Crescent Dental

Crescent Dental Insurance is available to qualified employees. The plans offer the
freedom to use the dentist of your choice. There are three levels of coverage: Basic Plan features:

• $1,000 annual maximum
• $100.00 lifetime deductible for Preventive and Basic services.
• Preventive Services are payable at *100%
• Basic Services are payable at *80%

* Percentage payable is based on allowable charges for covered procedures. Standard Choice Plan features:

• $1,000 annual maximum
• No deductible for Preventive and Orthodontia Services
• $50.00 deductible for Basic and Major Services
• 12 month waiting period for Major and Orthodontia Services
• Preventive Services are payable at *100%
• Basic Services are payable at *80% after deductible
• Major Services are payable at *50% after deductible
• $1,000 Orthodontia lifetime maximum

* Percentage payable is based on allowable charges for covered procedures. Comprehensive Plan features:

• $1,200 annual maximum
• No deductible for Preventive and Orthodontia Services
• $50 deductible for Basic and Major Services
• 12 month waiting period for Major and Orthodontia Services
• Preventive Services are payable at *100%
• Basic Services are payable at *80% after deductible
• Major Services are payable at *50% after deductible
• $1,000 Orthodontia lifetime maximum

* Percentage payable is based on allowable charges for covered procedures.

Level	Monthly	Bi-Weekly	10 Pay FAC
Single	$27.48	$13.74	$32.98
With Spouse	$53.38	$26.69	$64.04
With Children	$74.22	$37.11	$89.06
Family	$101.96	$50.98	$122.36

Level	Monthly	Bi-Weekly	10 Pay FAC
Single	$35.72	$17.86	$42.86
With Spouse	$71.44	$35.72	$85.74
With Children	$75.40	$37.70	$90.48
Family	$117.70	$58.85	$141.24

Level	Monthly	Bi-Weekly	10 Pay FAC
Single	$40.70	$20.35	$48.84
With Spouse	$81.40	$40.70	$97.66
With Children	$85.88	$42.94	$103.06
Family	$134.08	$67.04	$160.90

Contact Human Resources at 985/549-2587 for more information or to enroll