U.S. SSP STYLE GUIDE Dental - MetLifeGSSP U.S. | STYLE GUIDE IMPORTANT NOTES “PAGE 2” TAB STRUCTURE 1 Dsktp. Tabs - Spacing 2 Dsktp. Tabs - Fonts/Colors 3 Mobile Tabs - Spacing

Version 01 | 08.15.2017

U.S. SSP STYLE GUIDE

Dental

GSSP U.S. | STYLE GUIDE

IMPORTANT NOTES

“PAGE 2” TAB STRUCTURE 1 Dsktp. Tabs - Spacing 2 Dsktp. Tabs - Fonts/Colors 3 Mobile Tabs - Spacing 4 Mobile Tabs - Fonts, Colors 5 Tablet Tab Takeover Menu 6 Tablet Tab Takeover -Spacing 7 Tablet Tab Takeover - Fonts/Colors 8 Pnone Tab Takeover Menu 9 Tablet Tab Takeover - All Specs

“PAGE 2” I Want To MENUS 10 Dsktp. I Want To Menu 11 Dsktp. I Want To - All Specs 12 Tablet I Want To13 Tablet I Want To - All Specs14 Phone I Want To

POLICY INFORMATION TAB 16 Dsktp. Policy Info Tab 17 Dsktp. Policy Info Tab - Spacing 18 Dsktp. Policy Info Tab - Fonts/Colors 19 Tablet Policy Info Tab 20 Tablet Policy Info Tab - All Specs 21 Phone Policy Info Tab 22 Phone Policy Info Tab - All Specs 23 Dsktp. Benefits Info Turbo Flip 24 Dsktp. Benefits Info Turbo Flip - Spacing25 Dsktp. Benefits Info Turbo Flip - Fonts/Col-ors 26 Tablet Benefits Info Turbo Flip 27 Tablet Benefits Info Turbo Flip - All Specs 28 Phone Benefits Info Turbo Flip 29 Phone Benefits Info Turbo Flip - All Specs 30 Dsktp. Network Benefits Overlay

31 Dsktp. Network Benefits Overlay - Spacing 32 Dsktp. Network Ben. Overlay - Fonts/Colors 33 Tablet Network Benefits Takeover 34 Phone Network Benefits Takeover 35 Phone Network Benefits Takeover - All Specs 36 Dsktp. Leaving Metlife Overlay

COVERAGES TAB 37 Dsktp. Coverages Tab 38 Dsktp. Coverages Tab - Spacing 39 Dsktp. Coverages Tab - Fonts/Colors40 Tablet Coverages Tab41 Tablet Coverages Tab - All Specs42 Phone Coverages Tab 43 Phone Coverages Tab - All Specs 44 Dsktp. Composites Turbo Flip

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COMMON QUESTIONS TAB 55 Dsktp. Common Questions Tab 56 Dsktp. Common Questions - Spacing 57 Dsktp. Common Questions - Colors/Fonts 58 Tablet Common Questions Tab 59 Tablet Common Questions - All Specs

60 Phone Common Questions Tab 61 Phone Common Questions - All Specs

DRAWERS 62 Dsktp. Choose a Dental Office Drawer 63 Dsktp. Choose a Dental Office - Spacing 64 Dsktp. Choose a Dental Off. - Colors/Fonts 65 Dsktp. Send a Message by Email Drawer 65 Dsktp. Send a Message by Email Drawer 66 Dsktp. Email Coverage Info Drawer 1 67 Dsktp. Email Coverage Info Drawer 2 68 Dsktp. Email Cov. Info Drwr. 1 - All Specs 69 Tablet Email Coverage Info Drawer 1

Dental | CONTENTS (Section Headers hyperlink to Pages)

U.S. SSP | STYLE GUIDE

IMPORTANT - ABOUT THIS STYLE GUIDE!!!!!

Please read important notes on the following page and see downloads and Pattern Library URLs.

Please do not detach single pages to give to developers. All pages are inter-dependent. A style or spacing spec-ed on a page is not repeated on subsequent pages, so the entire guide is needed for reference for anyone coding this feature.

See www.ux.metlife.com for button, link, dropdown, form field behaviors and specs - and palette, fonts, etc.

My Accounts / PDP Plus

MY ACCOUNTS CLAIM CENTER DOCUMENTS & FORMS

2Welcome DavidCarestream, Inc.

Group DentalPDP PlusProvided by Carestream, Inc.

I want to… !

Eligibility is not a guarantee of coverage as actual benefit payments are determined only when a

claim is processed.

If MetLife determines that a less costly service than the covered service performed by a dentist

could have been performed to treat a dental condition, MetLife may pay benefits based upon the

less costly service if such service 1) Would produce a professionally acceptable result under

generally accepted dental standards, and 2) Would qualify as a covered service.

If MetLife pays a benefit based upon a less costly service, the dentist may charge a patient or a

patient's dependent for the difference between the service that was performed and the less costly

service. This may be the case, even if the service is performed by an in-network dentist.

A pretreatment estimate is recommended before the start of extensive dental treatment such as

crowns, veneers, bridgework, implants, orthodontics,or periodontal services. Learn more about how to request a pretreatment estimate.

© 2017 MetLife MetLife Term Life Insurance issued by MetLife Insurance Company USA, Charlotte, NC, 28277 (except in NY), on policy form #5E-23-12, and

by Metropolitan Life Insurance Company, New York, NY 10166 (NY only), on policy form #1E-23-12-NY. Both are MetLife companies. L1016481177[exp1217]

[All States][DC,GU,MP,PR,VI]

Privacy Policy • Terms of Use • Contact Us • Important Information

General Information

Network name: PDP Plus

Policy status: Enrolled

Effective coverage period: 09/01/2017-08/31/2018

Coverage elected for: David Faulkner, Joan Faulkner, Sean Faulkner

Coordination of benefits: Birthday Rule

Non-duplication of benefits applies

Co-pay: Yes

View co-pay schedules

""

Policy Coverages

Benefits available for for teeth lost prior to effective date: Yes

Maximum dependent age: Up to age 24

Maximum student age: Up to age 24

Orthodontics

Dependent child’s age: Up to age 19

Full-time student age: Up to age 19

All others: Not covered

View all coverages and procedures

Benefit Information

Name Effective Date

David Faulkner 09/01/2014Insured: Self

Joan Faulkner 09/01/2014Dependent: Spouse

Sean Faulkner 09/01/2014Dependent: Child

Your dependents are eligible for coverage. Each dependent is listed when the first claim or pretreatment for that dependent is processed.

DETAILS

LEARN MORE

Your dental plan is designed to make it more affordable to see a dentist regularly. You can go

to any licensed dentist, but staying in-network helps you save on services and get more value

from your plan!

Benefit programs offered by MetLife and its affiliates contain certain exclusions, exceptions, waiting periods, reductions, limitations and terms for keeping them in force. Contact MetLife or your plan administrator for more details.

The Benefits of Staying In-Network

PRINT CARDS

ID Cards

PDP PlusID Number 0123456

Network PDP Plus

Name David Faulkner

Dental Group Plan 142093

Your ID can be used when calling MetLife or submitting claims.

Member Service: www.website.com

LEARN MORE

News & UpdatesExcept as otherwise required by state law, the Carestream dental options allow associates to provide dental coverage for their unmarriedchildren who are (1) under the age of 19, or (2) qualified students under the age of 23. If you have any questions regarding dependent eligibility, please contact Carestream HR Services at1-800-234-6229.

Send us a request to add your dentist if he or she isn’t in your network.

Recommend a Dentist

ADD A DENTIST

Policy Information Coverages Claim History Common Questions

205px x 55px

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See Navigation and Footer in FOUNDATIONAL UI ELEMENTS PDF for final navigation details and specs.





I want to… !


claim is processed.














General Information







Co-pay: Yes


"

How a plan pays benefits when a patient is covered bymore than one dental benefits plan.

?

