|
Dental Benefits |
Deductible* (per year)$50 (Type B and C), Waived for Type A |
Max Benefit* (per year)
|
Schedule of Benefits*
|
Type A Type B Type C |
Coinsurance (Policy Pays)
In Network 100% 80% 50% |
Coinsurance (Policy Pays)-% of R&C
Non-Network 100% 80% 50% |
This web site is not a legal document. This web site is not a guarantee of coverage, eligibility, or provider status and is designed for informational illustration only. Benefits outlined on this web site are subject to change at any time. Please consult your benefit plan provider(s) or administrator(s) for legal documents regarding your plan and to check coverage and/or eligibility.
