Our dental plan is designed to encourage prevention of serious dental problems by helping you pay the cost of routine diagnostic and preventive care, as well as to help pay the expense of major dental repairs or replacement of teeth when needed. Your spouse and dependents are also entitled to receive benefits under the dental plan. Your contribution is paid through pay deduction and will be paid with pre-tax dollars.
If you do not enroll at the time you are hired, you may enroll later during annual open enrollment or if you experience a qualifying event.
Dental - Deductibles |
Employee Only Deductible |
$50 |
Family Deductible |
$150 |
Annual Benefit Maximum |
$1,000 per person |
Lifetime Orthodontic Maximum |
$1,000 per person |
Dental - weekly premiums |
Employee |
$ 6.53 |
Employee + Spouse |
$14.74 |
Employee + Kids |
$16.28 |
Family |
$19.55 |
The dental plan pays for covered services as outlined in the Summary Plan Description. A summary of covered items is listed below.
Benefit Description |
Annual Deductible |
Plan Pays |
Additional Limitations & Explanations |
Preventative Services |
No |
100% |
Does not apply to the annual benefit maximum. |
Basic Services |
Yes |
80% |
Subject to the annual benefit maximum. |
Major Services |
Yes |
50% |
Subject to the annual benefit maximum. |
Orthodontic Services |
No |
50% |
Subject to the annual benefit maximum for dependents through age 19 only. Orthodontia expenses do not apply to the annual deductible or benefit maximum. |