Policy Coverages




Orthodontics





Benefit Information

Name Effective Date





DETAILS

LEARN MORE



from your plan!



PRINT CARDS

ID Cards


Network PDP Plus

Name David Faulkner




LEARN MORE

News & UpdatesExcept as otherwise required by state law, the Carestream dental options allow associates to provide dental coverage for their unmarriedchildren who are (1) under the age of 19, or (2) qualified students under the age of 23. If you have any questions regarding dependent eligibility, please contact Carestream HR Services at1-800-234-6229.


Recommend a Dentist

ADD A DENTIST


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Welcome NicoleCarestream, Inc.


I want to… !

Eligibility is not a guarantee of coverage as actual benefit payments are determined only when a claim is

processed.

If MetLife determines that a less costly service than the covered service performed by a dentist could have

been performed to treat a dental condition, MetLife may pay benefits based upon the less costly service if

such service 1) Would produce a professionally acceptable result under generally accepted dental

standards, and 2) Would qualify as a covered service.

If MetLife pays a benefit based upon a less costly service, the dentist may charge a patient or a patient's

dependent for the difference between the service that was performed and the less costly service. This may

be the case, even if the service is performed by an in-network dentist.

A pretreatment estimate is recommended before the start of extensive dental treatment such as crowns,

veneers, bridgework, implants, orthodontics,or periodontal services. Learn more about how to request a

pretreatment estimate.

© 2015 MetLife MetLife Term Life Insurance issued by MetLife Insurance Company USA, Charlotte, NC, 28277 (except in NY),

on policy form #5E-23-12, and by Metropolitan Life Insurance Company, New York, NY 10166 (NY only), on policy form #1E-23-12-NY.

Both are MetLife companies.


"Policy Information

GET CARDS

ID Cards


Network PDP Plus

Name Asteca Bodok




General Information

Network name Network Name

Policy status Enrolled

Effective

coverage period Period

Coverage elected

for Employee Name, Employee Spouse, Employee Child

Coordination of

benefits Birthday RuleNon-duplication of benefits applies

Co-pay Yes

View co-pay

schedules

? $

Policy Coverages

Benefits available

for teeth lost

prior to

effective date Yes

Maximum

dependent

age Up to age 24

Maximum

student age Up to age 24

Orthodontics

Dependent

child’s age Up to age 19

Full-time


All others Not coverd

View all coverages

and procedures

Benefit Information

Name Effective Date

Asteca Bodok 09/01/2014Insured: Self

Arsuso Bodok 09/01/2014Dependent: Spouse

Arsuso Bodok 09/01/2014Dependent: Child

Duks Bodok 09/01/2014Dependent: Child


DETAILS

LEARN MORE

Your dental plan is designed to make it more affordable to see a dentist regularly.

You can go to any licensed dentist, but staying in-network helps you save on

services and get more value from your plan!



LEARN MORE

News & UpdatesExcept as otherwise required by state law, the Carestream, Inc. dental options allow associates to provide dental coverage for their unmarried children who are (1) under the age of 19, or (2) qualified students under the age of 23. If you have any questions regarding dependent eligibility, please contact Carestream’s HR Services at1-800-234-6229.


Recommend a Dentist

ADD A DENTIST

190px x 45px 40px

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Tapping this icon/tab invokes the Tabs Takeover





I want to… !


processed.









veneers, bridgework, implants, orthodontics,or periodontal services. Learn more about how to request a

pretreatment estimate.





"Policy Information

GET CARDS

ID Cards


Network PDP Plus

Name Asteca Bodok




General Information



Effective

coverage period Period

Coverage elected

for Employee Name, Employee Spouse, Employee Child

Coordination of

benefits Birthday RuleNon-duplication of benefits applies

Co-pay Yes

View co-pay

schedules

? $

Policy Coverages

Benefits available

for teeth lost

prior to

effective date Yes

Maximum

dependent

age Up to age 24

Maximum


Orthodontics

Dependent

child’s age Up to age 19

Full-time


All others Not coverd

View all coverages

and procedures

Benefit Information

Name Effective Date






DETAILS

LEARN MORE






LEARN MORE

News & UpdatesExcept as otherwise required by state law, the Carestream, Inc. dental options allow associates to provide dental coverage for their unmarried children who are (1) under the age of 19, or (2) qualified students under the age of 23. If you have any questions regarding dependent eligibility, please contact Carestream’s HR Services at1-800-234-6229.


Recommend a Dentist

ADD A DENTIST

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13px circle#A4CE4E

10px circles#999999

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RULE:color: #CCCCCClength: 610pxweight; 1px




Group DentalPDP Plus

Provided by Carestream, Inc.

I want to… !

+

−

Your Network BenefitsYour dental plan is designed to help protect your dental health and make it more affordable to see

your dentist regularly. You can go to any licensed dentist — in or out of the network. The choice is

yours.

Just remember that staying in-network helps you stretch your plan maximums and get more savings

from our dental benefits.

A participating dentist has agreed to accept negotiated fees as payment in full for services provided to

plan members. Negotiated fees typically range from 15% - 45%* below the average fees charged in a

dentist’s community for the same or substantially similar services.




Lorem ipsum dolor sit amet, consectetur adipisicing elit, sed do eiusmod tempor incididunt ut labore et

dolore magna aliqua. Ut enim ad minim veniam, quis nostrud exercitation ullamco laboris nisi ut aliquip.



Benefit programs offered by MetLife and its affiliates contain certain exclusions, exceptions, waiting periods, reductions,

limitations and terms for keeping them in force. Contact MetLife or your plan administrator for more details.

Custom Network

Out-of-Network

Out-of-Network MetLife Choice Savings Program

In Network

Benefits for Using a Participating, Network Dentist

Benefits for Using a Non-Participating , Out-of-Network Dentist

One of the largest Dental Networks

Savings

CLOSE

Policy Information

Coverages

Claim History

Common Questions







I want to… !

Policy Information

Coverages

Claim History

Common Questions


20px

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Tapping close without selecting a new tab returns to original page that launched this takeover.





I want to… !

Policy Information

Coverages

Claim History

Common Questions


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Policy Information

Coverages

Claim History

Common Questions


!

Policy Information

Coverages

Claim History

Common Questions


70px

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I want to… !


claim is processed.














General Information







Co-pay: Yes


""

Policy Coverages




Orthodontics





Benefit Information

Name Effective Date





DETAILS

LEARN MORE



from your plan!



PRINT CARDS

ID Cards


Network PDP Plus

Name David Faulkner




LEARN MORE

News & Updates Except as otherwise required by state law, the Carestream dental options allow associates to provide dental coverage for their unmarried children who are (1) under the age of 19, or (2) qualified students under the age of 23. If you have any questions regarding dependent eligibility, please contact Carestream HR Services at 1-800-234-6229.


Recommend a Dentist

ADD A DENTIST


Dentist or practice name (optional)

FIND

ZIP Code

07834

Find a Dentist Related Links

View Policy Documents

View Claim Forms

Update Preferences

Resources

Glossary

Oral Health Library

Tools

Recommend a dentist

Procedure Fee Tool

Request a Translation

View/Print ID Card

File a Grievance

I want to… !





I want to… !


claim is processed.














General Information







Co-pay: Yes


""

Policy Coverages




Orthodontics





Benefit Information

Name Effective Date





DETAILS

LEARN MORE



from your plan!



PRINT CARDS

ID Cards


Network PDP Plus

Name David Faulkner




LEARN MORE



Recommend a Dentist

ADD A DENTIST



FIND

ZIP Code

07834

Find a Dentist Related Links


View Claim Forms

Update Preferences

Resources

Glossary

Oral Health Library

Tools

Recommend a dentist

Procedure Fee Tool

Request a Translation

View/Print ID Card

File a Grievance

I want to… !

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fill: #FFFFFF 100%border: 1px inside* #007ABC 100%

opacity: 100%radius: 2px





I want to… !

Eligibility is not a guarantee of coverage as actual benefit payments are determined only when a claim is processed.

