Restorative. Gold, baked porcelain restorations, crowns and jackets. If a tooth can be restored with a material such as amalgam, payment of the applicable percentage for that procedure will be made toward the charge for another type of restoration selected by the patient and the dentist. The balance of the treatment charge will remain the responsibility of the patient.
Restorative fillings made of amalgams, silicates, plastics and synthetic porcelains. Includes temporary stainless steel crowns. Prosthetic: - repair of damaged dentures. Adding teeth to existing dentures, or relining or rebasing the dentures. Each procedure limited to once every 3 years. Accidental injury: - Major dental services as a result of an accident up to a maximum of $1,000.00 per year per person. In addition to the "Basic" services listed, all eligible employees and eligible dependents shall be entitled to receive 50% of eligible charges for the "Major" dental services listed below: Endodontics: - the usual procedures required for pulpal therapy and root canal filling. Periodontics: - the usual procedures for treatment of the disease of the tissues and bones supporting the teeth. Extensive Restorations: - gold inlays and onlays. - jackets, crowns and bridges to rebuild and replace missing teeth. - each procedure except crowns limited to once in a 5 year period. Crowns will not be replaced within 5 years of placement. Anesthesia: - nitrous oxide analgesia, administered in the dentist's office. Prosthetic: - partial or complete upper and lower dentures, provided by a dentist or licensed denturist. Each procedure limited to once every 5 years. Allowances include all adjustments. Orthodontic: - The correction of malposed teeth. Annual maximum for the dental plan is $1500.00 per person. Lifetime maximum for orthodontic coverage is $1500.00 per person. The dental plan is based on the prevailing Dental Fee Guide. Any charges over and above those listed on this guide shall be the responsibility of the employee. Hourly employees will be given a Health Spending Account each January 1, in the amount of $500 per year.
Restorative. Includes polishing, all adhesives and bonding agents, indirect pulp capping, bases, liners and acid etch procedures. - Replacement of crowns, inlays and onlays requires the existing restoration to be 60+ months old. - Includes pre-operative and post-operative evaluations and treatment under a local anesthetic. - Replacement of a denture or a partial denture requires the existing denture to be 60+ months old.
Restorative. Includes polishing, all adhesives and bonding agents, indirect pulp capping, bases, liners and acid etch procedures. - Replacement of crowns, inlays and onlays requires the existing restoration to be 60+ months old. - Includes pre-operative and post-operative evaluations and treatment under a local anesthetic. - For all listed dentures and partial dentures, Copayment includes after delivery adjustments and tissue conditioning, if needed, for the first six months after placement. The Enrollee must continue to be eligible, and the service must be provided at the Contract Dentist’s facility where the denture was originally delivered. - Replacement of a denture or a partial denture requires the existing denture to be 60+ months old.
Restorative. Filling teeth with amalgams, composites (including white fillings on all permanent teeth) and stainless steel crowns to restore surfaces that have broken as a result of decay. Fold foil can be used to repair teeth with existing gold restorations. Repair of fixed appliances (only by a dentist) or repair of removable appliances (either by a dentist or a denturist). Reline of fixed or removable appliances by a dentist or a denturist is allowed once every 6 months. Pulpal therapy and filling of root canals. Treatment of diseases of the soft tissue and the bone surrounding and supporting the teeth. The benefits under this section are those services required for major reconstruction of teeth that have deteriorated and for replacement teeth. Eligible expenses in this category will be reimbursed at the rate of 75% of with an unlimited maximum. The following services are covered; To replace missing teeth with a fixed prosthetic. Crowns and/or bridges may be replaced once every 60 months.
Restorative. Oral and maxillofacial surgery.
Restorative. Provides all the necessary procedures to rebuild, repair, or reform the teeth. Within this benefit are included amalgam, synthetic porcelain and plastic fillings, gold fillings and crowns when the teeth cannot be restored with a filling material.
Restorative. (a) Gold, baked porcelain restorations, crowns and jackets If a tooth can be restored with a material such as amalgam, payment of the applicable percentage of the charge for that procedure will be made toward the charge for another type of restoration selected by you and the dentist. The balance of the treatment charge remains your responsibility.
(b) Reconstructive Payment based on the applicable percentage will be made toward the cost of procedures necessary to eliminate oral disease and to replace missing teeth. Appliances or restorations necessary to increase vertical dimension or restore the occlusion are considered optional and their cost remains your responsibility.
Restorative. The student must address the teammates and coaches and admit to the violation, show remorse and recommit to provisions of CODE by resigning it in front of teammates and coaches. This process is educationally based and is patterned after the restorative justice model.
Restorative. Includes polishing, all adhesives and bonding agents, indirect pulp capping, bases, liners and acid etch procedures. - Replacement of crowns, inlays and onlays requires the existing restoration to be 60+ months old. - Includes pre-operative and post-operative evaluations and treatment under a local anesthetic. - For all listed dentures and partial dentures, Copayment includes after delivery adjustments and tissue conditioning, if needed, for the first six months after placement. The Enrollee must continue to be eligible, and the service must be provided at the Contract Dentist’s facility where the denture was originally delivered. - Replacement of a denture or a partial denture requires the existing denture to be 60+ months old. - Includes adjustments, if needed, for the first six months after placement, if the Enrollee continues to be eligible and the service is provided at the Contract Dentist’s facility where the implant was originally delivered. - Replacement of a retainer, pontic, or stress breaker requires the existing bridge to be 60+ months old. - FPD, as referenced below, stands for fixed partial denture. - Each retainer and each pontic constitutes a unit in a fixed partial denture (bridge). - Replacement of a crown, pontic, inlay, onlay or stress breaker requires the existing bridge to be 60+ months old. - Includes pre-operative and post-operative evaluations and treatment under a local anesthetic. - Pediatric Enrollee must continue to be eligible, benefits for medically necessary orthodontics will be provided in periodic payments to the Contract Dentist. - Comprehensive orthodontic treatment procedures (D8080, D8090) include all appliances, adjustments, insertion, removal and post treatment stabilization (retention). No additional charge to the Enrollee is permitted except for services provided by an orthodontist other than the original treating Contract Orthodontist or dental office.
