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2020/12/16 Council Agenda Packet
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2020/12/16 Council Agenda Packet
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Council Agenda Packet
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12/16/2020
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6.6 Reinstatement. The probationary period is waived for employees who are rehired no later than <br />90 days after employment terminates. The probationary period is waived for Members who become <br />ineligible for coverage due to a reduction of work hours, if the employee becomes eligible again no <br />later than 90 days after the date coverage was terminated. Coverage will begin on the first day of <br />the month following the date of re -hire or re -eligibility for coverage. <br />6.7 Extension of Benefits. Benefits for the following services that require multiple appointments may <br />extend after coverage ends. Enrollees who are terminated for good cause or failure to pay the <br />Premium are not eligible for an extension of benefits. <br />6.7.1 Crowns or Bridges. Adjustments for crowns or bridges will be covered for up to 6 months <br />after placement, if the final impressions are taken prior to termination and the crown or <br />bridge is placed no later than 60 days after termination. <br />6.7.2 Removable Prosthetic Devices. Adjustments for removable prosthetic devices will be <br />covered for up to 6 months after placement, if final impressions are taken prior to <br />termination and the prosthesis is delivered no later than 60 days after termination. <br />Laboratory relines are not covered after termination. <br />6.7.3 Immediate Dentures. The delivery of immediate dentures will be covered, if final <br />impressions are taken prior to termination and the immediate dentures are delivered no <br />later than 60 days after termination. If coverage terminates prior to the extraction of teeth, <br />the extractions will not be covered. <br />6.7.4 Root Canal Therapy. The completion of root canal therapy will be covered if the root canal <br />is started prior to termination and treatment is completed no later than 60 days after <br />termination. Pulpal debridement is not a root canal start. If the root canal requires <br />retreatment after 60 days from termination of coverage, retreatment will not be covered. <br />Restorative work following root canal therapy is a separate procedure and not covered <br />after termination. <br />6.7.5 Extractions. Post -operative checks are covered for 60 days from the date of the extraction <br />for extractions performed prior to termination. If teeth are extracted in preparation for a <br />prosthetic device and coverage terminates prior to the final impressions, coverage for the <br />prosthetic device will not be extended. Extractions are a separate procedure from <br />prosthetic procedures. <br />001 L-WA81 1 (5/20) 18 <br />
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