CODAC 2025 Emplyee Benefits Guide

VOLUNTARY DENTAL

FIND A DENTIST To find an Ameritas provider in your area, visit the website at www.ameritas.com. • Click on “Find a Health Provider” • Click on “Find a Dental Provider Online” • Enter your ZIP Code, City or State • Select “Classic (PPO)” • Click “Submit” for a comprehensive directory of dentists

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.

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)

$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

Employee Per Paycheck

Employee

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

Click here to learn about your dental benefits with Ameritas

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

Improving Health, Transforming Lives.

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CODAC Health, Recovery & Wellness | 2025 Employee Benefits Guide