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May 13, 2005

Dental Plan

Dental Plan Membership Fee

Individual: $99.95 per year 1
Family2: $149.95 per year 1

Plus, get 3 additional months added to your plan for FREE!

1 No additional sign-up fee. Join today and you may begin using your plan on Monday, May 16, 2005.

2 Those covered under this plan include spouse, dependent children up to the age of 24.



Plan Benefits and Highlights

No deductible or coinsurance
No annual maximums or minimums
Quick Activation
No major waiting periods
No pre-existing condition exclusions
One Periodic Oral Examination FREE per year at participating general dentist
FREE Bitewing X-Rays (once per year) at participating general dentist *
Orthodontia (orthodontics) included up to age 16
No referral required to see a Specialist
Group rates available


How this Plan Can Save You Money

The Dental Plan is a discount or "reduced-fee" dental plan. This plan is designed for health conscious consumers looking to maintain their oral health and minimize their dental care expenses.
General dentists and specialists who participate in the Dental Plan have agreed to accept a discounted fee as payment in full for each service performed. These discounted fees are up to 50% less than what a dentist would normally charge. A sample table of Dental Plan discounted fees can be found below.


Sample Discounted Fees and Savings

ADA Code Procedure Name Usual Fee 1 Discounted Fee (for Plan Members) 2 Member Savings
0120 Periodical examination * $50 FREE $50
0150 Comprehensive oral examination * $75 FREE $75
0210 Intraoral complete series x-ray films (including bitewings) * $110 FREE $110
0330 Panoramic film * $100 FREE $100
1110 Prophylaxis-adult (additional in same membership year) $91 $35 $56
1120 Prophylaxis-child (additional in same membership year) $67 $25 $42
1351 Sealant - Per Tooth $52 $16 $36
2330 White Filling $134 $55 $79
2750 Crown - Porcelain $995 $480 $515
2752 Crown - Porcelain Fused to Noble Metal $975 $450 $525
2950 Core Build-Up, Including Any Pins $250 $100 $150
3310 Root Canal - Anterior $625 $255 $370
3320 Root Canal - Bicuspid $725 $308 $417
3330 Root Canal - Molar $850 $385 $465
4341 Perio scaling and root planing (per quadrant) $200 $90 $110
5110 Upper Denture (Complete) $1,450 $560 $890
6210 Tooth Replacement / Bridge Prosthetic $975 $450 $525
7140 Single Tooth Extraction $175 $68 $107


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