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Group Health

Proposal• Prepared for

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Dental Benefit Comparison 2019-2020

© 2019 Risk Strategies | Proprietary &

Confidential

Calendar Year BenefitsDental Basic Option Dental Deluxe Option

In-Network Non-Network In-Network Non-Network

Annual Benefit

Maximum (Individual)$1,000 $2,000

Annual Deductible

Preventive Services Waived Waived

Individual / Family

Basic and Major Services $75 / $225 $50 / $150

Individual / Family

Preventive Care 100% 100%* 100% 100%*

Oral Evaluations

Cleanings and X-rays

(every 6 months)

Space maintainers

Topical fluoride applications

(child through age 18 only)

Basic Care 80% 80%* 80% 80%*

Fillings, extractions, anesthesia

Endodontics, oral surgery

Periodontics

Major Care 50% 50%* 50% 50%*

Inlays

Crowns

Bridgework

Repair of bridges and crowns

Dentures

* fees by Non-Network providers based on Usual & Customary, amounts in excess of plan allowance are patient responsibility

1 The Federal mandated coverage for Pediatric Dental/Vision benefits attributed to "small group", are not subject to these plans, however, similar benefits are available through the

AACA's dental & vision programs.

2 Disclaimer: This is a brief summary provided for informational purposes only. If there is a discrepancy between this summary and the Plan Documents the Plan Documents supersede

this summary. Any errors are unintentional.

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Vision Benefit 2019-2020


Confidential

Vision Rider Benefit Summary

Calendar Year Benefits Network FrequencyOut-of-Network

ReimbursementRoutine Eye Exam

Plan services are covered at 100%

up to a maximum of $300

Once every 12 months up to age 18

Once ever 24 months age 18+

Plan reimburses at the lesser of

billed charges or up to a

maximum of $300

Lenses

Standard Single Vision Lenses, or

Standard Bifocal Lenses, or

Standard Trifocal Lenses

Standard Progressive Lenses

Premium Progressive Lenses

Frame

Contacts

(In lieu of frame and lens benefit)

Non-Elective Contact Lenses

(Medically necessary hard lenses)

Elective Conventional Lenses

(When you choose contacts instead of

glasses)

1 The Federal mandated coverage for Pediatric Dental/Vision benefits attributed to "small group", are not subject to these plans, however, similar benefits

are available through the AACA's dental & vision programs.

2 Disclaimer: This is a brief summary provided for informational purposes only. If there is a discrepancy between this summary and the Plan Documents

the Plan Documents supersede this summary. Any errors are unintentional.

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Hearing Benefit 2019-2020


Confidential

Hearing Rider Benefit Summary

These benefits are not subject to the plans deductible or annual out-of-pocket maximum

Benefit PrerequisitesThe patient must be examined by a licensed physician (MD or DO) before obtaining a hearing aid. The plan allows you to choose any licensed

physician, audiologist, or surgeon.

You must purchase a hearing aid device to qualify for this benefit

Services & Supplies Benefit Frequency

One Otological (ear) exam by a physician or

surgeon

Plan services are covered at 80% up to a maximum payable of $800The benefit maximum is provided once every three years beginning with

the date of the ontological examination

One audiological (hearing) exam and

evaluation by a certified or licensed

audiologist, including a follow-up consultation

A hearing aid (monaural or binaural)

prescribed as a result of the examination

Ear molds

Hearing aid instruments

Initial batteries, cords and other necessary

supplementary equipment

A warranty

Follow-up consultation within 30 days

following delivery of the hearing aid

Repairs, servicing, or alteration of the hearing

aid equipment

→ Replacement of a hearing aid, for any reason, more than once in a three-year period;

→ Batteries or other supplementary equipment other than those obtained upon purchase of the hearing aid;

→ A hearing aid exceeding the specifications prescribed for correction of hearing loss;

→

Expenses incurred after coverage ends, unless you order a hearing aid before the termination and receive it within 90 days of the end date;

→ Services and supplies that are payable under a workers' compensation or occupational disease law;

→ Any expense that results from an act of declared or undeclared war or armed aggression;

→ Any expense that is in excess of the maximum plan allowance;

→ Any expense you or your dependents do not have to pay;

→ Any expense paid in whole or in part by any other provision of the Group Health Insurance Plan provided by the Policy holder.

1 Disclaimer: This is a brief summary provided for informational purposes only. If there is a discrepancy between this summary and the Plan Documents the Plan Documents supersede this summary. Any

errors are unintentional.

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New Plan Offerings 2019-2020

• New Offerings

• Offering New Medical plan - $3500 Deductible which lowers overall premium

• New Life Insurance program – up to $50,000 Basic Life Coverage

– No Aviation Exclusions

• New Voluntary Life Insurance Option with up to $100,000 Guarantee Issue (No

Medical Underwriting)

– No Aviation Exclusions

• Additional Voluntary Product Offerings

– Employee Assistance Program through Curalinc

– Identity Theft Protection

– Pet Insurance through Nationwide

– Legal Shield


Confidential