| Benefit Type | SILVER PLAN | GOLD PLAN | PLATINUM PLAN |
| $1,000 maximum | SILVER | GOLD | PLATINUM |
| $1,500 maximum | SILVER | GOLD | PLATINUM |
| BASIC SERVICES |
Examinatins & X-rays
| 100% | 80% | 100% |
| Cleaning & Flouride treatments | 100% | 80% | 100% |
| Routine Extractions | 100% | 80% | 100% |
| Fillings | 100% | 80% | 100% |
| Root canals | 100% | 80% | 100% |
| Denture repair | 100% | 80% | 100% |
| Periodontal Treatment | 100% | 80% | 100% |
| Surgical Procedures performed by dentist, including anaesthetics. | 100% | 80% | 100% |
| MAJOR SERVICES |
| Bridges, jackets and crowns | - | 80% | 80% |
| Full/partial dentures | - | 80% | 80% |
| Gold inlays and onlays, including veneers | - | 80% | 80% |
| ORTHODONTIC SERVICES (For dependents under 18 years of age) |
| Diagnosis and treatment for correction of malocclusion or malposed teeth | - | - | 50% to $1,500 lifetime maximum |