Dental Benefits
Benefits |
|
|---|---|
Deductible (Individual/Family) |
$50 / $150 |
Annual Maximum Per Person |
$1,000 |
Diagnostic and Preventive |
100% |
Basic Services |
80% |
Major Services |
50% |
Orthodontia |
50% |
Orthodontia Lifetime Max |
$1,000 |
Cost per Pay Period (24) |
|
|---|---|
Employee |
$16.06 |
Employee + Spouse |
$31.84 |
Employee + Child(ren) |
$38.36 |
Family |
$58.26 |
Downloads
Benefits |
|
|---|---|
Deductible (Individual/Family) |
$50 / $150 |
Annual Maximum Per Person |
$2,000 |
Diagnostic and Preventive |
100% |
Basic Services |
80% |
Major Services |
50% |
Orthodontia |
50% |
Orthodontia Lifetime Max |
$1,000 |
Cost per Pay Period (24) |
|
|---|---|
Employee |
$21.02 |
Employee + Spouse |
$41.63 |
Employee + Child(ren) |
$50.24 |
Family |
$76.32 |
Downloads