MMC Benefits Handbook
The Plan at a Glance
Plan Feature
Premier Dental Option
Standard Dental Option
 
In-Network
Out-of-Network
In-Network
Out-of-Network
Annual Deductible
Individual: $25 per calendar year
Family: $75 per calendar year
Individual: $25 per calendar year
Family: $75 per calendar year
Individual: $50 per calendar year
Family: $150 per calendar year
Individual: $50 per calendar year
Family: $150 per calendar year
Plan Payment
Preventive and diagnostic—100%
Basic Restorative—80%
Major Restorative—50%
Preventive and diagnostic—100% of reasonable and customary charges (R&C)
Basic Restorative—80% of R&C after deductible
Major Restorative—50% of R&C after deductible
Preventive and diagnostic—100%
Basic Restorative—80%
Major Restorative—50%
Preventive and diagnostic—100% of reasonable and customary charges (R&C)
Basic Restorative—80% of R&C after deductible
Major Restorative—50% of R&C after deductible
Orthodontia
50%
50% of R&C
Not covered
Orthodontia lifetime maximum
$2,500 per covered individual (combined in-network and out-of-network)
N/A
Annual maximum
$2,500 per covered individual (combined in-network and out-of-network)
$1,500 per covered individual (combined in-network and out-of-network)
Lifetime maximum
None
None
None
None
Contact Information
For Dental Services:
MetLife Dental Claims (Claims Administrator)
P.O. Box 981282
El Paso, TX 79998-1282
Phone: +1 800 942 0854
www.metlife.com/mybenefits (Enter "Marsh & McLennan Companies, Inc." in the Account Sign in box for your company name. Then click Dental Benefits.)
Marsh & McLennan Companies does not administer this Plan. MetLife's decisions are final and binding.