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 down the road.
Dental Base Plan
Benefit Highlights
In-Network
Deductible (Individual/Family)
$50/$150
Annual Plan Max (Per Person)
$1,000
Preventive Care
$0
Basic Services
50%
Major Procedures
50%
Orthodontia (Adults and Children)
Not covered
Out-of-Network
Deductible (Individual/Family)
$50/$150
Annual Plan Max (Per Person)
$1,000
Preventive Care
$0
Basic Services
50%
Major Procedures
50%
Orthodontia (Adults and Children)
Not covered
Plan Cost Per Pay Period
Employee Only: $10.11
Employee and Spouse: $20.23
Employee and Child(ren): $25.18
Employee and Family: $35.30
Dental Buy-Up Plan
Benefit Highlights
In-Network
Deductible (Individual/Family)
$50/$150
Annual Plan Max (Per Person)
$1,500
Preventive Care
$0
Basic Services
20%
Major Procedures
40%
Orthodontia (Children ages 8-18)
50% up to a lifetime maximum benefit of $1,500 per individual; deductible waived
Out-of-Network
Deductible (Individual/Family)
$50/$150
Annual Plan Max (Per Person)
$1,500
Preventive Care
$0
Basic Services
20%
Major Procedures
40%
Orthodontia (Children ages 8-18)
50% up to a lifetime maximum benefit of $1,500 per individual; deductible waived
Plan Cost Per Pay Period
Employee Only: $18.14
Employee and Spouse: $35.96
Employee and Child(ren): $50.40
Employee and Family: $68.22