Pittsburgh Technology Council
August 28, 2008
Home 
   Benefits
  Policies
     Resources
Statements

2003 Dental Insurance Benefits - Option I

Coverage

Following is a summary of the coverage levels, terms and conditions for Option I Dental Plan offered by the Council's Employee Benefits Group.

Benefits at a Glance
Option I
Preventive Services
Diagnostic 100%
Preventive 100%
Basic Services
Basic Restorative 100%
Endodontics 100%
Simple Extractions 100%
Oral Surgery N/C
Non-Surgical Periodontics N/C
Surgical Periodontics N/C
Major Services
Crowns, Inlays, Onlays N/C
Fixed Prosthetics N/C
Removable Prosthetics N/C
Orthodontics N/C
Deductibles
Program Calendar Year Deductible: None
Program Calendar Year Maximum: $1,000 per person

Payment of benefits is based on the Usual, Customary, and Reasonable (UCR) charges as determined by Highmark Blue Cross Blue Shield. This description outlines the principal features of the dental programs offered by the Council's Employee Benefits Group. It is not to be considered the contract of benefits and provisions. The complete terms of coverage are set forth in agreements issued by the individual carriers.

back to top

Provider Network

Members can use the  Provider Network Directory provided by United Concordia, Inc. and select "Penn Dental" to search for participating dentists in your area.

back to top

Rates

The rates listed below include a 3% administrative fee and are guaranteed to December 31, 2003.

Monthly Premium Rate Option I
Individual $12.85
Family $39.96

back to top

If you have any further questions, please contact us; we'll be glad to help you.

This information is not intended for use without professional advice. While we have attempted to make this site as accurate as possible, it is only a summary. For more information, see our disclaimer.


Last updated on:  Thursday, November 04, 2004  Page: 

Copyright © 2003 Pittsburgh Technology Council.
All Rights Reserved.