2026 AtlantiCare Benefits Booklet

DENTAL BENEFITS

WELCOME....................................2 WHAT’S NEW..............................3 HOW TO ENROLL......................4 HEALTHCARE TRANSFORMATION CONSORTIUM (HTC)...............6 GETTING TO KNOW YOUR PLAN.................................7 MEDICAL......................................8 PRESCRIPTION DRUG.......... 17 FQHC........................................... 19 ADDITIONAL MEDICAL PLAN RESOURCES................. 20 WELLNESS PROGRAM......... 21 DENTAL...................................... 23 VISION........................................ 25 LIFE INSURANCE.................... 28 DISABILITY............................... 30 VOLUNTARY OFFERINGS... 31 EDUCATIONAL SUPPORT & CAREER DEVELOPMENT...................... 31 FINANCIAL WELL-BEING.... 32 HEALTH &WELLNESS.......... 33 SAVINGS.................................... 34 VOLUNTARY BENEFITS....... 35 SPENDING ACCOUNTS............................... 38 RETIREMENT BENEFITS................................... 39 CONTACTS................................ 41 LEGAL NOTICES....................... 43 WELLNESS CHECKLIST........ 45

Make dental health a priority by choosing between two Horizon Dental plans, Basic or Dental Plus Ortho. Basic Dental ofers teammembers 100% coverage on preventative services with partial coverage on other dental services, such as fillings, extractions, implants and more. Plus Ortho coverage includes fewer out of pocket costs on most dental procedures as well as $2,000 lifetime orthodontia coverage for adults and children. Contact Horizon Dental at 1-800-433-6825 or www.horizonblue.com/dental .

BEFOREYOU GO: • Create a subscriber account on www.horizonblue.com/dental . • Eliminate any surprises during your upcoming visit to the dentist’s o ce by knowing the facts before you go. • Use the Find a Dentist tool to locate an in-network dentist. - Choose an“in-network”dentist: in-network dentists are also known as “participating dentists,” because these dentists participate in a specific dental network and they offer their services at

discounted rates for members of that specific dental plan. - In-network dentists also file your claim paperwork for you.

– 23 –

23