Page 25 - 2019 CommScope
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Transition of Care 2019 Employee Payroll
Dental transition of care will mostly impact orthodontia Premiums
treatments, endodontic treatments (root canals)
and prosthodontic treatments (crowns, bridgework, Weekly Semi-Monthly
dentures, etc.). On endodontic and prosthodontic Coverage Level (52 Pay Periods) (24 Pay Periods)
(crowns and bridgework) treatments, if the service Dental Plan A
starts prior to the effective date but is completed Employee $2.08 $4.52
after the 1/1 effective date, these will be considered Employee + Spouse $4.38 $9.49
an eligible expense under the MetLife dental plan. Employee + Children $5.21 $11.29
On partial or full dentures, if the inal impressions for Employee + Family $7.50 $16.26
appliances were completed prior, but delivery made Dental Plan B
after the 1/1 effective date, these will be considered Employee $6.14 $13.30
an eligible expense under the MetLife dental plan. On Employee + Spouse $12.89 $27.93
orthodontia, MetLife will review the treatment plan Employee + Children $15.34 $33.25
and what has been paid by the prior carrier. MetLife Employee + Family $22.10 $47.88
will review the treatment plan and process the claim.
This process ensures the total beneit paid between the No Premium Changes for 2019!
two carriers does not exceed the lifetime orthodontia
maximum under the MetLife dental plan.
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Dental transition of care will mostly impact orthodontia Premiums
treatments, endodontic treatments (root canals)
and prosthodontic treatments (crowns, bridgework, Weekly Semi-Monthly
dentures, etc.). On endodontic and prosthodontic Coverage Level (52 Pay Periods) (24 Pay Periods)
(crowns and bridgework) treatments, if the service Dental Plan A
starts prior to the effective date but is completed Employee $2.08 $4.52
after the 1/1 effective date, these will be considered Employee + Spouse $4.38 $9.49
an eligible expense under the MetLife dental plan. Employee + Children $5.21 $11.29
On partial or full dentures, if the inal impressions for Employee + Family $7.50 $16.26
appliances were completed prior, but delivery made Dental Plan B
after the 1/1 effective date, these will be considered Employee $6.14 $13.30
an eligible expense under the MetLife dental plan. On Employee + Spouse $12.89 $27.93
orthodontia, MetLife will review the treatment plan Employee + Children $15.34 $33.25
and what has been paid by the prior carrier. MetLife Employee + Family $22.10 $47.88
will review the treatment plan and process the claim.
This process ensures the total beneit paid between the No Premium Changes for 2019!
two carriers does not exceed the lifetime orthodontia
maximum under the MetLife dental plan.
25
