Page 6 - 2016 Enrollment
P. 6
Dental Benefits
Good dental health is important to your overall well-being. It is for this reason a
comprehensive dental plan is available through Lincoln Financial Group.
Dental Plan Summary
Percentages listed below represent the amount paid by the plan.
In-Network Out-of-Network
Deductible
Individual $50
Family $150
Calendar year maximum $1,000
Preventive care
(oral exams, routine cleanings, x-rays) 100% 100%
Basic care 80% 50%
(illings, simple extractions, endodontics/root canals)
Major care
(Surgical extractions, oral surgery, periodontics, bridges 50% 25%
and dentures, crowns, inlays, and onlays)
Orthodontia (for children up to age 19) 50% up to $1,000 lifetime maximum
You may experience higher out-of-pocket expenses when visiting an out-of-network
dentist.
Please refer to the Summary Plan Description for detailed information on covered
beneits.
Lincoln Financial Provider 2016 Dental Rates by Pay Period
Search If You are Paid Weekly
Search Go to www.lfg.com to use Employee (EO) $6.22
Lincoln Financial’s easy “Find a Dentist” Employee + spouse (ES) $12.88
tool. This tool will have you ind an in- Employee + child(ren) (EC) $13.38
network dentist in your area. Family (FA) $20.04
If You are Paid Semi-Monthly
Employee (EO) $13.48
Employee + spouse (ES) $27.91
Employee + child(ren) (EC) $28.99
Family (FA) $43.43
Note: Dental premium payroll deductions are taken on a pre-tax basis.
6
Benefits Enrollment
Good dental health is important to your overall well-being. It is for this reason a
comprehensive dental plan is available through Lincoln Financial Group.
Dental Plan Summary
Percentages listed below represent the amount paid by the plan.
In-Network Out-of-Network
Deductible
Individual $50
Family $150
Calendar year maximum $1,000
Preventive care
(oral exams, routine cleanings, x-rays) 100% 100%
Basic care 80% 50%
(illings, simple extractions, endodontics/root canals)
Major care
(Surgical extractions, oral surgery, periodontics, bridges 50% 25%
and dentures, crowns, inlays, and onlays)
Orthodontia (for children up to age 19) 50% up to $1,000 lifetime maximum
You may experience higher out-of-pocket expenses when visiting an out-of-network
dentist.
Please refer to the Summary Plan Description for detailed information on covered
beneits.
Lincoln Financial Provider 2016 Dental Rates by Pay Period
Search If You are Paid Weekly
Search Go to www.lfg.com to use Employee (EO) $6.22
Lincoln Financial’s easy “Find a Dentist” Employee + spouse (ES) $12.88
tool. This tool will have you ind an in- Employee + child(ren) (EC) $13.38
network dentist in your area. Family (FA) $20.04
If You are Paid Semi-Monthly
Employee (EO) $13.48
Employee + spouse (ES) $27.91
Employee + child(ren) (EC) $28.99
Family (FA) $43.43
Note: Dental premium payroll deductions are taken on a pre-tax basis.
6
Benefits Enrollment
