|
No Waiting Periods!
Immediate
Coverage!
Rates
are for 12 month coverage:
COMPARE & SAVE!
(10% Chamber Discount)
| PLAN |
RATE
|
CHAMBER
RATE |
| Individual
Only: |
$162.12 |
$145.90 |
| Individual
& Spouse |
$274.56 |
$247.10 |
| Individual
& Two Dependents |
$319.80 |
$287.82 |
| Individual
& One Dependent |
$241.68 |
$217.51 |
| Individual,
Spouse, up to 3 Dependents |
$388.80 |
$349.92 |
| Each
additional Dependent |
$151.20 |
$136.08 |
*Authorized
Chambers:
Detroit Regional Chamber
Farmington/Farmington Hills
Clawson Chamber of Commerce
|
CSI is proud to offer Golden Dental Plans "Dental Health
Plus"
|
100% Coverage/ No Copay
-
Oral Exam
-
X-Ray (Single Film)
-
Routine Cleaning
-
Flouride
-
Preventive Care Training
|
Also Coverage
For:
-
Restorative
-
Crown and Bridge
-
Oral Surgery
-
Prosthodontic
-
Periodontics
|
- *Review complete coverage descriptions & co-pay information:
CLICK
HERE (2 pages)
- Review Limitations & Exclusions CLICK
HERE
Print an application to
mail or fax in:
|
Fill out the forms
on line:
|
YOU MUST MAIL, FAX OR FILL OUT THE ONLINE FORMS ABOVE.
If you are faxing in the forms or filling them out online, you may pay online below, if you
are mailing in the forms, please include a check with full payment.
WE MUST RECEIVE BOTH
FORMS
(PART I and PART II)
|
