Dental Benefits
In-Network |
Out-of-Network |
|
|---|---|---|
Deductible (Individual/Family) |
No Deductible |
No Deductible |
Type I - Preventative Services |
Covered at 100% |
Covered at 100% |
Type II - Basic Services |
Covered at 100% |
Covered at 100% |
Type III - Major Services |
Covered at 50% |
Covered at 50% |
Implants |
50%; plan year max of $1,000 |
50%; plan year max of $1,000 |
Annual Maximum Benefit Per Person |
$1,000 |
$1,000 |
Dependent Limiting Age |
To age 26 |
To age 26 |
Employee Rates |
Weekly |
Bi-Weekly |
|---|---|---|
Employee |
$4.00 |
$8.00 |
Employee + Spouse |
$8.00 |
$16.00 |
Employee + Child(ren) |
$7.00 |
$14.00 |
Family |
$11.00 |
$22.00 |
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