SUMMARY OF COVERAGE DISABILITY PLAN Plan Features IN NETWORK Annual Deductible (Individual / Family) Preventive Care Basic Procedures (Extractions, fillings, etc.) Major Procedures (Crowns, dentures, etc.) Child Orthodontia Calendar Year Maximum Benefit OUT OF NETWORK Annual Deductible (Individual / Family) Preventive Care Basic Procedures (Extractions, fillings, etc.) Major Procedures (Crowns, dentures, etc.) Child Orthodontia Calendar Year Maximum Benefit

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