quick & easy application. guaranteed acceptance. use your existing dentist. 30-day money-back trial.

a product of stonebridge life insurance company

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Standard Insruance Plan A

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DATE OF BIRTH: ZIP CODE:

sample of

benefit level

covered services

PLAN A

PLAN B

preventive & diagnostic

• Oral Exams & Cleanings
• X-Rays

100%

50%

basic dental services

• Fillings & Restorative Services
• Anesthesis/Sedation
• Mouthguards

50%

50%

After 12 month waiting period:

major dental services

• Crowns
• Root Canals & Oral Surgery
• Tooth Extractions
• Denture Repairs

50%

50%

annual deductible (per insured - applies only to basic & major services only)

$50

$50

annual maximum (per insured)

$1000

$850

AM Best

Policy/Certificate #: SLDT1000IP/SLDT1000GC/GC537/GC538.
This coverage is issued by Stonebridge Life Insurance Company, an AEGON company. Stonebridge Life Insurance Company NAIC number 65021. Not available in all states. Administrative Office: 2700 W. Plano Parkway, Plano, TX 75075-8200. Home Office: Rutland VT 05701.
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