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Multiflex Dental

DENTAL COVERAGE INFORMATION

Introducing Multiflex, a comprehensive dental insurance plan created to offer you and your qualified family members the protection and flexibility you need to maintain your winning smile.

When you enroll with Multiflex, you receive affordable coverage for basic, preventive, and major dental services. Since you will be automatically accepted, your coverage begins the month after you application is received. What's more, this plan is fee of networks, so you have the power to keep your current dentist or choose a new one.

After you review the list of benefits Multiflex offers you and your family, complete and mail the enclosed enrollment form today. Just as soon as you receive your policy, you may begin enjoying the available benefits of the Multiflex Dental Insurance Plan.

COVERAGE ELIGIBILITY

All members and their spouse, regardless of age, and their children under 19 (23 if a full-time student) can enroll in this comprehensive dental coverage. Coverage is available for children only. Six Month waiting period for Basic Services, 18 Month waiting period for Major Services applies.

ELIGIBLE EXPENSES

For the plan to pay for covered expenses, a covered person must incur all eligible expenses while the policy is in force. Eligible expenses are dental services performed by:
  1. a licensed dentist acting within the scope of his license,
  2. a licensed physician performing dental services within the scope of his license, or
  3. a licensed dental hygienist acting under the supervision and direction of a dentist.

TERMINATION OF INSURANCE

The insurance of the policy holder may be terminated only: 

  • When the group's master policy is terminated;
  • On the date of the expiration of the grace period (31 days) if the insured person does not make the required premium payment;
  • On the premium due date next following the date the insured person ceases to be a member of the group;
  • Dependent coverage terminates when member coverage terminates or when they are no longer eligible.
DENTAL PLAN COVERAGE INFORMATION
 Multiflex

Benefits will be paid for reasonable and customary fees as defined by the plan policy. This plan has a maximum calendar year benefit for all services of $1,000, $1,500 or $2,000 per person depending on plan chosen. Six Month waiting period for Basic Services, 18 Month waiting period for Major Services applies.

 

PREVENTIVE

 You Pay...
Two routine exams of mouth and teeth per calendar year $50 Calendar year deductible*
Two cleanings, scalings, and polishings per calendar year  $50 Calendar year deductible*
Space maintainers $50 Calendar year deductible*

 

BASIC SERVICES

 You Pay...
Extraction of teeth 20% Coinsurance, $50 per member Calendar year deductible if under age 65*
X-rays 20% Coinsurance, $50 per member Calendar year deductible if under age 65*
Pin Retention of filings 20% Coinsurance, $50 per member Calendar year deductible if under age 65*
Fillings 20% Coinsurance, $50 per member Calendar year deductible if under age 65*
Antibiotic injections 20% Coinsurance, $50 per member Calendar year deductible if under age 65*

 

MAJOR SERVICES

 You Pay...
Oral Surgery 50% Coinsurance, $50 per member Calendar year deductible if under age 65*
Endodontic treatment of disease 50% Coinsurance, $50 per member Calendar year deductible if under age 65*
Periodontic services 50% Coinsurance, $50 per member Calendar year deductible if under age 65*
Crown build up for non-vital teeth 50% Coinsurance, $50 per member Calendar year deductible if under age 65*
Recementing 50% Coinsurance, $50 per member Calendar year deductible if under age 65*
Denture or bridge repair 50% Coinsurance, $50 per member Calendar year deductible if under age 65*
General anesthesia and analgesic 50% Coinsurance, $50 per member Calendar year deductible if under age 65*
Restoration services 50% Coinsurance, $50 per member Calendar year deductible if under age 65*
Prosthetic services 50% Coinsurance, $50 per member Calendar year deductible if under age 65*


* You only have to pay one calendar year deductible across all classes of benefits. Under 65: $50 Member deductible, $100 Member plus one deductible, $150 Family deductible. Preventive services covered at 100%. Over 65: $75 Member deductible, $150 Member plus one, $225 Family deductible. Preventive services covered at 80%.

EXPENSES NOT COVERED BY THIS PLAN

  • Overdentures and associated procedures

  • Charges in excess of those considered reasonable and customary

  • Cosmetic procedures

  • Replacement of dentures, bridges, inlays, onlays or crowns that can be repaired or restored to normal function

  • Implants; and for replacement of lost or stolen appliances, retainers, athletic mouthguards, precision or semi-precision attachments, denture duplication or sealants

  • Oral hygiene instructions; and for plaque control, completion of a claim form, acid etch, missed appointments, prescription or take-home fluoride or diagnostic photographs

  • Services not completed by the end of the month in which coverage ends, unless continuation of coverage had been requested and accepted by Security Life Insurance Company of America.

  • Procedures that have begun but not completed

  • Services and treatment provided without charge or for which there would be no charge in the absence of insurance

  • Services in connection with war or any act of war, whether declared or undeclared, or condition contracted or accident occurring while on full-time active duty in the armed forces of any country or combination of countries

  • Condition covered under any Worker's Compensation Act of similar law

  • Charges applied toward satisfaction of a deductible, if any

  • Treatments that are generally considered by the dental profession as experimental or investigational

  • Treatment of cleft palate and anodontia

  • Services or supplies payable under any medical expense plan

  • Orthodontia

  • Dental services rendered prior to the date the Insured is covered by the Policy

  • Diagnosis or treatment of TMJ

  • Hospital services

  • Any unmarried child age 19 years of age and over unless he is dependent upon you for support while a full-time student; a full-time student is one who is enrolled for 12 semester hours for credit in an accredited junior college, college or university; any exception for a full-time student will end at age 23

  • During any waiting period we require, when you voluntarily end your insurance and re-enroll at a later date; Your waiting period is two years and begins on a the date your coverage first ended.

*Coverage for this product may not be available in some states. This brochure provides a brief description of some important features of the Multiflex Plan. It is not the insurance contract, nor does it represent the insurance contract. A full explanation of benefits, exceptions and limitations is contained in the Certificate of Insurance.

Take the next step
order your dental coverage today

 

877.800.7340 local 612.991.3546
 
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