5604 Old Bullard Road, Suite 106
Tyler, Texas  75703
903-939-8133
1-866-939-8133
fax  903-939-2534
Offered through Standard

Group Number: Forney ISD -160-647902

Forney Dental Coverage ID Card

Preventive services, including 2 visits per year, are paid at 100%.  Basic services
such as fillings are paid at 80% and major services like crowns and root canals
are paid at 50%.  The maximum benefit for each person covered is $1000 per
year.  A $50 calendar year deductible applies to Type 2 and Type 3 services and
is waived for Type 1 services.  Orthodontic Services are also covered up to $1500.
Dental Insurance
Gentry
Financial Group
contact for
Forney ISD:

Chad Gentry
The Standard High Dental

*May use In Network Providers OR
Out of Network Providers with High
Plan
Employee Only
$24.84
Employee and Spouse
$58.48
Employee & Child(ren)
$57.87
Employee & Family
$88.29
The Standard Low Dental

*
Use only In Network Providers with
Low Plan
Employee Only
$21.33
Employee and Spouse
$50.21
Employee & Child(ren)
$49.69
Employee & Family
$75.81