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Fee for Service Dental Plan
Plan Overview:
The Fee for Service Plan allows participants the complete freedom to choose any dentist. A percentage (50% - 100%) of the covered procedure is paid directly to the dentist and the remaining balance (0% - 50%) is paid by the participant. This plan has a calendar year deductible to meet before coverage begins, as well as a maximum limit that the plan will pay for services in a calendar year.
Understanding UCR:
All participants of this plan will need to understand UCR; as it may affect the reimbursement for services and the additional out-of-pocket charges that they might have to pay. UCR stands for Usual, Customary, and Reasonable:
•Usual: is the fee that an individual dentist most frequently charges for a specific dental procedure.
•Customary: is the fee level determined by the administrator of a dental benefit plan from actual fees submitted for a specific dental procedure. This fee establishes the maximum benefit payable for that procedure.
•Reasonable: is the fee charged by a dentist for a specific dental procedure that has been modified by complications or unusual circumstances.
Therefore, the payment of this plan may differ from the dentist's usual fee if it is not billed at UCR. UCR fees are determined by the fees dentists charge in various geographic areas and by the population size. Usually the heavily populated areas, where the cost of living is higher, have higher dental fees.
Pre-tax Employee Premiums:
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Total Premium
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College Portion
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Employee Portion
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| Employee Only
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$ 46.38
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$ 36.71
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$ 9.67
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| Two Party
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$ 92.79
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$ 51.96
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$ 40.83
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| Family
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$ 129.90
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$ 49.31
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$ 80.59 |
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