AtlantiCare 2022 Benefits Booklet

Dental

TABLE OF CONTENTS WELCOME.................2 WHAT’S NEW. ...........3 SERVICE CENTERS AND WEBSITES..........4 HOW TO ENROLL....5-6 MEDICAL..............7-13 PRESCRIPTION DRUG. ................14-16 ADDITIONAL MEDICAL PLAN RESOURCES........17-22 DENTAL...............24-25 VISION.....................26 LIFECENTER..............27 LIFE INSURANCE. .....28 DISABILITY...............29 VOLUNTARY OFFERINGS. ........30-33 SPENDING ACCOUNTS. ............34 RETIREMENT BENEFITS..................35 WELLNESS. .........36-39 LEGAL NOTICES...40-42 GLOSSARY..........43-44 FAQs...................45-47 CONTACTS.........48-49 FORMS................50-56

Dental Plan Options AtlantiCare offers the choice of two dental plans, Basic or Plus Ortho, both through Horizon Dental. Coverage highlights include implants, composite resin and orthodontia coverage for children. The Horizon Dental Option Plan gives you the freedom to receive services from any dentist, so no matter which dentist you choose, you save money. When you understand your plan, you can get the most from your dental benefits. Before You Choose, Consider... • The kind of dental services you expect to use. Are you planning to have “major” dental services? Will your child need braces? • Simple extractions will be covered under the dental plan • What your overall cost is likely to be under each option

Using Your Dental Benefits It’s important to use your dental benefits because oral health is essential to overall health. Your dentist can spot the early signs of systematic diseases and can help you. Make dental health a priority and protect yourself by learning more about the connection between your oral health and overall health. • Create a subscriber account on www.horizonblue. com/dental • Eliminate any surprises during your upcoming visit to the dentist office by knowing your facts before you go! • 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 all of your claims paperwork for you. Use the Find a Dentist tool to locate an in-network dentist.

Contact Horizon Dental at 1-800-433-6825 or www.horizonblue.com/dental .

Bi-Weekly & Annualized Employee Dental Cost

Bi-Weekly Cost

Bi-Weekly Cost

Coverage Type

For Basic

For Plus Ortho

Employee

$2.50

$9.00

Employee/Child or Employee + Spouse

$5.00

$22.00

Family

$7.50

$25.00

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