Page 34 - 2021 Team Member Benefit Guide - English
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Dental Plan




     The Company offers two dental plans through MetLife. Both plans let you go to any dentist you
     choose - but you’ll pay less when you visit one who is a member of MetLife’s Preferred Dental
     Program network.
     Pre-treatment Estimate                        How to Access Benefits
     To assist you in budgeting for dental out-of-pocket   When you enroll for dental coverage,
     costs, it is recommended that you or your dentist   you will receive an ID card from
     request a pre-treatment estimate for any services   MetLife. Register for MyBenefits on
     that may cost more than $300. This often applies   MetLife’s website, www.metlife.com/
     to services such as crowns, bridges, inlays and   mybenefits. On this website, you can
     periodontics. To get an estimate, have your dentist   also find a provider, print an ID card,
     submit a request online at www.metdental.com   learn about plan benefits and check
     or call 1-877-638-3379. You and your dentist will   the status of a claim.  You can also
     receive a benefits estimate – for most procedures   call MetLife’s Customer Service at
     – while you’re still in the dentist’s office.   1-800-474-7371.

             Plan Provisions            Basic Dental Plan      Enhanced Dental Plan

     Deductible (Applies to Non-     $75 per Individual      $75 per Individual
     Preventive Services)            $225 Family Limit       $225 Family Limit
     Preventive Type A Services –    You pay:  $0            You pay:  $0
     checkups, cleanings, x-rays
     Basic Type B Services – fillings,   You pay: Deductible + 30% You pay: Deductible + 20%
     extractions
     Major Type C Services – crowns,   You pay: Deductible + 60% You pay: Deductible + 50%
     implants, root canals, etc.
     Annual Plan Limit per Covered   $1,000                  $2,000
     Individual
     Orthodontia (available to dependent  Not covered        You pay: 50% of allowable
     children under age 26 only)                             charges up to the plan’s
                                                             lifetime maximum of
                                                             $1,500; 100% of charges
                                                             in excess of plan’s lifetime
                                                             maximum.*
     * A child must be covered under the dental plan prior to the commencement of an orthodontia
     treatment program.




         MetLife Smartphone App
         You can:                             Search “MetLife” at iTunes App
         ;   Find a dentist                   Store or Google Play to download
         ;   Get estimates for most procedures  the MetLife US Mobile App,
         ;   View your plan summary
         ;   View your claims
         ;   Track your brushing and flossing
         ;   View your ID card
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