Page 9 - 2016 ACProducts Non-Union
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ACProducts
Dental Coverage
Dental coverage is offered through MetLife. Your cost for this
coverage is separate from the medical beneits cost. Below is a brief
summary of the plan design offered. Your current dental coverage
will rollover to next year unless you make changes during Open
Enrollment.
PPO Out-of-Network
Calendar Year Deductible
Individual $50
Family $150
Calendar Year Maximum
All Classes $1,000
Coinsurance
Preventive 100%
Basic 80%
Major 50%
Orthodontia
Coinsurance 50%
Lifetime Maximum $1,000 Children up to age 26
Your 2015 monthly contributions for dental coverage are shown
below:
PPO Plan
Employee $20.39
Employee + 1 $43.96
Family $80.68
9
Dental Coverage
Dental coverage is offered through MetLife. Your cost for this
coverage is separate from the medical beneits cost. Below is a brief
summary of the plan design offered. Your current dental coverage
will rollover to next year unless you make changes during Open
Enrollment.
PPO Out-of-Network
Calendar Year Deductible
Individual $50
Family $150
Calendar Year Maximum
All Classes $1,000
Coinsurance
Preventive 100%
Basic 80%
Major 50%
Orthodontia
Coinsurance 50%
Lifetime Maximum $1,000 Children up to age 26
Your 2015 monthly contributions for dental coverage are shown
below:
PPO Plan
Employee $20.39
Employee + 1 $43.96
Family $80.68
9