If MetLife determines that a less costly service than the covered service performed by a dentist could have been performed to

treat a dental condition, MetLife may pay benefits based upon the less costly service if such service 1) Would produce a

professionally acceptable result under generally accepted dental standards, and 2) Would qualify as a covered service.

If MetLife pays a benefit based upon a less costly service, the dentist may charge a patient or a patient's dependent for the

difference between the service that was performed and the less costly service. This may be the case, even if the service is

performed by an in-network dentist.

A pretreatment estimate is recommended before the start of extensive dental treatment such as crowns, veneers, bridgework,

implants, orthodontics,or periodontal services. Learn more about how to request a pretreatment estimate.





"Policy Information

PRINT CARDS

ID Cards


Network PDP Plus

Name David Faulkner




General Information



Effective

coverage period: 09/01/2017-08/31/2018


Coordination

of benefits: Birthday RuleNon-duplication of benefits applies

Co-pay: Yes


##

Policy Coverages

Benefits available for

for teeth lost prior

to effective date: Yes

Maximum

dependent age: Up to age 24


Orthodontics

Dependent

child’s age: Up to age 19

Full-time

student age: Up to age 19


View all coverages

and procedures

Benefit Information

Name Effective Date





DETAILS

LEARN MORE



from your plan!



LEARN MORE



Recommend a Dentist

ADD A DENTIST

−Related Links


View Claim Forms

Update Preferences

+Resources

+Tools


FIND

ZIP Code

07834

Find a Dentist

I want to… !





I want to… !














"Policy Information

PRINT CARDS

ID Cards


Network PDP Plus

Name David Faulkner




General Information



Effective

coverage period: 09/01/2017-08/31/2018


Coordination


Co-pay: Yes


##

Policy Coverages




Maximum



Orthodontics

Dependent


Full-time



View all coverages

and procedures

Benefit Information

Name Effective Date





DETAILS

LEARN MORE



from your plan!



LEARN MORE



Recommend a Dentist

ADD A DENTIST

−Related Links


View Claim Forms

Update Preferences

+Resources

+Tools


FIND

ZIP Code

07834

Find a Dentist

I want to… !

5px

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20px 30px

30px

20px

20px 20px

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If MetLife determines that a less costly service than the covered service performed by a dentist could have been performed to treat a dental condition, MetLife may pay benefits based upon the less costly service if such service 1) Would produce a professionally acceptable result under generally accepted dental standards, and 2) Would qualify as a covered service.

If MetLife pays a benefit based upon a less costly service, the dentist may charge a patient or a patient's dependent for the difference between the service that was performed and the less costly service. This may be the case, even if the service is performed by an in-network dentist.

A pretreatment estimate is recommended before the start of extensive dental treatment such as crowns, veneers, bridgework, implants, orthodontics,or periodontal services. Learn more

about how to request a pretreatment estimate.

LEARN MORE






Benefit Information

Name Effective Date






DETAILS

General Information



Effective coverage period Period

Coverage elected for Employee Name,

Employee Spouse, Employee Child

Coordination of benefits Birthday Rule


Co-pay YesView co-pay schedules

? "


I want to… #

$Policy Information

Policy Coverages

Benefits available for teeth lost prior to effective date Yes

Maximum dependent age Up to age 24

Maximum student age Up to age 24

Orthodontics

Dependent child’s age Up to age 19

Full-time student age Up to age 19

All others Not coverdView all coverages and procedures

GET CARDS

ID Cards

PDP PlusID Number 0123456Network PDP PlusName Asteca BodokDental Group Plan 142093




Recommend a Dentist

ADD A DENTIST

LEARN MORE

News & Updates Except as otherwise required by state law, the Carestream, Inc. dental options allow associates to provide dental coverage for their unmarried children who are (1) under the age of 19, or (2) qualified students under the age of 23. If you have any questions regarding dependent eligibility, please contact Carestream’s HR Services at 1-800-234-6229.


by Metropolitan Life Insurance Company, New York, NY 10166 (NY only), on policy form #1E-23-12-

NY. Both are MetLife companies.

Privacy Policy • Terms of Use

Contact Us • Important Information

−Related Links


View Claim Forms

Update Preferences

+Resources

+Tools


FIND

ZIP Code07834

Find a Dentist

I want to… #

&

270px

171px

250px





I want to… !


claim is processed.














General Information







Co-pay: Yes


""

Policy Coverages




Orthodontics





Benefit Information

Name Effective Date





DETAILS

LEARN MORE



from your plan!



PRINT CARDS

ID Cards


Network PDP Plus

Name David Faulkner




LEARN MORE



Recommend a Dentist

ADD A DENTIST






I want to… !


claim is processed.














General Information







Co-pay: Yes


"

How a plan pays benefits when a patient is covered by more than one dental benefits plan.

?

Policy Coverages




Orthodontics





Benefit Information

Name Effective Date





DETAILS

LEARN MORE



from your plan!



PRINT CARDS

ID Cards


Network PDP Plus

Name David Faulkner




LEARN MORE



Recommend a Dentist

ADD A DENTIST






I want to… !


claim is processed.














General Information







Co-pay: Yes


"


?

Policy Coverages




Orthodontics





Benefit Information

Name Effective Date





DETAILS

LEARN MORE



from your plan!



PRINT CARDS

ID Cards


Network PDP Plus

Name David Faulkner




LEARN MORE



Recommend a Dentist

ADD A DENTIST


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I want to… !


claim is processed.














General Information







Co-pay: Yes


"


?

Policy Coverages




Orthodontics





Benefit Information

Name Effective Date




Your dependents are eligible for coverage. Eachdependent is listed when the first claim or pretreatment for that dependent is processed.

DETAILS

LEARN MORE



from your plan!



PRINT CARDS

ID Cards


Network PDP Plus

Name David Faulkner




LEARN MORE



Recommend a Dentist

ADD A DENTIST


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I want to… !














"Policy Information

PRINT CARDS

ID Cards


Network PDP Plus

Name David Faulkner




General Information



Effective

coverage period: 09/01/2017-08/31/2018


Coordination


Co-pay: Yes


##

Policy Coverages




Maximum



Orthodontics

Dependent


Full-time



View all coverages

and procedures

Benefit Information

Name Effective Date





DETAILS

LEARN MORE



from your plan!



LEARN MORE



Recommend a Dentist

ADD A DENTIST





I want to… !














"Policy Information

PRINT CARDS

ID Cards


Network PDP Plus

Name David Faulkner




General Information



Effective

coverage period: 09/01/2017-08/31/2018


Coordination


Co-pay: Yes


##

Policy Coverages




Maximum



Orthodontics

Dependent


Full-time



View all coverages

and procedures

Benefit Information

Name Effective Date





DETAILS

LEARN MORE



from your plan!



LEARN MORE



Recommend a Dentist

ADD A DENTIST

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20px

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LEARN MORE






Benefit Information

Name Effective Date






DETAILS

General Information









? "


I want to… #

$Policy Information

Policy Coverages




Orthodontics




GET CARDS

ID Cards





Recommend a Dentist

ADD A DENTIST

LEARN MORE







%






LEARN MORE






Benefit Information

Name Effective Date






DETAILS

General Information









? "


I want to… #

$Policy Information

Policy Coverages




Orthodontics




GET CARDS

ID Cards





Recommend a Dentist

ADD A DENTIST

LEARN MORE







15px

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Benefits InformationBACK

These values may increase in the next year. This information is as of <mm/dd/yyyy>.The maximums may be combined with other types of procedures, such as TMJ and Periodontal.For additional limitations, please review applicable age limitations mentioned on your Policy Information tab.

Out-of-network

In network !

!

