Dental Plans
IN-NETWORK BENEFIT | ||
|---|---|---|
Annual Deductible
(Individual/Family) | $0/$0 (waived for preventive) | $0/$0 (waived for preventive) |
Annual Plan Maximum | $0.00 | $0.00 |
Preventive Services | Covered at 100% | Covered at 100% |
Basic Services | 0% | 0% |
Major Services | 0% | 0% |
Orthodontia | 0% | 0% |
Ortho Lifetime Max | $0.00 | $0.00 |
PER PAY PERIOD | LOW PLAN | HIGH PLAN |
|---|---|---|
Employee Only | $0.00 | $0.00 |
Employee + One | $0.00 | $0.00 |
Family | $0.00 | $0.00 |
Vision Plans
IN-NETWORK BENEFIT | |
|---|---|
Exam | $0 Copay |
Lenses | $0 Copay |
Frames | $0 allowance + 20% off balance over $0 |
Contact Lenses | 100% covered |
Medically Necessary | Covered in full |
Elective – Conventional | $0 allowance |
Frequency of Benefits | Exams: every 12 months Frames and Contacts: every 12 months Or Frames and Lenses: every 12 months |
PER PAY PERIOD
Employee Only | $0.00 |
Employee + One | $0.00 |
Family | $0.00 |