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 |
Dental Summary Plan Description
Certificate of Insurance - Basic | Certificate of Insurance - Comprehensive
Premiums
DENTAL INSURANCE PREMIUMS FOR 2012 PLAN YEAR |
TYPE OF COVERAGE |
MONTHLY PREMIUM |
BI-WEEKLY PREMIUM |
Basic Plan |
|
|
Single |
$ 19.72 |
$ 9.10 |
Family |
$ 45.37 |
$ 20.94 |
Comprehensive Plan |
|
|
Single |
$ 36.90 |
$ 17.03 |
Family |
$85.02 |
$ 39.24 |
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 mid-October through mid-November 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. Click the link below to view a list of MetLife Preferred Providers.
Vendor Information
MetLife
P.O. Box 981282
El Paso, TX 79998-1282
1-800-GET-MET8
www.metlife.com/mybenefits
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