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DENTAL
STANDARD DENTAL OUTLINE
Your Standard Dental plan includes preventive, basic, major, and orthodontic coverage tiers. Your plan features no waiting periods and flexibility.
| Service | IN-NETWORK | OUT-OF-NETWORK |
|---|---|---|
| Preventative | 100% | 50% |
| Basic | 80% | 40% |
| Major | 50% | 25% |
| Orthodontic | 25% | 25% |
ANNUAL LIMIT
Your plan covers up to $2,000 per member annually across all coverage tiers.
DEDUCTIBLE
The plan includes a deductible for basic, major, and orthodontic services, with a $50 per member and $150 per family deductible per plan year. Preventive care is exempt from the deductible.
ORTHODONTICS
Orthodontic services are covered at 25% up to a lifetime limit of $1,000 per member.
NETWORK
The plan grants access to the Connection Dental® national PPO network of dental providers. Find a provider at www.gehasolutions.com.