Unlimited Unlimited. Lifetime Maximum Unlimited, except for fertility services Unlimited, except for fertility services AACPS • Division of Human Resources • HR/Benefits • DPS/JH 2095/2a (Rev. 10/17) Appendix C Dental and Vision Options XXXX ARUNDEL COUNTY PUBLIC SCHOOLS Active Employees and Retirees Benefits as of January 2017 Dental and Vision Options Active Employees and Retirees Dental Options CareFirst Traditional CareFirst PPO Concordia Plus DHMO MD1560* Benefits In-Network Out-of-Network In-Network Oral Examination 100% of AB 100% of AB 80% of AB $5 copay Routine Cleaning 100% of AB 100% of AB 80% of AB 100% Sealants (limited to permanent molars – until end of year in which a member turns 19) 100% of AB 100% of AB 80% of AB 100% Bitewing X-ray 100% of AB 100% of AB 80% of AB 100% Palliative Treatment 100% of AB 100% of AB 80% of AB 95% Other X-rays as required 100% of AB 100% of AB 80% of AB 100% Space Maintainers 100% of AB 100% of AB 80% of AB 95% Fillings 100% of AB 80% of AB 60% of AB** 100% Simple Extractions 100% of AB 80% of AB 60% of AB** 75%-85% Pulpotomy 100% of AB 80% of AB 60% of AB** 75%-80% Direct Pulp Caps 100% of AB 80% of AB 60% of AB** 75%-80% Root Canals 100% of AB 80% of AB 60% of AB** 75%-80% Apicoectomy 80% of AB** 80% of AB 60% of AB** 75%-80% Oral Surgical Services 80% of AB** 80% of AB 60% of AB** 75%-85% Surgical Extractions 80% of AB** 80% of AB 60% of AB** 75%-85% Oral Surgery 80% of AB** 80% of AB 60% of AB** 75%-85% General Anesthesia 80% of AB** 80% of AB 60% of AB** See note 1 Periodontics 50% of AB** 80% of AB 60% of AB** 50%-65% Crown 80% of AB** 80% of AB 60% of AB** 60%-80% Prosthetic Appliances (including implants) 50% of AB 80% of AB 60% of AB** 60%-80% Implants not covered Orthodontics Children and Adults 50% of AB 50% of AB 35% of AB See note 3 Annual Deductible $25 Ind./$50 Family None $50 Ind./$150 Family None Annual Benefit Maximum $1,500 $1,500 None/See note 2 Ortho Lifetime Maximum $1,500 $1,500 See note 3 (AB Allowed Benefit) Under the Concordia Plus DHMO (MD1560*) Plan, out-of-network services are reimbursed up to a maximum amount, based on the fee schedule provided by United Concordia. *The above DHMO Plan percentages are approximate and used for comparison purposes only. Please refer to the United Concordia (XXXX) Schedule of Benefits for actual copayment amounts. All coverage is subject to the Plan’s exclusions and limitations. **After Deductible Note 1—General Anesthesia is considered integral to other procedures under ...
Unlimited Unlimited. Lifetime Maximum Unlimited, except for fertility services Unlimited, except for fertility services AACPS • Division of Human Resources • HR/Benefits • DPS/JH 2095/2a (Rev. 9/16) Appendix B Xxxx Arundel County Public Schools Division of Human Resources • Office of Benefits 2018 Medical Plans Comparison Chart
Unlimited Unlimited. Number of available UNIs 4 standard 4 standard 4 standard 1 with a second UNI available on request 2 1000/100 Base-T + 2 SFP Sockets standard L2CP support No No No Limited Limited Diversity On request with limited availability On request with limited availability On request with limited availability Available to Priority Users in selected areas Available to Priority Users in selected areas * Bandwidth options for each Bitstream Service are detailed in each Bitstream Service Description and further options can be developed using the Product Development Process. ** A 10G version is expected to be introduced in a future iteration of this product, but is not part of the initial offering. NID characteristics
Unlimited Unlimited. Annual Deductible Individual Family None None None None Reimbursement Levels Based on contracted amount Based on Reasonable & Customary Allowances
Unlimited Unlimited. Number of available UNIs 4 standard 4 standard 4 standard 2 1000/100 Base-T + 2 SFP Sockets standard 1 LC/A L2CP support No No No Limited Limited Diversity On request with limited availability On request with limited availability On request with limited availability Available to Priority Users in selected areas No * Bandwidth options for each Bitstream Service are detailed in each Bitstream Service Description and further options can be developed using the Product Development Process. ** layer 1 optical test of the fibre between a site and the LFC access node. UNI – E-NNI characteristics
Unlimited Unlimited. Notes: The family deductible and family out-of-pocket maximum for the plan shall be embedded. ● Deductible(s) apply only to covered medical services listed with a percentage (%) coinsurance. However, the deductible does not apply to Emergency Room Services @ Hospital where a percentage (%) coinsurance applies to other covered services. ● Network and Non-network deductibles, copayments, coinsurance and out-of-pocket maximums are separate and do not accumulate toward each other. ● Physicians Home and office visit copayment also applies if the office visit is billed with allergy injections. ● PCP is a Network Provider who is a practitioner that specializes in family practice, general practice, internal medicine, pediatrics, obstetrics/gynecology, geriatrics or any other Network provider as allowed by the plan. ● SCP is a Network Provider, other than a Primary Care Physician, who provides services within a designated specialty area of practice. ● Certain diabetic and asthmatic supplies have no deductible/copayment/coinsurance up to the maximum allowable amount at network pharmacies except diabetic test strips. ● Benefit period = calendar year.
