ADMINISTRATORS

Health Insurance -ASR
CLaims filed by calendar year

Deductible is 50/100 - 90% paid after deductible is met

Prescription co-pay - $5.00 generic/$10.00 name brand

Includes $10,000. basic Term Life with $10,000. AD&D

Benefit year is July 1 through June 30

b sit for PPOM Provider

Dental - Set, Inc.

Benefit year is calendar year 

Basic Benefit

Percentage begins at 50% increasing 10% each year to 100%

Includes 2 cleanings per year. Each person must go to the dentist at least 1 time per year or percentage

decreases back to 50%.

Orthodontic Expense

Percentage covered 50% - deductible $50.00

Lifetime Maximum Benefit is $1500.00

Vision - SET, Inc. 

Vision examination, lenses & frames: one service every 12 months. Policy year is defined as the 12-month

period July 1 through June 30

 

SET Ultra-Vision Plans provide benefits for eligible expenses at 100% of reasonable & customary fees or at follows:
Vision Exam $55.00

Single-vision lenses $73.00

Bifocal-vision lenses $84.00

Trifocal-vision lenses $100.00

Lenticular-vision lenses $124.00

contacts prescribed after cataract surgery or when

vision is not correctable to 20/70 in the better eye

except by their use. $175.00

Contact lenses in lieu of glasses not to exceed: $110.00

Life – MESSA
$50,000 Life and $50,000 AD&D

Long Term Disability – 
66 2/3% of contract after 90 days - Maximum eligible monthly salary $5,000