Page 16 - Skyline Windows | 2022 Benefits Guide

Dental Benefits
Administered by United Healthcare
Dental Benefits:
Effective 1st of the month following 30 days of employment.
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2022 BENEFITS GUIDE YOUR WINDOW OF OPPORTUNITY
Good oral care enhances overall physical health, appearance, and mental well- being. Problems with teeth and gums are common and easily treated. Keep your teeth healthy and your smile bright with the Skyline Windows dental benefit plan.
Tooth decay (cavities) is one of the most common chronic conditions in the United States. Untreated tooth decay can cause pain and infections that may lead to problems with eating, speaking, playing, and learning. (Source: Centers For Disease Control and Prevention)
UNITED HEALTHCARE DENTAL PLAN OPTIONS
Benefit Highlights
In-Network
N/A 80%
Out-of-Network
90th Percentile 80%
Annual Deductible*
Reimbursement Level
Preventive Dental Services
Basic Dental Services
Major Dental Services
Calendar Year Maximum
Orthodontia Services (Dependent children under age 19)
Orthodontia Lifetime Maximum
*Select Managed Care fee schedule can be found on www.myuhc.com
Select Managed Care* (S100B)
In-Network Only
N/A
See Fee Schedule N/A
N/A
DPPO
N/A
$25 Individual / $75 Family
See Fee Schedule
No Charge
No Charge
See Fee Schedule
50%
50%
$1,500
$1,500
A bright smile takes more than brushing and flossing.
See Fee Schedule
50%
50%