Unlimited Unlimited. 0704 90 10 White cabbages and red cabbages 6 Unlimited Unlimited
Unlimited Unlimited ex 0705 11 00 Cabbage lettuce (from 1 April to 30 November) 5,9 Unlimited Unlimited 0708 10 90 Fresh or chilled peas (from 1 June to 31 August) free 130 145 15 c 0708 90 00 Leguminous vegetables 5,9 Unlimited Unlimited 0709 60 10 Sweet peppers 4,3 Unlimited Unlimited 0709 60 99 Other 4,3 Unlimited Unlimited 0807 11 00 Water melons 4 Unlimited Unlimited
Unlimited Unlimited a The wording of the description of the products is to be considered as having no more than indicative value, the preferential scheme being determined, within the context of this Annex, by the coverage of the code. Where ex codes are indicated, the preferential scheme is to be determined by application to the code and corresponding description taken together. b This concession is only applicable to products non-benefiting from any kind of export subsidies and accompanied by a certificate (see Annex) indicating that no export refunds have been paid. c Quantities of goods subject to this existing tariff quota and released for free circulation as from 1 July 2002 before the entry into force of this Protocol shall be fully counted against the quantity provided for in the fourth column and should be submitted to the duty applicable at the moment of import. d Excluding tenderloin presented alone. e Excluding 1516 20 95, 1516 20 96 and 1516 20 98. 0809 30 10 Nectarines 4 Unlimited Unlimited 0808 10 Apples, fresh free 7 500 15 000 0 bc 1001 Wheat and meslin free 15 000 30 000 0 b 1002 Rye free 1 000 2 000 0 b 1003 Barley free 15 000 30 000 0 b 1004 Oats free 500 1 000 0 b 1005 10 90 1005 90 00 Maize free 5 350 10 000 0 b 1006 Rice free Unlimited Unlimited 1008 Buckwheat, millet and canary seed, other cereals free 500 1 000 0 b 1107 10 99 Malt free 1 500 3 000 0 b 1516 10 Animal fats and oils 10 1 000 1 000 0 c 1516 20 Vegetable fats and oils 9 1 000 1 000 0 ce 1517 10 90 Margarine 10 270 270 0 c 1601 00 Sausages and similar products free 300 350 50 bc 1602 41 to 1602 49 Prepared or preserved meat of swine ex 1602 20 90 Pâtés, different sizes 9 265 265 0 c a The wording of the description of the products is to be considered as having no more than indicative value, the preferential scheme being determined, within the context of this Annex, by the coverage of the code. Where ex codes are indicated, the preferential scheme is to be determined by application to the code and corresponding description taken together. b This concession is only applicable to products non-benefiting from any kind of export subsidies and accompanied by a certificate (see Annex) indicating that no export refunds have been paid. c Quantities of goods subject to this existing tariff quota and released for free circulation as from 1 July 2002 before the entry into force of this Protocol shall be fully counted against the quantity provided for in the fourth column and should be submitted to the d...
Unlimited Unlimited. Number of available UNIs 4 standard 4 standard 4 standard 4 standard 1 with a second UNI available on request NID: 2 1000/100 Base-T + 2 SFP Sockets standard Glass: 1 with a second UNI available on request L2CP support No No No No Limited Limited Diversity Lead-in diversity only available on request with limited availability Lead-in diversity only available on request with limited availability Lead-in diversity only available on request with limited availability Lead-in diversity only available on request with limited availability Available to Priority Users in selected areas Available to Priority Users in selected areas The Bandwidth options for each Bitstream Service are detailed in appropriate Bitstream Service Description. Clause 3.7.8 above lists options for Small Business Fibre and further options can be developed using the Product Development Process.
