Quick facts
Calendar Year Deductible - Individual (In-Network)
$0
Out-of-network: $0
Annual Maximum Benefit
$1000
Preventive Care Coverage
100%
Orthodontia Coverage
Not Covered
Basic Care Coverage
80%
Dependent Age Limits (Non-Student/Student)
20/26
Family Deductible Limit
3 per family
Major Care Coverage
50%
More details (1)
Lifetime Orthodontia Maximum
Not Applicable
Amounts are in-network unless noted.
Carrier contact
(888) 600-1600 — member services
Group number: 00508233
Your member ID card: check the carrier website or app, or ask HR for a copy.
Plan documents
Confirm details with your carrier for current plan information.