2020-2021 Benefits Guide rev 6.22.2021

DENTAL PLAN

The EAA offers dental coverage through MetLife. Our plan gives you the flexibility of choosing your own dentist, although, you will observe greater savings by seeking services

MetLife Dental Plan

DEDUCTIBLE INDIVIDUAL: FAMILY:

$50 Individual $150 Family

from dentist that are in the MetLife network. The dental plan has an individual deductible of $50. The types of services that you receive at the dentist’s office are categorized by type. The table on the right will show what percentage the plan covers after you meet your deductible based on the type of services you receive. Type A services are preventative services and include oral exams, x-rays, cleanings, sealants, topical fluoride applications, and other treatments. Type B services are basic restorative services and include fillings, repairs, root canals, periodontal scaling & root planning, and surgery.

ANNUAL MAXIMUM: COINSURANCE: PREVENTIVE SERVICES (Type A)

$1,500.00

100% No Deductible 80% After Deductible 50% After Deductible

GENERAL (BASIC) SERVICES (Type B)

MAJOR (Type C)

ORTHODONTIA: LIFETIME ORTHO MAXIMUM: Ortho applies to child only up to age 19

$1,500

SERVICES DEDUCTIBLE APPLIES TO:

ALL EXCEPT PREVENTIVE

Type C services are major restorative series and include crowns, inlays, onlays, bridges, dentures, general anesthesia, consultations, and implant services. Orthodontic services only apply to children under the age of 19. It is important to keep track of the number of times you can receive these services per year. For example, you may only receive 2 cleanings every 12 months or only 1 crown per tooth every 5 years. For additional information regarding the various services and how often you may receive services, please refer to the Summary of Benefits for more information. MetLife does not issue ID cards. When visiting your dentist’s office, provide them with Group #5965612 and your SSN for their office to find your benefits.

Employee Bi-Weekly Cost

Employee Monthly Cost

Dental Rates

Employee only dental coverage is offered at no cost to employees. If dependents were to be added, then employees will be responsible for the difference of their premium amounts. Refer to the table on the left to view monthly and bi-weekly costs.

Employee Only

$0.00

$0.00

Employee + Spouse Employee + Child(ren) Employee + Family

$27.94 $38.88 $74.02

$13.97 $19.44 $37.01

My Dental Benefits Employees can create a My Dental Benefits member account to easily manage their MetLife Dental coverage online and find an in-network provider. Most benefit inquiries can be handled conveniently online using MetLife’s simple, self-service member portal. MyBenefits provides you with a personalized, integrated, and secure view of your MetLife-delivered benefits. You can take advantage of several self-service capabilities as well as a wealth of easy to access information. As a first-time user, you will need to register on MyBenefits. To register, follow the steps outlined below. 1. Provide your group name: access MyBenefits and enter Edwards Aquifer Authority. Click ‘Submit’

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