Aetna is the administrator for the dental plan.

Dental plan features in-network

Feature

Dental PPO 1

Your Bi-weekly Cost for Coverage

Employee Only

Employee + Spouse

Employee + Children

Family

 

$4.32

$10.29

$11.07

$16.21

Preventive Care

Free

Annual Deductible

$50 single/
$150 family

Annual Plan Maximum Benefit

$2,000

Basic Care

You pay 20% (after deductible)

Major Care

You pay 50% (after deductible)

Orthodontia

You pay 50%

Lifetime Maximum – Orthodontia Benefit

$1,500
  1. Dental care you’re receiving before you enroll in the plan is not covered; and limitations, waiting periods or exclusions may apply for certain services.

When you take advantage of preventive care, your annual plan maximum will increase by $100 each year after (for up to three years). If you don’t receive preventive care, it reduces to the prior year’s maximum.

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