Page 24 - 2019 CommScope
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Dental Option 1: Dental Plan A



CommScope partners with MetLife to offer dental Beneits In-Network
coverage. To give employees choices and lexibility, we Provider Network PDP Plus
offer two dental plan options. Both plans utilize the Deductible
MetLife PDP Plus dental network. Individual $50
Dental health is just as important as medical health. Family $150
Practicing good dental health is important to maintain Preventive Services* 100% plan provided
coverage
a healthy mouth, gums and teeth. It can also improve Routine exams and cleanings, luoride
treatments, and x-rays
quality of life. Basic Services 80% plan provided
You receive the most value by choosing dentists who Treatments such as illings, periodontics, co-insurance after
are in the MetLife PDP Plus dental network. and endodontics deductible is met
As you review the dental plans below, please note Major Services 50% plan provided
co-insurance after
Treatments such as crowns and dentures
Dental Plan A does not have ANY orthodontia deductible is met
coverage. If you want orthodontia coverage in 2019, Annual Maximum $1,500 per person
you should enroll in Dental Plan B.
Orthodontia Not covered

Option 2: Dental Plan B



Beneit In-Network
What if I Don’t Use a MetLife Provider? Provider Network PDP Plus
MetLife will only pay off the average charge for a service Deductible $50
Individual
within a ZIP Code area. If your provider charges above
that amount you can be billed for the difference. Save Family $150
money by using an in-network provider! Preventive Services* 100% plan provided
Routine exams and cleanings, luoride coverage
treatments, sealants, and x-rays

CommScope Benefits Basic Services 80% plan provided
co-insurance after
Service Center Treatments such as illings, periodontics, deductible is met
and endodontics
„ Go to the CommScope Spectrum homepage and Major Services 50% plan provided
access the U.S. employee beneits website Treatments such as crowns and dentures co-insurance after
deductible is met
„ www.commscopeconnect.com Annual Maximum $2,000 per person

„ 833.554.4110
MetLife Orthodontia 50%

„ www.metlife.com (adults and children) $2,000
Orthodontia Lifetime Maximum
„ 800.942.0854

„ Download the free MetLife mobile app from your * Deductible does not apply
smartphone’s app store




24 ANNUAL ENROLLMENT GUIDE BENEFITS 2019
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