Pre-ex Condition Exclusion

[Christine Roberts]

A dental plan that is part of a self-funded health/dental/flex arrangement excludes coverage for preparation of dental devices (crowns, dental appliances, etc.) in instances where the device was partially prepared (e.g. where impression for prosthetic device was made, or tooth prepared for a crown)before coverage under the self-funded plan began. Presuming that the prior work was covered by a group health plan and there has been no break in service for purposes of HIPAA, would the pre-ex. condition exclusions prevent application of these restrictions?

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