Page 7 - PPP Guide
P. 7
Dental
How the Plan Works
Dental insurance helps you pay for preventive, basic, major services, Monthly Dental
and orthodontia services. Contributions
Employee $39.39
Premier Performance Products offers an active PPO Dental Plan. This Employee/spouse $77.71
means if you go to a dentist in the Advantage Plus network, you pay Employee/child(ren) $77.71
less—your portion and the Company’s portion of the bill are lower due Family $139.62
to provider discounts. If you go to a dentist out-of-network, both you
and the Company pay a higher portion of the bill. Refer to the chart Dental Provider Search
below. 1. Go to www.metlife.com/dental
If your current provider is in the network, these providers have agreed 2. Select “Find a participating dentist”
to charge within the Reasonable and Customary (R&C) limits. If you 3. Under “Select your Network Type”,
visit providers outside the network, they may charge more than what is select the “PDP” network
considered by the plan to be Reasonable and Customary—and you will 4. Enter remaining search criteria
be responsible for charges over the R&C amount.
Dental Expense Benefits
In-Network Out-of-Network
Annual Deductible Amount Important note:
Individual type A expenses $0 $0 if you do not
Individual type B and C expenses combined $50 $50 elect dental
Type D expenses $0 $0 coverage at this
Family type A expenses $0 $0 time and do
Family type B expenses combined $150 $150 not have other
Covered Percentage dental coverage
Type A expenses (preventive) 100% 100% currently, you
Type B expenses (basic) 80% 80% will be subject to
Type C expenses (major) 50% 50% waiting periods if
Type D expenses (orthodontics) 50% 50%
Maximums you enroll later.
For Orthodontic Treatment (covered for adult and dependents)
Aggregate maximum beneit (for all dental expense periods) $1,000
For Other Covered Dental Expenses
Maximum beneit (for one dental expense period) $1,000
Enrolled employees will not receive a dental ID card so you must provide the dentist
office with the policyholder’s name and SSN.
X The group number is KM5712154 X MetLife Customer Service number:
800.942.0854
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How the Plan Works
Dental insurance helps you pay for preventive, basic, major services, Monthly Dental
and orthodontia services. Contributions
Employee $39.39
Premier Performance Products offers an active PPO Dental Plan. This Employee/spouse $77.71
means if you go to a dentist in the Advantage Plus network, you pay Employee/child(ren) $77.71
less—your portion and the Company’s portion of the bill are lower due Family $139.62
to provider discounts. If you go to a dentist out-of-network, both you
and the Company pay a higher portion of the bill. Refer to the chart Dental Provider Search
below. 1. Go to www.metlife.com/dental
If your current provider is in the network, these providers have agreed 2. Select “Find a participating dentist”
to charge within the Reasonable and Customary (R&C) limits. If you 3. Under “Select your Network Type”,
visit providers outside the network, they may charge more than what is select the “PDP” network
considered by the plan to be Reasonable and Customary—and you will 4. Enter remaining search criteria
be responsible for charges over the R&C amount.
Dental Expense Benefits
In-Network Out-of-Network
Annual Deductible Amount Important note:
Individual type A expenses $0 $0 if you do not
Individual type B and C expenses combined $50 $50 elect dental
Type D expenses $0 $0 coverage at this
Family type A expenses $0 $0 time and do
Family type B expenses combined $150 $150 not have other
Covered Percentage dental coverage
Type A expenses (preventive) 100% 100% currently, you
Type B expenses (basic) 80% 80% will be subject to
Type C expenses (major) 50% 50% waiting periods if
Type D expenses (orthodontics) 50% 50%
Maximums you enroll later.
For Orthodontic Treatment (covered for adult and dependents)
Aggregate maximum beneit (for all dental expense periods) $1,000
For Other Covered Dental Expenses
Maximum beneit (for one dental expense period) $1,000
Enrolled employees will not receive a dental ID card so you must provide the dentist
office with the policyholder’s name and SSN.
X The group number is KM5712154 X MetLife Customer Service number:
800.942.0854
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