Dental
Dental coverage helps you maintain a healthy smile with preventive care, basic services, and major procedures. You can visit any licensed dentist, but you’ll save the most when you use an in-network provider who has agreed to discounted rates. Out-of-network dentists may charge more than the plan’s allowed amount, and you may be responsible for the difference. Most plans cover preventive services—such as exams, cleanings, and X-rays—at 100% when you stay in-network, making regular checkups an easy way to protect your oral health and avoid costly issues.
Dental Premium Plan
Benefit Highlights
In-Network
Deductible (Individual/Family)
$50/$100
Annual Plan Maximum
$1,500
Preventive Care
$0
Basic Services
20% after deductible
Major Procedures
40% after deductible
Orthodontia (Adults and Children)
50% up to a lifetime maximum benefit of $2,500 per individual; deductible waived
Out-of-Network
Deductible (Individual/Family)
$50/$100
Annual Plan Maximum
$1,500
Preventive Care
$0
Basic Services
20% after deductible
Major Procedures
40% after deductible
Orthodontia (Adults and Children)
50% up to a lifetime maximum benefit of $2,500 per individual; deductible waived
Benefit Cost (Bi-weekly)
Employee Only: $9.69
Employee and Spouse: $27.66
Employee and Child(ren): $28.27
Employee and Family: $39.70
Dental Base Plan
Benefit Highlights
In-Network
Deductible (Individual/Family)
$25/$75
Annual Plan Maximum
$1,500
Preventive Care
$0
Basic Services
20% after deductible
Major Procedures
50% after deductible
Orthodontia (Children to Age 19 / Age 24 for Full-time Student)
50% up to a lifetime maximum benefit of $1,500 per individual; deductible waived
Out-of-Network
Deductible (Individual/Family)
$50/$150
Annual Plan Maximum
$1,000
Preventive Care
10% after deductible
Basic Services
30% after deductible
Major Procedures
50% after deductible
Orthodontia (Children to Age 19 / Age 24 for Full-time Student)
50% up to a lifetime maximum benefit of $1,000 per individual; deductible waived
Benefit Cost (Bi-weekly)
Employee Only: $5.94
Employee and Spouse: $18.97
Employee and Child(ren): $19.38
Employee and Family: $27.23