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Other Important Information For Dental and Vision Care Coverage Other sources that provide benefits include the following:
The following guidelines determine which plan pays benefits first:
If the claims administrator determines that payments exceed the coordination of benefits provision, the administrator has the right to recover the overpayment from the other insurance company, the other plan sponsor, or you. There is an exception to this policy in the case of vision benefits. If both you and your spouse are covered under each other's vision benefits, you can receive benefits under both plans. The Coordination of Benefits will not apply. If the claims administrator determines that payments exceed the coordination of benefits provision, the administrator has the right to recover the overpayment from the other insurance company, the other plan sponsor, or you. For Prescription Drug Coverage By using the School District's plan up to the maximum benefit allowed for generic equivalents, you can reduce the amount you pay out-of-pocket. The following guidelines help you determine which plan pays the greater benefit. If you have exceeded the $750,000 annual maximum under the School District's plan, submit your prescription drug expenses to the State's medical plan, which has an unlimited maximum benefit amount. You will be responsible for a copay as follows:
If you have not exceeded the $750,000 annual maximum under the School District's plan, determine which plan best meets your needs. Under the School District plan, you will be responsible for a copay as follows:
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Disclaimer: Brandywine Benefits Online provides only an overview of your benefits from Brandywine School District and The State of Delaware. Brandywine School District and The State of Delaware reserve the right to amend or to terminate any benefit plan at any time, with or without notice. Review more important legal information about your benefits plans. Copyright ©2021 Willis Towers Watson. |