![]() ![]() By the early 20th century, almost half its business was outside North America, until the pressures of World War I forced it to stop its business in Europe. insurance company to start an agency in Europe. ![]() Two years later, he opened a branch in San Francisco, and later across the country, reaching territories such as Colorado, New Mexico, North Dakota, and South Dakota. With start-up funds from fellow German refugees, he opened Germania Life Insurance Company in 1860 on Wall Street in Manhattan, to cover the growing number of German immigrants arriving on American shores. Accused of treason, he fled post-revolution Europe and landed in the U.S. Guardian founder Hugo Wesendonck, a German civil rights lawyer, participated in the 1848-49 revolution and helped draft a constitution for a united Germany. If 9 out of 10 dentists in your local area are only charging $400 for root canals, then $400 is the “R&C” amount that the insurance company is going to reimburse your dentist no matter how much he or she charges you.The former Germania/ Guardian Life Insurance Building in Union Square, Manhattan Your out of network benefits have a $50 deductible and 80% coinsurance. If a member happens to be using a particularly expensive provider that is charging more than the “reasonable and customary” fees, then the member will be responsible for the deductible and coinsurance amount PLUS any charges in excess of R&C.Īn Out of network dentist is charging $500 for a root canal. If you go out of network, then the insurance company will only pay the “reasonable and customary” reimbursement rate for that service. Out of network providers, however, can charge whatever they want. They MUST accept the insurance company’s payment in full (less any deductible or coinsurance you may be responsible for). This NEVER applies if you are using in-network providers. This national database takes into account that the cost of living and cost of services will vary by geographic region. All insurance companies use a national database that tells you what 8 out of 10 providers within a certain area are charging for services. These are all terms that apply specifically to out of network claims for both your medical and dental plans. “Reasonable and Customary (R&C)” and “Usual Customary and Reasonable (UCR) Charges” and “Balance Billing” – What Does This All Mean? You do not select a primary care dentist and you have complete freedom to access care from any certified dental provider.īenefits are paid at “Reasonable and Customary” rates according to the specific benefit plan displayed in the dental section of this website. You are not confined to a network of participating dentists. What is an "PPO Dental Plan" and How Does It Work?Īn PPO Dental Plan means that you can go to any dentist of your choice. When Can I Change My Benefit Enrollment Election?.What If My Claims Are Denied or They Are Paid Incorrectly?.What if I Need to See a Dentist Before I Receive an ID Card and/or Before Benefits Department Has a Chance to Correct My Information with the Insurance Company?.What If I Do Not Have a Dental ID Card?.What if a Dentist Calls and My Insurance Company Tells Them I Am Not In the System or That My Coverage Has Been Terminated?.Do I File the Claim or Does My Dentist?.Can I Find Out What My Dental Work Will Cost Before I Have It Done?.Reasonable and Customary (R&C), Usual Customary and Reasonable (UCR) Charges and Balance Billing – What does this all mean?.What is an "PPO Dental Plan” and How Does It Work?.Fort Bend ISD Benefits and Wellness Committee.Resignation and Retirement Benefits Information (When Your Benefits End).Fort Bend ISD Cafeteria Summary Plan Document.Biometric Screening & Rally Health Survey Reqirement.Employee Assistance Program (EAP) and WorkLife benefits.Student/Parent Handbook and Code of Conduct.New Student Online Registration/Enrollment.International Business and Marketing Academy.Social Emotional Learning and Comprehensive Health.Social Emotional Learning & Enrichment Programs.Extended Learning (Before & After School Programs).Boundary Planning and Enrollment Management.Accountability, Assessment & Compliance.James Reese Career and Technical Center. ![]()
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