• for a crown, inlay or onlay, the tooth is prepared while You are insured and the crown, inlay or onlay installed within 3 calendar month(s) after Your insurance ceases. • for root canal therapy, the pulp chamber of the tooth is opened while You are insured and the treatment is completed within 3 calendar month(s) after Your insurance ceases. There is no extension for any Covered Dental Service not shown above.
internet services) or any other emergency or similar event not within either party’s control which may result in facilities, personnel, or financial resources being unavailable to provide or arrange for the provision of services in accordance with this Policy. Timelines for performance shall be extended to the extent necessary and agreed upon by both parties, provided that the party whose performance is affected notifies the other promptly of the existence and nature of the delay and the impacted party makes good faith effort to provide or arrange for the provision of service, taking into account the severity of the event. Administrative Policies Relating to this Contract We may adopt reasonable policies, procedures, rules and interpretations that promote orderly administration of this Contract. Assignability The benefits under this Contract are not assignable unless agreed to by Us. We may, at Our option, make payment to the Employee for any cost of any Covered Dental Expense received by the Employee or Employee’s covered Dependents from a Non-Participating Provider. The Employee is responsible for reimbursing the Non-Participating Provider. Clerical Error No clerical error on the part of Us shall operate to defeat any of the rights, privileges or benefits of any Employee. Entire Contract The entire Contract will be made up of the Policy; the Certificate; the application of the Employer, a copy of which is attached to the Policy; any riders and amendments to the Any provision of this Certificate that is in conflict with the applicable statutes of the state whose law governs the Policy or this Certificate or with any applicable federal statute is amended to conform to the minimum requirements of such statutes. Statements not Warranties All statements made by the Employer or any person covered under the Certificate will, in the absence of fraud, be deemed representations and not warranties. No statement made by You or the Employer to obtain insurance will be used to avoid or reduce the insurance unless it is made in writing and signed by You or the Employer and a copy is sent to the Employer, You and/or Your beneficiary. Policy or Certificate; and any enrollment forms. Conformity with State and Federal Statutes
HCDFB-BEX12
06-21
Miscellaneous Notice Regarding Provider Directory
You may obtain a listing of Participating Providers who participate in Our dental network without charge by visiting www.cigna.com; mycigna.com; or by calling the toll-free telephone number 1-(800) CIGNA24 (1-800-244-6224). Additional Programs We may, from time to time, offer or arrange for various entities to offer discounts, benefits or other consideration to Employees for the purpose of promoting the general health and well-being of Employees. We may also arrange for the reimbursement of all or a portion of the cost of services provided by other parties to the Group. Contact Us for details regarding any such arrangements. Oral Health Integration Program As a Cigna Covered Person, You may be eligible for additional dental benefits during certain episodes of care. For example, certain frequency limitations for Covered Dental Services may be relaxed for You if You have certain conditions, including but not limited to, pregnancy, diabetes or cardiac disease. Please review Your plan enrollment materials for details. You may contact Customer Service at 1-(800) CIGNA24 (1-800-244-6224) for additional information. Impossibility of Performance Neither Employer nor Cigna shall be liable to the other or be deemed to be in breach of this Contract for any failure or delay in performance arising out of unforeseeable events beyond the control of either party. Such events are limited to include natural disaster, war, riot, acts of terrorism (domestic and/or foreign), epidemic, pandemic, cyber events (including breakdown of communication facilities, web hosting and
myCigna.com
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