VACE Dental Insurance Program

Rates and Coverage Information

Coverage A(No deductible)

Diagnostic: Evaluations; X-rays

Preventive: Cleanings, Flouride, Space maintainers and Sealants for children

Delta Pays 100%

Lifetime Deductible (Applies to Coverage B and C (person / family)

$100/$300

Coverage B

Restorative: Fillings; Extractions; Root canal therapy; Periodontal treatment; repair of a removable denture; Emergency treatment.

After a 6 month waiting period Delta pays 80%

Coverage C

Prosthodontics: Removable and fixed partial dentures (bridges); Crowns; Dentures; Onlays.

After 12 month waiting period, Delta pays 50%

Coverage D (No deductible)

Orthodontics: Correction of crooked teeth for each subscriber and dependent

After 12 moth waiting period, Delta pays 50%

Maximum Benefits

Converges A, B & C per person per calendar year;

Coverage D per person per lifetime

.

$1000

$1000

**Monthly Rates

One Person:

Three or more persons:

Two Person:

.

$32.00

$56.60

$92.60

 

**There is no required employer cost participation. Rates are valid through 6-30-2002.

 

© Copyright Central Vermont Chamber of Commerce © 2002, All rights reserved.
CV chamber / P.O. Box 336 / Barre, Vermont 05641
(802)-229-4619

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