Dental

My Health

Dental

• Full-time Associates

  Eligibility: Full-time associates

  Provider: BCBSIL

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

  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.

  	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

  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. 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 option for dental emergencies after hours or when you can't get into your regular dentist. Also, members who are pregnant or have heart disease or diabetes can have three cleanings in one year (rather than the standard 2 cleanings).

  Rates and information can be found at ultabenefits.bswift.com.

• Part-time Associates

  Eligibility: Part-time associates

  Provider: MetLife

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

  	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 at ultabenefits.bswift.com.

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