The Plan Dentist you select may not perform all procedures listed.  The copayments shown apply to those Plan Dentists who perform those services. Therefore, you are encouraged to discuss availability of the scheduled services with your Plan Dentist. Charges for procedures not listed on the Copayment Schedule that are performed by your Plan Dentist are not covered under the Secure Choice Plan.

Should you require dental services that your selected Plan Dentist is unable to provide, you may obtain those services from a Plan Specialist at a reduced rate.  No referral is needed from your Plan Dentist in order for you to obtain services from a Plan Specialist.  There is no applicable copayment schedule for Plan Specialist services.  Instead, the following reductions off the Plan Specialist's normal retail charges apply to all services received from a Plan Specialist.  A 15% reduction applies if the Plan Specialist is an endodontist.  A 25% reduction applies if the Plan Specialist is any other type of specialist, including but not limited to an orthodontist.  You are responsible for paying the entire reduced charge at the time the service is received, or in accordance with the Plan Specialist's billing procedures.

Payment for each service of a Non-Plan Dentist or Non-Plan Specialist (at the provider's normal retail charge) is your responsibility, except for limited Plan Benefits for covered dental Emergency Services for temporary pain relief.

* Members are responsible for additional lab fees for these services.

* The Average Retail Charges were determined by Assurant Employee Benefits claims analysis for the year 2003.  The Retail Charges represent a mean average rounded to the nearest dollar representing what you may pay without the plan services.