Dental Benefits
PPO & Premier Networks |
|
|---|---|
Calendar Year Benefit Max |
$2,500 per member |
Deductible (Individual/Family) |
$25 per person/$75 per family |
Annual Maximum Benefits |
$2,500 per person |
Orthodontia Lifetime Max |
$1,500 per member |
Dependent Limiting Age |
26 |
Benefits |
PPO & Premier Networks |
|---|---|
Preventive Services |
100% |
Basic Services |
80% |
Orthodontia Services |
50% |
Implant Coverage |
50% |
Per Pay Period Rates |
|
|---|---|
Employee |
$6.89 |
Employee + Spouse |
$14.82 |
Employee + Child(ren) |
$16.80 |
Family |
$24.73 |
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