Dental Plans
You have access to dental coverage through Delta Dental. You can enroll in dental coverage for yourself and your eligible dependents, even if you are not enrolled in medical coverage through Haworth. The Delta Dental Plan provides you with a range of covered services, and preventive care is covered by your insurance at 100%. This dental summary is intended to provide you with a quick overview of the Haworth dental plan offerings.
For more information, please go to Hometown > HRHelp and search for "Delta".
| Dental Plan Details | Plan Level | Premium | Basic |
|---|---|---|---|
| Deductibles | |||
| Individual | $25 | $50 | |
| Family | $75 | $100 | |
| Maximum Annual Benefit Per Person (Excluding Preventitive Services) | $1,500 | $800 | |
| $1,500 | No Othrodontia Coverage | ||
| Class 1 Services (This class includes: Diagnostic & Preventive Treatment, X-rays, Sealants, Emergency Palliative Treatment) | 100% | 100% | |
| Class 2 Services (This class includes: Endodontic & Periodontic Services, Extractions, Minor Restorative Services) | 80% | 50% | |
| Class 3 Services (This class includes: Prosthodontic Services; Major Restorative Services; all Other Surgery) | 60% | 50% | |
| Class 4 Orthodontia (up to age 19) | 50% | No Orthodontia Coverage |
| Dental Premium (Bi-weekly) | Premium | Basic |
|---|---|---|
| Member Only | $5.78 | $1.90 |
| Member +1 | $10.70 | $3.00 |
| Family | $22.72 | $4.15 |
Vision
The Haworth vision plan helps you pay for routine eye exams, eyeglasses, contact lenses, and related supplies. Our plan is offered by VSP, a nationwide network that provides a convenient and easy-to-use benefit. When you visit a VSP provider, you receive discounted services, and the plan pays a percentage of the costs. You can enroll for vision coverage without participating in medical coverage through Haworth. This summary provides a quick overview of Haworth’s vision plan.
For more information, please go to Hometown > HRHelp and search for "VSP".
| Bi-Weekly Per-Pay-Period Vision Premium | |
|---|---|
| Member Only | $4.14 |
| Member +1 | $6.00 |
| Family | $10.76 |
| Benefit | Plan Features | Copay | Frequency |
|---|---|---|---|
| WellVision Exam | Focuses on your eyes and overall vision wellness | $20 | Every calendar year |
| Prescription Glasses | $20 | See Frames and Lenses | |
| Frames | $255 allowance for preferred frames | Included in prescription glasses | Every calendar year |
| $175 allowance for retail frames | Included in prescription glasses | Every calendar year | |
| 20% off amount over allowance | Included in prescription glasses | Every calendar year | |
| Lenses | Single vision, lined bifocal, and lined trifocal lenses | Included in prescription glasses | Every calendar year |
| Polycarbonate lenses for dependent children | Included in prescription glasses | Every calendar year | |
| Contacts (instead of glasses) | $120 allowance for contacts | Up to $60 | Every calendar year |
| Contact lens exam (fitting & evaluation) | Up to $60 | Every calendar year | |
| Diabetic Eyecare Plus Program | Services related to diabetic eye disease, glaucoma, and age-related macular degeneration (AMD) | $20 | As needed |
| Retinal screening for eligible members with diabetes | $20 | As needed | |
| Limitation and coordination with medical coverage may apply | $20 | As needed |