Horizons Diagnostics 2022 Benefit Guide - Physicians

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 Unum and offers “in and out-of-network” benefits.

Insurance Carrier:

Unum Dental Insurance

Plan Type:

Passive PPO

Calendar Year Deductible Calendar Year Maximum

$50 Individual / $150 Family $50 Individual / $150 Family

$1,000

$2,000

Preventive Services

100%

100%

Basic Services Major Services

80% 50%

80% 50%

Carryover Benefit

up to $250

up to $400

Orthodontic Lifetime (dependent children only) Out-of-Network Reimbursement Employee Monthly Deduction Employee Only

N/A

$1,500

90th Percentile

90th Percentile

$25.67 $57.79 $57.26 $91.17

$37.14 $73.36 $97.00 $144.30

Employee + Spouse Employee + Child(ren)

Family

8 Horizons Diagnostics, LLC. 2022 Enrollment Guide

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