Met to date: $50.00

Deductible: $50.00

Used to date: $600.00

$1,500.00 Plan Maximum$1,500.00 Plan Maximum



Used to date: $1,200.00




Deductible: $500.00

Deductible: $500.00

Deductible: $50.00

Met to date: $50.00

Met to date: $50.00

Met to date: $50.00

Benefit Period Maximum & Deductibles Lifetime Maximum and DeductiblesNetwork

Learn more about how your deductibles are met and maximums are calculated +





A pretreatment estimate is recommended before the start of extensive dental treatment such as crowns, veneers, bridgework, implants, orthodontics,or periodontal services. Learn more about how to request a pretreatment estimate.

Individual Basic Plan Family Basic Plan

Network: PDP PlusCoverage effective from: 09/01/2017

David Faulkner " Please Note: Benefits are not paid in a lump sum as 20% of the submitted total fee is reimbursed at 50%. Payments are made quarterly over the treatment plan outlined from the orthodontist.

Specifically, MetLife will pay an initial appliance component (banding fee) based on 20% of the submitted expense, at the 50% coinsurance level: $5,000 (submitted expense) x 20% = $1,000 x 50% benefit = $500

The first payment will be $500. The remaining expense will be spread over the expected length of treatment.

CLOSE

© 2017 MetLife MetLife Term Life Insurance issued by MetLife Insurance Company USA, Charlotte, NC, 28277 (except in NY), on policy form #5E-23-12, and by Metropolitan Life Insurance Company, New York, NY 10166 (NY only), on policy form #1E-23-12-NY. Both are MetLife companies. L1016481177[exp1217][All States][DC,GU,MP,PR,VI]


I want to… "








Out-of-network

In network !

!

Met to date: $50.00

Deductible: $50.00









Deductible: $500.00

Deductible: $500.00

Deductible: $50.00

Met to date: $50.00

Met to date: $50.00

Met to date: $50.00













CLOSE



I want to… "



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Out-of-network

In network !

!

Met to date: $50.00

Deductible: $50.00









Deductible: $500.00

Deductible: $500.00

Deductible: $50.00

Met to date: $50.00

Met to date: $50.00

Met to date: $50.00













CLOSE



I want to… "



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color: #333333 100%font-size: 13pxfont-face: NotoSans-Boldcharacter: 0.3pxline: 17px (1.4)

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color: #333333 100%font-size: 18pxfont-face: Font Awesome+ fa-plus []

BAND:fill: #007ABC 100%opacity: 100%radius: 0px

FRAME:border: 2px inside* #007ABC 100%opacity: 100%radius: 0px

fill: #F2F2F2 100%opacity: 100%radius: 0px

color: #0061A0 100%font-size: 14pxfont-face: NotoSans-Bold


height: 20pxfill: #0090DA 100%opacity: 100%radius: 0px

height: 20pxfill: #D8D8D8 100%opacity: 100%radius: 0px

border: 2px center * #0090DA 100%opacity: 100%border: 1px center

* #cccccc 100%opacity: 100%


Corner Color: #0090DA





I want to… !

Individual Basic Plan !




In network

Out-of-network

$3,000.00 Plan maximum$3,000.00 Plan maximum

Lifetime Maximum and Deductible


Deductible: $500.00Met to date: $50.00


Benefit Period Maximum and Deductible



Met to date: $50.00



Deductible: $50.00






© 2015 MetLife MetLife Term Life Insurance issued by MetLife Insurance Company USA, Charlotte, NC, 28277 (except in NY), on policy form #5E-23-12, and by Metropolitan Life Insurance Company, New York, NY 10166 (NY only), on policy form #1E-23-12-NY.



Please Note: Benefits are not paid in a lump sum as 20% of the submitted total fee is reimbursed at 50%. Payments are made quarterly over the treatment plan outlined from the orthodontist.

Specifically, MetLife will pay an initial appliance component (banding fee) based on 20% of the submitted expense, at the 50% coinsurance level:$5,000 (submitted expense) x 20% = $1,000 x 50% benefit = $500

The first payment will be $500. The remaining expense will be spread over the expected length of treatment. (Citi)


CLOSE

"Policy Information

Network: PDP Plus

Coverage effective from: <mm/dd/yyyy>

Insured Name !









I want to… !





In network

Out-of-network









Met to date: $50.00



Deductible: $50.00













CLOSE

"Policy Information

Network: PDP Plus


Insured Name !





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Learn more about how your deductibles are met and maximums are calculated

+



In network

Out-of-network




Deductible: $500.00

Met to date: $50.00

Deductible: $50.00

Met to date: $50.00






Deductible: $500.00

Met to date: $50.00


Met to date: $50.00



Deductible: $50.00


CLOSE


Network: PDP Plus


Insured Name !


Group DentalPDP PlusProvided by INPRS

I want to… !

"Policy Information

#














+



In network

Out-of-network




Deductible: $500.00

Met to date: $50.00

Deductible: $50.00

Met to date: $50.00






Deductible: $500.00

Met to date: $50.00


Met to date: $50.00



Deductible: $50.00


CLOSE


Network: PDP Plus


Insured Name !



I want to… !

"Policy Information

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I want to… !


claim is processed.














General Information







Co-pay: Yes


""

Policy Coverages




Orthodontics





Benefit Information

Name Effective Date





DETAILS

LEARN MORE



from your plan!



PRINT CARDS

ID Cards


Network PDP Plus

Name David Faulkner




LEARN MORE



Recommend a Dentist

ADD A DENTIST


+

−

Your Network BenefitsYour dental plan is designed to help protect your dental health and make it more affordable to see your dentist regularly. You can go to any licensed dentist — in or out of the network. The choice is yours.

Just remember that staying in-network helps you stretch your plan maximums and get more savings from our dental benefits.

A participating dentist has agreed to accept negotiated fees as payment in full for services provided to plan members. Negotiated fees typically range from 15% - 45%* below the average fees charged in a dentist’s community for the same or substantially similar services.


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Custom Network

Out-of-Network


In Network




Savings

CLOSE





I want to… !


claim is processed.














General Information







Co-pay: Yes


""

Policy Coverages




Orthodontics





Benefit Information

Name Effective Date





DETAILS

LEARN MORE



from your plan!



PRINT CARDS

ID Cards


Network PDP Plus

Name David Faulkner




LEARN MORE

News & Updates Except as otherwise required by state law, the Carestream dental options allow associates to provide dental coverage for their unmarriedchildren who are (1) under the age of 19, or (2) qualified students under the age of 23. If you have any questions regarding dependent eligibility, please contact Carestream HR Services at 1-800-234-6229.


Recommend a Dentist

ADD A DENTIST


+

−








Custom Network

Out-of-Network


In Network




Savings

CLOSE

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I want to… !


claim is processed.














General Information







Co-pay: Yes


"


?

Policy Coverages




Orthodontics





Benefit Information

Name Effective Date





DETAILS

LEARN MORE



from your plan!



PRINT CARDS

ID Cards


Network PDP Plus

Name David Faulkner




LEARN MORE

News & Updates


Recommend a Dentist

ADD A DENTIST


+

−








Custom Network

Out-of-Network


In Network




Savings



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color: #333333 100%font-size: 18pxfont-face: FontAwesome− fa-minus []

color: #333333 100%font-size: 18pxfont-face: FontAwesome+ fa-plus []

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See Metlife Pattern Library:

ux.metlife.com

For link behavior, specs and code.

Retain color for link as shown here.

color: #333333 100%font-size: 16pxfont-face: NotoSans-Boldcharacter: 0pxline: 22px (1.4)







I want to… !

+

−

Your Network BenefitsYour dental plan is designed to help protect your dental health and make it more affordable to see

your dentist regularly. You can go to any licensed dentist — in or out of the network. The choice is

yours.

Just remember that staying in-network helps you stretch your plan maximums and get more savings

from our dental benefits.











Benefit programs offered by MetLife and its affiliates contain certain exclusions, exceptions, waiting periods, reductions,

limitations and terms for keeping them in force. Contact MetLife or your plan administrator for more details.

Custom Network

Out-of-Network


In Network




Savings

CLOSE

!

