Welfare Summary Plan Description

DENTAL CARE BENEFIT See section 9

Benefit Funded by the Trust

The Plan provides Dental benefits only to Eligible Employees and their Dependents and to Retired Participants and their Dependents, age 65 and over.

Dental Calendar Year Deductible $75 per Participant; waived for Orthodontics only
Dental Calendar Year Maximum Benefit $2,000 per Participant
  % of Covered Expenses
Class I – Diagnostic and Preventive 80%
Class II – Basic Dental 80%
Class III – Major Dental 50%
Orthodontics – Dependent children under age 19 50%; up to $1,200 lifetime;
$75 deductible waived