Page 15 - Texas Rangers 2022 Front Office Flipbook

DENTAL COVERAGE

You save money when using providers who
participate in United Concordia’s Elite Plus
It’s important to have regular dental exams Network, as out of network providers can bill
and cleanings so problems are detected over maximum allowable charge that United

before they become painful—and expensive. Concordia will allow which means that the
Keeping your teeth and gums clean and provider may bill you the difference.
healthy will help prevent most tooth decay
and periodontal disease and is an important To check for participating providers, go to:
part of maintaining your medical health. www.unitedconcordia.com

The Texas Rangers’ dental plan is through
United Concordia. You do not need to elect
medical to enroll in dental coverage. Benefit In-Network Out of Network

Your dental plan provides coverage for
routine exams and cleanings and pays for a Annual Deductible $50 Individual $50 Individual
portion of other services, as shown in the $150 Family $150 Family
displayed table chart.
Annual Maximum $1,500 $1,500
United Concordia Dental’s standard (Per Person)
exclusions and limitations apply.
Class I: Diagnostic and
Preventive Includes Exams, 100% 100%
Cleanings and Fluoride (No Deductible) (No Deductible)
Treatments

Class II: Basic Services
Includes Fillings,
Periodontics, Endodontics, 80% after Deductible 80% after Deductible
Complex Oral Surgery
Class III: Major Services
Includes Inlays, Onlays, 50% after Deductible 50% after Deductible
Crowns, and Prosthetics
Orthodontia 50% after Deductible 50% after Deductible
(Dependent Children up to $1,500 Lifetime $1,500 Lifetime
Age 19) Maximum Maximum

The above is a summary of this benefit option.
Click here for more detailed information on this available benefit option.

2022 Rangers Baseball LLC (the Texas Rangers) Benefit Guide Page 15