J & L Ventures, LLC - Benefit Guide 2021 - 2022 Plan Year

Dental Coverage

Regular dental exams can help you and your dentist detect problems in the early stages when treatment is simpler and costs are lower.

Keeping your teeth and gums clean and healthy will prevent most tooth decay and periodontal disease, and is an important part of maintaining your medical health.

Your PPO dental plan is through Anthem BlueCross BlueShield and offers “in and out-of-network” benefits.

Insurance Carrier:

Anthem BlueCross BlueShield Dental Insurance

Plan Type:

Dental Plan 130

Calendar Year Deductible Calendar Year Maximum

$50 / Individual; maximum of $150 family

$1,000

Preventive Services

100%

Basic Services Major Services

80% 50% 80%

Endo/Perio

Orthodontic Lifetime (dependent chil- dren only) Out-of-Network Reimbursement Employee Bi-Weekly Deduction Employee Only

$1,000

N / A

$2.52 $4.80 $6.52 $9.00

Employee + Spouse Employee + Child(ren)

Family

J&L Ventures, LLC 2022 Enrollment Guide

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