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Unlike EPO members, however, PPO members are reimbursed for using medical care providers outside of their network of designated doctors and hospitals. However, when they use out-of-network providers PPO members are reimbursed at a reduced rate that may include higher deductibles and co-payments, lower reimbursement percentages, or a combination ...
GEHA Solutions, formerly known as PPO USA, was formed in 1997 to market the following products outside federal markets: Connection Dental Network, Connection Vision powered by EyeMed, and Connection Hearing by HearPO. GEHA acquired Surety Life in 2012, giving GEHA flexibility to offer additional products to existing and new customers.
North Carolina State Board of Dental Examiners v. Federal Trade Commission , 574 U.S. 494 (2015), was a United States Supreme Court case on the scope of immunity from US antitrust law . The Supreme Court held that a state occupational licensing board that was primarily composed of persons active in the market it regulates has immunity from ...
The National Institute of Dental and Craniofacial Research carried out further research into dental care for minorities and found that black and Hispanic families in lower-income areas had much higher incidences of tooth decay. [12] Similar research shows that poor dental hygiene directly affects educational abilities and school attendance. [13]
On January 15, 2009, UnitedHealth Group announced a $350 million settlement of three class action lawsuits filed in Federal court by the American Medical Association, UnitedHealth Group members, healthcare providers, and state medical societies for not paying out-of-network benefits. This settlement came two days after a similar settlement with ...
The Delta Dental Plans Association, also known as simply Delta Dental, is an American network of dental insurance companies composed of 39 independent Delta Dental members operating in all 50 states, the District of Columbia and Puerto Rico. These member companies provide coverage to 85 million people, enrolled in over 157,000 groups.
With indemnity dental plans, the insurance company generally pays the dentist a percentage of the cost of services. Restrictions may include the co-payment requirements, waiting period, stated deductible, annual limitations, graduated percentage scales based on the type of procedure, and the length of time that the policy has been owned.
ProCD, Inc. v. Zeidenberg, 86 F.3d 1447 (7th Cir. 1996) the click of a button accepting a license's terms on software counts as agreement; Specht v. Netscape, 306 F.3d 17 (2d Cir. 2002) simply clicking a download button does not indicate agreement to the terms of a contract if those terms were not conspicuous; Seixas v.