Dental Insurance

MetLife Dental Insurance

ACE, APA, Exempt, Food Service, Maintenance, Non-represented, and TOTEM employees are covered by MetLife's PDP Plus Plan (Group #315042). For more information contact MetLife's Customer Service Consultants.

 

Plan benefits

MetLife Dental Plan booklet 

Schedule of Benefits 

 

 

 

Dental plan options:
Coverage typeIn-networkOut-of-network
Type A - cleanings, oral examinations 100% of negotiated fee* 100% of R&C fee**
Type B - fillings 80% of negotiated fee* 80% of R&C fee**
Type C - bridges and fillings 50% of negotiated fee* 50% of R&C fee**
Deductible† In-network Out-of-network
Individual $25.00 $25.00
Family $75.00 $75.00
Annual maximum benefit In-network Out-of-network
Per person $3,000 $3,000

 * Negotiated fee refers to fees that participating dentists have agreed to accept as payment in full, subject to any co-payments, deductibles, cost sharing and benefits maximums. Negotiated fees are subject to change.

 

** R&C fee refers to the Reasonable and Customary (R&C) charge, which is based on the lowest of (1) the dentist's actual charge, (2) the dentists' usual charge for the same or similar services, or (3) the charge of most dentists in the same geographic area for the same or similar services as determined by MetLife.

 

† Applies only to Type B & C services

 


Dependent eligibility verification

 

Dependent Eligibility Verification

 

Your health benefits are an important part of your life and we are continually working to provide good service while keeping costs as low as possible. To do that we need to ensure that the district health plan pays claims only for those dependents who are eligible for benefits. All of the following criteria must be met for a dependent child to be eligible:

  • Coverage will be offered for children until age 26
  • Children must be enrolled according to the terms of the plan
  • Coverage of enrolled children will cease at age 26 unless applicable law requires us to offer coverage for a longer period of time

 

Newborns

 

Please come to the Benefits Office to enroll your newborn within 31 days of birth with a state or hospital birth certificate. Failure to enroll your child within this period will result in loss of medical coverage. You will need to enroll your dependent during the next open enrollment period for coverage to begin the following fiscal year.


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