Coinsurance of zero (0).
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 Q2f24f142. Spotted an error? Tell us.