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 | |
| Member + 1 | $50 | $100 | |
| Family | $75 | $100 | |
| Is the deductible waived for preventitive services? | Yes | Yes | |
| Maximum Annual Benefit Per Person (Excluding Preventitive Services) | $1,500 | $800 | |
| 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 | Dependents (No age limit) | 50% | No Orthodontia Coverage |
| Lifetime orthodontia plan maximum (per individual) | $1,500 | No Orthrodontia 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 | Standard Plan | Vision Buy Up Plan |
|---|---|---|
| Member Only | $4.14 | $6.09 |
| Member +1 | $6.00 | $8.85 |
| Family | $10.76 | $15.86 |
| Benefit | Plan Level | Standard Plan | Vision Buy Up Plan |
|---|---|---|---|
| In-Network | In-Network | ||
| Exam (once every calendar year) | WellVision Exam | $20 copay | $20 copay |
| Frames (once every calendar year) | Featured Frames | $225 Allowance | $224 Allowance |
| Retail Frames | $175 allowance, 20% off amount over allowance | $175 allowance, 20% off amount over allowance | |
| 2nd pair benefit | N/A | Coverage amount matches your primary benefit election | |
| Standard lenses (once every calendar year) | Single vision, bifocal, and trifocal lenses | $20 copay | $20 copay |
| Contacts in lieu of glasses (every calendar year) | Medically necessary | Covered in full | Covered in full |
| Elective | $120 allowance | $120 allowance | |
| Diabetic Eyecare Plus Program | Services related to diabetic eye disease, glaucoma, and age-related macular degeneration (AMD) | $20 copay | $20 copay |
| Retinal screening for eligible members with diabetes (as needed) | $20 copay | $20 copay |