Page 7 - My FlipBook
P. 7
Olshan Properties Corporate
Dental Coverage Eligible employees have access to a
comprehensive dental plan through
Dental Benefit Summary UnitedHealthcare.
In-Network Out-of-Network The plan through UnitedHealthcare
Calendar Year Deductible includes coverage for preventive, basic,
Individual $50 $50 major dental services, and orthodontia.
Family $150 $150 The calendar year maximum is $1,500.
Calendar Year Maximum The calendar year maximum is the
$1,500 $1,500 maximum amount UnitedHealthcare will
Coinsurance (Plan Pays) pay towards your dental services each
calendar year, per person covered under
Preventive 100% no deductible 100% no deductible the plan.
Basic 90% after deductible 80% after deductible
Major 60% after deductible 50% after deductible Our dental plan includes the Consumer
Orthodontia MaxMultiplier Rollover beneit with UHC.
Coinsurance 60% no deductible 50% no deductible Members who have at least one dental
visit during a plan year and do not exceed
Lifetime maximum $1,000 $1,000 a set threshold are rewarded with dollars
Beneit applies to Dependent children to age 19 which roll over to the next plan year.
Preventive Services Dollars may be used for future dental
Oral examination 100% no deductible 100% no deductible services. Rewards never expire. PPO plan
Prophylaxis, including 100% no deductible 100% no deductible members who receive ALL of their care
scaling and polishing from network providers receive additional
Fluoride treatment 100% no deductible 100% no deductible reward. Please contact UHC for additional
Sealants 100% no deductible 100% no deductible information on this program.
Space maintainers 100% no deductible 100% no deductible To ind an in-network dentist, please visit
Radiographs 100% no deductible 100% no deductible www.myuhcdental.com. When asked to
Basic Services select a network, choose National Options
Restorations 90% after deductible 80% after deductible PPO 30.
Simple extractions 90% after deductible 80% after deductible Also on myuhcdental.com, you have
Periodontics and 90% after deductible 80% after deductible access to a Treatment Cost Calculator. The
endodontics Treatment Cost Calculator provides true
Oral surgery 90% after deductible 80% after deductible prices for dental treatment costs based
Major Services on your plan. You can compare the rates
Crowns, inlays, onlays 60% after deductible 50% after deductible charged by different providers and learn
Dentures and bridges 60% after deductible 50% after deductible about any plan limits. Most importantly,
Implants 60% after deductible 50% after deductible you can see what your out-of-pocket costs
Bi-Weekly Employee Contributions will be, so you can plan ahead and avoid
Employee (Ee) $8.76 surprises.
Ee/spouse $17.39
Ee/child(ren) $17.70
Family $28.35
7
Dental Coverage Eligible employees have access to a
comprehensive dental plan through
Dental Benefit Summary UnitedHealthcare.
In-Network Out-of-Network The plan through UnitedHealthcare
Calendar Year Deductible includes coverage for preventive, basic,
Individual $50 $50 major dental services, and orthodontia.
Family $150 $150 The calendar year maximum is $1,500.
Calendar Year Maximum The calendar year maximum is the
$1,500 $1,500 maximum amount UnitedHealthcare will
Coinsurance (Plan Pays) pay towards your dental services each
calendar year, per person covered under
Preventive 100% no deductible 100% no deductible the plan.
Basic 90% after deductible 80% after deductible
Major 60% after deductible 50% after deductible Our dental plan includes the Consumer
Orthodontia MaxMultiplier Rollover beneit with UHC.
Coinsurance 60% no deductible 50% no deductible Members who have at least one dental
visit during a plan year and do not exceed
Lifetime maximum $1,000 $1,000 a set threshold are rewarded with dollars
Beneit applies to Dependent children to age 19 which roll over to the next plan year.
Preventive Services Dollars may be used for future dental
Oral examination 100% no deductible 100% no deductible services. Rewards never expire. PPO plan
Prophylaxis, including 100% no deductible 100% no deductible members who receive ALL of their care
scaling and polishing from network providers receive additional
Fluoride treatment 100% no deductible 100% no deductible reward. Please contact UHC for additional
Sealants 100% no deductible 100% no deductible information on this program.
Space maintainers 100% no deductible 100% no deductible To ind an in-network dentist, please visit
Radiographs 100% no deductible 100% no deductible www.myuhcdental.com. When asked to
Basic Services select a network, choose National Options
Restorations 90% after deductible 80% after deductible PPO 30.
Simple extractions 90% after deductible 80% after deductible Also on myuhcdental.com, you have
Periodontics and 90% after deductible 80% after deductible access to a Treatment Cost Calculator. The
endodontics Treatment Cost Calculator provides true
Oral surgery 90% after deductible 80% after deductible prices for dental treatment costs based
Major Services on your plan. You can compare the rates
Crowns, inlays, onlays 60% after deductible 50% after deductible charged by different providers and learn
Dentures and bridges 60% after deductible 50% after deductible about any plan limits. Most importantly,
Implants 60% after deductible 50% after deductible you can see what your out-of-pocket costs
Bi-Weekly Employee Contributions will be, so you can plan ahead and avoid
Employee (Ee) $8.76 surprises.
Ee/spouse $17.39
Ee/child(ren) $17.70
Family $28.35
7
