DENTAL & VISION INSURANCE
DENTAL
Administered by Lincoln Financial Group
Good oral care enhances overall physical health, appearance, and mental well-being. Problems with the teeth and gums are common and easily treated health problems. Keep your teeth healthy and your smile bright with the Equity Administrative Services, Inc. dental benefit plan.
Lincoln Financial Group will continue to administer the dental insurance plan. With Lincoln Financial Group, you have access to an extensive network of dentists utilizing the Lincoln Financial Group network of qualified dentists. With the flexibility of a PPO, you have the option of visiting any provider. However, by choosing an in-network provider, you’ll receive the highest level of benefit and save on out-of-pocket costs. When utilizing out-of-network providers, remember those benefits will be reimbursed at the in-network discounted reimbursement level. For example, if you have a procedure done that costs $80 and the in-network reimbursement level is $60, your reimbursement will be based on $60, and you will be responsible for the difference (in this case, $20).
The dental and vision plans are bundled together. If you enroll in the dental plan, you are automatically enrolled into the vision plan.
You can visit the Lincoln Financial Group website to search for a provider. You may also contact Member Services at 800-431-2958 to speak with a representative or follow the prompts to use the automated system.
RESOURCES
|
|
TRADITIONAL DENTAL PPO | |
| In-Network | Out-of-Network | |
| BENEFIT | ||
| Oral Exam | 100%, no deductible | 100%, no deductible |
| Bitewing X-Rays | 100%, no deductible | 100%, no deductible |
| Fillings | 100%, after deductible | 80%, after deductible |
| Major Services | 60% after deductible | 60% after deductible |
| Orthodontia | 50% Lifetime Maximum $1,000 | 50% Lifetime Maximum $1,000 |
| ANNUAL DEDUCTIBLE Waived for Preventive Services |
Calendar Year Deductible | |
| Individual | $50 per person | $50 per person |
| Family | $150 per family | $150 per family |
| CALENDAR YEAR MAXIMUM BENEFIT | ||
| Oral Exam | $1,500 per person + Maximum Rollover | $1,000 per person |
| Bitewing X Rays | ||
VISION
Administered by Lincoln Financial Group
Regular eye examinations can not only determine your need for corrective eyewear but also may detect general health problems in their earliest stages. Protection of the eyes should be a major concern for everyone.
The vision insurance is provided through VSP Vision Care. Using VSP network consists of private practicing optometrists, ophthalmologists, opticians, and optical retailers. You have the option of visiting any provider. However, by choosing a network provider, you will receive the highest level of benefit and save on out-of-pocket costs. You may access a list of participating providers through the VSP website, vsp.com. The vision plan provides an annual exam with a $10 copay for each covered family member. In addition, the plan covers prescription eyewear. You may choose between glasses or contacts. If you choose contacts, you will not be eligible to receive glasses (lenses and frame) in the same service period. The contact lens fitting, and evaluation is separated from the materials coverage.
RESOURCES
|
|
Vision Plan | |
| Benefit | In-Network | Out-of-Network |
| Exam Covered Once Every 12 Months |
$10 copay Covered in Full | Contact VSP |
| Lenses Covered Once Every 12 Months |
$25 copay Applied to lenses & frame | Contact VSP |
| Frames Covered Once Every 24 Months |
$150 allowance, 20% savings on the amount of allowance | Contact VSP |
| Contact Lenses Covered Once Every 12 Months |
$130 allowance | Contact VSP |
| EXTRA SAVINGS & DISCOUNTS | ||
|
Glasses and Sunglasses – 20% savings on unlimited additional pairs of prescription or non-prescription glasses/sunglasses, including lens enhancements, from a VSP provider within 12 months of your last WellVision Exam. Laser Correction Surgery – Average of 15% off the regular price; discounts available at contracted facilities. |
Email Katie Plush ([email protected]) or Vicki Barone ([email protected]) if you have any questions about the benefits or online enrollment process.
