Page 16 - Fontbonne 2020 Benefits
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DENTAL
Fontbonne University continues to Please visit www.deltadentalmo.com to search each network
offer a comprehensive dental plan of providers.
through Delta Dental.
Delta Dental of Missouri
Premier and Non-
As in years past, Delta Dental offers PPO Dentist Participating Dentist
two networks: a premier and non- Deductible
participating dentist network and a Individual $50 $100
PPO dentist network. You will ind Family Limit $100 $300
the greatest discounts with providers Applies To B & C B & C
who are under the PPO network. Most Maximums
providers in the PPO network are Calendar Year Maximum (A, B, and C) $1,500 $1,500
also in the premier network because Orthodontic Lifetime Maximum (D) $1,500 $1,500
it is a larger network. Note—dentists Coinsurance
not in either network are considered Coverage A (preventive) 100% 100%
non-participating providers; this means Coverage B (basic) 90% 80%
they can balance bill you and require Coverage C (major) 60% 50%
you to submit a claim. When seeking Coverage D (orthodontic) 50% 50%
treatment with a non-participating
provider you may also experience Dental Contributions—Monthly
higher out-of-pocket expenses. It Employee Only $7 .75
is always to your advantage to seek Employee + Spouse $55 .00
treatment with an in-network provider. Employee + Child(ren) $61 .00
Family $81 .00
Our dental coverage includes Delta’s MAX Advantage. This very beneicial
feature excludes preventive service charges (exams, cleanings, etc.), from
the calendar year maximum.
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Fontbonne University continues to Please visit www.deltadentalmo.com to search each network
offer a comprehensive dental plan of providers.
through Delta Dental.
Delta Dental of Missouri
Premier and Non-
As in years past, Delta Dental offers PPO Dentist Participating Dentist
two networks: a premier and non- Deductible
participating dentist network and a Individual $50 $100
PPO dentist network. You will ind Family Limit $100 $300
the greatest discounts with providers Applies To B & C B & C
who are under the PPO network. Most Maximums
providers in the PPO network are Calendar Year Maximum (A, B, and C) $1,500 $1,500
also in the premier network because Orthodontic Lifetime Maximum (D) $1,500 $1,500
it is a larger network. Note—dentists Coinsurance
not in either network are considered Coverage A (preventive) 100% 100%
non-participating providers; this means Coverage B (basic) 90% 80%
they can balance bill you and require Coverage C (major) 60% 50%
you to submit a claim. When seeking Coverage D (orthodontic) 50% 50%
treatment with a non-participating
provider you may also experience Dental Contributions—Monthly
higher out-of-pocket expenses. It Employee Only $7 .75
is always to your advantage to seek Employee + Spouse $55 .00
treatment with an in-network provider. Employee + Child(ren) $61 .00
Family $81 .00
Our dental coverage includes Delta’s MAX Advantage. This very beneicial
feature excludes preventive service charges (exams, cleanings, etc.), from
the calendar year maximum.
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