CLOSE

+

−

Your Network BenefitsYour dental plan is designed to help protect

your dental health and make it more

affordable to see your dentist regularly. You

can go to any licensed dentist — in or out of

the network. The choice is yours.

Just remember that staying in-network

helps you stretch your plan maximums and

get more savings from our dental benefits.

A participating dentist has agreed to accept

negotiated fees as payment in full for

services provided to plan members.

Negotiated fees typically range from 15% -

45%* below the average fees charged in a

dentist’s community for the same or

substantially similar services.








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adipisicing elit, sed do eiusmod tempor

incididunt ut labore et

dolore magna aliqua. Ut enim ad minim

veniam, quis nostrud exercitation ullamco

laboris nisi ut aliquip.



incididunt ut labore et dolore magna aliqua.

Ut enim ad minim veniam, quis nostrud

exercitation ullamco laboris nisi ut aliquip.

Benefit programs offered by MetLife and its

affiliates contain certain exclusions, exceptions,

waiting periods, reductions, limitations and terms

for keeping them in force. Contact MetLife or your

plan administrator for more details.

Custom Network

Out-of-Network


In Network




Savings

CLOSE

+

−

Your Network BenefitsYour dental plan is designed to help protect

your dental health and make it more

affordable to see your dentist regularly. You

can go to any licensed dentist — in or out of

the network. The choice is yours.

Just remember that staying in-network

helps you stretch your plan maximums and

get more savings from our dental benefits.

















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dolore magna aliqua. Ut enim ad minim

veniam, quis nostrud exercitation ullamco

laboris nisi ut aliquip.



incididunt ut labore et dolore magna aliqua.

Ut enim ad minim veniam, quis nostrud

exercitation ullamco laboris nisi ut aliquip.

Benefit programs offered by MetLife and its

affiliates contain certain exclusions, exceptions,

waiting periods, reductions, limitations and terms

for keeping them in force. Contact MetLife or your

plan administrator for more details.

Custom Network

Out-of-Network


In Network




Savings

270px







OrthodonticsBACK

D2335

D2392

D2394

D2940

Resin - Four or More Surfaces, Or Involving Incisal Angle (Anterior)

Resin-Based Composite - Two Surfaces, Posterior

Resin - Four or More Surfaces Posterior

Protective Restoration +

+

+

+

Procedure NameProcedure Code

Procedure codes are based on current dental terminology © American Dental Association.

Frequency Limitation: 1 time in 24 months

Initial Orthodontic Placement:

In Network: 25%

Out of Network: 25%

Ongoing Orthodontic Placement:

In Network: 25%

Out of Network: 25%

Maximum age for Orthodontics:

Dependent Child: Up to age 19

Dependent Child (full-time student): Up to age 23

All Others: No age limit

Remaining benefits for the appliance adjustment visits will be paid automatically on a periodic basis provided that the patient is still eligible for coverage, active treatment is still being rendered, and the lifetime orthodontic maximum benefits have not been exceeded.

Last date of Service: <mm/dd/yyyy>

Deals with the study and supervision of the growth and development of teeth. Orthodontic services include the preventive and corrective treatment for irregularities in the alignment of teeth and supporting structures. Orthodontic treatments may include braces or retainers. Treatment can be performed on baby teeth, permanent teeth or a combination (mixed dentition).

Coverages for: Kevin Millington !


Specifically, MetLife will pay an initial appliance component (banding fee) based on 20% of the submitted expense, at the 50% coinsurance level: $5,000 (submitted expense) x 20% = $1,000 x 50% benefit = $500 The first payment will be $500. The remaining expense will be spread over the expected length of treatment. (Citi)

View Plan Coverage Notes +

CLOSE


I want to… !

CoveragesPolicy Information Claim History Common Questions

You’re now leaving MetLifeChoose OK to continue or cancel to stay on this page.

CancelOK










Composites / Fillings

X-rays of a patients full mouth either individual x-rays (full mouth series)or one film (panotrex).

DETAILS



Deep Sedation / General ANES

X-rays of a patients full mouth either individual x-rays (full mouth series)or one film (panotrex). X-rays of a patients full mouth either individual…

DETAILS



Endodontics / Root Canal


DETAILS



Implants and Supported Prosphetics


DETAILS



Crown Repair


DETAILS



Denture


DETAILS


DETAILS


Extractions



DETAILS


Inlay / Onlay


View Only Routine ProceduresCoverages for: David Millington !




I want to… !













DETAILS





DETAILS





DETAILS





DETAILS



Crown Repair


DETAILS



Denture


DETAILS


DETAILS


Extractions



DETAILS


Inlay / Onlay






I want to… !


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DETAILS





DETAILS





DETAILS



Crown Repair


DETAILS



Denture


DETAILS


DETAILS


Extractions



DETAILS


Inlay / Onlay






I want to… !


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I want to… !

Coverages for: David Millington !

Composites/FillingsDETAILS

X-rays of a patients full mouth either

individual x-rays (full mouth series) or

one film (panotrex).


DETAILS



one film (panotrex). X-rays of patients…

Endodontics / Root CanalDETAILS





DETAILS




Crown RepairDETAILS




DentureDETAILS




ExtractionsDETAILS




Inlay / OnlayDETAILS





processed.









veneers, bridgework, implants, orthodontics,or periodontal services. Learn more about how to request a pretreatment estimate.

View Only Routine Procedures

"Coverages









I want to… !







DETAILS









DETAILS




Crown RepairDETAILS




DentureDETAILS




ExtractionsDETAILS









processed.











"Coverages





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I want to… !


"Coverages

Eligibility is not a guarantee of coverage as actual

benefit payments are determined only when a

claim is processed.

If MetLife determines that a less costly service than

the covered service performed by a dentist could

have been performed to treat a dental condition,

MetLife may pay benefits based upon the less

costly service if such service 1) Would produce a

professionally acceptable result under generally

accepted dental standards, and 2) Would qualify as

a covered service.

If MetLife pays a benefit based upon a less costly

service, the dentist may charge a patient or a

patient's dependent for the difference between the

service that was performed and the less costly

service. This may be the case, even if the service is


A pretreatment estimate is recommended before

the start of extensive dental treatment such as

crowns, veneers, bridgework, implants,

orthodontics,or periodontal services. Learn more about how to request a pretreatment estimate.



DETAILS

DentureDETAILS


ExtractionsDETAILS


Occusal GuardsDETAILS

Oral ExamsDETAILS

Oral SurgeryDETAILS

OrthodonticsDETAILS

Paliative TreatmentDETAILS

Periodontal Maintenance

DETAILS


DETAILS

© 2015 MetLife MetLife Term Life Insurance issued

by MetLife Insurance Company USA, Charlotte, NC,

28277 (except in NY), on policy form #5E-23-12, and

by Metropolitan Life Insurance Company, New

York, NY 10166 (NY only), on policy form #1E-23-12-




#



I want to… !


"Coverages

Eligibility is not a guarantee of coverage as actual

benefit payments are determined only when a

claim is processed.

If MetLife determines that a less costly service than

the covered service performed by a dentist could

have been performed to treat a dental condition,

MetLife may pay benefits based upon the less

costly service if such service 1) Would produce a

professionally acceptable result under generally

accepted dental standards, and 2) Would qualify as

a covered service.

If MetLife pays a benefit based upon a less costly

service, the dentist may charge a patient or a

patient's dependent for the difference between the

service that was performed and the less costly

service. This may be the case, even if the service is


A pretreatment estimate is recommended before

the start of extensive dental treatment such as

crowns, veneers, bridgework, implants,

orthodontics,or periodontal services. Learn more about how to request a pretreatment estimate.



