Page 56 - Dental Benefit Plan Summary
P. 56

TEXAS MUTUAL INSURANCE COMPANY DENTAL PPO PLAN



                   ■  UnitedHealthcare Dental communicates to you decisions about whether the Plan will
                       cover or pay for the Dental Services that you may receive (the Plan pays for Covered
                       Dental Services, which are more fully described in this SPD); and

                   ■  the Plan may not pay for all treatments you or your Dentist may believe are necessary. If
                       the Plan does not pay, you will be responsible for the cost.


                   Texas Mutual Insurance Company and UnitedHealthcare Dental may use individually
                   identifiable information about you to identify for you (and you alone) procedures, products
                   or services that you may find valuable. Texas Mutual Insurance Company and
                   UnitedHealthcare Dental will use individually identifiable information about you as
                   permitted or required by law, including in our operations and in our research. Texas Mutual
                   Insurance Company and UnitedHealthcare Dental will use de-identified data for commercial
                   purposes including research.

                   Relationship with Dentists

                   The relationships between Texas Mutual Insurance Company, UnitedHealthcare Dental and
                   Network Dentists are solely contractual relationships between independent contractors.
                   Network Dentists are not Texas Mutual Insurance Company's agents or employees, nor are
                   they agents or employees of UnitedHealthcare Dental. Texas Mutual Insurance Company
                   and any of its employees are not agents or employees of Network Dentists, nor are
                   UnitedHealthcare Dental and any of its employees agents or employees of Network
                   Dentists.

                   Texas Mutual Insurance Company and UnitedHealthcare Dental do not provide dental
                   services or supplies, nor do they practice dentistry. Instead, Texas Mutual Insurance
                   Company and UnitedHealthcare Dental arrange for Dentists to participate in a Network and
                   pay Benefits. Network Dentists are independent practitioners who run their own offices and
                   facilities. UnitedHealthcare Dental's credentialing process confirms public information about
                   the Dentists' licenses and other credentials, but does not assure the quality of the services
                   provided. They are not Texas Mutual Insurance Company's employees nor are they
                   employees of UnitedHealthcare Dental. Texas Mutual Insurance Company and
                   UnitedHealthcare Dental do not have any other relationship with Network Dentists such as
                   principal-agent or joint venture. Texas Mutual Insurance Company and UnitedHealthcare
                   Dental are not liable for any act or omission of any Dentist.

                   UnitedHealthcare Dental is not considered to be an employer of the Plan Administrator for
                   any purpose with respect to the administration or provision of benefits under this Plan.

                   Texas Mutual Insurance Company is solely responsible for:

                   ■  enrollment and classification changes (including classification changes resulting in your
                       enrollment or the termination of your coverage);
                   ■  the timely payment of Benefits; and

                   ■  notifying you of the termination or modifications to the Plan.






                   51                                              SECTION 10 - OTHER IMPORTANT INFORMATION
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