CODAC 2024 Guide To Your Benefits

VOLUNTARY DENTAL PLANS

FIND A DENTIST

To find an Ameritas provider in your area, visit the website at www.ameritas.com.

The Ameritas dental plan is a PPO that offers coverage in and out-of-network. It is to your advantage to utilize an in-network dentist in order to achieve the greatest cost savings. If you choose to go out-of-network, you will be responsible for any cost exceeding Ameritas’s negotiated fees, plus any deductible and coinsurance associated with your procedure.

Click on “Find a Health Provider”

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Click on “Find a Dental Provider Online”

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Enter your ZIP Code, City or State

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Select “Classic (PPO)”

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• Click “Submit” for a comprehensive directory of dentists

Dependents are eligible to age 19; Eligible to age 24 if unmarried full-time student.

In - Network

Low Plan

High Plan

Annual Maximum

$1,500

$2,500

Deductible - (individual/family) Waived for preventive

$50

$50

Preventive

100%

100%

Basic

100%

100%

Major

60%

60%

Orthodontia Deductible *Child Only

None

None

Orthodontia Coinsurance *Child Only

50%

50%

Orthodontia Maximum *Child Only

$1,500

$2,500

Dental Rewards Program

Additional accumulation toward annual maximum

FUSION Benefit - Participants have 90 days from the date of service to file a claim.

Up to $100 may be used for eye exams, frames, lenes, contact lenses

Low Plan

High Plan

RATES

Employee Per Month

Employee Per Paycheck

Employee Per Month

Employee Per Paycheck

Employee Only

$24.71

$11.40

$52.40

$24.18

Employee + Spouse

$50.89

$23.49

$107.17

$49.46

Employee + Children

$57.80

$26.68

$116.81

$53.91

Employee + Family

$83.95

$38.75

$171.52

$79.16

*Orthodontia benefit only applies to children. Must be banded by age 17 and completed by age 19. Please visit www.ameritas.com.

Click here to learn about your dental benefits with Ameritas

Improving Health, Transforming Lives.

CODAC Health, Recovery & Wellness | 2024 Employee Benefits Guide 9