2018 AAPL Benefits Guide

DENTAL INSURANCE

AAPL offers dental coverage through Guardian. The Dental PPO Plan allows you to use in-network or out-of-network benefits. If out-of-network dentists are used, you will be responsible to pay the difference between Guardian’s allowed amount and what the dentist may charge, also known as “balance billing”. The charts below provides a brief overview of the plan.

DentalGuard Preferred

In-Network

Out-Of-Network

Deductible

$0

$50

Individual

$0

$150

Family

Annual Maximum (per covered member)

$1,500

$1,000

Preventive Services

Covered in full

Covered in full

Exams, Cleanings, & Fluoride

Basic Services

Fillings, Simple Extractions, Perio & Endo (other than those listed below) Major Services Crowns, Bridges, Surgical Extractions, Root Canal, Dentures, Osseus Surgery & Endo Molars

90% covered after deductible

80% covered after deductible

60% covered after deductible

50% covered after deductible

Orthodontia

Coinsurance Lifetime Maximum

50% covered after deductible $1,000 (combined maximum for in-network and out-of network)

Employer Cost Monthly

Employee Cost Monthly

Employee Cost Bi-Weekly

Dental PPO

Employee Only

$ 41.54

$ 0.00

$ 0.00

Employee + Spouse

$ 41.54

$ 47.88

$ 22.10

Employee + Child(ren)

$ 41.54

$ 73.61

$ 33.97

Employee + Family

$ 41.54

$ 108.76

$ 50.20

1 Subject to balance billing. Please refer to your plan document for specific details.

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