SmileChoice Plan 100
Student Dental Plan
Information and Benefits

	NO DEDUCTIBLES			NO CLAIM FORMS
	NO ANNUAL MAXIMUMS			NO PRE-EXISTING CONDITION LIMITATIONS
	NO CLAIM FORMS			NO CHARGE X-RAYS
	NO CHARGE DENTAL EXAMS			24 HOUR EMERGENCY SERVICE
	COSMETIC SERVICES COVERED			ORTHODONTIC & VISION BENEFITS INCLUDED

The SmileChoice Plan 100 is a voluntary dental plan for California Students,their families, and Alumni Associations.
Look how much you can save!

SmileChoice Plan Options
	Plan Service		**Non-Member Cost		Plan 100
					Cost		Savings
	Dental Exam		$62.50		No Charge		$62.50
	X-rays		$105.00		No Charge		$105.00
	Routine Cleaning		$76.00		$20.00		$56.00
	Filling - 1 Surface		$115.00		$33.00		$82.00
	Root Planing		$185.00		$75.00		$110.00
	Root Canal, Molar		$859.50		$320.00		$539.50
	Porcelain with Metal Crown, Molar		$737.50		$380.00		$357.50
	Full Upper Denture		$1,200.00		$440.00		$760.00
	Full Upper & Lower Orthodontics (child)		$4,000.00		$1,795.00		$2,205.00
	Vision Exam		$60.00		$39.00		$21.00
	Single Vision Lenses		$65.00				25% Savings
	Anti-reflective Coat		$52.00				25% Savings
	Frames						25% Savings
** Non-Member cost based on California state average.

Membership (Prepayment) Fees

	Plan 100		Annual
	Member only		$81.35
	Member & one (1)		$129.95
	Family		$159.43