Page 12 - 2025-26 Gas Clip Technologies Benefit Guide
P. 12
Dental Options:
Lincoln Financial
2025-26 Rate Information
Dependent Information
Per Pay Period Semi-Monthly
Gas Clip Technologies offers employees the
Employee Only $ 4.31 opportunity to cover their spouse and
Employee + Spouse $ 8.43 dependent children. Children can join or remain
on a parent’s dental plan until age 26. When a
Employee + Child(ren) $10.97 child turns 26, they will lose dental coverage on
Employee + Family $16.33 the last day of their birth month.
Lincoln Dental $1,750 (Calendar Year) Max
Type of Service
Non-Network Dentists - Reimbursed at 90th U&C
Calendar Year Deductible Individual $50 / Family $150
Preventive Services Covered at 100%; No Deductible
Basic Services Subject to $50 Deductible; Covered at 80%
Major Services Subject to $50 Deductible; Covered at 50%
Annual Maximum $1,750 Per Calendar Year
Max Rewards can increase your annual maximum each year $350 or $525 for
Max Rewards (Additional Annual
Maximum Benefits) (In-Network) dentist to a max of $1,500 in your Account. TOTAL MAXIMUM
$3,250! See policy summary for details!
R&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.
12 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.
