Dental Care Insurance
BRONZE | SIlVER | GOLD | |
---|---|---|---|
Basic Maximum | Combined $1,500.00 per calendar year, co-insurance is 80% | Combined $1,500.00 per calendar year, co-insurance is 80% | Combined $1,500.00 per calendar year, co-insurance is 100% |
Major Maximum (co-insurance is 50%) | Not Included | Included | Included |
Orthodontic Maximum (co-insurance is 50%) | n/a | n/a | n/a |
Recall Frequency (Months) | 9 | 9 | 6 |
Composite Filing | All Teeth | All Teeth | All Teeth |
Size | 3+ employees | 3+ employees | 3+ employees |
Benefit Description: . Basic Services include endodontic & periodontal services. Scaling, root planning and gingival curettage will be combined and limited to a dollar maximum equivalent to 10 units. Fluoride eligible for dependents 18 and under only. Oral hygiene instruction excluded. Major work attached to implants are not eligible and excludes certain dentures and crowns. Standard PBC Schedule 3 applies for all dental services.
Termination Age: 75 years
Premium-Free Survivor Benefit Period: 24 months