IMPORTANT INFORMATION
Safeguard Dental Documents
Safeguard Dental Forms
Through Safeguard Dental, EPISD offers you the opportunity to select from three Dental Plans to meet your needs.
SafeGuard Dental HMO Plan TX-300
- Discounted Dental Program provides for deep discounts between 20%-30% on scheduled procedures provided by participating providers in the network.
- It is your responsibility to manage your dental care.
- Prior to receiving services, you should review the schedule of benefits (Discounted Fee Schedule).
- Only services provided by In-Network Providers are discounted.
- No Out-of-Network benefits are available under this plan.
| Monthly | Semi-monthly | |
| Employee Only | $ 8.34 | $4.17 |
| Employee & One | $13.90 | $6.95 |
| E & Children | $16.14 | $8.07 |
| E & Family | $19.48 | $9.74 |
SafeHealth Indemnity Dental Plan VC-2322
- Plan allows for you to receive care from any dentist.
- Reimburses for covered procedures based on the procedure class and percentage allowed after a $50 annual deductible per person or $150 annual deductible per family is met.
- 12 month waiting period on Major Services (Ex. crowns, removable & fixed bridges, complete & partial dentures, oral surgery, periodontics and endodontics)
| Monthly | Semi-monthly | |
| Employee Only | $20.72 | $10.36 |
| Employee & One | $41.44 | $20.72 |
| E & Children | $42.28 | $21.14 |
| E & Family | $63.00 | $31.50 |
SafeHealth Defined Benefit Dental Plan SR-32
- Plan allows for you to receive care from any licensed dentist.
- Reimburses for covered procedures based on the plan’s schedule of benefits after a $50 annual deductible per person or $150 annual deductible per family is met.
| Monthly | Semi-Monthly | |
| Employee Only | $14.10 | $ 7.05 |
| Employee & One | $28.22 | $14.11 |
| E & Children | $28.78 | $14.39 |
| E & Family | $42.90 | $21.45 |
For more information on how each plan works, click on the Safeguard Dental link.
www.safeguard.net




