ATK Dental Plans at a Glance Everyone deserves a healthy smile. Here’s an at-a-glance guide to the two dental plan options available to Orbital ATK employees. Plan Highlights Basic Plan Basic Plus Plan $50 per person $25 per person $150 per family $75 per family $1,000 $1,500 Orthodontia services No coverage 50% Orthodontia lifetime maximum $0 $2,000 100%, no deductible 100%, no deductible 50% after deductible 80% after deductible 50% after deductible 80% after deductible 50% after deductible 50% after deductible Annual deductible Annual maximum benefit (per person per year) Diagnostic and preventive services (oral exams, cleanings, X-rays, sealants, fluoride treatments received from in-network providers) Basic services (restorations, periodontiocs, oral surgery, endodontics) Major restorative services (crowns) Prosthetic services (dentures, bridges, implants) You can go to any dentist you wish for treatment but the plan will pay more for covered expenses if you go to an in-network provider. There are two levels of network dentists for both plan options: Delta Dental PPO (gives you the deepest network discounts available) and the Delta Dental Premier. Eligible services are paid at the Delta Dental allowable amount if your dentist belongs to either network. Plus, network providers file the claims for you. This is only a summary. Benefit and coverage details are found in Summary Plan Descriptions. S1804H, Copyright © 2015 1
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