Page 13 - Murad Benefits Guide 2020 NonCA

Dental Plan Choices

METLIFE | PPO PLAN
This plan offers you the freedom and flexibility to use the dentist of your choice. However, you will maximize your benefits and
reduce your out-of-pocket costs if you choose a dentist who participates in the MetLife network. When you utilize a network den-
tist, your out-of-pocket expenses will be less, however, you will usually pay the lowest amount for services when you visit a PPO
dentist. If you obtain services using a non-network dentist, you will be responsible for the difference between the covered amount
and the actual charges and you may be responsible for filing claims. The chart below provides a high-level overview of your dental
plan.

MetLife
Plan Name DPPO
Network Name In-Network Non-Network
Dental Benefits
Calendar Year Maximum Benefit $2,500
Annual Deductible
- Individual $50
- Family $150
Preventive Services No Charge 10%*
Basic Services Deductible, 20% Deductible, 20%*
Major Services Deductible, 50% Deductible, 50%*
Orthodontia
- Child 50% / $1,500 Lifetime Benefit Maximum
- Adult 50% / $1,500 Lifetime Benefit Maximum
*Dentists who are out-of-network have not agreed to pricing, and may bill you for the difference between what MetLife pays them
and what the dentist usually charges.

Cost Per Pay Period (26 per year) DPPO
- Employee $10.62
- Employee + spouse $19.85
- Employee + child(ren) $24.46
- Employee + family $38.31

NOTE:
We strongly recommend you ask your dentist for a predetermination if total charges are expected to exceed $300. Predetermina-
tion enables you and your dentist to know in advance what the payment will be for any service that may be in question.

FINDING A DENTAL PROVIDER:

Visit www.metlife.com, click "Dentist" in middle of page.

Enter zip code, city or state.

Then select the following network: PDP Plus.

MURAD EMPLOYEE BENEFITS 13