What is The Competitor Smile Dental Insurance Plan?
Competitor Smile Dental offers you access to high quality, affordable dental coverage for your entire family. Coverage is provided for preventive, basic and major dental services.
How are benefits covered?
Competitor Smile Dental pays benefits for each covered person in the
following manner:
First, you meet the $50.00 Calendar Year
Deductible per person.
(Maximum of three individual deductibles per family)
Then Competitor Smile Dental pays a
percentage
of covered expenses based on the Reasonable and Customary (R&C)
fees for those Covered Expenses. You can select your own dentist.
| SERVICES | GOLD | SILVER | BRONZE |
|---|---|---|---|
| Calendar Year Maximum (Per Person) |
$1,500 | $1,000 | $750 |
| Preventive: Exams, Cleaning, Fluoride Treatments | |||
| Year One | 100% | 100% | 100% |
| Year Two | 100% | 100% | 100% |
| Year Three and After | 100% | 100% | 100% |
| Waiting Period | None | None | None |
| Basic: X-rays, Fillings, Extractions and Oral Surgery | |||
| Year One | 20% | 20% | 20% |
| Year Two | 40% | 40% | 40% |
| Year Three and After | 60% | 60% | 60% |
| Waiting Period | None | None | None |
| Major: Crowns, Bridges, Dentures and Root Canals | |||
| Year One | 10% | 10% | No Coverage |
| Year Two | 25% | 25% | |
| Year Three and After | 50% | 50% | |
| Waiting Period | None | None | |
| Calendar Year Maximum (Per Person) |
$1,500 | $1,000 | $750 |
Who is eligible for this coverage?
This plan is offered to individuals and their spouse ages 18 through
64 and their eligible dependents (unmarried children from birth to age
19 or 23 if a full-time student Ñ this is subject to state
requirements.) Coverage may also be obtained by individuals and their
spouse ages 65 and older.
When does my coverage start?
Coverage starts on the effective date. The effective date issued will
begin on the 1st of the month (at 12:00 a.m.), following HPA, Inc.Õs
receipt of the completed Enrollment Form and payment of the first
month of premium.
What are my payment options?
You can pay in monthly installments by check, credit card, or auto
bank withdrawal. We accept MasterCard, Visa or Discover credit cards.
This site provides a brief
description of the benefits, exclusions and other provisions of the
policy or certificate Form Master Policy #GH-1112-38090 issued to the
Voluntary Group Trust. For a complete listing, see the policy or
certificate. Benefits may vary in different states. This dental
insurance plan may not be available in all states. ©2005 HPA, Inc.
All rights reserved.
S105121 (10/03)
