Page 13 - 2020 Stein Mart Weekly Benefits
P. 13
DENTAL INSURANCE
We partner with Delta Dental to offer you and your family members dental
insurance. There are two plans to choose from.
Examples of
Services In-Network Providers
Preventive: Remember to visit in-network dentists to receive the deepest level of discount
exams, cleanings, and get the most care out of your calendar year maximum.
fluoride, x-rays
and sealants
Basic: fillings, Managing your Dental Coverage
extractions, Go to www.deltadentalins.com or call 800.521.2651.
periodontics, Create an account online to access a variety of online tools and programs
repairs and oral including searching for a participating in-network dentist in your area.
surgery
Major: crowns,
inlays, dentures Base Plan Buy-Up Plan
and dental impacts
Calendar Year Deductible
Calendar Year Associate $50 $25
Maximum Family $100 $50
Calendar Year Maximum
The annual maximum $1,000
refers to the maximum $2,000
amount Delta Dental Services
will pay out in one Preventive Covered at 100% Covered at 100%
plan year. Basic 20% after deductible 20% after deductible
Major 50% after deductible 50% after deductible
Orthodontia Orthodontia
Lifetime Maximum Coinsurance 50% 50%
For orthodontia services, Lifetime Maximum $1,000 $2,000
the lifetime maximum is Benefit Applies to Dependent children Dependent children
the most the plan will up to age 19 up to age 19
cover for orthodontia
services for the lifetime
of your participation in Associate Weekly Rates
this program. The limit Base Plan
does not reset each Buy Up
plan year. Associate Only $3.21 $4.70
Associate + Dependents $7.70 $11.84
Weekly Store and Weekly Corporate Associates 10
Department Merchandise Managers For 2020 Benefits
We partner with Delta Dental to offer you and your family members dental
insurance. There are two plans to choose from.
Examples of
Services In-Network Providers
Preventive: Remember to visit in-network dentists to receive the deepest level of discount
exams, cleanings, and get the most care out of your calendar year maximum.
fluoride, x-rays
and sealants
Basic: fillings, Managing your Dental Coverage
extractions, Go to www.deltadentalins.com or call 800.521.2651.
periodontics, Create an account online to access a variety of online tools and programs
repairs and oral including searching for a participating in-network dentist in your area.
surgery
Major: crowns,
inlays, dentures Base Plan Buy-Up Plan
and dental impacts
Calendar Year Deductible
Calendar Year Associate $50 $25
Maximum Family $100 $50
Calendar Year Maximum
The annual maximum $1,000
refers to the maximum $2,000
amount Delta Dental Services
will pay out in one Preventive Covered at 100% Covered at 100%
plan year. Basic 20% after deductible 20% after deductible
Major 50% after deductible 50% after deductible
Orthodontia Orthodontia
Lifetime Maximum Coinsurance 50% 50%
For orthodontia services, Lifetime Maximum $1,000 $2,000
the lifetime maximum is Benefit Applies to Dependent children Dependent children
the most the plan will up to age 19 up to age 19
cover for orthodontia
services for the lifetime
of your participation in Associate Weekly Rates
this program. The limit Base Plan
does not reset each Buy Up
plan year. Associate Only $3.21 $4.70
Associate + Dependents $7.70 $11.84
Weekly Store and Weekly Corporate Associates 10
Department Merchandise Managers For 2020 Benefits
