Page 9 - 2015 New Hire Guide
P. 9
Fontbonne University
HooPayz, Price Dental
Transparency Service Good dental health is important to your overall well-being. At the
New for 2015, Fontbonne University same time, we all need different levels of dental treatment. It is for
will make available to eligible
associates and their dependents, price this reason that a comprehensive dental plan is available through Delta
transparency services through HooPayz . Dental.
HooPayz can assist members with
determining the lowest cost, highest Our dental coverage includes Delta’s MAX Advantage. This very
quality providers given a particular beneicial feature allows the calendar year maximum to not be applied
procedure .
for such routine preventive services such as exams, x-rays, cleanings,
Additionally, HooPayz can help and luoride treatments.
members review their Explanation of
Beneits (EOB) to ensure they are being The Delta Dental PPO Plan provides both in- and out-of-network
appropriately charged for services options. Within this plan, the amount of beneit you receive is
rendered .
much more generous when you use Delta’s PPO Providers. Delta’s
To contact HooPayz, simply visit their Premier network consists of providers who will give a discount, won’t
website at www .hoopayz .com or call require you to submit claim forms, and won’t balance bill you. Non-
866-981-4991 . There is no cost to the
member to access these services! participating providers can balance bill you and require you to submit a
claim. The beneit levels available both inside (PPO and Premier) and
outside the network are identiied in the dental plan summary below.
NOTE: You may experience higher out-of-pocket expenses when
visiting a non-participating dentist.
Delta Dental of Missouri
Premier and Non-
PPO Dentist Participating Dentist
Deductible
Individual $50 $100
Family Limit $100 $300
Applies To B & C B & C
Maximums
NOTE—Dental beneit deductions Calendar Year Maximum (A, B, & C) $1,500 $1,500
are taken on a pre-tax basis . Orthodontic Lifetime Maximum (D) $1,500 $1,500
Dental Contributions—Monthly Coinsurance
Employee Only $6 .80 Coverage A Preventive) 100% 100%
Employee + Spouse $49 .85 Coverage B (Basic) 90% 80%
Employee + Child(ren) $55 .50 Coverage C (Major) 60% 50%
Family $73 .65 Coverage D (Orthodontic) 50% 50%
9
HooPayz, Price Dental
Transparency Service Good dental health is important to your overall well-being. At the
New for 2015, Fontbonne University same time, we all need different levels of dental treatment. It is for
will make available to eligible
associates and their dependents, price this reason that a comprehensive dental plan is available through Delta
transparency services through HooPayz . Dental.
HooPayz can assist members with
determining the lowest cost, highest Our dental coverage includes Delta’s MAX Advantage. This very
quality providers given a particular beneicial feature allows the calendar year maximum to not be applied
procedure .
for such routine preventive services such as exams, x-rays, cleanings,
Additionally, HooPayz can help and luoride treatments.
members review their Explanation of
Beneits (EOB) to ensure they are being The Delta Dental PPO Plan provides both in- and out-of-network
appropriately charged for services options. Within this plan, the amount of beneit you receive is
rendered .
much more generous when you use Delta’s PPO Providers. Delta’s
To contact HooPayz, simply visit their Premier network consists of providers who will give a discount, won’t
website at www .hoopayz .com or call require you to submit claim forms, and won’t balance bill you. Non-
866-981-4991 . There is no cost to the
member to access these services! participating providers can balance bill you and require you to submit a
claim. The beneit levels available both inside (PPO and Premier) and
outside the network are identiied in the dental plan summary below.
NOTE: You may experience higher out-of-pocket expenses when
visiting a non-participating dentist.
Delta Dental of Missouri
Premier and Non-
PPO Dentist Participating Dentist
Deductible
Individual $50 $100
Family Limit $100 $300
Applies To B & C B & C
Maximums
NOTE—Dental beneit deductions Calendar Year Maximum (A, B, & C) $1,500 $1,500
are taken on a pre-tax basis . Orthodontic Lifetime Maximum (D) $1,500 $1,500
Dental Contributions—Monthly Coinsurance
Employee Only $6 .80 Coverage A Preventive) 100% 100%
Employee + Spouse $49 .85 Coverage B (Basic) 90% 80%
Employee + Child(ren) $55 .50 Coverage C (Major) 60% 50%
Family $73 .65 Coverage D (Orthodontic) 50% 50%
9
