Dental Insurance
A dental insurance plan works like a health insurance plan. You’ll pay a monthly amount to buy the plan (your premium). Most plans have a deductible, which is the amount you pay for covered services before your plan starts paying. Once you’ve met your deductible, you’ll usually pay for a percentage of covered services (coinsurance) or a fixed amount (copay). Your insurance plan typically pays for the rest, up to an annual maximum amount. A waiting period may apply for some services.
Benefits Summary
| Traditional Basic Plan | Traditional Buy-Up Plan | |||
| In-Network | Out-of-Network | In-Network | Out-of-Network | |
| Annual Deductible (Individual/Family) | $50/$150 | $100/$300 | $50/$150 | $50/$150 |
| Annual Benefit Maximum | $1,000 | $1,000 | $2,000 | $1,000 |
| Orthodontia Maximum | $1,500 | $1,500 | ||
| Out-of-Network Reimbursement | Negotiated Fee | 90th Percentile | ||
| Preventive Services-Deductible Waived | ||||
| Oral Evaluations | Covered at 100% No Deductible | Covered at 100% No Deductible | Covered at 100% No Deductible | Covered at 100% No Deductible |
| Prophylaxis: Cleanings | ||||
| Flouride Treatment (children under 19) | ||||
| Bitewing X-rays, Full Mouth X-rays | ||||
| Sealants (children under 16) | ||||
| Space Maintainers | ||||
| Basic Services | ||||
| Fillings (composite) | Covered at 80% No Deductible | Covered at 50% After Deductible | Covered at 80% After Deductible | Covered at 50% After Deductible |
| Oral Surgery | ||||
| Extractions (routine and surgical) | ||||
| Root Canal Therapy | ||||
| Periodontic Treatments | ||||
| Major Services | ||||
| Crowns | Covered at 50% After Deductible | Covered at 25% After Deductible | Covered at 50% After Deductible | Covered at 25% After Deductible |
| Dentures | ||||
| Bridges | ||||
| Endodontic Treatments | ||||
| Implants | ||||
| Orthondontia Services | ||||
| Diagnostics and Treatments | Covered at 50% No Deductible | Covered at 50% No Deductible | ||
The information above summarizes the Celebration Restaurant Group Dental Insurance plans and is for illustrative purposes only. In the event of a discrepancy between this illustration and the official plan documents, the official documents will govern.
Last Updated: October 18, 2024