|
Summary of Benefits
|
|
Discount
Plan
|
|
In-Network
|
Out-of-Network(2)
|
|
|
|
Preventative
Office visit, cleaning, oral exam and
x-rays
|
|
Up to 90% Fee
Reduction
|
N/A |
|
|
Basic Simple
extractions and fillings
|
|
Up to 60% Fee
Reduction
|
N/A |
|
|
|
Major Crowns,
bridges, dentures, inlays,
periodontics, endodontics and oral
surgery
|
|
Up to 50% Fee
Reduction
|
N/A |
|
|
|
Orthodontics
|
|
|
Waiting Periods
|
None |
|
Deductible
|
$None |
|
Annual Maximum
|
$No Maximum |
|
Additional Information
|
This is NOT AN INSURANCE POLICY
Gold PPO Network
|
|
Payment Method
|
|
All Plans allow Monthly payments by
Visa, MasterCard, Discover, American
Express or automatic bank account
withdrawals.
|
|
|
$8
|
|
Two Party
|
$11
|
|
Family
|
$15
|
|
|
|
|
|
|
|
|
|
|
|
|
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Please note: Enrollee must
be the legal age of 18 or
older to be enrolled on their
own plan.
Dental plans are fully
insured by ACE American
Insurance Company. Plan is
administered by Dental Select.
This description is intended
to highlight the benefits and
features only. A more complete
description of the benefits
can be found in the
Certificate of Insurance
issued to each insured and is
available for examination on
request.

ACE
USA
is
the
U.S.
domestic
operating
division
of
ACE
Limited.
Insurance
products
and
services
are
provided
by
the
U.S.
insurance
underwriting
companies
and
not
by
ACE
Limited.
This
plan
of
insurance
is
underwritten
by
ACE
American
Insurance
Company
|
|