Page 8 - 2016 Enrollment
P. 8
Dental Coverage
Dental Benefit Summary
The dental plan is offered through
Aetna. The plan includes coverage for Aetna
preventive, basic, major dental services, Passive PPO
and orthodontia. The calendar year Network: PPOII
maximum is $2,000. The calendar year In-Network/Out-of-Network
maximum is the maximum amount Individual $50
Aetna will pay towards your dental Family $150
services each calendar year, per person Calendar year maximum (per person) $2,000
covered under the plan. Coinsurance
We encourage you to stay up to date Preventive 100% no deductible
with your dental cleanings. Regular Basic 80% after deductible
dental exams can help you and your Major 50% after deductible
dentist detect problems in the early Orthodontia
stages, not to mention treatment is Coinsurance 60% no deductible
simpler and costs are lower. Keeping Lifetime maximum $1,500
your teeth and gums clean and healthy
will help prevent most tooth decay and Beneit applies to Children only (appliance must be
placed prior to age 20)
periodontal disease, and is an important Diagnostic/Preventive Services
part of maintaining your overall health.
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 50% after deductible
dentures
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 New Hire Benefits Guide
Dental Benefit Summary
The dental plan is offered through
Aetna. The plan includes coverage for Aetna
preventive, basic, major dental services, Passive PPO
and orthodontia. The calendar year Network: PPOII
maximum is $2,000. The calendar year In-Network/Out-of-Network
maximum is the maximum amount Individual $50
Aetna will pay towards your dental Family $150
services each calendar year, per person Calendar year maximum (per person) $2,000
covered under the plan. Coinsurance
We encourage you to stay up to date Preventive 100% no deductible
with your dental cleanings. Regular Basic 80% after deductible
dental exams can help you and your Major 50% after deductible
dentist detect problems in the early Orthodontia
stages, not to mention treatment is Coinsurance 60% no deductible
simpler and costs are lower. Keeping Lifetime maximum $1,500
your teeth and gums clean and healthy
will help prevent most tooth decay and Beneit applies to Children only (appliance must be
placed prior to age 20)
periodontal disease, and is an important Diagnostic/Preventive Services
part of maintaining your overall health.
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 50% after deductible
dentures
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 New Hire Benefits Guide
