Page 14 - Dental Benefit Plan Summary
P. 14
TEXAS MUTUAL INSURANCE COMPANY DENTAL PPO PLAN
SECTION 4 - PLAN HIGHLIGHTS
The table below provides an overview of the Plan's Annual Deductible, Annual Maximum
Benefit and Lifetime Maximum Benefits.
Plan Features Network Non-Network
Annual Deductible
■ Individual $50 $50
■ Family $100 $100
Annual Maximum Benefit
■ Individual $1,500 $1,500
Lifetime Maximum Benefit for $1,500 per Covered Person, per lifetime
Orthodontic Services
9 SECTION 4 - PLAN HIGHLIGHTS
