Eligibility
Eligibility
Full-time employees working at least 32 hours a week are entitled to the dental plan. An Employee will be covered under the Plan the date that the Employee begins working 32 hours a week.
Dependent coverage will take effect on the day that the Eligibility Requirement is met. A dependent is consider an employees spouse or child. (See the
Summary Plan Description
for the definition of a dependent.)
Deductible and Co-insurance Percentage
The dental insurance included a $25
deductible for single coverage and $75 for family coverage per calendar year.
Co-insurance varies according to the type of treatment. There is no cost for preventative care once every six months. Basic Services are covered at 80%, after the deductible. Major Services are covered at 50%, after the deductible. Orthodontic Services are available to Dependent Child to age 19. Orthodontic Services are covered at 50% after the deductible with a lifetime maximum benefit of $1,000.
Premium
The cost of coverage is included in the health care
premium.
Please Note: There is no Preferred Provider
Program for dentists. Therefore participants may select a
dentist of their choice.
PBA is Palmer’s third party administrator for the Dental Plan.
Please contact PBA for information and questions regarding your claims at 1-800-435-5694.
Send claims to:
PBA
P.O. Box 4687
Oakbrook, IL 60522-4687