Dental Plan

Introduction

The Dental Plan covers eligible expenses for the care of your teeth and gums. To be covered, charges must be:

• For medically necessary services and supplies, and
• Performed or billed by a licensed dentist, orthodontist, or oral surgeon.

For purposes of the Dental Plan, "medically necessary" means a service or supply is:

• Required to identify, prevent, or treat a dental condition,
• Consistent with the diagnosis and treatment of the condition,
• In accordance with standards of generally accepted dental practice,
• Not mainly for the convenience of the patient or the provider, and
• The most suitable level of service that can be safely provided.

The fact that a dentist or other provider prescribes or orders a service does not automatically make it medically necessary or eligible for reimbursement.

The Dental Plan is part of the Company's Health Care Program. After reviewing this information, you can find more information that applies to the Dental Plan by reviewing the Health Care Program Participation section.