AtlantiCare Benefits Book 2020

Dental

HOME TABL OF CONTENTS WELCOME.................2 WHAT’S NEW. ...........3 I E CENTERS AND EBSITES...................4 HO TO ENROLL.......5 MEDICAL..............6-12 PRESCRIPTION DRUG. ................13-15 ADDITIONAL MEDICAL PLAN RESOURCES.........16-18 DENTAL...............19-21 VISION.....................22 LIFECENTER..............23 LIFE INSURANCE. .....24 LONG TERM DISABILITY...............25 VOLUNTARY OFFERINGS. ........26-29 SPENDING ACCOU TS. ............30 RETIREMENT B NEFITS..................31 WELLNESS. .........32-36 LEGAL NOTICES..37-39 CONTACTS.........40-41 GLOSSARY..........42-43 FAQs...................44-46 FORMS................47-56 WHAT’S NEW SERVICE CENTERS AND WEBSITES HOW TO ENROLL MEDICAL PRESCRIPTION DRUG ADDITIONAL MEDICAL PLAN RESOURCES DENTAL VISION LIFE INSURANCE LONG TERM DISABILITY VOLUNTARY OFFERINGS SPENDING ACCOUNTS RETIREMENT BENEFITS WELLNESS LEGAL NOTICES CONTACTS GLOSSARY

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

HENRY Onsite Dental Care at AtlantiCare HENRY is a high-end mobile dental clinic that offers employees access to in-network dental care. • Employees can schedule appointments in advance and complete all patient forms online. • Henry preauthorizes insurance, making it a seamless experience. • HENRY has state-of-the-art equipment and a team of highly skilled dentists. • HENRY offers treatment such as Cleanings, X-ray Exams, Fillings and Crowns. • Your treatments at HENRY will be applied to your Delta Dental coverage. • HENRY will be at various AtlantiCare locations throughout the year – stay tuned for dates.

FORMS

21