400N Enrollment Form - Dental Alternatives Insurance Services Inc

This plan will provide you with excellent dental benefits and
save you money. You know how important it is to maintain
good oral health and this plan helps with low or no
co-payments for preventive services. But there is more than
just preventive care … restorative treatment is also covered
at co-payments considerably lower than what you might
expect to pay without this plan.
About this plan …
• No waiting periods, claims forms, deductibles or maximums
• You will access care through a network of pre-screened
general dentists. You and each enrolled dependent may
select a different network dentist.
• Emergency care is available (see Evidence of Coverage
within this booklet).
• Specialty care is covered; review the enclosed Schedule of
Benefits to find out more.