2023 Archdiocese of Atlanta Meritain Group Plan Doc - Manual / Resource - Page 99
DEFINITIONS
In this section you will find the definitions for the capitalized words found throughout this Dental/Vision Plan. There
may be additional words or terms that have a meaning that pertains to a specific section and those definitions will
be found in that section provided, however, that any such capitalized word shall have such meaning when used in
any other section. These definitions are not an indication that charges for particular care, supplies or services are
eligible for payment under the Dental/Vision Plan. Please refer to the appropriate sections of this Dental/Vision Plan
for that information.
Affiliated Companies means any of the Dental/Vision Plan Sponsor's affiliates, subsidiaries, or divisions may be
deleted or added to the Dental Vision Plan upon written notice on or before the date such deletion or addition is
effective.
Calendar Year means January 1 – December 31.
Close Relative means a Covered Person's Spouse, parent (including step-parents), sibling, child, grandparent or
in-law.
Claims Administrator means the organization providing services to the Employer in connection with the operation
of this Dental/Vision Plan and performing such other functions, including processing of claims, as may be delegated
to it.
Coinsurance has the same meaning as set forth in the section of this Dental/Vision Plan entitled “General Overview
of the Dental/Vision Plan”.
Covered Employee means an eligible Employee whose coverage has become effective and has not been
terminated.
Covered Expenses means the dental and/or vision expenses covered pursuant to the terms of this Dental/Vision
Plan.
Covered Person means, individually, an eligible Employee or eligible Dependent whose coverage has become
effective and has not been terminated.
Dentally Necessary means services or supplies, which are determined by the Dental/Vision Plan Administrator to
be:
(1)
Appropriate and necessary for the symptoms, diagnosis or direct care and treatment of the dental condition,
Injury or Illness;
(2)
Provided for the diagnosis or direct care and treatment of the dental condition, Injury or Illness;
(3)
Within standards of good dental practice within the organized dental community;
(4)
Not primarily for the convenience of the Covered Person, the Covered Person’s Dentist or another provider;
and
(5)
The most appropriate supply or level of service which can safely be provided.
Dental/Vision Plan means The Roman Catholic Archdiocese of Atlanta Group Dental and Vision Plan.
Dental/Vision Plan Administrator means RCAA Administrative Services, Inc., which is sponsoring this
Dental/Vision Plan for Employees of the Employer. The Dental/Vision Plan Administrator may hire persons or firms
to process claims and perform other Plan connected services.
Dental/Vision Plan Sponsor means RCAA Administrative Services, Inc.
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