What is the Benefit

Who is Eligible

 Claiming

Dual Member Note

Alternate Benefit

Maximums

Participating Dental Program

  Participating General Dentists

 Participating Specialists

Predetermination

Dental Claim Form

$ Limitations

Healthplex

 

 

Treatment Review

General Limitations

Schedule of Benefits

General Exclusion

Retiree Benefits

Retiree Self-Pay Benefits

 

 

 

Revised 05/03/11