Dental Insurance
The HRA Reimbursements will only be made if the member
incurs a deductible related medical
expensthroughGI Business Solutions (CGI) and is available with the medical plans. (M-F, 8:30a Who is Eligible and When: Employees that work 35 hours per week or more are eligible for dental insurance. Coverage begins after 30 days of continuous employment.
Dental Plan
UNIT 1: Preventative Services
UNIT 2: Basic Services
UNIT 3: Major Services
Covered at 100%
Covered at 80%
Covered at 50%
Routine Exams: Two per calendar year. Routine Cleaning (prophylaxis): Two per calendar year. (Expectant mothers, diabetics and those with heart disease receive one additional routine or periodontal cleaning within a calendar year). Emergency Exams: Subject to routine exam frequency limit. Fluoride: One treatment per calendar year (under age 1 9 ) Space Maintainers: Under age 1 9 only. Repairs not covered. Sealants: one treatment per tooth every 3 years to age 14 ) X-rays: Bitewing 2 per calendar year X-rays: Full mouth survey (one every 3 Calendar years ), extraoral
Periodontal Prophylaxis:
Periodontal Surgical Procedures:
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Fillings and stainless steel crowns
Repairs to Partial Denture, Bridge, Crown, Relines, Rebasing, Tissue Conditioning and Adjustment to Bridge/Denture, within policy limitations
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General Anesthesia: Covered only for specific procedures
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IV Sedation
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Crowns:.
Simple Oral Surgery
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Inlays, Onlays, Cast Post and Core, Core
Complex Oral Surgical Procedures
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Bridges:
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Dentures:
Simple endodontics: Root canal therapy for anterior teeth Complex Endodontics: Root canal therapy for molar teeth.
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Calendar Year Deductible: No Deductible Calendar Year Maximum: $1,250 per person
Maximum Accumulation: This allows for a portion of your unused maximum benefit to carry over to next year’s maximum benefit amount. To qualify, you must have had a dental service performed within the calendar year and used less than the maximum threshold.
M. Braun contributes towards the cost of the dental insurance. Below are the bi-weekly premiums for the cost of the Dental coverage: *No waiting period*
Employee Bi-Weekly Contribution
Dental Plan
Employee Employee + One Employee + Family
$8.73 $26.07 $49.76
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