Benefits Logo

TIS EPISD
Get Firefox

Safe Guard

2013 - 2014 Dental Plans

EPISD is please to continue offering MetLife Dental Plans. Select from one of three Plan Options that best meets your needs.

Dental HMO Plan TX-300

  • No waiting periods, claim forms, deductibles or calendar year maximums.
  • It is your responsibility to manage your dental care. 
  • Prior to receiving services, you should review the benefits summary for covered services and co-payments. (Co–payments apply only when services are performed by your selected Metlife general dentist.
  • Orthodontics and specialty care will have a 70% co-payment of dentist’s usual fee for those services.
  • No Out-of-Network benefits are available under this plan.
  • Benefits available only through the network of participating providers.
    DHMO Provider ListPDF Document
    DHMO Specialty Referral ProcessPDF Document

Safeguard Customer Service 1-800-880-1800

  

  Monthly Semi-monthly
Employee Only $ 8.34 $4.17
Employee & One $13.90 $6.95
E & Children $16.14 $8.07
E & Family $19.48 $9.74

MetLife Low Plan
MetLife Customer Service 1-800-942-0854

  • Calendar year Maximum - $1,000
  • Implants are a covered benefit
  • Orthodontia Lifetime Maximum - $1,000 per person
  • Reimburses for covered procedures based on the plan’s schedule of benefits after a $50 annual deductible per person or $150 annual deductible per family is met. 
  • Review the Plan Summary of Benefits prior to enrolling, to obtain a list of procedures that are covered and the reimbursement amount.
  • After claim has been filed Metlife will reimburse the employee for covered procedures (based on the Schedule of Reimbursements)
  • Plan allows for you to receive care from any licensed dental care provider.
  • Lower your out of pocket cost by 10 to 35% by using a provider under the "Preferred Provider Program"

NEW! 2013-2014 RATES

  Monthly Semi-Monthly
Employee Only $15.16 $7.58
Employee & One $30.34 $15.17
E & Children $30.94 $15.47
E & Family $46.12 $23.06

MetLife High Plan
MetLife Customer Service 1-800-942-0854
  

  • Using a Metlife PPO contracted dentist lowers your out-of-pocket expenses.
  • Treatment procedures are categorized into 4 different classes and the plan pays a specific percentage of the treatment cost for class.
  • Calendar year Maximum - $1,000
  • $50 annual deductible per person or $150 annual deductible per family
  • Plan allows for you to receive care from any licensed dental care provider.
  • Lower your out of pocket cost by 10 to 35% by using a provider under the "Preferred Provider Program"

NEW! 2013-2014 RATES

  Monthly Semi-monthly
Employee Only $22.26 $11.13
Employee & One $44.54 $22.27
E & Children $45.44 $22.72
E & Family $67.72 $33.86

www.metlife.com