Coverage For Your Dental Care Needs.
Research shows that oral health and overall health are closely related. So when you keep your teeth healthy, you are also helping to keep your body healthy.
Our PPO Dental plan offers coverage options for preventive/diagnostic, basic and major restorative services through Careington’s Maximum Care network of 200,000 providers.
Applying is simple and can be completed in minutes.
“Careington Benefit Solutions, a CAREINGTON International Company administers the dental insurance plans on behalf of Chesapeake through their extensive Maximum
Care Network. | 2
Premium for an adult Basic PPO Dental plan”
See the following pages for Type I, Type II and Type III covered services details | The chart above is only an illustration of benefit and premium options per covered
person. | Visit ChesapeakePlus.com to view a list of in-network providers. | *Waiting periods are waived for an insured person previously covered under full dental
coverage, provided such prior coverage was in effect for at least 12 consecutive months and is continuous to a date no more than 63 days prior to your application
Certain services include limitations. Benefits are reduced for non-network providers. See Policy for details. | Note: If an insured person opts to receive dental services or procedures that are not covered expenses under the Policy, a network provider dentist may charge his or her usual and customary rate for such services or procedures. Prior to providing an insured person dental services or procedures that are not covered expenses, the dentist should provide a treatment plan that includes each anticipated service or procedure to be provided and the estimated cost of each service or procedure. To fully understand the coverage provided under the Policy, you should read your Policy carefully.
Type I Covered Services:
Premiere and Basic plans include the following services with
no waiting period:
• Prophylaxis – once every six months
• Topical Flouride – once every 12 months, up to age 16
• Sealants – once every 36 months, up to age 16
• Oral evaluations – once every six months
• Bitewing X-rays – once every 12 months
• Vertical bitewings – once every 36 months
• Diagnostic casts
• Space maintainers – up to age six
• Intraoral films, extraoral films and panoramic film –
once every 36 months
• Amalgam, primary or permanent & resin-based composite
• Palliative (emergency) treatment of pain
• Fixed partial denture sectioning
• Local anesthesia
• Analgesia – up to age 13
• Inhalation of nitrous oxide
• Occlusion analysis and occlusion adjustment
1 Type I services for Premiere and Basic plans are covered at 100% in-network and 80% non-network. | 2
Type II services for Premiere plan are covered at 80% in-network and 60%
non-network. Type II services for Basic plan are covered at 50% for both in-network and non-network.
Type III Covered Services:
Premiere plan only includes the following services with a 12 month waiting period, unless stated otherwise:
• Inlays and onlays (and recementing, once every 12 months after a six month waiting period)
• Crowns; cast posts and core buildups
• Pin retention in addition to restoration – up to two procedures every 12 months
• Sedative fillings
• Pulp caps; therapeutic pulpotomy; pulpal therapy
• Root canal or endodontic therapy
• Extraction of erupted tooth; removal of impacted tooth
• Tooth transplantation
• Removal of cyst/tumor 1.25 cm and greater
• Incision and drainage of abscess
• Complete and partial dentures – once every five years for complete dentures to replace missing/broken teeth
• Adjustment and repair of dentures
• Gingivectomy/gingivoplasty – once every 36 months
• Gingival flap procedure and osseous surgery – each limited to once every 36 months
• Soft tissue graft procedures
• Periodontal scaling and root planning – limited to four separate quadrants every two years
• Full-mouth debridement to enable evaluation and diagnosis – once every 36 months
1 Type III services for Premiere plan only are covered at 60% in-network and 50% non-network.
For a complete listing of benefits, exclusions and limitations, please refer to your Policy. In the event of any discrepancies contained in this brochure, the terms and conditions
contained in the Policy documents shall govern. Dental Insurance Preferred Provider Organization (PPO) Policy, Form CH-26121-IP (01/12) FL. | The information contained herein is
accurate at the time of publication. This brochure provides only summary information.
Notice to Our Customers About Supplemental Insurance
• The supplemental plan discussed in this document is separate from any health insurance
coverage you may have purchased with another insurance company.
• This plan provides optional coverage for an additional premium. It is intended to supplement your
health insurance and provide additional protection.
• This plan is not required in order to purchase health insurance with another insurance company.
• This plan should not be used as a substitute for comprehensive health insurance coverage. It is
not considered Minimum Essential Coverage under the Affordable Care Act.
