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Company
Name
*Email
Phone
Address
We currently have the following coverage
Drug
Paramedicals ie. Massage, Chiropractor etc.
Vision
Dental
Orthodontics
Disability
Drug
Co-Insurance
70%
80%
90%
100%
Yearly Maximum
Paramedicals
Yearly Max for each paramedical provider
$250
$300
$400
$500
$750
$1000
Vision
Vision Co-Insurance
75%
80%
90%
100%
24 Month Vision Maximum
$150
$200
$250
$300
$400
$500
Dental
Dental Co-Insurance
60%
70%
80%
90%
100%
Levels of Coverage
Basic
Endodontic and Periodontal (E&P)
Major Dental
Orthodontics
Dental Yearly Maximum
Orthodontics
Orthodontics
Adult & Child
Child Only
Orthodontic Co-Insurance
50%
60%
75%
80%
90%
100%
Orthodontics Lifetime Max/Insurred
Disability
Income Replaced due to disability
50%
66.67%
75%
80%
90%
100%
Coverage for/until
2 Years Disability (Own Occupation)
2 Years Disability (Any Occupation)
5 Years (Own Occupation)
5 Years (2 Years Own Occupation/3 Years Any Occupation)
Until Age 65 (2 Years Own Occupation then Any Occupation)
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