Results for Dental
Dental Options
You have two dental options: the Basic option and the Comprehensive option.
What's Covered Under the Basic Option
With the Basic dental option, you get coverage for preventive and basic care, including sealants, bitewing X-rays and full-mouth X-rays.
You might consider the Basic option if you and your dependents do not anticipate needing much dental care, aside from preventive and basic care.
What’s Covered Under the Comprehensive Option
With the Comprehensive dental option, you get coverage for preventive and basic care, including sealants, bitewing X-rays and full-mouth X-rays. Plus, you get coverage for major care, like bridges, crowns, inlays, onlays, dentures and implant once every seven years. In addition, you’re covered for TMJ and orthodontia.
You might consider the Comprehensive option if you or your dependents need orthodontia during the upcoming plan year.
| Basic Option | Comprehensive Option | |
|---|---|---|
| Your Deductible | You You + one or You + family | You You + one or You + family |
| The Plan Pays: Preventive Care | Plan pays 100% Includes exams, cleanings, sealants, X-rays | Plan pays 100% Includes exams, cleanings, sealants, X-rays |
| Major Care | Not covered | Plan pays 50% after deductible |
| Orthodontia | Not covered | 50% up to the lifetime maximum of $2,000
|
| Temporomandibular Joint Dysfunction (TMJ) | Not covered | 50% up to the lifetime maximum of $1,000 |
| Annual Benefits Maximum | $1,500 | $2,000 |
Note: The premiums above are for full-time employees who work 40 hours per week and part-time employees who work 32 to 39 hours per week. Costs are approximately double for part-time employees who work 20 to 31 hours per week. These annual amounts will be taken out of your paycheck pre-tax throughout the year. 1 In addition you pay 50% in coinsurance for out-of-network ER and urgent care visits.
Reasonable and Customary Charges: The plan pays up to reasonable and customary (R&C) charges for out of network care. You are responsible for any cost difference if your expenses are more than the R&C limits.
A Note About Dental Services
There may be limitations to some of these benefits, including, but not limited to, the number of cleanings and oral exams covered in a calendar year, and time limitations for filling and crown replacements. For more information on services, go to Your Benefits™.
