6 DENTAL Good oral care enhances overall physical health, appearance and mental well-being. Problems with the teeth and gums are common and easily treated health problems. Keep your teeth healthy and your smile bright with our dental benefit plan. Hover over the insurance terms below to learn what they mean. ANNUAL DEDUCTIBLE Individual: $0 Family: $0 Individual: $50 Family: $150 See Schedule of Benefits PREVENTIVE SERVICES 100% 100% BASIC SERVICES 80% 80% MAJOR SERVICES 50% 50% ANNUAL PLAN MAXIMUM $2,000 $2,000 ORTHO SERVICES 50% 50% ORTHO LIFETIME MAXIMUM $1,000 $1,000 SEMI-MONTHLY RATES Employee: $25.00 Employee + Spouse: $50.77 Employee + Children: $60.49 Family: $91.71 Employee: $6.07 Employee + Spouse: $12.13 Employee + Children: $13.04 Family: $20.75 DENTAL PLAN PPO - In Network PPO - Out of Network DHMO The benefits and rates in this guide are for illustrative purposes only. To the extent the rates or the benefit plan information summarized herein differs from the underlying plan details specified in the insurance documents that govern the terms and conditions of the plans of insurance described in this guide, the underlying insurance documents will govern in all cases. Review Plan Summary PPO DHMO **Find A Provider **Please note to search the PPO network as PDP Plus