HRA Major Treatment Preferred Provider Co- insurance Plan Year Exclusions HSA immunization Class IV Second Surgical Opinion Durable Medical Equipment Occupational therapy Co- payment Out-of- Pocket Preventive and Diagnostic Treatment Termination date Echocardiogram Birthday rule Network Medically Necessary Self- funded Calendar Year Biopsy Fiduciary Sealants Incurred date Deductible Authorized Personal Representative ERISA Holter Monitor CT scan Pathology Bruxism EOB Open Enrollment High Deductible Health Plan Life- Threatening medical emergency Endoscopy Magnetic resonance imaging Benefits Medicare Plan Maximums Authorization Dialysis Sinusitis Balance Billing Out-of- Network Third-Party Administrators Stop loss (Re- insurance) Experimental and Investigational PET scan Prophylaxis Un- erupted tooth Claim Effective date Observation Crown Dental Caries TMJ Medicaid Physical therapy HRA Major Treatment Preferred Provider Co- insurance Plan Year Exclusions HSA immunization Class IV Second Surgical Opinion Durable Medical Equipment Occupational therapy Co- payment Out-of- Pocket Preventive and Diagnostic Treatment Termination date Echocardiogram Birthday rule Network Medically Necessary Self- funded Calendar Year Biopsy Fiduciary Sealants Incurred date Deductible Authorized Personal Representative ERISA Holter Monitor CT scan Pathology Bruxism EOB Open Enrollment High Deductible Health Plan Life- Threatening medical emergency Endoscopy Magnetic resonance imaging Benefits Medicare Plan Maximums Authorization Dialysis Sinusitis Balance Billing Out-of- Network Third-Party Administrators Stop loss (Re- insurance) Experimental and Investigational PET scan Prophylaxis Un- erupted tooth Claim Effective date Observation Crown Dental Caries TMJ Medicaid Physical therapy
(Print)
HRA
Major Treatment
Preferred Provider
Co-insurance
Plan Year
Exclusions
HSA
immunization
Class IV
Second Surgical Opinion
Durable Medical Equipment
Occupational therapy
Co-payment
Out-of-Pocket
Preventive and Diagnostic Treatment
Termination date
Echocardiogram
Birthday
rule
Network
Medically Necessary
Self-funded
Calendar Year
Biopsy
Fiduciary
Sealants
Incurred date
Deductible
Authorized Personal Representative
ERISA
Holter Monitor
CT scan
Pathology
Bruxism
EOB
Open Enrollment
High Deductible Health Plan
Life-Threatening medical emergency
Endoscopy
Magnetic resonance imaging
Benefits
Medicare
Plan Maximums
Authorization
Dialysis
Sinusitis
Balance Billing
Out-of-Network
Third-Party Administrators
Stop loss (Re-insurance)
Experimental and Investigational
PET scan
Prophylaxis
Un-erupted tooth
Claim
Effective date
Observation
Crown
Dental Caries
TMJ
Medicaid
Physical therapy
