Examples – MetLife, Chevron and AARP Dental Plans – Retiree’s In-Network Costs
| MetLife Plans | Chevron | AARP | |||
| Low Plan | High Plan | Plan A | Plan B | ||
| Annual Cost (Excl Co-Pay) – Single Individual |
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| Premium | $252.00 | $516.00 | $416.64 | $575.16 | $432.84 |
| Deductible | $75.00 | $75.00 | — | $50.00 | $100.00 |
| Total | $327.99 | $591.00 | $416.64 | $625.16 | $532.84 |
| Examples: Retiree’s Annual Cost | |||||
| Number 1: $300 | $252.00 | $516.00 | $416.64 | $575.16 | $572.84 |
| Preventative Only (Cleanings, Etc.) | |||||
| Number 2: $700 | $424.50 | $688.50 | $456.64 | $695.16 | $823.84 |
| Preventative (Cleanings, Etc.) Basic Restorative (Fillings, Etc.) |
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| Number 3: $1,800 | $1,752.00 | $1,303.50 | $1,166.64 | $1,350.16 | $1,322.84 |
| Preventative (Cleanings, Etc.) Major Restorative (Crown, Etc.) |
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| Number 4: $2,200 | $1,924.50 | $1,438.50 | $1,206.64 | $1,575.16 | $1,733.84 |
| Preventative (Cleanings, Etc.) Basic Restorative (Fillings, Etc.) Major Restorative (Crown, Etc.) |
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