Incentive Plan

An Incentive Plan is incorporated in this dental benefit.  The Benefit Level will begin at 80% on selected Basic Services for the first year, then increase 10% each succeeding benefit year, to a maximum of 100%, provided you visit the dentist at least once during the calendar year for a regular exam and/or cleaning.

 

Annual Maximum:  $1,000. per year, per person total benefit

Basic Services =  80% of "Reasonable and Customary" Charges are covered by SET SEG (Note Incentive Plan above)

Includes services such as:

Examinations

Cleaning (Prophylaxis)

Fillings

Fluoride Treatment (to age 18)

Diagnostic X-Rays

Oral Surgery and Anesthetics

Root Canals (Endodontics)

Periodontics

Lifetime Deductible = $0

 

Major Services =  80% of "Reasonable and Customary" Charges are covered by SET SEG

Includes services such as:

Inlays

Crowns and/or Bridges

Dentures (Full and Partial)

Crown and/or Bridge Repair

Annual Deductible = $0

 

Plan Definitions

Eligible participants:  Include each Active Full-Time Employee of Bay de Noc Community College.

Eligible dependents:  Include (1) an employee's spouse while not divorced or legally separated from the employee; (2) each of the employee's unmarried children who is a dependent within the meaning of the Internal Revenue Code of the United States, to age 25.  Coverage is provided through December 31 of the year in which the dependent becomes age 25.

Eligible dental care charges:  The actual costs charged for the listed treatments or services to the extent that such charges are reasonable and customary for the services performed or the materials furnished.  "Reasonable and customary" is determined from a compilation of reported usual dental fees charged by doctors in specific geographic areas.

Eligible charges:  Are reimbursed on a year defined as the 12-month period of January 1 through December 31.

Your Plan:

	Covers bridge and/or denture work for new or existing insured if the missing teeth were extracted prior to the effective date of the service contract (only exception is congenitally missing teeth);
	Waives the five-year replacement limitation on bridge, crown or denture work; and
	Covers single crowns under Basic Services rate (80%) but does not allow for the incentive increase.

Select the Dentist of your choice and make an appointment for an examination.  If the examination indicates that charges for necessary follow-up treatment will exceed $200, the dentist should submit a pre-treatment estimate to SET SEG.

Contact information: SET SEG, Inc. Marilyn Jones Hammond 415 W Kalamazoo Street Lansing, MI  48933 Phone:  800.292.5421  Ext. 715 Fax:      517.482.0800 Group # 00036 Contract # Your Social Security Number http://www.setseg.org

Here's to your HEALTHY SMILE!!