2022 Employee Benefit Guide This booklet provides only a summary of your benefits. All services described within are subject to the definitions, limitations, and exclusions set forth in each insurance carrier or provider’s contract. Plan Features IN NETWORK Annual Deductible (Individual / Family) Preventive Care Basic Procedures (Extractions, fillings, etc.) Major Procedures (Crowns, dentures, etc.) Child Orthodontia Calendar Year Maximum Benefit OUT OF NETWORK Annual Deductible (Individual / Family) Preventive Care Basic Procedures (Extractions, fillings, etc.) Major Procedures (Crowns, dentures, etc.) Child Orthodontia Calendar Year Maximum Benefit SUMMARY OF COVERAGE Benefits f or 2022 Dental Coverage 9