Greeley-Evans School District 6
School District
UMR/UnitedHealthcare Dental Cost & Benefits
Dental Benefits Cost
| Individuals Covered | Monthly Premium | Your Cost per Month |
|---|---|---|
| Employee Only | $37.00 | $0.00 |
| Employee + Spouse | $72.00 | $35.00 |
| Employee + Child(ren) | $85.00 | $48.00 |
| Family | $127.00 | $90.00 |
Dental Services Cost
| Type of Service | In-Network | Out-of-Network |
|---|---|---|
| Policy Year Deductible | $50 per individual / $100 per family | $50 per individual / $100 per family |
| Policy Year Maximum | $1,500.00 | $1,500.00 |
| Dependent Eligibility | To age 26 | To age 26 |
| Preventative | 100% | 100% |
| Basic Services - Periodontics/Endodontics | 80% | 80% |
| Major Services | 50% | 50% |
| Orthodontics | 50% | 50% |
| Orthodontics Lifetime Maximum | $1,500.00 per eligible person | $1,500.00 per eligible person |
| Orthodontics Age Limitation |
Dependent children to age 19; no adult coverage |
Dependent children to age 19; no adult coverage |
All employees who enroll in dental only will receive an ID card from UMR; if you need additional ID cards for your covered dependents, those will be provided upon request.
What is "balance billing"?
- Balance billing is additional amounts a non-participating (out-of-network) dentist charges you for the difference between the dental carrier’s allowed amount and the dentist’s fee.
- Participating (in-network) dentists agree to accept the dental carrier’s allowed fee and charge you only the copays and deductibles, when applicable.
- Non-participating (out-of-network) dentists may charge you the difference between the dental carrier’s allowed amount and their fee and may also require you to pay the full charge up front.