DETAILS

DentureDETAILS


ExtractionsDETAILS


Occusal GuardsDETAILS

Oral ExamsDETAILS

Oral SurgeryDETAILS

OrthodonticsDETAILS

Paliative TreatmentDETAILS

Periodontal Maintenance

DETAILS


DETAILS

© 2015 MetLife MetLife Term Life Insurance issued

by MetLife Insurance Company USA, Charlotte, NC,

28277 (except in NY), on policy form #5E-23-12, and

by Metropolitan Life Insurance Company, New

York, NY 10166 (NY only), on policy form #1E-23-12-




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10px

#




D2332

D2335

D2390

D2391

D2392

D2392

D2394

D2410

D2420

D2430

D2940

Resin - Three Surface, Anterior


Resin - Based Composite Crown, Anterior

Resin-Based Composite - One Surface, Posterior


Resin-Based Composite - Three Surfaces, Posterior


Gold Foil - One Surface

Gold Foil - Two Surfaces

Gold Foil- Three Surfaces


+

+

+

+

+

+

+

+

+

+

+D2331 Resin - Two Surface, Anterior

++SHOW MORED2330 Resin - One Surface, Anterior




CLOSECLOSE







Showing coverage details for zip code 07946

If this is not your dentist’s zip code, please update zip code

X-rays of a patients full mouth either individual x-rays(full mouth series) or one film (panotrex).


Dentist’s Zip Code SAVE

Please Note: Benefits are not paid in a lump sum as 20% of the submitted total fee is reimbursed at 50%. Payments are made

quarterly over the treatment plan outlined from the orthodontist.

Specifically, MetLife will pay an initial appliance component (banding fee) based on 20% of the submitted expense,

at the 50% coinsurance level: $5,000 (submitted expense) x 20% = $1,000 x 50% benefit = $500


Composites / FillingsBACK


I want to… !





Individual

In Network Out of Network

Benefit Period

Met-to-Date

Lifetime

Met-to-Date

$50

$0

$0

Not Applicable

$50

$0

$0

Not Applicable

Individual


Benefit Period

Used-to-Date

Lifetime

Used-to-Date

$1,500

$0

$0

$0

$1,500

$0

$0

$0

Family


Benefit Period

Met-to-Date

Lifetime

Met-to-Date

$50

$0

$0

Not Applicable

$50

$0

$0

Not Applicable

Family


Benefit Period

Used-to-Date

Lifetime

Used-to-Date

$0

$0

$0

$0

$0

$0

$0

$0

These values may increase in the next year. This information is as of <mm/dd/yyyy>.The maximums may be combined with other types of procedures, such as TMJ and Periodontal.

Maximum Benefits

Deductibles

Benefit Level

In Network: 80%Out of Network: 80%

D2330 Resin - One Surface, Anterior −

D2331

D2332

D2335

D2390

D2391

D2392

D2392

D2394

D2410

D2420

D2430

D2940

Resin - Two Surface, Anterior












+

+

+

+

+

+

+

+

+

+

+





CLOSE







Showing coverage details for zip code 07946If this is not your dentist’s zip code, please update zip code


Coverages for: David Millington "





patient's dependent for the difference between the service that was performed and the less

costly service. This may be the case, even if the service is performed by an in-network dentist.

A pretreatment estimate is recommended before the start of extensive dental treatment such

as crowns, veneers, bridgework, implants, orthodontics,or periodontal services. Learn more



patient's dependent for the difference between the service that was performed and the less

costly service. This may be the case, even if the service is performed by an in-network dentist.

A pretreatment estimate is recommended before the start of extensive dental treatment such

as crowns, veneers, bridgework, implants, orthodontics,or periodontal services. Learn more


Plan Coverage Notes −

CLOSE



I want to… "





Individual


Benefit Period

Met-to-Date

Lifetime

Met-to-Date

$50

$0

$0

Not Applicable

$50

$0

$0

Not Applicable

Individual


Benefit Period

Used-to-Date

Lifetime

Used-to-Date

$1,500

$0

$0

$0

$1,500

$0

$0

$0

Family


Benefit Period

Met-to-Date

Lifetime

Met-to-Date

$50

$0

$0

Not Applicable

$50

$0

$0

Not Applicable

Family


Benefit Period

Used-to-Date

Lifetime

Used-to-Date

$0

$0

$0

$0

$0

$0

$0

$0


Maximum Benefits

Deductibles

Benefit Level



D2331

D2332

D2335

D2390

D2391

D2392

D2392

D2394

D2410

D2420

D2430

D2940













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CLOSE















I want to… "





Individual


Benefit Period

Met-to-Date

Lifetime

Met-to-Date

$50

$0

$0

Not Applicable

$50

$0

$0

Not Applicable

Individual


Benefit Period

Used-to-Date

Lifetime

Used-to-Date

$1,500

$0

$0

$0

$1,500

$0

$0

$0

Family


Benefit Period

Met-to-Date

Lifetime

Met-to-Date

$50

$0

$0

Not Applicable

$50

$0

$0

Not Applicable

Family


Benefit Period

Used-to-Date

Lifetime

Used-to-Date

$0

$0

$0

$0

$0

$0

$0

$0


Maximum Benefits

Deductibles

Benefit Level



D2331

D2332

D2335

D2390

D2391

D2392

D2392

D2394

D2410

D2420

D2430

D2940













+

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CLOSE















I want to… "

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252px

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1020px

37px20px

20px20px

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16px

20px 20px

980px

42px

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Individual


Benefit Period

Met-to-Date

Lifetime

Met-to-Date

$50

$0

$0

Not Applicable

$50

$0

$0

Not Applicable

Individual


Benefit Period

Used-to-Date

Lifetime

Used-to-Date

$1,500

$0

$0

$0

$1,500

$0

$0

$0

Family


Benefit Period

Met-to-Date

Lifetime

Met-to-Date

$50

$0

$0

Not Applicable

$50

$0

$0

Not Applicable

Family


Benefit Period

Used-to-Date

Lifetime

Used-to-Date

$0

$0

$0

$0

$0

$0

$0

$0


Maximum Benefits

Deductibles

Benefit Level



D2331

D2332

D2335

D2390

D2391

D2392

D2392

D2394

D2410

D2420

D2430

D2940













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CLOSE















I want to… "

fill: #0090DA 100%opacity: 100%radius: 0px

fill: #A4CE4E 100%opacity: 100%radius: 0px

border: 2px inside* #A4CE4E 100%opacity: 100%radius: 0px

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color: #333333 100%font-size: 13pxfont-face: Noto Sans Bold

color: #333333 100%font-size: 16pxfont-face: Noto Sans Bold

fill: #007ABC 100%opacity: 100%radius: 0px


border: 1px center* #333333 100%opacity: 100%

color: #333333 100%font-size: 13pxfont-face: NotoSanscharacter: 0.1pxline: 17px (2.8)paragraph: 20px

border: 1px center* #CCCCCC 100%opacity: 100%


color: #333333 100%font-size: 18pxfont-face: Font Awesome+ fa-plus []

color: #333333 100%font-size: 18pxfont-face: Font Awesome− fa-minus []


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border: 1px center* #0090DA 100%opacity: 100%

color: #0061A0 100%font-size: 14pxfont-face: NotoSans-Bold

color: #333333 100%font-size: 13pxfont-face: NotoSans Regular / Boldcharacter: 0.3pxline: 17px (1.3)

color: #333333 100%opacity: 100%font-size: 15pxfont-face: NotoSans-Boldcharacter: 0pxline: 20px (1.3)

BOX:fill: #F2F2F2 100%opacity: 100%radius: 0px

border: 1px center* #CCCCCC 100%opacity: 100%

color: #FFFFFF 100%opacity: 100%font-size: 16pxfont-face: Georgia-Bold






I want to… !







DETAILS









DETAILS




Crown RepairDETAILS




DentureDETAILS




ExtractionsDETAILS









processed.











"Coverages





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Please Note: Benefits are not paid in a

lump sum as 20% of the submitted total

fee is reimbursed at 50%. Payments are

made quarterly over the treatment plan

outlined from the orthodontist.

