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DENTAL |
Dental
coverage is an important part of your overall
benefits package . The Plan pays a significant
portion of the cost for most dental services
for you and your eligible dependents. The Plan
pays benefits for services that are furnished
or recommended by a licensed dentist, up to
reasonable and customary charge
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Dental Benefits
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Calendar Year Maximum
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$1,000 per person |
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Lifetime Orthodontia Maximum |
$2,000 per person |
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Calendar Year Deductible |
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Routine Services |
$25 per person |
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All Other Covered
Services |
None |
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Co-payment
Percentages |
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Routine Services |
Plan pays 100%; after
deductible |
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All Orthodontia And Other
Services |
Plan pays 50% |
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This is a plan description. Not a
guarantee of benefits.
Benefits depend on eligibility, date
of service and Fund Plan
limitations.
In the event of a conflict between
the Summary Plan Description,
this web site and the Plan's legal
documents, the legal documents will
govern.
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