United Airlines AFA MEC Website

Association of Flight Attendants-CWA United Master Executive Council

Dental Plan Information

Date: July 6, 2016
Type: AFA Article

-Required Dental Plan: Traditional Dental PPO (Core Dental Plan)
-Optional Plans

2017* You Only You + Spouse You + Child(ren) You + Family
Traditional Dental PPO $9.58 $20.14 $21.12 $31.67
Aetna Dental HMO $4.33 $9.10 $8.24 $13.00

*Rates for 2017 and beyond are not yet available. Numbers used are approximations for illustration purposes.

APPENDIX B – PLAN DESIGN FOR CORE DENTAL PLAN

Benefit Features Core PPO Dental Benefits
In-network: Out-of-network:
Annual Deductibles
Individual $50 $50
Family (2 members of family must each satisfy individual deductible) $100 $100
Annual Benefit Maximum $2,000 $2,000
Orthodontics Lifetime Maximum $2,000 $2,000
Office Visit Copay $0 $0
PREVENTIVE SERVICES and DIAGNOSTIC SERVICES
Dental cleaning Topical Application of Fluoride, Sealants and Space Maintainers 100% Covered
frequency may apply to these services
100% Covered
frequency may apply to these services
MINOR RESTORATIVE SERVICES
Fillings, Endodontics, Periodontics, Oral Surgery Covered up to 80%; after deductible Covered up to 80%; after deductible; Subject to reasonable and customary limits
MAJOR RESTORATIVE AND PROSTHODONTICS
Initial placement of Dentures or Bridges to one or more natural teeth which are lost while covered by the Plan. Inlays and Crowns (Porcelain or Stainless Steel) Covered up to 50%; after deductible; frequency may apply to these services Covered up to 50% after deductible; Subject to reasonable and customary limits; frequency may apply to these services
ORTHODONTICS
Exams, X-Rays, Models, Appliances (Adult and Child) Covered up to 50%; after deductible; frequency may apply to these services Covered up to 50% after deductible; Subject to reasonable and customary limits; frequency may apply to these services

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