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University of Missouri
Benefits and Networks

Reimbursement Level
Network Fee ScheduleMaximum Plan Allowance90th Percentile of the Reasonable and Customary Prevailing Fee

PPO Network Premier Network Out-of-Network1
Preventive Services
(No deductible)

Basic Services
(After annual deductible)
Major Services
(After annual deductible)
Ortho Services Not covered
Maximum Annual Benefit $1,500 for each enrolled individual
Annual Deductible $100 per individual / $300 per family

(1) Out-of-network dentists may bill you for the difference between the covered dental expense determined by Delta Dental as the Reasonable & Customary (R&C) and the dentist's usual fee.

This overview highlights certain features of University of Missouri dental benefits. For full details, please refer to your Summary Plan Description (SPD). If there is a discrepancy between the wording here and the SPD, the document language will govern. University of Missouri reserves the right to amend, modify or terminate the dental plan at any time.