Premier Group Dental Insurance Plan

• Guaranteed Acceptance
• Economical Group Premium Rates
• Higher Overall Maximum Benefit for Each Covered Individual
• New $1,000 Accident Benefit
• Choose Your Own Dentist
• 157 ADA Covered Treatments and Procedures
• Coverage for Crowns and Dentures
• Optional PPO Dental Network -
  Your plan includes, an optional dental provider network powered by SmileMax®. The network is a group of credentialed dental professionals at more than 140,000 locations nationwide that have contracted to provide dental services at negotiated rates - to help reduce your out-of-pocket expenses. You may continue to choose any dentist; however, using a network provider can save you between 20 to 40 percent depending on the type of treatment. To find a network dentist, please call 1-800-221-3480 or visit the 'Find a Dental Provider' online search (click here). If your dentist does not currently participate in the network, a provider nomination form is available below for you to nominate him/her for membership.
• 30-Day Free Look
• Underwritten by The United States Life Insurance Company in the City of New York

Documents

• 'All-in-One' Brochure (Includes Enrollment Form):
  Please Select Your State AK AL AR AZ CA CO CT DC DE FL GA HI IA ID IL IN KS KY LA MA MD ME MI MN MO MS MT NC ND NE NH NJ NM NV NY OH OK OR PA RI SC SD TN TX UT VA VT WA WI WV WY
• Dental Claim Form
• Provider Nomination Form

 This document is in Adobe^® Reader^® format (.pdf) and will require Adobe Acrobat Reader.

The Premier Group Dental Insurance Plan is underwritten by The United States Life Insurance Company in the City of New York, NAIC No. 70106, domiciled in the state of New York with a principal place of business of 1 World Financial Center, 200 Liberty Street, New York, NY 10281. It is currently authorized to transact business in all states plus DC, except PR. This summary is a brief description of benefits only and is subject to the terms, conditions, exclusions and limitations of Group Policy No. V-610,110, Form No. G-19000. Coverage may vary or may not be available in all states.

The underwriting risks, financial and contractual obligations and support functions associated with products issued by The United States Life Insurance Company in the City of New York (United States Life) are its responsibility.

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