Basic Dental Plan
|
Lifetime Deductible |
$50/person |
|
Annual maximum benefit |
$1,500/person |
|
Diagnostic/preventive service: Exams, Cleaning (including periodontal), Application of fluoride, X-rays & Space maintainers |
80% * Deductible applies
|
|
Basic restorative services: Fillings, Surgery, Endodontics, Periodontal procedures such as bone and gum (gingival) surgery |
80% * Deductible applies
|
|
Major Restorative Services: Onlays, Crowns, Bridges |
50% * Deductible applies |
|
Orthodontia and treatment of Bruxism |
Not Covered |
|
Emergency treatment |
Same as any other covered expense |
* The plan pays benefits based on reasonable and customary charges.
Full-time and Part-time employees may elect employee only coverage or family coverage under the Basic Dental plan.
Vision is included in the cost for this plan.
2015 Bi-weekly Cost:
| Employee Only | $7.45 |
| Employee & Child(ren) | $17.29 |
| Employee & Spouse | $14.45 |
| Employee, Spouse & Child(ren) | $24.28 |
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