Archive: Dental 2020

 
 
 
 
 

Need help? Use the HealthJoy app to find a provider.

  • $1500 or $2000 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

Be a Good Consumer

  • Two preventative cleanings each year for no cost.
  • Always use an in-network provider.
Dental Information
Dental Plans
Platinum Network
Dental (1500)
Summary Plan Description
2019 amendment
Dental Plus (2000)
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
Children under 19
Waiting Period
Annual Maximum
Lifetime Maximum
All Members
20% Discount
No Waiting Period

No Maximum
20% Discount
No Benefit 50%
No Waiting Period
$1000
$2000
20% Discount
50%
No Waiting Period
$1000
$2000
Adults
Waiting Period
Annual Maximum
Lifetime Maximum
All Members
20% Discount
No Waiting Period

No Maximum
20% Discount
No Benefit 50%
No Waiting Period
$1000
$2000
20% Discount
50%
No Waiting Period
$1000
$2000
Maximum Benefit (Applies to Basic and Major Services Per Benefit Period)
Benefit Period is Per Calendar Year $1,500 $2,000
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

2021

Full Time

Part Time

  Monthly Pay Period Monthly Pay Period

Dental (1500)

Single $6 $3 $12 $6
Two party $17 $8.50 $27 $13.50
Family $23 $11.50 $36 $18

Dental Plus (2000)

Single $23 $11.50 $33 $16.50
Two party $54 $27 $86 $43
Family $74 $37 $109 $54.50
COBRA Rates

2021

COBRA

Dental 1500 (Cost per month)

Employee $31.62
Employee + 1 Child $72.42
Employee + Spouse $72.42
Employee + Children $97.92
Employee + Family $97.92

Dental Plus 2000 (Cost per month)

Employee $43.86
Employee + 1 Child $98.94
Employee + Spouse $98.94
Employee + Children $132.60
Employee + Family $132.60
Resources