Select Dental Plan 1000
$20.00
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Individual for
$45.00
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Plus 1 for
$75.00
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Family for
$109.00
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Dental Insurance Plan With $1000 Maximum Benefit
Dental insurance plan provides: No Waiting Periods for Group I - Preventive Procedures and Group II - Basic Procedures. Six month waiting period for: Group III - Major Procedures. No Referral Requirements. No Age Limit. See Any Dentist. More than 300 procedures covered. $1000 annual maximum benefit per person. Fully underwritten and insured by an A rated insurance company. Available for groups, individuals and families who are members of the UASB Association. Not available in GA, TX, NY, OR, LA.
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Dental Plan Summary
The dental insurance is fully underwritten and insured by Reliance Standard an A rated insurance company.
There is no reason for poor dental health. With all the advances in dental care, regular checkups and proper dental maintenance, no one should suffer from tooth decay or dental disease. By participating in the dental program, you have the opportunity to make regular checkups much easier and less costly.
We offer a dental insurance plan tailored to fit you and your family's needs. Not only is the plan flexible, but the plan can be written either as stand-alone coverage or as part of a package with other employee benefits.
See the Dentist you want to see, when you want to see them! No Referral Requirements. No Co-Insurance Percentages to Calculate. Your Dental Plan Network Provider will always be able to tell you what the contracted rate will be for your procedure prior to treatment. You will also know how much your insurance plan will reimburse before you file your claim. Everything from a simple cleaning...all the way to root-canals, crowns and even full dentures...this plan has them covered!
Benefit Summary
Calendar Year Deductible: $75 per person
Annual Maximum Benefit: $1000 per person
Preventive Procedures
Cleanings
X-Rays
Exams
Fluoride
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Basic Procedures
Fillings
Extractions
Oral Surgery
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Major Procedures
Full and partial dentures
Crowns
Onlays
Periodontics (gum disease)
Endodontics (root canal)
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Dental Service Payment Schedule
The following is a sample list of dental procedures payable under this plan. Click here to download a complete list of the procedures and service payment schedules.
CODE
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DESCRIPTION OF SERVICE
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COVERED EXPENSE
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Preventive
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0120
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Periodic Oral Evaluation (Twice in a Benefit Period).
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$19.00
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1110
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Prophylaxis - adult (Twice in a Benefit Period).
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$40.00
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1203
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Topical Fluoride (separate code) in conjunction with prophylaxis.
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$15.00
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0210
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Intraoral - complete series (including bitewings).
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$60.00
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0272
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Bitewings - two films (Twice in a Benefit Period).
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$17.00
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1510
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Fixed space maintainer, unilateral.
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$141.00
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Basic
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1351
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Sealant - per tooth
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$16.00
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2140
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Amalgam restoration - one surface, primary or permanent.
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$38.00
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7140
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Extraction, erupted tooth or exposed root (elevation and/or forceps removal).
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$42.00
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7240
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Surgical removal of tooth (completely bony).
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$158.00
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5510
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Denture repair - Repair broken base.
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$48.00
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9220
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Deep sedation/general anesthesia.
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$122.00
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Major
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5211
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Maxillary partial denture - resin base.
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$185.00
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3310
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Endodontics - root canal, anterior.
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$145.00
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4341
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Periodontal scaling and root planing, four or more teeth. Each quadrant is eligible for consideration once in a 2 year period.
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$48.00
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2792
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Crown - full cast noble metal.
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$209.00
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2980
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Crown repair.
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$40.00
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6242
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Pontics - porcelain fused to noble metal.
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$215.00
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Dental Plan Common Questions
THE PROBLEM
The main reason people don't go to the dentist is money. It's not fear, it's not time... it's money! Going to the Dentist is so expensive that many people simply cannot afford to take care of their teeth.
THE SOLUTION
The Select Dental Plan is "Revolutionary" and here's why!
QUESTION: Can I go to ANY Dentist?
ANSWER: Yes, you can go to any dentist, however if you select a dentist in the Dental Savings Network, you will receive the services at a muchreduced rate. This means that when you file your claim, and the insurance plan pays the scheduled reimbursement amount, there will be a smaller out of pocket cost to you.
QUESTION: Do I have to wait to get major dental work done?
ANSWER: All Basic and Preventive procedures are available as soon as your plan becomes effective. There is a 6 month waiting period for all Major Procedures.
QUESTION: Will I know what price I will be paying?
ANSWER: Yes, always discuss your contracted rate with your dentist prior to your procedure. You will also get a list that tells you what reimbursement the insurance will pay, so you will know exactly what your out of pocket costs will be.
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