Page 9 - University of the South-2022-Benefit Guide REVISED 3.30.22 FSA WAIT PERIOD

DENTAL PLAN

Eligible employees may choose to participate in the University's dental plan.
Coverage in the plan begins on the first day of the month following an
employee's hire. If selection is not made within 30 days of employment,
employees must wait until the annual enrollment period (normally in
November). The employee pays the total premium through payroll
deduction. A detailed description of the plan is available from the Office of
Human Resources.

It’s important to have regular dental exams and
cleanings so problems are detected before they Summary of Benefits
become painful—and expensive. Keeping your
teeth and gums clean and healthy will help Annual deductible Individual/Family
prevent most tooth decay and periodontal $50/$150
disease, and is an important part of maintaining *Applies to coverage B & C only
your medical health.
Annual Maximum per person $1,000
The University of the South offers you and your
eligible dependents the opportunity to enroll in Diagnostic and Preventive to
dental coverage through Delta Dental of include cleanings, fluoride 100%
Tennessee. treatments, sealants and x-rays

Basic Services to include fillings,
periodontics, scaling and root 80%
planning, oral surgery

While you have the Major Services to include crowns, 50%
option of choosing any bridges, full and partial dentures
provider, you will save
money when you use in- Orthodontia 50%
network dentists. When (Child only up to age 19)
using an out-of-network
dental provider, you will
pay more because the
provider has not agreed
to charge you a
negotiated rate.

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