Page 10 - 2017-18 TechLab Benefits Guide
P. 10
Find an In-Network Dental Coverage
Provider Access to good oral healthcare can help keep your overall health costs
While you have both in- and out-of- down. Regular oral health exams can help detect signiicant medical
network beneits, remember to visit conditions before they become serious. Dental professionals performing
in-network dentists to receive the checkups can spot symptoms which could indicate serious health
deepest level of discount on your
services. problems elsewhere in the body which need attention. For these reasons,
and many others, we offer a dental insurance beneit through Delta Dental
To ind a participating in-network of Virginia to our employees.
dentist in your area go to
deltadentalva.com.
In-Network
Examples of Services Calendar Year Deductible
Preventive—exams, cleanings, Individual $50
luoride, x-rays, sealants Family $150
Calendar Year Maximum $1,500
Basic—illings, extractions,
periodontics, repairs, and oral Coinsurance
surgery Preventive 100% no deductible
Basic 80% after deductible
Major—crowns, inlays, Major 50% after deductible
dentures, dental impacts
Your Monthly Cost
Employee $0.00
Employee and Spouse $47.22
Employee and Child(ren) $58.86
Family $94.46
This is a high level summary of your beneit coverage. Full coverage details are available in your
summary plan description (SPD). In the event there is a discrepancy between what is relected in
this guide and what is communicated in your SPD, the terms of your SPD will prevail.
10 2017–2018 Benefits Enrollment
Provider Access to good oral healthcare can help keep your overall health costs
While you have both in- and out-of- down. Regular oral health exams can help detect signiicant medical
network beneits, remember to visit conditions before they become serious. Dental professionals performing
in-network dentists to receive the checkups can spot symptoms which could indicate serious health
deepest level of discount on your
services. problems elsewhere in the body which need attention. For these reasons,
and many others, we offer a dental insurance beneit through Delta Dental
To ind a participating in-network of Virginia to our employees.
dentist in your area go to
deltadentalva.com.
In-Network
Examples of Services Calendar Year Deductible
Preventive—exams, cleanings, Individual $50
luoride, x-rays, sealants Family $150
Calendar Year Maximum $1,500
Basic—illings, extractions,
periodontics, repairs, and oral Coinsurance
surgery Preventive 100% no deductible
Basic 80% after deductible
Major—crowns, inlays, Major 50% after deductible
dentures, dental impacts
Your Monthly Cost
Employee $0.00
Employee and Spouse $47.22
Employee and Child(ren) $58.86
Family $94.46
This is a high level summary of your beneit coverage. Full coverage details are available in your
summary plan description (SPD). In the event there is a discrepancy between what is relected in
this guide and what is communicated in your SPD, the terms of your SPD will prevail.
10 2017–2018 Benefits Enrollment
