E-II. Dental Benefit

Employees and eligible family members will have the choice of PPO or Managed Care. PPO Dental Plan - Member selects an in-network or an out-of-network provider. Managed Care - Member selects a dentist in the provider network.

Plan Design:

ServicesPPO In-NetworkPPO Out-of-Network*Managed Care
Preventive 80% of PPO rate 80% of PPO rate 100%
Basic 80% of PPO rate 80% of PPO rate 85-75%
Major 50% of PPO rate 50% of PPO rate 70-65%
Individual Maximum
Benefits Limit $1,500 annually $1,500 annually None
*Deductible None $100 annually None

Employee Contributions:


Managed Care