Dental Insurance Plan
The voluntary group dental plan for healthcare providers and their families that provides affordable protection from today's dental costs.
Freedom of Choice
You enjoy the freedom to choose any dentist you want. You won't be forced to switch from your current dentist to a new
provider. There are no provider restrictions.
Comprehensive Coverage at an Economical Cost
You and your family can be covered for a full range of dental health services including exams, cleanings every six
months, fillings, sealants, simple extractions, complex oral surgery, minor and major restoration. See schedule of
benefits chart on the inside for more coverage details and any waiting periods.
No Waiting Periods or Deductibles for Preventive and Diagnostic Services
Once your coverage goes into effect, you can use your dental benefits for your next dental visit.
Maximum Benefit Limit
You, your spouse and dependent children
(typically under age 19 or 25 if a full-time
student) are entitled to receive up to $1,200
each of benefits per calendar year for dental procedures performed after the annual
deductible is met. An annual deductible of $50 per person ($150 family maximum)
is required each calendar year except for preventive and diagnostic services. The
deductible is applied against insurance covered expenses, not billed charges. The benefits of
this plan will coordinate with any other benefit plan to reimburse 100% of allowable charges.
There is an additional Accident Benefit of up to $1,000 maximum per calendar year for each
insured person. This Accident Benefit is separate from the annual maximum of the plan.
Guaranteed Acceptance for You and Your Family
This is an economical comprehensive dental insurance plan for ASRT members and their families. You are guaranteed
acceptance into the plan.
Insurance Protection That's Yours to Keep
Unlike most employer provided plans, this insurance coverage stays with you if
you should change jobs or become selfemployed. It is protection that is yours
to keep as long as you are an eligible participant, the group policy remains
in force, you pay your premiums when due, and you remain actively at work.
| Quarterly | Semi-Annually | |
|---|---|---|
| Member | $99.00 | $198.00 |
| Member & Spouse | $177.00 | $354.00 |
| Member & Child* | $177.00 | $354.00 |
| Family* | $239.00 | $478.00 |
Schedule of Benefits
Click here to view the Schedule of Benefits Chart.
What is not covered?
Click here to see the exclusions of the policy.
How to Enroll
Just complete the enrollment form and return it along with your payment. Your coverage will go into effect on the
first day of the month coinciding with or next following the date after your completed enrollment form and payment is
received. You must be actively at work on the date your insurance is to take effect. If you are not, insurance will
take effect on the day you resume such work. Your spouse must also be able to perform the normal activities of a
person of like age and sex, with like occupation or retired status on the date their insurance is to take effect.
If not, insurance will take effect on the day they resume such activities.
An A++ Rated Company Stands Behind This Plan
This Dental insurance plan is underwritten by The United States Life Insurance
Company in the City of New York, A member company of American International Group, Inc., which is rated A++ (Superior)
by the A.M. Best Company, an independent rating company. The A++ rating reflects United States Life's superior overall
financial strength and operating performance when compared to A.M. Best's standards. The rating is current as of July
1, 2006. For the latest A.M. Best's Ratings and A.M. Best's Company Reports, please visit the
A.M. Best web site at www.ambest.com.