DENTAL INSURANCE
McKibbon Hospitality offers dental coverage through United Healthcare. The Dental PPO Plan allows you to use in-network or out-of-network providers. Find in-network providers on www.myuhc.com by clicking on “Find Dentist” and searching within the “Options PPO 30” network. If out-of-network dentists are used, you will be responsible for paying the difference between United Healthcare’s allowed amount and what the dentist may charge, also known as “balance billing”. The chart below provides a brief overview of the plan.
DPPO PLAN
In-Network
Calendar Year Deductible (applies to basic & major services only)
Individual
$50
Family
$150
Annual Maximum (per covered member)
Per covered member
$1,000
Preventive Services
Exams, Cleanings, & Fluoride
Covered in full
Basic Services
Fillings, Simple Extractions, Oral surgeries, Periodontics, & Endodontics
Covered 70% after deductible
Major Services
Crowns, Bridges, & Dentures
Covered 50% after deductible
Out-of Network 1
Calendar Year Deductible
$50 / $150
Schedule of Services: Preventive
Covered 100% Covered 70% after deductible Covered 50% after deductible
Basic Major
Annual Maximum (pre covered member)
$ 1,000
80 th Usual & Customary Charges
Basis of Payment
Bi-Weekly Cost for Coverage
$10.31
Employee Only
$25.97
Employee + Spouse
$24.67
Employee + Child(ren)
$38.95
Employee + Family
1 Subject to balance billing. Please refer to your plan document for specific details. Copies can be found within forms library on the Benefits Portal.
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