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2016 Benefits Guide
12
DENTAL INSURANCE
Our dental plan is provided by MetLife. You will
have coverage both in network and out of
network. It is to your advantage to utilize a
network dentist to take advantage of contracted
fees. You will experience the deepest discounts
when seeing an in network dentist. If you go out
of network, you will be responsible for any
amount exceeding MetLife’s negotiated rates
plus any deductible and co-insurance associated
with your procedure.
To find a participating dentist in your elected
plan, visit
www.metlife.com/mybenefits .Please note if you are not currently enrolled or if
you chose not to enroll during your initial
eligibility period, you will be subject to a 6 month
waiting period on basic restorative services, a 12
month waiting period on all other basic services
and a 24 month waiting period on major and
orthodontia services if you chose to enroll at this
time.
MetLife Dental
Benefit/Service
In Network
Out of Network
Benefit
Preventive
100%
100%
Basic
90%
80%
Major
60%
50%
Ortho (child only up to age 19)
50%
50%
Endodontics
90%
80%
Periodontics
90%
80%
Oral Surgery
90%
80%
Implants
Covered
Covered
Deductibles & Maximums
Deductible Individual *
$25
$50
Deductible Family
$75
$150
Annual Maximum Per Person
$1,000
Lifetime Orthodontia Maximum
$1,000
*Does not apply to preventive services