SAFEGUARD HEALTH PLANS, INC. -1992

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FITP CONTIZACT FOR PREPAID SE1VI..., It is agreed between die ORGAW.ATION named in the Croup Contract for Prepaid Services Acceptance Agreement (hereinafter referred to as " R AIU ATI N" ) and SAFEGUARD HEALTH PLANS, INC., a California corporation (hereinafter referred to as "SAFEGUARD"), that: A. SAFEGUARD is a California corporation, licensed as a Health Care Service Pian under applicable Callfomia law, whose r e is t operate vario€�s dental health care service plans. Said services are established on a prepaid closed primary P� panel capltted basis. B. ORGANIZATION desires to obtain the services herein specified for and on behalf of its Eligible Participants as deflned herein. NOW, THEREFORE, the parties do mutually covenant and agree as follows: I. REFERENCE T_ ATTACHMENTS This Contract, together with the Group Contract for Prepaid Services Acceptance Agreement (the '"Acceptance Agreement"), Schedule of Benefits and Copaym nts and any Amendments, Dentist Directory, or other attachments hereto constitutes the entire agreement of the parties. DEFINITIQNS l BENEFIT PLAN shall mean the coverage provided in the schedule of Benefits and Comments; the Schedule of Limitations and Exclusions, and the Administrative Policies. 2.2 FQEAYMENrT shall mean an additional fee charged by Dentist to the member. 2.3 DENTIST QR PARTICIPAMG DENMS shall mean the dentist licensed by the Mate of California under contract to SAFEGUARD, and shall include any by ienists and technicians recognized by the dental profession who act with and assist the dentist. 2.4 DEPEMD—E 'T shall mean the lawful spouse and children, if enrolled in the Plan, of a member, including the definitions and terms contained in Paragraph 3.6. . FICA PARTICIPANT: shall mean an employee, member, or-beneficiary of RCAF TI I who is eligible to participate ate in the SAFEGUARD Flan under the eli ibilit y requirements determined by ORGANIZATION. 2.6 MEMBER shall mean an eligible participant who is actually enrolled in the SAFEGUARD Plan. The tens "Member" or "Members it, as used herein, shall be deemed to include all Subscribers and eligible Dependents as defined herein, if so enrolled in the Plan. .7 R GAI 11ZA I N means an association, employer, group or other organization to which the member belongs and which is the contracting entity as set forth in the Acceptance Agreement. . or SAELGUAR shall mean Safeguard Health Plans, Inc., a corporation licensed to provide prepaid dental services under the Knox-Keene Health Care Service Plan Act of 1975, as mended. 2.9 SLWSMBER, shall mean the person whose relationship with the ORGANIZATION is the basis for eligibility for membership in the Plan. III. PREPAYNaNT EEE AND ELIGIBILITY 3. I As set forth in the Acceptance Agreement, ORGANIZATION shall Pay SAFEGUARD the appropriate nionthly fee r mo��tb for eacb covered Member, as applicable, commencing on the effective date of this Contract, which sure prepayment � shall a the guaranteed monthly prepayment fee until contract renewal date. 3.2 The re P ayment fee is pain b Ii R A ATI N. The Subscriber may be responsible for a portion or the prepayment ent fee and if so, such contribution will be deducted from the Subscriber`s earnings by payroll deduction or otherwise paid to ORGANIZATION in such manner as it may select. If the Subscriber is responsible for fifty percent (50%) or more of the prepayment fee, the Subscriber shall remain enrolled in the Plan for a minimum of twelve consecutive months unless earlier terminated from ORGANIZATION. In the event such a Subscriber terminates enrollment in the Plan within the first twelve (12) months of coverage, the Subscriber will be ineligible tore-enroll in the Plan for a period of twenty-four 24 months after such termination. rmination. Ire all occasions, ORGANIZATION shall nevertheless be fully responsible for all payments of the prepayment fees due under this Contract. The, pym ent of this Sum shall relieve OR A LZA'nON and Subscribers of any der liability hereunder. 3.3 ORGANIZATION acknowledges and understands that this Contract provides solely and exclusively for services to b Pe rformed at dental facilities provided by SAFEGUARD. This Contract provides for services only, is not an insurance policy and does not indemnify or reimburse any Member or ORGANIZAIION in cash or any manner whatsoever, except as set forte in Paragraphs 4.6.