Dental Coverage and Cost

You can choose between two plans:

  • Basic Plan
    Provides benefits for diagnostic, preventive and basic care (including exams, cleanings, fillings and X-rays).
  • Comprehensive Plan
    Provides all of the above, plus offers coverage for a more extensive range of dental care including orthodontia.

Basic Plan Coverage

Deductible Per Person/Family$50/$150
Preventive/Diagnostic100% (Not Subject to Deductible)
Basic Services80% (After Deductible)
Major ServicesNot Covered
Annual Benefit Maximum$750 Per Person

Comprehensive Plan Coverage

Deductible Per Person/Family$100/$300
Preventive/Diagnostic100% (Not Subject to Deductible)
Basic Services80% (After Deductible)
Major Services50% (After Deductible)
Annual Benefit Maximum$2,000 Per Person
Orthodontia50% (After Deductible)
Orthodontia Lifetime Maximum$2,500 Per Person

Full-Time Monthly Dental Premiums

Coverage TierBasic PlanComprehensive Plan
Employee Only$5$24
Employee + Spouse/ Domestic Partner$16$55
Employee + Child$19$63
Family$31$96

Part-Time Monthly Dental Premiums

Coverage TierBasic PlanComprehensive Plan
Employee Only$15.50$34.50
Employee + Spouse/ Domestic Partner$34$72
Employee + Child$40.50$84.50
Family$59$124