Specifically, MetLife will pay an initial

appliance component (banding fee) based

on 20% of the submitted expense, at the

50% coinsurance level:$5,000 (submitted expense) x 20% = $1,000 x 50% benefit = $500

The first payment will be $500. The

remaining expense will be spread over the

expected length of treatment. (Citi)

Showing coverage details for zip code 07946If this is not your dentist’s zip code, please

update zip code



Dentist’s Zip Code

SAVE

D2331

D2332

D2335

D2390

D2391

D2392

D2392

D2394

D2410

D2420

D2430

D2940



Resin - Four or More Surfaces, Or Involving

Incisal Angle (Anterior)










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Deductibles

Maximum Benefits

Individual

In Network

Out of Network

BenefitPeriodMet-to-Date

Lifetime

Met-to-Date

$50

$0

$0

Not

Applicable

$50

$0

$0

Not

Applicable

Family

In Network

Out ofNetwork


Lifetime

Met-to-Date

$50

$0

$0

Not

Applicable

$50

$0

$0

Not

Applicable

Individual

In Network

Out of Network

BenefitPeriodUsed-to-Date

Lifetime

Used-to-Date

$1,500

$0

$0

$0

$1,500

$0

$0

$0

Family

In Network

Out of Network


Lifetime

Used-to-Date

$0

$0

$0

$0

$0

$0

$0

$0

Benefit Level


−Collapse this section


D2330 Resin - One Surface, Anterior


−



individual x-rays (full mouth series) or one

film (panotrex).


CLOSE





I want to… !







DETAILS









DETAILS




Crown RepairDETAILS




DentureDETAILS




ExtractionsDETAILS









processed.











"Coverages





25px

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update zip code




SAVE

D2331

D2332

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D2390

D2391

D2392

D2392

D2394

D2410

D2420

D2430

D2940














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Deductibles

Maximum Benefits

Individual

In Network

Out of Network


Lifetime

Met-to-Date

$50

$0

$0

Not

Applicable

$50

$0

$0

Not

Applicable

Family

In Network

Out of Network


Lifetime

Met-to-Date

$50

$0

$0

Not

Applicable

$50

$0

$0

Not

Applicable

Individual

In Network

Out of Network


Lifetime

Used-to-Date

$1,500

$0

$0

$0

$1,500

$0

$0

$0

Family

In Network

Out of Network


Lifetime

Used-to-Date

$0

$0

$0

$0

$0

$0

$0

$0

Benefit Level






−




film (panotrex).


CLOSE

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SAVE




Deductibles

Maximum Benefits

+

Procedure Code:D2331Procedure Name:Resin - One Surface, Anterior

+

Procedure Code:D2332Procedure Name:Resin - Three Surface, Anterior

+

Procedure Code:D2335Procedure Name:Resin - Four or More Surfaces, Or Involving Incisal Angel (Anterior)

+


CLOSE

Individual

In Network

Out of Network


Lifetime

Met-to-Date

$50

$0

$0

NotApplicable

$50

$0

$0

NotApplicable

Family

In Network

Out of Network


Lifetime

Met-to-Date

$50

$0

$0

NotApplicable

$50

$0

$0

NotApplicable

Individual

In Network

Out of Network


Lifetime

Used-to-Date

$1,500

$0

$0

$0

$1,500

$0

$0

$0

Family

In Network

Out of Network


Lifetime

Used-to-Date

$0

$0

$0

$0

$0

$0

$0

$0

Benefit Level



−



+


X-rays of a patients full mouth eitherindividual x-rays (full mouth series) or onefilm (panotrex).

Composites/FillingsBACK


I want to… "

#Coverages

$













SAVE




Deductibles

Maximum Benefits

+


+

Procedure Code:D2332Procedure Name:Resin - Three Surface, Anterior

+

Procedure Code:D2335Procedure Name:Resin - Four or More Surfaces, Or Involving Incisal Angel (Anterior)

+


CLOSE

Individual

In Network

Out of Network


Lifetime

Met-to-Date

$50

$0

$0

NotApplicable

$50

$0

$0

NotApplicable

Family

In Network

Out of Network


Lifetime

Met-to-Date

$50

$0

$0

NotApplicable

$50

$0

$0

NotApplicable

Individual

In Network

Out of Network


Lifetime

Used-to-Date

$1,500

$0

$0

$0

$1,500

$0

$0

$0

Family

In Network

Out of Network


Lifetime

Used-to-Date

$0

$0

$0

$0

$0

$0

$0

$0

Benefit Level



−



+


X-rays of a patients full mouth eitherindividual x-rays (full mouth series) or onefilm (panotrex).

Composites/FillingsBACK


I want to… "

#Coverages

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OrthodonticsBACK

D2335

D2392

D2394

D2940





+

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In Network: 25%

Out of Network: 25%


In Network: 25%

Out of Network: 25%












CLOSE


I want to… !







OrthodonticsBACK

D2335

D2392

D2394

D2940





+

+

+





In Network: 25%

Out of Network: 25%


In Network: 25%

Out of Network: 25%












CLOSE


I want to… !

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Acme Co. Group Message. Neque porro quisquam est qui dolorem ipsum

quia dolor sit amet, consectetur.

LEARN MORE

Headline

Email a SpecialistGet support for your dental insurance questions.

Send questions to [email protected]

<1-xxx-xxx-xxxx><Monday - Friday>

<08:00 AM to 11:00 PM ET>

Send <Claims, Billing, etc> questions to<MetLife address name>

<Address line 1><Address line 2><City, State, Zip>

Email

Phone

Fax

Mail

SEND AN EMAIL

<1-xxx-xxx-xxxx>

What is the Explanation of Benefits (EOB) statement?

Question

Question

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−

+

+

Does this answer your question?

Yes

No

Lorem ipsum dolor sit amet, consectetur adipiscing elit. Aenean euismod bibendum laoreet. Proin gravida dolor sit amet lacus accumsan et viverra justo commodo. Proin sodales pulvinar tempor. Cum sociis natoque penatibus et magnis dis parturient montes, nascetur ridiculus mus. Nam fermentum, nulla luctus pharetra vulputate, felis tellus mollis orci, sed rhoncus sapien nunc eget odio.

Learn More About Your Dental Insurance

I want to… "

Common QuestionsPolicy Information Coverages Claim History









LEARN MORE

Headline




<08:00 AM to 11:00 PM ET>



Email

Phone

Fax

Mail

SEND AN EMAIL

<1-xxx-xxx-xxxx>


Question

Question

Expand all

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+

+


Yes

No



I want to… "



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LEARN MORE

Headline




<08:00 AM to 11:00 PM ET>



Email

Phone

Fax

Mail

SEND AN EMAIL

<1-xxx-xxx-xxxx>


Question

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+


Yes

No



I want to… "



color: #333333 100%font-size: 35pxfont-face: Georgia-Boldcharacter: 0.3pxline: 40px (1.1)

color: #007ABC 100%\font-size: 12pxfont-face: NotoSans-Boldcharacter: 0px

color: #007ABC 100%\font-size: 14pxfont-face: NotoSans-Boldcharacter: 0pxline: 19px


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color: #333333 100%font-size: 14pxfont-face: NotoSans-Bold





I want to… !

"Common Questions






Question

Question

Expand all

−

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Yes

No





<08:00 AM to 11:00 PM ET>



Email

Phone

Fax

Mail

SEND AN EMAIL

<1-xxx-xxx-xxxx>



LEARN MORE

Headline





I want to… !

"Common Questions






Question

Question

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+

+


Yes

No





<08:00 AM to 11:00 PM ET>



Email

Phone

Fax

Mail

SEND AN EMAIL

<1-xxx-xxx-xxxx>



LEARN MORE

Headline

color: #333333 100%font-size: 28pxfont-face: Georgia-Boldcharacter: 0.2px

30px

30px

30px

50px

610px

354px

30px

79px79px







Question

Question

Expand all

−

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Yes

No




LEARN MORE

Headline

Email a Specialist



<08:00 AM to 11:00 PM ET>



Email

Phone

Fax

Mail

SEND AN EMAIL

<1-xxx-xxx-xxxx>

Get support for your dental insurance questions.



