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BENEFITS

Dental Insurance

United Concordia | PPO
With the United Concordia 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.

United Concordia
Plan Name PPO
Network Name Advantage Plus 2.0 Non-Network
Dental Benefits

Calendar Year Maximum Benefit $1,500 with Maximum Rollover
Deductible (Annual)
- Individual $50 $50
- Family $150 $150

Preventive No Charge No Charge
Exams, X-Rays, Cleanings, Fluoride Treatments, Sealants
Basic Services Deductible, 10% Deductible, 20%
Fillings, Oral Surgery, Endodontics, Periodontics, Anesthesia
Major Services Deductible, 40% Deductible, 50%
Inlays/Onlays/Crowns, Prosthetics (Bridges, Dentures)
Orthodontia (Children Only) 50% with $1,000 Lifetime Benefit Maximum

We 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.

Finding a Dental Provider
Go to www.unitedconcordia.com or call (800) 332-0366. Refer to the “Advantage Plus 2.0” network when
prompted.

Annual Maximum Rollover
Allows for a portion of unused calendar year maximum benefit to carry-over to next year’s maximum benefit amount. You can roll-over
$300 of your unused benefit dollars for receiving at least one dental exam during the plan year and using less than 50% of your annual
maximum. This applies to you and your covered dependents separately - each can roll-over $300 up to $1,200 per person.

Smile for Health
Enhanced benefit for people with certain medical conditions, such as Diabetes, Oral Cancer, Heart Disease and more. 100%
coverage available for services needed to control gum disease and targeted educations to help manage chronic illness better. Go to
www.unitedconcordia.com and sign in to My Dental Benefits and click My Oral Health to register.

Second Opinion Program
Designed to ensure you receive the best advice to make informed decisions about your dental care, United Concordia will cover a
second opinion from dental providers based on the ADA code listed at time of claim.

Davis Vision Discount Program
Provides significant discounts on eye exams, lenses, frames and additional eyewear options.

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