Health Care

Dental

Plan at a Glance

Feature	Dental Plan $50 Deductible	Dental Plan No Deductible
Annual Deductible	$50 individual $150 family	None
Preventive and Diagnostic Services Exams, cleanings, x-rays	100%, deductible waived	100%
Basic Services Fillings, simple extractions, anesthesia	80%	100%
Major Services Crowns, bridges, dentures, endodontic, periodontic, oral surgery	50%	60%
Orthodontia	Not covered	80% up to $2,000 lifetime¹
Temporomandibular Joint (TMJ) Syndrome	Not covered	60% up to $1,200 lifetime²
Annual Maximum Benefit (per covered person)	$1,000	$3,000
1. Orthodontia: Past benefits from any plan sponsored by Kraft Foods count toward lifetime limit and are separate from the annual maximum benefit. You must continue to be enrolled in the No Deductible Plan while receiving orthodontia services and payments. 2. Lifetime maximum is separate from the annual maximum benefit.

For more information, see MyBenefits Online.