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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Supplemental Insurance Plan

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DATE OF BIRTH: ZIP CODE:

sample of covered services

benefit level year 1

basic dental services

• Fillings & Restorative Services
• General Anesthesis/Sedation
• Occlusal (Mouthguards)

Up to 50%

coverage after 6 months

major dental services

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

Up to 50%

annual deductible (per insured)

$50

annual max deductible (per family)

$150

annual maximum (per insured)

$1,250

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.
© Copyright 2008, Stonebridge Life Insurance Company

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