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Dental Insurance

Summary of Benefits


The chart below summarizes the basic and comprehensive plan options. For limitations and exclusions please refer to your certificate/booklet. At all times the master contract is the prevailing authority.

BENEFITS

BASIC COVERAGE

COMPREHENSIVE
COVERAGE

Preventive

90%

90%

Basic Services

90%

90%

Major Services

Not covered

60%

Orthodontics

Not covered

50%

Orthodontics Lifetime Max

n/a

$1,000

Calendar Yr. Max. (In Network)

$ 1,250

$ 1,500

Calendar Yr. Max. (Out-of- Network)
$750
$1,000

Preferred Dental Providers are available for in-network calendar year max


Premiums

DENTAL INSURANCE PREMIUMS FOR 2010 PLAN YEAR

TYPE OF COVERAGE

 MONTHLY PREMIUM

BI-WEEKLY PREMIUM

Basic Plan

 

Single

$ 18.86

$   8.70

Family

$ 43.42

$ 20.04

Comprehensive Plan

 

Single

$ 35.31

$ 16.30

Family

$ 81.35

$ 37.54


Open Enrollment
An open enrollment period is held once each year to enroll, drop, or make changes in dental insurance. The open enrollment is usually from mid November to mid December with changes effective January 1st of the following year. New employees must enroll within the first 31 days of employment. If enrollment does not occur in the first 31 days of employment, they will have to wait until the open enrollment period.

Preferred Providers
The Dental program has a group of participating dentist known as the Preferred Dental Provider (PDP) network. Participants still have freedom of choice on dental providers. Coinsurance, deductibles and maximums are identical for PDP and non-PDP services. However, the PDP accepts scheduled fees after the deductible and coinsurances are met as payment in full. If you choose a non-PDP provider you, are responsible for paying the difference between the amount the plan pays and the dentist's billed charges. For a list of preferred providers visit the following web site: http://www.metlife.com/mybenefits

Carrier Information
MetLife
P.O. Box 981282
El Paso, TX 79998-1282
1-800-GET-MET8
www.metlife.com/mybenefits