Page 56 - Dental Benefit Plan Summary
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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