Preventative. Cleanings two (2) times in a calendar year; Fluoride - twice in a calendar year (age limit 19) Space Maintainers. Coverage II - Restorative, after deductible, 80% paid by insurance, 20% paid by patient. Amalgam, Silicate and Acrylic restorations; Oral Surgery - Extractions; Endodontics - Pupal therapy; root canal therapy; Periodontics - Treatment of gum disease, includes periodontal cleanings; Denture Repair - Repair of removable denture to its original condition; Emergency Treatment - Palliative. Coverage III - After deductible, 50% paid by insurance, 50% by patient. Crowns and buildups for crowns; First placement of inlays and bridges; First placement of partial or full dentures. Coverage IV - Orthodontia, 50% paid by insurance, 50% paid by patient. The maximum amount which the plan will pay is -$1,250, per person per Calendar Year. Orthodontia lifetime maximum is $1,000 per person. Employees shall pay 10% of the total cost for medical and dental insurance coverage. Such premiums shall be subject to the following weekly dollar caps: Single $5.17 $5.94 $6.83 $7.86 $9.04 $10.39 Two Person $10.22 $11.76 $13.52 $15.55 $17.88 $20.56 Family $15.41 $17.72 $20.38 $23.44 $26.95 $30.99 Employees will have the option of contributing premiums on a pre-tax basis under the terms of the Unitil Corporation Pre-Tax Premium Plan. Employees will also have the option of dropping medical insurance coverage and receiving two months of company contributions towards the premium, rounded to the nearest $10. If an employee dies, medical and dental insurance coverage will be continued for the employee's spouse and dependent children for up to six months under the terms of the Medical and Dental Insurance Extension Policy HR 1.26, effective June 1, 2000.
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Preventative. Cleanings two (2) times in a calendar year; Fluoride - twice once in a calendar year (age limit 19) ); Space Maintainers. Coverage II - Restorative, after deductible, 80% paid by insurance, 20% paid by patient. Amalgam, Silicate and Acrylic restorations; Oral Surgery - Extractions; Endodontics - Pupal therapy; root canal therapy; Periodontics - Treatment of gum disease, includes periodontal cleanings; Denture Repair - Repair of removable denture to its original condition; Emergency Treatment - Palliative. Coverage III - After deductible, 50% paid by insurance, 50% by patient. Crowns and buildups build-ups for crowns; First placement of inlays and bridges; First placement of partial or full dentures. Coverage IV - Orthodontia, 50% paid by insurance, 50% paid by patient. Maximum Contract Year Benefit - The maximum amount which the plan will pay is -$1,250, $1,250 per person per Calendar Year. Orthodontia lifetime maximum is $1,000 per person. Employees shall pay 10% of the total cost for medical and dental insurance coverage. Such premiums shall be subject to the following weekly dollar caps: Single $$ 5.17 $$ 5.94 $$ 6.83 $$ 7.86 $$ 9.04 $10.39 Two Person $10.22 $11.76 $13.52 $15.55 $17.88 $20.56 Family $15.41 $17.72 $20.38 $23.44 $26.95 $30.99 Employees will have the option of contributing premiums on a pre-tax basis under the terms of the Unitil Corporation Pre-Tax Premium Plan. Employees will also have the option of dropping medical insurance coverage and receiving two months of company contributions towards the premium, rounded to the nearest $10. If an employee dies, medical and dental insurance coverage will be continued for the employee's spouse and dependent children for up to six months under the terms of the Medical and Dental Insurance Extension Policy HR 1.26, effective June 1, 2000.. Employees will have the option of purchasing supplemental group term life insurance equal to 1x, 2x or 3x their base pay (hourly wage times 2080), and pay the premiums through payroll deduction. The first $100,000 coverage will be issued without any evidence of insurability if the employee signs up for coverage when initially eligible. Evidence of insurability may be required by the insurance company:
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