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Regardless which medical plan you select, dental coverage
is included automatically to all employees and retirees with
medical coverage. Employees who waive their medical coverage
through the City of Sarasota can elect DENTAL ONLY for themselves
and their family. This option is available for active employees
only.
The
rates for DENTAL ONLY coverage are as follows:
Tier
of Coverage |
Bi-Weekly
Rates |
Employee
Only
|
$2.00 |
Employee
+ One
|
$4.00 |
Employee
+ Family
|
$6.00 |
The
dental PPO option is an "open access" plan that
allows you to receive services from any dental provider without
selecting a Primary Dental Provider and does not require referrals
to specialists. In order to receive services, you can select
any participating dental provider in the Radius Network.
The PPO plan also provides benefits for services received
from out-of-network providers (providers that do not participate
in the network). You are responsible for coinsurance based
on the plan's Usual, Customary and Reasonable (UCR) charge
limitations. In addition to your coinsurance, out-of-network
providers may also "balance bill", which is the
difference between the plan's allowable amount and the out-of-network
provider's retail fee for any particular service. Therefore,
you have the potential to maximize your benefits when services
are received by in-network providers.
There
is a $50 deductible per person per calendar year. You do not
have to meet your deductible for cleanings. You are allowed
two cleanings per calendar year. They will be processed at
80%. However, if you go out of network and the amount exceeds
usual and customary, you are responsible to pay the difference.
After
meeting your deductible, claims will be paid at 80% for basic
services (fillings, x-rays, root canals) and at 50% for special
services (bridges, crowns, etc.) Our plan has a limit of $1,500
per calendar year per person for eligible dental expenses
so please advise your dentist of this limit. Orthodontia is
provided in the amount of $1,500, details of which are in
the SPD (Summary Plan Description).
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