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 |
$16.42 |
Employee + Spouse |
$32.54 |
Employee + Child(ren) |
$39.18 |
Family |
$59.50 |
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 |
$21.14 |
Employee + Spouse |
$41.90 |
Employee + Child(ren) |
$48.50 |
Family |
$74.72 |
Downloads