Page 8 - 2016 Open Enrollment
P. 8
Dental Coverage
Dental Benefit Summary
Aetna
Passive PPO
Network: PPOII
The dental plan will remain with Aetna In-Network/Out-of-Network
for 2016. Last year we increased the Individual $50
calendar year maximum from $1,500 to Family $150
$2,000. This allowed your dental beneit Calendar year maximum (per person) $2,000
to go even further as your calendar
year maximum is the maximum amount Coinsurance
Aetna will pay per covered member Preventive 100% no deductible
for dental services in a given calendar Basic 80% after deductible
year. We encourage you to stay up to Major 50% after deductible
date with your dental cleanings. Regular Orthodontia
dental exams can help you and your Coinsurance 60% no deductible
dentist detect problems in the early Lifetime maximum $1,500
stages, not to mention treatment is
simpler and costs are lower. Keeping Beneit applies to Children only (appliance must
be placed prior to age 20)
your teeth and gums clean and healthy Late Entrant Waiting Periods: waiting periods will apply to employees who do
will help prevent most tooth decay and not elect coverage when they are irst eligible
periodontal disease, and is an important Basic/major services 12 months
part of maintaining your overall health.
Orthodontia services 24 months
Diagnostic/Preventive Services
Includes cleanings, luoride, sealants, x-rays 100% no deductible
Basic Services
Includes oral surgery and illings 80% after deductible
Major Services
Includes, crowns, bridges, full and partial
dentures 50% after deductible
Notes: this is a synopsis of coverage only; the beneits summary contains exclusions and limitations that are not
shown here. Please refer to the beneits summary for the full scope of coverage.
In this dental plan, you have the option to receive care from an in-network or an
out-of-network dentist. The beneit is the same regardless of network status (Passive
PPO). However, you will receive the deepest discount and pay less out of your
pocket when you receive care from an in-network dentist. You can look to see if
your dentist is in-network or locate an Aetna dentist at www.aetna.com. Be sure to
search for dentists in the PPO II Network.
8
2016 Open Enrollment
Dental Benefit Summary
Aetna
Passive PPO
Network: PPOII
The dental plan will remain with Aetna In-Network/Out-of-Network
for 2016. Last year we increased the Individual $50
calendar year maximum from $1,500 to Family $150
$2,000. This allowed your dental beneit Calendar year maximum (per person) $2,000
to go even further as your calendar
year maximum is the maximum amount Coinsurance
Aetna will pay per covered member Preventive 100% no deductible
for dental services in a given calendar Basic 80% after deductible
year. We encourage you to stay up to Major 50% after deductible
date with your dental cleanings. Regular Orthodontia
dental exams can help you and your Coinsurance 60% no deductible
dentist detect problems in the early Lifetime maximum $1,500
stages, not to mention treatment is
simpler and costs are lower. Keeping Beneit applies to Children only (appliance must
be placed prior to age 20)
your teeth and gums clean and healthy Late Entrant Waiting Periods: waiting periods will apply to employees who do
will help prevent most tooth decay and not elect coverage when they are irst eligible
periodontal disease, and is an important Basic/major services 12 months
part of maintaining your overall health.
Orthodontia services 24 months
Diagnostic/Preventive Services
Includes cleanings, luoride, sealants, x-rays 100% no deductible
Basic Services
Includes oral surgery and illings 80% after deductible
Major Services
Includes, crowns, bridges, full and partial
dentures 50% after deductible
Notes: this is a synopsis of coverage only; the beneits summary contains exclusions and limitations that are not
shown here. Please refer to the beneits summary for the full scope of coverage.
In this dental plan, you have the option to receive care from an in-network or an
out-of-network dentist. The beneit is the same regardless of network status (Passive
PPO). However, you will receive the deepest discount and pay less out of your
pocket when you receive care from an in-network dentist. You can look to see if
your dentist is in-network or locate an Aetna dentist at www.aetna.com. Be sure to
search for dentists in the PPO II Network.
8
2016 Open Enrollment
