Page 64 - 2023 Hickory Crawdads - Benefits Guide_Neat

In addition, under federal law, you and your dependents may be entitled to continuation of
medical coverage. The section of this booklet entitled CONTINUATION OF COVERAGE UNDER
COBRA describes certain circumstances under which medical coverage may be continued
after the date coverage would otherwise end.

Dental and Vision Coverage

This section briefly summarizes the dental and vision benefits that may be available to you
under the Plan and describes some important rules regarding your elections under the Plan.
For a more complete description of the benefits available under each coverage option, please
refer to the separate descriptive booklets that you have received from the Board, your
Employer, insurance companies, and other organizations with which the Board has
contracted to provide benefits.

Your Employer may provide dental and/or vision benefits. If so, the available dental
coverage options are listed in Appendix D, and the available vision coverage options are
listed in Appendix V. You are responsible for making decisions regarding the coverage
option you choose (if more than one option is available to you) and your selection of
providers. You also have the option to waive the dental and/or vision coverage provided by
your Employer.

In addition, you and your provider are responsible for choosing the course of treatment for
(or for choosing not to treat) any illness, injury or other dental or vision condition. The
Board and/or your Employer are not in any way responsible for the outcome of any dental or
vision treatment or care (or lack of such treatment or care).

You should refer to the benefit booklets distributed to you to answer specific coverage
questions and to help you decide which options (if more than one option is available to you)
are right for you and your family. Copies of these benefit booklets are also available from
your Employer.

CLAIMS PROCEDURE

Please refer to the booklets and other descriptive materials you have received from the
Board, your Employer and insurance companies for the Plan’s claims procedures. These
booklets and other materials that describe a particular benefit under the Plan will contain a
specific set of claims and appeals procedures that you must follow to make a claim to receive
that particular benefit and/or to appeal a denied claim for that particular benefit. Although
these separate claims and appeals procedures will be very similar in most respects, there may
be important differences. Accordingly, you should follow the specific claims and appeals
procedures for a particular benefit very carefully. These documents are furnished
automatically, without charge, and as a separate document.

A request for benefits is a “claim” subject to these procedures only if it is filed by you or
your authorized representative in accordance with the Plan's claim filing guidelines. In

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