Benefit Summary 2020

Independence Dental (PPO) This Preferred Provider Plan offer both in-network and out-of-network coverage. Of the two plans, the PPO plan has the higher biweekly employee contribution. The plan has a per person annual maximum of $2,500 for a PPO dentist/$1,500 for a non-PPO dentist and features a deductible of $50 per person and $150 per family. After the deductible has been met, the plan pays for 90% of the cost for work done by in- network dentists and 70% for work done by out-of-network dentists.

Colbalt Plus (DHMO) Under this HMO-type plan the employee selects one permanent dentist from a pre-approved list. The DHMO plan has the lower biweekly contribution of the two plans. There is no annual maximum or deductible. Preventative care, X-rays, and restorative services are covered at 100%. Other services are offered with a specified co-payment.

KERN MEDICAL - BENEFITS SUMMARY - 9