Dental Summary - Dental Network of America

January 1, 2006 - December 31, 2006

Medical     Dental     Vision     Life/AD&D     Addt'l Life/AD&D     STD     LTD     LTC     Flex

Information provided is in summary format.  Any difference between the summary provided and actual contract will be settled in favor of the contract.
Deductible	$50 per individual
Waived for Preventive	Yes
Type I - Preventive	100%
Type II - Basic	80%
Type III - Major	50%*
Type IV - Orthodontics**	50%
Type I, II, III Annual Maximum	$1,500
Type IV Annual Maximum	$1,000
Waiting Period - Type IV (Orthodontic Services)	12 months
Predetermination Required For:	Treatment estimated to cost over $300
Vision Discount Plan	Click Here

*Major Services are covered at 50% if you had dental coverage in force immediately prior to your effective date on this plan.  If you had no prior dental coverage in force, major services will be covered at 10% the first year, 25% the 2nd year, and 50% thereafter.

**Type IV Dental Services available only to dependent children who are under age 19.

Mann Mortgage

1220-B Whitefish Stage Road

Kalispell, MT 59901

Phone: (406) 751-6251

Fax: (406) 751-6253 

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