California Dental Network's Indemnity Plan 1
California
Dental Network's Indemnity Plan 1 is an indemnity dental product that
allows members the ability to choose any dentist, including the ability to
select a dental specialist without having a gate keeper or needing a
referral from a general dentist. California
Dental Network's indemnity plan 1 is available to Employer Paid or
Voluntary groups of 2 or more members and may be offered as a stand alone
or dual choice option with any of California Dental Network's prepaid
plans, as long as at least 2 members of the group enroll in the indemnity
plan.
| California Dental Network's
Indemnity Plan 1 covers:
|
| Annual Maximum: |
$1,000 per calendar year maximum per
subscriber and each covered dependent.
|
| Annual Deductible:
|
$50.00 per person ($150 family maximum) exclusive of preventive
& diagnostic services.
|
| Orthodontic: |
$1,000 lifetime maximum for all
dependent children under the age of 19 is included at no extra charge. |
| Waiting
periods: |
12-months for Major restorations,
periodontics, fixed
prosthetics, removal prosthetics, and orthodontic services. |
This
plan pays benefits according to a fee schedule that is designed to
approximate the following coverage:
-
100% of the dentist's charges for preventive &
diagnostic procedures
-
80% of the dentist's charges for minor restorative, endodontic,
periodontic and oral surgery procedures, and
-
50%
of the dentist's charges for all major and other procedures.
|
Group with |
Group w/out |
| Monthly Rates |
Prior Coverage |
Prior Coverage |
| Employee Only |
$42.50 |
$39.20 |
| Employee + Spouse |
$85.10 |
$78.40 |
| Employee + Children |
$86.00 |
$79.30 |
| Employee + Family |
$145.60 |
$134.20 |
Groups with prior coverage will receive credit towards
the waiting periods. |