I want to… "

#Common Questions

$







Question

Question

Expand all

−

+

+


Yes

No




LEARN MORE

Headline

Email a Specialist



<08:00 AM to 11:00 PM ET>



Email

Phone

Fax

Mail

SEND AN EMAIL

<1-xxx-xxx-xxxx>

Get support for your dental insurance questions.



I want to… "

#Common Questions

20px

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$




Be sure you and your family finish all in-progress dental work before changing dental offices. (Check the “Evidence of Coverage” included with your enrollment materials for more information.)

David Faulkner

Joan Faulkner

Sean Faulkner

SUBMITCancel

You chose this dental office:

<Facility Name>

<Facility ID><Address 1><Address 2><City>, <State> <Zip><###-###-####>

Assign family members to this dental office.

Choose a Dental Office

Please check the information below.!

Please choose a least one family member.





David Faulkner

Joan Faulkner

Sean Faulkner

SUBMITCancel


<Facility Name>






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David Faulkner

Joan Faulkner

Sean Faulkner

SUBMITCancel


<Facility Name>







color: #333333 100%font-size: 14pxfont-face: NotoSans Regular/Boldcharacter: 0pxline: 19px (1.4)


color: #DB1818 100%font-size: 20pxfont-face: FontAwesomefa-exclamation-circle []character: 0pxline: 20px (1)

color: #333333 100%font-size: 14pxfont-face: Noto Sans Boldcharacter: 0pxline: 15px (1.2)

fill: #FDE8E8 100%opacity: 100%radius: 0px

color: #DB1818 100%opacity: 100%font-size: 13pxfont-face: NotoSans








LEARN MORE

Headline




<08:00 AM to 11:00 PM ET>



Email

Phone

Fax

Mail

SEND AN EMAIL

<1-xxx-xxx-xxxx>


Question

Question

Expand all

−

+

+


Yes

No



I want to… "



Send a Message by Email

Send us your product, policy, or account-related questions below.

We respond to all technical and/or security-related issues by phone rather than email. Call us at 1-XXX-XXX-XXXX.

All fields are required unless noted.

Tell us your name and email so we can reply to you:

Message

Your name

Email address

Send a copy to your email address.

CancelSEND





If MetLife determines that a less costly service than the covered service performed by a dentist could have been performed to treat a dental condition, MetLife may paybenefits based upon the less costly service if such service 1) Would produce a professionally acceptable result under generally accepted dental standards, and 2)Would qualify as a covered service.


A pretreatment estimate is recommended before the start of extensive dentaltreatment such as crowns, veneers, bridgework, implants, orthodontics,or periodontalservices. Learn more about how to request a pretreatment estimate.




X-rays of a patients full mouth either individual x-rays (full mouth series) or one film (panotrex).

DETAILS





DETAILS





DETAILS





DETAILS



Crown Repair


DETAILS



Denture


DETAILS


DETAILS


Extractions



DETAILS


Inlay / Onlay






I want to… !


Individual


Benefit Period

Met-to-Date

Lifetime

Met-to-Date

$50

$0

$0

Not Applicable

$50

$0

$0

Not Applicable

Individual


Benefit Period

Used-to-Date

Lifetime

Used-to-Date

$1,500

$0

$0

$0

$1,500

$0

$0

$0

Family


Benefit Period

Met-to-Date

Lifetime

Met-to-Date

$50

$0

$0

Not Applicable

$50

$0

$0

Not Applicable

Family


Benefit Period

Used-to-Date

Lifetime

Used-to-Date

$0

$0

$0

$0

$0

$0

$0

$0


Maximum Benefits

Deductibles

Benefit Level

In Network: 80%

Out of Network: 80%


D2331

D2332

D2335

D2390

D2391

D2392

D2392

D2394

D2410

D2420

D2430

D2940













+

+

+

+

+

+

+

+

+

+

+





CLOSE










Please Note:

Benefits are not paid in a lump sum as 20% of the submitted total fee is reimbursed at 50%. Payments are made quarterly over the treatment plan outlined from the orthodontist.




Email a PDF of procedures covered under David Millington’s plan.


Choose the categories of procedures to include:

Select all

Email Coverage Information

To:

Please enter a valid email address

CC (Optional)

Message (Optional)

Composites/Fillings

Crown Repair

Deep Sedation/ General ANES

Denture

Endodontics

ExtractionsChoosing a category is required

CancelSEND

Please check the information below.#












DETAILS





DETAILS





DETAILS





DETAILS



Crown Repair


DETAILS



Denture


DETAILS


DETAILS


Extractions



DETAILS


Inlay / Onlay






I want to… !


Individual


Benefit Period

Met-to-Date

Lifetime

Met-to-Date

$50

$0

$0

Not Applicable

$50

$0

$0

Not Applicable

Individual


Benefit Period

Used-to-Date

Lifetime

Used-to-Date

$1,500

$0

$0

$0

$1,500

$0

$0

$0

Family


Benefit Period

Met-to-Date

Lifetime

Met-to-Date

$50

$0

$0

Not Applicable

$50

$0

$0

Not Applicable

Family


Benefit Period

Used-to-Date

Lifetime

Used-to-Date

$0

$0

$0

$0

$0

$0

$0

$0


Maximum Benefits

Deductibles

Benefit Level

In Network: 80%

Out of Network: 80%


D2331

D2332

D2335

D2390

D2391

D2392

D2392

D2394

D2410

D2420

D2430

D2940













+

+

+

+

+

+

+

+

+

+

+





CLOSE










Please Note:





OK

Success! Your information has been sent













DETAILS





DETAILS





DETAILS





DETAILS



Crown Repair


DETAILS



Denture


DETAILS


DETAILSExtractions

X-rays of a patients full mouth eithe ll mouth series)or one film (panotrex).


DETAILS


Inlay / Onlay






I want to… !


Individual


Benefit Period

Met-to-Date

Lifetime

Met-to-Date

$50

$0

$0

Not Applicable

$50

$0

$0

Not Applicable

Individual


Benefit Period

Used-to-Date

Lifetime

Used-to-Date

$1,500

$0

$0

$0

$1,500

$0

$0

$0

Family


Benefit Period

Met-to-Date

Lifetime

Met-to-Date

$50

$0

$0

Not Applicable

$50

$0

$0

Not Applicable

Family


Benefit Period

Used-to-Date

Lifetime

Used-to-Date

$0

$0

$0

$0

$0

$0

$0

$0


Maximum Benefits

Deductibles

Benefit Level

In Network: 80%

Out of Network: 80%


D2331

D2332

D2335

D2390

D2391

D2392

D2392

D2394

D2410

D2420

D2430

D2940













+

+

+

+

+

+

+

+

+

+

+





CLOSE










Please Note:





Email a PDF of procedures covered under David Millington’s plan.


Choose the categories of procedures to include:

Select all


To:


CC (Optional)

Message (Optional)

Composites/Fillings

Crown Repair


Denture

Endodontics

ExtractionsChoosing a category is required

CancelSEND

Please check the information below.#

25px

25px

25px

25px

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I want to… !







DETAILS









DETAILS




Crown RepairDETAILS




DentureDETAILS




ExtractionsDETAILS









processed.











"Coverages





25px

25px10px10px

30px

290px

65px

20px20px

20px


79px 79px

610px


















update zip code




SAVE

D2331

D2332

D2335

D2390

D2391

D2392

D2392

D2394

D2410

D2420

D2430

D2940














+

+

+

+

+

+

+

+

+

+

+




Deductibles

Maximum Benefits

Individual

In Network

Out of Network


Lifetime

Met-to-Date

$50

$0

$0

Not

Applicable

$50

$0

$0

Not

Applicable

Family

In Network

Out of Network


Lifetime

Met-to-Date

$50

$0

$0

Not

Applicable

$50

$0

$0

Not

Applicable

Individual

In Network

Out of Network


Lifetime

Used-to-Date

$1,500

$0

$0

$0

$1,500

$0

$0

$0

Family

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