Dental Plan A Summary
Deductible: There is no deductible if you see a provider within the Ameritas Dental Network . Type 2 and Type 3 procedures have a combined $50 calendar year deductible when seeing a provider out of the network.
Maximum Benefit: The maximum dental benefit per calendar year is the most that will be paid for covered dental expenses incurred by each plan member. On Plan A, the maximum dental benefit per calendar year is $1,250 (combined in and out of network).
Allowance: Network providers have contracted fees that are guaranteed to be within your plan allowance.Type 1 and Type 2 out-of-network procedures are based on the 80th percentile of Usual and Customary (U&C), which means 8 out of 10 dentists’ charges in your specific area are at or below the plan allowance for a procedure.
Type 3 out-of-network procedures utilize the 70th percentile of U&C, which means 7 out of 10 dentists’ charges in your specific area are at or below the plan allowance for a procedure.
Preventive Plus: Preserve your annual maximum with Preventive Plus. Plan payments for covered Type 1 Preventive dental procedures are not deducted from your annual maximum benefit. This saves your annual maximum for Type 2 Basic or Type 3 Major procedures.
Dental Rewards: By visiting the dentist annually for preventive care, you can build up your annual maximum benefit to help pay for more expensive dental procedures in the future. File at least one dental claim during the benefit year and do not exceed the annual benefit threshold of $500. Preventive procedures apply to the annual threshold. You are then rewarded the following benefit year with $250 added to your $1,250 annual maximum. The maximum amount that can be carried over is $1,000.
At least one claim must be filed each benefit year or the annual maximum is reset to $1,250, at which point you can start rebuilding your Dental Rewards. Dental Rewards carry over between the plans if you change plans in the future.
Orthodontia: Coverage for orthodontic treatment is included on all plans. See the Orthodontia section below below for more details.
Vision Benefits: All employees participating in any of the group dental insurance plans will receive the vision benefit at no additional cost. See the Vision page for more details
Hearing Benefits: You, and your friends and family, can order a hearing test and hearing aids online through iHear. See the Hearing page for more information.
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