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$6$26
Employee + Spouse/ Domestic Partner$20$58
Employee + Child$22$69
Family$35$101

Part-Time Monthly Dental Premiums

Coverage TierBasic PlanComprehensive Plan
Employee Only$17$37
Employee + Spouse/ Domestic Partner$38$76
Employee + Child$45$92
Family$65$131