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 Plan 1

Benefit Highlights
In-Network

Deductible (Individual/Family)
$XX

Annual Plan Max (Individual/Family)
$XX/$XX

Preventive Care
$0

Basic Services
XX%

Major Procedures
XX%

Orthodontia (Adults and Children)
XX% up to a lifetime maximum benefit of $XXX per individual; deductible waived

Out-of-Network

Deductible (Individual/Family)
$XX

Annual Plan Max (Individual/Family)
$XX/$XX

Preventive Care
$0

Basic Services
XX%

Major Procedures
XX%

Orthodontia (Adults and Children)
XX% up to a lifetime maximum benefit of $XXX per individual; deductible waived

Plan Cost

Employee Only: $XX

Employee and Spouse: $XX

Employee and Child(ren): $XX

Employee and Family: $XX

Dental Plan 2

Benefit Highlights
In-Network

Deductible (Individual/Family)
$XX

Annual Plan Max (Individual/Family)
$XX/$XX

Preventive Care
$0

Basic Services
XX%

Major Procedures
XX%

Orthodontia (Adults and Children)
XX% up to a lifetime maximum benefit of $XXX per individual; deductible waived

Out-of-Network

Deductible (Individual/Family)
$XX

Annual Plan Max (Individual/Family)
$XX/$XX

Preventive Care
$0

Basic Services
XX%

Major Procedures
XX%

Orthodontia (Adults and Children)
XX% up to a lifetime maximum benefit of $XXX per individual; deductible waived

Plan Cost

Employee Only: $XX

Employee and Spouse: $XX

Employee and Child(ren): $XX

Employee and Family: $XX

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