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Dental Insurance In addition to protecting your smile, dental insurance helps pay for dental care and usually includes regular checkups, cleanings, and X-rays. Several studies suggest that oral diseases, such as periodontitis (gum disease), can affect other areas of your body—including your heart. Receiving regular dental care can protect you and your family from the high cost of dental disease and surgery. ABC Company will continue to offer Dental Insurance through Delta Dental. Below is a cart outlining the benefits available to you: Type of Service Dental PPO: In-Network Dental PPO Out-of-Network DHMO Plan Deductible Waived for Preventive Waived for Preventive See Schedule for Cost $50 / $150 $50 / $150 Annual Benefit Max $1,500 $1,500 See Schedule for Cost Diagnostic & Preventive You pay 0% Coinsurance You pay 20% Coinsurance Cleanings, X-Rays, Oral Exams, See Covered Benefit Schedule Space Maintainers, Sealants, Plan pays 100% Plan pays 80% Flouride Diagnostic & Preventive You pay 20% Coinsurance You pay 40% Coinsurance See Covered Benefit Schedule Fillings, Simple Extractions, Plan pays 80% Plan pays 60% Emergency Treatment, X-Rays Major Services Crowns, Bridges and Dentures, You pay 50% Coinsurance You pay 50% Coinsurance Inlays, Onlys, Veneers, Root Canal See Covered Benefit Schedule Treatment, Gum Disease Plan pays 50% Plan pays 50% Treatment, General Anesthesia, Oral Surgeries Orthodontia No Deductible. You pay 50%. Plan pays 50%. See Covered Benefit Schedule Dependent Children $1000 Lifetime Maximum 14

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