Page 8 - 2018 Harbin Benefit Guide

Dental coverage is Dental
provided by UMR.
Dental Benefits

Access to good oral healthcare is important to your overall health. This is
why Harbin Clinic offers dental insurance as a core part of your beneits
package. As with medical insurance, you will almost always pay less if you

visit an in-network dentist or specialist. To locate an in-network provider,
visit www.umr.com.

Dental Beneits At-a-Glance
In-Network Out-of-Network*
Eligibility
Coverage begins on the irst day of the month following your
date of hire
Calendar Year Deductible
Individual $50 $50
Annual Maximum
Individual $1,000 $1,000
Participation Percentage
Preventive Care Covered at 100% Covered at 100%
Basic Care Covered at 80% after Covered at 80% after deductible
deductible
Major Care Covered at 50% after Covered at 50% after deductible
deductible
Orthodontia
Less Than 19 Covered at 50% no Covered at 50% no deductible
Years of Age deductible
Lifetime $1,000 $1,000
Orthodontia
Maximum
* Out-of-network provider services are paid based on the maximum reimbursable charge. You
are responsible for the balance of the out-of-network provider’s actual charge.

Dental

Monthly
Employee Only $34
Employee and Spouse $64
Employee and Child(ren) $74
Employee and Family $104

8 2018 Benefits Guide