Deductible $60 per covered member, $150 per family Annual Plan Maximum $1,500 / person Preventive Services Exams, Cleanings, Fluoride, X-Rays You Pay 0% Basic Services Fillings, Extractions, Endodontics, Crown Repairs You Pay 15% Major Services Crowns, Dentures, In/Outlays, Periodontics You Pay 30% Orthodontia Services To Age 19: You Pay 30% Age 19 and Over: You Pay 50% Orthodontia Maximum To Age 19: $500 per Year Age 19 and Over: $500 per Lifetime