Page 12 - Washington Nationals 2023 Benefits Guide -10.26.22_Neat
P. 12
DENTAL PLAN
Group Number 280490
It’s important to have regular dental exams and cleanings so problems are detected before they become painful—and
expensive. Keeping your teeth and gums clean and healthy will help prevent most tooth decay and periodontal
disease and is an important part of maintaining your medical health.
The Washington Nationals’ dental plan is through United Concordia. You do not need to elect medical in order to
enroll in dental coverage. Your benefits will be available the 1 of the month following 30 days of employment.
st
Your dental plan provides coverage for routine exams and cleanings and pays for a portion of other services, as
shown in the displayed table chart:
PROVISION In-Network Out of Network
Annual deductible $50/$150 $50/$150
Individual/Family
Annual Maximum per person $1,500 $1,500
Diagnostic and Preventive, to include cleanings, 100%, no deductible 100%, no deductible
fluoride treatments, sealants and x-rays
Basic Services to include fillings, periodontics, 80%* 80%*
scaling and root planning, oral surgery
Major Services to include crowns, bridges, full and 50%* 50%*
partial dentures
Orthodontia (Child only up to age 26) 50%*; $1,000 lifetime maximum 50%*; $1,000 lifetime maximum
*After deductible is met.
Type of Coverage Employee Cost Per Month
Individual $5.00
Employee+ Child(ren) $10.00
Employee + Spouse $10.00
Family $20.00
You save money when using providers who participate in United Concordia’s Elite Plus Network,
as out of network providers can bill over maximum allowable charge that United Concordia will
allow which means that the provider may bill you the difference.
To check for participating providers, go to: www.unitedconcordia.com
The above is a brief summary of this benefit option.
Click here for more detailed information on this available benefit option.
2023 Washington Nationals Benefit Guide Page 12
