| III |
Dental Care |
| Reimbursement Percentage For Each Insured Person |
| Year One |
Year Two |
Year Three |
|
| 50% |
50% |
50% |
|
|
| Annual Maximum for Each Insured Person |
|
| Basic Services (cleaning, recall exams) |
| Year One |
Year Two |
Year Three |
|
| $300 |
$300 |
$500 |
Maximum increases in year three |
|
Where no maximum is stated, the Program reimburses 50% up to the usual and customary cost of these items:
Benefit Year – is 12 months from the effective date of coverage.