Introduction

Dental benefits include scheduled dental benefits, dental implants and orthodontics described as follows:

• Scheduled dental benefits are available to you and your dependents based on specified maximums in a Dental Fee Schedule with a $2,000 annual maximum. If expenses exceed the Dental Fee Schedule maximums or the $2,000 annual maximum, this plan will not pay the additional costs. These expenses are not subject to the $200 annual deductible or $2,300 annual coinsurance maximum. Please see Scheduled Dental Benefits for additional information.
• Dental implants are available to you and your dependents and are paid at 50 percent with a $1,000 lifetime maximum. If expenses exceed this $1,000 lifetime maximum, this plan will not pay the additional costs. These expenses are not subject to the $200 annual deductible or $2,300 annual coinsurance maximum. Dental implant benefits are not available to participants and dependents with a $675 dollar bank deduction. Please see Dental Implants for additional information.
• Orthodontic benefits are available to you and your dependents and are paid at 50 percent with a lifetime maximum of $1,500. If expenses exceed this $1,500 lifetime maximum, this plan will not pay the additional costs. These expenses are not subject to the $200 annual deductible or $2,300 annual coinsurance maximum. The lifetime orthodontic maximum for eligible children with a $675 dollar bank deduction is $1,000. Please see Orthodontic Benefits for additional information.