Dental Plan
MetLife Dental Insurance
Dental ID Card: Dental cards will be available for you to download at metlife.com/mybenefits. Dental cards will not be mailed to your home. You do not need to present an ID card to confirm your eligibility. Simply, tell your provider that your dental coverage is through MetLife, and they can pull your information up in their system.
Access to CSU Dental Plan Information: The website customized for CSU’s plan will be available for those enrolled in the dental plan. This will allow you to access your plan of benefits, copayments, coinsurance and claims information. Visit metlife.com/mybenefits, or contact customer service at 800.942.0854.
Mobile App: The app is available on the Apple® App Store and Google Play.
Employee Monthly Dental Pre-Tax Premium
| Full-Time Faculty and Staff | Part-Time Admin Faculty and Staff (30–39 Hours) | |
|---|---|---|
| Employee Only | $3.06 | $7.64 |
| Employee + 1 | $5.96 | $14.90 |
| Family | $10.32 | $25.80 |
Dental Plan Schedule of Coverage
| In-Network Provider1 % of Negotiated Fee2 | Non-Network Provider1 % of R&C Fee3 | |
|---|---|---|
| Coverage Type | ||
Type A: Preventive6 (exams, cleanings, topical fluoride applications, x-rays, space maintainers, sealants) | 100% | 100% |
Type B: Basic Restorative6 (fillings, simple extractions, crown, denture, and bridge repair, endodontics, oral surgery, periodontics) | 80% | 80% |
Type C: Major Restorative6 (crown, denture, and bridge recementations, implants, bridges, dentures, crowns/inlays/ onlays, general anesthesia, TMJ) | 60% | 60% |
Type D: Orthodontia | 60% | 60% |
| Deductible5 | ||
| Individual | $50 | $50 |
| Family | $150 | $150 |
| Annual Maximum Benefit4 | ||
| Per Person | $1,500 | $1,200 |
| Orthodontia Lifetime Maximum | ||
| Per Person | $1,200 | $1,200 |
1 “In-Network Benefits” refers to benefits provided under this plan for covered dental services that are provided by a participating dentist. “Out-of-Network Benefits” refers to benefits provided under this plan for covered dental services that are not provided by a participating dentist.
2 Negotiated fees refer to the fees that participating dentists have agreed to accept as payment in full for covered services, subject to any copayments, deductibles, cost sharing and benefits maximums. Negotiated fees are subject to change.
3 R&C fee refers to the Reasonable and Customary charge, which is based on the lowest of (1) the dentist’s actual charge, (2) the dentist’s usual charge for the same or similar services, or (3) the charge of most dentists in the same geographic area for the same or similar services as determined by MetLife.
4 We will never pay more than the greater of the In-Network Maximum Benefit Amount or the Out-of-Network Maximum Benefit Amount. For example, if a Covered Service is received Out-of- Network and We pay $300 in benefits for such service, $300 will be applied toward both the In-Network and the Out-of-Network Maximum Benefit Amounts applicable to such service.
5 Applies only to Type B, C, & TMJ Services. Deductible will only need to be satisfied one time for in and out of network.
6 Services listed are examples. Please see Certificate of Coverage for a list of all the covered services.
Take Action:
- Download your ID card at metlife.com/mybenefits.
- Notify your dentist that Metlife is your insurance company.
- Smartphone users can manage their dental plan through the Metlife mobile app.