dental benefits
summary plan descriptions
dental PPO plan
The summary plan descriptions (SPD) provides specific details about your benefits, such as eligibility, covered services and participation rules. If there recent updates to the SPD since the last publication date, look for the summary of material modification (SMM) included in the very front of the book.
The documents listed below are called a summary of material modification (SMM). An SMM explains recent updates to your plan that are not yet captured or updated in your summary plan description (SPD) since the last publication date. Be sure to review the SMM for an understanding of important plan updates.
- Increase to orthodontic care lifetime maximum (January 1, 2022)
- Increase to cost share for major dental care services (January 1, 2022)
- 2D Oral/facial photographic images (January 1, 2020)
- When there is no network provider near you (January 1, 2019)
- X-Ray limitation updates (January 1, 2018)
Other General Plan Changes
- "Other dependent" legal guardian administrative clarification (January 1, 2021)
- New address for benefits correspondence (June 1, 2020)
- New dependent verification requirement (January 1, 2019) | Learn more
- New qualifying life event (January 1, 2019)
- Employee after-tax contributions eliminated (January 1, 2019)
- New fee for insufficient funds (January 1, 2019)
Review the schedule of benefits to understand basic information about your dental plan, such as benefits, copayments, deductibles, coinsurance and plan contact information.
- Dental PPO Benefit Summary and Highlights (U.S.-payroll)
dental HMO plan
The summary plan descriptions (SPD) provides specific details about your benefits, such as eligibility, covered services and participation rules. If there recent updates to the SPD since the last publication date, look for the summary of material modification (SMM) included in the very front of the book.
The documents listed below are called a summary of material modification (SMM). An SMM explains recent updates to your plan that are not yet captured or updated in your summary plan description (SPD) since the last publication date. Be sure to review the SMM for an understanding of important plan updates.
- New address for benefits correspondence (June 1, 2020)
Review the schedule of benefits to understand basic information about your dental plan, such as benefits, copayments, deductibles, coinsurance and plan contact information.
- 2022 Dental HMO Schedule of Benefits
dental PPO plan (expatriates in U.S.)
The summary plan descriptions (SPD) provides specific details about your benefits, such as eligibility, covered services and participation rules. If there recent updates to the SPD since the last publication date, look for the summary of material modification (SMM) included in the very front of the book.
The documents listed below are called a summary of material modification (SMM). An SMM explains recent updates to your plan that are not yet captured or updated in your summary plan description (SPD) since the last publication date. Be sure to review the SMM for an understanding of important plan updates.
- New address for benefits correspondence (June 1, 2020)
Review the schedule of benefits to understand basic information about your dental plan, such as benefits, copayments, deductibles, coinsurance and plan contact information.
- 2022 Dental PPO Benefit Summary and Highlights (Expatriates in the U.S.)
This communication provides only certain highlights about benefit provisions. It is not intended to be a complete explanation. If there are any discrepancies between this communication and the legal plan documents, the legal plan documents will prevail to the extent permitted by law. Oral statements about plan benefits are not binding on Chevron or the applicable plan. Chevron Corporation reserves all rights, for any reason and at any time, to amend, change or terminate these plans or to change or eliminate the company contribution toward the cost of such plans. Such amendments, changes, terminations or eliminations may be applicable without regard to whether someone previously terminated employment with Chevron or previously was subject to a grandfathering provision. Unless required by applicable law, there are no vested rights with respect to any Chevron health and welfare plan benefit or to any company contributions towards the cost of such health and welfare plan benefits. Some benefit plans and policies described in this document may be subject to collective bargaining and, therefore, may not apply to union-represented employees.
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