2016 Rate Schedule: PPO Plan – Plan Features Out of Network In-Network Single: $31.60 + Spouse: $64.45 $100.00 $100.00 Lifetime Deductible + Children: $69.80 Deductible Lifetime Deductible Waived Waived with prior comparable Family: $106.05 with comparable coverage coverage $1,000 Annually Per Person One of the most important things you can Annual Maximum Waived with comparable coverage do for your oral health is maintaining good oral hygiene. 100% 100% Diagnostic and Preventive Healthy teeth are essential to your overall Services health and well-being. No Waiting Period No Waiting Period Daily preventive care will aid in preventing dental problems before they 80% 80% Services develop. No Waiting Period No Waiting Period Brush for two to three minutes, at least twice a day, with fluoridated Basic Oral Surgery toothpaste. 55% 50% Waiting Period Waived with 6 Months 6 Months Prior Comparable Coverage. Floss daily to remove plaque from places your toothbrush can't reach. Major Services 55% 50% Eat a healthy diet to provide the Waiting Period Waived with 12 Months 12 Months nutrients necessary (vitamins A and Prior Comparable Coverage. C, in particular) to prevent gum disease. Orthodontia N/A N/A Avoid cigarettes and smokeless tobacco, which may contribute to gum disease and oral cancer. Exercise preventive care and schedule regular dental checkups the surest way to detect early signs of periodontal disease. — Your vision health is an important part of complete wellness. The Avesis Benefit Program is designed to provide you and your covered family member the care, value and service to help maintain good vision and overall health.
Plan Features PPO Plan – In-Network Out of Network Deductible $100.00 Lifetime Deductible Waived with prior comparable coverage $100.00 Lifetime Deductible Waived with comparable coverage Annual Maximum $1,000 Annually Per Person Waived with comparable coverage Diagnostic and Preventive Services 100% No Waiting Period 100% No Waiting Period Services 80% No Waiting Period 80% No Waiting Period Basic Oral Surgery Waiting Period Waived with Prior Comparable Coverage. 55% 6 Months 50% 6 Months Major Services Waiting Period Waived with Prior Comparable Coverage. 55% 12 Months 50% 12 Months Orthodontia N/A N/A 2016 Rate Schedule: Single: $31.60 + Spouse: $64.45 + Children: $69.80 Family: $106.05 One of the most important things you can do for your oral health is maintaining good oral hygiene. Healthy teeth are essential to your overall health and well-being. Daily preventive care will aid in preventing dental problems before they develop. Brush for two to three minutes, at least twice a day, with fluoridated toothpaste. Floss daily to remove plaque from places your toothbrush can't reach. Eat a healthy diet to provide the nutrients necessary (vitamins A and C, in particular) to prevent gum disease. Avoid cigarettes and smokeless tobacco, which may contribute to gum disease and oral cancer. Exercise preventive care and schedule regular dental checkups — the surest way to detect early signs of periodontal disease. Your vision health is an important part of complete wellness. The Avesis Benefit Program is designed to provide you and your covered family member the care, value and service to help maintain good vision and overall health.
2016_New_Hire_Benefits_Guide.docx