TradeGlobal Hourly Non-Exempt

DENTAL INSURANCE

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

BRONZE Dental PPO Plan

GOLD Dental PPO Plan

In-Network

Out-of Network*

In-Network

Out-of Network*

Calendar Year Deductible Individual

$50

$100

$25

$25

$150

$300

$75

$75

Family

Annual Maximum

$1,250

$2,250

Diagnostic & Preventive Exams Cleanings Fluoride X-Rays Sealants Regular Restorative Services Amalgam Fillings Extractions - Single Tooth Endodontics (Root Canal) Periodontics (Gum Disease) Major Services Crowns

Covered in full

Covered in full

Covered in full

Covered in full

Covered 80% after deductible

Covered 50% after deductible

Covered 90% after deductible

Covered 80% after deductible

Covered 50% after deductible

Covered 25% after deductible

Covered 60% after deductible

Covered 50% after deductible

Bridges Dentures Orthodontia Services

50% $500 Lifetime Maximum

50% $2,000 Lifetime Maximum

Children only under the age of 19

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

Employee Costs Per Pay Period Employee Only Employee + Spouse Employee + Child(ren)

BRONZE PPO

GOLD PPO

$ 3.54 $ 7.18 $ 9.43 $14.27

$ 5.81 $11.79 $15.39 $22.84

Family

7

Made with FlippingBook - professional solution for displaying marketing and sales documents online