Thank you for your interest in the MultiFlex Dental Insurance Plan Underwritten by Nationwide Life Insurance Company. A family membership covers the head of household including spouse, and your unmarried children ages 19 or younger, and extends to age 23 if the dependent is a full-time student who is living at home. Your acceptance into this dental insurance plan is guaranteed while offering coverage for basic, preventative, and major dental services.

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You will find the basic dental insurance plan benefits and limitations noted below.

Monthly premiums are based upon the area you live in, age of the oldest member and the maximum calendar benefit $1,000, $1,500 or $2,000 per person depending on the plan you selected. Benefits will be paid for reasonable and customary fees as defined by the plan policy. Merchant Business Administration (MBA) is the administrator of the plan. They charge a $5 monthly fee plus a $1 National Small Business Association (NSBA) monthly membership fee which will be added to your monthly payment as shown. Participation in the NSBA is mandatory to access the dental insurance plan.

Effective Date:

Your order must be received by the 5th day of the month for coverage to start on the 1st of the same month. Otherwise, the coverage will not start until the 1st day of next month. You and your dependents are covered on the later of: the date they accept your enrollment and determine an effective date; or the date you first acquire a dependent, if the date is after your coverage begins.

Class A:  Preventive Services Include:

1. Two routine (including any initial exam) examinations of mouth and teeth per calendar year;

2. Two prophylaxis (cleaning and polishing teeth) per calendar year;

3. One topical fluoride per calendar year to age 16;

4. Space maintainers to preserve space between teeth for premature loss of a primary baby tooth.  This does not include use for orthodontic treatment.

Class B:  Basic Services Include:

1. Simple extraction of teeth;

2. Bitewing x-rays, 2 per calendar year;

3. One diagnostic x-ray, full or panoramic in any 3 year period, and;

4. Pin retention of fillings;

5. Fillings of amalgam, silicate, acrylic, synthetic porcelain and composite filling materials (restorations of mesioilingual, distolingual, mesiobuccal and distobuccal surfaces considered single surface restorations);

6. Antibiotic injections administered by Dentist.

Class C:  Major Services Include:

1. Oral surgery, including post-operative care for:

   1. removal of teeth, including impacted teeth;

   2. extraction of tooth root;

   3. alveolectomy, alveoplasty and frenectomy;

   4. excision of periocoronal gingiva, exostosis or hyperplastic tissue and excision of oral tissue for biopsy;

   5. reimplantation or transplantation of a natural tooth; and

   6. excision of a tumor or cyst and incision and drainage of an abscess or cyst.

2. Endodontic treatment of disease of the tooth, pulp, root and related tissue as follows:

   1. root canal therapy (not covered if pulp chamber was opened before covered);

   2. pulpotomy;

   3. apicoectomy; and;

   4. retrograde fillings.

3. Periodontic services, limited to:

   1. two prophylaxis following surgery per calendar year;

   2. root scaling and planing, once per quadrant of mouth in any 6 month period;

   3. occlusal adjustment, performed with covered surgery;

   4. gingivectomy, gingival curettage and mucogingival;

   5. osseous surgery including flap entry and closure;

   6. pedical or free soft tissue grafts; and

   7. one appliance (night guards) in 5 year period.

4. One study models in 3 year period;

5. Crown buildup for non-vital teeth;

6. Recementing inlays, onlays and crowns;

7. Recementing bridges;

8. One repair of dentures or bridges in any 2 year period, limited to 20% of cost of replacement;

9. General anesthesia and analgesic, including intravenous sedation for oral surgery;

10. Restoration services, limited to:

    1. gold or porcelain inlays, onlay, and crowns for tooth with extensive caries or fracture that is unable to be restored with an amalgam, silicate, acrylic, synthetic porcelain or composite filling material;

    2. replacement of existing inlay, onlay or crown after 5 years of the restoration initially placed or last replaced.  This limitation will not apply if replacement is necessary due to the extraction of functioning natural teeth while covered;

    3. stainless steel crowns;

    4. post and core.

11. Prosthetic services, limited to:

    1. initial placement of dentures or fixed bridgework (including acid etch metal bridges), when denture or bridgework includes replacement of a natural tooth extracted or lost while covered under the Policy.  This limitation ends after covered under the Policy for 36 months;

    2. replacement of dentures or fixed bridgework that cannot be repaired after 5 years from the date of placed or last replaced;

    3. addition of teeth to existing partial denture, only if to replace natural teeth extracted or lost while covered under the Policy.  This limitation will not apply after covered under the Policy for 36 months;

    4. relining or rebasting of existing removable dentures, only after one year from date the denture was placed and only once in any 2 year period.

    Additional Important Information

1. For overdentures and associated procedures for charges in excess of those considered reasonable and customary;

2. For cosmetic procedures;

3. For the replacement of dentures, bridges, inlays, onlays or crowns that can be repaired or restored to normal function;

4. For implants and for replacement of lost or stolen appliances, replacement of retainers, athletic mouthguards, precision or semi-precision attachments, denture duplication;

5. For oral hygiene instructions and for plaque control, completion of a claim form, acid etch, broken appointments, prescription or take-home fluoride, or diagnostic photographs;

6. For services not completed by the end of the month in which coverage ends unless continuation of coverage has been requested and accepted by Us;

7. For procedures that are begun, but not completed;

8. For services and treatment provided without charge or for which there would be no charge in the absence of insurance;

9. For services in connection with war or any act of war, whether declared or undeclared, or condition contracted or accident occurring while on full-time active duty in the armed forces of any country or combination of countries;

10. For a condition covered under any Worker's Compensation Act or similar law; that are applied toward satisfaction of a Deductible, if any; that are generally considered by the dental profession as experimental or investigational;

11. For the treatment of cleft palate and anodontia;

12. For services or supplies payable under any medical expense plan;

13. For orthodontia, unless included within Coverage Schedule;

14. Prior to the date the Insured is covered under the Policy;

15. For the diagnosis or treatment of TMJ;

16. For hospital services;

17. For any unmarried child age 19 years of age and over unless he is dependent upon You for support, while a full-time student. A full-time student is one who is enrolled for 12 semester hours for credit in an accredited junior college, college or university. Any exception for a full-time student will end at age 23;

18. During any waiting period they require, when You voluntarily end Your insurance and re-enroll at a later date, Your waiting period is 2 years and begins on the date Your coverage first ended.