Dental

My Health

Dental

• Full-time Associates

  Ulta Beauty's dental plan is separate from our medical plan, so you can choose to enroll even if you decide not to participate in a medical plan.

  Once you've enrolled in dental coverage through BCBSIL, register for Blue Access for Members to review your claims and get additional copies of your ID card at any time. Once registered, there are additional programs and resources offered to members. To confirm or find a provider in the network, use the BCBS Physician Finder.

  Eligibility: Full-time associates

  Provider: BCBSIL

  Enroll: https://ultabenefits.bswift.com/

  	In Network	Out of Network
  Maximum Benefit Per Calendar Year Per Person	$2,000	$1,000
  Deductible (annual) (Per Person/Per Family)	$50/$150	$75/$225

  Percentage Payable by the Plan

  Preventive and diagnostic (cleanings, exams, X-rays)	100% (no deductible)	90% (no deductible)
  Basic services (fillings, repairs, periodontal)	80% after deductible	70% after deductible
  Major services (crowns, dentures, bridges, implants)	50% after deductible	40% after deductible
  Orthodontia for Adults and Dependent Children	50% after deductible, $1,500 lifetime max	50% after deductible, $1,500 lifetime max
  Virtual Urgent Dental Care	Virtual dental care costs mirror in-person costs above	Virtual dental care costs mirror in-person costs above

  Going to an in-network dentist provides you with more coverage, but you'll still have some benefits if you choose to go out-of-network.

  The BCBS Dental plan includes a convenient virtual care option through Teledentistry.com for dental emergencies that occur after hours or when you're unable to see your regular dentist. These visits are considered in-network and are covered at 100% when billed as a problem-focused exam.

  Additionally, members who are pregnant or have diabetes or heart disease may be eligible for an additional cleaning benefit, allowing up to three cleanings per year instead of the standard two.

  Rates and information can be found in the Benefits Guide or at ultabenefits.bswift.com.

• Part-time Associates

  Eligibility: Part-time associates

  Provider: MetLife

  Enroll: https://ultabenefits.bswift.com/

  MetLife does not issue ID Cards. Your dental provider will verify your coverage using your SSN.

  	In Network	Out of Network
  Annual Plan Maximum	$1,250	$1,250
  Annual Deductible Per Person	$50	$50

  Percentage Payable by the Plan

  Preventive and diagnostic (cleanings, exams, X-rays)	100% (no deductible)	100% (no deductible)
  Basic services (fillings, repairs, periodontal)	60% after deductible	60% after deductible
  Major services (crowns, dentures, bridges, implants)	50% after deductible	50% after deductible
  Orthodontia for Adults and Dependent Children	No coverage	No coverage

  Rates and information can be found in the Benefits Guide or at ultabenefits.bswift.com.

  Visit MetLife’s website for additional detailed plan information - MetLife Dental Plan.