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| August 28, 2008 |
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Concordia Flex Option II

Coverage
Following is a summary of the coverage levels, terms
and conditions for Option II Dental Plan offered by the Council's Employee Benefits Group.
Benefits at a Glance
| Option II |
Diagnostic (Routine Exams, X-Rays) |
100% |
Preventive (Cleaning, Scaling, Polishing) |
100% |
Basic Restorative (Fillings) |
100% |
Endodontics (Root Canals) |
100% |
| Simple Extractions |
100% |
Oral Surgery (Wisdom Teeth Removal) |
N/A |
Non-Surgical Periodontics (Gum Disease) |
100% |
Surgical Periodontics (Gum Disease) |
100% |
| Crowns, Inlays, Onlays |
N/A |
Fixed Prosthetics (Bridges) |
N/A |
Removable Prosthetics (Bridges) |
N/A |
| N/A |
| Yearly Deductible |
N/A |
| Lifetime Maximum (per person) |
N/A |
| $25 Except Preventive |
| $800 per person |
Payment of benefits is based on the Usual, Customary,
and Reasonable (UCR) charges as determined by United Concordia. 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.
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Provider Network
Members can use the Provider Network Directory provided by United Concordia. If a member lives in Pennsylvania, select Concordia Advantage network to find participating providers in your area. If a member lives in a state other than Pennsylvania, select Advantage Plus as the network.
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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: Wednesday, December 07, 2005 Page:
Copyright © 2003 Pittsburgh Technology Council. All Rights Reserved.
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