2021 Part-Time Apple Dental Plan Overview

Carrier MetLife
Overview The summary below highlights some of the features of the Apple Part-Time Dental Plan. For
comprehensive details about the plan, see the Apple Benefits Book.

When you use a MetLife Preferred Dental Program Plus (PDP Plus) network dentist, the Apple
Dental Plan provides a higher level of coverage, which will save you and Apple money, since
payments are based on negotiated rates.
You may receive care from any provider; however, benefits from a non-PDP Plus provider are
only payable at the applicable percentages noted below of Eligible Expenses. Utilizing a
provider from the PDP Plus network will ensure a higher payment and will save you money.
All of the coverage percentages noted below are based on MetLife’s definition of Eligible
Expenses. Eligible Expenses for PDP Plus providers are based on negotiated rates, while non-
PDP Plus providers are based on various data resources.
How the Apple Part-Time Dental Plan Works
Network Type PDP Plus Dentist Non-PDP Plus Dentist
Dental Plan Year Deductible $50 per person, up to $150 maximum
Preventive Care 100% 90%
(not subject to a deductible or annual (not subject to a deductible or annual
maximum) maximum)
Basic Care 80% after deductible 70% after deductible
Major Care 50% after deductible 50% after deductible
Orthodontia 50% after deductible 50% after deductible
Annual maximum benefit for basic and major
$1,000 per person
services
Separate lifetime orthodontia benefit $1,000 per person
Before-Tax Cost
Employee Per Pay Period: $4.24
Per Month: $9.19
Per Year: $110.28
Employee + Spouse or Domestic Partner Per Pay Period: $19.69
Per Month: $42.66
Per Year: $511.92
Employee + Child(ren) Per Pay Period: $21.20
Per Month: $45.93
Per Year: $551.16
Employee + Family Per Pay Period: $37.49
Per Month: $81.23
Per Year: $974.76

The Apple Part-Time Dental Plan Chart highlights commonly used services and generally indicates how you and the dental plan will cover
dental expenses you and/or your enrolled dependents incur. Some services are subject to frequency and coverage limits. This chart does not
reflect all covered services, plan exclusions, limitations or restrictions. It is not a contract or guarantee of coverage. See the Apple Benefits
Book for more information.

October 2020 | 2021 Apple Part-Time Dental Plan Overview People Support - peoplesupport@apple.com