CompBenefits Dental PPO

1
CompBenefits Dental PPO

• Larger In-Network Providers
• Out-of-Network Flexibility with better Benefit
  Level
• Deductibles In-Network Out-of-Network
• 50/person
• 150/family
• No deductible for preventive
• 50 combined deductible for orthodontic

2
CompBenefits Dental PPO

• CO-INSURANCE
• In-Network Out-of-Network
• Preventive 100 100
• Basic 70 70
• Major 50 50
• Orthodontic 50 50
• Coverage based on preferred provider schedule
• of discounted fees

3
CompBenefits PPO

• Calendar Year Maximum 1,200/person
• Lifetime Orthodontic Maximum
• 1,000/child under age 19
• No Orthodontic Benefit for Adults
• 12 month waiting period for Major
• and Orthodontic Services
• See plan booklet for exclusions and
  limitations

4
CompBenefits PPOCOST PER MONTH

• Single 22.30
• Employee/Spouse 45.50
• Employee/Child 46.82
• Family 75.74