Page 9 - Marcus & Millichap EE Guide 2020

Dental Benefits

SIPs are not eligible for this coverage

MetLife | DHMO Dental Plan - Select states only (CA, FL, NJ, NY, and TX)
With the Dental Health Maintenance Organization (DHMO) plan through MetLife, you are required to select a general dentist to
provide your dental care. You will contact your general dentist for all of your dental needs, such as routine check‐ups and
emergency situations. If specialty care is needed, you do need a referral. For covered procedures, you'll pay the pre‐set copay or
coinsurance fee described in your DHMO plan booklet. Please keep a copy of your booklet to refer to when utilizing your dental
care. This will show the applicable copays that apply to all of the dental services that are covered under this plan.

MetLife | PPO Dental Plan - All States
With the MetLife Preferred Provider Organization (PPO) dental plan, you may visit a PPO dentist and benefit from the negotiated
rate or visit a non‐network dentist. When you utilize a PPO dentist, your out-of-pocket expenses will be less. You may also obtain
services using a non-network dentist; however, you will be responsible for the difference between the covered amount and the
actual charges and you may be responsible for filing claims.

MetLife MetLife
Plan Features
DHMO Plan PPO Plan
MetLife Dental
Network Network Non-Network
Network
Dental Benefits

Calendar Year Maximum Unlimited $2,350
Office Visit Copay $5 Copay None
Deductible (Annual) Waived for Preventive Services

1
- Individual $0 $75 $100
- Family $0 Max 3 per Family Max 3 per Family
2
Preventive (Plan Pays) See Copay Schedule 100% 100%
Exams, X-Rays, Cleanings
2
Basic Services (Plan Pays) See Copay Schedule 80% 80%
Fillings, Oral Surgery,
Endodontics, Periodontics
2
Major Services (Plan Pays) See Copay Schedule 50% 50%
Crowns, Prosthetics

Orthodontia
- Covered Members Children & Adults Children & Adults
- Copay $1,850 Child / $1,850 Adult N/A
- Coinsurance N/A 50%
- Lifetime Benefit Max N/A $2,000
- Dependent Age Up to 26 Up to 26

1. Texas, Mississippi and Louisiana Residents: Mandatory passive PPO applies, meaning your non-network deductible is $75/$225, which matches the in-network
deductible. Please keep in mind, it is always better to stay in-network for a cost savings – we encourage you to stay in-network.
2. Dentists who are non-network have not agreed to pricing, and may bill you for the difference between what MetLife pays them and what the dentist usually
charges.

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

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