OBMSM Basic Specialty Option

With the OBM Basic Specialty Option, members receive insured preventive dental services, discounted vision services, and basic employee life. Please see below for a list of some of the benefits and services included.

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Dental OBM Basic Specialty Option Benefit Details
Dental

In-Network : National Options PPO 20

Out-of-Network (MAC)*

Preventive/Basic/Major Coinsurance
100%/0%/0% 100%/0%/0%
Annual Maximum $1000 $1000
Deductible (Single/Family) $0/$0 $0/$0
Preventive Care (teeth cleaning and x-rays) 100% 100%
Basic Care (filling, restorations, root canals, endodontics, periodontics, oral surgery) 0% 0%
Major Care (crowns, bridges and dentures) 0% 0%
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Vision OBM Basic Specialty Option Benefit Details
Vision

In-Network

Out-of-Network

Eye Exam $10 copayment; every 12 months Not available
Pediatric Eye Exam Members ages 0-12 years of age will get an additional eye exam benefit. $10 Copayment; every 12 months Not available
Frames 30% off retail frame price. 10% off at in-network Walmart locations Not available
Lenses $45/$65/$95 copayment Not available
Contacts 20% discount Not available
Materials Frequency Unlimited Not available

Benefits Include

  • $25,000 Employee Life Benefits

* Out-of-network benefits are paid based on UnitedHealthcare Dental's Maximum Allowable Charge (MAC) schedule.

Please note: This is a sample summary provided for informational purposes only. Coverage is subject to the terms and conditions of the Member Certificate or other applicable Member benefit information.