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5.02 Such deductible amount shall apply: (Box checked if applicable) iX ] Once each calendar year or portion thereof during which the patient is continuously eligible under the Con- tract. [ ] Once during any period in which the patient is continuously eligible under this Contract. [ ] To all services except the following: The amount an eligible patient pays for the foregoing services shall not be applied toward satisfying the deductible. 5.03 The maximum amount payable for Diagnostic and Preventive, Basic, Crowns, Jackets and Gold or Cast Restorations, and Prosthodontic Benefits provided to any Eligible Person in any calendar year shall be $'1 ~000.00 5.04 If an Eligible Person is entitled to coverage under two or more group insurance policies or group prepaid health care programs, including a CDS Program, then the Benefits of this Contract shall be provided as follows: (i) If the other policy or program(s) primarily cover services or expenses other than dental care, then this program shall be primary. (ii) If the other coverage is by a dental insurance policy or prepaid dental care program, the policy or program covering the patient as an employee shall be primary over the policy or program covering the patient as a dependent, and the policy or program covering the patient as a dependent child of a male person shall be primary over the policy or program covering the patient as a dependent of a female person. (iii) When primary coverage cannot be determined according to (i) and (ii) above, the program which has covered the eligible patient for the longer period of time shall be primary. If the program provided by this Contract is "primary", as provided above, this program shall provide Benefits without regard to any policy or program, and if the program provided by this Contract is not "primary", this program shall provide Benefits only to the extent that the Benefits obtained from such other insurance or program are inadequate to provide full payment for the services which are Benefits provided by this Contract. ARTICLE VI - CONDITIONS UNDER WHICH BENEFITS SHALL BE PROVIDED 6.01 Benefits, except as otherwise provided in Article IV hereof, are available from the Eligibility Date of an Eligible Person. 6.02 While an Eligible Person may elect the service of any licensed Dentist, neither CDS nor Applicant undertakes to guarantee the availability of any particular Dentist. 6.03 As a condition precedent to the approval of claims hereunder, COS shall be entitled to receive, to such extent as may be lawful, from any attending or examining Dentist, or from hospitals in which a Dentist's care is provided, such information and records relating to attendance to or examination of or treatment provided to an Eligible Person as may be required in the administration of such claims, or to require that an Eligible Person be examined by a dental consultant retained by CDS in or near his community or residence; provided, however, that CDS shall in every case hold such information and records as confidential. 6.04 The amounts payable by CDS with respect to services provided by a California Dentist who is not a Participating Dentist shall not exceed the applicable percentage herein specified of the fees charged, or of the Prevailing Fee, whichever shall be less. -8- 11-77 AD/RET