Page 6 - Dentons 2021 Benefits Guide Retiree

HIGHLIGHTS FOR 2021

Medical Plans Dental Plans Vision Plan

„ Medical plan carrier— „ Dental plan carrier— „ NEW Vision carrier—VSP
Blue Cross Blue Shield of MetLife
IL „ Broad network of private
„ Annual Benefit Maximum and retail providers to
„ Medical supplement on Enhanced plan give you access to care
Plan carrier (Part F)— $2,000/year; Basic plan locally and nationally
United American maximum is $1,000/year
„ Access to Eyeconic.com,
„ Pharmacy supplement „ Orthodontia coverage VSP’s online retail store
Plan carrier (Part D)— for adults and dependent
Express Scripts children „ $150 frames allowance
plus $50 additional
„ You will have three plans allowance on select
to choose from: frames

† PPO 1200, CDHP 1500, „ Discounts on additional
or CDHP 3000 glasses and LASIK surgery
„ Tele-medicine services
available with no
copay for PPO, and
no coinsurance after
deductible for CDHP
plans. This applies to both
medical and behavioral
health visits, all included
with your BCBS of IL
plan—MDLIVE

„ Your current plan
elections will
automatically roll over
into 2021

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