Dental coverage

​Dental coverage is an optional benefit with no hourly work requirements for participation. The Dental Plan, administered by Aetna, provides coverage for preventive and many basic and major services.

The Dental Plan includes coverage for

  • preventive and diagnostic care, such as routine checkups and cleanings;
  • basic services, such as fillings;
  • major services, such as prosthodontics and crowns; and
  • orthodontic treatment for eligible dependent children.

Eligibility

An employer may choose to offer dental to any employee, regardless of the number of regularly scheduled work hours, and their eligible dependents. Ministers enrolled in Pastor's Participation must be offered dental coverage.

Costs

Monthly costs are shown below. Employers may, but are not required to, contribute toward the cost of dental coverage.

2019 Monthly Costs ​ ​
  DMO PPO/Passive PPO
Member-only $25.87 $36.95
Member + Spouse $52.79 $75.44
Member + Children $69.24 $97.37
Member + Family $96.79 $136.03

 

Network options

Two types of dental provider networks are offered:

  • dental maintenance organization (DMO)
  • preferred provider organization (PPO)

Both DMOs and PPOs have network providers that have agreed to provide services for lower, negotiated fees. You can visit out-of-network providers if you are covered under the PPO.

The plan options that are available to you are determined by your home address ZIP code:

  • dual option (DMO and PPO plans)
  • only the PPO plan
  • Passive PPO plan (offered if you live in an area without reasonable access to PPO providers; therefore, your benefits are not reduced if you see an out-of-network provider)

 

Plan Feature DMO PPO Passive PPO
    Network Out of Network  

Preventive and diagnostic services, such as routine checkups, cleanings, and bitewing X-rays

100%

100%

(no deductible)

100%

(no deductible)

100%

(no deductible)

Basic services, such as fillings and simple extractions

100%

80%

(after deductible)

70%

(after deductible)

80%

(after deductible)

Major services, such as bridges, crowns, and dentures

60%

60%

(after deductible)

40%

(after deductible)

60%

(after deductible)

Annual plan maximum (per individual)None$2,000$1,000$2,000
DeductiblesNone$50$100$50
Family deductibleNone$100$200$100
Orthodontia (children only)YesYesYesYes
Orthodontia benefit50%

50%

(after deductible)

50%

(after deductible)

50%

(after deductible)

DeductibleNone$50$100$50
Lifetime maximumNone$2,000$1,000$2,000
Frequency limits may apply for some services. ​ ​ ​ ​

 

Call to Health

​You can improve your well-being and earn reduced deductibles by answering the Call to Health.

Answer the call