Other Important Information
EXCLUSIONS AND LIMITATIONS
We will not provide any benefits for charges arising directly or indirectly, in whole or in part, from:
For Basic and Premiere Plans: Treatment, care, services or supplies for which benefits are not specifically provided for in the Policy | Charges exceeding the maximum
benefit amount, if any | Attempted suicide or any intentionally self-inflicted injury | Directly or indirectly engaging in illegal activity| Treatment of disturbances of the
temporomandibular joint (TMJ) | A service not furnished by a dentist, unless by a dental hygienist under the dentist’s supervision and x-rays are ordered by the dentist | Plaque
control, completion of claim forms; broken appointments, prescription or take-home fluoride, or diagnostic photographs | Oral/facial images, including intra- and extra-oral
images | Pulp vitality tests | Chairside, labial veneers (laminates) | Regional block anesthesia | Hospital, house or extended care facility calls | Office visits for the purpose of
observation, during or after regularly scheduled hours | Office visits outside of regularly scheduled hours | Enamel microabrasions | Services not completed by the end of the
month in which coverage terminates | Procedures that are begun, but not completed | Those services for which there would be no charge in the absence of insurance or for any
service or treatment provided without charge | Services in connection with war or any act of war, whether declared or undeclared, or condition contracted or accident occurring
while on full-time active duty in the armed forces of any country or combination of countries | Care or treatment of a condition for which benefits are payable under any Workers’
Compensation Act or similar law | Orthodontic procedures | Covered expenses for which an insured person is not legally obligated to pay | Experimental/Investigational treatment
For Basic Plan Only: Cosmetic procedures
For Premiere Plan Only: Cosmetic procedures, unless due to an injury or for congenital/developmental malformation. Facing on crowns, or pontics, posterior to the second
bicuspid is considered cosmetic | The replacement of full and partial dentures, bridges, inlays, onlays or crowns that can be repaired or restored to normal function | Implants;
replacement of lost or stolen appliances; replacement of orthodontic retainers; athletic mouth-guards; precision or semi-precision attachments; denture duplication; or splinting
| Replacement of any prosthetic appliance, crown, inlay, or onlay restoration, or fixed bridge within 5 years of the date of the last replacement, unless due to an injury | Post
removals unless in conjunction with endodontic therapy | Intentional re-implantation, including necessary splinting | Surgical procedure for isolation of tooth with rubber dam |
Canal preparation and fitting of performed dowel or post | An initial placement of a partial or full removable denture or fixed bridgework if it involves the replacement of one or
more natural teeth lost before coverage was effective under the Policy. This limitation does not apply if replacement includes a natural tooth extracted while covered under the
RENEWABILITY: Your Policy is conditionally renewable, subject to Chesapeake’s right to discontinue or terminate coverage as provided in the termination of coverage section of the Policy.
PREMIUM CHANGES: Chesapeake reserves the right to change the table of premiums, on a class basis, becoming due under the Policy at any time and from time to time; provided, Chesapeake has given you written notice of at least 45 days prior to the effective date of the new rates.
TERMINATION OF COVERAGE: Your coverage will terminate and no further benefits will be payable under the Policy or any attached riders, if any: | At the end of the period for which premium has been paid | If your mode of premium is monthly, at the end of the period through which premium has been paid following our receipt of your request of termination | If your mode of premium is other than monthly, upon the next monthly anniversary day following our receipt of your request of termination. Premium will be refunded for any amounts paid beyond the termination date | On the date of fraud or misrepresentation by you | On the date we elect to discontinue this plan or type of coverage | On the date we elect to discontinue all coverage in your state | On the date an insured person is no longer a permanent resident of the United States.
SureBridge is one of the leading brands of supplemental insurance coverage in the United States,
helping to provide financial security for Americans of all ages and their families. Our comprehensive
portfolio of products is available from licensed insurance agents in 46 states and the District of Columbia
and is available through HealthMarkets Insurance Agency Inc., as well as through other unaffiliated
insurance distributors. SureBridge policyholders can receive direct cash benefits for expenses caused by
unexpected medical issues, sustained illnesses, and end-of-life challenges.
The SureBridge portfolio includes dental, vision, and other insurance plans that complement an
individual’s health insurance. These plans help provide an additional layer of protection in the event of
accidental injury, catastrophic illness, hospitalization, or cancer.
SureBridge® is a registered trademark used for both insurance and non-insurance products offered by subsidiaries of HealthMarkets, Inc. Supplemental and life insurance products are
underwritten by The Chesapeake Life Insurance Company®. Administrative offices are located in North Richland Hills, TX. Products are marketed through independent agents/producers.
Insurance product availability may vary by state.
I am James Sparkman. I am the founder and CEO of TermLife Mutual. I am afamily-oriented person. My wife and I have been married for over 20 years! We have 5 children. We have 2 set of twins and 1 middle child. Since joining the financial services industry in 2004, I have made it my focus to help individuals, families and business owners save money on life insurance costs, reduce taxes, protect assets, build wealth and eliminate debt. While I try to help everyone that I can, I particularly enjoy working with those that seek to enjoy the journey of life.
TermLife Mutual is a life insurance agency that primarily provides individuals, families, and business owners with Term Life insurance. While TermLife Mutual’s flagship product is Term Life insurance, we do have other insurance products and services. Our goals are to help insure America with quality life insurance.
We work with multiple life insurance companies however our primary partner is Haven Life who are wholly owned by MassMutual Life insurance company. MassMutual is an A+ rated life insurance company that has been around for over 160 years.
Most of life insurance industry is still catching up with the times of internet and technology. Most life insurance is still sold thru a life insurance agent. At TermLife Mutual, we have partnered up with one of most up-to-date technology to allow our clients to purchase life insurance without the need for agent nor medical exams (no needles). This is our strong point that separates us from most life insurance agencies. We have platform that you can complete a quick application in less than 10 minutes without the need for agent. Our partners at
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