Accidental injury — A bodily injury to a covered person that is caused solely by external, violent and accidental means and results directly in a covered expense, independently of other causes. Intentionally self-inflicted injuries are not covered.

Amalgamated Transit Union (ATU) — The collective bargaining agreement you work under that governs your eligibility to participate in the Trust. (See Participating in the Plans — Eligibility for details.)

Calendar year — Each year, January 1 through December 31.

Claims administrator —The Trust Office.

Claims administrator (from Vision) — VSP.

Collective bargaining agreement — A collectively bargained agreement between the District and a labor organization that requires contributions to the Trust.

Covered person — A retiree of the District or a dependent of the retiree who meets the plan's eligibility and enrollment requirements.

Dependent — The spouse or domestic partner of a covered employee or any unmarried child of the employee, spouse or domestic partner who meets the plan's eligibility requirements.

District — School District No. 1, Multnomah County, Oregon.

District Council of Unions (DCU) — The collective bargaining agreement you work under that governs your eligibility to participate in the Trust. (See Participating in the Plans — Eligibility for details).

Illness — A condition, disease, ailment or bodily disorder (other than an injury and pregnancy), or physical disorder that causes functional impairment. Illness does not include any state of mental health or mental disorder (which is otherwise defined in this handbook).

Injury — Physical damage to the body inflicted by a foreign object, force, temperature or corrosive chemical or that is the direct result of an accident, independent of illness or any other cause. Injury does not mean bodily injury caused by routine or normal body movements such as stooping, twisting, bending or chewing and does not include any condition related to pregnancy.

Non-VSP provider — Any optometrist, optician, ophthalmologist or other licensed and qualified vision care provider who has not contracted with VSP to provide vision care services and/or vision care materials to covered persons of VSP.

Plan (from Dental and Vision) — The School District No. 1 Health and Welfare Trust Early Retiree Voluntary Dental/Vision Plans described in this handbook.

Plan administrator — The administrator retained by the Board of Trustees to administer the plan under the Board's direction and control. Administrative duties include (but are not limited to) maintaining eligibility records and processing claims.

Plan document (from Dental and Vision) — The written Trust Early Retiree Voluntary Dental/Vision Plan document.

Plan year (2016) — February 1 to December 31.

Plan year (2017) — January 1 to December 31.

Portland Federation of School Professionals (PFSP) — The collective bargaining agreement you work under that governs your eligibility to participate in the Trust. (See Participating in the Plans — Eligibility for details).

Preauthorization — Prior authorization needed from the prescribing physician before certain prescriptions will be filled by a retail pharmacy or the mail-order service. Preauthorization may be required due to the specific drug, the supply size or dosage, or the timing of the prescription or refill.

Trust — The School District No. 1 Health and Welfare Trust.

Trust agreement — The Trust Agreement of the School District No. 1 Health and Welfare Trust Fund and any valid amendments.

Usual and customary or reasonable (UCR) rates (from Dental) — The fees and prices regularly charged by your dentist and other dentists in your area for the dental services and supplies generally furnished for cases like yours.

Usual and customary or reasonable (UCR) rates (from Vision) — The rates charged for a given vision service or supply by similar providers in your geographic area.

Visually necessary or appropriate — Services and materials medically or visually necessary to restore or maintain a patient's visual acuity and health and for which there is no less expensive professionally acceptable alternative, as determined by VSP.

VSP preferred provider — An optometrist or ophthalmologist licensed and qualified to practice vision care and/or provide eyewear who has contracted with VSP to provide vision care services and/or eyewear to VSP members.