Page 7 - 2020 Goodwill Benefits Guide
P. 7
2020
Goodwill Industries Benefits Enrollment
DENTAL
Taking care of your mouth, gums, and teeth is important to your overall
health. Goodwill provides dental insurance so you can afford to care about
your oral health. We offer two plans administered by BlueCross BlueShield
of Tennessee. You may elect to pay an additional premium in order to
cover eligible family members, and/or to purchase additional beneits
under the buy-up plan.
Base Plan Buy-Up Plan
Calendar Year Deductible
Individual $50 $0
Employee + 1 or Family $150 $0
Calendar Year Maximum
$750 $1,500
Coinsurance
Preventive 100% no deductible 100% no deductible
Basic 80% after deductible 100% after deductible
Major 50% after deductible 60% after deductible
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.
Finding In-network Providers
Remember to visit in-network dentists to receive the deepest level of
discount on your services.
How Do I Find an In-network Dental Care Provider?
You can ind an in-network dentist by completing one of the following:
Go to bcbst.vitalschoice.com. Under Please Select Network, select
Dental, then select Find Dental Care. You can enter your ZIP Code to
narrow your options
Call Customer Service at 800.523.1478
Contact your designated Human Resources Business Partner for
assistance
Examples of Services
Preventive—exams, cleanings, luoride, x-rays, and sealants
Basic—illings, extractions, periodontics, repairs, and oral surgery
Major—crowns, inlays, dentures, and dental implants
7
Goodwill Industries Benefits Enrollment
DENTAL
Taking care of your mouth, gums, and teeth is important to your overall
health. Goodwill provides dental insurance so you can afford to care about
your oral health. We offer two plans administered by BlueCross BlueShield
of Tennessee. You may elect to pay an additional premium in order to
cover eligible family members, and/or to purchase additional beneits
under the buy-up plan.
Base Plan Buy-Up Plan
Calendar Year Deductible
Individual $50 $0
Employee + 1 or Family $150 $0
Calendar Year Maximum
$750 $1,500
Coinsurance
Preventive 100% no deductible 100% no deductible
Basic 80% after deductible 100% after deductible
Major 50% after deductible 60% after deductible
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.
Finding In-network Providers
Remember to visit in-network dentists to receive the deepest level of
discount on your services.
How Do I Find an In-network Dental Care Provider?
You can ind an in-network dentist by completing one of the following:
Go to bcbst.vitalschoice.com. Under Please Select Network, select
Dental, then select Find Dental Care. You can enter your ZIP Code to
narrow your options
Call Customer Service at 800.523.1478
Contact your designated Human Resources Business Partner for
assistance
Examples of Services
Preventive—exams, cleanings, luoride, x-rays, and sealants
Basic—illings, extractions, periodontics, repairs, and oral surgery
Major—crowns, inlays, dentures, and dental implants
7
