Chat with Client Services
Site Search
Medical
Dental
Pharmacy
Vision
FSA
Need help? Use the HealthJoy app to find a provider.
- $2,000 or $2,500 benefit coverage
- Two preventive basic cleanings each year at no cost
- Basic and major dental services coverage
- Providers nationwide
- Orthodontia benefits on the Dental Plus plan
Dental Plans
|
Platinum Network
|
Dental (2000) Summary Plan Description 2019 amendment |
Dental Plus (2500) Summary Plan Description 2019 amendment |
||
|---|---|---|---|---|
| Contracted Dentist | Non-Contracted Dentist | Contracted Dentist | Non-Contracted Dentist | |
| Preventive | ||||
| Routine exams, cleanings (2 per year), topical fluoride, x-rays, space maintainers, sealants | 100% | 100% of R&C | 100% | 100% of R&C |
| Basic | ||||
| Composite fillings, extractions, oral surgery, endodontics, periodontics (No Waiting Period) |
80% | 80% of R&C | 80% | 80% of R&C |
| Major | ||||
| Crowns, bridges, dentures, surgical implants (No Waiting Period) |
50% | 50% of R&C | 50% | 50% of R&C |
| Orthodontics | ||||
| Lifetime Maximum All Members |
No Benefit 20% Discount |
No Benefit | $2000 20% Discount |
$2000 |
| Maximum Benefit (Applies to Basic and Major Services Per Benefit Period) | ||||
| Benefit Period is Per Calendar Year | $2,000 | $2,500 | ||
| Deductible (Per Benefit Period) | ||||
| Per Person: Family Maximum: |
$50.00 $150.00 |
$50.00 $150.00 |
$50.00 $150.00 |
$50.00 $150.00 |
| Specialists | Contracted Specialist payment: | Non-contracted Specialist payment: | Contracted Specialist payment: | Non-contracted Specialist payment: |
| Endodontists, Oral Surgeons, Pediatric, Periodontists, Prosthodontists | 1) You receive a 20% discount off the Specialist fee 2) Plan pays according to the Reasonable and Customary fees 3) Member pays the difference between plan payment and discounted Specialist fee |
Paid the same as non-contracted dentists | 1) You receive a 20% discount off the Specialist fee 2) Plan pays according to the Reasonable and Customary fees 3) Member pays the difference between plan payment and discounted Specialist fee |
Paid the same as non-contracted dentists |
Dental Rates
2023 |
Full Time |
Part Time |
|---|---|---|
| Monthly | Monthly | |
Dental (2000) |
||
| Single | $7 | $14 |
| Two party | $18 | $29 |
| Family | $24 | $38 |
Dental Plus (2500) |
||
| Single | $24 | $34 |
| Two party | $57 | $91 |
| Family | $78 | $115 |
COBRA Rates
2023 |
COBRA |
|
|---|---|---|
Dental 2000 (Cost per month) |
||
| Employee | $34 | |
| Employee + 1 Child | $77 | |
| Employee + Spouse | $77 | |
| Employee + Children | $102 | |
| Employee + Family | $102 | |
Dental Plus 2500 (Cost per month) |
||
| Employee | $46 | |
| Employee + 1 Child | $104 | |
| Employee + Spouse | $104 | |
| Employee + Children | $140 | |
| Employee + Family | $140 | |
Resources
