Page 10 - 2018 Movilitas Benefit Guide
P. 10
Dental
Dental Benefits Dental Beneits At-a-Glance
High Plan with
Access to good oral healthcare is Low Plan High Plan Adult Ortho—NEW
important to your overall health. Deductible $50/$150 $50/$150 $50/$150
This is why Movilitas offers dental (individual/family)
insurance as a core part of your Deductible does not apply to preventive services
beneits package. You have the Calendar Year Year 1: $1,500 Year 1: $2,000 Year 1: $2,000
Maximum
Year 2: $1,750
Year 2: $2,250
Year 2: $2,250
(1)
choice between 3 options under Year 3: $2,000 Year 3: $2,500 Year 3: $2,500
the new Cigna dental program. As Year 4: $2,250 Year 4: $2,750 Year 4: $2,750
with medical insurance, you will Coinsurance
almost always pay less if you visit Preventive 100% 100% 100%
an in-network dentist or specialist. Basic 50% 80% 80%
To locate an in-network provider, Major (2),(3) 50% 50% 50%
Orthodontic
visit www.cigna.com. Coinsurance Not covered 50% 50%
Lifetime Maximum Not covered $2,000 $2,000
1 When you receive preventive dental care your annual dollar maximum will increase the next
calendar year .
2 Services are subject to a 12 month waiting period.
3 Services are for covered dependents up to age 19 under the High Plan and there is a NEW
High plan option for those over age 19 who wish to have orthodontia services .
Dental
High Plan with
Low Plan High Plan Adult Ortho—
Semi-Monthly Semi-Monthly NEW
Semi-Monthly
Employee Only $15 .06 $18 .55 $18 .92
Employee and Spouse $29 .74 $36 .71 $37 .44
Employee and Child(ren) $35 .57 $50 .82 $51 .84
Employee and Family $55 .08 $76 .12 $77 .64
Dental coverage is
provided by our new
carrier partner, Cigna .
10 2018 Benefits Enrollment
Dental Benefits Dental Beneits At-a-Glance
High Plan with
Access to good oral healthcare is Low Plan High Plan Adult Ortho—NEW
important to your overall health. Deductible $50/$150 $50/$150 $50/$150
This is why Movilitas offers dental (individual/family)
insurance as a core part of your Deductible does not apply to preventive services
beneits package. You have the Calendar Year Year 1: $1,500 Year 1: $2,000 Year 1: $2,000
Maximum
Year 2: $1,750
Year 2: $2,250
Year 2: $2,250
(1)
choice between 3 options under Year 3: $2,000 Year 3: $2,500 Year 3: $2,500
the new Cigna dental program. As Year 4: $2,250 Year 4: $2,750 Year 4: $2,750
with medical insurance, you will Coinsurance
almost always pay less if you visit Preventive 100% 100% 100%
an in-network dentist or specialist. Basic 50% 80% 80%
To locate an in-network provider, Major (2),(3) 50% 50% 50%
Orthodontic
visit www.cigna.com. Coinsurance Not covered 50% 50%
Lifetime Maximum Not covered $2,000 $2,000
1 When you receive preventive dental care your annual dollar maximum will increase the next
calendar year .
2 Services are subject to a 12 month waiting period.
3 Services are for covered dependents up to age 19 under the High Plan and there is a NEW
High plan option for those over age 19 who wish to have orthodontia services .
Dental
High Plan with
Low Plan High Plan Adult Ortho—
Semi-Monthly Semi-Monthly NEW
Semi-Monthly
Employee Only $15 .06 $18 .55 $18 .92
Employee and Spouse $29 .74 $36 .71 $37 .44
Employee and Child(ren) $35 .57 $50 .82 $51 .84
Employee and Family $55 .08 $76 .12 $77 .64
Dental coverage is
provided by our new
carrier partner, Cigna .
10 2018 Benefits Enrollment
