BENEFITS AT A GLANCE
Employees may choose between the High Option, the Low Option, or waive coverage. Whichever plan is chosen, the employee must remain in the same plan until the next Open Enrollment period. At that time, employees will be able to switch from the High Plan to the Low Plan, or from the Low Plan to High Plan without penalty.
Employees can use any dentist, but choosing a network provider will have lower out of pocket costs.
MetLife Provider Listing within 25 miles of 30240 Zip Code
BENEFITS AND COVERED SERVICES:
| High Plan | Low Plan | |
| Preventative | 100% | 50% |
| Basic | 80% | 40% |
| Major | 50% | 30% |
| Orthodontic | 50% | 50% |
| Out of Network | 90% UCR | 51% UCR |
ID CARDS
MetLife ID Cards are mailed to employees home address. You do not need a card for benefits; however, employees can regiser and print an ID card online (Search for Troup County Board of Education), or use the MetLife Mobile App.
CERTIFICATE OF COVERAGE
High Option Dental Plan- Traditional Plan
Low Option Dental Plan – Lower Provider Payments/Balance Billing
MONTHLY PREMIUMS
| Plan | Coverage | 2023 Rates MetLife |
| High Option | Employee Employee + 1 Family | $49.13 $87.30 $137.97 |
| Low Option | Employee Employee + 1 Family | $22.53 $39.21 $80.93 |
DEDUCTIBLE
| High Plan: $50 per person each calendar year, Maximum of $150 per family |
| Low Plan: $50 per person each calendar year, Maximum of $150 per family |
| Deductible is waived for Diagnostic and Preventative |
ANNUAL MAXIMUMS
| High Plan: $1,000 per covered person per calendar year |
| Low Plan: $1,000 per covered person per calendar year |
| Diagnostic & Preventative DO NOT count toward Annual Maximum |
OTHER PROVISIONS
Orthodontic Benefits are $1,000 Lifetime Maximum per covered person. This includes Adult and Child(ren) benefits.
Children are covered to age 26 if they are dependent on the employee for support.
CUSTOMER SERVICE
MetLife Claim and Benefits information: www.metlife.com/mybenefits or call 1-800-942-0854