Page 8 - Tender Greens Benefit Guide Sample
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DENTAL
Assurant| PPO Dental Plan
The Assurant PPO plan is a preferred provider dental plan. The benefits cover a wide range of dental services. You may visit a
PPO Dentist and benefit from the negotiated rate or visit a non-network Dentist. When you utilize a PPO Dentist, your out of
pocket expenses will be less. You may also obtain services using a non-network dentist; however, you will be responsible for
the difference between the covered amount and the actual charges and you may be responsible for filing claims.
Plan Features Assurant PPO
In-Network Non-Network
Calendar Year Maximum $2,500
Deductible (Annual) $0
Preventative (Plan Pays) 100% 100%
- Deductible Waived Yes Yes
Basic Services (Plan Pays) 100% 100%
Major Services (Plan Pays)
- Crowns, inlays, onlays & cast 100% 100%
restorations 70% 50%
- Bridges & dentures, implants
Orthodontia - Adult & Child
- Coinsurance 50% 50%
- Lifetime Maximum $2,000 $2,000
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