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Dental Care
CS Dental Insurance is underwritten and administered by Citizens Security Life Insurance Company, Home Office: Louisville, KY, Policy: GA 206
| Services* |
Coverage
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Basic
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Preferred
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| Type I – Diagnostic & Preventative** |
100%
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| Type II – Basic Restorative Services*** |
80%
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| Type III – Major Restorative Services**** |
50%
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* Out of network reimbursement based on maximum allowable charge (MAC)
** Type I services include: exams, cleanings, topical fluoride, space maintainers and bitewings
*** Type II services include: x-rays, emergency treatment for pain, fillings, and simple extractions.
**** Type III services include: denture repair, oral surgery (except TMJ), non-surgical periodontics, surgical periodontics, periodontal maintenance, crowns, inlays, onlays, endodontics, and prosthodontics.
Limitations and exclusions may apply. See policy for details.
Additional Benefit Information
Waiting Period
- Type III Services – 12 month waiting period
Dependant Eligibility
- Eligible dependents of the insured include the insured’s lawful spouse and unmarried children less than 19 or less than 26 if a full-time student.
Annual Maximum
Applies individually to member and each covered family member per policy year
- Basic - $500
- Preferred - $1000
Annual Deductible
Applies to Type II and III
- Basic – Type II / $50, Type III / $150
- Preferred – Type II / $50, Type III / $150
| Monthly Rates |
Basic
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Preferred
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| Member Only |
$18.70
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$27.54
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| Member + Spouse |
$38.09
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$49.76
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| Member + Child(ren) |
$39.34
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$49.91
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| Family |
$59.74
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$79.65
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TransSmile Group Dental Insurance is underwritten by Transamerica Life Insurance Company. Home Office: Cedar Rapids, IA, Policy Form Series CPDEN100, CCDEN100. *Rates do not apply in the State of California. Please request rates for California residents.
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