DENTAL
Your dental coverage is provided through Principal. Below are the main highlights of the Principal Dental Plan. For a full summary and description of all covered services, please refer to the Summary of Benefits & Coverage (SBC) at the end of this guide. You can find and search for in-network providers at www.principal.com. Your cost per-pay period for each tier of coverage can be found at the bottom of the page.
| Benefits | In-Network | Out-of-Network |
|---|---|---|
| Network Name | Principal | N/A |
| Deductible - Ind./Fam. | $50 / $150 | $50 / $150 |
| Coinsurance - Preventive | 100% | 100% |
| Coinsurance - Basic | 80% | 80% |
| Coinsurance - Major | 50% | 50% |
| Calendar Year Benefit Max. | $1,000 | $1,000 |
| Orthodontia Covered (Yes/No) | No | No |
| Coverage Tier | Cost per Semi-Monthly |
|---|---|
| Employee Only | $0.00 |
| Employee + Spouse | $8.99 |
| Employee + Child(ren) | $13.32 |
| Family | $23.91 |