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Summary Plan Description (SPD)
AMENDMENT NO. 25
TO
THE
SOUTHERN CALIFORNIA IBEW-NECA HEALTH PLAN
Effective for orthodontic claims in progress on and after June 1, 2007, the Summary Plan Description, effective June 1, 2004 is amended as follows:
On page 90, under the heading "Orthodontic Benefits - Dependent Children", the lifetime maximum in the amount of $1,000 is deleted and in its stead the maximum lifetime amount of $1,400.
On page 101, under the heading "Orthodontia", ADA Procedure Code 8001 is deleted in its entirety and in its stead the following:
8001 |
Full Banded Case - Child |
50% of Treatment Schedule |
Approved and adopted at the Board meeting held on this 17th day of July 2007, at City of Commerce, California.
BY: Signature on File
Chairman
BY: Signature on File
Secretary