Page 8 - 2020 Recaro North America Assembly Benefits Guide
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Dental



      Principal Network Only Core Plan & In-and-Out of Network Buy-Up Plan


            Core (Network Only) Summary (Click here to                         Buy-Up (In-and-Out of Network) Summary (Click
                                download)                                                        here to download)

                                 Network            Non-Network                                       Network            Non-Network
            Service                                                               Service
                               Coinsurance           Coinsurance                                    Coinsurance           Coinsurance

        Preventative               100%                   0%                  Preventative               100%                 100%


             Basic                  80%                   0%                       Basic                 90%                   80%


             Major                  50%                   0%                      Major                  60%                   50%

                                                            Weekly Rates


                               Core Rates                                                        Buy-Up Rates

                          Tier             Weekly Rate                                         Tier            Weekly Rate


                       Employee               $2.82                                         Employee              $4.29


                      Employee &                                                          Employee &
                         Spouse               $5.62                                          Spouse               $8.23
                      Employee &                                                          Employee &
                       Child(ren)             $7.06                                         Child(ren)           $10.63


                         Family              $10.37                                          Family              $15.34


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