Multiflex Dental Select Plus 2000

Primary Benefits
Plan Type	DPPO
Coinsurance	Preventive - 0%, Basic - 20% after deductible, Major - 40% after deductible *(0-12 months waiting period based on the different benefit)*
Deductible	$50 individual / $150 family
Annual Maximum Benefit	$2000
Office Visit Find Dentists	Preventive - 0% coinsurance, Basic - 20% coinsurance after deductible, Major - 40% coinsurance after deductible
Teeth Cleanings	0% Coinsurance, deductible waived
Restorative Dentistry/Fillings	20% Coinsurance after deductible
Oral Surgery	40% Coinsurance after deductible
Extractions	40% Coinsurance after deductible
X-Rays	20% Coinsurance after deductible
Crowns	40% Coinsurance after deductible
Root Canals	40% Coinsurance after deductible
Periodontics	40% Coinsurance after deductible
Dentures	40% Coinsurance after deductible
Topical Fluoride	0% Coinsurance, deductible waived
Sealant	0% Coinsurance, deductible waived
Bridges	40% Coinsurance after deductible
Endodontics	40% Coinsurance after deductible
Additional Information
A.M. Best Rating	A+ as of 11/16/2018
Electronic Signature for Application Available	Yes
Details and documents about this plan
View Plan Brochure Exclusions and Limitations

The benefits matrix is a summary for informational purposes only. Review the evidence of coverage and insurance policy (plan contract) for a detailed description of coverage benefits, limitations, and exclusions. Only the terms and conditions of coverage benefits listed in the policy are binding.
The benefits listed may be contingent on your use of physicians, hospitals, dentists and services within the specific insurance company's provider network.
The Copayment, Deductible, and Coinsurance amounts are your share of the costs for covered benefits. These amounts are subject to change.
The quotes or rates shown above are estimates only. Your premium is subject to change based on your medical history (pursuant to state law of residence), the underwriting practices of the insurance company, the optional benefits you selected, if any, and other relevant factors, such as changes in rates which take effect before your requested effective date. The insurance company always determines your actual premium. Insurance companies reserve the right to change the terms of a policy upon proper notification.

- If you go to a Maximum Care Dentist you could receive a discount on the visit and or procedure.
- NSBA offers many benefits to its members including, but not limited to: Consumer Medical Bill Solutions: Medical bill negotiation on your unpaid medical bills with a typical savings of 25-45% of your medical bill. Discounts & Rewards: Enjoy a multitude of savings, discount offers, and cashback rewards on all of your favorite retail, entertainment and travel purchases, along with access to voluntary benefits, and health and well-being benefits and much more! Outlook Benefit Solutions: Offering discount Vision, Rx, and Hearing. Up to 50% savings on eye exams (in selected areas nationwide) and on purchase of eye wear at over 11,000 optical locations and average discount of 10%-50% off the pharmacy's standard price. In order to learn more about these great benefits, visit www.nsba.net.
- While you are free to see any dentist you choose, out-of-network benefits will be paid based on MAC fees which is the Maximum Allowable Charge of a pre-determined fee schedule used to pay out-of-network claims. You may be responsible for the difference between the MAC and the actual dental charge from a out-of-network provider. Using an out-of-network provider will result in decreased savings on your dental services.

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