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| CANCELLATION AND TERMINATION OF BENEFITS |
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Delta Dental will cancel enrollment of an Eligible Dependent immediately upon receipt of a written notice regarding the loss of dependent status; however, an unmarried dependent child may continue eligibility if:
- he or she is incapable of self-support, or self-sustaining employment, because of a physical or mental incapacity that began prior to reaching the limiting age,
- he or she is chiefly dependent on you for support, and
- proof of dependent's disability or incapacity is provided within 31 days of request by Delta Dental and subsequently as required. Such requests will not be made more than once a calendar year after the Eligible Dependent reaches age 23.
Coverage for Eligible Dependents beyond the limiting age will continue in effect until the end of the period for which we have accepted premium. Delta Dental's liability is limited to a refund, on request, of the premiums paid for the period not covered by the contract if the age of the Eligible Dependent is misstated and according to the correct age of the covered dependent, the coverage provided by the Contract would not have become effective.
Delta Dental will also cancel coverage upon 15 days written notice if either of the following occur:
- the Enrollee is guilty of misconduct detrimental to safe operations and the delivery of services while in a Contract Dentist's facility; or
- the Enrollee knowingly commits or permits another person to commit fraud or deception in obtaining Benefits;
or upon 30 days notice in case the Enrollee fails to pay Copayments; provided, however, that the Enrollee may be reinstated during the term of this Program upon payment of all delinquent charges.
Coverage for an Enrollee will terminate as of the date enrollment is cancelled under the terms of this Contract. However, we will continue to provide Benefits for completion of any treatment in progress (less any applicable Copayment). Cancellation of a primary Enrollee's enrollment, as described above, shall automatically cancel the enrollment of any of his or her dependent Enrollees. |
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