AWA Dental Plus

The percentage shown is the percentage of the policy’s maximum allowable charges (MACs) that the policy will pay for covered services provided by either a participating dentist or a nonparticipating dentist. participating dentists accept the maximum allowable charge as payment in full. Nonparticipating dentists may bill you for the difference between their charge and the maximum allowable charge paid by the policy. United Concordia Dental’s standard exclusions apply. Dependent children are eligible to age 26 in all states. The United Concordia Individual Dental Insurance Policy (“Policy”) includes a complete listing of covered services, limitations, exclusions, cancellation and renewal provisions. In the event of conflict, the Policy will govern. PPO individual dental products underwritten by: United Concordia Insurance Company when issued in AR, AZ, CA, CO, CT, FL, GA, IN, LA, MA, MI, MS, NM, OH, OK, OR, RI, SC, TN, TX, VA, WA and WV; United Concordia Life and Health Insurance Company when issued in DC, DE, IL, KY, MD, MO, NC, NJ and PA; United Concordia Dental Corporation of Alabama when issued in AL; and United Concordia Insurance Company of New York when issued in NY. United Concordia Insurance Company is not licensed in AL, DE, DC, IL, KY, MD, MO, NJ, NY, NC and PA. Not all products are available in all jurisdictions. United Concordia policies cover dental benefits only. United Concordia Insurance Company, California certificate of authority number 3739-0, is domiciled in Arizona at its statutory address, 2198 East Camelback Road, Suite 260, Phoenix, AZ 85016. Available Concordia products are underwritten by United Concordia Insurance Company in OK and written on OK policy form OKIN01-0312UCIC. The administrative office of UCCI and/or its licensed corporate affiliates is located at 4401 Deer Path Road, Harrisburg, PA 17110.

¹ Issue Age is 18 and over; dependent children covered up to age 26.

² Orthodontics is for dependent children up to age 19.