1VAC55-20-470: Benefits coverage

A. Interpretations of covered services will be made in the following manner, listed in order of priority:

1. The contract documents, including the request for proposal;

2. Member handbooks or contract booklets;

3. The interpretation of the department;

4. The interpretation of the department's contractors.

B. The benefit provisions of the contract documents are contained in the contract booklets or member handbooks distributed to employees by their benefits administrators.

C. The benefits administrators have copies of the contract booklets and member handbooks for all plans offered by that employer. By appointment, any employee or citizen may inspect the entire contract or contracts at the offices of the department.