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Consolidated Association of Resolute Employers
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Dental Rewards ®—If within a calendar year an individual goes to the dentist at least once and never uses more than $500 of the plan maximum, the plan maximum will increase an additional $250 for the next year. This will continue to build up to a maximum total of $2,000 ($1,000 annual maximum, plus $1,000 maximum carryover) as long as the two provisions are met. If the member does not submit a covered claim during the calendar year, they will lose their accumulated carryover benefits and will not earn any for that year. If the member exceeds the $500 threshold, they will not lose any accumulated carryover, however they will not earn any additional carryover for that year. Freedom to choose your provider—Additional savings can be seen if you use a network provider. Providers can be found at www.ameritasgroup.com
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Eye Care Fusion Benefit
-Benefit - 100% up to a maximum of $100 with $0 Deductible. The amount used up to the $100 is deducted out of the total $1,000 maximum allowed for dental/Eye Care benefits. There is no limitation on frequencies.
Exams—Includes case history; external examination of the eye and adnexa; ophthalmoscopic examination; determination of refracture status; binocular balance; tonometry test for glaucoma; gross visual field when indicated; summary finding; prescribing of lenses.
Frames
Lenses—Single; Bifocal; Trifocal; No line bifocal or progressive power; Lenticular
Contact Lenses
*Please refer to your certificate of insurance for complete details on all benefits, frequencies and plan limitations or view the limitations enclosed
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Monthly Premium |
Value |
Standard |
Royal |
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Single Only |
$23.77 |
$33.88 |
$43.25 |
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Insured & One (Spouse or Child) |
$43.97 |
$62.36 |
$79.53 |
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Insured & 2 or More |
$65.38 |
$91.08 |
$116.69 |
*Eligible applicants must be a member in good standing of CARE
*Please refer to your certificate of insurance for complete details on all benefits, frequencies and plan limitations or view the limitations enclosed
Ameritas Group Dental and EyeCare - Dental Limitations and Exclusions:
Covered Expenses will not include and benefits will not be payable for expenses incurred:
for Type 3 Procedures in the first 12 months the person is covered under this contract
for initial placement of any prosthetic crown, appliance, or fixed partial denture unless such placement is needed because of the extraction of one or more teeth while the insured person is covered under this contract. But the extraction of a third molar (wisdom tooth) will not qualify under the above. Any such prosthetic crown, appliance, or fixed partial denture must include the replacement of the extracted tooth or teeth
for appliances, restorations, or procedures to: a. alter vertical dimension; b. restore or maintain occlusion; or c. splint or replace tooth structure lost as a result of abrasion or attrition
for any procedure begun after the insured person's insurance under this contract terminates
or for any prosthetic dental appliances installed or delivered more than 90 days after the Insured's insurance under this contract terminates
to replace lost or stolen appliances
for any treatment which is for cosmetic purposes
for any procedure not shown in the Table of Dental Procedures. (There may be additional frequencies and limitations that apply, please see the Table of Dental Procedures for details.)
for orthodontic treatment under this benefit provision. (If orthodontic expense benefits have been included in this policy, please refer to the Schedule of Benefits and Orthodontic Expense Benefits provision found on 9260)
for which the Insured person is entitled to benefits under any workmen’s compensation or similar law, or charges for services or supplies received as a result of any dental condition caused or contributed to by an injury or sickness arising out of or in the course of any employment for wage or profit
for charges which the Insured person is not liable or which would not have been made had no insurance been in force
for services that are not required for necessary care and treatment or are not within the generally accepted parameters of care
because of war or any act of war, declared or not
Ameritas Group Dental and EyeCare - Eye Care Limitations and Exclusions:
Covered Expenses will not include and benefits will not be payable for expenses incurred for:
vision examinations more than the frequency as indicated on the plan summary page
lenses more than the frequency as indicated on the plan summary page
frames more than the frequency as indicated on the plan summary page
contact lenses more than once in any twelve month period. When chosen, contact lenses shall be in lieu of any other lens or frame benefit during the twelve month period. When lenses and frames are chosen, expenses for contact lenses are not Covered Expenses during the twelve month period
examinations performed or frames or lenses ordered before the member was covered under the eye care expense benefits.
subject to extension of benefits, any examination performed or frame or lens ordered after the member's coverage under the eye care expense benefits ceases
sub-normal eye care aids; orthoptic or eye care training or any associated testing.
non-prescription lenses.
replacement or repair of lost or broken lenses or frames except at normal intervals.
any eye examination or corrective eyewear required by an employer as a condition of employment.
medical or surgical treatment of the eyes.
any service or supply not shown on the Schedule of Eye Care Procedures.
coated lenses; oversize lenses (exceeding 71 mm); photo-gray lenses; polished edges; UV-400 coating and facets, and thints other than solid.
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