Page 9 - 2021 Marcolin Benefit Guide

Dental Plan

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.

Marcolin USA offers dental benefits which are to be provided through a new carrier, MetLife. You are given two benefit options: A high
plan with orthodontia and a high annual maximum, and a low plan without orthodontia and a lower annual maximum. Both plans
utilize MetLife’s Preferred Dentist Program Plus (PDP Plus) network.
MetLife

Benefits
Enhanced Plan Base Plan
In-Network Out-of-Network In & Out-of-Network

Calendar Year Deductible $50/$150 $50/$150 $50/$150
(Single/Family)
Calendar Year Maximum $2,000 $750

Preventive/Diagnostics 100% 100% 100%
Basic Services 85% 75% 70%

Major Services 65% 55% 50%

Orthodontia Services
50% 50% N/A
(Child to age 19)
Orthodontia Lifetime Max
$1,500 N/A
(Child to age 19)

Vision Plan

EyeMed
Benefits
In-Network Out-of-Network

Routine Eye Exam $10 Copay Up to $30
Every 12 months
Frames / Glasses Up to $150 Allowance; 20% off
Every 12 months amount over balance Up to $75
Lenses**
Every 12 months $10 Copay Between $25 - $60 reimbursement
Single, Bifocal, Trifocal
Contact Lenses Up to $150 Allowance, 15% off Up to $120
Every 12 months amount over balance
(materials) Medically Necessary: Paid-in-Full Medically Necessary: $210

Marcolin USA also offers employees the opportunity to take advantage of free and discounted sunglasses and optical frames.
st
Full-time employees (30+ hours) are eligible on the 1 of the month following your initial eligibility period; Sales Representatives and
Sales Management are eligible upon date of hire.

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**Reflects the cost of standard lenses. Any options will be an additional cost such as progressive lenses, anti-reflective coating etc.
Note: This is a summary of your coverage only. Please refer to your summary plan description for the full scope of coverage.