Page 11 - 2026 Affinity Neurocare Benefit Guide Final v2

Dental Options:

Lincoln Financial

2026 Rate Information
Dependent Information
Per Pay Period Bi-Weekly
Affinity Neurocare offers full-time employees the
Employee Only $ 9.27 opportunity to cover their spouse & dependent

Employee + Spouse $32.90 children. Children can join or remain on a
parent’s dental plan until age 26. When a child
Employee + Child(ren) $46.32 turns 26, they will lose dental coverage on the
Employee + Family $77.30 last day of their birth month.

Lincoln Dental $1,250 (Calendar Year) Max
Type of Service
Non-Network Dentists - Reimbursed at 90th U&C

Calendar Year Deductible Individual $25 / Family $75

Preventive Services Covered at 100%; No Deductible
Basic Services Subject to $25 Deductible; Covered at 80%

Major Services Subject to $25 Deductible; Covered at 50%

Annual Maximum $1,250 Per Calendar Year

Max Rewards can increase your annual maximum each year $350 or $500
Max Rewards (Additional Annual for (In-Network) dentists to a maximum of $1,250 in your Account as long as
Maximum Benefits) your annual claims are under $800. You need to see the dentist at least one
to qualify. TOTAL MAXIMUM $2,500! See policy summary for details!

U&C Plan - pays 90% of the Usual and Customary charge for the area
Out of Network
where services are provided.

Orthodontia Not Covered

Type of Service Benefit Description

Routine Oral Examinations, Bitewing X-rays, 2 annual Routine cleanings,
Preventive Services Routine Cleanings, Fluoride Treatments Sealants. Dental X-Rays
(including Periapical Films) 6 Per Year

Services Include: Basic Restorative Services (amalgam fillings on all
teeth, resin based composite fillings on anterior teeth), Simple
Basic Services Extractions, Surgical Extractions and Removal of Impacted Teeth,
Endodontics (including Root Canal Treatment),4 annual Periodontal
Cleanings, Non-surgical Periodontal Therapy-Scaling & Root Planning

Crowns, Inlays, Onlays and most related services, Bridges, Full and
Major Services Partial Dentures, Denture Reline and Rebase Services, Implants and
related services.

11 Please note: This summary is intended for general information purposes.
It is not a guarantee of benefits. Please reference the Summary or contact the carrier for specific details.