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Section 1 Definitions <br />1.1 <br />"Child" means a child of the Member (or Member's spouse or Member's domestic partner), <br />including a natural child- stepchild; adopted child; child for whom the Member (or Member's spouse <br />or Member's domestic partner) has assumed a legal obligation for total or partial support of the <br />child in anticipation of adoption of the child; or child for whom the Member (or Member's spouse or <br />Member's domestic partner) has court -appointed legal guardianship. Child also includes a child <br />for whom the Member (or Member's spouse or Member's domestic partner) is required to provide <br />dental coverage by a legal qualified medical child support order (QMCSO). <br />1.2 "Company" means Willamette Dental of Washington, Inc. <br />1.3 "Contract" means this agreement between the Company and the Policyholder. This Contract <br />including the Application for Large Group Dental Coverage, appendices, exhibits, riders, <br />amendments, and endorsements, if any, constitutes the entire contract between the parties and <br />supersedes all prior agreements between the parties. <br />1.4 "Copayment" means the fixed dollar amount that is the Enrollee's responsibility to pay under this <br />Contract for each office visit or Covered Service. All Copayments are due at the time of visit or <br />service. <br />1.5 "Covered Service" means a dental service listed as covered in this Contract for which benefits <br />are provided to Enrollees. <br />1.6 "Dental Emergency" means a dental condition manifesting itself by acute symptoms of sufficient <br />severity, including severe pain or infection such that a prudent layperson, who possesses an <br />average knowledge of health and dentistry, could reasonably expect the absence of immediate <br />dental attention to result in (i) Placing the health of the individual, or with respect to a pregnant <br />woman the health of the woman or her unborn child, in serious jeopardy; (ii) Serious impairment to <br />bodily functions; or (iii) Serious dysfunction of any bodily organ or part <br />1.7 "Dentist" means a person licensed to practice dentistry in the state where treatment is provided. <br />1.8 "Denturist" means a person licensed to practice denturism in the state where treatment is <br />provided Benefits for Covered Services provided by a Denturist will be provided if (i) the service <br />is within the lawful scope of the license, and (ii) this Contract would have provided benefits if the <br />Covered Service had been performed by a Dentist. <br />1.9 `Dependent" means a Member's spouse, domestic partner, or Child, who is eligible and enrolled <br />for coverage. For the purposes of this Contract, all terms and benefits available to a spouse shall <br />apply equally to domestic partners. <br />1.10 "Enrollee" means a Member or a Dependent. <br />"Experimental or Investigational" means a service that is determined to be experimental or <br />investigational. In determining whether services are Experimental or Investigational, the Company <br />will consider the following: <br />a. Whether the services are in general use in the dental community in the State of Washington; <br />001 L-WA811(5/20) 2 <br />